Psychological preparation for invasive medical and dental procedures has been based on the rationale that high levels of preprocedural fear are detrimental to patients' subsequent adaptation. After a brief survey of the theoretical and empirical evidence pertaining to this rationale, the major psychological approaches designed to alleviate preprocedural concern and enhance recovery are discussed. Outcome studies that have employed informative, psychotherapeutic, modeling, behavioral, cognitive-behavioral, and/or hypnotic techniques are summarized and evaluated. Although the research suggests that each of these approaches can be effective, such serious methodological problems as heterogeneity of sample characteristics, limited range of outcome measures, and lack of manipulation checks prevent definitive conclusions. Legal-ethical concerns and the issue of cost effectiveness are also considered. Suggestions are made for future research and theory development.
American Psychological Association-approved doctoral and internship programs in clinical and counseling psychology were surveyed regarding training opportunities in medical psychology. A total of 42 graduate and 65 internship programs responded. Survey resultsindicated that the majority ofboth types of programs offered didactic and experiential training, including diagnostic and therapeutic activities with a wide variety of medical/ surgical patients. There appears to be a sufficient number of faculty psychologists identified with special interest and/or expertise in this area, as well as sufficient interest among training directors and trainees, to adequately prepare new psychologists for employment in the expanding job market of medical centers and other types of medical settings.
Recent definitional developments have required a revaluation of the term medical psychology, especially as it relates to the newly emerging interdisciplinary field of "behavioral medicine." The author proposes that medical psychology should now most logically be considered as only one of many contributing specialties within the larger discipline of psychology that, along with other disciplines, converge to form the interdisciplinary thrust which is the hallmark of behavioral medicine, A schematic representation of these relationships is proposed with special emphasis placed upon the content areas (knowledge and techniques) through which the various disciplines interface. Recent organizational developments aimed at providing psychologists with more structured forums for political representation and idea sharing are also discussed.
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