Changes in medical problems and use of medical services following psychological intervention.

Abstract

Important life changes and significant psychological stress occur before, during, and after episodes of physical illness in the lives of many individuals. Significant life-adjustment or developmental difficulties have been shown to be associated with high use of medical services. This article calls attention to reduction in medical problems and use of medical facilities with referral for psychological services. On the assumption that psychologists can contribute significantly to reduction in patients' psychological stress levels and associated physical complaints, a new selfimage for many psychologists could be that of health care professional. Furthermore, this self-image and role could be implemented by having psychologists contribute to the treatment of patients in a continuous manner, starting with the initial patient visit to a health care facility.Medicine has recently shown great achievements in understanding mechanisms of disease, in developing new treatments, and in expanding technological capability. Yet the extent to which health care needs are being met continues to be questioned. Observers of the evolution of a biomedical model of disease are calling attention to the limits of explaining illness solely in terms of verifiable changes in biological function and structure (Engel, 1977;Leigh & Reiser, 1977;Lipowski, 1977;Weiner, 1977). According to Engel (1977) additional perspectives must be included in medicine for health care to have a sufficient impact on illness. Engel proposed a biopsychosocial model that takes into account the patient, the social context, and the health care system in which the patient has the opportunity to have his or her needs met. Weiner (1977) acknowledged that the mechanisms by which psychosocial stimuli are translated into v biological change remain unclear, yet he proposed an important role for psychological and social factors in the predisposition to, inception of, and maintenance of disease. Leigh and Reiser (1977) 420 • MAY 1979 • AMERICAN PSYCHOLOGIST

Behavioral medicine

“…costly medical services are often overutilized by patients experiencing psychologic distress or difficulties coping with medical conditions. 2 Recognition of link between behavior and disease-Life-style and chronic behavior patterns play an important role in determination of the onset and course of disease. Knowledge is accumulating that in addition to genetic factors, aging, and infectious disease processes.…”

Cost-Effectiveness of Providing Mental Health Services: The Offset Effect

“…Examples of this are to be found in the high incidence of psychotic reactions following open heart surgery reported by Kimball [2], the 30 percent incidence of secondary emotional problems among burn patients reported by Andreasen and Norris [3] , and the 5 percent suicide rate among chronic hemodialysis patients reported by Abram [4]. Further relevant research in this area of medical interrelationships involves the finding that the probability of multiple medical consultations and surgeries increases directly with the amount of emotional disturbance, while the adequacy of functional recovery is inversely related [5]. The work of Rahe [6] and Holmes, et al [7], demonstrating that the greater the number of social events that involve change in ongoing life adjustment, the greater the probability of subsequent major illness is also relevant, despite the fact that the cause and effect relationship is not entirely clear.…”

Behavioral Medicine: Symbiosis between Laboratory and Clinic

“…Perhaps this is one of the reasons why there is evidence that the availability of suitable brief psychotherapy in a clinic established to deal with physical disorders can reduce the total load of that clinic, including the time spent in psychotherapy (Rosen & Wiens 1979).…”