Hospital practice: Psychology's call to action.

Abstract

The general public has recently made demands for continuity of care in psychological services from outpatient settings to inpatient facilities and back. These demands plus three economic and structural modifications within our nations' health-care arena, including the incursion of for-profit health-care corporations into the health delivery industry, the 1985 JCAH decision to include nonphysician providers on hospital medical staffs, and the 1990 California Supreme Court Decision (CAPP v. Rank) ensuring full medical staff participation by California psychologists, have opened the doors to the independent practice of psychology in hospitals, rehabilitation centers, nursing homes, and day treatment facilities. This article presents current professional realities for psychologists in hospitals and health-care settings and reviews the work of the American Psychological Association in support of hospital independent practice.Professional psychology is steadily being drawn into the maelstrom of the crisis in American health care. Today our nation spends more on health care than any other nation in the world, and we are the only industrialized nation, other than South Africa, to have not enacted a comprehensive national health-care program (Mitchell;. Recently, both the Bush Administration and the U.S. Congress have entered into the beginning stages of a truly national debate regarding what type of program would most effectively meet the needs of our nation (DeLeon, Wedding, Wakefield, & VandenBos, 1992). With the report by the Administration that even though current healthcare expenditures already represent approximately 13% of our Gross Domestic Product (GDP)-up from less than 6% only 3

Responding to society's needs: Prescription privileges for psychologists

“…The psychologist as health care professional was heralded by Enright, Resnick, Ludwigsen and DeLeon (1993) when they quoted several sources in making the point that our profession "represents more than 'merely' mental health care; we have become a bona fide health care profession" (p. 135). In discussing psychologists in hospital practice, these authors observed: "As psychology has matured as a bona fide health care profession, it has sought to systematically expand its professional boundaries, both in terms of providing new and innovative clinical services and in the locus of its clinical care" (p. 140).…”

A Psicologia no hospital geral: aspectos históricos, conceituais e práticos

“…Em 1978, a Califórnia foi o primeiro estado a inserir psicólogos nas equipes de saúde, o que possibilitou o crescimento significativo da profissão nas instituições hospitalares (Dorken, 1993). Na década de 1980, a American Psychological Association regulamentou as práticas dos Psicólogos da Saúde por meio de documentos que tinham o objetivo de apresentar as principais diretrizes para a atuação da categoria (Enright, Resnick, Ludwigsen, & DeLeon, 1993).…”

“…A American Psychological Association publicou, em 1985, um documento intitulado "A Hospital Practice Primer for Psychologists", que apresentava informações sobre a estrutura dinâmica das instituições hospitalares, destacando as habilidades necessárias dos profissionais de saúde com o propósito de facilitar a inserção do psicólogo no contexto hospitalar. Destaca-se que, em 1991, outro documento foi publicado pela mesma associação, o "Guidelines on Hospital Privileges: Credentialing and Bylaws", o qual apresentava as orientações para o treinamento de psicólogos para a atuação nos hospitais com ênfase na delimitação das atividades relacionadas à avaliação e à intervenção psicológica (Enright et al, 1993). Foram discutidas as propostas para a implantação dos serviços de Psicologia nos hospitais gerais com o objetivo de promover a integração entre teoria, prática e pesquisa para avaliar os modelos de atuação em Psicologia da Saúde.…”

“…Foram discutidas as propostas para a implantação dos serviços de Psicologia nos hospitais gerais com o objetivo de promover a integração entre teoria, prática e pesquisa para avaliar os modelos de atuação em Psicologia da Saúde. Enright et al (1993) destacam que os documentos da American Psychological Association contribuíram para a legitimação das práticas psicológicas no ambiente hospitalar, assim como para a publicação de pesquisas, com o surgimento do periódico Journal Health Psychology, em 1982, que, com reconhecimento internacional, publica pesquisas até os dias de hoje.…”

Appalachian diabetes patients' preferences for mental health treatment

“…Psychologists are beginning to work in many sectors of health care, including day treatment programs, medical-surgical units, nursing homes, rehabilitation facilities, and comprehensive health maintenance organizations (HMOs) (Biaggio & Bittner, 1990;DeLeon, 1991;Enright, Resnick, DeLeon, Sciara, & Tanney, 1990;Enright, Resnick, Ludwigsen, & DeLeon, 1993;Johnstone et al, 1995;Tulkin & Frank, 1985; see also Wiggins, 1994). The use of a collaborative practice model between physicians and psychologists is becoming more common due to the combination of medical and psychosocial needs of many patients (Abraham et al, 1991;Biaggio & Bittner, 1990;Bray & Rogers, 1995;Doherty & Baird, 1983;Dym & Berman, 1986;Enright & Blue, 1989;Glenn, 1985;Hepworth & Jackson, 1985;Johnstone et al, 1995;McDaniel, 2 Hepworth, & Doherty, 1992;McDowell, Burgio, Dombrowski, Locher, & Rodriguez, 1992;Natvig, 1991;Pion, 1991;Prindaville, Sidwell, & Milner, 1983;Sargent, 1985).…”