How do psychological factors like anxiety and depression impact physical health in the moment and over the course of a person's lifespan? What are the psychological components of public health concerns like poor nutrition, lack of physical activity, and substance abuse? And are there effective psychological treatments, interventions, and policy strategies that can improve the overall physical wellbeing of individuals and society at large?
These are some of the fundamental questions addressed by health psychologists, a group of specialists within the larger practice of clinical and research psychology who work in tandem with other health care professionals to implement preventative care measures, facilitate better patient treatment outcomes, and help people manage chronic and acute illnesses. Health psychology is a relatively new area of specialization that was first recognized as an official division within the American Psychological Association (APA) in 1970, after decades of research had established a definitive link between mental and physical health.
By its very nature, psychology has always been concerned with a person's overall health and wellbeing. But by the mid-20th century, new models of illness had begun to take into account not just biological and physiological causes, but also the effects of social, cultural, and psychological factors. As a result, psychologists have become an integral and increasingly important part of the health care system, and health psychologists are at the forefront of the research and clinical counseling that continues to fuel the movement toward a more holistic, mind-body conception of health care.
PhD in Health Psychology Concepts
- Research design and methodology
- Social psychology
- Testing and measurement
- Psychology of social change
- Ethics and standards of professional practice
- Clinical neuropsychology
- Health psychology history and fundamentals
- Behavioral nutrition
- Stress and coping mechanisms
Benefits of Earning a Doctorate in Health Psychology
It's no secret that health care is a growing sector of the economy. With the baby boomer generation reaching retirement age, and more people gaining access to health care through the Affordable Care Act, the demand for trained professionals across the board in the health care industry is rising. In addition, the imperative to improve care, both from an outcome and from an economic standpoint, has put acute pressure on federal and state governments, policy makers, insurance companies, and health care providers to effect better preventative care measures along with programs that encourage patients undergoing treatment to properly follow recovery protocols.
These are all areas in which health psychologists, also often referred to as clinical health psychologists, are playing key roles. As the APA points out in its introduction to careers in health psychology, "From working in clinical settings to conducting research and influencing health care policy, health psychologists measure the impact of behavior on health and create ways to help people make the behavior choices that induce good health and prevent illness. In this field, psychologists have many professional options, and the demand for their expertise is high. That's because hospitals and other health care entities realize the many ways health psychologists can improve their strategies for care, particularly in the area of prevention."
That much is clear. However, because the work of a health psychologist involves treating patients, conducting research on patient populations, and consulting with doctors, nurses, and other health care professionals on critical care issues, state licensure is required to practice professionally. In most cases, that means earning a PhD in health psychology, or the largely equivalent PsyD in health psychology. Accredited doctorate in health psychology programs are designed to give students the knowledge, skills, and supervised experience they'll need to pass state licensure exams and qualify for the growing number of jobs in the field. As the APA stresses, "Those with doctoral degrees have the most options; they are able to work independently and will often supervise research or clinical teams, including those working in the areas of managing weight and preventing obesity, pain management, helping individuals cope with genetic diseases, preventing re-hospitalization of patients and planning walkable communities to encourage physical activity."
What to Expect in a Health Psychology PhD Program
A successful career in health psychology requires a deep knowledge of psychological theory and practice, just like in any other branch of psychology. Health psychologists must be familiar with methods for conducting and interpreting psychological studies and research; the various accepted techniques for psychological assessment, treatment and therapy; and how neurological, biological, social, and cultural factors impact cognitive function and mental wellbeing. In addition, health psychology relies on a working knowledge of the health care system, health care administration, and the ways in which health care policies are designed and implemented.
The APA's division 38, which is its official body devoted to clinical health psychology, emphasizes three core areas of competency for graduates with a PhD in health psychology, as characterized here by the Health Psychology Center of San Diego:
- Clinical Research: Health psychology researchers may concentrate on investigating effective preventative measures, explore health promotion techniques, study the causes of health problems, investigate how to motivate people to seek treatment, and how to assist people cope with illness or pain.
- Public Policy: Health psychologists may work in private or government settings and have a role in making public policy on health related issues. Their business might point to advising executive groups on health care improvement, address disparities in health care, or lobby government agencies.
- Clinical Counseling: Health psychologists regularly administer behavioral evaluations, participate in clinical interviews, and conduct personality tests. They participate in managing interventions with individuals and/or groups, train people about anxiety reduction methods, offer addiction cessation advice, and teach people how to refrain from unhealthy behaviors.
Typically, doctoral programs in health psychology are designed to be completed in four to six years, which may include a full year of supervised internship experience, and in some cases research for a dissertation project. The requirements vary from program to program. Depending on the school, a bachelor's degree in psychology or a related discipline may be sufficient for admission, although some programs insist upon or favor applicants with a master's degree in psychology.
Coursework also varies from program to program. However, here are some of the foundational classes that are typical in the field of health psychology at the doctoral level:
- Theories of the Human Mind and Contemporary Psychological Practice
- Behavioral Science Research Methods and Design
- Ethical, Legal, and Professional Issues in Health Psychology
- Clinical Behavioral Analysis and Assessment
- Childhood and Developmental Psychology
- Abnormal Psychology and Behavioral Disorders
- Theory and Practice of Health Psychology
- Cultural and Diversity Issues in Health Psychology
- Community Research and Public Health Policy
- Cognitive Neuropsychology
- Social Psychology
- Communities at Risk and Psychological Interventions
Health Psychology Doctoral Degrees: the PhD and the PsyD
There are essentially two paths to earning a doctorate in health psychology: the PhD, or doctor of philosophy in health psychology; and the PsyD, or doctor of science in health psychology. PhD programs are based on the research university method of training, which puts equal emphasis on theory and practice. PsyD programs grew out of the medical school model for training physicians, and may place a greater emphasis on practice over theory. However, on a practical level, there are often few distinct difference between PhD and PsyD programs in health psychology. The APA points this out, noting that, "PhD programs tend to emphasize training to conduct empirical research, whereas PsyD programs tend to emphasize training in practice," but going on to say that, "this distinction is relative and there is substantial variability within programs of the same degree type. For example, some PsyD programs require considerable training in conducting empirical research, while some PhD programs emphasize training in practice." In other words, there's more to be gained by looking at the relative details of specific programs then by weighing the general perceived difference between a PhD and a PsyD degree.
Specializations in Health Psychology
Health psychology is itself an area of specialization within the larger discipline of psychology. In fact, some universities offer doctoral degrees in health psychology as an area of concentration in the study of clinical psychology. However, as the field of health psychology has grown, and the challenges and complexities of administering health care have multiplied, several areas of concentration have emerged, largely through graduate research and individual program specializations. For example, in addition to clinical health psychology doctoral programs, or clinical or counseling psychology degrees with a health emphasis, some graduate schools offer degrees in what has become known as experimental health psychology. The former train students, as the APA details, "broadly as scientist-practitioner psychologists with a special focus on applying their clinical skills to health issues." The latter tend to focus more on, "health psychology research rather than patient care." Beyond that distinction, there are four areas in which health psychologists tend to narrow their focus:
- Clinical Health Psychology: Clinical health psychologists work in tandem with medical professionals and health care administrators to implement preventative care protocols, and use the tools of behavioral psychology to help patients better manage health and medical issues.
- Community Health Psychology: Community health psychologists work with other health care workers and social service providers in the community to promote better behavioral attitudes toward health and wellbeing. They're often included in community-wide interventions designed to combat particular psychosocial problems that lead to illness and disease.
- Critical Health Psychology: Critical health psychologists are concerned with the socioeconomic factors and other issues, including race and gender, that contribute to physical and behavioral health. They conduct research on such indicators, coordinate interventions, and help craft fairer and more equitable health care policies.
- Public Health Psychology: Public health psychologists create and conduct studies and other research to determine causalities between psychosocial factors and physical health in an effort to help community, educational, and governmental health care administrators create better programs and policies for combating illness.
Licensure and Certifications for Health Psychologists
Like all psychologists, health psychologists must be licensed in the state they practice in order to work as professional psychologists and even to refer to themselves as psychologists. The licensing requirements vary from state to state, but typically a doctoral degree plus one to two years of supervised internship experience is required, along with passing the Examination for Professional Practice in Psychology. In addition, the American Board of Professional Psychology (ABPP) offers voluntary certifications in 15 areas of psychological practice, including clinical health psychology. ABPP certification in an area of specialization may be preferred or even required by some employers.
Careers Paths, Salaries, and Job Outlook in Health Psychology
Because health psychology is a relatively new field that often falls under the larger umbrella of clinical and counseling psychology, there isn't a lot of employment data that specifically targets health psychologists. It is worth noting that, according to the latest Bureau of Labor Statistics Occupational Employment Statistics data, offices of health practitioners, outpatient care centers, and general medical and surgical hospitals were among the top five largest employers of psychologists in 2014. In addition, four of the five top-paying industries for psychologists were in areas that typically employ health psychologists, including scientific research and development services, hospitals, and physicians offices.
The BLS Occupational Outlook Handbook notes that just under a third of all psychologists, or 29 percent, worked in health care and social assistance in 2012. The BLS also predicts a fairly robust rate of 12 percent job growth for psychologists through 2022, while emphasizing that, "Greater demand for psychological services in schools, hospitals, mental health centers, and social services agencies should drive employment growth."
The average annual salary for psychologists, as of May 2014, stood at $74,030, with the highest tenth percentile earning $113,640 or above, and the lowest tenth percentile pulling in $40,080 or less a year. A 2009 survey by the APA found, "that health psychologists working in direct human services earned an average of $80,000 per year. Many who work in large universities or health systems earn more."