456 Health Psychology
represents a historical landmark in the change of beliefs in
medicine, psychology, and the general public regarding
mind–body relationships.
FORMALIZATION OF THE FIELD
WITHIN PSYCHOLOGY
Historically, psychologists were active participants in the
development of psychosomatic medicine. In fact, a number of
presidents of the American Psychosomatic Society have been
psychologists, including Margaret Thaler Singer (1972, the
first PhD and the first woman to be president), Robert Ader
(1979), C. David Jenkins (1983), Bernard Engel (1985), Karen
Matthews (1990), James Blumenthal (1995), and Margaret
Chesney (1997).
Perhaps the first action of organized psychology in relation
to organized medicine was the appointment of a committee in
1911 that examined the teaching of psychology in medical
schools (Franz, 1913). This early focus was designed to pro-
mote psychological competence in medical practice through
the instruction of medical students; thus, psychology began
its role in the health care system as a teacher of medical stu-
dents. The growth of health-service-provider psychologists
came later.
American Organizational Efforts
A landmark event for health psychology within organized
psychology was a report prepared by William Schofield for
the board of directors of the American Psychological Associ-
ation (APA):The Role of Psychology in the Delivery of
Health Services(Schofield, 1969). This essay had a much
broader focus than its title implies, as it addressed both theo-
retical and research aspects of the discipline that had implica-
tions for “the promotion and maintenance of health, the
prevention and treatment of illness” (p. 565). Schofield noted
how organized psychology had been implicitly dualistic,
often contrasting mental health with physical health and dis-
tributing more discipline resources to the former. For exam-
ple, his examination of articles indexed inPsychological
Abstractsfor 1966 and 1967 found three focuses in health:
schizophrenia, psychotherapy, and mental retardation. Alto-
gether, major and much more numerous health problems such
as pain, surgery, heart disease, cancer, smoking, and medical
hospitalization accounted for less than 10% of publications
in those years! He noted that only a smattering of individual
psychologists pursued interests in medical nonpsychiatric
problems and opined that with the possible exception of
involvement with the physically handicapped, the discipline
had only “superficially mined” the area of the psychology of
physical illness. He also predicted that this would not change
without change in the education and training of future
psychologists.
Scofield argued cogently for psychology to view itself as a
health science and a broadly based health profession (not just
a mental health profession); yet it would be another 30 years
before this perspective became mainstream within organized
psychology.
In 1973, another seminal event occurred when the APA
Board of Scientific Affairs established the Task Force on
Health Research upon the recommendation of the Committee
on Newly Emerging Areas of Research. Miriam Kelty (who
in 2000 received a Career Service Award for her work in
health psychology) served as APA staff liaison. Three decades
ago the societal context was increased public concern about
rising health costs and deficiencies in the way health care was
delivered in the United States. Although health had become a
social issue and was no longer solely the province of medi-
cine, psychology as a discipline was described as “surpris-
ingly slow to recognize and accept research challenges in this
problem area. Possibly the historical prominence of mental
health as a focus for applied psychology has overshadowed
other types of health-oriented psychological research” (APA,
1976, p. 264). The task force did identify nearly 500 psychol-
ogists with health research interests, but half of those were
employed outside of health settings and many were not mem-
bers of the APA, having resigned because they found no divi-
sional affiliation compatible with their interests. Moreover,
their research tended to be published in non-APA journals, a
number of which were not even included in thePsychological
Abstracts Search and Retrieval (PASAR)database and thus
not available to the average APA member.
The Task Force on Health Research found that approxi-
mately 40 health research articles were published per year
between 1966 and 1973. Of those, about 66% were related to
psychobiological aspects of health (stress, psychosomatics,
social and environmental factors, effects of illness on behav-
ior), 18% dealt with health care delivery issues (mostly
specific aspects of treatment and rehabilitation rather than
systems research), and 16% were studies of attitudes relevant
to health and health care. To foster the development of
knowledge in this area the task force made a series of recom-
mendations: (a) increase awareness among psychologists of
support for health research from agencies other than the
National Institute of Mental Health (NIMH), (b) eliminate
mind–body dualism in conceptualizing human behavior by
adopting more integrated models, (c) develop graduate edu-
cation programs to promote early awareness of opportunities
for research and practice, and (d) “find a suitable home within