Handbook of Psychology

CHAPTER 1

Health Psychology: Overview and Professional Issues

DAVID F. MARKS, CATHERINE M. SYKES, AND JENNIFER M. MCKINLEY

5

THE DEFINITION AND SCOPE OF
HEALTH PSYCHOLOGY 6
Relationships with Other Professions 8
The Clinical and Community Approaches to
Health Psychology 8
Conditions That Promote and Maintain Health 9
Inalienable Right to Health and Health Care for All 10
Centrality of the Scientist-Practitioner Model 10
EDUCATION AND TRAINING IN THE
UNITED STATES 10
EDUCATION AND TRAINING IN EUROPE 12
Rationale for Training 12
Complementing Other Fields of
Applied Psychology 13
Professional Autonomy and Complementary
Independence 13
Stages of Competency 13
Training Guidelines for Professional Health
Psychologists 13
Implementation of Training 14

EDUCATION AND TRAINING IN THE

UNITED KINGDOM 14

Professional Competence 15

Research Competence 16

Consultancy Competence 16

Teaching and Training Competence 16

Optional Competences 16

SIMILARITIES AND DIFFERENCES BETWEEN THE U.S.,

EUROPEAN, AND U.K. MODELS 17

A Common Core 17

Differences between Regions or Countries and Gaps

in Training 17

CRITIQUE OF PROFESSIONALIZATION 18

ETHICAL AND POLICY ISSUES 19

Poverty and Inequality 19

Economics 20

New Technologies 20

The Aging Population 20

CONCLUSIONS 20

REFERENCES 21

The importance of psychological processes in the experience
of health and illness is being increasingly recognized. More
and more evidence is accumulating for the role of behavior in
current trends of morbidity and mortality: Certain health be-
haviors reduce morbidity and mortality (Breslow & Enstrom,
1980; Broome & Llewellyn, 1995; Marks, Murray, Evans, &
Willig, 2000; Matarazzo, Weiss, Herd, Miller, & Weiss, 1984;
Taylor, 1986). Maes and von Veldhoven (1989), reviewing
all the English language handbooks on health psychology

known at that time, counted 15 published during the period

1979 to 1989. Recent developments, especially in clinical

practice, have been even more encompassing, and health psy-

chologists are in increasing demand in clinical health care

and medical settings. In the United States, the single largest

area of placement of psychologists in recent years has been in

medical centers. Psychologists have become vital members

of multidisciplinary clinical and research teams in rehabilita-

tion, cardiology, pediatrics, oncology, anesthesiology, family

practice, dentistry, and other medical “elds (American Psy-

chological Association [APA], 1996). With this increasing

participation of psychologists in health services, guidelines

for professional training programs and ethical practice have

been developed in the United States, Europe, and elsewhere.

This chapter reviews some of the professional and ethical is-

sues that have been identi“ed and discussed in these regions.

The emphasis is on education and training.

In reviewing the “eld•s development in the United States,

Wallston (1993) states, •It is amazing to realize that formal

The authors would like to thank the members of the EFPPA Task
Force on Health Psychology (convenor: David F. Marks): Carola
Brucher-Albers, Berufsverband Deutscher Psychologen e.V.; Frank
J. S. Donker, Nederlands Institut van Psychogen; Zenia Jepsen,
Dansk Psykologforening; Jesus Rodriguez-Marin, Colegio O“cial
de Psicologos; Sylvaine Sidot, Association Nationale des Organiza-
tions de Psychologues; Brit Wallin Backman, Norsk Psykologforen-
ing. Sections of this chapter are adapted from the Task Force report
(Marks et al., 1998).