Medical psychology

Medical psychology is a very broad field and has been defined in various ways. The Academy of Medical Psychology's definition applies to both the practices of consultation and prescribing in Medical Psychology, when allowed by statutes. These professionals are trained in a specialty of psychology concerned with the application of psychological principles to the practice of medicine and both physical, as well as, mental disorders. They apply psychological theories, scientific psychological findings, and techniques of psychotherapy, behavior modification, cognitive, interpersonal, family, and life-style therapy to improve the psychological and physical health of the patient. Clinical psychologists with post doctoral specialty training as medical psychologists are the practitioners with refined skills in clinical observation in of the field of psychology, learning, central nervous system adaptation and change, and adaptation and lifestyle change applying a number of different methods in several different mediums of treatment. These highly qualified and post graduate specialized doctors are trained for service in primary care centers, hospitals, residential care centers, and long-term care facilities and in multidisciplinary collaboration and team treatment. They are trained and equipped to modify physical disease states and the actual cytoarchitecture and functioning of the central nervous and related systems using psychological and pharmacological techniques (when allowed by statute), and to provide prevention for the progression of disease having to do with poor personal and life-style choices and conceptualization, behavioral patterns, and chronic exposure to the effects of negative thinking, choosing, attitudes, and negative contexts. (http://www.amphome.org/MedPsychDef.pdf)

Medical psychology may also refer to a growing specialty area of clinical psychological practice in which clinical psychologists, who have undergone specialized education and training at the post-doctoral level, integrate somatic and / or psychotherapeutic modalities into the management of mental illness. In the United States, New Mexico and Louisiana, and all branches of the U.S. uniformed services currently authorize medical psychologists to prescribe medications. In Louisiana, the term of medical psychologist refers, in statute, specifically to those psychologists licensed by the Louisiana State Board of Medical Examiners and who are authorized and licensed to prescribe medications. The term mirrors precisely the terminology of the United States Drug Enforcement Administration (DEA). In 2009, psychologists with prescriptive authority in Louisiana had the regulation of their practice of medical psychology and psychology transferred to the Louisiana State Board of Medical Examiners. Louisiana is the only state in the U.S. where a medical board has authority over the regulation of the entire practice of psychology (for medical psychologists). It is important to note that the Division 38 of the American Psychological Association and The Academy of Medical Psychology does not agree or recognize that the term medical psychologist has, as a prerequisite, the ability, certification, or licensure to prescribe medications in the care and management of patients nor should the term be equated with having prescriptive authority. (http://www.health-psych.org/MedPsych.cfm) (http://www.amphome.org/MedPsychDef.pdf)

Behavioral Medicine (related to Behavioral Health, Clinical Health Psychology and Psychosomatic Medicine) is a related branch of clinical practice in which psychologists emphasize the biopsychosocial approach to medicine, a model which recognizes the importance of addressing the interaction between physical, psychological and social factors in both the prevention and management of disease. Practitioners of behavioral medicine differ from medical psychologists in that they focus on the scientific application of behavioral interventions to a wide variety of medical conditions (e.g., asthma, gastrointestinal illnesses, cardiac conditions, spinal cord and brain injuries, chronic pain, headaches, and addictive illness).

Definitions

Medical psychology, as defined by most medical dictionaries is defined as "the branch of psychology concerned with the application of psychological principles to the practice of medicine". Other similar definitions include: "the application of clinical psychology or clinical health psychology, usually in hospital, medical, or health care settings" and "the study and application of psychological factors related to any and all aspects of physical health, illness, and its treatment at the individual, groups, and systems level"

Medical psychology, as defined by Division 55 of the American Psychological Association (APA), "is that branch of psychology that integrates somatic and psychotherapeutic modalities into the management of mental illness and emotional, cognitive, behavioral and substance use disorders." Division 55 is the organization within APA that represents medical psychologist who have prescriptive authority and is a leader in defining this new practice area for clinical psychological practitioners with prescriptive authority.

The Academy of Medical Psychology defines medical psychology as a specialty trained at the post doctoral level and designed to deliver advanced diagnostic and clinical interventions in Medical and Healthcare Facilities utilizing the knowledge and skills of clinical psychology, health psychology, behavioral medicine, psychopharmacology and basic medical science. (http://www.amphome.org/MedPsychDef.pdf)

A specialty of medical psychology has established a specialty board certification, American Board of Medical Psychology and an Academy of Medical Psychology (http://www.amphome.org/) requiring a doctorate degree in psychology and extensive post doctoral training in the specialty and the passage of an oral or written examination, as does The International College of Professional Psychology (ICPP), (http://www.icpppsych.com) which is a Board Certifying Diplomate Fellow Credentialing Organization approved by the Florida State Licensing Psychology Board.

Education

In 2006, the American Psychological Association (APA) recommended that the education and training of medical psychologists, who are specifically pursuing one of several prerequisites for prescribing medication, integrate instruction in the biological sciences, clinical medicine and pharmacology into a formalized program of postdoctoral education.

The following Clinical Competencies are identified as essential in the education and training of medical psychologists:

I. Basic Science: anatomy, & physiology, biochemistry;

II. Neurosciences: neuroanatomy, neurophysiology, neurochemistry;

III. Physical Assessment and Laboratory Exams: physical assessment, laboratory and radiological assessment, medical terminology;

IV. Clinical Medicine and Pathophysiology: pathophysiology with emphasis on the principal physiological systems, clinical medicine, differential diagnosis, clinical correlation and case studies, chemical dependency, chronic pain management;

V. Clinical and Research Pharmacology and Psychopharmacology: pharmacology, clinical pharmacology, pharmacogenetics, psychopharmacology, developmental psychopharmacology;

VI. Clinical Pharmacotherapeutics: professional, ethical and legal issues, combined therapies and their interactions, computer-based aids to practice, pharmacoepidemiology;

VII. Research: methodology and design of psychopharmacology research, interpretation and evaluation, FDA drug development and other regulatory processes.

The 2006 APA recommendations also include supervised clinical experience intended to integrate the above seven knowledge domains and assess competencies in skills and applied knowledge.

The above prerequisites are not required or specifically recommended by APA for the training and education of medical psychologists not pursuing prerequisites for prescribing medication.

The national psychology practitioner association (NAPPP; www.nappp.org)and top national certifying body (Academy of Medical Psychology; www.amphome.org)have established the national training, examination, and specialty practice criterion and guidelines in the specialty of Medical Psychology and have established a national journal in the specialty. Such certifying bodies, view psychopharmacology training (either to prescribe or consult) as one component of the training of a specialist in Medical Psychology, but recognize that training and specialized skills in other aspects of the treatment of behavioral aspects of medical illness, and mental illness affecting physical illness is essential to practice at the specialty level in Medical Psychology. The Louisiana Academy of Medical Psychology (LAMP) the largest and only organization representing practitioners of medical psychology in Louisiana and, as defined by Louisiana statute within any jurisdiction in the United States, no longer recognize the Academy of Medical Psychology as an adequate certifying body for its practitioners, and have resigned from that body en masse.

See also

• Prescriptive authority for psychologists movement
• Health psychology

External links

• http://www.health-psych.org/MedPsych.cfm
• http://division55.org/ American Psychological Association - Division 55 - American Society for the Advancement of Pharmacotherapy
• http://icpppsych.com International College of Professional Psychology
• http://nappp.org/ National Alliance of Professional Psychology Providers
• http://www.amphome.org/ Academy of Medical Psychology
• http://www.rxp.nappp.org/ National Alliance of Professional Psychology RxP Training Program
• http://www.abbhp.org/ American Board of Behavioral Health Practice
• http://www.nibhq.org/ National Institute For Behavioral Health Quality
• http://division55.org/ContinuingEducation.htm Postdoctoral training programs in clinical psychopharmacology
• http://www.apapractice.org/apo/insider/professional/psychopharmacology.html# Psychopharmacology Examination for Psychologists (PEP)
• http://division55.org/TabletOnline.htm Division 55 newsletter "The Tablet"
• http://www.medicalpsychology.nl Department Medical Psychology Tilburg University The Netherlands