HCA

Health Psychology Committee Report
Beth Lowery
HCA 250

The Health Psychology Committee is committed to enhance the health of patients and to assist patients in obtaining the shortest hospital stay, while improving the hospital's performance with respect to following the appropriate protocols and regimens. To that end, the Committee has established a new Division of Psychiatry, which is staffed by five specialists who are responsible for addressing specific interests of a wide-ranging population and assisting the hospital in treating the "whole" patient. The committee has sought to address a key issue facing individuals who are facing a hospital stay – that is, an overriding fear of hospitals. According to the Child Development Institute (2008), one of the major fears faced by adults and children is that of hospitals. This fear often manifests itself in stress, which can make the illnesses or ailments of the patient worse. Stress impacts the response of the immune system to the physical systems of the body, and psychological interventions can assist the patient in developing coping methods to address these stressors (Sarafino, 2006). The committee's hope is that integration of psychology and health care will reduce the stresses on the patient, enhance their health, increase compliance by the patient with treatment programs, and shorten their hospital stays. Additionally, the patient will be provided with coping skills that will help them deal with their illness both inside the hospital and once they are discharged and on their own. The program includes the services of five psychologists in the Division of Psychiatry. The positions are: Child Psychologist, Adult Psychologist, Substance Abuse Counselor, Pain Management Specialist, and Inpatient-only Psychologist. The specialists will work with individual patients and will coordinate with the patient's physicians and other specialists to develop and implement a holistic treatment plan. The Division will meet collectively to discuss cases, offer peer support and advice, and assess progress of the patients.
The division psychologists will employ positive approaches that focus on hope, coping, and self-control. According to Bolt (2004), people who have developed the ability to cope and control their reactions to stressors can withstand the stresses of their illnesses and other issues of health. Because patients have a say in their treatment plan, they are more likely to be positive towards complying with their plan and have a better attitude towards the overall outcome. The psychologists will identify challenging areas, help set goals for behavior and through patterns, identify the benefits that will accrue from the goals, anticipate obstacles to achieving the goals, and help develop coping skills to assist the patient throughout the process. In addition, the psychologists will need to address a very important issue – the social network of each patient (Bolt, 2004).
The psychologists' role in developing an attitude of hope cannot be underestimated. “Hope is a good thing, maybe the best of things (Bolt, 2004, p.159).” A patient who has hope has a greater propensity for optimism, which in turn influences their health and response to treatment. People who are optimistic are distressed less by surgical procedures than people who are pessimistic and patients who are optimistic feel that they have greater control over their circumstances and their lives (Bolt, 2004). In addition, optimism can also help patients recover more quickly than pessimistic patients. Thus, incorporating psychology into the protocols of treatment can shorten the hospital stays of patients (Bolt, 2004). Consequently, the Division of Psychiatry will emphasize positive methods aimed at strengthening hope, self-control, and coping for each patient. The five psychologists and their duties are described below.

The Division's Child Psychologist will coordinate and collaborate with local schools to help encourage the schools to implement health education programs for the children of school age. Because of the recent emphasis on obesity prevention, the programs will focus on healthy eating and exercise. Other areas to be addressed by the Child Psychologist would be to address psychological issues that affect responses to medical treatment, such as coping mechanisms and fear of hospitals, as well as directly working with the schools to develop programs and implement techniques for integrating seriously ill children in their classrooms. In addition, the Child Psychologist works with individual children to help them develop coping skills for dealing with anxiety and stress during their hospitalizations. The psychologist will work with the child in advance of known hospitalizations to help them understand the process and to help reduce their anxiety. When the child enters the hospital, the psychologist will take them on a tour to help them develop greater ease with their surroundings (Sarafino, 2006). Additionally, the psychologist will focus on helping the child deal with temporary distress due to separation from their guardian or parent for periods of hospitalization (Sarafino, 2006).
The Child Psychologist will work with children who are ill in group settings to help reinforce the idea that they are not alone. The group sessions will also assist the psychologist in assessing and observing other physical and behavioral challenges the child may be facing so they can work in concert with others within the Division and with the child's physicians to address the issues. The child psychologist will regularly meet with the child in his or her room, with the family and the child's surgeons, physicians, and other psychologists in the division to help ease the child's fears and to minimize their exposure to stresses and maximize their ability to cope with the stresses of their illness and hospitalization.
Finally, if the child has a terminal illness, the psychologist will assist the family and the child in coping with and developing skills for addressing the psychological aspects of the illness. The psychologist will help the family and the child to understand the stages of grief, and help them come to an acceptance and understanding of the issues they will face. The psychologist will coordinate with other professionals, including hospice, to help the family and child through their challenges. The Adult Psychologist helps adults by providing them with stress-relief interventions; enhancing their coping skills, diagnosing stress disorders, and helping the patient deal with terminal or chronic illnesses. In keeping with the overall goals of the Division, the Adult Psychologist will focus on positive methods, optimism, and individual control. The Adult Psychologist will coordinate with the Pain Management Specialist and other specialists, as necessary, to address pain issues, reduce stress, and help the patient adjust to their situation. The Psychologist will help patients work through their reactions to diagnoses, and will work with the patients and their families to develop positive methods for coping with their diagnoses. When facing terminal illnesses, the psychologist will coordinate with other specialists in the Division and with Hospice workers to address the needs of the individual and their family. When a patient is admitted for substance abuse issues, or when a patient develops a substance abuse problem, the Counselor will coordinate their recovery program and care while in the hospital. In addition, the Counselor will be responsible for coordinating and arranging for after care for the patient prior to their discharge. Care for the substance abuse patient is complex, and people who are addicted to drugs or alcohol have a physical and psychological dependence on the substance. The interventions developed by the Counselor must address these physical and psychological dependences (Sarafino, 2006). The substance abuse patient will suffer from withdrawal, and depending on their addiction, the Counselor will need to address interventions to help them deal with the psychological stresses and physical challenges as a result of the withdrawal. Additionally, the Counselor develops the detoxification plan for the patient. This will include an assessment of the patient's readiness for treatment and change. The Substance Abuse Counselor will hold individual and group therapy sessions with patients to help the patient understand that they are not alone, which can help inspire hope in the patient (Sarafino, 2006). The individual therapy will focus on coping skills to help reduce the potential of the patient to relapse, and will seek to help the patient understand that they have choices and can make the choices that are best for their bodies and themselves. The counselor will also help the patient by developing a plan for cognitive restructuring to help replace negative and destructive thoughts with positive, constructive, and realistic thoughts and will also help the patient learn how to handle stress by using relaxation exercises (Sarafino, 2006). In keeping with the Division's focus on optimism and hope, the Substance Abuse Counselor will focus on health and wellness for the patient by using different methods of treatment that are specifically designed for the individual patient. Because hope is essential to recovery, the Counselor will focus on giving the patient hope throughout the treatment process (Taylor, 2008). The Pain Management Specialist will focus on the psychological aspects of pain. The specialist will first focus on non-pharmaceutical interventions for dealing with pain, such as relaxation techniques, coping mechanisms, and other interventions that will assist them in addressing pain. When pharmaceutical intervention is necessary, the Pain Management Specialist will coordinate with the patient's physician. When the specialist is able to reduce or eliminate the pain of the patient, they will be more likely to have a positive approach and hopefulness for their recovery (Psychzone, 2001). When patients have a combination of a physical illness and a substance abuse issue, the specialist will coordinate their care with other members of the team, such as the Substance Abuse Counselor and Adult Psychologist, as well as the patient's physician, to ensure the best treatment protocol is addressed. The specialist will emphasize biofeedback, physical therapy, cognitive restructuring, relaxation training, and massage therapy in the treatment of all assigned patients (Psychzone, 2001). When the patient is facing a terminal or chronic illness, the specialist will help develop the most beneficial protocol to keep the patient comfortable and as free as possible from pain. The Inpatient-only Psychologist will coordinate with all other specialists on staff in the Division, as well as with the patient's physician, to help prepare the patient for their procedures, hospitalization, and surgery. The focus will be on helping the patient develop a positive and optimistic outlook about their experience and to help them develop a sense of control over the situation. The Psychologist will use a variety of age-appropriate approaches, including personal discussion, videos, audios, printed materials, and books to help the patients understand and develop greater comfort with the situation. By helping educate the patient regarding their experience, their anxiety levels will be reduced and the patient will feel more in control of their situation (Sarafino, 2006). The Psychologist will work with other Division staff to help the patient develop coping skills, including the use of guided imagery, biofeedback, distraction, and relaxation techniques. In addition, the Psychologist will apply operant conditioning approaches when appropriate (Sarafino, 2006). Finally, the psychologist will assess the pain of the patients upon admission and will work with other Division members to develop a strategy to help the patient deal with their pain in the most appropriate and beneficial manner.

Health care has been focused on addressing the physical maladies of individuals without focusing on the entire patient. The new Division, with the coordinated approach focusing on the whole patient – the psychological and physical issues of the patient – will help reduce hospital stays and increase patient compliance with treatment protocols. Engendering hope in the patient is an essential component to the patient's recovery (Bolt, 2004). Thus, the primary role of these new professionals will be to help the patients develop a sense of hope, develop their coping skills, and develop a sense of control over their health care and environment. Through education, counseling, understanding, and coordination, the Division of Psychology can contribute positively to the patient's recovery.

References

Bolt, M. (2004). Pursuing human strengths: A positive psychology guide. New York: Worth Publishers.

Child Development Institute (2009). Helping your child deal with fears and phobias. Retrieved from: http://childdevelopmentinfo.com/disorders/fears.htm.

Psychzone, Inc. (2001). Pain Management. The Health Psychology Network (2008). Retrieved from: http://www.healthpsychology.net/Pain_Management.htm.

Taylor, A. (2008, September 25). A new deal for children's trust. Community Care, 1737 (32-34). Retrieved from SIRS database.

Sarafino, E.P. (2006). Health psychology: Biopsychosocial interactions (5th ed.). Hoboken, N.J.: John Wiley & Sons.