What is the future perspective of health psychology? - Chapter 18

What is meant by the need for theory-driven practice?

Important variables that influence behavior are included in theories about health. These theories are always evolving and becoming more extensive. As a result, the theories are recent and form a basis for interventions. An example is quitting smoking. Many professionals think it is best to scare them so that they will change. But psychological theories offer alternative factors that may make more sense:

• The health belief model suggests that we should not only convince smokers that smoking leads to illness, but that we should also convince them that the benefits of giving up smoking are greater than the benefits of continuing to smoke.
• The theory of planned behavior further emphasizes the role of attitudes and beliefs in behavioral change. It also indicates the role of peers and other important people in the development of personal smoking cessation strategies. Planning behavioral change is emphasized.
• Social cognitive theory suggests that people must first believe that they can stop smoking before trying. This can be done by observing coping models.
• Theories of addiction suggest that people need to avoid addictive substances gradually, but just above the onset of withdrawal symptoms. 

It is known that an intervention must contain a number of elements through which the reactions of a patient at the start of a disease can be optimized:

• The patient's beliefs about the disease must be discovered. If these are not correct or meaningful, it must be considered whether they can be changed and whether the patient is attempting to do so.
• It is important that patients learn how to deal with their (serious) illness as effectively as possible. Teach patients, depending on the context, problem-focused coping or emotion-focused coping.

The above points provide a structure from which an intervention can be built. The intervention must be adapted to the individual and is subject to changes by environment and people.

How can a theory be put into practice?

In addition to the theories, psychologists and health professionals are extremely important in putting a theory into practice. Many healthcare workers do not have the freedom to determine when and which intervention they perform. They are bound by rules and guidelines that prescribe what the intention is. There must be good evidence that the interventions and theories are effective. The most important tasks of the health psychologist are:

• Promoting and maintaining health.
• Preventing and managing illness.
• The identification of psychological factors that contribute to physical diseases.
• Improve the healthcare system.
• Formulating health policy.

However, the guidelines for the duties of health psychologists differ per country. Questions to be answered by health psychologists are: how do people adapt to a chronic illness? Which factors influence healthy eating? How is stress associated with heart disease? Why do patients often not take their medication as prescribed? The Netherlands does not have a training program for health psychologists, just like various southern European countries.

According to Lazarus, the lack of cooperation and communication between researchers and clinicians is a familiar and painful subject for most psychologists. It is therefore difficult to reach professionals. Psychology can, however, influence healthcare by publishing in relevant journals. The factors that contribute to the fact that clinical guidelines are not being sufficiently followed include weakness in communicating evidence to doctors, conflicting sources of information and opinions for doctors, difficulty getting the right people together to work together for change, and resistance to change. Other factors are personal attitudes and beliefs about target behavior, personal characteristics of the professional, the content of information, the transfer of information, and organizational issues.