Psychology as a Health-Care Profession: Implications for training.

Abstract This article places a magnifying glass on psychology's current training realities in the context of global health developments, particularly those of the Canadian health-care system. The authors argue that curriculum review and revision is needed to solidify psychology as a true health care profession; such a review should be proactive and must consider the likely changes in our overall health-care system. In preparing for anticipated changes in health care, it is proposed that curricula modifications be made to better reflect how psychology can contribute (in a broad fashion) to the health of Canadians. Two particular models for psychology's future role are offered for discussion: a) a modified, comprehensive parallel/vertical model that sees psychologists similar to other health-care providers; versus, b) a more innovative horizontal/cross-cutting model in which psychologists provide a unique blend of education, innovation, teaching, system consultation, prevention, as well as direct service provision, to patients with physical and mental health problems. The objectives of this article are to reflect upon the status quo of psychology's role in health care, upon the need to be prepared for massive changes in health care in Canada, and upon the desire for the profession of psychology to play a major role in these changes, including efforts to position itself in a more substantial role than was awarded to us in the past. This background then serves to enunciate recommendations for how professional training can and must change to map onto system changes and to maximize the potential of psychologists in the marketplace. As the title suggests, this article explicitly defines psychology as a Health-Care Profession rather than limiting it to a Mental Health-Care Profession. In fact, the position taken here is that any separation of physical health care from mental health care is artificial, counterproductive to the well-being of patients, regressive, and antithetical to modern psychology and medicine alike. Note also that this article is in part based upon the personal views and experiences of the authors, an academic clinical psychologist and two psychology graduate students, whose views have been shaped by many years of academic training and teaching, clinical supervision and research design, and - in the case of the first author - being involved in professional organizations and serving as a clinical program director. This article does not portend to describe 'just the facts; rather, it is often opinionated, it does not offer ready solutions, and its main purpose is to trigger a lively discourse. It imposes a magnifying glass on our current training realities in the context of more global health-care changes, and then reflects on the implications of this analysis for possible changes in university curricula. The practice of psychology cannot stay stagnant if the structure of health care is itself changing or else we are manufacturing our own erosion. Universities, therefore, need to be training psychologists to be ready for such changes. Given that, arguably, no perfect health-care system exists anywhere world-wide, changes will have to arise from vivid discussion and forethought, will require courage and political will, and will inevitably carry some risk for failure. Despite risks inevitably embodied in any change, it is posited here that the last thing we can afford to do at this time is to stick our heads in the sand while we let others decide our fate. Figure 1 illustrates where in the process of change we see the place of this article; in particular, we want to prevent the crossed-out option in this sequence model from becoming reality, and encourage proactive planning so as to maintain control over the future of our profession. The timing of this attempt at provoking discussion about a changed role for psychology is not at all accidental. There is widespread consensus among Canadians that the Canadian health-care system is in need of an overhaul. …

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