The Practice of Clinical Health Psychology Robin Perkins, Ph.D. Clinical Psychologist Archbold Integrative Medicine Center

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The Practiceof Clinical HealthPsychologyRobin
Perkins, Ph.D.Clinical PsychologistArchbold
Integrative Medicine Center
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Health PsychologyUtilizes the contributions
of the science of psychology to promote and
maintain health, prevent illness, and identify
causes related to health, illness, and wellbeing.
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Titles Behavioral MedicineMedical
PsychologyPsychosomatic MedicineHealth
Psychology
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Requirements Ph.D. in Psychology Prefer
Specific graduate training and graduate
internship in Clinical Health
Psychology State License in Psychology
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Areas of WorkAcademic InstitutionsMedical
Centers / HospitalsResearch InstitutionsPrivate
PracticePrimary Care Practices
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Top Three Professional ActivitiesClinical
Practice 65Research 55Teaching /
Supervision 50
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Clinical FocusIndividual PsychotherapyGroup
PsychotherapyPsychological TestingTeaching
Family Therapy
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Specific Areas of Clinical FocusCardiologyNeur
ology Pain ManagementSmoking CessationStress
ManagementDiabetesCancerPulmonary Diseases
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Cardiac PsychologyPrevalence 4,000 People
in the U.S. suffer from myocardial Infarction
(MI) each day 1 out of 5 Americans
have an MI before the age of 60
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Cardiac Risk FactorsModifiable
Non-ModifiableTotal Cholesterol Age and
LDL MaleDiabetes Family
HistorySedentary Personal History
LifestyleSmokingObesityStressPsychosocial F
actors
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Major Psychosocial VariablesType A
BehaviorAnger and HostilityChronic
StressJob StrainExhaustion Social
IsolationDepression
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CharlieCharlie is referred to you by his
cardiologist.The referral reads Stress
Management.Charlies wife calls and makes
the first appointment.Charlie cancels the
first appointment but attends the second with
his wife.
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CharlieAssessment Diagnostic
Interview Psychosocial Mental
Status Medical history Psych Hx /
Sx Psychological Testing ?
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Charlie 48 years old white male Family
history of heart diseaseFather died of a
heart attack at age 50 yearsOlder brother
Fred is a cardiac cripple.
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CharlieMarried (second time) for 25
years.Oldest son (22 years) is in
college.Has one daughter still living at home
(16 years).
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CharlieCompleted 4 years of collegeDegree
in Criminal JusticeWorks as a prison guard
in a low security federal prison for men.
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CharlieSmokes 1.5 to 2 packs of cigarettes
per day.Does not exercise and really
struggles to meet physical demands of
job.Drinks 1 to 2 beers per night, usually
after work. Diet SAD
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CharlieHas no friends outside of a few
co-workers that he occasionally has a beer with
after work.Does not attend church with his
wife and daughter.Does not have much
contact with other family.
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CharlieNo significant past
medical history.No significant past
mental health history.No family history of
mental health issues.
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CharlieCharlie presents as alert and
oriented in all spheres. Walks with a cane,
poor posture.Does not make good
eye contact.Speech is normal.
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CharlieMood seems depressed.Affect is
flattened.Range is restricted.He reports not
knowing why he is here and denies any problems.
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Charlie Talk with wife? Important Issues
to address?Build rapport?
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CharlieWife presents as very supportive of
Charlie.She reports that she is worried about
him He tends to work too hard.Is not
sleeping at night.He is normally controlling
with a temper now worse.
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CharlieIssues to address?
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Issues to address?Personality factorsGeneral
stressWork stressSmokingAlcohol?Exercise
Diet
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Issues to address? Mood depression?- Anxiety?
SleepSocial Isolation
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CharlieRapportHow can I help?What does
Charlie want?Depression / Anxiety / Fear
/Denial?Start with medical and work to
psychological
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Other thoughts about Charlie?
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Questions?Thank You