Self-assessment in clinical health psychology: a model for ethical expansion of practice.

Society expects autonomous professions to ensure the competency of it practitioners, and professions should facilitate the continuing education and training of its members. Given the shift from psychology as a mental health profession to that of a health profession, the authors propose a self-assessment model for the individual practitioner to gauge his or her readiness to provide professional service in expanded areas of practice. This model could also be useful to the American Psychological Association, state psychological associations, and other purveyors of continuing education programs in systematically developing postgraduate experiences. A template for self-assessment that reflects well-accepted core domains of knowledge and skills is presented.

Psychology's future in medical schools and academic health care centers.

An exciting challenge exists for psychology to establish itself in the general health care delivery system. Advances in treating physical as well as emotional disorders offer the discipline the chance to expand its traditional and formerly limited role. Convincing empirical evidence suggests that psychology can simultaneously improve health care treatment and reduce its costs. Opportunities and obstacles on the path to success in this expanded venture are examined.

Prednisonephobia.

The use of chronic systemic corticosteroids in allergic diseases should be restricted to cases where these agents are essential. Potentially fatal asthma and idiopathic anaphylaxis are examples of essential need for prednisone. The usual dose requirements on an alternate day regimen are often modest in these diseases, and complications of steroid therapy are minimal and are of no major concern particularly when the alternative may be a fatality. In spite of these facts, certain patients have a phobic response to the requirement for prednisone therapy. We report seven cases of prednisonephobia and classify this phobia as interpersonal, iatrogenic, bibliophilic, or parental. Some of these phobic reactions may seriously interfere with medical management or patient survival. An information sheet is included which may help certain of these patients.

Postdoctoral education and training for clinical service providers in health psychology.

It was recommended by the 1983 National Working Conference on Education and Training in Health Psychology (Stone, 1983) that 2 years of postdoctoral education and training be mandated for future licensed health service providers in health psychology. The background for requiring this postdoctoral training, a model for education, criteria for developing programs, issues of funding, and a rationale for accepting this mandate are presented. Highlighted are the stable and consistent growth of health psychology, the need to expand the period of clinical training to meet the many advances in the field, and the challenges that exist for the fully trained clinical health service provider.

Police-referred psychiatric emergencies: advantages of community treatment.

Police traditionally have brought persons they define to be in need of psychiatric intervention to state hospitals. However, as large state facilities decline, community mental health centers must be prepared to receive these individuals. The present study defines the client population that police bring to a large, urban community mental health center. In addition, a two-year follow-up compares the dispositions of those persons brought by police to the community mental health center with the outcomes for patients treated at a state facility. Treatment benefits inherent in such a community-based program are discussed.