Ronald H. Rozensky

Preparation for the delivery of telehealth services: A self-study framework for expansion of practice.

Linked to increasing consumer demand for access to health care information and to the worldwide expansion of telecommunication services, telehealth has emerged as a new domain of practice within professional psychology. Psychologists who plan to incorporate telecommunication technologies (e.g., Internet and point-to-point videoconferencing) into their practices should first conduct a self-assessment and then enhance their knowledge and skills in using these alternative forms of service delivery. The current article provides a self-study framework, known as STEPS, for psychologists to use in planning for telehealth practice. STEPS focuses on 5 key domains of telehealth practice and organizes specific self-study questions around each of these domains.

Commentary: Healthcare Reform and Psychology's Workforce: Preparing for the Future of Pediatric Psychology

Upcoming changes to the healthcare delivery system, detailed in the Patient Protection and Affordable Care Act (ACA; Public Law No: 111–148, March 23, 2010), focus on the growing expectation that interprofessional organizations (institutional practices such as accountable care organizations (ACOs) and patient center healthcare homes) will become the nexus of the delivery of efficient, cost effective, and quality healthcare services (Orszag & Emanuel, 2010; Rozensky, 2011). If the legislation survives the legal battles currently being waged, the healthcare delivery system will look very different by the end of this decade (Clay, 2011). The healthcare workforce of the future must be prepared to enhance quality of patient care utilizing defined, interprofessional competencies as they practice within an increasingly evidence-based, team-based, integrated care system—from prevention to primary to tertiary care—and for patients and families across the lifespan (Institute of Medicine, 2001; Wilson, Rozensky, & Weiss, 2010). This article describes several challenges and opportunities facing professional psychology given the upcoming demands of the ACA and evolving healthcare system. We argue that preparation for increased institutional practice is required and that several philosophical and practical changes will be necessary as our profession adapts to this new healthcare system. The interprofessional strengths of pediatric psychology are discussed in particular and specific opportunities and recommendations are offered to enhance the future of pediatric psychology in (the new) healthcare. Some Questions Professional Psychology Might Answer to Prepare to Successfully Participate in Upcoming Changes to the Healthcare System

Health care reform: preparing the psychology workforce.

This article is based on the opening presentation by the author to the Association of Psychologists in Academic Health Centers’ 5th National Conference, “Preparing Psychologists for a Rapidly Changing Healthcare Environment” held in March, 2011. Reviewing the patient protection and affordable care act (ACA), that presentation was designed to set the stage for several days of symposia and discussions anticipating upcoming changes to the healthcare system. This article reviews the ACA; general trends that have impacted healthcare reform; the implications of the Act for psychology’s workforce including the growing focus on interprofessional education, training, and practice, challenges to address in order to prepare for psychology’s future; and recommendations for advocating for psychology’s future as a healthcare profession.

The institution of the institutional practice of psychology: health care reform and psychology's future workforce.

Implications for the future of professional psychology are discussed and related to the Patient Protection and Affordable Care Act, patient-centered health care homes and accountable care organizations, and the growing importance of interprofessional competencies in health care. The need for increased information about the psychology workforce is related to the history of the institutional practice of psychology and how that data must be used to plan for the supply of psychologists required to meet the service demands of the changing health care system. Several challenges to the field of psychology are offered, along with steps that must be taken by the profession to prepare for increased institutionally based health care services in the future. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

A Decade of Clinical Psychology in Medical Settings: The Short Longer View

The progress and accomplishments of psychology in medical settings over the past decade since the publication of the Handbook of Clinical Psychology in Medical Settings (J. J. Sweet, R. H. Rozensky, & S. M. Tovian, 1991) and the subsequent founding of the Journal of Clinical Psychology in Medical Settings (JCPMS) in 1994 are highlighted. Areas of progress and accomplishments reviewed include professional developments with our field, roles and services provided by psychologists, education, training and research issues, and program administration in medical settings. The current status of, and possible changes in, medical settings is identified. Future challenges and opportunities for the profession are discussed.

A shooting incident in an elementary school: Effects of worker stress on public safety, mental health, and medical personnel

The effects of impact of event and five categories of worker stress were studied with 140 police, fire, medical, and mental health personnel who were involved in emergency service work following a shooting in an elementary school. A questionnaire distributed 6 months after the incident was utilized. Public safety personnel reported a recollection of significantly fewer intrusive thoughts than medical and mental health professionals immediately following the incident. Groups did not differ in intrusive or avoidance scores on the Impact of Event Scale 6 months after the event and all groups showed a significant decrease in both scores over time. Stepwise linear regression showed that a self-reported qualitatively heavy work load predicted intrusiveness and avoidance of thoughts both immediately after and at the 6-month anniversary of the incident. Additionally, time pressure and quantitatively heavy work load also predicted avoidance score at the time of the incident. Results are discussed in terms of control models of anxiety and as foci for debriefing with affected personnel.

Clinical Psychology in Medical Settings

The history of psychology has been traced through the behavior of early civilizations covering a span of 4,000 years (Kimble & Schlesinger, 1985a,Kimble & Schlesinger, 1985b). The history of modern scientific psychology is relatively brief, encompassing a little more than a century. Nevertheless, Pion (in press) noted that, since 1977, the demand for doctoral psychologists, as reflected by employment figures, has actually increased more rapidly than the employment of all other doctoral scientists. Further, Pion cited National Science Foundation statistics indicating that, in 1986, 94% of doctoral psychologists were actually working in psychology. This figure represents a higher percentage than in any other scientific field.

Clinical psychology in medical settings: Psychology's role in health care

The number of clinical psychologists working in medical settings has grown along with the range of services provided by psychologists to patients with a multitude of medical problems across the lifespan. Medical care cost savings brought about by these psychological interventions is highlighted along with issues of public policy and specialization of training. The opportunity for ongoing development of clinical psychology in medical settings is described as unlimited and the mission of the newJournal of Clinical Psychology in Medical Settings is presented as supporting that growth.

Freestanding Psychology: The Only Way in Academic Health Centers

Psychology must assure that its programs, faculty and staff, clinical services, research enterprises, and training programs must be freestanding in Academic Health Science Centers and not organized within any other department except a freestanding Department of Psychology. Without this autonomy, it is argued, Psychology can never reach its full potential as a health care science and profession in hospital and academic health care center settings. This thesis is argued on the basis of issues of finances, credentialing and privileging, role modeling for psychologist trainees, the importance of Psychologys persona within the health science center and in the eyes of the public, and finally, academic freedom.

Psychology in Academic Health Centers: A True Healthcare Home

This article is based on the invited presentation by the author at the American Psychological Association’s Annual Convention, August 4–7, 2011, upon his receipt of the Joseph D. Matarazzo Award for Distinguished Contributions to Psychology in Academic Health Centers presented by the Association of Psychologists in Academic Health Centers. This article relates the history, roles, and responsibilities of psychologists in academic health centers to the ultimate survival and success of professional psychology. It describes implications of the Patient Protection and Affordable Care Act (ACA) on the institutional practice of psychology including how psychology’s place in academic health centers positions the field well for the future of healthcare reform. The article provides several recommendations to help professional psychology prepare for that future of integrated, interprofessional healthcare.