Madeline Foster, MSPH
Clinical Psychology Ph.D. Student
School of Psychology
Fielding Graduate University
It is not uncommon for psychology to be a second career. Often, those of us who have had other academic and professional experiences benefit from transferable skills that enhance our ability to be successful as psychologists. Now in the second year of my doctoral studies in clinical psychology, my previous academic and career experiences in public health have offered a unique opportunity to approach my clinical practice from a different perspective. Below, I reflect on some of the core public health principles that I apply to my clinical practice and how they can be used to enhance our clinical work as psychologists.
A Population Mindset
As psychologists, much of our training focuses on becoming skilled clinicians, able to help the person sitting directly in front of us in a session. However, as I have begun my first patient interactions, I cannot help but notice the questions ingrained in me from my public health training – How many others are out there unable to access the care I am providing right now? What can I learn from this patient that might help me expand care opportunities to reach these people? What are the barriers to treatment and healthy behaviors this patient can help me understand? By encouraging psychologists to continually ask such questions and to use their individual patient encounters as a source of information and inspiration for expanding care and taking a global perspective, we start to do the imperative work of thinking on a population level.
The Determinants of Health
While many of us know the importance of taking a holistic approach when treating chronic physical conditions like diabetes and heart disease, holistic factors must be examined with the same scrutiny when preventing and managing psychopathology. Public health perspectives revolve around several determinants of health including social factors, physical influences, and environmental considerations. Mental health also sits inside a complex web of factors that can influence the prevalence and severity of psychological disorders, as well as access to care. While determinants of health are often evaluated by psychologists during the intake and diagnostic process, they must be also considered throughout the process of psychological intervention. Given that the holistic nature of health has been deeply ingrained in me from my public health training, I approach every clinical encounter with the whole person front of mind. I often find myself considering an individual’s diet, physical activity habits, housing, insurance status, and social network while I work with them to identify how I can help them improve their health beyond psychotherapy intervention.
Prevention is Key
During our training as psychologists, we specialize in the management and treatment of mental health disorders. However, it is just as important that we put our professional resources into early interventions, education, and health promotion, to improve psychological health and prevent mental health disorders. While there is no way to completely prevent mental illness, there are several protective factors that can reduce the risk of psychopathology developing and interfering with an individual’s quality of life. By educating and supporting the public through advocacy, psycho-education, and policy work to make better lifestyle choices, we can encourage the conversation around mental health to encompass prevention, rather than just cures. I hope that over my career as a psychologist, we as a profession will use our collective expertise to put as much effort into prevention as we currently do treatment.
Conclusion
Ultimately, my public health training has shaped my view of providing healthcare as a psychologist. While many of my applications of public health principles to clinical practice may seem apparent, it is worth reminding ourselves that as health care providers we have a duty to think beyond the individuals we provide direct care to.