Edited and reviewed by: Axel Cleeremans, Free University of Brussels, Belgium
*Correspondence: Gianluca Castelnuovo
This article was submitted to Clinical and Health Psychology, a section of the journal Frontiers in Psychology
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The Specialty Section of Clinical and Health Psychology covers a wide range of topics related to clinical psychology, health psychology, psychotherapy, counseling, rehabilitation psychology, neuropsychology, and all fields of psychological interventions in traditional clinical settings (public and private hospitals, clinics, services, laboratories, etc.) as well as innovative clinical settings (remote outpatients' clinics, tele-health, e-health, and mHealth based settings). The connection between medicine and psychology in the multidisciplinary and integrated treatment of main organic and mental diseases is a key achievement of the biopsychosocial approach in the modern era of clinical and research activities in health field. This section welcomes contributions concerning the guidelines, protocols, investigations, and researches in clinical and health psychology conducted in different settings, including articles in psychocardiology, behavioral medicine, psycho-oncology, psychogeriatry, pain management, healthy lifestyle programs (such as weight loss programs), neuropsychological rehabilitation, and all other medical areas in which psychology is significantly present. I welcome clinical trials, observational studies, research articles, reviews, meta-analysis, perspective and opinion articles, short reports about evidence-based practice in clinical and health psychology, empirically supported psychological treatments to offer a stronger scientific perspective on psychological applications in health settings.
The major aim of this article is to discuss current unresolved and critical problems in clinical health psychology-psychotherapy as well as to propose new and consider old areas of investigation to be published in this journal section.
Clinical psychology faces relevant challenges in the twenty-first century. According to Levin and Potts (Levin and Potts,
Moreover, clinicians do not commonly adopt empirically supported treatments (ESTs) (Foa et al.,
The situation is not simple neither for psychiatry that, according to a recent systematic review and meta-analysis of psychiatry, psychiatric treatments, and psychotherapy, underlined that at the beginning of the twenty-first century, “people have the (quite legitimate) need to be listened to by someone who takes them seriously and who is trying to understand them with their problem. Accordingly, the reason why psychologists/psychotherapists are in some instances preferred over psychiatrists could be that, in the eyes of the public, psychologists and psychotherapists are more ready to provide patients with an opportunity to talk over their problems (Holzinger et al.,
Moreover, decades of research have not provided enough knowledge about the active components and mechanisms of change for many evidence-based treatments (Longmore and Worrell,
Finally, the financial support for psychosocial treatment development has been significantly reduced (Gaudiano and Miller,
Fortunately, the last 40 years have seen huge progress in evidence-based psychological therapies, especially cognitive-behavioral therapy (CBT; Layard and Clark,
Castelnuovo (
Beutler (
Even if positive long-term effect on health has been largely demonstrated by ESTs (Castelnuovo,
Steps to legitimize clinical psychology in the health care system have been clearly indicated in a recent paper by Castelnuovo et al. (
Clinical Health Psychology (or Clinical and Health Psychology) is a growing and promising field of the clinical psychological science and practice. According to a pioneering editorial by Dornelas, “Increasing numbers of psychotherapists have become interested in applying the science of psychology to problems of health and illness. Today, there are many psychologists, medical social workers, and psychiatrists who provide psychotherapy in a variety of primary-care and rehabilitation settings. Health psychology is an extraordinarily broad field” (Dornelas,
Although medical field alone could be considered “a soul without psychology” (TIME magazine—Dec. 24, 1956), there is fortunately no medical area without a corresponding field in Clinical Psychology, e.g., psycho-cardiology, psycho-oncology, psycho-geriatrics, psycho-pneumology, psycho-endocrinology, psycho-neurology and neuropsychology, psychology in pain management, and psychology in surgery, among others, are only some examples of the significant effect of psychology on clinical settings.
After the Lancet warned, “No health without mental health” (Prince et al.,
In 1977, Engel presented the biopsychosocial model as “a blueprint for research, a framework for teaching, and a design for action in the real world of health care” (p. 129, Engel,
Even if different ways to treat a mental disorder are available, for example, focusing on individual, relational, familiar, social, or cultural issues, one of the main trends in official medicine is to provide an intervention limited to the individual and biological levels (psychopharmacological one considering mental health area). If a problem of a severe depression is generated at a biological, molecular, and neurological levels, an effective treatment should focus on a specific level; however, if a person presents difficulties limited to peculiar and selected situations and contexts (such as at work but not in the family or alone but not with other people), the most appropriate treatment would be questionable. Should the bio-pharmacological approach be considered the best treatment according to the “similia similibus curantur” principle (Longino,
Many psychiatrists have criticized the continued use of psychopharmacological treatments instead of psychological interventions (Moncrieff,
According to the Moncrieff et al. (
Charney noted that the future of diagnostic classification of mental disorders could be based on neuroscience, biology, and genetics, with the creation of a possible Pathophysiologically Based Classification System, perhaps in DSM 6, forgetting another time Hippocrates' principles and the biopsychosocial model (Charney et al.,
I hope that in the next years, this specialty section could become a functional platform for clinicians and researchers to discuss empirical findings, opinions, theories, methods, and hypotheses in clinical health psychology.
To motivate the researchers in this area, I propose 10 key topics that could be interesting and promising drivers of research in our field.
(1) Integration between Psychological Treatments-Psychotherapy and Pharmacology.
The future research has to move from an old logic that emphasizes the contrast between pharmacological treatments and psychological ones to an integrative approach due to a large amount of evidence for the effectiveness of combination treatment over pharmacotherapy or psychotherapy alone, with depression being a typical example to consider (Guidi et al.,
(2) Integration between psychological treatments-psychotherapy and neuroscience.
Neuroimaging evidences can help us understand psychological and psychopathological phenomena to better develop our knowledge of models and treatment procedures (Allen et al.,
(3) Development of new areas of connection between clinical health psychology and medicine not yet explored.
Next to traditional areas of collaboration between medicine and psychology, such as psychocardiology (Ginsberg et al.,
(4) Integration of bio-physiological data with psychological ones.
The psychosomatic field that focuses on the direct psychobiological effects of cognitions and emotions on the pathophysiology of medical diseases is a growing field of research (Guidi et al.,
(5) Focus on Positive Psychology.
Positive psychology and positive psychotherapy are interesting new approaches in mental health care, and more investigation is needed in Frontiers journal (Clinical and Health Psychology section) too (Schrank et al.,
(6) Integration of clinical psychological protocols with latest technologies, monitoring strategies, mHealth, and virtual reality.
The use of mHealth platforms and new technologies could help clinicians in some critical situations provide the continuity of health assistance after a traditional period of inpatient care and opportunities to monitor and motivate patients, specifically in the follow-up phase of the treatment (Castelnuovo et al.,
(7) Adapting clinical psychological protocols to special populations and contexts (chronic care management, elderly or active aging, immigrants, etc.).
Clinical health psychology has to develop new protocols and adapt old ones to new emerging populations and contexts, such as chronic patients (Castelnuovo et al.,
(8) Study of mediators and moderators of change in clinical psychology and psychotherapy.
The efficacy of the empirically supported treatments (ESTs) from the evidence-based medicine (EBM) perspective has already demonstrated, and the Common Factors approach typically considers each psychological interventions positively due to the presence of successful common core elements (Castelnuovo,
(9) Development of assessment techniques in clinical health psychology.
New validated questionnaires, scales, and semi-structured interviews need to be developed to give health care professional reliable and valid psychometric tools that would have a clinical effect (Belar et al.,
(10) Delivering guidelines and recommendations for applications with clinical impact-.
To achieve a real impact in the clinical community, research has to fill the gap between theory and practice, providing “toolkits” for clinicians, such as guidelines or recommendations. The Italian Consensus Conference on Pain in Neurorehabilitation that produced specific recommendations in clinical health psychology is one example that should be followed (Aloisi et al.,
As underlined in 2010, “to better exploit its latent power, Clinical Psychology has to establish a better alliance with Medicine it in all clinical acts and to show a better scientific aptitude. Guidelines, protocols, and investigations using an Evidence-Based approach need to be developed in all psychological areas that are concerned with the treatment of main organic and mental diseases, specifically, more space has to be dedicated to Evidence-Based Practice in Clinical Psychology and Empirically Supported Psychological Treatments” (Castelnuovo,
Clinical Psychology, alternatively Clinical Health Psychology, cannot forget its deep, specific, and peculiar psychological model that built on the biopsychosocial framework (Engel,
The author confirms being the sole contributor of this work and approved it for publication.
The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.