Journal of Clinical Psychology in Medical Settings最新文献

Psychologists working in medical and academic health settings bring unique skills that make them well-suited for policy advocacy. Their training in trust-building, translating evidence, and understanding context can be applied to influence policies that impact access, quality, and equity in healthcare. This article explains how clinical and counseling skills align with policy engagement and shows their relevance through examples such as Medicaid reform, telehealth parity, and racial equity impact assessments. It introduces conceptual frameworks and practical strategies to demonstrate how psychologists can participate in coalition building, communication, and policy evaluation. Training recommendations emphasize the importance of incorporating advocacy skills into graduate programs, offering mentorship, and providing ongoing professional development to equip psychologists for leadership in evolving healthcare systems. Advocacy is presented not just as a supplement to practice, but as a natural part of psychologists' professional identity. By embedding advocacy into education and practice, psychologists can promote health equity and help ensure policies are based on both scientific evidence and lived experience.

Academic health center (AHC) psychologists finding novel leadership pathways, both within and outside their AHCs, can provide valuable opportunities for professional enrichment and growth. In this manuscript, we describe how psychologists' training, experiences, and skills contribute to leadership success in traditionally medically-led organizations (MLOs). We also describe how four ACH pediatric psychologists, all at different career stages, found unique leadership roles within traditionally medically-led organizations (MLOs). For each leadership role example, we describe (1) how career stage, expertise, and values intersect with the leadership opportunity, (2) the psychologist's organizational context and leadership role structure, and (3) the psychologist's leadership contributions and collaborative strategies. We also provide concrete recommendations to other ACH psychologists who wish to explore leadership roles throughout their careers.

The 2025 Association of Psychologists in Academic Health Centers (APAHC) national biennial conference was held in Saint Petersburg, Florida, May 1-3, 2025. Our conference theme was "Impact of Psychology in Complex Healthcare Systems: Opportunities, Innovation, and Intentional Growth," with a goal of showcasing the meaningful work academic health center psychologists do around the United States to enhance care and care access for the communities in which they live and work. The conference included invited plenary speakers as well as concurrent speakers who were selected based on a competitive application process. This special issue includes invited manuscripts from plenary speakers and concurrent speakers. All manuscripts were peer reviewed by field experts. The conference co-chairs, Drs. Melissa A. Faith, Ph.D., ABPP, and Lisa Ramirez, Ph.D., ABPP, served as guest editors for this special issue, with editorial support from JCPMS Editor Dr. Andrea Bradford. This article provides a brief overview of the conference theme as well as a framework for this special issue.

Child-Adult Relationship Enhancement (CARE) is an evidence-informed approach to promote positive child-adult relationships in youth with behavior problems or traumatic stress. Implementing CARE in community settings may extend accessibility to evidence-based practices (EBP) for children in underserved areas. The present study examined health professionals' perceptions of CARE. Participants were 277 professionals from a statewide training initiative including early childhood educators (n = 178), allied health professionals (n = 48; speech, occupational, physical therapists), and behavioral health clinicians (n = 51) completing CARE training. Participants completed the Evidence-Based Practice Attitude Scale (Aarons (2004) Mental Health Services Research 6:61-74) (pre-training). Post-training, participants completed two scales created for this study which assessed participants perceptions of the training experience. Structural equation modeling evaluated differences in health professionals' perceptions of CARE and EBP. CARE was the most well received by allied health professionals, who reported greater favorability of EBP relative to behavioral health clinicians (0.12, 95% CI [.04, .24]). Additionally, results indicated greater favorability of EBP-mediated perceived usefulness (0.17, 95% CI [.07, .31]). CARE is a well-received training for professionals working with youth. Interprofessional training may enhance developmental and behavioral outcomes for youth, and our findings suggest particular receptivity to CARE by allied health professionals and implicate EBP favorability as a key driver.

Innovative behavioral health interventions in medical settings are often constrained by financial and structural barriers within the U.S. health insurance system. Providers are caught between two billing pathways: DSM-based codes, which do not reflect health-focused interventions, and health and behavior codes, which remain inconsistently recognized and poorly reimbursed. This disconnect makes it difficult to sustain innovative care despite clear clinical benefit. Moreover, it stifles clinical advancements and contributes to health inequity. The Comfort Ability^® Program (CAP) intervention, a family-based, group treatment for pediatric chronic pain, illustrates both the promise and the challenge of this landscape. The CAP intervention integrates CBT, ACT, MI, and behavior management strategies in a comprehensive one-day format. It has been adopted by more than 45 healthcare institutions worldwide and demonstrates improved outcomes and reduced barriers to care. However, despite clinical success and scalability, CAP faces many reimbursement obstacles in the U.S., reflecting broader systemic issues. This manuscript reviews psychology billing reforms, outlines system-level challenges working within medical settings, and discusses real-world implications for providers striving to deliver integrated, patient-centered care. We propose concrete steps to support clinicians in navigating current barriers while advocating for system-level reforms that can sustain innovation in behavioral health delivery.

The SARS-CoV-2 (COVID-19) pandemic strained healthcare systems and professionals. Psychologists were not immune from these effects. This study examined stressors, well-being, and the roles of psychologists in academic health centers during the second year of the pandemic. Members of the Association of Psychologists in Academic Health Centers (APAHC) completed a survey addressing burnout, work capacity, stress, career satisfaction, sources of professional stress, and changes in practices. Items were compared with the 2017 APAHC Membership Survey. Compared to 2017, the 2021 respondents reported increased stress and burnout, as well as diminished work capacity, without decreased career satisfaction. Additionally, the number of professional stressors endorsed by the majority of respondents increased from four stressors in 2017 and seven in 2021 when retrospectively reporting prior to March 2020, to thirteen stressors in post-March 2020 reporting. In 2021, burnout was associated with greater overall stress, perceived faculty stress, fewer hours for relaxation or to pursue enjoyable activities, more non-billable clinical hours, and time spent on non-clinical consultation. Higher stress levels and fewer hours for relaxation were associated with being overextended in one's work capacity. These findings may inform well-being initiatives for psychologists in academic health centers and highlight the imperative for well-being for psychologists.

The rapidly expanding international scope of pediatric psychology presents significant collaborative opportunities as well as ethical challenges. In a quest of common ethics terminology and primary ethical considerations across international borders, we conducted an online survey with open-ended questions focusing on procedures essential to obtaining ethical approval for research with pediatric patients. Participants from 14 countries responded. This report provides an overview of some key international differences and challenges while providing recommendations for addressing each aspect. Key factors include ensuring international collaborators begin ethical planning from inception of the project; identifying pediatric ethics thought and policy leaders in each country; and confirming pertinent policies and procedures in each location.

Artificial Intelligence (AI) has been developed through interdisciplinary efforts since the 1940s, but generative AI and Large Language Models (LLMs) gained unprecedented attention with the launch of ChatGPT by OpenAI in late 2022. As these AI tools have become globally ubiquitous, significant implications arise for clinicians within and beyond healthcare settings. The simulation or emulation of human intelligence through coded heuristics now permeates clinical domains, creating new opportunities alongside ethical challenges that require careful exploration. For healthcare psychologists, regardless of specialty, it has become a priority to remain at the forefront of these technological advances. This includes developing literacy not only in psychological emulation software but also in the rapidly growing hardware that supports AI. Well-informed clinicians must act as responsible stewards of this advancing technology and its application in healthcare. These responsibilities must be approached through the lens of both existing and evolving ethical standards in human psychology. Although these tasks may seem daunting, the urgency, opportunities, and necessity for healthcare psychologists to engage thoughtfully with AI are clear. This engagement ensures that patient care benefits from innovation while upholding ethical principles. Said opportunities and the urgency for healthcare psychologists are discussed.

This paper examines ethical challenges in clinical health psychology through a diversity-informed lens, drawing on insights gained from a 2025 panel discussion at the biannual meeting of the Association of Psychologists in Academic Health Centers (APAHC), held at Johns Hopkins All Children's Hospital in St. Petersburg, FL. The ethically relevant outcomes from the panel centered on four key domains: (1) ethical practice with diverse patients using organ transplantation as an exemplar, (2) ethical oversight in academic medicine and research, including the roles of Institutional Review Boards (IRBs), (3) the implications of grant terminations based on "gender identity" or diversity, equity, and inclusion (DEI) considerations, and (4) the implications of legal challenges to training a health care workforce that represents the populations they will serve. Across these domains, the panel emphasized the importance of advancing ethical practices that address persistent disparities affecting historically underserved communities.