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Working in health psychology

By Evelyn Howe

As a student I mixed socially with medical and dental students who, when they graduated, asked my advice about managing their patients. I had none to give them, and this inspired me to undertake my doctoral research in health psychology. I am the first woman to hold a PhD in Dentistry, awarded by the faculty of dentistry in Australia, but for me, my career as a health psychologist happened by accident.

I practise in the Specialist Medical Centre of a rehabilitation hospital. On a typical day I see patients who are in the process of recovery from injury and illness: they may have suffered strokes, have acute exacerbation of chronic disease, been in a motor vehicle accident or be experiencing complications and side effects of illness or its medical treatment. I also hold a part-time senior lectureship in dentistry at the University of Sydney where I teach communication skills and patient management.

At the Centre I am part of a multidisciplinary pain management team that runs group programs in key areas of rehabilitation - goal setting and motivation, pacing, stress management and health behaviour change. Medical case conferences are an interesting aspect of my work, and involve planning patient treatment in a team context. I also work on the development of behaviour modification programs for patients with neurological injuries and several times during the year I run in-service programs for hospital staff.

Business and government organisations use my consultation services to address employee health issues and provide health services in employee assistance programs. Recently I was involved in the promotional "Miles of Smiles" program for the oral health of preschool children.

In clinical areas I have provided psychological treatment in relation to menopause, chronic pain, multiple sclerosis, burns, cancer, oral dysfunction, abnormal gag reflex and lymphoedema as a member of a medical or dental team. I have also been privileged to work as an executive member of the APS College of Health Psychologists.

Having a varied educational background in psychology has proved fortunate as it has enabled me to be an eclectic practitioner rather than one wedded to a specific school of thought. This has been helpful in health psychology where I have to develop treatments that use the core principles but with a dash of creativity, because best-practice treatment protocols are often unavailable.

Countless people have influenced my work and my life, providing me with inspiration for my research and holding my hand when needed. Colleagues have enthused me, the dental profession taught me how to run a private practice, the medical profession taught me how to work in teams, and psychology Professor Kim Ng once told me: "Psychology is really common sense but never forget, Evelyn - sense isn't all that common".

As a health psychologist you are in the privileged position of seeing people as they really are, without their masks of good behaviour. Sometimes, when you see the horrible things that can happen, the world seems a very scary and unsafe place and at these times you must rest and nurture yourself. But then you have the unsurpassable experience of seeing what people can overcome, how truly great the human spirit is. At these times all you can do is feel humble, honour your patients and give thanks.

Health is the keystone to economic recovery and development, and as such there is an urgent need for us to promote health in developing countries. We also need to know more: we need a stronger, more vibrant and resilient theoretical basis for health psychology. As well as researching in every area of clinical disease, there should also be a focus on prevention and the application of our skills to the promotion of health rather than just treatment of illness.