Neil Bockian, Ph.D., is a Professor in the Adler School’s Doctor of Psychology in Clinical Psychology (Psy.D.) program in Chicago, and directs its concentration in primary care and behavioral medicine psychology. He is a practicing clinical psychologist, with extensive expertise in treating patients with medical problems such as chronic pain, spinal cord injury, cancer, multiple sclerosis, and other conditions.
Behavioral medicine and primary care psychology constitute the fastest-growing areas in clinical psychology. Although overlapping in practice, behavioral medicine is the use of behavioral and psychological interventions to ameliorate disease—while primary care psychology is the integration of psychologists into medical settings in order to provide more timely, accessible mental health care to the general population.
The Adler School concentration provides training in both, because the need to better integrate psychologists into the healthcare arena is highly evident. With healthcare costs spiraling out of control, our society is desperately seeking ways to reduce the burden. Approaches such as reducing payment to Medicare providers or applying other budgetary interventions are most prominent. However, primary care psychology and behavioral medicine address the problem in a radically different, and, arguably, better way.
The majority of healthcare costs are attributable to behavior. Tobacco use, excessive eating, the consumption of alcohol and illegal drugs, and unsafe sexual practices are major causes of cancer, heart disease, liver disease, and infectious disease. Primary care and behavioral medicine psychologists can address these behaviors.
In addition, large numbers of people have medically unexplained illnesses. In most cases, a person’s medical symptoms are at least partly related to anxiety. Under excessive stress, the body releases adrenaline, cortisol, and other potent chemicals into the bloodstream—the fight-or-flight response. Gastric distress, fatigue, heart palpitations, high blood pressure, and other problems naturally ensue. Once again, primary care and behavioral medicine psychologists can help address these issues.
By integrating into the healthcare system to reduce patients’ anxiety and promote behavioral change, primary care and behavioral medicine psychologists can facilitate improved health worldwide. The power of psychological interventions surprised me when I first worked in health care settings.
For example, in my own practice and in the literature at large, I found that chronic pain patients’ pain levels are reduced, on average, by about 50 percent through psychological intervention. Similarly, I found the magnitude of the need for psychological services staggering. Estimates indicate that up to 75 percent of primary care patients have unaddressed psychosocial complaints.
In my view, primary care psychology and behavioral medicine are integral facets of social justice and the Adler School’s mission. Primary care psychology is inherently team-oriented and collaborative; in conjunction with behavioral medicine, it reduces the need for unnecessary medical procedures, which benefits individuals as well as society as a whole. We address issues such as health care disparities, and how to reduce them, as part of the curriculum, confluent with the work of the Adler School’s Institute on Social Exclusion and its Center for the Social Determinants of Mental Health. Through behavioral medicine and primary care psychology, prospective practitioners have the opportunity to develop meaningful careers in a growing area of need and social benefit.