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Health Psychology in Occupational Health: What is it and how can it help? 

By Dr Julie Denning

Published 11 December 2023

I always knew that I wanted to be a psychologist, since observing an educational psychologist on a work placement when I was 17 and seeing the difference it made to children’s and their parents’ lives, it was what I wanted to do. I didn’t stick with educational psychology, I didn’t want to teach (you had to, way back when) and this became a barrier. 

Instead, I opted for Health Psychology. I loved it. The MSc was interesting; my research thesis investigated condom use behaviours in teenagers at an FE college. As a shy 21-year-old, this was a bit of a challenge as most of the students were only a few years younger than me! My PhD was a baptism of fire and took me longer than expected as I needed to pay the rent and so was a jobbing researcher / Lecturer / PhD student for 6 years.

My real break, although I didn’t realise it at the time was when an occupational health physician contacted me out of the blue. He and his colleague, an occupational health physiotherapist, were trying to solve their mystery of how to help a small but significant group of patients experiencing persistent pain who weren’t recovering using traditional physiotherapy approaches. They knew they needed some psychological input, and it turned out that I was their Gal.

I know now that this was my first role as a health psychologist in occupational health.

But let’s rewind a bit. What is a health psychologist?

I am more often than not introduced as a clinical psychologist, even after stating my health psychologist status. This is as frustrating as being called Julia when my name is Julie. Same derivative but very different. So, for clarity here is the definition of health psychology as outlined by the British Psychological Society:

The goal of health psychology is to study the psychological processes underlying health, illness and health care, and to apply these findings to the promotion and maintenance of health, the analysis and improvement of the health care system and health policy formation, the prevention of illness and disability, and the enhancement of outcomes for those who are ill or disabled.​ (https://www.bps.org.uk/member-networks/division-health-psychology​)

What is interesting for me is when this descriptor is cross-referenced with ACAS’s explanation of occupational health:

 

An employer might want to use occupational health to help:

  • when an employee is struggling with their physical or mental health
  • make the right reasonable adjustmentsfor disabled people at work
  • when an employee has been off sick for a long time or is returning to work after sickness absence
  • reduce the amount of time people need to take off sick
  • keep to other health and safety regulations
  • control risks to mental health, such as too much pressure at work, bullying and harassment
  • Occupational health could be through the employer’s occupational health service or an outside agency.

https://www.acas.org.uk/using-occupational-health-at-work

 

Health Psychologists are here to study the processes underlying health illness and healthcare to enhance outcomes for those who are ill and disabled and occupational health helps employees struggling with their physical or mental health.

Health psychology can be directly applied to help occupational health achieve its goals. This is what I have been doing now for the past 23 years in my role as a health psychologist working within occupational health and vocational rehabilitation. Let me explain from four different perspectives:  1) wellbeing, 2) absence management, 3) OH staff support, 4) OH departmental support.

Wellbeing:

Health psychologists are very well placed to support occupational health providers in developing health and wellbeing interventions. We are trained in research methods and data analysis as well as the design and delivery of interventions to change health behaviours. Classic examples include helping people to eat a balanced diet, take regular physical activity or stop smoking. We use behaviour change models and theory to help formulate our thinking and create an underpinning and framework for the interventions that we design. We are data-driven as a profession, both quantitively and qualitative and will always be focused on evaluating what we design to ensure that it is fit for purpose and that it works. In my career, I have developed many an intervention and services for employees, and I have been dogged about collecting the best data I can in a real work research setting. This isn’t always easy I might add and challenges my PhD training!

Absence management:

Health psychologists are well versed in supporting people to manage their illness whether it be pain, fatigue, adjustment, fears about symptoms recurring or flaring up and coping. We are trained on individual differences and automatically therefore take an individualized and holistic approach to our understanding of health behaviours. We have numerous models we can draw upon. For those of you who are nerds like me, check out the illness representations model (Leventhal et al 1991), the stages of change model (Prochaska and DiClemente, 1982), the theory of planned behaviour (Ajzen 1991), or if you’re feeling it, head over to the COM-B Model (Michie et al 2011).  All these help us to understand what factors we need to take into consideration when helping someone who is struggling with their symptoms to self-manage and improve their quality of life. Implicit in this (and something I am working on to make explicit as my role as Chair of the Vocational Rehabilitation Association) is the role of work as a health outcome and putting that at the heart of interventions to reduce sickness absence. This is a work in progress: watch this space. In any case, a health psychologist can help you to unpick your reasons for sickness absence on many levels and will provide you with helpful solutions.

OH Staff:

I have consistently delivered training supporting allied health professionals, nurses, intercalated medical students and even trainee psychiatrists on how to apply psychological theory to improve health outcomes. I have done this through training, mentoring and supervision and upskilling health professionals in having more meaningful conversations with their patients to truly understand their perspective and thereby enable them to achieve improved health outcomes. I will never tire of training in the biopsychosocial approach and still, all these years later, marvel at how most clinicians avoid asking questions about emotions. I still have never had an answer to my question ‘What are you most afraid of when asking about mood?’  My hunch is fear of enabling suicidal action. In my experience to date, I am more concerned when people don’t tell me about their emotions than when they do. Upskilling clinicians has been one of the most rewarding elements of my career as a health psychologist. So often a patient doesn’t need a psychologist, rather they need, say, an upskilled physiotherapist who is comfortable exploring (all) the elements of the biopsychosocial model to facilitate behaviour change and in many cases make a huge difference to someone’s life.    

OH department: 

Health psychologists can also support OH at a departmental level helping them to better understand the health status and general wellbeing of their employer’s workforce. They can help with wellbeing surveys, analysis of big organizational health data, implementation of tools such as the HSE management tools, wellbeing policy design and strategy development. In response to findings, they can design initiatives to help the whole group as well as the individual with, for example, targeting wellbeing initiatives.

I am sure that there are many other ways that health psychologists can help OH and I am always happy to have my brain picked, so I welcome conversation and discussion on this. We are a yet untapped profession that could be just what is needed to help OH. Just as I did all those years ago on my first OH gig.

I hope this article has helped go a little way to your understanding and you will now be able to say…

 

‘you’ll need a health psychologist to help you with that…’

References:

Ajzen, I. (1991). The Theory of Planned Behavior. Organizational Behavior and Human Decision Processes, 50, 179-211.

Leventhal, H., Benyamini, Y., Brownlee, S., Diefenbach, M., Leventhal, E. A., Patrick-Miller, L., & Robitaille, C. (1997). Illness representations: Theoretical foundations. In K. J. Petrie & J. A. Weinman (Ed.), Perceptions of health and illness: Current research and applications (pp. 19–45). Harwood Academic Publishers.

Prochaska, J. O., & DiClemente, C. C. (1982). Transtheoretical therapy: Toward a more integrative model of change.

Susan Michie,1 Maartje M van Stralen,2 and Robert West3 The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implement Sci. 2011; 6: 42.

Dr Julie Denning | Linkedin

Dr Julie Denning, CPsychol (Health)

Managing Director Working to Wellbeing

Supporting people back to work

Chair, Vocational Rehabilitation Association

2021 VRA Winner

 

OH Today Volume 30 Issue 3
Front cover of OHJ Today Volume 30 Issue 3
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