UNIT – 2

TYPES OF HEALTH PSYCHOLOGY

1) CLINICAL HEALTH PSYCHOLOGY

 Clinical health psychology refers to the application of scientific knowledge
to clinical questions that arise across the healthcare sector.
 This type of health psychology deals with the application of psychological
knowledge and techniques to the treatment and management of physical
health issues.
 Clinical health psychologists work directly with patients to help them cope
with chronic illnesses, pain management, stress reduction, and adapt to
medical conditions like diabetes or heart disease. They often provide
therapy or counselling to help people make lifestyle changes (like quitting
smoking or losing weight) and develop coping strategies.
 They often work in hospitals, clinics, and private practices alongside other
healthcare professionals.

2) PUBLIC HEALTH PSYCHOLOGY

 PHP is population-oriented. A major aim of PHP is to investigate potential
causal links between psychosocial factors and health at the population
level.
 Public health psychology emphasizes the role of psychological factors in
health at the population level, aiming to promote health and prevent
disease within communities.
 Public health psychologists work on designing and promoting health
programs that can prevent diseases and promote healthy lifestyles in
communities. They focus on large-scale interventions that promote
healthy lifestyles, like campaigns to reduce smoking n improve nutrition,
encourage vaccination n healthy eating habits
 They work in government agencies, non-profits, and academic
institutions.
 3) COMMUNITY HEALTH PSYCHOLOGY
 Community health psychology investigates community factors that
contribute to the health and well-being.
 This type looks at health within the context of the community,
emphasizing the role of social systems and community resources in
promoting health and preventing disease.
 Community health psychologists work on grassroots levels, engaging with
communities to identify their specific health needs and develop programs
that address specific needs, like reducing obesity n increasing access to
mental health services. They improve access to healthcare, and build
supportive environments for health improvement.
 They often work with community organizations, local government, and
non-profits, focusing on empowerment and participatory approaches to
health.

4) CRITICAL HEALTH PSYCHOLOGY

 Critical health psychology prioritizes social justice and the universal right
to good health for people of all races, genders, ages, and socioeconomic
positions. A major concern is health inequality, and the critical health
psychologist acts as an agent of change working to create equal access to
healthcare.
 Critical health psychology critiques the traditional approaches to health
and illness, questioning power dynamics, social justice, and the influence
of socio-political factors on health.
 It emphasizes the need for more inclusive, equitable healthcare practices
and addresses the ways in which social inequality, race, gender, and class
impact health outcomes.
 Critical health psychologists work in academic settings, advocacy groups,
and research institutions, often focusing on policy change and social
justice issues related to health.
 MEDICAL MODEL OF HEALTH N ILLNESS

 The medical model Is also known as “Biomedical model”. The term

‘biomedical’ comes from the Greek word bios (meaning ‘life’) and the
Latin word medicus (meaning ‘healing’).
 The term “biomedical” combines biology and medicine to understand and
treat health related issues.
 The biomedical model explains ‘health’ as the absence of disease.
According to this model, ‘disease’ is considered as any pathogen that
causes a disturbance to the normal, or natural functioning of the body.
 It is the most dominant model used in western medicine by health care
practitioners today.
 It focuses on identifying clear symptoms and using medical investigations
(diagnostic tests) to find the root cause of the illness/disease. Based on
these findings, medical interventions are used to bring the patient back to
good health.
 The biological approach of the medical model focuses on a person’s
genetics, neurotransmitters, neurophysiology, neuroanatomy, and other
aspects of their physical makeup.
 The medical model of mental illness treats mental disorders like physical
illnesses, such as a broken arm. It assumes that there is a physical or
biological cause behind the mental health problem, like an imbalance in
the neurotransmitter levels, and often treats it with medication or medical
interventions.

Some of its major characteristics:

i. Cause of disease - This model explains ‘health’ as the absence of
disease. According to this model, diseases are always caused by
something external like virus, bacteria or other body abnormalities and
not related to a person’s emotions or mental state.
ii. Responsibility for disease - People are not seen as responsible for
their own illness. They are considered victims of external factors or
internal issues.
iii. Treatment - Treatment focuses only on the biological/physical aspect. It
involves removal of pathogenic agents either through drugs or surgery.
 The objective of treatment is the removal of symptom and relief from
any type of pain.
iv. Techno-oriented Model - This model heavily relies on technology and
machines for diagnosis and treatment. From making a generic drug to
performing a surgery, everything requires technology.
v. Practitioner-Physician relationship - This model considers that
physicians possess all the required knowledge n expertise to treat
patients. The patient plays a passive role and is seen more as a recipient
of care.

HEALTH – ILLNESS CONTINUUM MODEL

The Health-Illness Continuum is a model that illustrates the dynamic, ever-

changing state of health. It views health as a spectrum, from severe illness
(premature death) to optimal wellness (high-level wellness)

It is a graphic illustration of well – being , developed by Dr. John W. Travis in

1972.

The health continuum shows patients the path to a better, healthier lifestyle.
The far left end of the continuum, in the treatment paradigm, is premature
death. As patients move to the right, they reach the neutral point, leaving
the treatment paradigm solely in the wellness paradigm. Finally, at the far
right of the continuum is high-level wellness.

One of the health continuum benefits is that it is visual tool patients can use
to see and plan their journey to better health. It is a roadmap leading to a
healthier lifestyle and optimal health wherever a patient begins.

The core of this model Is individuals’ ability to move towards better health
and well-being whenever they don’t have visible illnesses. It is essential,
however, to work on one’s mental health and awareness, educate oneself,
and stimulate self-growth.

The Individual’s state of health is one of continual change. He moves back

and forth from health to illness and back to health again, his condition is
rarely constant. He may wake up feeling great, develop a headache mid-
morning, and feel fine again by noon.

The health-illness continuum illustrates this process of change, in which the

individual experiences various states of health and illness, ranging from
extremely good health to death that fluctuate throughout his life.
STAGES OF HEALTH ILLNESS CONTINUUM
1. Pre-Mature Death (Extreme Illness) - The far left of the continuum,
representing severe health deterioration and life-threatening conditions.

Example: A person in the final stages of cancer or a patient in a coma after a

traumatic injury.

2. Disability - This stage refers to a diminished quality of life due to long-

term physical or mental impairment.

Example: A stroke survivor with partial paralysis who needs assistance with
daily activities or someone with severe mental health disorders like
schizophrenia affecting daily functioning.

3. Symptoms - Symptoms are signs of illness or disease that may not be

disabling but indicate the presence of health issues.

Example: A person experiencing persistent headaches and nausea as early

signs of a migraine or stress-related issue.

4. Signs - Signs are objective, measurable indicators of illness, typically

detected through medical examination or testing.

Example: A doctor detecting high cholesterol or elevated blood sugar during

routine tests, signalling the onset of heart disease or diabetes.

5. Neutral Point - The midpoint of the continuum, representing neither

illness nor particularly high wellness. The individual is in a state of
balance but not actively pursuing higher levels of health.

Example: A person who feels fine and has no diagnosed medical conditions
but does not exercise or prioritize healthy eating.

6. Awareness - This stage involves recognizing unhealthy habits or

potential risks to one’s health but not yet taking concrete action to
improve it.

Example: A smoker becoming aware of the risks of lung cancer but not yet
quitting the habit.

7. Education - The individual seeks knowledge and learns more about

health and well-being, preparing to take proactive steps to improve.

Example: A person researching online or attending a workshop on how to

manage stress or improve sleep quality.
 8. Growth - Growth involves the active application of learned health
behaviours and an ongoing commitment to improving physical, mental,
and emotional well-being.

Example: A person regularly exercising, eating a balanced diet, and

managing stress effectively to improve their overall health.

9. High-Level Wellness - The far-right side of the continuum, representing

optimal health, where the person feels vibrant and is functioning at their
highest potential in all aspects of life.

Example: A person who is physically fit, emotionally stable, socially

connected, and intellectually stimulated, fully engaged in life with minimal
health concerns.

HIGH – LEVEL WELLNESS MODEL

 The High-Level Wellness Model was developed by Dr. Halbert Dunn in

1959, emphasizes a holistic view of health that goes beyond the mere
absence of disease and promotes a dynamic process of growth and
personal development.
 Dr. Halbert L. Dunn’s High-Level Wellness Model is a pioneering
framework in public health and preventive care. It redefines wellness,
focusing not just on disease management but on optimizing well-being.
 Dunn’s model defines wellness as an active process of growth, balance,
and improvement through which individuals become aware and make
choices toward a more successful existence.
 He emphasized that people can achieve “High-Level Wellness” by making
informed and conscious decisions about their physical, emotional,
intellectual, social, and spiritual health.
 This model encourages individuals to maximize their potential in each
area, leading to a higher quality of life and overall well-being.

Key Concepts of Dunn’s High-Level Wellness Model:

i. Wellness as a Process - Wellness is not a static state, but a

continuous process of growth and adaptation. It requires ongoing effort to
 balance all aspects of life, including physical, emotional, mental, and
social well-being.
ii. Integration of Body, Mind, and Spirit - Dunn emphasized that
wellness is holistic, meaning it involves the integration of physical,
mental, and spiritual health. These dimensions are interdependent, and
optimal wellness requires balancing all of them.
iii. Health as a Spectrum - Dunn viewed health as existing on a
continuum, ranging from poor health (illness) to high-level wellness. High-
level wellness is achieved when a person actively engages in behaviours
that promote physical, emotional, and social well-being, regardless of any
existing health conditions.
iv. Personal Responsibility - Dunn highlighted the importance of
individual responsibility in achieving high-level wellness. He believed that
people must take an active role in maintaining and improving their health
through lifestyle choices, such as regular exercise, a healthy diet, stress
management, and social connections.
v. Maximizing Potential - High-level wellness involves striving to reach
one’s fullest potential in all aspects of life, including personal fulfilment,
career, relationships, and mental and emotional growth.

HIGH - LEVEL WELLNESS GRID

Dunn’s High-Level Wellness Grid is a dynamic interaction between an

individual’s health and their environment.

 Health Axis (Vertical) : Represents the state of health (from illness to

wellness).
 Environmental Axis (Horizontal) : Represents environmental factors (from
unfavourable to favourable).

Four Quadrants of Dunn’s Grid:

Dunn’s model divides wellness into four quadrants, based on the interaction
between the environment and an individual’s state of health:

i. High-level Wellness in a Favourable Environment: This represents

the ideal state, where the individual enjoys good health and is in an
environment that supports their wellness.
ii. Emergent High-level Wellness in an Unfavourable Environment:
The person is striving for wellness but is in a challenging or adverse
environment that hinders their progress.
 iii. Protected Poor Health in a Favourable Environment: The person
has poor health, but a supportive environment helps them manage their
condition.
iv. Poor Health in an Unfavourable Environment: The most challenging
quadrant, where the individual is both in poor health and in an
unsupportive or hostile environment.

HEALTH BELIEF MODEL

 The Health Belief Model (HBM) is a social psychological health behaviour

change model developed to help explain and predict health-related
behaviours ( i.e. how individuals make decisions regarding their health
behaviours ) by focusing on the attitudes and beliefs of individuals
 It was developed in the 1950s by socials psychologists at the U.S Public
Health Services and remains one of the best known and most widely used
theories in health behaviour research.
 This model focuses on what people believe about their health and what
makes them decide to take action to stay healthy.
 The HBM suggests that people’s beliefs about health problems, perceived
benefits of action and barriers to action, and self efficacy explain
engagement or lack of engagement in health promoting behaviours.
 A stimulus, or cue to action must also be present in order to trigger the
health promoting behaviour.

CORE COMPONENTS OF HBM

HBM suggests that these core components explain how people judge the risk
of certain illnesses and how they view the effectiveness of treatments,
ultimately shaping their decision to adopt health-promoting behaviours

There are six core components of this model, the first four were the original
principles and the last two were added as research on the model
progressed / developed :

I. Perceived Susceptibility – This refers to the individual’s belief about the

likelihood of getting a particular health condition.

If a person perceives that they are at risk of developing a particular health

issue, they are more likely to engage in behaviours to reduce that risk. On
 the contrary, individuals who feel they are not at risk are less likely to take
preventive measures.

Example: A person who has a family history of heart disease might believe
they are at higher risk, leading them to adopt preventive behaviours like
exercising and healthy eating.

II. Perceived Severity – This refers to the individual’s belief about the
seriousness of the health condition and its consequences.

If a person believes that a health problem is severe, they are more likely to
take action. However, if they think the condition is mild or will not have
serious consequences, they may not see the need for behaviour change.

Example: A smoker who believes that lung cancer could lead to serious
health issues or even death may be more motivated to quit smoking.

III. Perceived Benefits - This refers to an individual’s belief in the

effectiveness of the advised action to reduce the risk or seriousness of the
health condition.

A person will not engage in health behaviour unless they also believe that
taking action will reduce the threat. The perceived benefits can include both
health-related outcomes (e.g., lowering blood pressure) and social or
emotional benefits (e.g., feeling better about oneself).

Example: A person may begin exercising because they believe it will reduce
their risk of heart disease, or they might take medication because they
believe it will control their diabetes.

IV. Perceived Barriers - These are an individual’s assessment of the obstacles

to behaviour change.

A person will not take action if they perceive too many barriers. The fewer
the perceived barriers, the more likely an individual will engage in health-
promoting behaviours.

Example: A person may know that eating healthy is beneficial, but if they
think eating healthy is too expensive, they may avoid changing their diet and
continue eating unhealthy / junk food.
V. Cues to Action - These are factors that triggers an individual’s decision-
making process to engage in health-promoting behaviours.

Cues to action act as triggers that encourage people to make changes in

their behaviour. Without these triggers, people might keep delaying or
ignoring important changes to their health.

Example: A person might decide to get a flu shot after hearing about an
influenza outbreak on the news.

VI. Self-Efficacy - This is an individual’s belief in one’s own ability to

successfully execute the behaviour required to produce the desired
outcomes.

Self-efficacy plays a crucial role in behaviour change. If people believe they

are capable of performing a certain behaviour (e.g., exercising regularly or
quitting smoking), they are more likely to take action. Conversely, a lack of
confidence in one’s abilities can be a major barrier to behaviour change.

Example: A person who feels confident that they can follow a weight loss
program is more likely to succeed in doing so.

PARADIGM OF HEALTH MODEL

The Paradigm of Health Model, or Health Paradigm Model refers to

conceptual frameworks that guide our understanding of health, disease, and
well-being.

Paradigms in health models can shape how health is defined, assessed, and
managed.

These models guide the focus of health professionals, policymakers, and

individuals approach towards health promotion, disease prevention, and
treatment. Over time, health models have evolved, influenced by changing
societal, scientific, and cultural views.

Key paradigms in health models:

1.Biomedical Model

 Focuses on biological factors as the sole determinants of health.

 Defines health as the absence of disease.
 Relies on diagnosis, treatment, and medical technology to address illness.
2. Biopsychosocial Model

 Integrates biological, psychological, and social factors in understanding

health and illness.
 Emphasizes patient-centered care and holistic treatment.
 Recognizes the interaction between mind, body, and environment.

3. Ecological Model

 Considers the interaction between individuals and their environments.

 Examines health at individual, interpersonal, community, and societal
levels
 Highlights the role of social determinants of health, such as education,
income, and housing.

4. Holistic Model

 Views health as a balance of physical, mental, emotional, social, and

spiritual well-being.
 Incorporates complementary practices like meditation, yoga, and
alternative medicine.
 Promotes self-care and a harmonious lifestyle.

Implications of the Model

a) Holistic Viewpoint: Recognizes that health is shaped by a combination

of biological, psychological, social, and environmental factors, advocating
for comprehensive care.
b) Health Promotion: Encourages proactive measures to maintain and
enhance health, rather than focusing exclusively on treating diseases.
c) Collaborative Efforts: Highlights the need for partnerships between
sectors such as healthcare, education, and environmental planning to
tackle social determinants of health.
d) Patient-Centered Care: Advocates for health approaches tailored to
individual preferences, needs, and values, making care more personalized
and effective.