Health psychology benefits patients, providers, staff

During her “first career” in marketing and advertising, Anne Mary Montero, PhD, was sitting behind a one-way mirror, observing a focus group on packaged foods. An interesting psychological insight came up within the group, and Montero was eager to discuss it with her colleagues.

“They just looked at me cross-eyed,” she said. “And I thought, ‘oh, wow, I’m in the wrong room.’”

This experience—which she describes as a “lightbulb moment”—prompted Montero to pursue a career in psychology. Now, she’s a health psychologist and Adjunct Assistant Professor of Medicine in the Division of Gastroenterology/Hepatology, where she works closely with her physician colleagues to provide patient care.
 
“I feel very honored to do this work,” she said. “My colleagues and I may be practicing in different disciplines, but we’re working in collaboration toward a common goal.”

According to the American Psychological Association, health psychologists study how biological, social and psychological factors influence health and illness, and use psychological science to promote health, prevent illness and improve health care systems. They conduct clinical interviews, make behavioral assessments, help patients follow treatment regimens, and do important research. Like Montero, health psychologists are often embedded in medical teams.

This integrated model has clear benefits for patients, but it also lessens the burden on time-compressed physicians.

“Since I’m on the team, physicians don’t need to refer patients out to external providers for psychological assessment,” Montero said.

She also steps in to educate patients on how to improve their health through behavior changes. For example, she shares strategies for smoking cessation, sticking to an exercise routine, and improving sleep hygiene.

An overarching theme in Montero’s work is validating and normalizing the mind-body connection.

“I like to explain to patients that physical and mental health are like a two-way arrow in the body,” Montero said, citing the pathways between the brain and the digestive organs as an example. “As you experience stress, it reverberates throughout your body. Health psychologists attend to what’s happening within that mind-body interaction, and help patients build upon their own resources to improve their psychological and medical experience.”

Recently, Montero has been called on to share some of her expertise in this area with Department of Medicine staff. Once a month, she joins them on their regular “Zoom Wellness Chats,” which they have held twice a week since the stay-at-home order in March, to share stress management strategies.

For this group, and for others working remotely during the pandemic, Montero recommends reinforcing boundaries between work and leisure time.

“Constantly working from home without a sense of closure is very taxing for our brains,” she said. “A lack of closure means lack of control. It’s really important to pause, take breaks and come up for air.”

She also says that maintaining good sleep and exercise routines can do wonders for what she calls our “shock absorbers” for stress.

“We’re facing many unknowns and a constantly shifting timeline” for the pandemic, she said. “Putting just a few behavioral shifts into place around sleep and exercise can have a hugely positive impact on your ability to function.”

This advice applies to frontline health care providers, too. In addition, Montero encourages health care providers—already at risk for burnout before COVID-19—to focus on their intention, their effort, and their purpose during this time, rather than putting disproportionate emphasis on outcomes.

“As providers, we all have resources that contribute mightily to our patients’ well-being and to our own, and that includes feeling connected to our purpose,” she said. “Health psychologists help build on that for our teams, our patients, and our communities—and I’m honored to have a part in that.”