Health Psychology in Action E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 549

Veröffentlichungsjahr: 2012

Beschreibung

A definitive guide to the growing field of health psychology, which showcases contributions from academics and professionals working at the cutting edge of their discipline.

• Explores the field of modern health psychology, its latest developments, and how it fits into the contexts of modern healthcare, industry and academia
• Offers practical, real-world examples and applications for psychological theory in health care settings
• Provides a timely resource to support the new HPC registration of health and other psychologists
• Includes contributions from practitioners in a wide range of health care settings who share their own vivid personal experiences, as well as more general guidance to applying theory in practice

Leseprobe

Contents

Cover

Title Page

Copyright

About the Editors

List of Contributors

Preface

Acknowledgements

General

Mark Forshaw

David Sheffield

Chapter 1: Applying Health Psychology to Dentistry: ‘People, Not Teeth’

Introduction: Why Dentistry?

What's a Psychologist Doing in Dentistry?

Interdisciplinarity

The Importance of Theory

Oral Health–Related Quality of Life

The Impact of Oral Health on Children, Adolescents and Their Families

Improving Communication Skills of the Dentists of Tomorrow

Professional Service, Development and Supervision

Challenges and Joys

Chapter 2: Promoting the Application of Health Psychology in Primary Health Care

Brief Lifestyle Interventions in Primary Care

Chapter 3: Health Psychology in the NHS: The Long and Winding Road …

Assessment

Group Work

One-to-One Work

Research

Teaching and Training

Chapter 4: A Journey into Health Psychology and Beyond

Foundations

Developing as a Researcher

Teaching Health Psychology

Applied Practice

Synergy

The Future

Chapter 5: Health Psychology in Cyberspace

Where Did It All Begin?

Success

Life Happens

What Else Do I Do?

Chapter 6: Working in Academia: A Different Kind of Practice, but Practice Nonetheless

How It All Began …

Day-to-Day Life in Academia

Research Activity – Health Psychology in Practice

The Doctorate in Health Psychology

Where Next for Health Psychology?

Chapter 7: Shared Decision Making

Introduction

What Is Shared Decision Making?

When Is SDM Appropriate?

Patient Preferences for Involvement in Decision Making

Risk Communication

Competencies of Health Care Professionals and Patients for Shared Decision Making

SDM Interventions

How Can Health Psychology Contribute to the Agenda for Patient Choice and SDM?

Conclusion

Chapter 8: Writing, Training, Teaching, Researching, Consulting, Quality Assurance and the Kitchen Sink

What I Do

Ups and Downs

What Next?

Chapter 9: What Are the Roles of a Health Psychologist in Clinical Practice? Defining Knowledge, Skills and Competencies

Early-Career Health Psychology Competences

Expanding and Developing Our Health Psychology Roles

Health Psychology in the National Health Service – Key Competences

Reflections on the Variety of Health Psychology Skills

New Horizons

And So to the Future!

Chapter 10: Health Psychology: The Missing Ingredient from Health and Safety?

Raw Ingredients

The Mixing

The Cooking: Some Challenges

Acknowledgements

Chapter 11: Keeping Up Appearances in Health Psychology

Appearance Research: A Role for Health Psychology

Conceptions of the Person in Health Psychology

Developing Measures to Test Theories and Outcomes

Applications of Health Psychology to Clinical Practice

Teaching and Training Health Psychology

Regulation of Teaching and Training

Summary

Acknowledgements

Chapter 12: Social and Political Health Psychology in Action

Finding a Location

Working with Older People

Challenges and Joys

Filtering Health Psychology

‘Set the Sails, I Feel the Wind A-Blowing’ (The Low Anthem, 2009)

Chapter 13: Tailoring Behavioural Support and Tailoring Health Psychology Careers

Introduction

My Background – What Led Me to Stage 2

The Work That I Do

Reflections of Working in Health Psychology

Future Steps for Health Psychology

Chapter 14: Working with Chronic Pain

Background

What, Where, When and Why?

Challenges and Joys of the Job

How Health Psychology Is Interpreted through the Filter of My Work

Where Health Psychology Is Heading …

Chapter 15: Combining Practice and Academia as a Health Psychologist

Introduction: How I Became a Health Psychologist with a Foot in Both Practice and Academia

Practice

Academia

Challenges and Joys

Future of Health Psychology

Chapter 16: Health Psychologists in Action – Working for the Pharmaceutical Industry

Personal Background and Why I Began to Work in the Pharmaceutical Industry

The What, Where, When and Why

Challenges and Joys of My Role(s)

How Health Psychology Is Interpreted through the Filter of My Own Work

Where Health Psychology Is Heading

Glossary

Chapter 17: The Rapid Growth of Health Psychology in Medical Schools and Clinical Practice

Health Psychology Research in Medical Schools (Chronic Pain and Health Care Communication)

Health Psychology Teaching in Medical Schools

Application of Health Psychology in Clinical Practice

Our Thoughts: Health Psychology, the Past and the Future

Conclusion

Chapter 18: The Lived Experience of a Qualitative Health Psychologist

Starting Out

Finding My Niche

The Work of a Qualitative Health Psychologist

Summing Up

Chapter 19: Health Psychology in Sickle Cell and Other Long-Term Haematological Conditions

Establishing a Health Psychology Service in Sickle Cell Disease

The Psychological Needs of People with Sickle Cell Disease

What Does Coping with SCD Entail?

Traditional Approaches

Why Health Psychology?

The Nature of HPS

My Role within the Multidisciplinary Team

Self-referrals

Neuropsychology Service

An Evidence-based Approach to Service Development

Psychologist-led Group Support

Patient Information

Education of Staff

Health Psychology Placement

Staff Support

Guidelines and Protocols Concerning Patient Care

UK Psychologists in SCD Group

Patients Living Longer: Accounting for Unmet Needs

Health Psychology Scoping Exercise

Summary

Why I Love Being a Health Psychologist

Chapter 20: Afterword

Where Are We Going?

Index

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1 2013

About the Editors

Mark Forshaw is a Chartered and Registered Health Psychologist and Chartered Scientist. He has worked variously at the University of Manchester, Coventry University, Leeds Metropolitan University and Staffordshire University. He has a specific leadership role in external liaison and consultancy, holds some national positions in professional body work, and is the author of a number of books and articles across a wide range of psychological research themes and issues. Outside work, he is a film ‘buff’, an avid traveller, a poet, a painter of ‘semi-abstract’ work, and a number of other things he doesn't have enough time for. He tries very hard not to take things seriously, most of all himself.

David Sheffield is the Associate Head of the Centre for Psychological Research at the University of Derby. He is a Health Psychologist with the UK Health Professions Council and a Chartered Psychologist with the British Psychological Society Division of Health Psychology. Following a PhD at Glasgow Caledonian University, he worked in the United States for 6 years in cardiology divisions; there he was supported by grants by the National Institutes of Health to examine the role of psychological factors in the perception of pain in cardiac patients and the effects of mental stress on ischaemia. Returning to lecture at Staffordshire University in 2001, he helped to develop the first Professional Doctorate in Health Psychology in the United Kingdom that provided Stage 2 training. As well as contributing to doctorate, masters and degree programmes, he has supervised 13 doctoral students to completion. He moved to the University of Derby where his research extends to stress and cardiovascular responses, positive psychological interventions to improve well-being, pain and mathematics anxiety.

List of Contributors

Sarah Baker is a Chartered Psychologist and Associate Fellow of the British Psychological Society. She obtained her PhD from the University of Plymouth in 1995 and was a Lecturer in Health Psychology at Keele University before making the move into the field of Dentistry in 2005. She is currently a Senior Lecturer at the University of Sheffield in the School of Clinical Dentistry. She is based in the Unit of Dental Public Health, which consists of an interdisciplinary team of clinicians and academics at the forefront of patient-based research in relation to oral health.

Amy Baraniak is a trainee health psychologist at Staffordshire University. Amy worked for a number of years in primary health care with a varied role involving oversight of the implementation of the Quality & Outcomes Framework (QOF) and a number of enhanced services before taking on additional responsibility for providing smoking cessation and computerized cognitive-behavioural therapy interventions. Amy moved to the University of Derby in August 2009 where she lectures in Health Psychology with a focus on the application of health psychology within a primary health care setting.

Julian Bath is a Consultant Health Psychologist based at the Health Psychology Department of Gloucestershire Royal Hospital. He is the manager of the Gloucestershire Cardiac Rehabilitation Psychology Service and manager of the Gloucestershire Community Psychology Research Team. He also manages clinical, counselling and health psychologists providing services to renal medicine and adult diabetes. He has a broad range of experience working clinically with groups and individuals in cardiac rehabilitation, renal care and diabetes and a wealth of research and consultancy experience. He has numerous publications including the recent Wiley-Blackwell book,Cardiac Rehabilitation: A Workbook for Use with Group Programmes.

Sheila Bonas works in private practice as a Health Psychologist and Counsellor, and also has a part-time academic post in Clinical Psychology at the University of Leicester. She has worked as a registered Health Psychologist in the National Health Service (NHS) in pain management and a cystic fibrosis service. In her academic experience she has enjoyed working at the interface where psychology interacts with the practice of medicine and health-related behaviour. Her research interests include work on research methodology, medical education and health professional–patient communication, and she has been increasingly drawn to use qualitative methods, especially phenomenology.

Neil Coulson is a Chartered and Registered Health Psychologist. He has worked previously at the University of Exeter, University of Plymouth, University of Derby and University of Nottingham. He is currently based at the Institute of Work, Health & Organisations (IWHO) at the University of Nottingham where he has been the Deputy Director of IWHO for the past four years. He is currently the Course Director for the Professional Doctorate in Health Psychology programme. He has held and continues to hold a number of positions on committees and boards of professional bodies such as the British Psychological Society. His research interests focus on the role of online support communities in helping patients manage long-term illness.

Lorna Dodd is a Health Psychologist working as a Senior Lecturer in Psychology at Newman University College, Birmingham. Lorna lectures on a number of undergraduate and postgraduate psychology modules, is involved in developing new and exciting programmes to align with current psychology trends and engages in scholarly work and health psychology research. Lorna has a Doctorate in Health Psychology from Staffordshire University and is a member of several professional bodies. Lorna’s area of research falls within the umbrella of health behaviours and health-related lifestyles of young adults, in particular, a student population.

Darren Flynn is a Chartered Psychologist. His PhD investigated the psychological aspects of idiopathic scoliosis. He was previously a Research Fellow, a Lecturer in Psychology and a Senior Lecturer in Research Methods. Currently he is a Senior Research Associate with the Decision Making and Organisation of Care Group in the Institute of Health and Society at Newcastle University, working on the development of decision support for thrombolytic treatment in acute stroke care. He has co-authored a book on the influence of nonmedical factors on medical decision making and articles on subjects such as prostate cancer, dementia, gastrointestinal disorders and idiopathic scoliosis.

Claire Hallas is a Practitioner Psychologist with the UK Health Professions Council and a chartered psychologist with the British Psychological Society Division of Health Psychology. She has a PhD from the University of Liverpool, and postgraduate training in Cognitive Behavioural Therapy from the Oxford Cognitive Therapy Centre. She has spent the last 15 years delivering psychology services in a variety of UK National Health Service trusts specializing in the psychological care of cardiothoracic and oncology patients. She held a Consultant Health Psychologist post and was the Deputy Director of Rehabilitation & Therapies Services from 2004 to 2008 in a London tertiary care trust. She has worked as a Consultant Health Psychologist at the Department of Behavioural Medicine, Sultan Qaboos University Hospital in the Sultanate of Oman where she developed health psychology clinical services and teaching on the medical education programme. She is the author of a number of book chapters and research articles on the subject of mood disorders with respiratory and cardiovascular disease and the neuropsychological outcomes of cardiovascular surgery.

Jennifer Lunt is a Principal Health Psychologist at the Health and Safety Laboratory (HSL), which is an agency of the Health and Safety Executive (HSE), the independent watchdog for work-related health, safety and illness in the United Kingdom. Jennifer has a Professional Doctorate in Health Psychology from Staffordshire University, and is a Chartered Health Psychologist. When completing her doctorate she drew on her experiences in applying health psychology to health and safety. As a technical lead she has responsibility in assuring the technical quality of projects that relate to this area through a team of experienced occupational and health psychologists and health scientists. Her portfolio of work ranges from behavioural change and worker engagement, to disease reduction barriers and enablers, risk communication, retention at work, sickness absence and work-related well-being. Prior to joining HSL, Jennifer worked as a trainer and research psychologist for a human factors training consultancy, and has previously worked in the NHS delivering occupational stress management interventions.

Tim Moss is a Reader in Health Psychology at the University of the West of England (UWE), Bristol. He is registered with the Health Professions Council, the regulatory body for psychology in the United Kingdom. He leads the MSc Health Psychology programme, and is former programme director of the professional doctorate in health psychology programme at UWE, as well as contributing to other MSc and undergraduate programmes. He is the supervisor of several PhD students in the field of psychosocial adjustment to differences of appearance. Tim is the co-ordinator of the Derriford Appearance Scales project (www.derriford.info), providing measurement tools, advice and consultancy in the field of appearance and visible difference in the United Kingdom, Europe, Japan and the United States, amongst others. Tim is a member of the BPS Health Psychology Training Committee, and a BPS Assessor for the Stage 2 qualification in health psychology. He is a former Visitor for the Health Professions Council, involved in the evaluation of professional training programmes in psychology. From 2010, Tim has represented professional psychology training on the Advisory Board of the Psychology Network. He is also a fellow of the Royal Society for Public Health, and maintains an interest in public health applications of psychology. In 2011, Tim was appointed as Associate Head of Department of Psychology at UWE, with the Research/Knowledge Exchange portfolio.

Michael Murray is Professor of Social and Health Psychology and Head of the School of Psychology at Keele University, Staffordshire. Prior to that, he held appointments at other universities in England, Northern Ireland and Canada. He has published over 100 journal articles and chapters and (co-)authored and edited several books and collections on critical and qualitative approaches to health psychology including Qualitative Health Psychology: Theories and Methods (with Chamberlain, Sage 1999),Critical Health Psychology (Palgrave, 2004) and Health Psychology: Theory, Research & Practice (with Marks, Sage 2010). He is the Associate Editor of the Journal of Health Psychology and of Psychology & Health and sits on the editorial boards of several other journals including Health, Psychology & Medicine, Health Psychology Review, Arts & Health and Subjectivity. His current research interests include the use of participatory methods to engage communities in various forms of collective action.

Felix Naughton completed his PhD and Health Psychology BPS Stage 2 training at the University of Cambridge in 2010. His general research interest is in changing health behaviours, particularly smoking, and he is specifically interested in the use of new technologies in health care and health promotion.

Shilpa Patel is a Registered Psychologist and an academic researcher. She is a member of the British Psychological Society and Division of Health Psychology. She has a Professional Doctorate in Health Psychology from Staffordshire University and currently holds two posts, clinical and academic. She works clinically as a Health Psychologist in pain management at Milton Keynes NHS Foundation Trust and academically at Warwick Medical School, where her research focuses on musculoskeletal pain. Shilpa is a successful investigator on NIHR-funded research and has published and presented in the field of pain and pain management.

Sue Peacock is a Consultant Health Psychologist and registered with the Health Professions Council. She has a PhD from the University of Leicester, and currently works in the Pain Management Department at Milton Keynes Hospital NHS Foundation Trust and in private practice. She is the author of a number of research articles mainly relating to chronic pain. She has served on various committees within the British Psychological Society and currently is the psychology representative and secretary for the British Pain Society's Pain Management Programme Special Interest Group.

Karen Rodham is a registered and Chartered Health Psychologist and Associate Fellow of the British Psychological Society. She has a PhD from the University of Portsmouth and currently divides her work time between her academic and practice duties. She works four days a week as a Lecturer in Health Psychology at the University of Bath and one day a week as a practising Health Psychologist at the Royal National Hospital for Rheumatic Diseases. She is a qualified mountain leader and has a deep and enduring love for the mountains. She cherishes the time spent alone walking and clambering about in the outdoors, but also enjoys her voluntary work with young people completing their expeditions for the Duke of Edinburgh Award.

Katja Rüdell is a Chartered Psychologist. She has a PhD from the University of London, currently works in the Patient Reported Outcomes Centre of Excellence in the Primary Care Business Unit at Pfizer Ltd and has an honorary lectureship at the University of Kent. Her clinical health psychology background is in smoking cessation and her research interests are in development of patient-reported outcome measures for evaluating health care interventions, patients’ perspectives on illness and cross-cultural health psychological research.

Harbinder Sandhu is a Registered Psychologist and member of the British Psychological Society and Division of Health Psychology. She has a Professional Doctorate in Health Psychology from Staffordshire University and is an Assistant Professor in Health Psychology at Warwick Medical School, University of Warwick and Health Psychologist in Chronic Pain Management, Milton Keynes NHS Foundation Trust. Harbinder is the author of a number of research articles in the area of clinician–patient communication. She is also the recognized UK trainer for the Roter Interaction Analysis System, an internationally valid and reliable tool used in health care communication skills assessment and analysis.

Rachel Shaw is a Health Psychologist registered with the Health Professions Council and a Chartered Psychologist of the British Psychological Society (BPS). She is Honorary Secretary of the Qualitative Methods in Psychology Section of the BPS. Rachel completed her PhD at De Montfort University in 2001. She currently works as a Lecturer in the School of Life and Health Sciences at Aston University. Her research interests include illness experience, health management, media framing of health issues, metasynthesis of qualitative evidence, interpretative phenomenology and reflexivity. Rachel has publications in health psychology and qualitative methods in psychology journals. She is also author of several chapters in qualitative methods textbooks.

Veronica Joan Thomas (commonly known as Nicky) is a registered health psychologist with the HPC. She obtained a PhD from London University Goldsmith's College. She is currently working as Consultant Health Psychologist in the Department of Haematology and Haemophilia at Guy's and St Thomas’ NHS Foundation Hospitals Trust in London. She is also an honorary Lecturer in Health Psychology at the Institute of Psychiatry, Kings College London. She has held a variety of clinical, research and academic Health Psychology posts within Kings College, London and University College London Medical Schools. She has considerable experience in psycho-oncology and has worked in the Cancer Research Campaign department teaching communication and counselling to senior physicians and nurses working in cancer care. She has undertaken numerous research projects and is the author of a number of articles and chapters in academic books.

Preface

Mark Forshaw and David Sheffield

What is health psychology? One early and oft-used definition comes from Matarazzo (1982); ‘Health Psychology is the aggregate of the specific educational, scientific and professional contributions of the discipline of psychology to the promotion and maintenance of health, the prevention and treatment of illness, the identification of etiologic and diagnostic correlates of health, illness and related dysfunction, and the analysis and improvement of the health care system and health policy formation’ (p. 4). However, nearly every book on the subject seems to have a slightly different definition, something discussed in some detail, for example, in Forshaw (2002). Not much has changed since then, except that we probably have even more definitions than we had before. Of course, developments come in two ways: top-down and bottom-up. Proclaiming that health psychology is X, Y and Z, and then expecting all health psychologists to devote themselves to X, Y and Z, is a top-down approach, and is very valuable at times, especially, we would argue, in the middle stages of a profession. We believe we are moving out of the middle stages. The bottom-up approach involves looking to see what people who view themselves as health psychologists are getting up to, and defining the subject based on that. Health psychology is what health psychologists do. In our view, this is what happens in the earliest stages of the development of a profession, and again in the latter stages, to allow for some rejigging before the formula is mostly complete. In the earliest days of health psychology, groups of people were doing certain kinds of work, and they saw that they had things in common, and that those things weren't adequately captured by the professions in existence. Health psychology thus emerged, from the work of those people, defined organically. That set of topic areas rapidly became what health psychology was defined as, for sensible reasons. It was a guide to new generations of health psychologists and other interested parties. Division 38 of the American Psychological Association formed in 1978, after many years of hard work setting up and lobbying by numerous individuals, notably Stephen Weiss. It took the health psychologists in the United Kingdom a little longer to convince the British Psychological Society of a need for a Section, which became a full-fledged Division in 1997, after being in existence as a Section from 1986. In BPS structures, Sections are groups of people with academic or political interests, and Divisions are reserved for recognized professions. Once a Division was inaugurated, a training model was needed, and this was first established in 2001. Benchmarked around postgraduate-level descriptors, and competence based, it rolled out firstly in the form of BPS-run Qualifications and shortly thereafter as courses in higher education institutions. Stage 1 of the qualifications is the MSc-level component of the training focusing on knowledge, which is then followed by Stage 2, at D-level, which is practice oriented. At the time of writing, we are currently experiencing the second version of this Stage 2 training, revised and streamlined following extensive consultation. Although British health psychologists lagged a little behind their US counterparts in the earlier days, there has been a tremendous rush forward in recent years. We, as a professional community, are very proud of our achievements in the last 25 years, and equally proud of the trainees who have made their way through the system in the last decade, some of whom have contributed to this volume. We have an eminent past, a vibrant present and an assured future. At times of global uncertainty, and academic unrest in the United Kingdom, it is comforting to know some things are in good hands.

However, we are always open to change, which is precisely what should happen in a relatively modern, developing profession. It is time to take stock, and to reconfigure somewhat. New people, with new ideas, new theories and new ways of working, have entered our profession, and started to stretch the boundaries, and to toy with the emphasis. We welcome that, just as one welcomes a child outgrowing its clothes. Our view is that it is time to ask what health psychology is, all over again, and this book is that very survey laid bare. This book is the new bottom-up. If you want to know where the latest research is heading, we have journals for that. It is much more difficult to discover where real health psychologists themselves are heading, in their careers, in their thinking and in their views on the profession itself. You can talk to some of them at conferences, perhaps, but that is by no means an ideal way to get opinions, reflect on them and compare them to a range of other ideas from diverse professionals. We have done our best, in this book, to draw together that diversity and present a version of reality that we believe captures modern health psychology, mainly from a UK standpoint.

You will find, in this book, those who mostly regard themselves as ‘academics’, those who primarily regard themselves as ‘practitioners’ and everything in between. To some extent, this distinction is disingenuous, since most people take an academic, evidence-based approach to their work, and most academics are practitioners in that they teach and train and help to build the theories than underpin the practice. There's more to academia than the ivory tower, and there's more to practice than client work. Realizing this is one of health psychology's most valuable gifts. Health psychology is where academia and practice meet, and the same cannot necessarily be said for all areas of our discipline, which still maintain marked separations.

Naturally, we cannot lay claim to this book being entirely representative, although we have made every effort. Quite simply, we could not approach every single health psychologist, even though between us we possibly know most of them in some capacity or another. We tried to strike a balance between different career stages, and different working environments, and to give a flavour of the vast range of health issues to which we apply ourselves. However, we have aimed to give readers an idea of where health psychology is heading, so there are more early-career psychologists than might be found in many texts. This has enabled us to show the remarkable spread of health psychology across training, practice, industry and academic environments, and the impressive talents of our authors, reflecting the talents of health psychologists more widely.

We are delighted to be able to set out a vision of health psychology both present and future, and we are pleased that this Noah's Ark of a book is now ready to set sail. We are proud to present to you Health Psychology in Action.

References

Forshaw, M. (2002). Essential Health Psychology, London: Arnold.

Matarazzo, J.D. (1982). Behavioral health's challenge to academic, scientific and professional psychology. American Psychologist, 37, 1–14.

Acknowledgements

General

The editors would like to thank the contributors for their patience in the process, and their timely responses to our demands and queries. This is a team effort, and we wouldlike to express our pride at being part of the virtual UK health psychology team. In addition, thanks to the entire staff at Wiley-Blackwell for their understanding and for believing in us that this book was fit for publication, even from day one of the proposal stage. In particular, thanks to Karen, Andy and Andrew.

Mark Forshaw

Thanks to the friends and colleagues across the health psychology community who helped me to become the health psychologist I am. In particular, thanks to Sandra Horn, for recognizing I had something to give. For me, following in your footsteps to chair DHPTC was a radical moment in my development. My gratitude also goes to BPS office team members, past and present, including Alex, Angie, Bethan, Helen, Kajal, Lucy, Rupal and Wilfred. Last but not least, thanks to Amanda Crowfoot for her patience and constructive ideas every time I have said something like ‘You'll never guess what's happened now’. It's the sort of thing I say a lot.

David Sheffield

I would like to thank to all my colleagues at the University of Derby and my former colleagues at Staffordshire University. I am also grateful to Doug Carroll and colleagues at Glasgow Caledonian University for getting me started. Thanks to my students past and present who have maintained my enthusiasm. Finally, love and thanks to Sarah, Isaac and Phoebe.

1

Applying Health Psychology to Dentistry: ‘People, Not Teeth’

Sarah Baker

Introduction: Why Dentistry?

I originally intended to become a sociologist but got unwittingly sidetracked into doing a psychology degree, which I began in 1987 at the University of Plymouth. I was not one of those people who knew what they wanted to do aged 10, so I fell into doing a PhD at the same institution. My thesis was on the psychophysiological indices of stress and a great amount of time, thought and energy went into devising ways of making people stressed. Once this was achieved, the rest of the time was spent in a dark soundproof room, my polygraph and I, stressing people and measuring their sweat. Three years later, I embarked on a research assistant job whilst writing up my thesis. Following years in a darkened room with a polygraph, this job, investigating psychophysiological reactions whilst playing video games, was rather fun. However, after a year I clearly could not put it off any longer; a responsible job was needed. I got my PhD and took up a postdoctoral research fellow position in the Department of Psychology at the University of Surrey. The Wellcome Trust–funded study on the psychophysiological and behavioural correlates of social phobia had much in common with the previous 5 years; I spent much of it in a small darkened room measuring the responses of socially phobic individuals whilst they had to interact with others. I realised a number of things early on; in order to spend time with people rather than a large machine (aka a polygraph), to get a bigger room (with lighting) and have job security, I would have to apply for lectureship positions. Given my anxiety of public speaking at the time, this was not something I warmed to. I duly became a Lecturer in Biological Psychology at Coventry University in 1997, followed by a Lecturer in Health Psychology at Keele University in 1998, where I stayed until 2005. The position in the Psychology Department at Keele was where I really learnt my research skills; particularly the importance of theory and methodology. However, I was also forming the opinion that research in health psychology, that is research, needed to move out of psychology departments into ‘the field’. I wanted, in the old cliché, to ‘make a difference’ through research; to make it useful and relevant to patient populations. I could only do that by putting my job where my mouth was. Moving to medicine was the obvious choice – there were now quite a few psychologists working in medical schools – but why have the route already mapped for you? I opted for Dentistry. I left the Psychology Department and travelled to the Dental School in Sheffield in 2005. There are 16 dental schools in the United Kingdom, including Sheffield, and I can count the number of psychologists working in these on one hand. Inevitably, ‘What is a psychologist doing in dentistry?’ or its alternative ‘So you do dental anxiety then?’ have been asked many times by dental undergraduates, dentists and even psychologists. It was an interesting, in some ways an impulsive choice but, most certainly, the right choice.