Innovative Approaches to Health Psychology: Prevention and Treatment Lessons from AIDS

American Journal of Clinical Hypnosis,  Apr 2003  by Hornyak, Lynne M

• E-mail
• Print
• Link

Innovative Approaches to Health Psychology: Prevention and Treatment Lessons from AIDS. Margaret A. Chesney & Michael H. Antoni, Eds. Washington, DC: American Psychological Association (2002). 367 pages, $39.95. Reviewed by: Lynne M. Hornyak, Ph.D.; Washington, DC.

Fifteen years ago, behavioral medicine professionals were faced with the deadly epidemic of Acquired Immune Deficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV), for which there was no history or literature upon which to base their interventions. As editors Chesney and Antoni point out, researchers and clinicians "borrowed lessons" from the treatment of other diseases to innovate and gain expertise with treating HIV and AIDS. In the process, they identified a host of new target populations, new approaches to the management of these chronic medical conditions as well as new behavioral intervention challenges created by advances in biomedical treatment. The editors now present these "lessons learned" from AIDS to inspire researchers and clinicians to seek and create further opportunities for their skills and contributions in the broad spectrum of health challenges.

The book is divided into three parts. Each chapter in Part I focuses on a population at highest risk for contracting and spreading the HIV virus. The four populations covered are adolescents, African American adolescents at risk, gay and bisexual men engaging in unsafe sexual behavior (particularly unprotected anal intercourse), and intravenous drug users. The authors illustrate what they did to tailor and market the message to their specific population based on biopsychosocial factors (e.g., challenges, stressors, needs, roles, motivations) of that group. They also discuss their prevention and treatment interventions in detail, as well as outcome results and lessons learned.

The six chapters of Part II each focus on a special issue faced by medically ill individuals. The authors typically cite research and treatment literature culled from other medical conditions, and point out similiarities and differences in applying interventions with HIV-positive individuals. The topics covered are therapeutic issues and tasks in individual counseling, working with HIV-positive mothers during pregnancy and postpartum, stress management and relaxation training interventions for optimal disease management, and group interventions to promote psychological adjustment, pain management and improving sleep quality.

Finally, Part III focuses on the opportunities and challenges created by new biomedical innovations. Two chapters address issues arising with development of HIV vaccines and PostExposure Prophylaxis/Prevention (PEP) for sexual exposure to HIV, and identify the opportunities for behavior change counseling. The last chapter addresses the difficulties involved in adhering to complex biomedical regimens involved in HIV therapies.

The chapters are well-written and contain sufficient information to understand the particular treatment program or protocol presented. The volume does not provide short biographies (except those of the editors) for those of us unfamiliar with the prominent researchers and clinicians in the HIV\AIDS field. However, the authors' experience and expertise come through in the details of the intervention programs and projects, as well as their institutional affiliations.

The editing seems careful and competent in that the chapters consistently meet the goals stated in the foreword and introduction. These goals include translating research into practice, examining the issues and problems involved in providing prevention and treatment interventions "in the field," and providing a model of how health professionals can develop new opportunities for clinically based practice and research in critically important health arenas. The volume is full of ideas for researchers and clinicians to pursue not only in the HIV\AIDS arena but with other chronic medical conditions.

As for limitations, if you are looking for applications of hypnotic methods to the treatment of HIV, you will be disappointed. There are three references to hypnosis-- a reporting of two studies in which hypnosis was included in a multi-strategy stress management intervention (p. 182), a generic reference to self-hypnosis as a stress management tool in a psychoeducational group intervention (pp. 209-210), and a report of several studies occurring before 1992 on the use of hypnosis to relieve cancer pain (pp. 227-228). On the other hand, one can easily see the numerous opportunities for hypnosis research and treatment applications throughout the book.

A second minor limitation is that the authors predominantly refer to practitioners as "health psychologists" which could be off-putting to non-psychologists. That this volume is part of the American Psychological Association Division of Health Psychology (38) series is the most obvious explanation. It is recommended that the reader hallucinate a more acceptable word in place of "health psychologist" if that term is bothersome.