Occ-health psychology looks at mental health needs of workers

Well established in Europe, OHP gaining notice in United States

It has been 17 years since the National Institute for Occupational Safety and Health (NIOSH) formally recognized psychological disorders as a leading occupational health risk, but getting American businesses to accept the benefits offered by occupational health psychology (OHP) may take longer than that.

Through the initial efforts of NIOSH and the American Psychological Association (APA), graduate psychology programs at a dozen U.S. schools now offer concentrations in OHP. The term "occupational health psychology" is becoming more familiar in the workplace, but because the benefits don’t show up on earnings reports right away, U.S. business is warming slowly to the notion that preventive workplace mental health can pay off.

"The ultimate goal of occupational health psychology is a healthy workplace, and a healthy workplace guarantees a high-performance organization," says Peter Y. Chen, PhD, industrial/organizational (I/O) psychologist and associate professor at Colorado State University’s department of psychology in Fort Collins.

Promoting the mind/body/bottom-line connection

In 1990, two years after NIOSH formally recognized psychological disorders as occupational health risks, APA and NIOSH formed a partnership to promote the new discipline of OHP. This was followed in 1994 with a joint funding of seven postdoctoral positions in occupational psychology at Duke University Medical Center, Wayne State University, and Johns Hopkins University, and in 1998 with funding for 12 universities to develop and implement OHP curricula for graduate students.

The idea, new to the United States, is well established in Europe, where "work psychology" is as common a term there as "workers’ comp" is here. Interest in the field in the United States grew along with the workplace, according to James A. McCubbin, PhD, professor and chair of the psychology department at Clemson (SC) University.

"Occupational health psychology is an interdisciplinary field that has developed from overlapping interests — industrial-organizational, personnel psychology, and clinical psychology," he explains. "Part of what has stimulated interest and market demand [for occupational health psychology] has been the evolution of the workplace over the past 30 years."

McCubbin cites changes such as the role of women in combat support roles in the military, growth in gender and minority diversity, and demands of the work environment as fuel for increased psychological demands on workers and, consequently, efforts by occupational health and psychology communities to help.

Ronald G. Downey, PhD, psychology professor at Kansas State University, says his school established its certificate program in OHP in 2000, but only in the past year has it developed a market. "It’s a new program [at KSU] in a new field, and so it takes some time," he says.

Not just stress

Corporate downsizing and organizational changes in most workplaces have created new sources of psychological stress for workers, but OHP is not just about stress. "It’s a variety of health-related issues in the workplace, ranging from substance abuse to enhancing employee assistance programs, anticipating and dealing with mental health issues," McCubbin says. "It’s about the effects of psychological and organizational factors on physical health."

NIOSH, in pushing for the creation of the OHP concentration of studies, was responding to psychologists who argued that the psychology field needs to take a more active role in research and practice to prevent occupational stress, illness, and injury. Research and practice in OHP may cover a wide range of topics, but NIOSH has urged that the relatively new field give special attention to the primary prevention of organizational risk factors for stress, illness, and injury at work.

This viewpoint is expressed in the NIOSH-proposed definition of OHP: "OHP concerns the application of psychology to improving the quality of work life, and to protecting and promoting the safety, health and well-being of workers." The notion of health "protection" in this definition refers to intervention in the work environment to reduce worker exposures to workplace hazards, while health "promotion" refers to individual-level interventions to equip workers with knowledge and resources to improve their health and thereby resist hazards in the work environment.

Although both of these types of interventions can be defined as primary prevention, the NIOSH-proposed definition places priority on health protection, Chen says.

OHP addresses both prevention and psychological issues as they arise, but Chen says the most common U.S. specialist in OHP is trained in I/O psychology, and would therefore be more concerned with intervention and prevention. "We would not go into tertiary counseling therapy or hospital treatment," he says. "That would belong to the clinical psychologists."

Some OHP graduate programs are imbedded in universities’ clinical psychology programs, however, and so treatment would be more of a factor with those specialists, Chen notes.

"Occupational health psychology is especially concerned with the dramatic transformation of work and employment that has been under way in industrial economies since the 1980s, and how changing organizational structures and processes are influencing the health and well-being of workers and their families," McCubbin says. "All these change in the work environment have created a number of sources of occupational stress, and we’re coming to widely appreciate that these types of psychological factors can have a palpable effect on workplace productivity, from absenteeism due to health reasons to diminished performance and capacity to effectively carry out one’s job mission."

Prevention and maintenance

While occupational health nurses and physicians tend to the physical aspects of workplace injury and illness, psychologists trained in OHP can deal with the related issues of compliance, rehabilitation, and the effects of chronic pain. "Occupational health psychology covers a lot of areas relating to safety procedures and compliance — how to get people to follow directions and use safety procedures," says McCubbin. "It also covers reintegration into the workplace after an illness. People are living longer and staying in the workplace longer, so there are issues relating to chronic illnesses, like blood pressure and glucose control."

Helping workers cope with psychological issues relating to chronic pain is a major focus of OHP. The depression and stress that can accompany chronic physical pain is a serious cause of health-related productivity loss, McCubbin adds. "Lower back pain is a great cost to employers, and it’s an area psychology has a lot to say about."

But he agrees with Chen that OHP’s greatest impact is probably on prevention. "As insurance and actuarial figures come in on that, it supports the role of workplace wellness and how it can provide significant savings in the long run," he says. "Educating employees about why they should follow safety rules, and dealing with the psychological factors that influence them to follow those rules, saves a lot more than waiting until something happens and dealing with it then."

But business being business, both Chen and McCubbin say workplace psychology can be a hard sell to business owners. "Human beings are the assets of any organizations, and if you have lot of unhealthy people, physically or psychologically, you won’t create a high-performance organization in the long run," says Chen. "But the benefits [of OHP] can’t be seen in the short range. They can’t be seen from accounting immediately, within a year or two. It’s a long-term process."

Chen says employers in areas that require high degrees of safety consciousness — construction, for example — are more aware of the benefits of preventive occupational psychology. "But I am not quite positive that they belong to the majority," he says.

Career choices

OHP concentrations minors, or majors are offered at Bowling Green State University, Clemson University, Colorado State University, Kansas State University, Portland State University, Tulane University, University of California at Los Angeles, University of Connecticut, University of Houston, University of Minnesota, University of South Florida, and University of Texas at Austin.

The programs range from graduate minors as part of existing I/O and clinical psychology programs; concentrations within master degree programs; and full interdisciplinary master of science and PhD degrees.

The core curricula in these training programs usually include course work covering a survey of occupational safety and health; job stress theory and mechanisms; organizational risk factors for occupational stress, injury, and illness; health implications of stressful work, including physical and psychological, health, and economic outcomes; organizational interventions (e.g., work redesign) and programs (employee assistance programs, work-family programs, etc.) for reduction of occupational stress, injury, and illness; and research methods and practices in public and occupational health and epidemiology.

Other themes that are included in some programs include the macroergonomics of hazard management and musculoskeletal disorders, gender discrimination and workplace civility, rest break schedules during computer-mediated work, health psychophysiology of work teams, and utility analyses for OSH programs.

But what do graduates do with all this new, cutting-edge knowledge? "That’s really hard to answer," says McCubbin. "We envision there’s a need, that there has to be a parallel evolution in the job market. What’s happening in this market is that this specialty is being brought into the traditional I/O career paths as an additional area of expertise, and expands [graduates’] effectiveness."

While work psychology is a full specialty in Europe, OHP still is a subspecialty of clinical, social, or I/O psychology in the United States, he says. "My belief is that if our I/O grads, as they enter the job market because they have this OHP training in additional to traditional I/O psychology training, will be viewed favorably in the job market."

Downey said the students who pursue the graduate certificate at KSU, offered as a distance learning program, are either already established in their careers or are in graduate programs in psychology or counseling, and want to build on that. "One of our students has a masters in counseling and is using [his OHP training] in terms of vocational counseling and advice to clients about health issues in the workplace," Downey says. "Another student is a lieutenant commander in the Navy and is doing the program to help her understand and establish policies and procedures on health issues for the Navy."

Some programs steer their graduates into academia. "Our program is new and we have not had any graduates yet, [but] research universities like this one are most interested in graduates becoming academic researchers, and that is certainly a goal," says Charles J. Holahan, PhD, professor in the University of Texas at Austin’s psychology department. "I envision that some students will also go into applied work either as independent consultants [e.g., stress management] or within larger occupational settings [e.g., wellness programs]."

Chen says the addition of OHP studies broadens the career horizon for Colorado State I/O psychology graduates.

Besides slow acceptance within the business community, OHP met with some early resistance from the traditional I/O discipline. "There is some inertia in the disciplinary fields, some natural inertia that must be overcome as this field matures," McCubbin says. "At this point, [OHP] is really interdisciplinary, and not encapsulated on its own as much as it is bringing another layer of expertise to the I/O discipline."

For information and links to the OHP programs offered at U.S. universities, visit the NIOSH web site at www.cdc.gov/niosh/ohp.html.

For more information, contact:

  • Peter Y. Chen, PhD, Industrial/Organizational Psychologist; Associate Professor, Department of Psychology, Colorado State University, Fort Collins, CO 80523. Phone: (970) 491-2143.
  • Ronald G. Downey, PhD, Professor of Psychology, Kansas State University. Phone: (785) 532-5475. E-mail: downey@ksu.edu.
  • Charles Holahan, PhD, Professor of Psychology, University of Texas at Austin. Phone: (512) 471-3320. E-mail: holahan@psy.utexas.edu.
  • James A McCubbin, PhD, Professor and Chair, Department of Psychology, College of Business and Behavioral Science, 415 Brackett Hall, Clemson University, Clemson, SC 29634. Phone: (864) 656-7368. E-mail: jmccubb@clemson.edu.