Jonathan Houdmont and Stavroula Leka
This chapter introduces occupational health psychology by defining the subject matter and exploring the features that make it distinct from other related areas. The influence of key research groups and studies, characteristics of the changing world of work, and legislative developments that have contributed to the development of the discipline, are considered. The chapter closes by introducing the bodies that represent and support research, training, and professional practice in occupational health psychology on the international stage.
There are numerous descriptors for subject specialties that concern the application of psychology in the workplace: industrial and organizational psychology, work and organizational psychology, work and health psychology, vocational psychology, and occupational psychology to name but a few. Each of these specialties has a distinct perspective on the dynamic relationship between work and the worker (although some overlap is inevitable), and exists as a formalized entity supported, to varying degrees, by representative bodies, academic and practitioner journals, international conferences, and professional training pathways. To this collection there is a new entrant that since the early 1990s has attracted interest, but about which little has been written for the student embarking upon study of the specialty: occupational health psychology.
In this chapter we set out the nature and definition of this specialty, and trace its emergence by selectively highlighting a series of influential research groups and studies, characteristics of the changing world of work, and legislative developments that have materialized during the twentieth century in Europe and North America. We conclude with an examination of the contemporary character of occupational health psychology in which consideration is given to structures that exist to support the research, training, and practitioner activities of an expanding international constituency.
What is Occupational Health Psychology?
Where did the term 'occupational health psychology' originate? What is the vision of occupational health psychology? Why is occupational health psychology important?
Occupational health psychology (OHP) is a youthful discipline with much to offer the aspiring practitioner. This book is designed to facilitate the knowledge development of those who wish to develop a career in OHP: individuals with a curiosity and enthusiasm for the application of psychological theory and evidence to bring about improvements in the health of workers. The term 'occupational health psychology' was coined in 1990 at the University of Hawaii by a team of academics who observed unfulfilled potential for psychologists to support the development of healthy work environments (Raymond, Wood, & Patrick, 1990). OHP has grown at a rapid rate in the two decades that have passed since Raymond and colleagues set in motion a new specialty. This can be seen in, among other things, the ongoing rise in the submission rate of scientific articles to the discipline's dedicated academic journals (Journal of Occupational Health Psychology and Work & Stress), and the influence of these journals within the broader applied psychology field; the growth in researcher, educator, practitioner, and student attendance at international OHP conferences; the expansion of OHP training provision in Europe and North America; the growth in employment opportunities for OHP practitioners; and the expansion of outlets for practitioners to publish and share best practice.
Alongside these activities, debate on the nature and scope of OHP has crystallized and consensus has developed among academics and practitioners on its aims and objectives. This has allowed for the advancement of a shared vision whereby OHP is understood to have its focus on the creation of 'healthy workplaces in which people may produce, serve, grow, and be valued' (Quick et al., 1997, p. 3). Within this vision, healthy workplaces are understood to be ones 'where people use their talents and gifts to achieve high performance, high satisfaction, and well-being' (ibid.).
The appeal of OHP can be found in the important and unique role it plays in the management of challenges to safety and health in the organizational context. For many decades, prior to the advent of OHP, occupational safety and health professionals had at their disposal a knowledge- and skill-set that was fit for purpose in respect of the control and prevention of exposures to traditional work-related hazards such as physical, biological, or chemical agents (Sauter & Hurrell, 1999). The practitioner's professional toolkit was robust and effective in so far as it was designed to deal with the prevalent work-related hazards of the time. The adequacy of the toolkit was, however, called into question towards the end of the twentieth century as a consequence of the rise in workplace psychosocial hazards. Defined as 'those aspects of work design and the organization and management of work, and their social and organizational contexts, which have the potential for causing psychological, social or physical harm' (Cox, Griffiths, & Rial González, 2000, p. 14), psychosocial hazards, and the health-risks they pose, have in recent years entered the consciousness of employers, policy- and law-makers, and occupational safety and health practitioners due to their association with characteristics of the contemporary world of work such as internationalization and increased global competition, the continual evolution of information and communication technologies, and changes to the configuration of the workforce (Kompier, 2006). Psychosocial hazard exposures hold the potential to cause serious harm. However, education and training provision for occupational safety and health professionals has traditionally neglected psychosocial issues; thus, it is in the management of these that the OHP practitioner can make a unique contribution to the prevention of occupational illness and injury, and promotion of occupational health and well-being. This is an important role; indeed, there is evidence to suggest that psychosocial hazards are likely to continue to pose a growing threat to worker well-being (see Research Close-Up 1.1). As such, the services of the OHP practitioner are likely to be of increasing value to organizations as the twenty-first century unfolds.
The OHP moniker was coined in 1990, since which time the discipline has flourished in Europe and North America. Agreement can be found on the vision for OHP, and the discipline now plays an important role in the prevention of occupational illness and injury, and promotion of occupational health and well-being.
The Definition of Occupational Health Psychology
How is occupational health psychology defined? What commonalities and differences exist between European and North American definitions?
With any youthful discipline it takes time for consensus to develop around a precise definition in respect of its key ingredients or features. OHP is no exception; although there is agreement among the discipline's protagonists on its aims and objectives, evidence of divergence can be found between North American and European perspectives on its definition (Cox, 2000). This is specifically so in relation to the specialties that inform and comprise OHP. At one level it could be argued that divergence is a mere matter of semantics because OHP protagonists the world over adhere to a universal understanding of the discipline. However, because the definitions adhered to by academics will determine, in part, the content of training programmes, divergence may have the unfortunate consequence of conspiring against the creation of programme accreditation procedures and professional training pathways that are required to sustain the discipline in the long term.
For this reason, it is imperative that international consensus is ultimately achieved on the definition of OHP. Fortunately, despite the absence of a shared heritage across the international OHP community, broad agreement on the nature of the discipline can be found in the definitions advanced by the discipline's European and North American representative bodies. In Europe, the generally accepted definition is that advanced by the European Academy of Occupational Health Psychology (EAOHP). This is based on the definition posited by Cox, Baldursson, and Rial González (2000), whereby OHP is considered 'the contribution of applied psychology to occupational health' (p. 101). This definition locates OHP at the interface between occupational health and psychology. Cox and colleagues suggest that the areas of psychology that might be applied in addressing occupational health issues include health psychology, work and organizational psychology, and social and environmental psychology. This perspective is illustrated in Figure 1.1. The contribution of these areas of psychology implies that OHP practitioners have their focus on the psychological, social, and organizational aspects of occupational health questions. The European perspective recognizes that occupational health is a multidisciplinary area and that OHP practitioners offer a focused specialization that they may usefully apply within multidisciplinary teams. In this way, it 'requires that European occupational health psychologists are aware of and recognize the contributions that can be made by others, and can appreciate their intellectual positions, knowledge and practical skills' (ibid., p. 103).
The North American perspective on OHP is in large part consistent with the European approach. Nevertheless, differences can be identified. Whereas the European tradition draws on procedures, practices, and methodologies from various fields of applied psychology, North American definitions encompass psychological perspectives alongside those from other occupational sciences such as occupational and environmental health, organizational behaviour, human factors, sociology, industrial engineering, ergonomics, and economics (Adkins, 1999; Chen, Huang, & DeArmond, 2005). This perspective gives rise to the definition advanced by the North American representative body for the discipline - the Society for Occupational Health Psychology (SOHP) - whereby OHP is viewed as involving:
The interdisciplinary partnerships of psychological and occupational health science professionals seeking to improve the quality of working life, and enhance the safety, health and well-being of workers in all occupations. Because it exists at the intersection of behavioral science and occupational health disciplines, OHP is inclusive of knowledge and methods from psychology, public/occupational health, organizational studies, human factors, and allied fields (such as occupational sociology, industrial engineering, economics, and others). (Society for Occupational Health Psychology, 2008)
This multidisciplinary perspective, illustrated in Figure 1.2, was established at the outset of the discipline's existence in North America. In their seminal article, Raymond, Wood, and Patrick (1990) called for training in a discipline that 'would integrate and synthesize insights, frameworks and knowledge from a diverse number of specialties, principally health psychology and occupational (public) health but also preventative medicine, occupational medicine, behavioral medicine, nursing, political science, sociology and business' (p. 1159). Interestingly, in recent times, debate in North America has resurfaced on the extent to which OHP should exist primarily as a psychological discipline (Sinclair, 2009), suggesting that opinion on its interdisciplinary status may be divided.
Despite definitional differences, there is little doubt that advocates for OHP the world over unanimously endorse the aforementioned vision for OHP delineated by Quick et al. (1997). Likewise, most would agree with the high-level characteristics posited by Cox et al. (2000) as defining the discipline. These include acknowledgement that OHP is: (a) an applied science, (b) evidence driven, (c) oriented towards problem solving, (d) multidisciplinary, (e) participatory, (f) focused on intervention, with an emphasis on primary prevention (see Definition 1.1), and (g) operational within a legal framework.
OHP can be defined simply as 'the contribution of applied psychology to occupational health'. This 'interface' definition, adhered to in Europe, recognizes that occupational health is a multidisciplinary area and that OHP practitioners offer a focused specialization that they may usefully apply within multidisciplinary teams. The North American perspective on OHP is in large part consistent with the European approach, but differs in that it encompasses psychological perspectives alongside those from other occupational sciences.
OHP Topic Areas
How have OHP topic areas been identified? Which topic areas fall under the OHP umbrella?
Further evidence for the youthfulness of OHP can be found in the absence of an agreed list of topic areas that the discipline might address beyond its traditional focus on work-related stress. Although the field is yet to achieve a level of maturity whereby agreement exists in respect of the domains that ought to be encompassed within the OHP umbrella, what is clear is that irrespective of what these might be, OHP should be inclusive in so far as is reasonable (Chen, DeArmond, & Huang, 2006). Three contrasting approaches have been applied for the purpose of drawing conclusions on the topic areas that comprise the focus of OHP: scrutiny of existing educational curricula, analyses of themes as they have appeared in the discipline's academic journals, and expert surveys.
Scrutiny of existing curricula
One approach to the identification of OHP topic areas, which has been applied in the US context, has involved the analysis of existing curricula. Scrutiny of topics addressed in 12 US doctoral OHP training programs revealed one topic taught across programs: introduction to the discipline of OHP. Work-related stress was the second most prevalent topic area, taught at seven institutions (Fullagar & Hatfield, 2005). A similar analysis of the content of 11 US doctoral curricula identified the consistent appearance of six topic areas: (a) survey (overview) of occupational safety and health, (b) job stress theory, (c) organizational risk factors for occupational stress, injury, and illness, (d) physical and psychological health implications of stressful work, (e) organizational interventions for the reduction of work-related stress, and (f) research methods and practices in public/occupational health and epidemiology (Barnes-Farrell, 2006). These curriculum areas are consistent with seven broad areas identified by Macik-Frey, Quick, and Nelson (2007) as representing the major research themes addressed in papers published in the Journal of Occupational Health Psychology (see below). It might be reasonable to assume that consistency between OHP curricula and published research themes has arisen owing to programme designers having relied on the latter to inform the former.
Published research themes
Themes in the published research literature provide an indication of some important topics that ought to perhaps be included under the OHP umbrella and, specifically, within education and training curricula. Through analysis of themes addressed in papers published in the Journal of Occupational Health Psychology over an 11 year period from the journal's inception in 1996, Macik-Frey, Quick, and Nelson (2007) identified seven broad areas that represented the major themes considered by researchers. Work-related stress was identified as the single most researched area, followed by burnout; work-family issues; aggression, violence and harassment; safety; employment issues; and health issues. Within these broad areas four topics were identified as holding promise for future OHP research: positive psychology, virtual work, moods and emotions, and intervention studies.
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