Innovations in behavioral medicine

The chapter begins with a brief history of the behavioral medicine movement along with an overview of contemporary activities in the field. Three subsequent sections review technical innovations in major areas of clinical behavioral medicine: treatment, health care delivery, and preventive health care. The final section describes the methodological characteristics of research in behavioral medicine, discusses the field in light of the psychosomatic medicine and behavior modification movements, and calls for a conceptual integration that is authentically behavioristic. Already the quality of research in behavioral medicine appears comparable to that of research in behavior therapy. Even so, when viewed in terms of contemporary methodological desiderata, most of the work is fairly unimpressive. Possibly needed are "hybrid" experimental approaches in which the inferential power of intrasubject phase manipulations and between-subject outcome comparisons are combined. There is good reason to believe that behavioral medicine will follow the historical course of behavior therapy/modification, not the course of psychosomatic medicine. Behaviorally knowledgeable psychologists can become major service providers in liaison with well-informed medical practitioners. Some potentially deleterious influences on the behavioral medicine movement are (inevitable) mentalistic and dualistic thinking and a retreat toward psychosomatic medicine. Field behaviorism as an organizing schema can, in principle, serve as a safeguard against such untoward influences.