Robert, a 58-year-old accountant in Cleveland, was six weeks past his triple bypass surgery and could not understand why he felt worse than before the operation. The surgery had gone well by every cardiac measure. His ejection fraction had improved. But he was waking at three each morning with chest tightness that the cardiology workup had ruled out as cardiac, snapping at his wife, and unable to face the cardiac rehabilitation program that the hospital kept reminding him to start. His cardiologist made a referral inside the same hospital — to a board-certified clinical health psychologist embedded in the cardiology service. The psychologist had completed a fellowship in cardiac psychology at a Midwestern academic medical center and worked specifically with post-surgical patients. She did not treat Robert as someone with a separate “psychiatric problem” piped over from the medical team. She understood the trajectory of post-bypass adjustment, the cluster of anxiety and demoralization that 30 percent of cardiac patients experience, and the specific cognitive and behavioral interventions that get patients into rehab and back into life. Eight sessions later Robert was in cardiac rehab three times a week and sleeping through the night.
Most Americans living with chronic illness — cancer, cardiac disease, diabetes, chronic pain, organ transplant — never learn that there is a clinical specialty designed for the psychological dimensions of their care. A board-certified health psychologist is a clinical psychologist with subspecialty training in the interface of behavior and physical health. The field, known as health psychology, is recognized as APA Division 38, with its own board certification (ABCHP) and academic training pathway. A skilled health psychologist works inside medical teams rather than parallel to them. This guide explains what they do, where to find them, and how to know if their care is right for you.
Health psychology as APA Division 38
The American Psychological Association’s Division 38, the Society for Health Psychology, has been the professional home for the specialty since 1978. Health psychology emerged from behavioral medicine — the recognition that behavior, cognition, and emotion influence the onset, course, and management of physical disease. Health psychologists today work across cancer care, cardiac rehabilitation, diabetes care, chronic pain programs, organ transplant evaluations, weight management, smoking cessation, sleep medicine, and primary care behavioral integration.
Division 38 maintains continuing education programs, an annual conference, and the journal Health Psychology, one of the most-cited journals in psychology. The division also defines training competencies through the Council of Clinical Health Psychology Training Programs, which accredits the postdoctoral fellowships where most clinical health psychologists train. Information about the specialty’s research base and clinical applications is available through the American Psychological Association at apa.org.
Board certification through the ABCHP
The American Board of Clinical Health Psychology (ABCHP), a member board of the American Board of Professional Psychology (ABPP), confers board certification on clinical health psychologists who meet rigorous training and practice criteria. Board certification requires a doctorate in clinical or counseling psychology, two years of postdoctoral supervised experience in clinical health psychology, submission of a practice sample with case work, and passage of an oral examination. Diplomate status under ABCHP is the highest formal credential in the field.
The ABCHP directory at abchp.com lists board-certified providers searchable by state. The numbers are smaller than for clinical psychology generally — there are roughly two hundred ABCHP diplomates nationally — because most health psychology practice happens within academic medical centers and integrated care settings rather than independent private practice. Patients seeking care outside these settings may need to look at clinicians who completed accredited postdoctoral fellowships even if they have not pursued ABCHP certification. Our guide on finding specialists for chronic illness mental health outlines this approach.
Where health psychologists work
The largest concentrations of clinical health psychologists are in academic medical centers, where they work as embedded specialists across departments. Common settings include:
- Oncology — supporting patients through diagnosis, treatment, survivorship, and end of life. Centers like Memorial Sloan Kettering, MD Anderson, Dana-Farber, and the City of Hope have dedicated psycho-oncology services staffed by health psychologists.
- Cardiology and cardiac rehabilitation — addressing post-MI and post-surgical depression, anxiety about recurrence, and adherence to lifestyle change.
- Transplant programs — conducting psychological evaluations for organ transplant candidacy and supporting patients pre- and post-transplant.
- Chronic pain clinics — delivering CBT for chronic pain, ACT for pain, biofeedback, and graded exposure for movement-fearful patients.
- Diabetes and endocrinology — addressing diabetes distress, adherence to complex regimens, and emotional eating.
- Bariatric and weight management programs — pre-surgical evaluations and behavioral intervention for sustained weight management.
- Pulmonary and sleep medicine — CBT-I for insomnia, CPAP adherence work, and adjustment to chronic respiratory disease.
- Primary care behavioral integration — short-format consultation in primary care offices for stress, sleep, pain, and behavior change.
What health psychologists actually treat
The clinical work spans psychological adjustment to medical illness, behavior change for chronic disease management, and the treatment of conditions that present at the mind-body interface. Specific common presentations include:
Cancer adjustment: distress at diagnosis, treatment-related anxiety, body image after surgery and chemotherapy, fear of recurrence in survivorship, family communication around prognosis. Health psychologists in oncology programs often co-deliver care with oncology social workers and may use protocols like Meaning-Centered Psychotherapy developed at Memorial Sloan Kettering for advanced cancer patients.
Cardiac psychology: post-MI depression (which roughly doubles mortality risk if untreated), anxiety about recurrence, panic that mimics cardiac symptoms, adherence to cardiac rehabilitation, and the psychological work of returning to normal life after a serious cardiac event. Many cardiac rehab programs require or strongly encourage psychological assessment.
Diabetes management: diabetes distress (a non-clinical-depression syndrome of being worn down by disease management), insulin omission in eating disorders, adherence to medication and glucose monitoring, and the family work of supporting children and adolescents with type 1 diabetes. The American Diabetes Association recognizes mental health screening as standard of care.
Chronic pain: CBT for chronic pain protocols target catastrophic thinking, kinesiophobia, and pacing. ACT for pain emphasizes psychological flexibility and value-based action despite pain. Biofeedback for tension headache and migraine has decades of research support. Multidisciplinary pain clinics typically embed health psychologists alongside physiatrists, physical therapists, and pain physicians.
How health psychology differs from clinical psychology and psycho-oncology
Clinical psychology is the broad field that includes psychotherapy and assessment for psychiatric conditions. Health psychology is a specialty within clinical psychology focused on the medical-psychological interface. A board-certified clinical psychologist with no health psychology training may treat a cancer patient’s depression but typically does not have the systems-level fluency — knowing the chemotherapy regimens, the surgical recovery timelines, the survivorship issues — that a psycho-oncologist or health psychologist brings.
Psycho-oncology is the specific subspecialty of health psychology and consultation-liaison psychiatry focused on cancer. Practitioners may be psychologists, psychiatrists, or social workers. The American Psychosocial Oncology Society (APOS) is the professional organization. Health psychology is the broader umbrella that includes psycho-oncology along with cardiac, diabetes, transplant, and other medical specialty areas. A patient seeking integrated care for chronic illness usually does best with a clinician embedded in or closely networked with the relevant medical service line. Our guide to cancer adjustment and meaning-centered work covers psycho-oncology specifically.
Finding board-certified health psychologists
The ABCHP directory at abchp.com is the most authoritative listing of board-certified clinical health psychologists. The APA Division 38 membership directory is searchable for division members, who include clinicians, researchers, and trainees. Academic medical centers list their behavioral medicine and psychology faculty publicly; checking the website of the closest academic hospital under cancer center, cardiology, transplant, or pain medicine often reveals named health psychologists on the team.
Patients in regions without large academic medical centers may need to use telehealth. PSYPACT, the Psychology Interjurisdictional Compact, allows licensed psychologists to provide telehealth across state lines in participating states. Several PSYPACT-eligible health psychology practices serve patients nationally for specific issues like chronic pain CBT, cancer survivorship, and bariatric pre-surgical evaluations. The National Institutes of Health publishes evidence summaries on behavioral interventions for chronic disease at nih.gov.
Insurance integration with medical care
Health psychology services bill under standard psychotherapy CPT codes (90791, 90834, 90837) and, importantly, under Health and Behavior Assessment and Intervention codes (96156, 96158, 96159, 96164, 96165, 96167, 96168). The H&B codes were created specifically for psychological services tied to a medical diagnosis rather than a psychiatric diagnosis. Their use can simplify reimbursement when the primary issue is, for example, adjustment to a cancer diagnosis or adherence to diabetes management without a free-standing psychiatric diagnosis.
Medicare covers health psychology services. Most commercial plans cover them under behavioral health benefits or, when delivered by an embedded provider in a medical clinic, under medical benefits. Patients should verify which set of benefits applies — copays, deductibles, and visit limits can differ. Health psychologists working in hospital outpatient departments often bill under hospital outpatient codes that have different patient cost-sharing than freestanding psychotherapy. Our piece on insurance for behavioral health in chronic disease walks through these variations.
Behavioral medicine integration in primary care
Primary care behavioral health (PCBH), an integration model developed in the early 2000s and now widespread in federally qualified health centers and large primary care groups, embeds behavioral health consultants — often clinical psychologists or licensed clinical social workers with health psychology training — in the primary care office. The work is brief, often a fifteen to thirty minute consultation initiated by the primary care physician’s warm handoff. Common targets include sleep, pain, weight, smoking, alcohol use, and stress-related symptoms.
Collaborative Care, a related but distinct model developed at the University of Washington, uses a care manager (often a social worker or nurse) and a consulting psychiatrist to support primary care management of depression and anxiety. Both models have RCT support and are increasingly reimbursed by commercial and government payers under specific behavioral health integration billing codes. Patients in primary care practices using these models often have access to behavioral medicine without a separate referral and intake process.
Asking your medical team for a referral
The most reliable path to a health psychologist is asking the medical specialist treating your condition. Oncologists, cardiologists, endocrinologists, transplant teams, and pain medicine physicians know the psychologists embedded in or networked with their service. A specific request — “I would like to be evaluated by a psychologist who works with cancer patients” — usually produces a more useful referral than a vague mention of stress.
If your medical team does not have an embedded psychologist or strong referral relationship, calling the closest academic medical center’s behavioral medicine or psychology department often connects you with the right person. Many academic centers maintain intake lines specifically for outside referrals to their health psychology services. The work is often time-limited (six to twelve sessions) and focused, which makes it accessible for patients juggling multiple medical appointments.
Frequently asked questions
Do I need a psychiatric diagnosis to see a health psychologist?
No. Health and Behavior CPT codes allow billing for psychological services tied to a medical diagnosis. Adjustment to cancer, cardiac rehabilitation participation, or chronic pain management can be the focus without a separate psychiatric diagnosis.
Is a health psychologist the same as a therapist?
Health psychologists are licensed psychologists with subspecialty training. They provide psychotherapy, but their training and practice focus on the medical-psychological interface, not all clinical conditions.
Will a health psychologist coordinate with my medical team?
Yes. Coordination with treating medical providers is a defining feature of health psychology practice. Many work within shared electronic medical records and attend interdisciplinary case conferences.
How long does treatment last?
Many health psychology interventions are time-limited — eight to twelve sessions for adjustment to a new diagnosis, six to ten sessions for CBT-I or CBT for chronic pain. Survivorship and long-term disease management may involve longer-term intermittent contact.
Are health psychologists involved in transplant evaluation?
Yes. Most transplant programs include a psychological evaluation as part of pre-transplant workup, conducted by a clinical health psychologist with transplant experience. This evaluation assesses readiness, support systems, and adherence factors.
The bottom line
For Americans living with chronic disease, a health psychologist is often the missing piece between excellent medical care and the actual quality of life that medical care is supposed to make possible. Board-certified clinical health psychologists embedded in academic medical center oncology, cardiology, transplant, and pain programs deliver evidence-based interventions specific to the medical condition. The ABCHP directory and APA Division 38 are the most reliable starting points; the most efficient path is asking the medical specialist treating you for an embedded referral. The care is real, the evidence is strong, and most patients only learn about it after they have spent months struggling alone.
If you are in crisis or thinking about suicide, call or text 988 to reach the Suicide and Crisis Lifeline, available twenty-four hours a day.
This article is for informational purposes only and does not constitute medical or psychological advice. Diagnosis and treatment of mental health and medical conditions require evaluation by licensed clinicians. The mention of programs, organizations, and clinicians is illustrative and does not constitute endorsement.