Health Psychology Class on Addressin SDOH in Clinical Health Psych Settings.

1. Health Psychology
A crash course in human neurobiology and what psychoneuroimmunology is in health

2. Class Overview for the Day
 10 Min – Connect and Reflect
 5 Min – Skills practice
Visualization/Wisemind Practice, ‘what is
love right now.’
 10 Min – Student Presentation
 20 Min – SDOH Small groups discussion
 30 Min – Lecture on SDOH
 20 Min – Class exercise ICE Berg model for
my clinic or community
 10 Min – Wrap up and announcements

3. Skills Practice
Group Practice of Clinical Skill

5. Visualization What is
Love Now
• When we are overwhelmed is when we are most
likely to use coping that does not support us. This
tool can help.
• HALT-BS: When we are feeling overwhelmed it is
often due to a need. This need can be assessed
using HALT-BS. Hungry, Angry, Lonely, Tired, Board,
Stressed.
• Please Skills; Please skill in DBT is another powerful
skill to assess what one needs at a moment.
• Kinds of Rest: Mental Rest, Emotional Rest, Sensory
Rest, Creativity Rest, Social Rest, Spiritual Rest.

6. Visualization
Skill Practice
• Cleansing Breath: take a deep breath in all at once and then let out
with a slow sigh, three times.
• Imagine a time when you felt supported that was helpful for you: by
some one, an animal, nature, a spiritual presence.
• Sensation: Explore what it feels like in your body when you imagine
that feeling of being supported. Good sensations, challenging
sensations, and don’t get too stuck in either.
• Check In: Check in with your body, mind and spirit. And ask, ‘what
love do I need right now?’ This is a wise mind practice to don’t force
an answer just let it come. And then put that down and ask again
three to five more times, waiting for an answer and letting your
‘wise mind answer.’
• Committed Action: Think about a values based committed action
you could do based on this insight. Imagine how you would feel
doing this action and when you could do the action.

7. Student Brief Health Psych
Presentation 1
Sharing the insights and skills from professional development

8. Student
Presentation A

9. Student
Presentation B

10. From Silos to Community
Building a Health Team

14. Small Group Discussion
Epigenetics and SDOH
• What role does epigenetics play
in SHOD leading to poor health?
• How can psychotherapy play a
role in transforming the
epigenetics of stress and
overwhelm
• What is an upstream approach
to addressing SDOH and early
stress?
• How can a psychologist help
with these three goals?

15. Health Psychology – Exercise 2
Addressing SDOH in Health Care – Starfish

16. https://knowablemagazine.org/article/mind/2021/unseen-scars-childhood-trauma

19. MARIEL CASE FORMULATION
Mariel is a 37-year-old first generation Salvadorian American, heterosexual, sis-gender woman who has been married for 18 years. She
has pain in her hands that has not been identified but makes it hard for her to take care her responsibilities in a way she likes. Her
goals are to ‘feel better’ ‘argue less’ and have ‘no pain.’ She identifies as catholic but does not practice. She reports early life trauma
that included emotional and physical abuse. Some of which lead her to choose to immigrate. She feels loved by but is in stress with
her husband at this time. He also has a long history of trauma and overwhelm but is loving and engaged with the family.
She has 2 children who are living at home 14 and 16. She can not sleep well at night, she has always felt one edge in her life, she
reports not feeling safe anywhere, she has images that flash in her mind of either terrible future events or terrible past events. In your
brief therapy intake she says, ’people tell me they love me, but I think I am broken and worthless. I just don’t feel good at all.’ She
feels most triggered when she is alone, when she tries to look for work, when she remembers her abuse, and when she tries to do
self-care tasks and pain increases. She reports that she often thinks to herself, “I ruined things, I am no good’ in these situations.
She reports loving her children but feeling like she is a ‘burden.’ She reports losing her temper more than she would like with her
spouse and children. She denies any abuse in the home. She states when she get’s anger her husband works more. She reports feeling
lonely, missing her home in El Salvador but not missing her family who she feels stressed by when they visit the states. She is applying
for her green card and struggles with the test due to feelings of overwhelm that she states make learning English difficult. You are
meeting with her using a phone translator. She appreciates the translation.
She has a family income of $52,000. She has had times when the family has had to make tuff choices around food and housing. Her
neighborhood has a park and she feels safe there mostly but there have been a lot of break ins in her neighborhood. She has had to
work hard to keep utilities paid and the family shares one car. It is not always easy to drive to appoitnments. She lives in an area that
has limited access to healthy foods. She needs to drive 15 min to get to a store with good groceries.

20. Brief
Intervention
• A medical provider calls you in to meet with Mariel. The
provider states that Mariel has been feeling
overwhelmed and is struggling. The provider asks that
you meet with her offer some skills and see if there’s
anything you can do to support her.
• The provider asks that you talk with Mariel about both
the stressors in her life on SDOH form and the
psychological stressors she is facing and offer advice on
care.
• In the session you meet with Merial and have a PhQ-9
Form, a PC-PTSD form filled out and an SDOH Screener.
• You connect with Mariel and ask her what of the SDOH
would most help her?
• When you leave us 211 to make a plan, switch roles and
come back and discuss plan.

21. Health Psychology - Lecture
Addressing SDOH in Health Care – Upstream Work

22. Systems Thinking Designing Person
Sized Change that Matters
Health Psychologists Treat Communities, Systems and Individuals

24. https://community.solutions/built-for-zero/functional-zero/

30. Group Exercise
Addressing SDOH in clinical care

31. Small Groups Exercise
• In small groups practice explore common SDOH
that you find in your clinical work or area.
• Discuss some levers and vectors of change for
these factors.
• Discuss how could your refer, develop systems or
address one of these factors.
• Use ICE Berg Model to Explore one indepth.

32. Class Wrap Up
Review, Next Week, and Announcements