Teaching and training of the psychosomatic approach.

In the United States, teaching and training of the psychosomatic approach relies upon (1) the application of psychosomatic concepts, such as reaction to stress, life change and illness, and neuroendocrine influences on disease process to the delivery of mental health services to the sick and dying through liaison programs, and (2) the focussing upon relevant methodology of psychological care in the context of American medicine with its growing knowledge of social implications of health care. Such methodology includes the teaching of data collection, substantive psychiatric disorders in the medically ill, supportive therapy and crisis intervention, psychopharmacology, emotional reaction to illness, and management of obstacles to a psychosocial approach. The resistance of nonpsychiatrist personnel to psychological factors and of psychiatric personnel to medical factors are obstacles which require particular emphasis in graduate and postgraduate training in this clinical area.