Systems Issues and Considerations

Psychologists are trained to understand their clients as embedded in and affected by multiple systems. Bronfenbrenner’s social ecological theory explains development as occurring within a series of layered, nested, interacting systems. It also serves as a model for medical adherence, health promotion, and healthcare disparities. This chapter utilizes Bronfenbrenner’s model to examine the many roles of the CL psychologist by placing the psychologist within those systems. First, we examine how the psychologist affects and is affected by patients, families, students, colleagues, clinics, institutions, and national policy. Further, we consider how psychologists promote health, effect behavior change, educate, and promote better delivery of healthcare within those systems. Drawing on a rich and diverse literature, this chapter outlines the multifaceted nature of CL psychology and the unique role psychologists play in addressing the mental health needs of children across the medical continuum.