Appropriateness and Accountability in Clinical Psychology within the NHS: Towards a Conceptual Framework

Titolo Rivista RIVISTA DI PSICOLOGIA CLINICA
Autori/Curatori Alessandro Ridolfi, Valentina Panella, Chiara Ghetti
Anno di pubblicazione 2026 Fascicolo 2025/2
Lingua Inglese Numero pagine 23 P. 36-58 Dimensione file 0 KB
DOI 10.3280/rpc2-2025oa20575
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Clinical psychology within the Italian National Health Service (NHS) is undergoing a structural transition, increasingly required to align with governance principles such as appropriateness and accountability. Yet, these constructs - central to international health policy - have not been systematically articulated within psychological practice. This paper develops a conceptual framework that redefines appropriateness and accountability as intrinsic disciplinary dimensions rather than external administrative requirements. Appropriateness is framed as the alignment of psychological intervention with clinical need, psychosocial context, care pathway positioning, and proportional use of public resources. Accountability is defined as the ability of psychologists to justify decisions, demonstrate outcomes, and contribute to the governance and sustainability of public health services across individual, organisational, and participatory levels.

The framework is situated within current developments in the Italian NHS, including the experimental introduction of the primary care psychologist (psicologo di base), the formal integration of psychologists within multidisciplinary care pathways (PDTA), and the increasing relevance of digital data systems and outcome monitoring. A conceptual matrix of appropriateness and a three-phase model of strategic integration are proposed to guide policy, training, and professional practice.

By positioning clinical psychology as a system-based public health discipline, the paper offers a theoretical foundation for enhancing its institutional role, improving coordination across care levels, and supporting value-based and equitable healthcare delivery.

Parole chiave:National Healthcare Service;Appropriateness;Accountability;Clinical psychology

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Alessandro Ridolfi, Valentina Panella, Chiara Ghetti, Appropriateness and Accountability in Clinical Psychology within the NHS: Towards a Conceptual Framework in "RIVISTA DI PSICOLOGIA CLINICA" 2/2025, pp 36-58, DOI: 10.3280/rpc2-2025oa20575