What is Clinical Psychology? & History of Clinical Psychology. PSY 204: Introduction to Clinical Psychology Yudit Namer

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(1)

What is Clinical Psychology? &

History of Clinical Psychology

PSY 204:

Introduction to Clinical Psychology

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What is Clinical Psychology?

•  A subfield of the larger discipline of psychology

interested in behavioural and mental process

(especially human)

1.  research on behaviour and mental process

2.  assessment or measurement of the abilities and characteristics of human beings

3.  effort to help people who are psychologically distressed

(3)

What is Clinical Psychology?

•  APA Division 12: “The field of Clinical

Psychology integrates science, theory, and

practice to understand, predict, and alleviate

maladjustment, disability, and discomfort as

well as to promote human adaptation,

adjustment, and personal development. Clinical

Psychology focuses on the intellectual,

emotional, biological, psychological, social, and

behavioral aspects of human functioning across

the life span, in varying cultures, and at all

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What is Clinical Psychology?

•  “Clinical attitude/approach”

▫  the tendency to combine knowledge from research on human behaviour and mental process with

efforts on individual assessment in order to understand and help a particular person

▫  learn general principles that apply to human behaviour problem in general

▫  know how general principles shape lives,

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Clinical Psychology & Related mental

health professions

•  Counseling psychologists and school

psychologists

•  Social workers

•  Psychiatrists

•  Psychiatric nurses

•  Marriage and family therapists

•  Paraprofessionals

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Activities of Clinical Psychologists

•  Assessment:

▫  collecting information about people (behaviour, characteristics, abilities, intellectual functioning). ▫  use information

!  to diagnose problems,

!  to guide client toward optimal vocational choice, !  to facilitate the selection of job candidates,

!  to describe the personality characteristics, !  to select treatment techniques,

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Activities of Clinical Psychologists

•  Treatment:

▫  offering treatments designed to help people better understand and solve distressing psychological problems.

!  interventions may be psychotherapy, behaviour modification, psychological counselling etc.

!  modality may be outpatient, inpatient, brief over several years

!  goal may be finding a specific solution to a problem or reconstruction of personality

!  may be offered free of charge, or for a fixed fee !  results may be positive, neutral or negative

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Activities of Clinical Psychologists

•  Research:

▫  research activity makes clinicians to stand out among other professionals

▫  research skills necessary

!  to critically evaluate published research and decide which assessments and treatment strategy is more appropriate for clients

!  to objectively evaluate results of their own practice

!  to evaluate the effectiveness of mental health centres’ or service agencies’ effectiveness

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Activities of Clinical Psychologists

•  Teaching:

▫  classes such as abnormal psychology, clinical

psychology, personality, psychotherapy, research design, assessment and etc.

▫  supervising hours

•  Consultation:

▫  advice organisations about variety of problems (such as education, advice, direct service, or reducing the conflict etc.)

•  Administration:

▫  such as a head of a college or university psychology department, director of a graduate programme, dean of a faculty, etc.

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Activities of Clinical Psychologists

Activity % involved in % Time

Psychotherapy 84 37 Diagnosis/ assessment 74 15 Teaching 50 9 Clinical supervision 62 7 Research/Writing 47 10 Consultation 54 7 Administration 52 11

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A day in the life of a Clinical

Psychologist (Dr Melinda Losee)

Monday

8:00 - check messages, e-mail, return calls 9:00 - psychotherapy client 10:00 - psychotherapy client 11:00 - case conference -review new cases

12:00 - continuing education luncheon 1:00 - intake new psychotherapy client 2:00 - consult with psychiatrist re: inpatients 3:00 - intake new psychotherapy client 4:00 - supervision of Master’s level clinicians 5:00 - paperwork

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Clinical Psychology Training

•  The Boulder Model:

▫  Scientist-practitioner model: proficiency in research and professional practice

▫  PhD – Doctorate of philosophy ▫  Training in three broad areas:

!  Research !  Assessment !  Intervention

▫  Advanced education in core areas of psychology

!  Biological bases

!  Learning and cognition !  Social influences

!  Individual differences

▫  Experiential learning

!  Clinical practica (leading to pre-doctoral internship) !  Research mentoring (leading to doctoral dissertation)

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Clinical Psychology Training

•  Vail Model:

▫  Less emphasis on scientific training, more on preparation for the delivery of clinical services ▫  Practitioner-scholar model

▫  PsyD – Doctorate of psychology

▫  Emphasis is on training for practice

▫  First program 1968 – University of Illinois

▫  Currently – about 25% of APA accredited doctoral training programs in clinical psychology offer

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History of Clinical Psychology

•  Did not emerge as a discipline until the

beginning of the 20th century and did not fully

develop until the end of the 2nd WW

•  Three sets of social and historical factors shaped

and continue to influence the field:

1.  The use of scientific methods in psychology 2.  The study of human individual differences

3.  Changes in how behaviour disorders have been viewed and treated over the years

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History of Clinical Psychology

•  First psychology lab is opened by Wilhelm Wundt at Leipzig in 1879

•  Attention to individual differences:

▫  Darwin’s Origin of Species:

!  variation of individual characteristics occurs within and between species,

!  natural selection takes place in part on the basis of those characteristics

▫  Galton applied Darwin’s notions to individual differences, especially in mental abilities

▫  Cattell applied psychological method to the study of individual differences

▫  Alfred Binet began to develop measures of complex mental ability in children with and without disabilities

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History of Clinical Psychology

•  Changing conception of behaviour disorder:

▫  Magical forces and supernatural events (possessed by demons or spirits, treatment methods like exorcism)

▫  4th century B.C.: Hippocrates suggested these aberrations stem from natural causes (distribution of bodily fluids: blood, black bile, yellow bile, and phlegm)

▫  Middle Ages: demonological explanation regained prominence, religious personnel again took over responsibility for dealing with all cases of deviance

▫  16th century: hospitals and asylums started to treat deviant individuals (St Mary of Bethlehem Hospital in London, i.e. Bedlam)

▫  18th and early 19th centuries: more humane living conditions and treatment begun to appear

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History of Clinical Psychology

•  Emergence of scientific psychiatry

▫  J. Langdon Down – Down’s Syndrome ▫  Ewald Hecker – hebephrenia

▫  Emil Kraepelin

!  textbook on psychiatry – 1883 !  dementia praecox

▫  Improved classification

▫  Differentiation of mental retardation from mental illness

▫  Acceptance of non-biological causes of mental disorders

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History of Clinical Psychology

•  Birth of discipline

▫  Ligthner Witmer (1867-1956)

!  established first psychological clinic in 1896 !  first to propose a helping profession within

psychology

!  established the first clinical psychology journal – The Psychological Clinic

!  established first training program in clinical psychology

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History of Clinical Psychology

•  WWI through WWII

▫  To classify military recruits in terms of intellectual prowess and psychological stability

!  Army Alpha and Army Beta

!  Stanford-Binet – 1916 (revised 1937) !  Wechsler-Bellvue – 1939

!  Rorschach Inkblot Test – 1921

!  Thematic Apperception Test – 1938 !  MMPI – 1943

!  Jung’s Word Association Test !  Draw-A-Man Test

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History of Clinical Psychology

•  Post WWII

▫  American Psychological Association

▫  Mass testing of the intelligence, ability, and personality of the military personnel

!  Army General Classification Test !  Short forms of Rorschach and TAT

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Clinical Psychology –

Professional Organizations

•  1917 – First organization under the name "clinical

psychology” – American Association of Clinical Psychology •  1919 – American Psychological Association (APA) developed a

section on Clinical Psychology, offered certification until 1927 •  1930 – American Association of Applied Psychology, acted as

the primary forum for psychologists until after World War II when APA reorganized

•  1945 – APA created what is now called The Society of Clinical Psychology (Division 12),

▫  II – Clinical Geropsychology

▫  III – Society of a Science of Clinical Psychology ▫  IV – Clinical Psychology of Women

▫  V – Clinical Psychology of Ethnic minorities ▫  VI – Emergencies and Crises

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Clinical Psychology – Training

•  David Shakow’s Committee on Training in

Clinical Psychology recommended that:

▫  Clinical psychologist should be trained first as a psychologists (i.e. as a scientist first and second as a practising professional)

▫  Clinical training should be as rigorous as that

given to non-clinicians and thus should consist of a four year doctorate, including a year supervised clinical internship experience

▫  Clinical training should focus on assessment, research, and treatment

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Clinical Psychology – 21st century

•  Current struggles

▫  More clinicians join group practices to cut the costs ▫  An increase in the use of brief therapies that focuses

on problem solving skills and rapid symptom reduction

▫  An emphasis on prevention, so that fewer clients in extended and expensive psychotherapy

▫  A demand to use only empirically effective methods ▫  A larger role for clinicians at BA or MA level

▫  More involvement with people with serious or chronic diseases

▫  Pressure to obtain privilege to prescribe cost-effective psychoactive drugs

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Clinical Psychology – 21st century

•  Cultural diversity

▫  refers to variations in ethnic and racial

background, sexual and religious orientations, or other dimensions that create psychological

experiences that are significantly different from experiences of persons in other cultures or groups ▫  psychological disorders may manifest themselves

differently across cultural groups ▫  culturally bound syndromes

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