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 Yudit Namer

2 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 socioeconomic levels.

4 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, problems, and treatments on an individual level

5 Clinical Psychology & Related mental health professions Counseling psychologists and school psychologists Social workers Psychiatrists Psychiatric nurses Marriage and family therapists Paraprofessionals Other specialists and caregivers

6 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,! to help legal decision etc.

7 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

8 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! evaluate and supervise research projects by their students

9 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.

10 Activities of Clinical Psychologists Activity % involved in % Time Psychotherapy Diagnosis/ assessment Teaching 50 9 Clinical supervision 62 7 Research/Writing Consultation 54 7 Administration Norcross, Karg & Prochaska, 1997

11 A day in the life of a Clinical Psychologist (Dr Melinda Losee) Monday 8:00 - check messages, , 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

12 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)

13 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

14 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

15 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

16 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 Organic causes of mental disorders

17 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

18 History of Clinical Psychology Birth of discipline Ligthner Witmer ( )! 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

19 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! Bender-Gestalt Test

20 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 Treatment for post-war pathologies

21 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 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 VII Association of Medical Psychology

22 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

23 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

24 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