Clinical Psychology: Definition & Scope

Clinical Psychology Defined

• Clinical psychology applies psychological principles to assess, prevent, ameliorate, and rehabilitate psychological distress, disability, dysfunctional behavior, and health-risk behavior.
• It also enhances psychological and physical well-being.
• Clinical psychology includes both scientific research and clinical service.
• Scientific research focuses on discovering general principles.
• Clinical service focuses on the study and care of clients.
• Information gathered from both activities influences practice and research (CPA, 1993).
• Earlier definitions focused on assessment, evaluation, and diagnosis.
• Newer definitions place greater importance on intervention, prevention, research, and evidence-based practice.
• Clinical psychologists engage in prevention, assessment, intervention, research, consultation, teaching, and supervision.
• Clinical psychologists work with individuals, couples, families, groups, and organizations in forensics, neuropsychology, and health settings.

Differences between Clinical Psychology and Other Mental Health Professions

• Clinical and counseling psychology have minimal differences except for training opportunities, settings, and populations.
• School psychologists combine psychology and education to diagnose childhood disorders and create programs for schools and families; requires education and child experience.
• Psychiatrists need a doctorate, while clinical psychologists can practice with a master’s degree.
• Psychiatry emphasizes physiology, biological functioning, and pharmacology and has less training in assessment and psychotherapy.
• Clinical social work emphasizes client well-being through policy, program planning, case management, counseling, and advocacy. Different degrees may be required.

Cognitive Behavioural Therapy (CBT)

• CBT focuses on the connection between thoughts, feelings, and behaviors.
• CBT has more empirical support than other psychotherapies, such as short-term psychodynamic psychotherapy.
• Its emphasis leads to more research on CBT's effectiveness, including cross-cultural considerations.
• Overemphasis on CBT may lead to lack of diversity and differing views in the mental health field.
• It can be difficult to find therapists specializing in other modalities, and non-CBT therapies may lack funding and research.

Diagnosis by Clinical Psychologists

• Potential benefits include awareness of issues such as severe side effects of psychopharmaceuticals (e.g., benzodiazepines such as lorazepam.)
• Psychologists providing diagnoses and prescriptions would create a more efficient and positive framework, and would shift the weight of responsibility more evenly among those who work for the mental health system.
• Risks include a heavier focus of psychiatrists and medical professionals on pharmaceuticals and a lighter focus of clinical psychologists on science.

Avoiding Certain Clients

• Domestic violence perpetrators
• Suspend judgment to provide a fair and unbiased chance
• Believe the therapy can assist the individual.
• It is important to be aware of personal preferences and biases to prevent negative impact on clients.

Psychotherapy Compared to Talking with a Friend

• Psychotherapy differs from talking to a friend due to ethical code issues
• Conflicts of interest may arise
• Personal investment should be avoided
• Bias due to close, emotional relationships should be avoided
• Psychotherapy has mutually agreed upon goals with structure
• Clinical Psychologists are accountable for advice and are norm-referenced.

Clinical Psychologist as Generalist

• It may be possible for a clinical psychologist to be a generalist, but referral to specialist may be required like general practitioners and family doctors operate.
• Challenges include extended schooling and training to understand populations.

Disillusioning Calvin from Clinical Psychology Aspirations

• Alberta master's programs lack accreditation and PhD programs approval
• Graduates responsible for ensuring classes approved by College of Alberta Psychologists
• Accredited programs are incredibly competitive.
• Finding and paying for a supervisor to practice is necessary.
• Multiple graduate program applications with potential for decline are required
• Graduate programs need a bare minimum of research experience and publications usually volunteering
• Moving for graduate programs may be necessary, even multiple times for a PhD
• Tri-council funding application is necessary
• Additional costs of licensure after grad school which include the cost of time and materials

Cognitive Behavioral Therapy (CBT) Intervention

• CBT treats generalized anxiety disorder, OCD, and social anxiety disorder.
• Based on the cognitive model, emotions and behaviors influence the perception of events.
• Thoughts influence feelings, with CBT psychologists using the cognitive model.
• Socratic dialogue and questioning challenge negative core beliefs, dysfunctional assumptions, and negative automatic thoughts.
• Strengths include empirical evidence, structure, usefulness for various diagnoses, accessibility, and cost-effectiveness.
• Weaknesses: CBT is better for some disorders (anxiety) and can be uncomfortable, not addressing underlying issues, or being too individual-focused.

Use of Collateral Information in Assessments

• Psychologists can use collateral information to understand client behaviors, relationships, and habits through interviews with family, friends, etc.
• Collateral info is part of the information gathering stage especially when children are involved.
• Psychologists should look for common threads, follow up to understand conflicting information, and discuss it with the client.
• Differences in information may be caused by differing settings or unique experiences.

Addressing one approach therapy

• Interpersonal therapy (IPT) is suited for those needing assistance with daily routines and social rhythms to prevent mood episodes. It is used in Bipolar 1 and depression.
• Some clients may not need help or some situations might be too severe.
• Clients might lack insight to identify triggers or disruptions in their lives.
• CBT works for anxiety disorders
• IPT relies on trust, psychoeducation, goal-oriented therapy, and elements of cognitive-behavioral therapy.
• Clients must track daily and commit long-term to make the therapy effective.
• Therapists might specialize in other therapies because of biases.