Module 1: Clinical Psychology - Batangas State University PDF

SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES TABLE OF CONTENTS Clinical Psychology: Definition and Training ………………….……………………………. 3 Parameters to Define Professional Practice in Clinical Psychology ……………………….…. 4 Training ……………………………………………………………………………………… 4 Balancing Practice and Science: Scientist-Practitioner Model …………………………...…… 5 Comparing PhD and PSYD …………………………………………………………….…....... 5 Evolution of Clinical Psychology ……………………………………………………….…….. 9 Principal Figures in Clinical Psychology ……………………………………….…….……….. 10 Major Areas of Research in Clinical Psychology ……………………………………………... 11 Other Significant Professional Concerns in Clinical Psychology ……………………………... 12 Current controversies in Clinical Psychology ……………………………………………….… 13 PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 2 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES MODULE 1: CLINICAL PSYCHOLOGY: DEFINITION AND TRAINING Introduction This module covers the definition of Clinical Psychology, education and training, employment settings and difference of clinical psychologist from other helping professionals. Intended Learning Outcomes ILO 1: Describe key concepts, principles, and overarching themes in psychology; ILO 2: Use basic psychological terminology, concepts, and theories in psychology to explain behavior and mental processes and describe its application business, health care, educational, and other workplace settings; ILO 3: Identify key characteristics of major content domains in psychology and recognize major historical events, theoretical perspectives, and figures in psychology and their link to trends in contemporary research; ILO 4: Predict how individual differences influence beliefs, values, and interactions with others, including the potential for prejudicial and discriminatory behavior in oneself and others; ILO 5: Conceptualize an infographics materials that is an example of relevant and practical applications of psychological theories, principles and dynamics to everyday Filipino experiences; ILO 6: Apply ethical standards to evaluate psychological science and practice CLINICAL PSYCHOLOGY: DEFINITION AND TRAINING Clinical psychology is the psychological specialty that provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty that is broadly inclusive of severe psychopathology - and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems; having advanced scientific and theoretical knowledge germane to the specialty and understanding of psychopathology and diagnostic/intervention considerations. Includes mental health issues across the lifespan based on a solid understanding of psychopathology. PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 3 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES Assessment: ability to integrate and synthesize personality test data with additional standardized assessment measures. Consultation: ability to consult with other health and behavioral health care professionals and organizations regarding severe psychopathology, suicide and violence. Research Base: engagement with specific research and critical review of science, knowledge and methods pertaining to those areas identified as distinct to clinical psychology. PARAMETERS TO DEFINE PROFESSIONAL PRACTICE IN CLINICAL PSYCHOLOGY Populations Clinical psychology as a specialty provides services to individuals and families across the lifespan and from all ethnic, cultural and socioeconomic backgrounds, as well as groups and communities. Problems/Issues The specialty of clinical psychology addresses behavioral and mental health issues faced by individuals across the lifespan including: Intellectual, emotional, psychological, social and behavioral maladjustment. Disability and discomfort. Minor adjustment issues as well as severe psychopathology. Procedures Assessment: diagnostic interviewing, behavioral assessment, administration and interpretation of psychological test measures Intervention (primary, secondary and tertiary levels): clinical services to individuals, families and groups Consultation: inter- and intra-professional practice with other health and behavioral health professionals and organizations Research: engagement with specific research and critical review of science, knowledge and methods pertaining to clinical psychology. https://www.apa.org/ed/graduate/specialize/clinical#:~:text=Clinical%20psychology%20is%20the%20ps ychological,%3B%20and%20research%2Dbased%20practice. TRAINING To be a Licensed Psychologist in the Philippines, a graduate of MA in Psychology needs to pass the Licensure Examination for Psychologist. The examination is conducted by the Board PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 4 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES of Psychology under the supervision of the Professional Regulations Commission (PRC). Training is area of specialization On other. countries like US, These professionals require doctoral-level degrees. Programs typically include individual research projects alongside supervised internship and practicum experiences. To obtain the state licensure required for practicing clinical psychologists, candidates typically complete about 3,000 hours of supervised clinical work and pass a professional practice exam. Some clinical psychologists earn additional specialty certifications that qualify them for work in specific fields. https://www.learnhowtobecome.org/psychologist/clinical-psychologist/ BALANCING PRACTICE AND SCIENCE: SCIENTIST-PRACTITIONER MODEL The scientist-practitioner model is founded on the ideology that trained professional psychologists should be knowledgeable in both research and clinical practice. Emphasis should be placed on the successful integration of science and practice, where the relationship between the two variables is carefully considered. Education and training in either research or practice alone, or concurrently without integration, is viewed as not fulfilling the requirements of this model. Furthermore, there are three vital assumptions of the scientist-practitioner model. The first assumption is that professionals with knowledge and skills related to research will facilitate effective psychological services. The second assumption identified research as imperative to the development of a scientific database. Last, the creators of the scientist-practitioner model assumed that direct involvement in clinical practice by researchers will result in studies on important social issues. Each assumption incorporates the integration of science and practice. https://journals.sagepub.com/doi/10.1177/0002764206296454#:~:text=The%20scientist%2Dpractitioner %20model%20is,both%20research%20and%20clinical%20practice.&text=The%20first%20assumption %20is%20that,will%20facilitate%20effective%20psychological%20services. COMPARING PhD AND PsyD PhD (Doctor of Philosophy) in Psychology PhD psychology programs are plentiful, but also fairly competitive, with more rigorous admission criteria. Because of the strong focus on research, they’re ideal for students not only interested in clinical practice but also in academia and research. PhD psychology programs also provide valuable training for those who want to practice psychology in clinical settings. A PhD in Psychology can open up a multitude of career paths—from teaching to patient care to forensic psychology. PsyD (Doctor of Psychology) PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 5 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES Developed in the late 1960s as an alternative to PhD psychology programs, a PsyD is typically pursued by individuals interested solely in the hands-on, straightforward practice of psychology, without dedicating professional time to research or academia. Like a PhD in Psychology, the Doctor of Psychology degree (PsyD) prepares students to practice psychology in a wide range of clinical settings. A PsyD, however, focuses more on clinical practice and less on research. As a result, this degree requires fewer research and statistics courses and thus takes less time. PHD IN PSYCHOLOGY PSYD (DOCTOR OF PSYCHOLOGY) Ideal for those interested in hands on, Ideal for those interested in clinical practice, straightforward practice of Psychology without academia, and research. dedicating professional time to research or academia. Strong focus on research Strong focus on clinical Prepares students to practice in a wide range Prepares students to practice in a wide range of of clinical settings. clinical settings. Multiple career path options: Teaching Patient care Primary career path is Clinical Psychology and Forensic Psychology working directly with patients. Scientific researcher Scientific researcher & Clinical practice Fairly competitive Requires less time to complete Rigorous admission criteria Requires fewer research and statistics courses Plentiful Programs Alternative to PhD Psychology Programs Which degree is fitted depends on the persons interests and career goals. https://www.waldenu.edu/online-doctoral-programs/phd-in-psychology/resource/whats-the-difference- between-phd-in-psychology psyd#:~:text=Like%20a%20PhD%20in%20Psychology,and%20thus%20takes%20less%20time. A clinical psychologist has spent all of his/her study focusing on psychology and clinical psychology. A psychiatrist has studied medicine first, then gone on to a further four years of study and work with mental illness. Psychologists only use therapies based on talking or doing things, whereas psychiatrists will sometimes use medication to help in treatment. A clinical psychologist may provide counselling and psychotherapy but will also draw from rigorous scientific research to ensure that treatments are effective and well matched to what the client wants. Clinical psychologists will often be more “active” than psychotherapists and counsellors. PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 6 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES Clinical Psychologists do not currently prescribe drugs but most will have a good understanding of relevant medicines and will be able to identify when you should consult your doctor for medical help. PSYCHIATRY Psychiatry is a medical specialty, in the same way that cardiology, pediatrics, and orthopaedic surgery are medical specialties. Psychiatry is the medical specialty that deals with mental illness. Like other specialists, psychiatrists have to undertake a basic medical degree and then complete advanced training in their particular area of specialty. PSYCHOTHERAPY Psychotherapy, or talk therapy, is a way to help people with a broad variety of mental illnesses and emotional difficulties. Psychotherapy can help eliminate or control troubling symptoms so a person can function better and can increase well-being and healing. Problems helped by psychotherapy include difficulties in coping with daily life; the impact of trauma, medical illness or loss, like the death of a loved one; and specific mental disorders, like depression or anxiety. There are several different types of psychotherapy and some types may work better with certain problems or issues. Psychotherapy may be used in combination with medication or other therapies. https://www.psychiatry.org/patients-families/psychotherapy COUNSELING Counselling as a professional occupation arose not from the clinic but from more social settings. It focuses on helping people resolve problems or role issues related to work or school or family matters. Here are some general characteristics of counselling: It is concerned with “normal” problems rather than mental health problems It is concerned with role functioning, with choices to be made, and with actions to be taken It is more concerned with present events than with past events Counselling may not be traditionally associated with qualifications in psychology, or with any particular form of training. In the Philippines, Republic Act No. 9258, AN ACT PROFESSIONALIZING THE PRACTICE OF GUIDANCE AND COUNSELING AND CREATING FOR THIS PURPOSE A PROFESSIONAL REGULATORY BOARD OF GUIDANCE AND COUNSELING, APPROPRIATING FUNDS THEREFOR AND FOR OTHER PURPOSES. The Act is known as the "Guidance and Counseling Act of 2004”. The declaration of policy of this law to wit “It is hereby declared a policy of the Senate to promote the improvement, advancement and protection of the guidance and counseling services profession by undertaking and instituting measures that will result in professional, ethical, relevant, efficient, PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 7 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES and effective guidance and counseling services for the development and enrichment of individuals and group lives. The State recognizes the important role of guidance and counselors in nation-building and promotes the sustained development of reservoir of guidance and counselors whose competence have been determined by honest and credible licensure examinations whose standards of professional practice and service are world-class and Internationally recognized, globally competitive through preventive regulatory measures, programs and activities that foster their continuing professional development. COACHING Coaching, like counselling, primarily aims to help “healthy” clients. Instead of helping them solve problems, coaching focuses on helping persons utilize their abilities more effectively than they have previously. Some general characteristics of coaching are that it can focus on personal work but it is usually used in business settings; it tends to help persons achieve personal and business goals; and no license or official registration is needed to practice coaching. PSYCHOLOGIST Degree: MA, PhD, PsyD, EdD Training: Graduate courses in human behavior, development, personality, research, statistics, psychotherapy, assessment, ethics. Two years for master's degree, four to six years for doctoral degree, followed by one to two years of full-time internship. Can prescribe medications: In certain states with additional training. PSYCHIATRIST Degree: MD, (medical doctor) ,DO (Doctors of osteopathic medicine) Training: Medical school with broad focus on biological functioning (four years) followed by specialized residency about mental illness and its treatment, with a focus on medications (three to four years). Can prescribe medications: Yes. Social Worker Degree: MSW, (master of social work) LCSW (licensed clinical social worker) Training: Graduate courses on human behavior, psychotherapy, community resources. Two years of graduate training, followed by two to three years of supervised clinical work. Can prescribe medications: No. https://www.apa.org/ptsd-guideline/patients-and-families/psychotherapy-professionals PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 8 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES Evolution of Clinical Psychology Origins of Clinical Psychology The first known use of the term clinical psychology was in a 1907 article by Lightner Witmer in the inaugural issue of Psychological Clinic, the journal he edited. The field has roots as an area of professional practice some-what separate from those as an academic endeavor. Witmer founded the first psychology clinic in 1896 at the University of Pennsylvania (Witmer, 1897) and was one of the first to advocate the use of psychology in order to help people rather than only to carry out re-search. His clinic focused on work with school-aged children with academic and behavioral problems, in-cluding difficulties with reading and spelling, mental retardation, and what would today perhaps be labeled as childhood autism. At times it extended into the adult age range. Clients were examined at this psychological clinic using procedures adapted from the laboratory psychology of the day and the results were used pri-marily to direct remedial teaching to try to overcome the difficulties presented. Witmer trained many doctoral students in psychology at the University of Pennsylva-nia in such clinical methods. He encouraged them to seek more intensive training in the form of full-time internships at such nearby sites as the Training School at Vineland, New Jersey, a residential institution for per-sons with mental retardation. He traced the intellectual origins of his work to such European figures as Rodriguez Perreira (a Portuguese-French teacher of the deaf) and J. M. G. Hard (the French physician who had worked to try to socialize the Wild Boy of Aveyron). He identified others who influenced him as the physician Edouard Seguin, who founded a school in Paris to try to rehabilitate children with mental retardation, and the physician- educator Maria Montessori, who devel-oped innovative educational procedures for use with slum children in Rome. Despite the historical impor-tance of Witmer in relation to clinical psychology, the work he did resembles the diagnostic teaching done by special educators more than it does the activities of present-day clinical psychologists. The fields of abnormal psychology and psychotherapy, which are key parts of present-day clinical psy-chology, had a much more ancient origin. The study of psychopathology can be traced back at least to the med-ical writings attributed to Hippocrates dating from the fifth century BCE and to the work of philosophers such as Democritus who were not physicians (Routh. 1998). The precise origins of psychotherapy are more elusive. According to Jerome Frank’s (1961) influential book, Persuasion and Healing, such practices may be ubiqui-tous in human societies. The involvement of psychologists in the study of psychopathology and its treatment obviously had to wait until the late nineteenth century, when a formal discipline of psychology developed, but research on psychopathology soon became a part of this new field. The neurologist Charcot appointed Pierre Janet to direct a psychology laboratory at the Salpetriere Hospital in Paris in 1890 to study the female patients with hysteria there. Alfred Binet was another early French psychol-ogist who worked with Charcot and was greatly influ-enced by him. The German psychiatrist Emil Kraepelin spent time working with the psychologist Wilhelm Wundt at the University of Leipzig. Kraepelin was an influential figure in the development of descriptive psychopathology and of psychopharmacology. He later carried out psychological research in his psychiatry service at the University of Munich. PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 9 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES In the United States beginning toward the end of the nineteenth century, there was great interest in ab-normal psychology and psychotherapy among many of the early psychologists, including William James, G. Stanley Hall, Boris Sidis, and Morton Prince. James pre-sented the Lowell lectures on exceptional mental states in Boston in 1896 (Taylor. 1982) and was interested in research on automatic writing. Hall at one point served as the lay superintendent of a mental hospital in Mary-land and later taught psychology to psychiatry resi-dents at Worcester State Hospital in Massachusetts. Morton Prince. a psychologically oriented physician, studied a famous case of a woman with multiple per-sonality. He established the Journal of Abnormal Psy-chology in 1906, and he founded the Harvard Psycho-logical Clinic in 1926. What might be termed the Boston school of abnormal psychology and psycho-therapy was active in the 1890s and at the turn of the century, though it tended to be absorbed by the psy-choanalytic movement after the first decade of the new century. Clinical psychology also had significant roots in psy-choanalysis. The two fields have shared a century-long history and have a continuing relationship. Breuer and Freud published the book that established psychoanal-ysis, Studies in Hysteria, in 1895. From the beginning, Freud expressed the wish that psychoanalysis not be simply a medical specialty and was willing to train an-alysts with various backgrounds, including psychology. The psychoanalysts who were professional psycholo-gists included Otto Rank. Theodore Reik, and many others. One complication was that the American Psycho-analytic Association wished to restrict the practice of psychoanalysis and especially access to its training pro-grams to psychiatrists only. For many years psycholo-gists in the United States who wanted to be trained and supervised in psychoanalysis had to achieve this in ir-regular or devious ways. This restrictive policy was not overcome until four clinical psychologists lead by Bry-ant L. Welch sued the American Psychoanalytic Asso-ciation for antitrust violations and won an out-of-court settlement in the 1980s. Principal Figures in Clinical Psychology In a field that is hardly more than a century old, the choice of a few individuals as principal figures is bound to be a bit arbitrary. We will confine this discussion to persons who are no longer living. One of these pioneers was Alfred Binet, the co-developer of the first valid in-telligence test (Binet & Simon. 1905). This test signifi-cantly distinguished children with mental retardation from their typically developing peers, and various ver-sions of it have been in continuous clinical use ever since that time. This line of research was significantly advanced by Lewis M. Terman (1916), who standardized Binet’s test and published norms for it using sizable groups of children of different ages. Terman (1925; Ter-man & Oden. 1947) went on to demonstrate the long-term reliability of this test and its predictive utility not only in relation to academic performance but also other life achievements. Then Jean W. Macfarlane of the Uni-versity of California at Berkeley had the wisdom to con-vert a flawed study of the effects of clinical guidance of children into a life- span study of development within the general population. She and her colleagues (includ-ing Erik Erikson) paid attention not only to cognitive development but also to aspects of personality and so-cial adjustment. PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 10 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES Carl R. Rogers in the 1940s helped move the field of clinical psychology from an overly exclusive preoccu-pation with mental testing toward a more balanced em-phasis on psychotherapeutic intervention as well (Rogers. 1951). Rogers’ client-centered or person- centered approach to psychotherapy was original with him but was indirectly influenced by Freud as interpreted by the psychologist-psychoanalyst Otto Rank and the social worker Jessie Taft. Rogers had the boldness to carry out tape recordings of actual therapy sessions and to ini-tiate controlled research on psychotherapy process and outcome. Clinical psychological assessment came to encom-pass personality and psychopathology as well as cog-nitive functioning. One of the most innovative ventures in this domain was developed by Starke R. Hathaway, who was a coauthor of the Minnesota Multiphasic Per-sonality Inventory (MMPI; Hathaway & McKinley. 1943). In contrast to earlier questionnaire measures of psychopathology, the MMPI was empirically validated using groups of patients with particular psychiatric di-agnoses compared to normal control subjects. In addi-tion, the MMPI provided novel “validity” scales enabling the psychologist to detect subjects’ attempts to dissemble or to present themselves in an unduly favor-able or unfavorable light. The validity scales also de-tected patterns of incomprehension. Confusion, or ran-dom responding. The MMPI continues to be one of the most widely used measures of its kind and has been translated into many different languages. George A. Kelly developed some original approaches to assessing how individuals construed their social world. His personal construct theory (Kelly. 1955) was also the basis of an approach to intervention that was perhaps the first example of cognitive therapy, presently one of the most widely used kinds of treatment. In the United Kingdom, Hans Eysenck founded a De-partment of Psychology within the Institute of Psychi-atry at the University of London. Eysenck devised his own questionnaires for the assessment of personality and psychopathology that were widely used and influ-ential. He published a critique of the effectiveness of psychotherapy that, though not without its own flaws, spurred research on psychosocial intervention through-out the world (Eysenck. 1952). Eysenck was also a pi-oneer in promoting behavioral approaches to therapy. These emerged as a strong influence on clinical psy-chology beginning in the 1960s. Major Areas of Research in Clinical Psychology The focus of the work of the principal figures in clinical psychology discussed above was primarily on assess-ment and treatment. Clinical psychology has also em-phasized research on psychopathology throughout its existence. The research program of David Shakow, be-gun at Worcester State Hospital, for example, con-cerned attentional difficulties in schizophrenia (e.g., Shakow, 1962). He used the classic experimental par-adigm of reaction time to demonstrate difficulties pa-tients with schizophrenia have in maintaining “set/’ They are easily distracted and may be overly influenced, for example, by the timing of the RT signal on the im-mediately preceding trial. Paul E. Meehl (1962), an-other clinical psychologist whose research often focused on schizophrenia, elaborated an influential theory about how genetic factors are involved in this group of disorders. Meehl defined “schizotaxia” as the hypothetical genetic factors hypothesized to be necessary but not sufficient for the development of schizophrenia. Meehl used the term “schizotypy” to refer to the corresponding phenotype. A schizotype is thus a person at risk for PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 11 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES schizophrenia and might manifest traits such as inter-personal aversiveness and subclinical cognitive slippage. Given an adverse environment, for example, perinatal difficulties or other stresses, the schizotype might man-ifest the clinical disorder of schizophrenia. In another domain of psychopathology research, clinical psychologist Martin E. P. Seligman (1975) translated his basic research on “learned helplessness” in dogs into a prototype for understanding how clinical depression might develop in human beings. The dog, in a shuttle apparatus, learns that nothing it can do will avoid episodes of electric shock. Similarly, a human might acquire a predisposition to depression in the form of the habit of making internal, stable, and global attributions for failure (“I failed because that is just the way I am. I will always be that way, and this applies to every domain of my life”). Other Significant Professional Concerns in Clinical Psychology A concern of clinical psychology throughout its exis-tence as an organized specialty group has been with the credentialing of practitioners. The purposes of these efforts are to give public recognition to psychol-ogists qualified to offer their services to the public and to discourage practice by others not so qualified. Beginning in 1919, the American Psychological Association attempted to implement a plan to certify individuals who met certain criteria as “consulting psychologists.” This plan did not prove to be functional. Only 25 psy-chologists were ever so certified, and the scheme had to be discontinued after only a few years (Routh. 1994). During the period after World War II, from 1945 to 1977, every U.S. state passed legislation certifying or licensing psychologists to practice independently. Cer-tification generally refers to the protection of the title “psychologist,” while licensing usually refers to protection of the practice itself. These laws typically required possession of a doctoral degree in psychology, plus two years of supervised experience in the field, one of which could be predoctoral. All Canadian provinces, the United Kingdom, most countries in the British Com-monwealth, and the Scandinavian countries imple-mented similar licensing schemes, though not neces-sarily with the requirement of training at the doctoral level. Other countries in Europe and Latin America ap-pear to be on the road to developing similar legislation, but this is far from a worldwide development. There are wide variations from one country to another in the le-gal qualifications for the independent practice of psy-chology. Such laws, where they exist, are usually ge-neric to psychology and do not refer to clinical psychology separately by name. In 1947, the organization presently known as the American Board of Professional Psychology was estab-lished and soon began to examine candidates for its diploma signifying advanced competence in clinical psychology. This process was intended to be the equiv-alent of board certification in psychiatry or other med-ical specialties. Clinical psychologists in independent practice in the United States have fought a long, extensive battle for recognition by hospitals, insurance companies, and third-party payers. This has led to the establishment of a National Register of Health Service Providers in Psy-chology to provide insurance companies with the names of practitioners who have training at the doc-toral level, active state licensure, and a formal intern-ship involving at least a year of full-time clinical train-ing. https://www.google.com/search?q=evolution+of+clinical+psychology&oq=evolution+of+clinical+psyc hology+&aqs=chrome..69i57j0l2j0i22i30.7482j1j7&sourceid=chrome&ie=UTF-8 PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 12 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES Current controversies in Clinical Psychology Article: CURRENT CONTROVERSIES IN CLINICAL PSYCHOLOGY Apsara KAtuwal Dangol This article includes a brief description related to current controversies, challenges, problems and debates going on in the field of Clinical Psychology. Clinical Psychology deals with the treatment of mental illness, abnormal behavior and psychiatric problem, these current controversies create meaning in updating this concerned field. Prescription Privilege Movement The first prescription privilege movement was introduced in Hawaii in 1985, where a psychologist was seeking a bill for prescription authority. The only thing that differentiated psychiatrist and psychologist were degree and prescription authority. But now even psychologists are able to prescribe medicines for a patient with 2 years of postdoctoral training or clinical psychopharmacology. Former President of American Psychological Association, Patrick H. DeLeon & Morgan T. Sammons (expert in psychopharmacology) took part in the first experimental pilot program of psychologists prescribing medication (Dittman, 2003). New Mexico (2002) and Louisiana (2004) have granted prescription privileges to a trained psychologist. And still, the debate is going on to find why or why not to give prescriptive authority. Evidence Based Practice and Manualized Therapy Evidence Based Practice is crucial in clinical practices as it is about healing humans where negligence cannot be done. Hans Eysenck's (1952) said that psychotherapy has no positive outcome after he did research with patients and he was proved wrong by Smith and Glass (1977) and Smith, Glass and Miller(1980). Every therapy has its own importance, to some extent some may work and some won't as the psychology of human beings also matters. Usually, evidence- based practices have to be carried out rather than non-empirical therapy. Manualized therapy has been working towards target disorder. For example, Exposure plus response therapy works for behavior therapy and Specific cognitive therapy works for depression. These manualized therapy has been showing effectiveness which has been included in the journal as well. Mental Illness- Over diagnosed Mental Illness has been over diagnosed because of which every person falls in minor or major mental illness diagnosis. Usually, people have been identified as having a mood disorder which is common these days. Though DSM has tried to simplify and eliminate some disorders, still it is over diagnosed. Many criticisms were made as it was declared that even normal life experiences fall on mental illness and none could escape from this mental illness category. Cosgrove et. al (2006)found that of 170 panels of DSM IV, 95 of them, 57% had ties with major pharmaceutical companies. Still, research is going on to know how pharmaceuticals are encouraging for over- diagnosing mental illness. PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 13 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES Payment methods: Third party payment vs Self-payment Earlier the client used to pay directly to a clinical psychologist. But health companies knowing the worth of clinical psychologists have included them as their co-worker. Due to this third-party involvement, there can be effects in therapy. Murphy et al (1998) did a survey where it was found that psychologists were having a negative effect due to third party involvement (managed care) as they used to make clinical practices decisions and there was some lacking point in the quality of therapy. There was also an effect on diagnosis and also confidentiality though maintained has to be shared with insurance companies. So, somehow, ethical concern was harmed. Cybertherapy Clinical Psychology has been touched by technology these days. Therapy these days can be conducted via computer. Video conferencing through skype to take the interview and treat a client, different questionnaires in apps for identifying the disorder, awareness sites, online psychotherapy programs, etc is all about cybertherapy. As it is approaching, there are less or more advantages according to client perception. Reger and Gahm (2009) found that cognitive behavioral treatment related to anxiety disorder shows the same effect whether by person or computer. But major complications or disorders were not benefitted so far. Current Controversies in Clinical Psychology, https://uk.sagepub.com/sites/default/files/upm- binaries/58621_Chapter_3__Pomerantz_(Clinical)_I_Proof_(Low_Res)_3.pdf END OF WEEK 2 LECTURES AND DISCUSSION Well done on finishing Week 2 WHAT COULD YOU LEARN NEXT? Cultural Issues in Clinical Psychology MODULE 1 - ACTIVITY Do you want to be a clinical psychologist? Why? What are your research interests? What are your long term career goals? PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 14 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES TABLE OF CONTENTS Multiculturalism …………………………………………………………………….… 3 Professional efforts in Clinical Psychology …………………………………………... 4 Knowledge of Diverse Culture ………………………………………………………... 5 Why Should You Learn Different Cultures? ………………………………………….. 7 Culturally Appropriate Clinical Skills ………………………………………………… 8 Etic versus Emic Perspective …………………………………………………………… 8 Culture: Definition, Functions, Characteristics, Elements of Culture ………………… 9 PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 2 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES MODULE 2: CULTURAL ISSUES IN CLINICAL PSYCHOLOGY Introduction This module covers the definition of cultural issues and concepts related to multicultural settings which include psychologists’ skills, the efforts to address cultural issues. Intended Learning Outcomes ILO 1: Describe key concepts, principles, and overarching themes in psychology; ILO 2: Use basic psychological terminology, concepts, and theories in psychology to explain behavior and mental processes and describe its application business, health care, educational, and other workplace settings; ILO 3: Identify key characteristics of major content domains in psychology and recognize major historical events, theoretical perspectives, and figures in psychology and their link to trends in contemporary research; ILO 4: Predict how individual differences influence beliefs, values, and interactions with others, including the potential for prejudicial and discriminatory behavior in oneself and others; ILO 5: Conceptualize an infographics materials that is an example of relevant and practical applications of psychological theories, principles and dynamics to everyday Filipino experiences; ILO 6: Apply ethical standards to evaluate psychological science and practice MULTICULTURALISM "Multiculturalism" is the co-existence of diverse cultures, where culture includes racial, religious, or cultural groups and is manifested in customary behaviors, cultural assumptions and values, patterns of thinking, and communicative styles (Jan 22, 2020 www.ifla.org ) Diversification of Philippine Population A country of many islands, the Philippines is also a country of many languages. The Tagalog language of Manila has been chosen as the base of the national Filipino language, even if Cebuano counts as many speakers. The languages of the Philippines have common grammatical structures, but wide differences in vocabulary. Contrary to Latin America where Spanish and Portuguese PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 3 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES became the dominant language, Spanish did not dominate the local languages, since colonial priests preferred to learn local languages rather than teaching Spanish to their flocks. English, as the second colonial language, is spoken much more, since the Americans educated Filipinos in English as part of their “benevolent assimilation” policy. Today, there is debate about the role of English, a colonial language, in the educational system, while English is a definite asset for the Philippines in the global economy. The Philippine diversity is also ethnic, with many tribes of “indigenous people'', mostly located in remote hilly areas. Legislation tends today to protect their customs and lifestyles, even if it seems too late for many of them. Other minority groups include the Chinese and Koreans, who play an important role in the country’s economic life. https://www.researchgate.net/publication/316323010_The_Diversity_of_the_Philippine_Population Professional efforts in clinical psychology 1. Publications on cultural issues in mental health have appeared in recent years. e.g. Journals: Cultural Diversity and Ethnic minority, Hispanic Journal of Behavioral Sciences, Journal of Black Psychology 2. Emergence of APA Divisions and Psychological Association of the Philippines (PAP) Divisions e.g. Psychology of Religion, Psychology of Women, Society for the study of ethnic minority, LGBTQA+ (PAP) 3. Ethical code “ethical principles of psychologist and code of conduct relating to multiculturalism Principle E. Respect for people's right and dignity Standard 2.01 countries of competence Standard 3.01 unfair discrimination Standard 9.06 interpreting assessment results 4. DSM effort toward multiculturalism Cultural variation is embedded in the description of specific disorders it provides general guidance for clinicians to help to help with overall cultural competence 5. Revisions of prominent assessment method -MMPI and Wechsler Scales PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 4 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES Cultural Competence Cultural competency is the ability to understand, communicate with and effectively interact with people across cultures. Cultural competence encompasses. Being aware of one's own world view. developing positive attitudes towards cultural differences. Gaining knowledge of different cultural practices and world views. Cultural competence begins with learning about one’s own culture not only the basic facts such as where the ones parents or ancestors came from but also the values assumptions and biases that one has developed as a result of all cultural influences (Harris 2012) When psychologists attain Cultural Self-Awareness -which refers to the awareness of how culture has influenced the self.- the psychologist may adopt a viewpoint toward clients that is less egocentric and more appreciative of the varying experiences of life. CSA is important regardless of psychologists own cultural background weather a majority or minority, the psychologist will inevitably encounter clients whose cultural background differ. (Gelso, 2010) https://journals.sagepub.com/doi/abs/10.1177/0146167217752117#:~:text=Cultural%20self%2 Dawareness%20refers%20to,cultural%20identification%20and%20well%2Dbeing. KNOWLEDGE OF DIVERSE CULTURE What are the Benefits of Learning Different Cultures? In today’s ever-changing world, people world over are fast realizing the importance of learning, understanding, and appreciating diverse cultures. Why is this necessary? It plays a major role in developing communities that excel in problem-solving and enhancing varying conditions. Let’s discuss the benefits of understanding different cultures. 1. GETTING TO UNDERSTAND THE WORLD BETTER The world comprises people with diverse cultures. Where possible, being exposed to different cultures helps you embrace and appreciate people that are different from you. Further, the more your children interact with other children from different cultures, the more they respect and value them. PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 5 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES Going for summer camps is a great way of exposing your children to diverse cultures and practices. Whether they will interact with other children from different countries or regions, they will learn something new during camp. 2. MINIMIZE STEREOTYPES When your children learn about people and their different cultures, they’ll be less likely to classify them depending on stereotypes. Remember, everybody is different and what one person does shouldn’t be used to define an entire community. 3. HELPS PREVENT AND OVERCOME ETHNIC AND RACIAL DIVISIONS Ethnic and racial divisions can hurt society. For instance, it could lead to a lack of opportunities, misunderstandings, and in the worst cases, violence. Communities marred by ethnic and racial rivalry often suffer from both human and financial resources. These vices distract communities from finding concrete solutions to their budding issues. 4. ENHANCES EFFECTIVE COMMUNICATION Language is a critical part of human communication. However, it’s not the only contributing factor to effective communication. Culture enhances communication in varying ways. For instance, culture can influence speaking tendencies such as; figurative language, speed, and presentation. Culture also contributes to the way people depict their gestures and body language. 5. CREATES OPPORTUNITY TO MEET NEW PEOPLE There are different ways of meeting new people. For instance, participate in different celebrations, attend camp, visit people from diverse cultures, and celebrate special days. This enables students, especially, to meet, interact with, and make new friends. This is an ideal way of expanding a student’s social circle and creating room for them to learn about different cultures. 6. EXPOSURE TO NEW EXPERIENCES Children can get exposed through; sampling new foods, participating in different cultural celebrations and listening to stories. Further, engaging in different activities such as art or even learning how to play a new musical instrument. Exposure to new things helps children to explore the world better. PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 6 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES WHY SHOULD YOU LEARN DIFFERENT CULTURES? Learning and understanding different cultures are critical in day to day life. Here are the reasons why you should be conversant with diverse cultures. 1. THEY ARE INTERESTING Learning about other cultures is interesting. Today we live in a digital world where children spend most of their time with their gadgets. To discourage a sedentary lifestyle, expose your children to different cultures from an early stage. Sending your children to camp is one way of achieving this. While on camp, your children will be exposed to different culture promoting activities. Having hands-on experience is better than reading or even watching the same on television. 2. IT STIMULATES THE MIND Being exposed to culture learning opportunities stimulates your mind, and helps you think in diverse ways. It’s an ideal way of challenging your thought development and enhancing how you refine information. 3. IT PROMOTES UNDERSTANDING Lots of problems can arise from misunderstandings, especially because we live in a multicultural world. By learning and understanding different cultures you understand why people do things the way they do. When you identify with other people, you sympathize with their situation. This facilitates understanding and prevents misunderstandings. 4. YOU UNDERSTAND VARIOUS WAYS OF DOING THINGS Cultural practices shouldn’t be the reason why people oppress one another. While discarding some practices is impossible, some sections of different cultures need to be renounced. Learning about diverse cultures helps you realize that there are numerous approaches to life, and you may not be the best. Many times, interacting with people from different cultures helps you view life from a different perspective. When you learn about different cultures, you establish new ways of thinking and approaching and solving problems. PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 7 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES 5. YOU BECOME MORE PREPARED TO COPE WITH THE EVER-CHANGING WORLD In today’s techno-savvy times, the world is rapidly becoming smaller. As people travel far and wide, there are high chances that you will encounter people with varying cultures. You’ll need to master the art of tolerating each other. Remember, you’ll also want people to tolerate you and the best way of achieving this is by being understanding. This plays a major role in living in an all-round community and making you a versatile human being. If your children will be going to camp, they’ll need to learn about other cultures to avoid misunderstandings. Learning about other people’s customs and cultures enriches the children’s experience everywhere they go. https://leselfes.com/understanding-different-cultures/ CULTURALLY APPROPRIATE CLINICAL SKILLS Understanding Microaggressions – are comments or actions made in a cross-cultural context that convey prejudicial, negative, or stereotypical beliefs and may suggest dominance or superiority of one group over the other (Found and Arredondo, 2007) There are “little things” that one person may say to another without any intention of hostility or any awareness that the comments might be intimidating or insulting but in fact they are. Examples: Do you have a girlfriend? – question for a gay client What did Santa give you? – question for a 7-year poor or Buddhist boy Psychologists must examine the thoughts and beliefs that underlie them which may result in greater humility and self-awareness for the psychologist. Efforts towards the attainment of culturally appropriate clinical skills have emphasized the notion of cultural adaptation of treatments with empirical evidence to support them (Bernal, Jimenez, 2009) Are we alike? Or all different? ETIC VERSUS EMIC PERSPECTIVE Dana (1993) describes 2 distinct perspectives that psychologists have used during the history of the profession. PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 8 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES Etic perspective emphasizes the similarities between all people. It assumes universality among people and generally does not attach importance to differences among cultures. It is in the normative point of view. Emic perspective recognizes and emphasizes culture specific norms. In emic perspective a psychologist considers clients behavior, thoughts and feelings within the context of the client’s own culture. Rather than imposing norms of another culture on the client (Koldemyr, 2015) hence “must be understood on their own terms.” CULTURE: DEFINITION, FUNCTIONS, CHARACTERISTICS, ELEMENTS OF CULTURE Culture consists of all learned, normative behavior patterns – that is, all shared ways or patterns of thinking and feeling as well as doing. Word ‘culture’ comes from the Latin word ‘cultura,’ related to cult or worship. In its broadest sense, the term refers to the result of human interaction. Meaning of Culture Culture is a comprehensive and encompassing term that includes what we have learned about our history, values, morals, customs, art, and habits. A culture is “the complex of values, ideas, attitudes, and other meaningful symbols created by people to shape human behavior and the artifacts of that behavior as they are transmitted from one generation to the next.” The above definition highlights three important attributes of an individual’s culture. First, it is ‘created by people,’ evolving due to human activities and passed on to the succeeding generations. Second, the impact of cultural influence is both intangible and tangible. People’s basic attitudes and values are a direct result of their cultural environment. Beliefs in freedom of speech and choice, heterosexuality, and God are products of human action. Additionally, people leave physical evidence of their culture through art and craftwork, buildings, furniture, laws, and food. Third, the cultural environment evolves, and it is most often evolves over lengthy periods. Changes in women’s roles in the home and business and the outward desire for leisure time have come about quite slowly. Other changes, however, occur quicker. Clothing styles, for example, come and go rather hastily. Culture has been defined in some ways, but most simply, as the learned and shared behavior of a community of interacting human beings. PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 9 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES 3 Aspects of Culture If we explain the above definition, we can identify three aspects of a given culture; 1. culture is a pattern of behavior, 2. culture is learned, and 3. culture is transmitted from one generation to the next. 3 Components of Culture If you study a culture, whether modern or backward, you will identify three important components in it. 3 Components of Culture are; 1. cognitive component, 2. material component, and 3. normative component. Cognitive Component The basic component of any culture is one relating to people’s knowledge about the universe’s creation and existence. This aspect is based on either people’s observation or on certain factual evidence that they have. An individual of a backward culture believes in gods, superstitions, and other objects as a part of their cognitive aspect. But, in a technologically advanced society, the cognitive aspect is based on scientific experiments and their applications. The cognitive component of an advanced society’s culture is quite distinct from that of a primitive one because of the refinement of knowledge through systematic testing and observation. Material Component Another important component of any given culture is the material feature of society. It consists of all the tangible things that human beings make, use, and give value to the material component varies from culture to culture as the cognitive component. It is based on the technological state that society has achieved and understood, looking at society’s artifacts. The artifacts include the type of housing where people live, the furniture they use, and other material goods they possess. Since it is tied to the level of technological advancement of the society, the material features of cultures are very diverse as technological achievements vary. PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 10 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES Normative Component The other important component of a culture is the normative component. The normative component is composed of society’s values and norms, which guides and regulates behavior. In other words, it consists of the values, beliefs, and rules by which society directs people’s interactions. Understanding culture means understanding its values. Values are shared standards of acceptable and unacceptable, good and bad, desirable, and undesirable. Values are abstract, very general concepts that are expressed by norms. Norms are rules and guidelines, setting forth proper attitudes and behaviors for specific situations. For example, in South Asian countries, the culture places a high value on religious training; therefore, our norms specify formal religious education for every child up to a certain age. Mass religious education norms create a need for religious teachers, books, and other related materials. Among the values the culture holds, some are core or central values, while others are peripheral values. Core values are the deeply held enduring beliefs that guide our actions, judgments, and specific behaviors, supporting our efforts to realize important aims. Although not as deeply embedded or as fundamental as central values, our peripheral values reflect our central values. If you value your health, you may value regular exercise and a low-salt, low-cholesterol diet. You may also abstain from smoking cigarettes and drinking alcoholic beverages. Functions of Culture We will review the functions that culture performs and assess whether culture can be a liability for an organization. Culture performs some functions within an organization. First, it has a boundary-defining role; it creates distinctions between one organization and another. Second, it conveys a sense of identity for organization members. Third, culture facilitates the generation of commitment to something larger than one’s individual self-interest. Fourth, it enhances the stability of the social system. Culture is the social glue that helps hold the organization together by providing appropriate standards for what employees should say and do. PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 11 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES Finally, culture serves as a sense-making and control mechanism that guides and shapes employees’ attitudes and behavior. It is this last function that is of particular interest to us. Elements of Culture Languages, Norms, Symbols, Values, Attitude, Rituals, Customs and Manners, Material Culture, Education, Physical Artifacts, Language, Jargons, and Metaphors, Stories, Myths, and Legends, Ceremonies and Celebrations, Behavioral Norms, and Shared Beliefs and Values. Culture is a comprehensive concept that includes almost everything around us and influences an individual’s thought processes and behavior. It would be difficult for a marketer to succeed if he overlooks culture’s importance as an indicator of behavior. So, it is a must for social scientists, marketing and business executives, decision-makers to consider the importance of the cultural setting within which client or consumer behavior occurs. https://www.iedunote.com/culture END OF WEEK 3 LECTURES AND DISCUSSION Well done on finishing Week 3! WHAT COULD YOU LEARN NEXT? Week 4 Ethical issues in Clinical Psychology MODULE 2 – ACTIVITY In your opinion, how important is the issue of cultural self-awareness to clinical psychologists? What is the best way to increase cultural self-awareness among current members of the profession? PSY 316 – CLINICAL PSYCHOLOGY | DR. MARIE GRACE D. ALEA 12 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES TABLE OF CONTENTS Psychological Association of the Philippines Code Ethic …………….………………………. 3 Ethics in Clinical Psychology ………………………………………………...…………….…. 5 Contemporary Ethical Issues ………………………..………………………………………… 6 Conducting Research in Clinical Psychology ………………………………..…………...…… 7 Efficacy versus effectiveness of therapy ………………………………………………..…....... 8 Evolution of Clinical Psychology ……………………………………………………….…….. 9 Use of Technology in Clinical Psychology Research ………………………….…….………... 10 DR. MARIE GRACE D. ALEA, LPT PSY 316 – CLINICAL PSYCHOLOGY | DR. LUCILLE D. EVANGELISTA, RPsy 2 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES MODULE 3: ETHICAL ISSUES IN CLINICAL PSYCHOLOGY AND CONDUCTING RESEARCH Introduction This module covers the APA/PAP ethical standards and ethical decision making. It also covers Ethics in Clinical Assessment as well as Ethics in Clinical Research. IT also covers the ways on Conducting Research in Clinical Psychology and its ethical concerns. Intended Learning Outcomes ILO 1: Describe key concepts, principles, and overarching themes in psychology; ILO 2: Use basic psychological terminology, concepts, and theories in psychology to explain behavior and mental processes and describe its application business, health care, educational, and other workplace settings; ILO 3: Identify key characteristics of major content domains in psychology and recognize major historical events, theoretical perspectives, and figures in psychology and their link to trends in contemporary research; ILO 4: Predict how individual differences influence beliefs, values, and interactions with others, including the potential for prejudicial and discriminatory behavior in oneself and others; ILO 5: Conceptualize an infographics materials that is an example of relevant and practical applications of psychological theories, principles and dynamics to everyday Filipino experiences; ILO 6: Apply ethical standards to evaluate psychological science and practice Psychological Association of the Philippines Code Ethics The code of ethics of the Psychological Association of the Philippines may be found also in https://www.prc.gov.ph/sites/default/files/PSYCHOLOGY-CodeEthics-2017-11.pdf Aspirational and Enforceable In both APA and PAP code of ethics, the items in the general principles section are aspirational. They describe an ideal level of ethical functioning or how psychologist should strive DR. MARIE GRACE D. ALEA, LPT PSY 316 – CLINICAL PSYCHOLOGY | DR. LUCILLE D. EVANGELISTA, RPsy 3 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES to conduct themselves. They don’t include specific definitions of ethical violations, instead they offer broad descriptions of exemplary ethical behavior. There are five general principles In contrast to the general principles section the ethical standards section of the ethical code includes enforceable rules of conduct. Thus if a psychologist is found guilty of an ethical violation it is a standard (not a principle) that has been violated. Ethical Decision Making Ethical decision-making refers to the process of evaluating and choosing among alternatives in a manner consistent with ethical principles. In making ethical decisions, it is necessary to perceive and eliminate unethical options and select the best ethical alternative. Clinical psychologist must be equipped with this process. Confidentiality Confidentiality is a part of the ethical guidelines of psychologists and means that information between a patient and a therapist cannot be shared with anyone. This applies to patients and any health professional, including doctors and nurses. There are a few exceptions to confidentiality such as the concept of duty to warn which means that confidentiality can be broken if the patient is a threat to themselves (such as being suicidal) or others (threatening to harm another person). The Health Insurance Portability and Accountability Act (HIPAA) protects the confidentiality of health records at a federal level in the United States and includes the confidentiality of therapy and mental health information within it. Informed Consent Informed consent is the process by which researchers working with human participants describe their research project and obtain the subjects' consent to participate in the research based on the subjects' understanding of the project's methods and goals. Most research projects require informed consent. The Ethics Code of the American Psychological Association describes informed consent, in part, as follows: “Informed Consent, psychologists inform participants about (1) the purpose of the research, expected duration and procedures; (2) their right to decline to participate and to withdraw from the research once participation has begun; (3) the foreseeable consequences of declining or withdrawing; (4) reasonably foreseeable factors that may be expected to influence their willingness to participate such as potential risks, discomfort or adverse effects; (5) any prospective research DR. MARIE GRACE D. ALEA, LPT PSY 316 – CLINICAL PSYCHOLOGY | DR. LUCILLE D. EVANGELISTA, RPsy 4 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES benefits; (6) limits of confidentiality; (7) incentives for participation; and (8) whom to contact for questions about the research and research participants' rights. They provide opportunities for the prospective participants to ask questions and receive answers.” APA reiterated its policy with respect to informed consent in light of a study involving approximately 700,000 Facebook users without their knowledge. The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States. APA's membership includes nearly 130,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance the creation, communication and application of psychological knowledge to benefit society and improve people's lives. Boundaries and Multiple Relationships The process of psychotherapy is relationship based. As such, how psychotherapists conduct themselves in these relationships has significant clinical and ethical implications. The Ethical Principles of Psychologists and Code of Conduct (APA Ethics Code, APA, 2010) makes clear the ethical obligations relevant to boundaries and multiple relationships that are likely to be well known by psychotherapists (e.g., it is unethical to engage in sexual relations with your clients). Yet, the APA Ethics Code cannot provide strict rules to apply to every clinical situation that may arise in practice. Psychotherapists must apply their judgment in making decisions about the appropriateness of different actions and behaviors, hopefully utilizing the guidance provided by the Ethics Code, consultation with colleagues, and a decision-making process. Competence Ethical standards address the boundaries of competence. Psychologist provide services, teach and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study of professional experience (APA 2002) Ethics in Clinical Assessment Test selection should entail a number of factors including the psychologist competence, the clients culture, language, age, and the reliability and validity. DR. MARIE GRACE D. ALEA, LPT PSY 316 – CLINICAL PSYCHOLOGY | DR. LUCILLE D. EVANGELISTA, RPsy 5 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES Test security is necessary. Psychologists should make an effort to protect the security and integrity of the test materials they use. In other words psychologists should prevent the questions, items and other stimuli included in the psychological tests from entering the public domain. Ethics in Clinical Research Psychologists should be careful not to mistreat or harm some of their client/research participants in the process of studying the effectiveness of a certain therapy for example. Example comparing no treatment with control or experimental group. Contemporary Ethical Issues Managed care and ethics According to health affairs, The “managed care problem” is understood generally as the need to protect individuals against large companies that care more about their bottom line than about people. The premise of the BEST (Best Ethical Strategies for Managed Care) project is that the “managed care problem” is best understood as an ethical problem—a conflict of values that arises as the country changes from a patient-centered to a population-centered approach to health care. The BEST project team worked with nine managed care organizations to identify their most intractable problems. The team redefined these problems in terms of ethical dilemmas, then studied each organization in search of innovative, exemplary approaches. These exemplary approaches are being shared publicly with the aim that they be adapted and adopted by other organizations facing similar difficulties and by regulators and legislators hoping to improve the health care system. Technology and ethics In technology we speak of ethics in two contexts; one is whether the pace of technological innovation is benefiting the humankind or not, the other is either severely empowering people while choking others for the same. Technology, for example, has drastically replaced people at work. In the field of psychology, the one concern include online therapy (communication specially the non-verbal) confidentiality and identity. Ethics in Small Communities In small communities, multiple relationships are perhaps the most distinctively difficult ethical issue for clinical psychologist in small communities. In fact nonsexual overlapping relationships are not a matter of if as much as when the daily lives of many small and contained community DR. MARIE GRACE D. ALEA, LPT PSY 316 – CLINICAL PSYCHOLOGY | DR. LUCILLE D. EVANGELISTA, RPsy 6 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES psychologist (Schank 2003) unlike those from larger communities, so keeping personal and professional aspects of their lives may be impossible. Conducting Research in Clinical Psychology Below is an abstract of a study on conducting research in psychology Conducting research in clinical psychology practice: Barriers, facilitators, and recommendations Kirsten V. Smith corresponding author 1 and Graham R. Thew 1 Abstract Objectives The combination of clinical psychologists’ therapeutic expertise and research training means that they are in an ideal position to be conducting high‐quality research projects. However, despite these skills and the documented benefits of research to services and service users, research activity in practice remains low. This article aims to give an overview of the advantages of, and difficulties in conducting research in clinical practice. Method We reviewed the relevant literature on barriers to research and reflected on our clinical and research experiences in a range of contexts to offer practical recommendations. Results We considered factors involved in the planning, sourcing support, implementation, and dissemination phases of research, and outline suggestions to improve the feasibility of research projects in post‐qualification roles. Conclusions We suggest that research leadership is particularly important within clinical psychology to ensure the profession's continued visibility and influence within health settings. Practitioner points Clinical implications Emerging evidence suggests that clinical settings that foster research are associated with better patient outcomes. Suggestions to increase the feasibility of research projects in clinical settings are detailed. DR. MARIE GRACE D. ALEA, LPT PSY 316 – CLINICAL PSYCHOLOGY | DR. LUCILLE D. EVANGELISTA, RPsy 7 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES Limitations The present recommendations are drawn from the authors’ practical experience and may need adaptation to individual practitioners’ settings. This study does not attempt to assess the efficacy of the strategies suggested. Keywords: clinical psychology, research, research in practice, barriers to research, clinical psychology training, professional issues Why psychologist conduct research? Psychologists utilize the scientific method to conduct psychological research. Researchers seek not only to describe behaviors and explain why these behaviors occur; they also strive to create research that can be used to predict and even change human behavior. They try to investigate treatment outcome. “treatment outcome should refer to changes in condition (psychological, somatic, physical, social, and cultural) reflecting favorable or adverse effects on the patients well-being” (J. E. Lewis, 1998) Efficacy versus effectiveness of therapy According to Singal et al (2014), Intervention studies can be placed on a continuum, with a progression from efficacy trials to effectiveness trials. Efficacy can be defined as the performance of an intervention under ideal and controlled circumstances, whereas effectiveness refers to its performance under ‘real-world' conditions.1 However, the distinction between the two types of trial is a continuum rather than a dichotomy, as it is likely impossible to perform a pure efficacy study or pure effectiveness study. Internal and external Validity Internal validity refers to the degree of confidence that the causal relationship being tested is trustworthy and not influenced by other factors or variables while External validity refers to the extent to which results from a study can be applied (generalized) to other situations, groups or events. (Streefkerk, 2020) Assessment Method Clinical psychologist conduct research to evaluate and improve the assessment methods they use with clients. Such studies may involve the development, validation and expanded use of new DR. MARIE GRACE D. ALEA, LPT PSY 316 – CLINICAL PSYCHOLOGY | DR. LUCILLE D. EVANGELISTA, RPsy 8 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES instruments. The establishment of normative data for specific populations on an assessment tool; a comparison of multiple assessment tools to one another; or other research questions. Numerous professional journals including assessment, psychological assessment and journal of personality assessment are dedicated primarily to empirical studies of assessment issues in clinical psychology. Diagnostic Issues Clinical psychologist explore issues of diagnosis and categorizations regarding psychological problems. Such studies may examine the validity or reliability of existing or proposed diagnostic constructs, the relationship between disorders, the prevalence or course of disorders or numerous related topics. Studies often appear in journals of consulting and clinical Psychology and other journals. Professional Issues Clinical psychologist also examine elements of their own profession through empirical research. They study psychologists beliefs, activities and practices, among other aspects of their professional lives. Professional psychology: Research and Practice; Psychotherapy: Theory, Research and Practice, Training and Journal of Clinical Psychology are among the journals that feature such research. Teaching and Training Issues Clinical psychologists pursue research questions related to how to educate those entering the profession. Training philosophies, specific course work, opportunities for specialized training and the outcome of a particular training efforts all represents areas of study Training and Education in Professional Psychology; Teaching of Psychology and Journal of Clinical Psychology are among them. How do Psychologists do Research? Experimental Method Quasi Experiments Between Group and Within group design Analogue Design Correlational Methods Case studies Metanalysis DR. MARIE GRACE D. ALEA, LPT PSY 316 – CLINICAL PSYCHOLOGY | DR. LUCILLE D. EVANGELISTA, RPsy 9 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES Use of technology in Clinical Psychology Research Technology has transformed the study of psychology. It has led to innovation in treatment, education, assessment, and research. Technology usually provides a more convenient and cheaper alternative when used for assessment and treatment purposes. https://www.online-psychology-degrees.org/study/technology-changing- psychology/#:~:text=Technology%20has%20transformed%20the%20study,for%20assessment%20and%2 0treatment%20purposes. Within the field of education and training, computer conferencing systems are increasingly used to offer coursework at a distance. The pedagogy goes beyond the presentation of didactic materials to include collaboration, “communities of practice,” and the learning of meta-skills such as reflective thinking and real-world problem solving. Online supervision of graduate students within a psychology training program is part of the larger domain of “telehealth,” which uses telecommunication technology to provide health information and intervention, and consultation and supervision across distances. The technology is expanding to include interactive video disks and expert system-based, computer-assisted training programs https://www.researchgate.net/publication/228018480_Role_of_Technology_in_Clinical_Psychology Ethical Issues in Research in Clinical Psychology Informed consent Avoid deception Fabrication of data List of authors Sharing of data to other competent researchers to reanalyze it for verification END OF WEEK 1 LECTURES AND DISCUSSION Well done on finishing Week 4! WHAT COULD YOU LEARN NEXT? Assessment a. Diagnosis and Classification Issues: DSM 5 and More MODULE 3 – ACTIVITY Create an outline of the Psychologist code of conduct DR. MARIE GRACE D. ALEA, LPT PSY 316 – CLINICAL PSYCHOLOGY | DR. LUCILLE D. EVANGELISTA, RPsy 10 SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES TABLE OF CONTENTS Definition of Normality and Abnormality ……………….…….……………………………. 3 Brief History of Diagnosis and Classification of Mental Disorders ……………………….…. 5 DSM Early Editions ……………………….………………………………………………… 6 The Criticisms of the DSM ………………………….........................................................…… 8 The Alternative Directions in Diagnosis and Classification…………………………….…....... 9 DR. MARIE GRACE D. ALEA, LPT 2 PSY 316 – CLINICAL PSYCHOLOGY | DR. LUCILLE D. EVANGELISTA, RPsy SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES MODULE 4: ASSESSMENT DIAGNOSIS AND CLASSIFICATION ISSUES: DSM 5 AND MORE Introduction This module covers the definition of Normality and Abnormality, who defined abnormality, why defining abnormality is important, brief history of diagnosis and classification of mental disorders, before DSM, DSM early editions, DSM more recent editions, DSM 5 the current edition. The criticisms of the DSM and the alternative directions in Diagnosis and classification. Intended Learning Outcomes ILO 1: Describe key concepts, principles, and overarching themes in psychology; ILO 2: Use basic psychological terminology, concepts, and theories in psychology to explain behavior and mental processes and describe its application business, health care, educational, and other workplace settings; ILO 3: Identify key characteristics of major content domains in psychology and recognize major historical events, theoretical perspectives, and figures in psychology and their link to trends in contemporary research; ILO 4: Predict how individual differences influence beliefs, values, and interactions with others, including the potential for prejudicial and discriminatory behavior in oneself and others; ILO 5: Conceptualize an infographics materials that is an example of relevant and practical applications of psychological theories, principles and dynamics to everyday Filipino experiences; ILO 6: Apply ethical standards to evaluate psychological science and practice Definition of Normality And Abnormality Normal Relating to what is considered standard, average, typical, or healthy. This general meaning is applied in a variety of different contexts, including statistics (referring to scores that are within the usual or expected range), biology (referring to the absence of malformation or other pathology), and development (referring to progression and growth that are comparable to those seen in others of similar ages). However, the term is most often applied to behavior that conforms to a culturally DR. MARIE GRACE D. ALEA, LPT 3 PSY 316 – CLINICAL PSYCHOLOGY | DR. LUCILLE D. EVANGELISTA, RPsy SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES accepted norm, especially as an indication that a person is mentally healthy and does not have a psychological disorder. Normality The state or condition of being normal Abnormal Relating to any deviation from what is considered typical, usual, or healthy, particularly if the deviation is considered harmful or maladaptive. In statistics, for example, abnormal scores are those that are outside the usual or expected range. The term, however, is most often applied to behavior that differs from a culturally accepted norm, especially when indicative of a mental disorder. —abnormality n. —abnormally adv. Abnormality The state or condition of being abnormal. Or a defect or malformation in structure or function. https://dictionary.apa.org ASK STUDENTS THE DEFINITION OF ABNORMAL ☺ Jerome Wakefield is a renowned scholar in the field of abnormal psychology. In clinical psychology Wakefield’s definition of abnormality suggests that mental disorders are most aptly conceived as "harmful dysfunctions" involving two distinct and separable components: 1) the failure of a mechanism in the person to perform a natural function for which the mechanism was designed by natural selection, and 2) a value judgment that the dysfunction is undesirable. Who Defined Abnormality The definition of abnormality along with other definitions continues to be debated by academics and researchers in the field. The 5th edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (the DSM-5) lays out explicit and specific guidelines for identifying and categorizing symptoms and diagnoses. The DSM reflects a medical model of psychopathology in which disorder is an entity defined categorically and features a list of specific symptoms (blaneu, 205, Deacon, 2013) Why Defining Abnormality Is Important The process by which disorders are defined is much more than academic exercise from scholars to debate. These definitions it yields have very real consequences for professionals and non- professionals alike. (Kinghorn 2013, Widiger 2008) DR. MARIE GRACE D. ALEA, LPT 4 PSY 316 – CLINICAL PSYCHOLOGY | DR. LUCILLE D. EVANGELISTA, RPsy SECOND SEMESTER BATANGAS STATE UNIVERSITY – THE NATIONAL ENGINEERING UNIVERSITY A.Y. 2023 - 2024 COLLEGE OF ARTS AND SCIENCES Importance for professionals If defined, it is the basis for diagnosis; and patients and professionals will conceptualize that an individual has this form of mental illness. If a certain disorder never appeared in any DSM edition researchers would be less likely to study it. Importance for Clients (Pros and Cons) If a disorder is labelled and defined, clients will identify and demystify an otherwise nameless experience, feel as though she shares a recognized problem with others. A diagnosis may help to avail of health insurance. On the other hand, the label could carry a stigma that may damage self-image, lead to stereotyping and other consequences such as fitness to stand in court, sentencing decisions for child custody and others. Brief History of Diagnosis and Classification of Mental Disorders, Before DSM Pre–World War II In the United States, the initial stimulus for developing a classification of mental disorders was the need to collect statistical information. What might be considered the first official attempt to gather information about mental health in the United States was the recording of the frequency of “idiocy/insanity” in the 1840 census. By the 1880 census, seven categories of mental health were distinguished: mania, melancholia, monomania, paresis, dementia, dipsomania, and epilepsy. In 1917, the American Medico–Psychological Association, together with the National Commission on Mental Hygiene, developed a plan adopted by the Bureau of the Census for gathering uniform health statistics across mental hospitals. Although this system devoted more attention to clinical usefulness than did previous systems, it was still primarily an administrative classification. In 1921, the American Medico–Psychological Assoc

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