Introduction to Clinical Psychology PDF

UNIVERSITY OF THE CORDILLERAS College of Arts and Sciences Department of Psychology and Behavioral Science MODULE 1 INTRODUCTION TO CLINICAL PSYCHOLOGY Clinical Psy...

UNIVERSITY OF THE CORDILLERAS College of Arts and Sciences Department of Psychology and Behavioral Science MODULE 1 INTRODUCTION TO CLINICAL PSYCHOLOGY Clinical Psychology in Historical Context The history of Clinical Psychology has been tied to the history of Abnormal Psychology. With a disorder comes the attempt to treat it. You will see a significant shift in belief regarding the causal factor of a disorder and the treatment—from superstitious belief to scientific awareness. Early Beginnings: Gods spirits, demons, and witches The spiritistic model would suggest that abnormal behaviors were due to the possession of spirits, demons, or other supernatural powers. Ancient China, Egypt, Hebrew, and Greece often attributed abnormal behavior to a demon or a God that has been taken over a person. To determine if it was the work of a “good spirit” or a “bad spirit”, they would often rely on the person’s behavior. If there is a religious significance to the person’s behavior, then it must be a “good spirit”. However, most of the possessions were considered the work of an evil spirit. Back then, the primary treatment for possessions was exorcism, or casting an evil spirit out of a person. It involves different techniques which mainly include prayer, magic, noise-making, and the use of “potions” made from ship’s dung and wine. Another commonly used treatment was trephination or drilling a hole in a person’s skull to release the evil spirit residing inside the person. Eventually, there was significant progress and improvement in understanding mental disorders. The shift in perspective can be traced back to Hippocrates, who denied the claim of demonic possessions. He claimed that, like any other medical condition, mental disorders had natural causes and appropriate treatment. According to him, the four bodily fluids or humors (blood, black bile, yellow bile, and phlegm) directly affect a person’s pattern of behavior. His suggested treatments include proper diet, rest, and exercise. Humorism theory is generally acknowledged as the first medical model of disordered behavior paved the way for the concept of mental illness and legitimized the involvement of the medical profession in its treatment. Progress and change slowed down for quite some time. It was not until the 18 th century that the treatment for psychological disorders became more humane, and moral management – treatment where the focus was on the patient’s individual social Page 1 of 6 and occupational needs. Afterward, it was in the 19th and 20th centuries when another round of significant changes emerged. Early Pioneers of Humane Treatment of Mental Disorders 1. Philippe Pinel (France) o Worked successfully to move mentally ill individuals out of dungeons in Paris, where they were held as inmates rather than treated as patients (Cautin, 2011; Charland, 2015; Ehrenwald, 1991). o He created new institutions in which patients were not kept in chains or beaten but rather, given healthy food and benevolent treatment. o Treatise on Insanity (1806) reflected Pinel’s goal of empathy rather than cruelty for the mentally ill. 2. William Tuke (Great Britain) o He raised funds to open the York Retreat, a residential treatment center where the mentally ill would always be cared for with kindness, dignity, and decency. The York Retreat became an example of the humane treatment of the mentally ill and initiated the movement to improve the treatment of mentally ill individuals. 3. Benjamin Rush (United States) o He is often regarded as the father of American psychiatry for he was instrumental in changing the way institutionalized mental patients were treated in the United States. 4. Eli Todd (United States) o A physician in Connecticut who was inspired by Pinel’s movement for a more humane treatment of the mentally ill. o He raised funds to open The Retreat in Hartford, Connecticut in 1824. i. Todd ensured that their patients were treated in a humane and dignified way. ii. He and his staff emphasized patients’ strengths rather than weaknesses, and they allowed patients to have significant input in their own treatment decisions. 5. Dorothea Dix o Devoted the rest of her life to improving the lives and treatment of the mentally ill. o Her efforts resulted in the establishment of more than 30 state institutions for the mentally ill throughout the United States providing more decent, compassionate treatment for the mentally ill than they might have otherwise received (Reisman, 1991). Aside from what is mentioned above, the development of a classification system became apparent. This led to the development of the first edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM). These changes paved the way for the knowledge and practices that we know today. Page 2 of 6 What is Clinical Psychology? Clinical Psychology can be thought of as a field, a method, and a process. Clinical Psychology is a field of psychology that deals with psychological knowledge and practice employed in helping a client who has some behavior or mental disorder to find adjustment and self-expression. It includes training and actual practice in diagnosis, treatment, and prevention, as well as research for the expansion of knowledge. Additionally, it is a method because of the use of specific techniques in the course of therapy with the client. Lastly, it is a process because assessment and treatment follow a certain flow. From the definition, we can summarize that clinical psychology deals with: - Specific techniques (knowledge and practice) - Clients served (people in distress) - Problems dealt with (diagnosis, treatment, prevention) - Work setting (clinic – a place where persons come for individualized diagnosis and treatment) - Training (actual practice) The term clinical psychology was first used by Lightner Witmer, thus he is often credited as the founder of the field. He also founded the first psychological clinic at the University of Pennsylvania in 1896. In addition, an accurate, comprehensive, contemporary definition of clinical psychology would need to be more inclusive and descriptive. The Division of Clinical Psychology (Division 12) of the American Psychological Association (APA) defines clinical psychology as follows: 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. (APA, 2012a) The Clinical Attitude: What is our Approach? CLINICAL ATTITUDE Clinical attitude is a distinct element in the practice of Clinical Psychology. Remember, in clinical psychology, we are dealing with an actual person. The goal is to help the client achieve “ginhawa” (relief) through knowledge and practice. To achieve this, we must adhere to clinical attitude. Clinical attitude refers to the attitude of studying an individual as a unique whole through the intuitive integration of measurement findings, together with direct observation. With this, we achieve the goal of understanding and helping the individual. Page 3 of 6 The approach is personological where we consider the personality and psychological variables converging in the individual along with the external factors (family, group, community, etc.) affecting the person. It centers on the unique person; thus, the clinician’s emotions/feelings take a backseat. The clinician must act in the service of another by setting aside one’s own interests/motives during the clinical hour. Embodying the clinical attitude, we must take note of the following: - Be objective - Be willing to change your mind in the face of good reason - Focus on validity and soundness - Don’t take disagreement personally How do we differentiate the clinical method from other methods? Three main methods for understanding an individual’s behavior 1. Experimental method o Involves the observation of events, development of hypothesis to explain observed events, manipulation of variables, and testing of hypothesis, o In clinical psychology, experimental studies take the form of randomized clinical trials (RCT) 2. Differential method o Aims to explore differences. This includes intra-individual differences (differences within the person) and inter-individual differences (differences between and among individuals) 3. Between-group vs Within-group Designs BETWEEN-GROUP DESIGN o Between-groups - participants in different conditions receive entirely different treatments o Within–groups - Involves comparisons of participants in a single condition to themselves at various points in time. o Mixed-groups - combine aspects of between-group and within-group designs 4. Case Studies o Involve a thorough and detailed examination of one person or situation o Include descriptive observations of an individual’s behavior and an attempt by the researcher to interpret it. 5. Cross-sectional vs Longitudinal Designs o Cross-sectional designs: Assess or compare a participant or group of participants at one point. o Longitudinal designs: Emphasize changes across time, often making within- group comparisons from one point in time to another. Page 4 of 6 How do clinical psychologists differ from other professions? Clinical Psychologist vs Counseling Psychologist Clinical Psychologist Counseling Psychologist More psychologically disturbed Client Less pathological clients individuals Works in hospitals and inpatient Work more often in university Work Setting psychiatric units. counseling centers. Theoretical Humanistic/ Client-Centered Behaviorism Orientation approaches Applications of psychology to Vocational Testing and Career Interests medical settings Counseling Clinical Psychologist vs Psychiatrist Clinical Psychologist Psychiatrist Post-graduate and Doctorate Degree Licensed Medical Doctor Programs (PhD) Trained to appreciate the Emphasis on the physiological Training BIOLOGICAL aspects of their client's abnormalities of the brain problems Perception of View the client’s problems as “Fix” the brain by prescribing Client’s Problem behavioral, emotional, and cognitive. medication (Noll, 2015) Approach to Psychotherapy Psychopharmacology treatment Psychotherapy vs Counseling Psychotherapy Counseling Focuses on recurring or chronic issues. Focuses on short-term, or current issues. Therapy may be long-term and can take Therapy may be short-term. place over many years. A psychological professional usually A psychological professional delivers the delivers counseling, although people, therapy. such as volunteers or pastoral counselors, may also offer counseling. Therapy may focus on a psychological May deal with functioning individuals disorder or problem with psychological who are experiencing difficulties in their functioning. current situation. Development of Psychotherapy ▪ In the middle of the 20th Century, psychotherapy rose to a more prominent place in clinical psychology where the psychodynamic approach dominated (Routh, 1996). ▪ In the 1950s & 1960s, behaviorism surfaced as a fundamentally different approach to human beings and their behavioral or emotional problems. The behavioral approach emphasizes an empirical method, with problems and progress measured in observable, quantifiable terms. Page 5 of 6  ▪ In the 1960s, humanistic therapy flourished as Roger’s relationship- and growth- oriented approach to therapy offered an alternative to both psychodynamic and behavioral approaches that many therapists and clients found attractive. ▪ The family therapy revolution took root in the 1950’s. ▪ Most recently, interest in cognitive therapy, with its emphasis on logical thinking as the foundation of psychological wellness, has intensified to the point that it has become the most popular singular orientation among clinical psychologists (Engel, 2008; Norcross & Karpiak, 2012; O’Donohue, 2009). Development of the Profession ▪ 1917: The American Association of Clinical Psychologists was founded. ▪ 1919: Transition to the Clinical Section of the APA ▪ 1921: Foundation of the Psychological Corporation ▪ 1940s: Education and training in clinical psychology became more widespread and more standardized ▪ 1950s: Proliferation of therapy approaches with new behavioral and humanistic/existential approaches rivaling established psychodynamic techniques. ▪ 1953: Publication of the first Ethical Code of the APA ▪ 1960s & 1970s: Psychotherapy as a recognized part of American health care. ▪ 1980s: Clinical psychologists enjoyed increased respect from the medical establishment as they gained hospital admitting privileges. Page 6 of 6