Summary of Clinical Psychology (PSY 335; Chapters 1-7, 12 and 13)
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Course
PSY 335
Institution
Ryerson University (Ru
)
This document contains a comprehensive set of detailed notes taken from the textbook for PSY 335 (Clinical Psychology; Chapters 1-7, 12, 13). The notes summarize key concepts, theories, and findings discussed in the chapters required for the course, providing a structured and accessible resource fo...
Hunsley, J., & Lee, C. (2014). Clinical Psychology: An Evidence-Based Approach. (3rd Ed.). United States:
Wiley.
The Evolution of Clinical Psychology
INTRODUCTION
• Dental health is a state of well-being in which every individual realizes his or her own potential,
can cope with the normal stresses of life, can work productively and fruitfully, and is able to make
a contribution to his or her community
• More than 450 million people have mental disorders
• About half of all mental disorders begin before people reach age 14
• 1 out of every 10 Canadian adolescents and adults reported symptoms consistent with a diagnosis
of a mental disorder such as alcohol or illicit drug dependence, a mood disorder (i.e., major
depressive disorder or bipolar disorder), or a serious anxiety disorder (i.e., social phobia, panic
disorder, or panic disorder with agoraphobia
• $63 billion annually
DEFINING THE NATURE AND SCOPE OF CLINICAL PSYCHOLOGY
• Clinical psychology is the branch of psychology that focuses on developing assessment strategies
and interventions to deal with these painful experiences that touch everyone's life
• Clinical psychology is based firmly on scientifically supported psychological theories and principles
• Clinical psychology is a science-based profession
• The development of effective assessment, prevention, and intervention services relies on basic
research into the nature of emotional distress and well-being
• The practice of clinical psychology also covers indirect services that do not involve contact with
those suffering from a mental disorder, such as consultation activities, research, program
development, program evaluation, supervision of other mental health professionals. And
administration of health care services
• SEE PAGE 9
EVIDENCE-BASED PRACTICE IN PSYCHOLOGY
• Critics of a science-based approach to clinical psychology express the following concerns:
o Group-based data cannot be used in working with an individual
o Clients have problems now and we cannot afford to wait for the research
o Each individual has a unique constellation of life experience, culture, and societal context
o Not enough research to treat all problems
o At people are prone to a host of decision-making errors and biases
• Questions surrounding the appropriateness of adopting a evidence-based practice model (EBP):
suggests that psychiatrists should adopt this model
o Synthesize information drawn from research and systematically collected data on the
patient in question. The clinician's professional experience, and the patient's preferences
when considering health care options
o Informing patients, based on the best available research evidence, about viable options for
assessment, prevention, or intervention services
o Endorsed by the CPA and APA
MENTAL HEALTH PROFESSIONS
• Clinical psychology is primarily concerned with the application of psychological knowledge in
assessment, prevention, and/or intervention in problems in thoughts, behaviours, and feelings
, o Conduct psychological research and contribute important information to the science of
psychology
• Counselling Psychology
o Counselling is a generic term used to describe a range of mental health professions with
various training and licensure requirements
o Counselling psychologists provided services to individuals who were dealing with normal
challenges in life: predictable developmental transitions, such as leaving home to work or to
attend university or college, dealing with changes in work or interpersonal roles, and
handling the stress associated with academic or work demands
o Counseling psychologists dealt with people who were, by and large, well adjusted, whereas
clinical psychologists dealt with people who were experiencing significant problems in their
lives and who were unable to manage the resulting emotional and behavioural symptoms
o Most commonly employed in educational settings (such as college or university counselling
clinics) or general community
• Clinical psychologists, in contrast, were most likely to be employed in hospital
settings—both in general hospitals and in psychiatric facilities
• Usually trained in different academic settings and in different academic traditions
o The distinction is becoming less and less meaningful
• Both promote the use of scientifically based intervention
• School Psychology
o Have specialized training in both psychology and education
o Employed in diverse organizations such as schools, clinics, and hospitals, and in private
practice
o Most school psychologists are employed by school board
o Emphasized services related specifically to the learning of children and adolescents
• Now includes attention to social, emotional, and medical factors in a context of
learning and development
• Psychiatry
o Psychiatrists are physicians who specialize in the diagnosis, treatment, and prevention of
mental illnesses
o Psychiatric training deals extensively with physiological and biochemical systems and
emphasizes biological functioning and abnormalities
o Evaluate the extent to which psychological symptoms result from or are exacerbated by
medications used to treat physical ailments and chronic illnesses
o Receive relatively little training in human psychological development, cognition, learning, or
psychological functioning in general
o Limited training in research skills such as research design and statistical analysis
o Emphasizes psychopharmacological treatment over psychological treatment
o Tend to receive less training in the use of scientifically based psychological assessment and
psychotherapy psychiatrists could prescribe medication
• Clinical Social Work
o Focus on ways to improve the health and well-being of individuals, families, groups, and
communities
o Includes activities such as policy development, program planning, program management,
research consultation, case management, discharge planning, counselling, therapy, and
advocacy
o Are employed in diverse settings, including hospitals, community mental health centres,
mental health clinics, schools, advocacy organizations, government departments, social
, service agencies, child welfare settings, family service agencies, correctional facilities, social
housing organizations , family courts, employee assistance programs, school boards, and
private counselling and consultation agencies, coordinates services with a range of social
and community agencies, medical services, and other service
• Other Mental Health Professions
o Psychiatric nurses are professionals who offer services to individuals whose primary care
needs relate to mental and developmental health
• Employed in diverse settings, including acute psychiatry, long-term geriatric care and
home care, residential and community programs for the developmentally
handicapped, etc
o Child and youth care workers .) focused on the assessment and treatment of specific mental
health problems such as addictions or traumc
• Have the least training and are the least likely to be members of a regulated
profession
AVAILABILITY OF MENTAL HEALTH SERVICE PROVIDERS
• Fewer than 1 psychologist, psychiatrist, or social worker for every 100,000 people
o Only 1 mental health professional for every 10,000 people who suffer from a mental
disorder
A BRIEF HISTORY OF CLINICAL PSYCHOLOGY
• The Roots of Clinical Psychology
o Mental disturbances were caused by natural causes rather than by demonic possession
o Hippocrates emphasized what is now known as a biopsychosocial approach to
understanding both physical and psychological disorders (i.e., that biological, psychological,
and social influences on health and illness must be considered
• Plato emphasized the role of societal forces and psychological needs in the
development and alleviation of mental disorders, whereas Aristotle emphasized the
biological determinants of mental disorders
o St. Vincent de Paul proposed that mental and physical illnesses were caused by natural
forces and that the extreme manifestations of mental disturbances were not caused by
witchcraft or satanic possession
• Those suffering from severe mental illness were isolated in asylums
o During the period of the Enlightenment
• Reformer Philippe Pinell ordered that the chains be removed from all mental patients
and that patients be treated humanely
• In the United States, Benjamin Rush promoted the use of moral therapy with the
mentally ill a treatment philosophy that encouraged the use of compassion and
patience rather than physical punishment or restraints
o Jean-Martin Charcot e, is credited with being the primary developer of clinical neurology
• Use of suggestion and hypnosis
• The History of Assessment in Clinical Psychology
o Was almost entirely an assessment-based discipline until the middle part of the 20th
century
o Francis Gallon studied individual differences among people, especially differences in motor
skills and reaction times, which he believed were related to differences in intelligence
o Wilhelm Wundt, who studied sensation and perception, established the first psychology
laboratory
o James McKeen Cattel is credited with coining the term mental tests to describe the battery
of tests and tasks he developed to evaluate people's cognitive functioning
, o The pre-eminent individuals who influenced the early work on assessment in clinical
psychology are the German physiatrist Emil Kraepelin and the French psychologist Alfred
Binet
• Kraepelin was convinced that all mental disorders were associated with biological
factors and that these biological causes of the disorder could not be effectively
treated by the rather primitive methods available
• Examining the symptomatic behaviour of a large number of patients
• Kraepelin called these groups of symptoms that frequently co-occurred syndromes,
and his classification system was built around identifying the ways in which these
syndromes related to and differed from eachother
• His classification of what is now known as schizophrenia was one of his major
accomplishment
o Alfred Binet wanted all children to receive schooling to maximize their potential to learn and
develop
• In particular there was concern to provide an education to those children with limited
cognitive abilities who were unlikely to benefit from typical teaching methods
• Binet-Simon scale of intelligence
• Lewis Terman developed the e Stanford-Binet Intelligence Test
o The field of psychological assessment grew rapidly
• First World War: Physicians were employed to evaluate the physical fitness, mental
fitness and mental ability of the recruits for various military activities
• Establishment of the first standards for the development of scientifically sound psych
logical tests
• The discipline of clinical psychology was officially recognized within the APA by 1919
o Measurement of abilities continued to be a central focus for clinical psychologists
• Release of the Wechsler-Bellevue test
• Development of interest tests e developed for training and personnel hiring purposes
• Emergence of projective tests to evaluate personality and psychological functioning
▪ The Rorschach Inkblot Test
▪ Thematic Apperception Test (TAT)
o Second World War
• The assessment milestone of the 1940s was unquestionably the publication of the
Minnesota Multiphasic Personality Inventory (MMPI)
▪ Relied extensively on attention to statist 1 procedures and test development
o Fundamental differences between projective test and the MMPI according to Paul Meehls
• Found that a purely clinical approach to assessment was typically inferior to a more
statistically oriented approach to accurately describing or diagnosing adults
• The statistical approach, in contrast, involved the use of basic demographic
information and data from standardized tests that were entered into statistical
equations to yield descriptions and/ or predictions
▪ Scientific methods including, whenever possible, standardized psychological
measures must be used to test the viability of the hypotheses
o Many personality researchers and clinical psychologists behaved that Walter Mischel had
underestimated the influence of personality factors and overestimated the power of social
situations in determining behaviour
• His analysis bolstered the rising influence of behavioural assessment approaches on
clinical assessment
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