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Contemporary Clinical Psychology Third Edition






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Contemporary Clinical Psychology Third Edition. Thomas Plante, Ph.D., ABPP Santa Clara University and Stanford University School of Medicine. Chapter 1. What Is Contemporary Clinical Psychology?. Clinical Psychology Activities. Research Assessment Treatment Teaching Consultation
Contemporary Clinical Psychology Third Edition

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Slide 1

Contemporary Clinical PsychologyThird Edition

Thomas Plante, Ph.D., ABPP

Santa Clara University and

Stanford University School of Medicine

Slide 2

Chapter 1

What Is Contemporary Clinical Psychology?

Slide 3

Clinical Psychology Activities

Research

Assessment

Treatment

Teaching

Consultation

Administration

Slide 4

Clinical Psychology Employment Settings

  • Private and Group Practices

  • Colleges and Universities

  • Hospitals

  • Medical Schools

  • Outpatient Clinics

  • Business and Industry

  • Military

  • Other Locations

Slide 5

Clinical Psychology Subspecialties

  • Child Clinical Psychology

  • Health Psychology

  • Neuropsychology

  • Forensic Psychology

  • Geropsychology

Slide 6

Clinical Psychology Organizations

  • American Psychological Association

  • American Psychological Society

  • State and County Psychological Associations

  • National Register of Health Care Providers

  • American Board of Professional Psychology

  • Other Organizations

Slide 7

Related Fields

  • Counseling Psychology

  • School Psychology

  • Psychiatry

  • Social Work

  • Psychiatric Nursing

  • Marriage and Family Counseling

  • Other Counselors

  • Other Psychologists

Slide 8

Chapter 2

Foundations and Early History of Clinical Psychology

Slide 9

Early Conception of Mental Illness: Mind and Body Paradigms

  • Greeks

  • Middle Ages

  • Renaissance

  • 19th Century

  • Birth of Psychology

Slide 10

The Founding of Clinical Psychology

  • Lightmer Witmer

  • Binet's Intelligence Test

  • Mental Health and Child Guidance Movement

  • Sigmund Freud in America

  • The Influence of World War I

  • Clinical Psychology Between World Wars I and II

Slide 11

Significant events in the history of clinical psychology

  • 2,500–500 BC Supernatural, magic, herbs, and reason approaches to illness

  • 470–322 BC Greeks use holistic approach

  • 130–200 AD Galen develops foundation of Western medicine

  • 500–1450 Middle Ages: supernatural forces influence health and illness

  • 1225–1274 Saint Thomas Aquinas uses scientific thinking

  • 1490–1541 Paracelsus uses movements of the stars, moon, sun, and planets to understand behavior

  • 1500–1700 Renaissance and scientific discoveries suggesting biological factors influence health and illness

  • 1596–1650 René Descartes develops mind/body dualism

  • 1745–1826 Pinel developed humane moral therapy to treat mentally ill

  • 1802–1887 Dorothea Dix advocates for humane treatment of mentally ill

  • 1848 New Jersey becomes first state to build a hospital for mentally ill

Slide 12

Significant events, continued

  • 1879 Wundt develops first laboratory in psychology

  • 1879 William James develops first American psychology laboratory at Harvard

  • 1883 G. Stanley Hall develops second psychology laboratory at John Hopkins

  • 1888 James McKeen Cattell develops third American psychology laboratory

  • 1890 James publishes Principles of Psychology

  • 1890 James McKeen Cattell defines “mental test”

  • 1892 American Psychological Association founded

  • 1895 Breuer and Freud publish Studies on Hysteria

  • 1896 Witmer establishes first psychological clinic at U. Penn

  • 1900 Freud publishes The Interpretation of Dreams

  • 1904 Binet begins developing an intelligence test

  • 1905 Binet and Simon offer Binet-Simon Scale of Intelligence

  • 1905 Jung creates a word association test

  • 1907 Psychological Clinic, first clinical journal published

  • 1908 Beers begins mental hygiene movement

  • 1909 Clinical psychology section formed at APA

  • 1909 Freud’s only visit to America at Clark University

Slide 13

Significant events, continued

  • 1909 Healy develops child guidance clinic in Chicago

  • 1916 Terman develops Stanford-Binet Intelligence Test

  • 1917 Clinicians of APA leave to form American Association of Clinical Psychologists (AACP)

  • 1917 Yerkes and committee develop Army Alpha test

  • 1919 AACP rejoins APA

  • 1921 James McKeen Cattell develops Psychological Corporation

  • 1921 Rorschach presents his inkblot test

  • 1924 Mary Cover Jones uses learning principles to treat children’s fears

  • 1935 APA Committee on Standards and Training define clinical psychology

  • 1935 Murray and Morgan publish the TAT

  • 1936 Louttit publishes first clinical psychology textbook

  • 1937 Clinicians leave APA again to form American Association of Applied Psychology (AAAP)

  • 1937 Journal of Consulting Psychology begins

  • 1939 The Wechsler-Bellevue Intelligence Scale is published

  • 1943 Hathaway publishes MMPI

  • 1945 AAAP rejoins APA

Slide 14

Chapter 3

Recent History of Clinical Psychology

Slide 15

Significant events: 1940s and 1950s

  • 1940s

  • 1945 AAAP rejoins APA

  • 1945 Connecticut passes first certification law for psychology

  • 1946 VA and NIMH fund clinical psychology training

  • 1947 ABEPP is founded to certify clinicians

  • 1949 Halstead presents neuropsychological testing battery

  • 1949 Boulder Conference defines scientist-practitioner model of training

  • 1950s

  • 1950 Dollard and Miller publish Personality and Psychotherapy: An Analysis in Terms of Learning, Thinking, and Culture

  • 1951 Rogers publishes Client-Centered Therapy

  • 1952 Eysenck publishes The Effects of Psychotherapy: An Evaluation

  • 1952 American Psychiatric Association publishes diagnostic categories in Diagnostic and Statistical Manual (DSM - I)

  • 1953 APA publishes Ethical Standards

  • 1953 Skinner presents operant principles

  • 1955 Joint Commission on Mental Health and Illness founded

  • 1956 Stanford University training conference

  • 1958 Wolpe publishes Psychotherapy by Reciprocal Inhibition

  • 1958 Miami training conference

  • 1959 Mental Research Institute (MRI) founded

Slide 16

Significant events: 1960s and 1970s

  • 1960s

  • 1960 Eysenck publishes Handbook of Abnormal Psychology: An Experimental Approach

  • 1963 Congress passes legislation creating community mental health centers

  • 1965 Chicago training conference

  • 1965 Conference at Swampscott, MA, starts community psychology movement

  • 1967 Association for Advancement in Behavior Therapy founded

  • 1968 First PsyD program founded at the University of Illinois

  • 1969 First freestanding professional school of psychology founded at California School of Professional Psychology

  • 1970s

  • 1970 DSM II published

  • 1973 Vail training conference

  • 1976 National Council of Schools of Professional Psychology (NCSPP) founded

  • 1977 George Engel publishes paper in Science defining biopsychosocial model

  • 1977 Wachtel publishes Psychoanalysis and Behavior Therapy: Toward an Integration

Slide 17

Significant events:1980s and 1990s

  • 1980s

  • 1980 DSM III published

  • 1981 APA ethical standards revised

  • 1982 Health psychology defined

  • 1986 NCSPP Mission Bay training conference

  • 1987 Salt Lake City training conference

  • 1987 DSM III-R published

  • 1988 American Psychological Society founded

  • 1989 NCSPP San Juan training conference

  • 1990s

  • 1990 NCSPP Gainesville training conference

  • 1991 NCSPP San Antonio training conference

  • 1992 Michigan Conference on postdoctoral training

  • 1994 DMS IV published

  • 1995 APA publishes a list of empirically validated treatments

  • 1998 International Society of Clinical Psychology founded in San Francisco

  • 1999 Guam authorizes psychologists to prescribe psychotropic medication

Slide 18

Significant recent events in 2000s

  • 2001 APA alters mission statement to reflect psychology as a health care discipline

  • 2002 APA ethics code revised

  • 2002 New Mexico allows psychologists medication prescription authority

  • 2003 Health Insurance Portability and Accountability Act (HIPAA) becomes law

  • 2004 Louisiana allows psychologists prescription authority

  • 2006 APA publishes findings from a Presidential Task Force on Evidence-Based Practice

  • 2008 The U.S. Congress passes the Paul Wellstone Mental Health and Addiction Equity Act of 2007 allowing mental health parity in health care

Slide 19

Chapter 4

Research:

Design and Outcome

Slide 20

Research Methods and Designs

  • Experiments

  • Quasi-Experimental Designs

  • Case Studies

  • Correlational Methods

  • Epidemiological Methods

  • Cross-Sectional and Longitudinal Designs

Slide 21

Treatment Outcome Research

  • Treatment Package Strategy

  • Dismantling Treatment Strategies

  • Constructive Treatment Strategies

  • Parametric Treatment Strategy

  • Comparative Treatment Strategy

  • Client-Therapist Variation Strategy

  • Process Research Strategy

Slide 22

Examples of Threats to Internal and External Validity

  • Threats to internal validity

  • History

  • Maturation

  • Testing

  • Instrumentation

  • Statistical Regression

  • Selection Bias

  • Experimental Mortality

  • Threats to external validity

  • Testing

  • Reactivity

  • Multiple-Treatment Interference

  • Interaction of Selection Biases

Slide 23

Different Levels of Research

  • Level 1 Basic laboratory research on factors associated with behavior change

  • Level 2 Analogue treatment research to identify effective ingredients of therapeutic procedures under controlled laboratory conditions

  • Level 3 Controlled clinical research with patient populations

  • Level 4 Clinical practice. Therapists may measure outcome in case studies or clinical series.

Slide 24

Questions and Challenges Conducting Treatment Outcome Research

  • Is the treatment provided in a research program similar to the treatment provided in actual clinical practice?

  • Are the patients and therapists used in a research study typical of patients and therapists in actual practice?

  • How and when is treatment outcome measured?

  • Statistical versus clinical significance.

  • How can treatment outcome decisions be made when some studies might conclude one thing and other studies conclude something different?

  • What is a program of research and how is it conducted?

Slide 25

Contemporary Issues in Clinical Psychology Treatment Outcome Research

  • Biopsychosocial approaches to psychopathology research

  • Meta-analysis

  • Empirically supported treatments

  • Comprehensive and collaborative multi-site clinical trial research projects

  • Community-wide interventions

  • Ethical issues

  • Multicultural issues

Slide 26

Chapter 5

The Major Theoretical Models: Psychodynamic,

Cognitive-Behavioral, Humanistic, and

Family Systems

Slide 27

The Four Major Theoretical Models in Clinical Psychology

  • Psychodynamic Approach

  • Cognitive-Behavioral Approach

  • Humanistic Approach

  • Family Systems Approach

Slide 28

Alternatives to the Psychodynamic Approach

  • Behavioral Approach

  • Cognitive Approach

  • Humanistic Approach

  • Family Systems Approach

  • Psychotropic Medication

  • Community Mental Health Movement

  • Integrative Approaches

  • Biopsychosocial Approach

Slide 29

The Psychodynamic Approaches

  • Freud’s Psychoanalytic Perspective

  • The Revisionist or Neo-Freudian Perspective

  • The Object Relations Perspective

Slide 30

The Behavioral and Cognitive-Behavioral Approaches

  • The Classical Conditioning Perspective

  • The Operant Perspective

  • The Social Learning Perspective

  • The Cognitive Perspective: Beliefs, Appraisals, and Attributions

Slide 31

The Humanistic Approach

  • The Client-Centered Perspective

  • Maslow’s Humanistic Perspective

  • The Gestalt Perspective

Slide 32

The Family Systems Approach

  • The Communication Approach

  • The Structural Approach

  • The Milan Approach

  • The Strategic Approach

  • The Narrative Approach

Slide 33

Chapter 6

Integrative and Biopsychosocial Approaches in Contemporary Clinical Psychology

Slide 34

A Call to Integration

  • Commonalities among Approaches

  • Efforts toward Integration

  •  Eclectism

  •  Beyond Psychological Models

Slide 35

Biopsychosocial Factors

  • Diathesis-stress perspective

  • Reciprocal-gene-environment perspective

  • Psychosocial factors influencing biology

  • Development of the biopsychosocial perspective

Slide 36

Biopsychosocial Applications

  • Obsessive-Compulsive Disorder

  • Anxiety and Panic

  • Cardiovascular Disease

  • Cancer

Slide 37

Chapter 7

Contemporary Psychological Assessment I:

Interviewing and Observing Behavior

Slide 38

Interviewing

  • Rapport

  • Effective Listening Skills

  • Effective Communication

  • Observation of Behavior

  • Asking the Right Questions

Slide 39

Types of Interviews

  • Initial Intake or Admissions Interview

  • Mental Status Interview

  • Crisis Interview

  • Diagnostic Interview

  • Structured Interviews

  • Computer-Assisted Interviews

  • Exit or Termination Interviews

Slide 40

Standard Clinical Interview

  • Identifying Information

  • Referral Source

  • Chief Complaint or Presenting Problems

  • Family Background

  • Health Background

  • Educational Background

  • Employment Background

  • Developmental History

  • Sexual History

  • Previous Medical Treatment

  • Previous Psychiatric Treatment

  • History of Traumas

  • Current Treatment Goals

Slide 41

Chapter 8

Contemporary Psychological Assessment II:

Cognitive and Personality Assessment

Slide 42

Halstead-Reitan Neuropsychological Test Battery

  • Category Test

  • Tactual Performance Test

  • Rhythm Test

  • Speech Sounds Perception Test

  • Finger Oscillation Test

  • Trail Making Test

  • Strength of Grip Test

  • Sensory-Perceptual Examination

  • Tactile Perception

  • Modified Halstead-Wepman Aphasia Screening Test

  • Wechsler Adult Intelligence Scale—IV (WAIS-IV)

  • Minnesota Multiphasic Personality Inventory—2 (MMPI-2)

Slide 43

MMPI-2 Scales

  • Validity Scales

  • ? (Cannot Say)

  • L (Lie)

  • F (Validity)

  • K (Correction)

  • Clinical Scales

  • 1 Hypochondriasis (Hs)

  • 2 Depression (D)

  • 3 Conversion Hysteria (Hy)

  • 4 Psychopathic Deviate (Pd)

  • 5 Masculinity-Femininity (Mf)

  • 6 Paranoia (Pa)

  • 7 Psychasthenia (Pt)

  • 8 Schizophrenia (Sc)

  • 9 Hypomania (Ma)

  • 0 Social Introversion (Si)

Slide 44

MCMI-III Scales

  • Clinical Personality Patterns Scales

  • Scale 1 Schizoid

  • Scale 2A Avoidant

  • Scale 2B Depressive

  • Scale 3 Dependent

  • Scale 4 Histrionic

  • Scale 5 Narcissistic

  • Scale 6A Antisocial

  • Scale 6B Aggressive (Sadistic)

  • Scale 7 Compulsive

  • Scale 8A Passive-Aggressive (Negativistic)

  • Scale 8B Self-Defeating

  • Clinical Syndrome Scales

  • Scale A Anxiety

  • Scale H Somatoform

  • Scale N Bipolar: Manic

  • Scale D Dysthymia

  • Scale B Alcohol Dependence

  • Scale T Drug Dependence

  • Scale R Post-Traumatic Stress Disorder

Slide 45

MCMI-III Scales, continued

  • Severe Syndrome Scales

  • Scale SS Thought Disorder

  • Scale CC Major Depression

  • Scale PP Delusional Disorder

  • Severe Personality Pathology Scales

  • Scale S Schizotypal

  • Scale C Borderline

  • Scale P Paranoid

  • Modifying Indexes (Correction Scales)

  • Scale X Disclosure

  • Scale Y Desirability

  • Scale Z Debasement

Slide 46

16PF (Fifth Edition)

  • A Warmth

  • B Reasoning

  • C Emotional Stability

  • E Dominance

  • F Liveliness

  • G Rule Consciousness

  • H Social Boldness

  • I Sensitivity

  • L Vigilance

  • M Abstractedness

  • N Privateness

  • O Apprehension

  • Q1 Openness to Change

  • Q2 Self-Reliance

  • Q3 Perfectionism

  • Q4 Tension

Slide 47

Rorschach Sample

Slide 48

Rorschach Sample

Slide 49

Chapter 9

Psychotherapeutic Interventions

Slide 50

Common Denominators in Psychotherapy

  • Professional Person

  • Professional Manner

  • Professional Setting

  • Duration of Sessions

  • Frequency of Sessions

Slide 51

Stages of Psychotherapy

  • Initial Consultation

  • Assessment

  • Development of Treatment Goals

  • Implementation of Treatment

  • Evaluation of Treatment

  • Termination

  • Follow-Up

Slide 52

Modes of Psychotherapy

  • Individual Treatment

  • Group Psychotherapy

  • Couples Psychotherapy

  • Family Therapy

Slide 53

Chapter 10

Psychotherapeutic Issues

Slide 54

Ten Issues about Psychotherapy

  • Does Psychotherapy Work?

  • Long-Term Therapy versus Short-Term Treatment

  • Psychotherapy Dropouts

  • Is One Type of Therapy Better than Another?

  • Enduring Psychotherapy Effects

  • Common Factors Associated with Positive Psychotherapy Outcome

  • Change Is Challenging

  • Level of Training for Psychotherapists

  • Health Care Costs and Psychotherapy

  • Psychotherapy Harm

Slide 55

Chapter 11

Areas of Specialization in Contemporary Clinical Psychology

Slide 56

Clinical Health Psychology

  • Smoking

  • Obesity

  • Alcohol Consumption

  • Stress Management

  • Acquired Immune Deficiency Syndrome (AIDS)

  • Chronic Pain

Slide 57

Child Clinical Psychology

  • Attention Deficit/Hyperactivity Disorder (ADHD)

  • Learning Disorders

  • Child Abuse and Neglect

  • Anorexia Nervosa

Slide 58

Clinical Neuropsychology

  • Epilepsy

  • Brain Injuries

  • Degenerative Diseases

Slide 59

Forensic Psychology

  • Involuntary Commitment

  • Insanity Defense

  • Child Custody

  • Jury Selection

Slide 60

Geropsychology

  • Degenerative Diseases

  • Vascular Diseases

  • Parkinson’s Disease

  • Psychiatric Issues (Anxiety, Depression, Substance Abuse)

Slide 61

Chapter 12

Consultative, Teaching, and Administrative Roles in Contemporary Clinical Psychology

Slide 62

Consultation

  • Consultation Defined

  • Consultation Roles

  • Types of Consultation

  • Stages of Consultation

  • To Whom Do Clinical Psychologists Offer Consultation?

  • Effective Consultation

  • Problems in Consultation

Slide 63

Teaching

  • Teaching in Academic Settings

  • 1. Psychology Departments

  • 2. Medical Schools and Hospitals

  • Teaching in Nonacademic Settings

  • 1. Clinics

  • 2. Workshops

  • 3. Business and Industry

  • 4. General Public

Slide 64

Chapter 13

Ethical Standards in Contemporary Clinical Psychology

Slide 65

Ethical Principles

  • Competence

  • Integrity

  • Professional and Scientific Responsibility

  • Respect for People’s Rights and Dignity

  • Concern for Others’ Welfare

  • Social Responsibility

Slide 66

Ethical Standards

  • Advertising and Other Public Statements

  • Therapy

  • Teaching, Training, Supervision, Research, and Publishing

  • Forensic Activities

Slide 67

Chapter 14

Current and Future Trends and Challenges in Contemporary Clinical Psychology

Slide 68

Trends in Society

  • Contemporary Changes in the American Family

  • Multicultural and Diversity Issues

  • Advances in Science, Technology, and Medicine

  • Money

  • Gender Shifts in Professions

Slide 69

Research and Practice Issues

  • Managed Health Care

  • Prescription Privileges

  • Medical Staff Privileges

  • Private Practice

  • Specialization

  • Empirically Supported Treatments

  • Reaching Beyond Mental Health in Contemporary Clinical Psychology

  • Training Issues

Slide 70

Chapter 15

Becoming a Clinical Psychologist:

A Road Map

Slide 71

Ten Important Goals During the College Experience

  • High Grade Point Average

  • High Graduate Record Examination Scores

  • Quality Research Experience

  • Quality Clinical Experience

  • Excellent Verbal Skills

  • Excellent Interpersonal Skills

  • Reliability and Dependability

  • Excellent Productivity

  • Excellent Letters of Recommendation

  • High Motivation

Slide 72

Applying to Graduate Programs in Clinical Psychology

  •  PhD versus PsyD versus MA

  • University versus Freestanding Professional School

  • Accreditation

  • Training Curriculum and Emphasis

Slide 73

After Graduate School

  • Clinical Internship

  • Postdoctoral Fellowship

  • Specialization

  • Certification and/or Licensure

  • Employment


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