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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

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contemporary clinical psychology third edition

Contemporary Clinical PsychologyThird Edition

Thomas Plante, Ph.D., ABPP

Santa Clara University and

Stanford University School of Medicine

chapter 1
Chapter 1

What Is Contemporary Clinical Psychology?

clinical psychology activities

Clinical Psychology Activities

Research

Assessment

Treatment

Teaching

Consultation

Administration

clinical psychology employment settings
Clinical Psychology Employment Settings
  • Private and Group Practices
  • Colleges and Universities
  • Hospitals
  • Medical Schools
  • Outpatient Clinics
  • Business and Industry
  • Military
  • Other Locations
clinical psychology subspecialties
Clinical Psychology Subspecialties
  • Child Clinical Psychology
  • Health Psychology
  • Neuropsychology
  • Forensic Psychology
  • Geropsychology
clinical psychology organizations
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
related fields
Related Fields
  • Counseling Psychology
  • School Psychology
  • Psychiatry
  • Social Work
  • Psychiatric Nursing
  • Marriage and Family Counseling
  • Other Counselors
  • Other Psychologists
chapter 2
Chapter 2

Foundations and Early History of Clinical Psychology

early conception of mental illness mind and body paradigms
Early Conception of Mental Illness: Mind and Body Paradigms
  • Greeks
  • Middle Ages
  • Renaissance
  • 19th Century
  • Birth of Psychology
the founding of clinical psychology
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
significant events in the history of clinical psychology
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
significant events continued
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
significant events continued1
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
chapter 3
Chapter 3

Recent History of Clinical Psychology

significant events 1940s and 1950s
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
significant events 1960s and 1970s
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
significant events 1980s and 1990s
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
significant recent events in 2000s
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
chapter 4
Chapter 4

Research:

Design and Outcome

research methods and designs
Research Methods and Designs
  • Experiments
  • Quasi-Experimental Designs
  • Case Studies
  • Correlational Methods
  • Epidemiological Methods
  • Cross-Sectional and Longitudinal Designs
treatment outcome research
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
examples of threats to internal and external validity
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
different levels of research
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.
questions and challenges conducting treatment outcome research
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?
contemporary issues in clinical psychology treatment outcome research
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
chapter 5
Chapter 5

The Major Theoretical Models: Psychodynamic,

Cognitive-Behavioral, Humanistic, and

Family Systems

the four major theoretical models in clinical psychology
The Four Major Theoretical Models in Clinical Psychology
  • Psychodynamic Approach
  • Cognitive-Behavioral Approach
  • Humanistic Approach
  • Family Systems Approach
alternatives to the psychodynamic approach
Alternatives to the Psychodynamic Approach
  • Behavioral Approach
  • Cognitive Approach
  • Humanistic Approach
  • Family Systems Approach
  • Psychotropic Medication
  • Community Mental Health Movement
  • Integrative Approaches
  • Biopsychosocial Approach
the psychodynamic approaches
The Psychodynamic Approaches
  • Freud’s Psychoanalytic Perspective
  • The Revisionist or Neo-Freudian Perspective
  • The Object Relations Perspective
the behavioral and cognitive behavioral approaches
The Behavioral and Cognitive-Behavioral Approaches
  • The Classical Conditioning Perspective
  • The Operant Perspective
  • The Social Learning Perspective
  • The Cognitive Perspective: Beliefs, Appraisals, and Attributions
the humanistic approach
The Humanistic Approach
  • The Client-Centered Perspective
  • Maslow’s Humanistic Perspective
  • The Gestalt Perspective
the family systems approach
The Family Systems Approach
  • The Communication Approach
  • The Structural Approach
  • The Milan Approach
  • The Strategic Approach
  • The Narrative Approach
chapter 6
Chapter 6

Integrative and Biopsychosocial Approaches in Contemporary Clinical Psychology

a call to integration
A Call to Integration
  • Commonalities among Approaches
  • Efforts toward Integration
  •  Eclectism
  •  Beyond Psychological Models
biopsychosocial factors
Biopsychosocial Factors
  • Diathesis-stress perspective
  • Reciprocal-gene-environment perspective
  • Psychosocial factors influencing biology
  • Development of the biopsychosocial perspective
biopsychosocial applications
Biopsychosocial Applications
  • Obsessive-Compulsive Disorder
  • Anxiety and Panic
  • Cardiovascular Disease
  • Cancer
chapter 7
Chapter 7

Contemporary Psychological Assessment I:

Interviewing and Observing Behavior

interviewing
Interviewing
  • Rapport
  • Effective Listening Skills
  • Effective Communication
  • Observation of Behavior
  • Asking the Right Questions
types of interviews
Types of Interviews
  • Initial Intake or Admissions Interview
  • Mental Status Interview
  • Crisis Interview
  • Diagnostic Interview
  • Structured Interviews
  • Computer-Assisted Interviews
  • Exit or Termination Interviews
standard clinical interview
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
chapter 8
Chapter 8

Contemporary Psychological Assessment II:

Cognitive and Personality Assessment

halstead reitan neuropsychological test battery
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)
mmpi 2 scales
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)
mcmi iii scales
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
mcmi iii scales continued
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
16pf fifth edition
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
chapter 9
Chapter 9

Psychotherapeutic Interventions

common denominators in psychotherapy
Common Denominators in Psychotherapy
  • Professional Person
  • Professional Manner
  • Professional Setting
  • Duration of Sessions
  • Frequency of Sessions
stages of psychotherapy
Stages of Psychotherapy
  • Initial Consultation
  • Assessment
  • Development of Treatment Goals
  • Implementation of Treatment
  • Evaluation of Treatment
  • Termination
  • Follow-Up
modes of psychotherapy
Modes of Psychotherapy
  • Individual Treatment
  • Group Psychotherapy
  • Couples Psychotherapy
  • Family Therapy
chapter 10
Chapter 10

Psychotherapeutic Issues

ten issues about psychotherapy
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
chapter 11
Chapter 11

Areas of Specialization in Contemporary Clinical Psychology

clinical health psychology
Clinical Health Psychology
  • Smoking
  • Obesity
  • Alcohol Consumption
  • Stress Management
  • Acquired Immune Deficiency Syndrome (AIDS)
  • Chronic Pain
child clinical psychology
Child Clinical Psychology
  • Attention Deficit/Hyperactivity Disorder (ADHD)
  • Learning Disorders
  • Child Abuse and Neglect
  • Anorexia Nervosa
clinical neuropsychology
Clinical Neuropsychology
  • Epilepsy
  • Brain Injuries
  • Degenerative Diseases
forensic psychology
Forensic Psychology
  • Involuntary Commitment
  • Insanity Defense
  • Child Custody
  • Jury Selection
geropsychology
Geropsychology
  • Degenerative Diseases
  • Vascular Diseases
  • Parkinson’s Disease
  • Psychiatric Issues (Anxiety, Depression, Substance Abuse)
chapter 12
Chapter 12

Consultative, Teaching, and Administrative Roles in Contemporary Clinical Psychology

consultation
Consultation
  • Consultation Defined
  • Consultation Roles
  • Types of Consultation
  • Stages of Consultation
  • To Whom Do Clinical Psychologists Offer Consultation?
  • Effective Consultation
  • Problems in Consultation
teaching
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
chapter 13
Chapter 13

Ethical Standards in Contemporary Clinical Psychology

ethical principles
Ethical Principles
  • Competence
  • Integrity
  • Professional and Scientific Responsibility
  • Respect for People’s Rights and Dignity
  • Concern for Others’ Welfare
  • Social Responsibility
ethical standards
Ethical Standards
  • Advertising and Other Public Statements
  • Therapy
  • Teaching, Training, Supervision, Research, and Publishing
  • Forensic Activities
chapter 14
Chapter 14

Current and Future Trends and Challenges in Contemporary Clinical Psychology

trends in society
Trends in Society
  • Contemporary Changes in the American Family
  • Multicultural and Diversity Issues
  • Advances in Science, Technology, and Medicine
  • Money
  • Gender Shifts in Professions
research and practice issues
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
chapter 15
Chapter 15

Becoming a Clinical Psychologist:

A Road Map

ten important goals during the college experience
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
applying to graduate programs in clinical psychology
Applying to Graduate Programs in Clinical Psychology
  •  PhD versus PsyD versus MA
  • University versus Freestanding Professional School
  • Accreditation
  • Training Curriculum and Emphasis
after graduate school
After Graduate School
  • Clinical Internship
  • Postdoctoral Fellowship
  • Specialization
  • Certification and/or Licensure
  • Employment