Clinical Psychology

Spring 2015Kyle Stephenson

Overview – Day 2

•History of clinical psychology▫Assessment, Treatment, and Research –

beginning and growth▫The profession – beginning and growth

•Current issues in clinical psychology▫Models of training▫The nature of practice▫Prescription privileges▫Cultural diversity

• Clinical Psychology• What is clinical psychology?

• History of clinical psych• Current activities of clinical psychologists• Future of the field

• Research in clinical psychology• Research methods• Prevalence research • Theoretical models• Efficacy & effectiveness research

• Assessment• Interviewing• Intelligence assessment• Personality assessment• Behavioral assessment• Neuropsychological assessment

• Theoretical orientations to treatment• Psychodynamic• Humanistic• Cognitive-behavioral• Acceptance-based• Couples/family

Ethics

In the beginning, there was assessment...•Early areas of focus

▫Assessment of youth having difficulties in school

▫Classifying recruits according to ability level

•Tests to know▫Rorschach▫Wechsler▫MMPI

Faces to know - assessment

Beginnings of treatment

Advances in treatment

Research: Beginnings

•Firsts▫First psychological laboratory - Wilhelm

Wundt (1879)▫First Psychology Text - Principles of

Psychology (1890) by William James•Classical conditioning - Pavlov

Research: Post WWII and Beyond•Diagnostic manual – DSM-I appeared in

1952•Research on effectiveness of

psychotherapy*•Other specialty areas are growing in

importance▫Behavioral Genetics - both genetic and

environmental influences on the development of behavior are evaluated

▫Brain imaging – able to see structure and function

Overview – Day 2

•History of clinical psychology▫Assessment, Treatment, and Research –

beginning and growth▫The profession – beginning and growth

•Current issues in clinical psychology▫Models of training▫The nature of practice▫Prescription privileges▫Cultural diversity

The Profession: Beginnings

•Founding of the American Psychological Association (APA) in 1892

•Lightner Witmer establishes first psychological clinic in 1896

•Psychology journals – Witmer founded the first, The Psychological Clinic, in 1907

The Profession: Post War and Beyond•Impact of returning soldiers from WWII

▫Assessment and diagnosis evolving into treatment

•Certification/licensing of clinical psychologists became required – 40’s and 50’s

•APA published Ethical Standards in 1953, establishing an ethical code for psychologists

The Profession: Post War and Beyond•Influence of cognitive behaviorism•Growth of APA•Schism in 1988 – academic/scientific wing

of the APA felt ignored▫Led to the creation of the American

Psychological Society in 1988 (now called the Association for Psychological Science)

Overview – Day 2

•History of clinical psychology▫Research – beginning and growth▫The profession – beginning and growth

•Current issues in clinical psychology▫Models of training▫The nature of practice▫Prescription privileges▫Cultural diversity

Practitioner-Scholar

Scientist-Practitione

r

Clinical- Scientist

Practice Research

Models of Training in Clinical Psychology•The Scientist-Practitioner Model

▫Ph.D.▫Also known as the Boulder Model; 1949▫Practice with skill while being able to

conduct and review research

▫Video example

Models of Training in Clinical Psychology•The Scientist-Practitioner Model

▫Pros Balanced in the theoretical and the practical Rooted in academia and research

▫Cons May polarize into camps Difficult to gain expertise in both

Models of Training in Clinical Psychology•Practitioner-Scholar

▫The Doctor of Psychology (Psy.D.) Degree▫Emphasis on the development of clinical

skills and a relative de-emphasis on research competence

Models of Training in Clinical Psychology•The Doctor of Psychology (Psy.D.) Degree

▫Higher acceptance rate▫Lower % who get financial assistance▫Lower % get internship▫More Psy.D.’s awarded than Ph.D.’s

▫PsyD professors

Models of Training in Clinical Psychology•Clinical Scientist Model

▫Ph.D.▫1991: McFall’s Manifesto

Scientific Basis Establishing Criteria for Services Focus on research

▫Empirical Emphasis

Overview – Day 2

•History of clinical psychology▫Research – beginning and growth▫The profession – beginning and growth

•Current issues in clinical psychology▫Models of training▫The nature of practice▫Prescription privileges▫Cultural diversity

Private Practice

•Has it peaked?•Economic squeeze•Today’s Ph.D. clinicians may be replaced

by tomorrow’s master’s-level mental health professionals

The Costs of Health Care

•United States spent $2.26 trillion dollars on healthcare in 2007 (16% of GDP)▫From 2007 to 2017, it is predicted that the

proportion of the GDP devoted to health care costs will rise to 19.5%

•Shifting role of PhD’s•Evidence-based treatments •Greater use of technology & self-help

treatments

Overview – Day 2

•History of clinical psychology▫Research – beginning and growth▫The profession – beginning and growth

•Current issues in clinical psychology▫Models of training▫The nature of practice▫Prescription privileges▫Technology▫Cultural diversity

Prescription Privileges

•Pros▫Can provide wider variety of treatments to

a wider range of clients▫Increase in efficiency and cost-

effectiveness of care ▫Will give clinical psychologists a

competitive advantage in the health care marketplace

▫Example

Prescription Privileges

•Cons▫May lead to a de-emphasis of

“psychological” forms of treatment ▫May also damage clinical psychology’s

relationship with psychiatry and general medicine

▫Possible to have necessary training?

▫One firm take

Overview – Day 2

•History of clinical psychology▫Research – beginning and growth▫The profession – beginning and growth

•Current issues in clinical psychology▫Models of training▫The nature of practice▫Prescription privileges▫Cultural diversity

Culturally sensitive mental health providers should…•Make a commitment to cultural

awareness as well as knowledge of self and others as cultural beings

•Recognize the importance of multicultural sensitivity

•Integrate multiculturalism and diversity into education and training

•Recognize the importance of culture in psychological research and clinical work

Take-Home

•Clinical psychology is a young field, and its history is interesting and important

•Clinical psychology continues to evolve▫A number of current issues have the

potential to drastically change the day to day experience of clinical psychologists