PSY 244 CLINICAL PSYCHOLOGY-I

1. PSY 244CLINICAL PSYCHOLOGY-I BAHAR BAŞTUĞ Assist. Prof. Dr.

2. Areas of Specialization: Clinical Child Psychology & Health Psychology

3. Lecture Preview • Clinical Health Psychology • Child Clinical Psychology

4. The principles and practices of clinicalpsychology can beapplied to manyareas of research and clinical service. Many psychologists maintain a general clinical practice, some are focusing their skills in an area of specialization. Clinical psychology has developed a number of specialty areas.

5. Clinical psychology has a similar developmental process to medicine. Psychologists have been trained in a general manner and have applied their skills to all patients and problems they could be able to evaluate and treat. As the field has become more sophisticated in specific problems, specialties have come out.

6. Some specialty areas are health psychology,child psychology, neuropsychology, and forensicpsychology. Subspecialty areas have alsoemerged, such as pediatric neuropsychologyand forensic health psychology. Within each specialty area many psychologists focus on a particular populationor problem area. For example, someprofessionals who specialize in clinical healthpsychology work in the eating disorders, smoking cessation, or alcoholabuse. Some who specialize in neuropsychologyfocus their attention on elderly stroke.

7. Some of the specialty areas overlap. A pediatric neuropsychologist might specialize in head injuries suffered by children and be called on to begin a great deal of forensic work. Such a psychologist may be said to specialize in forensic pediatric neuropsychology. Another psychologist may specialize in geriatric health psychologyworking with AD.

8. There are some reasons to develop specialities: 1. As clinical psychology grows, more information has become available through research and practice that can be applied to specific problems and populations. Clinical psychology is no longer limited to mental illness. Medical problems such as cancer, head injury, heart disease, and AIDS as well as legal problems such as child custody decisions are within the domain of clinical psychology.

9. 2. Clinical psychology uses an interactive and evidence- based perspective. An integrated and evidence- based biopsychosocial model allows for both growth and overlap of specializations. 3. Specific postgraduate training programs have become available in a number of specialty areas.

10. Areas of Specialization • Clinical Health Psychology • Child Clinical Psychology • Clinical Neuropsychology • Forensic Psychology • Geropsychology

11. Clinical Health Psychology is currently one of the most popular and fastest growing specialties since 1980. Health psychologyinvolves the contribution of psychology to problems related to health and illness.

12. Definition “the total of the specific educational, scientific,and professional contributions of thediscipline of psychology to the promotionand maintenance of health, the preventionand treatment of illness, the identification ofetiologic and diagnostic correlates of health,illness, and related dysfunction, and to theanalysis and improvement of the health caresystem and health policy formation”

13. Clinical Health Psychology Health psychologyinvolves the contribution of psychology to problems associated withhealth and illness.

14. Clinical Health Psychology Health psychologists work in many different settings including hospitals, clinics, universities, businesses, and private practices. They use the principles of psychology and behavior change to help people cope better with medical illnesses as well as prevent potential illnesses from developing. They conduct research on the relationships between behavior and health and consult withorganizations to maximize health promotingbehavior and policies.

15. Clinical Health Psychology At the beginning of 20th century, influenza, measles, tuberculosis, and otherinfectious diseases were the cause of deaths. Today, lifestyle factors such as smoking, high-fat diets, sedentary lifestyles, unsafe sexual practices, accidents are the causes of death. Heart disease, cancer, stroke, and other causes of death are associated with lifestyle factors. Therefore, most health problems are together behavioral problems. The main reasons of illness are due to emotions, cognition, social relations, and behavior.

16. Clinical Health Psychology The principles of clinical psychology have been used to help people live more healthy lifestyles to avoid developing illnesses and to help treat illnesses once they have developed. Diabetes, cancer, heart disease, arthritis, asthma, AIDS, autoimmune diseases such as lupus and multiple sclerosis, chronic pain control, and other health problems have been of interest to health psychologists.

17. Clinical Health Psychology Intervention strategies used in health psychology are complex and multidimensional. Individual and group psychotherapy, education, biofeedback, relaxation training, coping skills training interventions have been used to treat these problems.

18. Clinical Health Psychology Interventions integrate medical treatment with education, psychotherapy, and social support to maximize health and minimize illness. Smoking, obesity, alcohol consumption, stress management, AIDS, and chronic pain have received attention from health psychology in recent years.

19. Clinical Health Psychology Diseases related to health psychology: Irritable bowel syndrome, Panic disorders, Asthma, Hypertension, Cardiovascular disease, Ulcers, Headache, Diabetes , Cancer, Spinal injuries, Epilepsy, Sleep disorders, Sexual disorders, Substance abuse

20. Clinical Health Psychology • Smoking • Obesity • Alcohol Consumption • Stress Management • Acquired Immune Deficiency (AIDS) • Chronic Pain

21. Smoking

22. Smoking is the largest preventable cause of premature death. It has been associated with many illnesses such as cancer and heart disease. Smokers are more likely to engage in unhealthful behavior such as eating high-fat foods and leading sedentary lifestyles. Health psychology has been involved in smoking quit psychoeducational programs to prevent from beginning the smoking habit.

23. Intervention programs and public policies have been useful in decreasing the number of adult smokers. People generally begin the smoking during teenage years because of peer pressure, cultural norms, modeling of family, friends, and celebrities, as an act of rebellion, a representation of independence.

24. The pleasurable effects of smokingoccur after a number of attemptsat smoking and not during the firstsmoking. Smoking mayresult in coughing, headache, nauseaor other aversive symptoms. When habituation occured, the addictive qualities of nicotine as well as the psychological dependence result in a very difficult habit for most people to break. Anx, depr, irritability, and anger are associated with nicotine withdrawal. Therefore, smoking often is used to avoid the negative consequences of withdrawal.

25. The majority of people who attempt to quit smokingare unsuccessful. Treatments include biological interventions such as the nicotine patch and gum. They supply a constant dose of nicotine without the harmful effects on lungs or other organs. These treatments provide the drug effect without the psychological and social support that maintains the psychological dependence on smoking.

29. Other treatment approaches include psychological interventions such as problem solving and coping skills training, hypnotherapy, biofeedback, and behavior modification approaches. Educational and social interventions such as group support are also used. Social engineering and public policy approaches such as smoking bans in public places and large taxes for high price discourage smokers from maintaining their habit. Biopsychosocial approaches such as a nicotine patch along with CBT coping strategies in the context of a support group may work best.

30. Antidepresan (Bupropion)

31. Obesity Overweight is defined as weighing 20% more than ideal, a BMI of between 25–29.9 kg/m2.

32. Obesity Obesity is defined as a body mass index of 30 kg/m2 or higher. Obesity has been associated with coronary heart disease, cancer, gall bladder disease, skeletal-joint problems, diabetes, infections, and other illnesses. Morbid obesity (i.e., weighing 100% above ideal weight) is associated with premature death.

33. Obesity Biopsychosocial factors contribute to the obesity: • Genetic factors and family history • Lifestyle factors such as sedentary behavior, high-fat food consumption, and TV viewing • Psychological and social factors such as stress, depr, access to highly attractive foods, and culture.

34. Obesity Like smoking, the majority of those who try to lose weight are not successful. Most people try to diet on their own, many choose to join weight loss programs. These programs use an integrative approach combining medical intervention with social support, education, and counseling. Others usemedical programs offered bymedical centers and clinics.

35. Obesity The majority of those who attempt to lose weight either on their own or in an program do not maintain their weight loss. In fact about 95% of those who lose weight regain weight lost within 5 years.

36. Obesity Treatments reflect the biopsychosocialmodel.They include surgery, medication, and very low calorie liquid diets for those who are morbidly obese. To treat obesity: • behavioral modification, • problem-solving coping strategies, • hypnotherapy, • psychotherapy, • group support, • nutritional information programs, and • exercise programs are used.

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38. Obesity Multimodal approaches integrate medical intervention with various forms of education and counseling. In addition to individual treatment, public health and informational approaches have been used.

39. Alcohol Abuse

40. Alcohol Abuse Alcohol abuse continues a major threat to the health. The numerous physical, psychological, and social problems are caused by alcohol. 50% of all traffic accidents are alcohol related as well as most murders, suicides, rapes, and violent crimes. Approximately 100,000 deaths in the USA each year are due to alcohol consumption. Alcohol disinhibits people’s control over their behavior and makesthem less concerned about the consequencesof their actions.

41. Alcohol Abuse Like smoking and obesity, biopsychosocial factors are associated with both the development of alcohol-related problems and their treatment. Alcohol problems are associated with genetic and biological vulnerability. Many individuals seem to have inborn tendency to developing an alcohol-related problem. About 25% of Asian individuals havea negative physiological reaction to alcohol. It results in little alcohol abuse in Asian people.

42. Alcohol Abuse Psychological factors: anx, depr, stress social factors: peer influence, low income, play an important role in the development of alcohol problems.

43. Relationship of alcohol and stress Alcohol is used as a way to buffer stress and becomes a maladaptive coping strategy. Those who experience many negative life events and little social support are at risk for developing alcohol problems. Drinking alcohol is temporarily beneficial since it can help people to feel less stressed and distract them from problems.

44. Alcohol Treatment Treatment and prevention programs for alcoholabuse reflect the biopsychosocial perspective. Alcohol treatment might include the use of Antabuse, a medication that prevents the metabolism of acetaldehyde. It results in severe nausea and vomiting when alcohol is consumed. disülfiram

45. Alcohol Treatment might include medical detoxification in an inpatient hospital with individual, family, group, and educational components. Psychotherapy and group support such as Alcoholics Anonymous (AA) are beneficial. Relapse is extremely high. Only about 50% of those treatedfor alcohol remain sober one yearfollowing treatment. 75%of those who join AA drop out within a year.

47. Stress Management Stress has been related to the numerous physical and mental health problems. Psychological and social stress impacts many systems of the body. Chronic psychosocial stress has been found to damage the brain by hypercortical activity in the hippocampus. People who lack a sense of control and self-efficacy in their lives are vulnerable to stress-related problems. Environmental stressors contribute to poor physical and mental health.

48. Stress Management Stress managementhelp people who have many physical and mental health problems. Social support help in the treatment of stress-related problems. Social support and stress management provided in group therapy assist in helping cancer patients live longer.

49. Stress management Stress management techniques such as: relaxation training, meditation, biofeedback, diaphragmatic breathing, psychotherapy, and visual imagery have been found useful in reducing stress.

50. Acquired Immune Deficiency (AIDS)