Contemporary Clinical Psychology Third Edition

1. Contemporary Clinical PsychologyThird Edition Thomas Plante, Ph.D., ABPP Santa Clara University and Stanford University School of Medicine

2. Chapter 1 What Is Contemporary Clinical Psychology?

3. Clinical Psychology Activities Research Assessment Treatment Teaching Consultation Administration

4. Clinical Psychology Employment Settings • Private and Group Practices • Colleges and Universities • Hospitals • Medical Schools • Outpatient Clinics • Business and Industry • Military • Other Locations

5. Clinical Psychology Subspecialties • Child Clinical Psychology • Health Psychology • Neuropsychology • Forensic Psychology • Geropsychology

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

7. Related Fields • Counseling Psychology • School Psychology • Psychiatry • Social Work • Psychiatric Nursing • Marriage and Family Counseling • Other Counselors • Other Psychologists

8. Chapter 2 Foundations and Early History of Clinical Psychology

9. Early Conception of Mental Illness: Mind and Body Paradigms • Greeks • Middle Ages • Renaissance • 19th Century • Birth of Psychology

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

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

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

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

14. Chapter 3 Recent History of Clinical Psychology

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

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

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

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

19. Chapter 4 Research: Design and Outcome

20. Research Methods and Designs • Experiments • Quasi-Experimental Designs • Case Studies • Correlational Methods • Epidemiological Methods • Cross-Sectional and Longitudinal Designs

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

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

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.

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?

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

26. Chapter 5 The Major Theoretical Models: Psychodynamic, Cognitive-Behavioral, Humanistic, and Family Systems

27. The Four Major Theoretical Models in Clinical Psychology • Psychodynamic Approach • Cognitive-Behavioral Approach • Humanistic Approach • Family Systems Approach

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

29. The Psychodynamic Approaches • Freud’s Psychoanalytic Perspective • The Revisionist or Neo-Freudian Perspective • The Object Relations Perspective

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

31. The Humanistic Approach • The Client-Centered Perspective • Maslow’s Humanistic Perspective • The Gestalt Perspective

32. The Family Systems Approach • The Communication Approach • The Structural Approach • The Milan Approach • The Strategic Approach • The Narrative Approach

33. Chapter 6 Integrative and Biopsychosocial Approaches in Contemporary Clinical Psychology

34. A Call to Integration • Commonalities among Approaches • Efforts toward Integration •  Eclectism •  Beyond Psychological Models

35. Biopsychosocial Factors • Diathesis-stress perspective • Reciprocal-gene-environment perspective • Psychosocial factors influencing biology • Development of the biopsychosocial perspective

36. Biopsychosocial Applications • Obsessive-Compulsive Disorder • Anxiety and Panic • Cardiovascular Disease • Cancer

37. Chapter 7 Contemporary Psychological Assessment I: Interviewing and Observing Behavior

38. Interviewing • Rapport • Effective Listening Skills • Effective Communication • Observation of Behavior • Asking the Right Questions

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

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

41. Chapter 8 Contemporary Psychological Assessment II: Cognitive and Personality Assessment

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)

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)

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

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

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

47. Rorschach Sample

48. Rorschach Sample

49. Chapter 9 Psychotherapeutic Interventions

50. Common Denominators in Psychotherapy • Professional Person • Professional Manner • Professional Setting • Duration of Sessions • Frequency of Sessions