Chapter 2 Contemporary Clinical Psychology Copyright 2014 John

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Chapter 2 – Contemporary Clinical Psychology Copyright © 2014 John Wiley & Sons, Inc.

Chapter 2 – Contemporary Clinical Psychology Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Activities of Clinical Psychologists n Clinical psychologists do a variety of activities including: –

Activities of Clinical Psychologists n Clinical psychologists do a variety of activities including: – – – n providing psychological assessment providing psychological intervention conducting research providing clinical training consulting with other professionals and agencies Clinical psychologists work with – Individuals, couples, families, groups and organizations – All across the life span Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Activities of Clinical Psychologists n Percentage of Psychologists Who Engage in Each Activity –

Activities of Clinical Psychologists n Percentage of Psychologists Who Engage in Each Activity – – – – Assessment and diagnosis Psychotherapy Consultation Research Teaching Supervision Administration n 58 76 38 47 49 47 46 Adapted from Norcross & Karpiak (2012). Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Activities of Clinical Psychologists n Percentage of Psychologists Time in Each Activity – –

Activities of Clinical Psychologists n Percentage of Psychologists Time in Each Activity – – – – Assessment and diagnosis Psychotherapy Consultation Research Teaching Supervision Administration n 14 35 6 15 11 6 11 Adapted from Norcross & Karpiak (2012). Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Activities of Assessment in Clinical Psychology n Assessment is very common and comes in

Activities of Assessment in Clinical Psychology n Assessment is very common and comes in many forms – – Evaluating the functioning of an individual client Evaluating a family or social unit of some sort Diagnosis Formal standardized testing (cognitive, behavioral or personality) – Assessment in psychotherapy n n n Planning Monitoring Evaluating Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

The Assessment process n n Assessment is an ongoing process, not defined by psychometric

The Assessment process n n Assessment is an ongoing process, not defined by psychometric evaluations It is an ongoing process of hypothesistesting We adopt both the idiographic approachexploring the uniqueness of the particular person and his/her circumstances The nomothetic approach: What is common to this person and other persons of this age and other demographic variables? Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Steps in the assessment process 1. 2. 3. 4. 5. 6. Review referral information

Steps in the assessment process 1. 2. 3. 4. 5. 6. Review referral information Decide whether to accept Obtain relevant background information Consider the influence of relevant others Observe the person in several settings Select and administer an assessment test battery Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Steps (cont-d) 1. 2. 3. 4. 5. 6. Review referral information Decide whether to

Steps (cont-d) 1. 2. 3. 4. 5. 6. Review referral information Decide whether to accept Obtain relevant background information Consider the influence of relevant others Observe the child in several settings Select and administer an assessment test battery Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Diagnosis involves assigning the cluster of symptoms to a cat gory of mental disorders

Diagnosis involves assigning the cluster of symptoms to a cat gory of mental disorders n Diagnosis is based on the DSM n It enables the planning of intervention n Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Activities of Intervention in Clinical Psychology n Intervention is very common as well –

Activities of Intervention in Clinical Psychology n Intervention is very common as well – Psychotherapy: talk therapy n n Most people attend fewer than 10 sessions regardless of problem Different approaches (psychodynamic, cognitive-behavioral, experiential, etc) focus on different issues, (although most challenge thoughts and validate emotions) In North America cognitive behavioral is most common, followed by an integrative approach and psychodynamic The Prescription Privileges Debate – Currently only a select few psychologists can prescribe (in New Mexico and Louisiana) Copyright © 2014 John Wiley & Sons, Inc. All – Highly debated rights reserved.

Activities of Prevention in Clinical Psychology n Prevention is less common but growing –

Activities of Prevention in Clinical Psychology n Prevention is less common but growing – Primary prevention: prevention of a disease before it occurs – Secondary prevention: reducing the recurrence of a disease – Tertiary prevention: reducing the overall disability that results from a disease n Prevention usually based in community settings – Psychologist usually has several roles in prevention n Developing programs Implementing programs Copyright © 2014 John Wiley & Sons, Inc. All Evaluating outcomesrights of reserved. programs

Additional Activities of Clinical Psychologists n Consultation – Clinical consultation: offering advice and information

Additional Activities of Clinical Psychologists n Consultation – Clinical consultation: offering advice and information for others treatment professionals – Organizational (or community) consultation: evaluating a service, or providing an opinion on how an organization is doing n n Usually there is a needs assessment, program development, program evaluation, and policy consultation Research – All psychologists are trained to conduct and evaluate research – APA’s ethics code requires a commitment to Copyright © 2014 John Wiley & Sons, Inc. All increasing scientific knowledge rights reserved.

Additional Activities of Clinical Psychologists n Research (cont) – Small percentage produce research –

Additional Activities of Clinical Psychologists n Research (cont) – Small percentage produce research – Much more common in university settings – Range and content of research varies dramatically n n Can be on normal human functioning, psychopathology, assessment, intervention or prevention Teaching – University courses (graduate or undergraduate) in variety of areas related to clinical psych – Also can teach in several other settings (e. g. , community colleges, in clinics training professionals, to medical students, in workshops/seminars etc. ) Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Additional Activities of Clinical Psychologists n Clinical Supervision – Close monitoring of training clinicians

Additional Activities of Clinical Psychologists n Clinical Supervision – Close monitoring of training clinicians – Done in an individual meeting or with a number of training clinicians (group supervision) – Some supervisors have supervisees audio or videotape their sessions n Research Supervision – Assisting in the development and implementation of a research study or program n Administration – organization, program development, meetings in Copyright © 2014 John Wiley & Sons, Inc. All rights reserved. committees

First Pillar of Clinical Psychology: Science n Science of Clinical Psychology – Clinical Psychologists

First Pillar of Clinical Psychology: Science n Science of Clinical Psychology – Clinical Psychologists must maintain their knowledge of research relevant to their activities – This is true for all theoretical orientations – However, how research informs practice differs for many clinical psychologists – Balance between open-mindedness and skepticism Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Second Pillar of Clinical Psychology: Ethics n Five general ethical principles of the APA

Second Pillar of Clinical Psychology: Ethics n Five general ethical principles of the APA (2010) – Beneficence and nonmalficence: help and avoid doing harm – Fidelity and responsibility: developing trust and show awareness of their professional responsibilities – Integrity in professional relationships – Justice: all people should have access to benefit from the contribution of psychology – Respect for people’s rights and dignity n Informed consent – all individuals in therapy and participants in research must indicate that they understand are willing participants Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Ethical, Legal, and Professional Issues Laws: n Imposed by legislative bodies n Requires interpretation

Ethical, Legal, and Professional Issues Laws: n Imposed by legislative bodies n Requires interpretation n Distinction between civil and criminal law n Civil law uses less exacting standards Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Cont-d Ethics: n Derived from philosophical ideas and professional norms n Imposed on members

Cont-d Ethics: n Derived from philosophical ideas and professional norms n Imposed on members of a profession n Has a moral basis Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Ethical Principles Autonomy: respect for rights of others to make their own choices and

Ethical Principles Autonomy: respect for rights of others to make their own choices and hold their own beliefs n Nonmaleficience: do no harm n Beneficence: promoting positive growth & welfare of others n Justice: acting fair, impartial & reasonable n Fidelity: faithful and trusting of others n Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Con-d Develop ethical reasoning skills and sensitivity n Be aware of motivations and interests

Con-d Develop ethical reasoning skills and sensitivity n Be aware of motivations and interests n Exercise power with care n Learn limits of professional role n Understand implications of assessment findings and recommendations n Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Using client’s language n Considering school, environmental, and political factors n Eliminating bias, prejudice,

Using client’s language n Considering school, environmental, and political factors n Eliminating bias, prejudice, and discriminatory factors n Documenting cultural and sociopolitical factors n Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Additional Aspects to Clinical Psychology n Training in Clinical Psychology – Scientist-practitioner model (Boulder

Additional Aspects to Clinical Psychology n Training in Clinical Psychology – Scientist-practitioner model (Boulder Model) – Clinical scientist model – Practitioner-scholar model (Vail Model) APA Accreditation in Clinical Psychology n Providing services that are competent for the larger multicultural community n Licensure n Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Ethical Violations Misuse of assessment instruments n Wrongful use of derived data n Performing

Ethical Violations Misuse of assessment instruments n Wrongful use of derived data n Performing outside of competence n Misinterpretations of assessment data n Invasion of privacy n Violation of confidentiality n Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

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