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Hello check notepad for instructions  Clinical Psychology: Past and Present Presented by Nathaniel Chapman, Psy.D. What comes to mind? The field

Hello check notepad for instructions 

Clinical Psychology:
Past and Present

Presented by Nathaniel Chapman, Psy.D.

What comes to mind?

The field of clinical psychology?

Mental Illness?

Clinical psychology

A broad discipline concerned with the scientific study of psychopathology and with the assessment and treatment of persons with emotional, cognitive, and behavioral problems.

Psychiatry vs Clinical Psychology

Education

Training

Scope of professional practice

Psychologist-more exposure to the behavioral sciences and greater expertise in psychometrics

Psychiatrist- medically trained with more emphasis on biological aspects of psychopathology and psychopharmacology.

History of Clinical Psychology

The field has roots as an area of professional practice as opposed to academia

Inspired to use psychology to help people

History of Clinical Psychology

Lightner Witmer’s Psychology Clinic (1896)

Early interventions for school-aged children with academic and behavioral problems, including difficulties with reading and spelling, Intellectual Disabilities

History of Clinical Psychology

During World War I (1914-1918), assessment developed to screen and classify the thousands of new recruits to the U.S. Army

A concern of clinical psychology throughout its existence has been with the credentialing of practitioners. These efforts began in 1919.

Contributions to classification and diagnosis after World War I, 1919-1939

History of Clinical Psychology

Carl R. Rogers helped move the field of clinical psychology toward psychotherapeutic interventions

After World War II, from 1945 to 1977, every U.S. state passed legislation certifying or licensing psychologists to practice independently.

History of Clinical Psychology

After World War II, there was a move to standardize training in clinical psychology

the Veterans’ Ad­ministration (VA) and the newly established National Institute of Mental Health (NIMH) supported these training efforts via grants in clinical psychology.

PsyD model arouse in 1973 at the Vail conference

Training for all clinical psychologist is uniform in the United States but not necessarily in other countries.

General Professional Knowledge (Graduate Courses)

Ethics and Professional Issues

History & Systems of Psychology

Supervision

Industrial and Organizational Psychology

Human Development

Social Psychology

Psychophysiology

Psychotherapy Graduate Courses

Child and Adolescent Psychopathology

Adult Psychopathology

Assessment Graduate Courses

Assessment: Intelligence Testing

Objective Assessment

Projective Assessment

Diagnostic Interviewing

Treatment and Intervention Graduate Courses

Psychological Intervention

Case Conceptualization

Cognitive/Affective Bases of Behavior

Examination for Professional Practice in Psychology (EPPP)

Assessment and Diagnosis (16%

Biological Bases of Behavior (10%)

Cognitive-Affective Bases of Behavior (13%)

Ethical/Legal/Professional Issues (16%)

Growth and Lifespan Development (12%)

Research Methods and Statistics (7%)

Social and Cultural Bases of Behavior (11%)

Treatment, Intervention, and Prevention and Supervision (15%)

I/O is not a single area, but its concepts are sprinkled throughout the exam.

Abnormal psychology

Scientific study of abnormal behavior in an effort to describe, predict, explain, and change abnormal patterns of functioning

What Is Psychological Abnormality?

Common feature across definitions

The Four Ds (Focus on three)

Deviance

Distress

Dysfunction

Danger

Influences

Norms

Culture

Context

The Elusive Nature of Abnormality

Abnormality is defined by general criteria in society.

Criteria are used to judge cases.

Any definition of abnormality may be unable to be applied consistently.

Szaz:

Deviations called “abnormal” are only “problems of living.”

Societies invent the concept of mental illness to better control or change people who threaten the social order.

In short, although abnormality generally is defined as behavior that is deviant, distressful, dysfunctional, and sometimes dangerous, these criteria often are vague and subjective.

Few categories of abnormality are as clear-cut as they seem; most continue to be debated by clinicians.

What Is Treatment?

Treatment or therapy

What Is Treatment?

Essential features of all therapy forms

Sufferer or patient

Trained, socially accepted healer or therapist

Series of therapeutic contacts between the healer and the sufferer

A sufferer who seeks relief from the healer

A trained, socially accepted healer, whose expertise is accepted by the sufferer and his or her social group

A series of contacts between the healer and the sufferer, through which the healer tries to produce certain changes in the sufferer’s emotional state, attitudes, and behavior

Treatment

A systematic process for helping people overcome their psychological difficulties. It typically requires a patient, a therapist, and a series of therapeutic contacts

How Was Abnormality Viewed and Treated in the Past?

Ancient Views and Treatments

Mind as a battleground

Regarded abnormal behavior as the work of evil spirits

Ancient Views and Treatments

Treatment

Trephination and exorcism

Treatment for severe abnormality was to force demons from the body through trephination and exorcism.

Greek and Roman Views and Treatments

500 b.c. to 500 a.d.

Hippocrates believed and taught that illnesses had natural causes; four humors (blood, phlegm, black bile, and yellow bile).

Treatment

Quiet life

Vegetable diet

Exercise

Celibacy

Bleeding

Humors: yellow bile, black bile, blood, and phlegm

Europe in the Middle Ages: Demonology Returns

500–1350 a.d.

The Church rejected scientific forms of investigation and controlled all education

Mental disorders had demonic causes; mass madness; shared delusions and hallucinations

Treatment-Exorcism

At the close of the Middle Ages, demonology and its methods began to lose favor again (1400 AD)

Treatment

Torture

Gradually hospitalization

The Renaissance and the Rise of Asylums

1400–1700 a.d.

With increased scientific knowledge, demonological views of abnormality continued to decline

Care at religious shrines (e.g., Gheel) was the precursor of community health programs

Asylums emerged by the mid-sixteenth century

Treatment Examples

The Nineteenth Century: Reform and
Moral Treatment

Nineteenth century

Care of people with mental disorders began to improve

Pinel (France) and Tuke (England)

Advocated moral treatment that emphasized humane and respectful techniques

Moral treatment movement ended in the United States and Europe by the early twentieth century

Benjamin Rush (father of American psychiatry) and Dorothea Dix (Boston schoolteacher)

Promoted moral treatment in the United States

Movement disintegrated in the late nineteenth century; mental hospitals warehoused inmates and provided minimal care

By the end of the nineteenth century, several factors led to a reversal of the moral treatment movement:

Money and staff shortages

Declining recovery rates

Overcrowding

Emergence of prejudice

By the early years of the twentieth century, the moral treatment movement had ground to a halt; long-term hospitalization became the rule once again.

The Early Twentieth Century: Dual Perspectives

Somatogenic perspective

Abnormal functioning has physical causes

Two factors responsible for the rebirth of this perspective

Emil Kraepelin: Physical factors are responsible for mental dysfunction

New biological discoveries linked such things as untreated syphilis and general paresis

Results were generally disappointing until effective medication was developed

Eugenics and Mental Disorders

The Early Twentieth Century: Dual Perspectives

Psychogenic perspective

Abnormal functioning has psychological causes

Rise in popularity based on work with hypnotism

Mesmer: Hysterical disorders

Freud: Psychoanalysis; outpatient therapy

Psychoanalytic theory and treatment became widely accepted

Did you know

How Are People with Severe Disturbances Cared For?

New psychotropic medications discovered in 1950s

Antipsychotic drugs

Antidepressant drugs

Antianxiety drugs

Led to deinstitutionalization and rise in outpatient care

The Impact of Deinstitutionalization

Psychotropic medications: Drugs that mainly affect the brain and reduce many symptoms of mental dysfunction.

The number of patients (around 42,000) now hospitalized in public mental hospitals in the United States is a small fraction of the number hospitalized in 1955. (Information from Lang, 1999; Smith & Milazzo-Sayre, 2014; Torrey, 2001.)

How Are People with Severe Disturbances Treated?

Before 1950

Almost all outpatient care took the form of private psychotherapy

Today

Outpatient care is the primary mode of treatment; more insurance coverage

Prevention programs are increasing; positive psychology has grown

Programs dealing with one kind of psychological problem have been created

The Increasing Influence of Insurance Coverage

Today the dominant form of insurance coverage is the managed care program, in which the insurance company determines key care issues

Reimbursements for mental disorders tend to be lower than those for medical disorders

In 2008, a federal parity law went into effect; in 2014, the Affordable Care Act (ACT) went into effect

In 2011, a federal parity law went into effect.

Recent Decades and Current Trends

Negative public attitudes still exist, but there have been major changes in the last 60 years in the ways clinicians understand and treat abnormal functioning:

More theories and treatment types

More research and information

More disagreements about abnormal functioning

Survey: 43% of people believe that people bring mental health disorders upon themselves; 35% consider mental health disorders to be caused by sinful behavior.

Multicultural Psychology

seek to understand how culture, race, ethnicity, gender, and similar factors affect behavior and thought and how people of different cultures, races, and genders may differ psychologically

What Are Today’s Leading Theories and Professions?

A variety of professionals offer help to people with psychological problems

Degree Began to Practice Current Number Average Annual Salary
Psychiatrists MD, DO 1840s 49,000 $194,000
Psychologists PhD, PsyD, EdD Late 1940s 188,000 $73,000
Social workers MSW, DSW Early 1950s 649,000 $46,000
Counselors Various Early 1950s 570,000 $45,000

Technology and Mental Health

The digital world provides new triggers and vehicles for the expression of abnormal behavior

Use of tele-mental health services rapidly increasing

Mental health apps in the marketplace are increasing sharply

Enormous volume of Web-based misinformation

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