Clinical Psychology Spring 2015 Kyle 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- Practitioner 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 exampleVideo 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 professorsPsyD 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 ▫ExampleExample

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 takeOne 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