Name IQRA ASHRAF

Roll no 20556

Subject APPLIED PSYCHOLOGY

Topic CLINICAL PSYCHOLOGY

Submitted to SR WAQAR

CLINICAL PSYCHOLOGY
• Definition:
• According to Lighter WITMER;

Lighter WITMER was the founder of

psychological clinical (1896)defined clinical psychology as
discipline concerned with study of individuals by
observation or experimentation with good of facilitating
change in those individuals.

• As WITMER worked with school age children experiencing problems

in learning, he saw psychological treatment as educational in nature.
APA(American Psychological Association)

“clinical psychology is a form of applied psychology

which aim to define the behavior capacities and behavior
characteristics of individuals through methods of
measurement, analysis, and observation; and which, on
the basis of an integration of these findings with data
received from physical examination and social histories,
gives suggestions and recommendations for the proper
adjustment of the individual.”

• APA in 1981: “A clinical psychologist is a professional who Applies

principles and procedures to understand, predict and alleviate
intellectual, emotional, psychological, behavioural
problems.”(specialty Guidelines for the delivery o8f services by clinical
psychologist, Washington, DC: APA).

INTRODUCTION

Clinical psychology is integration of science,theory and clinical

knowledge for purpose of understanding, preventing and relieving
psychologically based distressed or dysfunction and to promote
subjective well-being and personal development.

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 • Central to its practice and psychological assesment and
psychotherapy, although clinical psychologist also engage in research,
teaching, consultation, forensic testimony, and program development
and administration. In Many countries clinical psychology is a
regulated mental health profession.

• Clinical psychology is a subfield of psychological discipline concerned

with mental and emotional health of human population. Professionals
who work in areas are tasked with using their finely honed analytical
and communication skills to help clients increase their quality of life
and work through burdensome issues.

• Clinical psychology roles are well suited to individuals with a strong

work ethic who are able to show empathy while also being very
oriented to solving problems.

Aims and scope of clinical psychology:

Clinical psychology is both tied to and distinct from other areas of

psychology. The common bond with other areas of psychology lies in sgared
commitment to psychological research, while the unique features of clinical
psychology involve the application of research to understanding, treatment,
and prevention of psychopathology. Clinical psychology is also distinct from
other mental health fields, including psychiatry, clinical social work, and
psychiatric nursing.
Clinical psychologist work in a variety of setting including universities,
medical hospitals psychiatric hospitals, psychological clinics and

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independent practice. They are involved in activities that include research,
teaching and administration as well as assessment, diagnosis, treatment,
and prevention of psychopathology.

Role of clinical psychology:

Clinical psychology can offer a range of professional services

including:
1. Administer and interpret psychological assesment and testing
2. Conduct psychological research
3. Consultation (especially with schools and businesses)
4. Development of prevention and treatment programs
5. Program administration
6. Provide expert testimony (forensic psychology)
7. Provide psychological treatment (psychotherapy)
8. Teach
9. In practice,clinical psychologist may work with individuals
couples families, or other group in a variety of settings, including
private practices hospitals, mental health organizations , schools
businesses, and non profit agencies. Some of which can earn
board certification,includes:
Child and adolescent
Family and relationship counselling
Forensic
Health
Neuropsychological disorders

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Components of clinical psychology career:

Analytical skills
Clinical psychologist are tasked with gathering and
assessing information about their clients in order to make a diagnosis

Communicative skills
These professionals are entrusted with clients
deepest and darkest thoughts and life stories, and being able to communicate
empathetically and create a safe yet professional environment is crucial.

Research skills
Clinical psychologist working in research must have a
strong understanding of scientific method and be able to employ
various approaches and frameworks to their research question.

• What does a clinical psychologist do?

The main function of a clinical psychologist is to
concentrate on career basics
Whether working directly with patients or creating and conducting
independent research studies, clinical psychologist are chiefly concerned with
understanding the mental, emotional , and behavioral problems affecting
patients ranging from young children to aging seniors.
• Roots of research and Assessment in clinical psychology:
The evolution of field of clinical psychology after lighter witmer can be
understood through an examination 9f how clinical psychologist came to
be involved in each of four different activities:
1. Research

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 2. Assessment
3. Treatment, and
4. Prevention

RESEARCH

How clinical psychologist involved in research?

Witmer and other founder of clinical psychology were were researcher who
were interested in the application of their research to the benefit of others
Clinical Researchers try to add these bodies of knowledge both to increase
their understanding of psychopathology, illness and health and to improve
their methods for it’s treatment and prevention.
Because of their broad training in basic behavioral science, clinical
psychologist are able to draw conclusions and contribute to research in a
variety of different areas and to collaborate with professionals from other
disciplines.

THE SCOPE OF CLINICAL PSYCHOLOGICAL RESEARCH

Clinical psychological research has steadily grown in its scope since the
early 1900s. This subfield now includes:
Research on basic characteristics and prevalence of
psychopathology.(epidemiology), the cause of psychopathology (etiology),
the measurement of behaviour and psychological characteristics of
individuals ( assessment), the role of the brain and central nervous
system(clinical Neuropsychology), the treatment of psychopathology
(psychotherapy), the prevention of psychopathology and the promotion of
psychological health psychological factor and physical health and
illness(health psychology/behavioral medicine).

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RESEARCH THAT SHAPED THE FIELD
Two examples are particularly prominent in this regard:
1. Effectiveness of psychotherapy
2. Statistical vs. Clinical prediction

1)Effectiveness of psychotherapy
The early 1950s, the field of psychotherapy was in its early stages of
development, and much of practice of psychotherapy was based on the
psychoanalytic model developed by Freud.
Research on the effectiveness of this approach to psychotherapy
was very limited, however- most practitioner simply assumed
that methods they were using were effective in treating their
patients.
Given this widespread acceptance of belief that psychotherapy was
effective, a paper published in 1952 by British psychologist Hans
Eysenck created enormous controversy.

Eysenck argued that there was little or no evidence that psychotherapy was
any more effective than no treatment at all.
• He reached this conclusion by comparing (two sources of data: the
results of 24 studies that had been conducted on outcomes of
psychotherapy, and information on rates of recovery from emotional
distress in absence of treatment, or what is referred to as spontaneous
remission.

• Eysenck reported that treated individuals actually did worse than did
people who received no psychotherapy: Whereas 72 percent
individuals who did not receive treatment recovered from their

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 problems, only 44 percent of those receiving psychoanalysis and 64
percent of those receiving “eclectic” psychotherapy recovered.

• Although the rates of improvements represented by Eysenck are much

lower than those found in many studies that have been published since
the appearance of his paper, his report had a significance impact on the
field.

Eysenck challenged Clinical psychologist and other mental

health professionals to provide better evidence for effectiveness
of their treatment methods.

2)Statistical Vs. Clinical prediction

A second example of research that changed the field is

short but; “statistical versus Clinical prediction”
published by psychologist Paul Meehl in 1954 that had a
significant impact on psychological testing and
assessment.

Before Maheel published book, psychologist relied heavily on

subjective judgment and institutions in interpreting the results of
psychological tests.
This approach, referred to as clinical judgment or clinical prediction, was
based on the assumption that clinical psychologist learn a unique set of skills
that allows them to make accurate judgements about people and to predict
such things as patients ability to benefit from psychotherapy, people’s
potential for success in a job or the likely course of individuals psychological
problems.

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 Before Meehl challenged these assumptions by demonstrating that
judgments based on Statistical data representing patterns of behavior in
large samples of people.

2)ASSESSMENT

CLINICAL PSYCHOLOGIST INVOLVEMENT IN ASSESSMENT

Since its inception, psychology has been uniquely concerned with the
measurement of differences between individuals on important cognitive and
personality characteristics.
The study of differences between individuals on psychological tests
and measurement began with the work of Sr Francis Galton in England in
the late 1800s. Galton was fascinated by the work of his cousin chaless
Darwin on differences in characteristics both between and within species,
Galton focused on the concept of individual differences between people,
especially in various aspects of perception and material abilities.

THE INFLUENCE OF BINET'S INTELLIGENCE TEST

BACK GROUND TO BINET'S INTELLIGENCE
Around the time that witmer was developing the application
of psychology to help children who were experiencing difficulties learning in
school, event in Europe were also leading to development of method to
measure children’s potential for learning.
IN 1904, the minister of public instruction in Paris wanted to ensure that
children with intellectual skills were still provided with an education. Alfred
Binet and theodore Simon were commissioned by French government to
develop a tool to aid in decisions about the appropriate educational
programs for French school children.

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 Binet was French researcher trained in both law and medicine. In
order to study individual differences he felt it was necessary to sample a
wide range of complex intellectual processes so that the spread of score
obtained by different individuals would be broad (Reisman, 1976)
BINET’S work resulted in first formal test of intelligence, in1905 Binet-
Simon scale, consisting of increasing difficulty.

WORLD WAR 1; A TEST FOR CLINICAL PSYCHOLOGY

As united state prepared to enter the war that was rangin in

Europe in 1917, the American military was faced with an unprecedented
task: the conscription and creation of massive army and navy.
The psychological test that were available and in use at that time
required individuals administration. These test were impractical for use with
large number of recruits involved in military. The effort yields into two tests
3. The Army alpha (a test of verbal skills) and
4. The Army beta (a test of non verbal skills)

Assessment After world war 1

The tests included both verbal and non verbal skills of intelligence
tests, career interest, personality and vocational skills tests. Test were
available for children of all ages and abilities as well as for adults.

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Diagnostic statistical Manual of Mental Disorders:DSM-5:

DSM-5 was published by American Association. The DSM-5

Provides a common language and standard criteria for

classification of mental disorders.

• Intelligence achievement tests

These tests were designed to measure specific kind of
cognitive functioning(often referred to as IQ)in comparison to a norming-
group.

• Personality tests
Tests of personality aims to describe patterns of behavior,
thoughts, and feelings. They generally fall within two categories: objective
and projective. Objective measurement such as the MMPI, are based on
restricted answer such as yes/no, true/false, or a rating scale-which allows
for computations of scores that can compare to normative group. Projective
tests, such as the rorschach inkblot test , allow for open ended answers.

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 • Neuropsychological tests
Neuropsychological tests consist of specifically designed tasts used to
measure psychological functions known to be linked to a particular brain
structure or pathway.

• Clinical observation
Clinical psychologist are also trained to gather data by observing
behavior. Clinical interview is a vital part of assessment, even when
using other formalized tools, which can employ either a structured or
unstructured format such assessment looks at certain areas , such as
general appearance and behavior mood and effects perception,
comprehension, orientation insight, memory, and content of
communication.

• Four main types of psychotherapy/ perspectives of clinical

psychology :
The clinical psychology is dominated in terms of training and
practice by essentially four major schools of practice:
i. Psychodynamic,
ii. Humanistic,
iii. Behavioral/cognitive behavioral ,and
iv. System or family therapy

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Psychodynamic: school of psychotherapy:

The psychodynamic perspective developed out of Sigmund Freud. The

core object of psychoanalysis is to make the unconscious conscious- to
make the client aware of his or her own primal drives(namely those
relating to sex and aggression) and the various defenses use to keep
them in check. Major variations on Freudian psychoanalysis practiced
today: include
i. Self psychology,
ii. Ego psychology, and
iii. Object psychodynamic psychology,
• With common them including
• Examination of transference
• Defenses an appropriation of the power of
unconscious, and a focus on how early
developments in childhood have shaped the
client’s current psychological state.

Humanistic school of psychotherapy

Humanistic school of psychotherapy was developed in 1950s in

reaction to both behaviorism and psychoanalysis, largely due to the person-
centered therapy of carl rogers (often referred to as Rogerian therapy) and
existential psychology developed by viktor Frankl and Rollo May.
Roger believe that a client needed only three things from clinician to
experience therapeutic improvement-
a)congruence

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b)unconditional positive regard, and
c)empathetic understanding

Behavioral and cognitive behavioral schools

• Behavior therapy:
Behavior therapy is a rich tradition of behavioral school of
psychotherapy. It is well researched with a strong evidence base. Its roots
are behaviorism. In Behavior therapy sets up conditions for the environment
to feedback back on it. Some times the feedback leads the behavior to
increase the positive reinforcement i. e . , reward some time the behavior
decreases by negative reinforcement.
a) Community reinforcement approaches for treating addictions,
b) Acceptance and commitment therapy,
c) Functional analytic psychotherapy: including dialectic Behavior
therapy and behavioral activation. Moreoveru specific techniques
such as contingency management and exposure therapy have come
from this tradition.

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 • Cognitive behavioral therapy(CBT):
Cognitive behavioral therapy developed by
combination of cognitive therapy and rational emotive behavior therapy
both of which grew up by cognitive psychology and behaviorism. CBT is
based on theory that how we think(cognition) how we feel(emotions).
CBT also developed, including dialectic Behavior therapy and mindful-based
cognitive therapy.

SYSTEM OR FAMILY THERAPY: FAMILY THERAPY

System or family therapy works with couples or

families , and emphasizes family relationships as an important factor in
psychological health the central focus tends to be on interpersonal
dynamics.

Other major therapeutic orientations:(List of psychotherapies)

• Existential psychotherapy
Postulates that people are largely free to chose who we
are and how we interpret and interact with the world
• Gestalt therapy:
One influential therapy that came out of existential therapy is
Gestalt therapy, primarily founded by Fritz Perls in 1900s. It is welk known
for techniques designed to increase various kinds of self-awareness the vest
known perhaps being the “empty chair technique” .

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 • Postmodern
Postmodern psychology says that experience of reality is a
subjective construction built upon language social context and history with
no essential trusts.
• Transpersonal
The transpersonal perspective places a strong focus on the
spiritual facet of human experience. It is not a set of techniques so much as
a willingness to help a client explorer spirituality and or transcendent states
of consciousness. It also is concerned with helping clients achieve their
highest potential.
• Multiculturalism
Although the theoretical foundations of psychology are rooted in
European culture, there is a growing recognition that there exist profound
differences between various ethnic and social groups and that system of
psychotherapy need to take those differences into greater consideration.
• Feminism
Feminism therapy is an orientation arising from disparity
between the origin of most psychological theories (which have male and
female authors) and the majority of people seeking counselling being
female.
• Psychotherapy of positive psychology
Positive psychology is the scientific study of
human happiness and well-being, which started to gain momentum in 1998
due to the call of Martin Seligman, then president of APA.
• Integrative psychotherapy
In the last couple of decades, there has been a grown
movement to integrate the various therapeutic approaches, especially with

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increase understanding of culture, gender, spiritual, and sexual- orientation
issues.

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