Clinical and Counseling Psychology

Do you need a medical degree in addition to a residency in psychiatry in order to be a psychiatrist?

Yes, and the can be referred to as medical physicians.

The doctor of psychology degree puts an emphasis on...

the development of clinical skills and a relative de-emphasis on research competence

What is a health psychologist?

Psychologist whose research or practical work focusses on good health or the prevention of an illness, or the treatment of individuals with diagnosed medical conditions

What is a Rehabilitation Psychologist?

Psychologists who focus on individuals with physical or cognitive disabilities and the ramifications that come along with them.

What else does clinical psychology focus on?

Research, Teaching, Intervention, and Assessment

The field of clinical psychology integrates what? It also helps us understand and alleviate discomfort and dysfunction. It also promotes human adaption, adjustment, and personal development.

Science, theory, and practice

What are some technological innovations in clinical psychology?

Tele-health, Ambulatory assessment, and computer assisted treatment

What are psychiatric nurses?

They work closely with psychiatrists or clinical psychologists to implement the therapeutic recommendations and in most states they have prescription privileges.

By WWI, why were they testing for ability (Army Alpha / Beat)?

To see who was quilified

True or False: Psychiatry is rooted in the medical tradition and regards psychopathology as a mental "illness" that can be remedied with medical treatments.

True

True or False: The therapy relationship makes substantial and consistent contributions to psychotherapy outcome independent of the type of tx. Practice and treatment guidelines should address client behaviors and qualities that promote the therapy relationship. Efforts to promulgate practice guidelines or EBPs without including the therapy relationship are seriously incomplete and potentially misleading.

True False, therapist behaviors True

True or false: Private practice has grown steadily over the years

True (40%)

Is there an over-supply of practitioners and an undersupply of research-oriented clinical psychologists?

Yes

What is the percentage of clinical psychologists that partake in a university and then medical school.

-18% and 8%

How many women are clinical psychologist in the field? Ethnic minority?

-34% and 7%

What is behavior therapy and when did it first start becoming popular?

-A popular learning framework for treating disorders that is based on the principles of conditioning -40s and 50s

What are some advantages of the disability/dysfunction definition? Disadvantages?

-Advantages: Relatively little inference is required; dysfunction is apparent, OFten prompts people to seek treatment because their normal life is interupted -Problems: How many domains of functioning must you see problems?, Does emotional distress necessary cause dysfunction?

What are the three levels of competency in prescription privileges and what do they entail?

-Basic Pharmacology Training: knowledge of the biological basis of neuropsychopharmacology, mastery of medications that are used and abused -Collaborative Practice: competence in diagnostic and physical assessment, drug interactions, and drug side effects; hands-on training in psychopharmacology -Prescription Privileges: can prescribe

Subjective/personal distress. What is it? Advantages, Problems?

-Behaviors that are accompanied by distress are abnormal -Advantages: Seems reasonable to expect that person can assess whether or not s/he is experiencing distress -Problem: What is abnormal behavior isn't accompanied by distress - Psychosis

What are the pros of prescription privileges?

-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

What is the difference between categorical and dimensional systems?

-Categorical: You have it or you don not (Has advantages for research and understanding) -Dimensional: Rank on a continuous qualitative dimension (May better capture individuals functioning)

What are some differences between clinical and counseling doctoral programs?

-Clinical: Twice as man applicants, Avg. GRE scores of accepted higher, research focusing on psychological disorders, clinical health psychology, and clinical child and adolescent psychology is more common Counseling: Higher percentage of ethnic minority students and those with master's degrees, research focusing on minority/cross-cultural issues and vocational testing more common.

What are combined professional-scientific training programs?

-Combined specialty of counseling, clinical, and school psychology

What is the purpose of a diagnosis?

-Communication -Enables and promotes empirical research -Research on etiology possible -Diagnosis suggests prognosis

What were some of Alfred Adler's ideas

-De-emphasized sexual drives, social integration more central

What are the four characteristics of abnormal behavior?

-Disability -Personal Distress -Violation of Social Norms/Statistical Infrequency -Dysfunction

What must syndrome be associated with?

-Distress, disability, or increased risk of problems

True or False: Theoretical Orientation -Is psychodynamic increasing over the years? -Is cognitive-behavioral increasing over the years? -Not many clinical psychologist consider themselves eclectic/integrative.

-False, decreasing -true -False, many

True or False: Coursework from program to program is the same and normally includes a standard set of courses aimed to provide an understanding of the basics.

-False, differ from program to program

True or False: Clinical Social Workers -They are mental health professionals trained in psychiatric diagnosis and only individual psychotherapy -There training is limited to a 2 years master's degree -They are intensely involved in the day-to-day lives of their patients They focus more on social and environmental factors that contribute to their patient's difficulties

-False: Trained in both individual and group therapy -True -True -True

Diagnosis and assessment: Interwar period: What is the intelligence debate and what was the first satisfactory measure of adult intelligence?

-How do you define intelligence, measure it, study it? Are there multiple different intelligences? -Wechsler Intelligence Test

During training all of clinical psychologists are required to do a dissertation. What is this and what is it designed for? What do most programs stress for the kind of research on the dissertation?

-Intensive original research project -Contribute significant new info to the field -Experimental or correlational research

Clinical -scientist model -How did it arise? -What does it focus on? Other characteristics?

-It arose from concerns that clinical psychology is not sufficiently grounded in science -Scientific basis -Establishing criteria for services Focus in training (see next point) -Focuses on evidence-based approaches to assessment, prevention, and clinical intervention. Emphasis on empirical evidence

What were some main ideas in diagnosis and assessment in the post-war period and beyond? (Three)

-MMPI- Minnesota Multiphasic Personality Inventory -Radical Behaviorism: Only overt behaviors can be measured -Diagnostic manuals and structured diagnostic interviews -Managed Care -Brief, focal assessment

What are some key ideas of culturally sensitive mental healthy services?

-Make commitment to cultural awareness as well as knowledge of self and others as cultural beings -Recognize importance of multicultural sensitivity -Integrate multiculturalism and diversity into education and training -recognize importance of culture in psychological research and clinical work

What is projective testing and some examples of them?

-Patients respond to ambiguous stimuli: Rorschach Inkblots, Thematic Apperception Test, Bender-Gestalt Test

Today's Ph.D. clinicians will be replaced by tomorrow's master's-level mental health professionals?

-Ph.D.'s are expensive, so if standardize so master's can do it, it will take less money.

What are probably effective elements of therapy relationships? (6)

-Positive Regard ¨ Congruence/Genuineness ¨ Feedback (Both need to provide feedback) ¨ Repair of Alliance Ruptures (Break alliance, and then if able to get back, maybe you can do other big things in their life since they trust you again.) ¨ Self-Disclosure (well-timed self-disclosure can be helpful, but have to keep to a minimum.) ¨ Countertransference Management (Emotions we have from past relationships tend to make their way into new relationships, so have to be aware of own issues going into therapy with client. Also, the client doesn't get to see all of your personality, so this may be difficult if you give them wrong impression) ¨ Quality of Relational Interpretations- If you are going to interpret, they have to be good/positive interpretations so it isn't draining

What is the scientist-practitioner model? Is it the predominant training philosophy in clinical psychology today? Does it integrate the role of scientist with practitioner? What does it require? What is a drawback?

-Practice with skill while being able to conduct and review research -Yes -Yes -Requires that students acquire research competence by contributing to ongoing studies and eventually conducting their own original research project -Not everyone wants to do research because they want to spend time helping others directly.

What are some reasons psychotherapy may be a declining?

-Prescription Privileges -Decrease in interest -Perceived lack of prestige

What services in general do counseling psychologists provide?

-Preventative treatment -Consultation -Development of outreach programs -Vocational counseling Short-term counseling/ therapy from one to fifteen sessions

What are the implications of training for prescription privileges?

-Programs that seek to prepare psychologists for prescribing at a later point in their career may screen out applicants that do not have a good foundation in undergraduate courses in the physical sciences -May change the very nature of the practice of clinical psychology as we know it

What are the pros and cons of the scientist-practitioner model? (2 pros, 1 con)

-Pros: Balanced in theoretical and the practical, rooted in academia research -Cons: May polarize into camps

Closely Related Mental Healthy Models of Clinical Psych. Include:

-Psychiatrist -Counseling psychologist -Social Worker -School Psychologist -Health Psychologist -Rehabilitation Psychologist -Psychiatric Nurse -Non regulated "therapist" or "psychotherapist"

What does statistical infrequency suggest for a definition? Advantages? Problems?

-Rare behaviors are abnormal -Normal curve indicates that some behaviors are common while others are rare -Advantages: Cutoff points can be established and used, Intuitive appeal: we tend to think we know abnormal behavior when we see it -Problems: Choice cutoff point (How do we decide), number of deviations required, cultural relativity (deviance differs from group to group)

What does a certification do?

-Restricts use of psychologist title and is on state to state basis

What does a license do?

-Restricts use of psychologist title and professional activities (APA guidelines influence states and this also puts potential limitations on academia

What does research involve in training in clinical psychology? Do most programs require a master's thesis and all programs require an intensive original research project (dissertation) to receive a doctorate?

-Statistics, research methodology, and participation in research. -Yes

What are some criticisms of classification?

-Stigma against those classified with mental disorder -Categories do not capture uniqueness of persons -Classification may emphasize trivial similarities

What are the demonstrably effective elements of therapy relationship and tell a little bit about each.

-The alliance (Patient's view of therapy and treatment. If you can build alliance, can slip past person's self-defense and have patient tell you more because they trust you. -Cohesion in Group Therapy -Empathy -Goal Consensus and Collaboration (What are we working on together, need to have same goals)

What are school psychologists and what activities may they partake in?

-They are psychologists who work with educators to promote intellectual, social, and emotional growth of school-age children -Activities may include: evaluating children with special needs, developing programs with interventions to address these needs, and consulting with teachers and administrators on school policy

True or False: The therapy relationship acts in concert with discrete interventions, patient characteristics, and clinician qualities in determining treatment effectiveness. Adapting or tailoring the therapy relationship to therapist characteristics (in addition to diagnosis) enhances the effectiveness of treatment.

-True -False, client characteristics

When does the internship come during training and why is it useful? (3 reasons)

-Usually at the end -Allows students to gain experience working in a professional setting -It also exposes students to clinical psychologists who may have different ideas and theoretical orientations than those encountered at the university, which helps to combat provincialism -Stimulates ideas for future research projects

Do students also enroll in advanced clinical coursework that focuses on subjects of interest more in depth.

-Yes

Are diagnoses constructs?

-Yes, most are not testable with certainty

What are the characteristics of professional schools that offer Psy. D.?

-usually have no university affiliation -focuses on competence in assessment and psychotherapy and puts a de-emphasis on research competence -Most award the Psy.D. degree instead of the traditional Ph.D. -May employ part time professors -Often accept 100+ students -Majority of them not APA accredited -Lower % get financial assistance -Lower % get internship

How many clinical training programs identify with the clinical-science model?

50

Who establishes competency certification?

American Board of Professional Psychology

What is a construct?

An abstract concept or inferred attribute.

What is neuropsychological assessment?

An assessment approach—based on empirically established brain-behavior relationships—that evaluates a person's relative strengths and weaknesses across a number of areas.

In the beginning for diagnosis and assessment, what was tested in the late 1800s?

Assessment of individual differences, such as mental testing.

In the early 1900s, what was tested in Paris?

Assessment of intelligence and personality testing.

Define diagnosis

Classification of disorders by symptoms and signs

After post-war, what were some ideas interventions?

Cognitive-Behavior Therapy, Eclectics (Clinicians who employ techniques of more than one theoretical orientation), brief time-limited therapy

A mental disorder is considered to represent a ____________ with an individual.

Dysfunction

In the clinical scientific model, what is taught?

Evidence-based assessments and interventions

What was the classification of psychopathy in the early beginnings?

Exogenous - Curable Endogenous - Incurable

Counseling psychology represents a wide range of theoretical orientations and treats clients only in their 20s. True or False.

False: Across the life span

True or False: Counseling psychology traditionally worked with very sick individuals and was historically focused on inmates in psychiatric wards.

False: Healthy or slightly maladjusted or slightly maladjusted individuals and focused on educational or career counseling

True or False: More men than women are receiving their doctorates in psychology, especially clinical psychology.

False: More women than men

Clinical Psychology focuses on I E B P S B factors across the life span, in varying cultures, and at all socioeconomic levels.

I=Intellectual E=Emotional B=Biological P=Psychological S=Social B=Behavioral

Explain what abnormal behavior is in disability/dysfunction and its three sub-categories.

Impairment of life function can be a component of abnormal behavior -Social=Interpersonal relationships are affected -Occupational:Job is disrupted, perhaps even lost -Personal=Day to day functioning impaired

What does psychopathology examine?

It examines the nature and development of abnormal behavior, feelings, and thoughts

What is the concept of the practicum?

Learning through clinical practica, or exposure to clinical work and practical applications and skills

What are the cons of prescription privileges?

May lead to a de-emphasis of "psychological" forms of treatment ◦ May also damage clinical psychology's relationship with psychiatry and general medicine ◦ Lead to increases in malpractice liability costs

What is the basis of the scientist practitioner model?

Practice with skill while being able to conduct and review research

Is there a qualifying exam in clinical psychology and if yes, then what does it entail?

Yes, usually made up of a written and sometimes oral examinations in the third year. It can cover all of psychology or just clinical

Why was there a split in the APA and the APS was created?

academic/scientific wing of the APA felt ignored so this led to the creation of the American Psychological Society in 1988 (now called the Association for Psychological Science)

What did behaviorism teach clinicians?

taught clinicians the power of conditioning in the development and treatment of behavior disorders