Clinical Psych Exam 1
ABPP
-American Board of Professional Psychology -certification of professional competence in 15 areas -each area has own board and rules -no special legal authority -requirements more rigorous than licensure
-1st published in 1953 -goal of this is to protect the public -it guides the professional behavior of clinical psychologists -revised 9 times -most recent edition= 2002 -two amendments in 2010 -one amendment in 2016
APA code of ethics
-created for scientists in 1988 -committed to advancing science -renamed American Psychological Society in 2006 -goals= generate knowledge based on science and apply this knowledge to improve mental health of the public
APS (Association for Psychological Science)
-astronomer -compared his subjective measurements to everyone else's and found that everyone's' measurements differed and were systematic -this difference was person specific and stable -created an equation -started the field of "personality"
Bessel
-1895, sophisticated intelligence tests were developed by him by the order of the French gov. -these tests distinguished normal from defective children -French gov. beginning to fund public education and wanted to invest money in those who could benefit from it -measured experimentally based, flexible mental FUNCTIONS
Binet
-interested in intelligence -established set of standardized methods to measure individual differences -went to Germany and earned PhD under Wundt -measured experimentally based, flexible mental FUNCTIONS -established the "Psychological Corporation" which sells tests, provided consultation and research services to business and industries
Cattell
-1859, "Origin of Species" -Two ideas 1. variation (individual differences) occur both within and between species 2. natural selection takes place at least in part on these individual differences
Charles Darwin
-originally a school teacher who likely suffered from depression -volunteered in female jails -believed inmates were mentally ill, not criminals -convinced leaders to build over 30 more humane state institutions in US and other countries -challenged the idea that people can't be cured or helped
Dix
-opened humane treatment centers in US -Harvard Retreat--> now Institute for Living -"Law of Kindness"= mentally ill should not be shunned, stigmatized and should be treated fairly with knowledge and kindness -allowed patients to have input in treatment decisions
Eli Todd
-F was a physicist and focused on relationship between objective subjective reality -F & W gave people various kinds of physical stimuli and people were to indicate when they could detect the stimulus
Fechner and Weber
-set out to measure individual differences -designed tests aimed at measuring the fixed capacities which he thought made up the mind -tried to measure intelligence by reaction times -set up mental testing center in London -measured inherited, fixed and mental STRUCTURES
Galton
-revised the Binet-Simon scales into the Stanford-Binet scales -established first Child Guidance Clinic in the US in 1909 -was a PHYSICIAN not a psychologist -he set the stage for a series of controversies
Healy
-interested in conscientiousness -they tried to develop a mental chemistry analyzing various kinds of physical sensations into their composite parts
Hemholtz and Wundt
-know your own cultural biases -practice within your biases and do not extend past them -form friendships and learn values -network with out of your culture professionals, get supervision if you must see diverse clients -if encountering client outside of cultural bias, REFER
Jacobs'/Beck's advice
-lobbied a rich industrialist to form a committee to insure uniform and humane treatment throughout the US -sparked from book written by Clifford Beers who wrote about the way himself and and others were treated in mental hospitals -assumed that young offenders had a mental problem that he needed to treat before it caused more serious problems -took a psychodynamic approach to treatment
James and Meyer
-Maskelyne's assistant -job was to record the exact moment at which certain stars crossed a certain point in the sky -was fired bc Maskelyne thought his measures were off
Kinnebrook
-considered to be the pioneer of diagnosis -differentiated between exogenous (outside) and endogenous (inside) disorders -coined some of earliest terms to categorize mental illness (schizophrenia, paranoia, etc.)
Kraepelin
-objective test -comprehensive personality test that measures various pathologies
MMPI
-written in 1991 -scientific clinical psych is the ONLY legitimate and acceptable form of clinical psych -Psychological services should NOT be administered to public unless -4 criteria: 1. clinician describes the intervention clearly 2. clinician states known benefits and risks of the intervention clearly 3. effects of the intervention are validated scientifically 4. positive effects of the intervention are known to outweigh its possible negative effects
McFall Manifesto
-astronomer -
Nevil Maskelyne
name the 3 states that have granted prescription privileges to appropriately trained psychologists
New Mexico, Louisiana, Illinois
-new accreditation system for clinical psych programs -enhance health and mental health care -empirically supported treatments are effective and cost effective
PCSA
-degree emphasizes practice AND research -smaller classes -lower acceptance rate -typically in university departments -offers more funding -greater placement in APA-APS accredited internships
PhD
-advocated for more humane/compassionate treatment for mentally ill -introduced the need for case history, treatment notes and illness classification, indicating care about patients -said patients should be seen as individuals -documented therapies that cured patients and kept case notes on progress
Phillippe Pinel
-degree emphasizes practice OVER research -larger classes -higher acceptance rate -often for profit free-standing professional schools -offer less funding -less successful in placement in APA-APS accredited internships
PsyD
-prof of psych @ Indiana University -scientific clinical psych is the ONLY legitimate and acceptable form of clinical psych -president of the Academy of Psychological Clinical Science
Richard McFall
-1921 -projective test where clients respond to ambiguous stimuli
Rorschach Inkblot test
-"Father" of American Psychiatry -Quaker background -signer of the declaration of independence -published 1st textbook on mental diseases -believed mental diseases were caused by irritation of blood vessels in the brain
Rush
-1947, "Committee on Training in Clinical Psychology appointed by APA to recommend content of clinical programs, set up training standards and report on current programs -his report became "bible" of all departments hoping for a favorable review by the APA -clinical psychologists should by trained as psychologists (as scientists) -clinical training should be as rigorous as non-clinicians -training should focus on holy trinity (ASSESSMENT, RESEARCH, and THERAPY)
Shakow
intelligence test intended for children and widely used today
Stanford-Binet test
-court case regarding college student telling his psychologist at student health that he was going to kill his gf -therapist broke confidentiality and contacted campus po po -police found student and student promised to stay away from gf -student never returned to therapy and killed gf -TAKE AWAY: 1. therapist has the "DUTY TO WARN" potential victim 2. therapist has "DUTY TO PROTECT" -this is for California only
Tarasoff
-1935 -projective test where clients respond to ambiguous interpersonal scenes
Thematic Apperception Test
-Quaker background -devoted much of life to improving mentally ill's treatment in asylums -raised funds to open the York Retreat which was a pleasant environment with decent food, therapeutic gentleness, humanity and respect
Tuke
-1914 -Robert Yerkes (APA prez) recruited psychologists to develop tests (personality, diagnostic, etc.) to slot men into groups -alpha= literate men -beta= illiterate men -by 1918 psychologists could test children and adults
WWI
-psychologists gave over 60 million tests to over 20 million men -many clinicians "hooked" on delivering interventions but no one else liked it because they weren't science based -1946= not enough qualified people so VA defined clinical psychology into existence -VA said they would pay and train clinical psychologists which is the support they needed
WWII
intelligence test designed for adults
Wechsler-Bellevue test
-first person to use the term clinical psychology -first recognized clinical psychologist -wrote the first clinical journal -graduated from UofPenn in 1888 -used scientific method to study individual differences and diagnose behavioral disorders -20-30 years his clients were mostly children with school difficulties -interested in PREVENTION
Witmer
-said to be the founder of experimental psychology -psychology can't be science without precise methods, measurements, and empirical studies
Wundt
-response to new cultural environment -balance between adopting new culture and retaining OG culture -it is likely critical but there is little data to support this -4 strategies: 1. assimilation (high new, low OG) 2. separation (low new, high OG) 3. marginalization (low new and OG) 4. integration (high new and OG)
acculturation
-by 1930s there were 50 psychological clinics and at least 12 child-guidance clinics in US -psychologists worked side by side with psychiatrists and the distinction was difficult to maintain -clinical psych not recognized as a stand alone profession -still no official training programs for clinical psychologists
after WWI
-the process of learning about one's own culture
awareness
-name the 3 components of cultural competence -SKA! (cue nick's rapper noise)
awareness, knowledge, and skills
1. identify nature of conflict and identify factual info that may be relevant to conflict and resolving it (LAY IT ALL OUT THERE) 2. see ethical standards and any appropriate professional standards (SEEK RESOURCES TO HELP) 3. look to ethical principles 4. look to university or employer codes/policies/regulations on the matter 5. seek consultation for resolving ethical conflicts 6. apply appropriate legal standards 7. make reasoned decision and document each of these steps (CONCLUSION)
beck's model on ethical decision making
-1949 conference of directors of clinical training -emphasizes practice AND research -in psych departments at universities, state schools or some private
boulder model (scientist-practitioner)
type of definition of culture that says many variables define a culture (like SES status, religion, gender, age, etc.)
broad def of culture
-this is a weak form of regulation -cannot call oneself a psychologist with just this -involves and exam and review of training/professional experience
certification
focuses on the intellectual, emotional, biological, psychological, social and behavioral aspects of human functioning across the life span, in varying cultures, and at all socioeconomic levels
clinical psychology
-1990's -science should be the basis of clinical psych -awards PhD's NOT PsyD's -emphasis on scientific method and evidence based clinical methods -1991 McFall Manifesto
clinical scientist model
issues: 1. religion and spirituality 2. managing disorders, depression, anxiety, eating disorders, substance abuse 3. making life decisions, school, job, dating, marriage/divorce 4. end of life decisions for self or others 5. sexuality preferences, abortion, etc. 6. marital issues, money, sex, affairs, kids 7. children and parents, discipline, parenting
common issues in therapy
-the ability to be sufficiently capable, skilled, experienced, and expert to complete the professional tasks you undertake -must know your limits of this and work well within it (if you don't know something, seek additional training, read journals, etc.) -keep yourself healthy and on top of your shit
competence
-generally retain some control over info generated about us but has limits -give up some privacy
confidentiality
-in general, psychologists ethically obligated to maintain this -profession built on trust that we will not disclose personal info -situations in which breaking this is okay: 1. danger to self/others 2. child abuse 3. elder/vulnerable adult abuse 4. court order
confidentiality
-parents have legal right to be informed and have access to all records (up until 18) -important to make arrangements between therapist and parents on what to discuss/not discuss with child
confidentiality with adults
-they see less disturbed clients -tend to endorse humanism more and behaviorism less -tend to be more interested in vocational/career counseling
counseling psychologist
-this is a type of therapy that can be: -synchronous: online support groups, chat rooms, tele-video conferencing, audio conference, second life OR -time delayed: email therapy -can lead to inaccurate diagnosis, confidentiality and privacy is not guaranteed, no way to know who is treating you -but it's cost effective, efficient, and you can reach the under-served population
cybertherapy
-20% of US school children speak a language other than English at home -by 2050, 1/2 of US pop will identify at least partially as an ethnic minority
diversity in the US
-journals and books made on cultural topics -new APA divisions -revisions to DSM (defining culture bound syndromes)
efforts to emphasize culture
-emphasizes culture-specific norms -appreciates clients in the context of their own culture
emic
-emphasizes similarities between all people -assumes universality -downplays culture-based differences
etic
-more individualized treatments -This approach requires responsiveness and attention in order to adapt treatment flexibly to meet client's needs and goals -establishes minimal levels of competence -decreased reliance on clinical judgment -training improvements
evidence-based practice
-era lasted from 1896-WWII -clinical psych was a scientific discipline -psychologists were contributing members of the mental health team -psychologists were under the direction of a psychiatrist
first era of clinical psych
-reaction time tests used to diagnose disease before other tests can -product of Fechner and Weber
health psychology
This group of people has several risk factors for poor health outcomes yet still live longer than anyone else. What is this paradox called?
hispanic paradox
-this is required for research, assessment, therapy, and other professional activities -for therapy, this is an ongoing process rather than a one-time event -it must allow client the opportunity to ask questions and receive answers
informed consent
one can gain this through reading, direct experiences, relationships with people of various cultures, or asking client to explain cultural meaning
knowledge
-this is a stronger form of legislation than certification -laws vary across states, but several commonalities -describes and defines title, training required, and specific activities that are offered to the public -must have doctorate from APA accredited program, 1-2 years of post-doc experience, pass examination for professional psychologists
licensing
-an integrated approach to financing and delivery of health care -by end of 1997, 85% of Americans belonged to some kind of this -they attempt to control costs and reduce use of services while ensuring quality
managed health care
-part of evidence based practice -used to ensure uniformity across therapists and to minimize variability
manualized therapy
principles of: -striving to benefit those whom you work (do good) and take care to (do not harm) -fidelity and responsibility -integrity (seek to promote accuracy, honest and truthfulness in science, teaching and practice -justice (equality and fairness) -respect for people's rights and dignity
moral principles of APA code
-axis 1= clinical disorders -axis 2= personality disorders -axis 3= mental/physical disorders -axis 4= educational/psychosocial factors -axis 5= global assessment of functioning -now, axis 1-3 are grouped together and 4-5 are same but use different tools
multiaxial system
-PB and Honey sandwich= 1st 3 forces!! (1st generation= Psychoanalysis, 2nd= Behaviorism, 3rd= Humanism) -argues that culture shapes how clients understand their problems -what do you call your problem? -what do you think your problem does to you? -what do you think the cause of this problem is? -how do you think this problem should be treated? -who else do you turn to for help?
multiculturalism as a 4th force
-knowing someone in more than one role (having someone as a student but also being their babysitter) OR -knowing someone close to that person (friendship with dad of student) -unethical when= objectivity, competence or judgment can be impaired or when there is boundary crossing (your therapist is also a local restaurant owner)
multiple relationship
type of definition of culture that ethnicity and race are the defining characteristics of culture
narrow def of culture
-type of self certification -those who are licensed/certified in their own states -submit name and pay to be listed
national register
tests that are typically paper/pencil, self-report, and more scientifically sound than projective tests
objective tests
-training for license (1 year) -after doctoral degree -supervised but more independence -required for state licensure -Successful completion of the postdoctoral internship DOES NOT authorize a psychologist to practice independently.
post-doctoral
-internship (1 year) -at end of doctoral program before PhD/PsyD awarded
pre-doctoral
-constitution fundamental right to life liberty and property (4th, 5th, 14th amendment) -informational, physical, relational
privacy
-they obtain MA's -complete training in 2 years -longer clinical supervision -little emphasis on psychological testing or research -may specialized in career, school, college counseling
professional counselors
-they go to med school and are physicians -training is different from a clinical psychologist -have prescription privileges -increasing emphasis on biological/pharmaceutical rather than "talk therapy"
psychiatrist
-they work in schools -more limited professional focus -consult with adults in children's lives
school psychologist
-era started in 1950 -transformed from an academic discipline to a service profession -liberated itself from psychiatry
second era of clinical psych
have privacy and confidentiality IF you're competent
self determination
this is developed from knowing that techniques should be consistent with the values and life experiences of each client
skills
-they tend to emphasize social factors in clients' problems -act as patient advocates -get MAs rather than doctorate degrees -training emphasizes on treatment and fieldwork over research/formalized assessment
social worker
1. resolving ethical issues 2. competence 3. human relations 4. privacy and confidentiality 5. advertising and other public statements 6. record keeping and fees 7. education and training 8. research and publication 9. assessment 10. therapy
standard section of APA code
this consists of: -a safe environment -a place to establish trust -a place to build a professional relationship -a place to get to know your client's world (client's meaning of certain things) -place to explore client's concerns -non judgmental place -place to get help -place that provides best possible service
therapy
-1973 conference -emphasizes practice OVER research -awards PsyD's ("born" at this conference) -higher acceptance rates and larger classes -160% increase in PsyD degrees 1988-2001
vail model (practitioner-scholar)
