CHAPTER 1: Introduction to Clinical Psychology: Definition and Training

Question 1

The term clinical psychology was first used in print by

Answer 1

Lightner Witmer in 1907

Question 2

envisioned clinical psychology as a discipline with similarities to a variety of other fields, specifically medicine, education, and sociology

Answer 2

Lightner Witmer (1907)

Question 3

a person whose work with others involved aspects of treatment, education, and interpersonal issues

Answer 3

clinical psychologist

Question 4

foresaw clinical psychology as applicable to people of all ages and with a variety of presenting problems.

Answer 4

Lightner Witmer (1907)

Question 5

the branch of psychology that studies, assesses, and treats people with psychological problems or disorders

Answer 5

clinical psychology

Question 6

The field of Clinical Psychology integrates science, theory, and practice to understand, predict, and alleviate maladjustment, disability, and discomfort as well as to promote human adaptation, adjustment, and personal development. Clinical Psychology 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.

Answer 6

The Division of Clinical Psychology (Division 12) of the American Psychological Association (APA) defines clinical psychology as follows:

Question 7

involves rigorous study and applied practice directed toward understanding and improving the psychological facets of the human experience, including but not limited to issues or problems of behavior, emotions, or intellect.

Answer 7

Clinical psychology

Question 8

The aspiring clinical psychologist must obtain a

Answer 8

doctoral degree in clinical psychology

Question 9

Most students enter a doctoral program with only a bachelor’s degree, but some enter with a master’s degree. Often, that master’s degree was earned from a “terminal” master’s program in clinical psychology (meaning that their program ends at the master’s level).

Answer 9

Some graduates of such master’s programs go on to earn doctoral degrees, while others enter the work force in some capacity

Question 10

For those entering with a bachelor’s degree, training typically consists of at least 4 years of intensive, full-time coursework, followed by a 1-year, full-time predoctoral internship.

Answer 10

Required coursework includes courses on psychotherapy, assessment, statistics, research design and methodology, biological bases of behavior, cognitive-affective bases of behavior, social bases of behavior, individual differences, and other subjects

Question 11

A master’s thesis and doctoral dissertation are also commonly required, as is a practicum in which students start to accumulate supervised experience doing clinical work.

Answer 11

When the on-campus course responsibilities are complete, students move on to the predoctoral internship, in which they take on greater clinical responsibilities and obtain supervised experience on a full-time basis.

Question 12

there are many paths to the profession.

Answer 12

The most common specialty areas are clinical child, clinical health, forensic, family, and clinical neuropsychology

Question 13

the coexistence of three distinct models of training currently used by various graduate programs:

Answer 13

the scientist-practitioner (Boulder) model

the practitioner-scholar (Vail) model

the clinical scientist model

Question 14

In 1949, the first conference on graduate training in clinical psychology was held in Boulder, Colorado.

Training in clinical psychology should jointly emphasize both practice and research

Answer 14

The Scientist-Practitioner (Boulder) Model

Question 15

to become a clinical psychologist, graduate students would need to receive training and display competence in the application of clinical methods (assessment, psychotherapy, etc.) and the research methods necessary to study and evaluate the field scientifically

Answer 15

coursework should reflect this dual emphasis, with classes in statistics and research methods as well as classes in psychotherapy and assessment

Question 16

Scientist-Practitioner Model (Boulder Model)

Answer 16

Graduate students would (under supervision) conduct both clinical work and their own empirical research (thesis and dissertation). These graduate programs would continue to be housed in departments of psychology at universities, and graduates would be awarded the Ph.D. degree.

Question 17

In 1973, another conference on clinical psychology training was held in Colorado—this time, in the city of Vail

Answer 17

The Practitioner-Scholar (Vail) Model

Question 18

these programs typically offer more coursework directly related to practice and fewer courses related to research and statistics

Answer 18

So the practitioner-scholar model of training was born, along with a new type of doctoral degree, the PsyD

Question 19

the more empirically minded members of the clinical psychology profession began a campaign for a strongly research-oriented model of training

Answer 19

The Clinical Scientist Model

Question 20

in the 1990s, a movement toward increased empiricism took place among numerous graduate programs and prominent individuals involved in clinical psychology training.

Answer 20

science should be the bedrock of clinical psychology

Question 21

stressed the scientific side of clinical psychology more strongly than did the Boulder model

Answer 21

Clinical Scientist Model

Question 22

a PhD from a clinical scientist program implies a very strong emphasis on the scientific method and evidence-based clinical methods

Answer 22

In 1991, Richard McFall, at the time a professor of psychology at Indiana University, published an article that served as a rallying call for the clinical scientist movement

Question 23

McFall (1991) argued that “scientific clinical psychology is the only legitimate and acceptable form of clinical psychology . . . after all, what is the alternative? Does anyone seriously believe that a reliance on intuition and other unscientific methods is going to hasten advances in knowledge?”

Answer 23

“Manifesto for a Science of Clinical Psychology,”

Question 24

A few years later, a conference of prominent leaders of select clinical psychology graduate programs took place at Indiana University. The purpose of the conference was to unite in an effort to promote clinical science. From this conference, the _______ was founded.

Answer 24

Academy of Psychological Clinical Science

Question 25

there has been a shift in the theoretical orientation of faculty toward cognitive/cognitive-behavioral and away from psychodynamic/psychoanalytic

Answer 25

a considerable increase in the percentage of doctoral students who are female and members of racial or ethnic minorities

Question 26

Undoubtedly, technology is increasingly influential in the training of clinical psychologists.

Answer 26

For an increasing number of students, learning psychotherapy or assessment techniques involves the use of webcams and other computer-based methods that allow supervisors to view, either live or recorded, students trying to apply what they have learned in class

Question 27

Another growing emphasis in training is specific competencies or outcome-based skills the students must be able to demonstrate.

Answer 27

Specific competencies that may be required of students could center on intervention (therapy), assessment, research, consultation/collaboration, supervision/ teaching, ethics, cultural diversity, and management/administration.

Question 28

What do Graduate Programs Prefer?

Answer 28

1. Know your professional options.
2. Take, and earn high grades in, the appropriate undergraduate courses.
3. Get to know your professors.
4. Get research experience.
5. Get clinically relevant experience.
6. Maximize your GRE score.
7. Select graduate programs wisely.
8. Write effective personal statements.
9. Prepare well for admissions interviews.
10. Consider your long-term goals.

Question 29

Numerous roads lead to the clinical psychologist title; moreover, numerous professions overlap with clinical psychology in terms of professional activities.

Answer 29

Know your professional options.

Question 30

Among the most commonly required or recommended courses are statistics, research/experimental methods, psychopathology, biopsychology, and personality.
Choose electives carefully, too—classes that have direct clinical relevance, including field studies or internships, are often seen favorably.

Answer 30

Take, and earn high grades in, the appropriate undergraduate courses.

Question 31

Letters of recommendation are among the most important factors in clinical psychology graduate admissions decisions (Norcross, Hanych, & Terranova, 1996). Professors (and, to some extent, supervisors in clinical or research positions) can be ideal writers of such letters.

Answer 31

Get to know your professors.

Question 32

Conducting research with a professor affords you additional experience with the empirical process, as well as a chance to learn about a specialized body of knowledge and develop a working relationship with the professor.
If your contribution is significant enough, this research experience could also yield a publication or presentation on which you are listed as an author, which will further enhance your application file.

Answer 32

Get research experience.

Question 33

Whether the clinical experience takes the form of an internship or practicum (for which course credit is earned), a paid job, or a volunteer position, it can provide f irsthand knowledge about selected aspects of the field, and it demonstrates to admissions committees that you are serious and well informed about clinical psychology.

Answer 33

Get clinically relevant experience.

Question 34

Appropriately preparing for this test—by learning what scores your preferred programs seek, studying for the test either informally or through a review course, taking practice exams, and retaking it as necessary—can boost your odds of admission.

Answer 34

Maximize your GRE score.

Question 35

It is best to learn as much as possible about potential programs:
What is the model of training (Boulder, Vail, or clinical scientist)?
To what clinical orientations does the faculty subscribe?
What areas of specialization do the faculty members represent? What clinical opportunities are available?

Answer 35

Select graduate programs wisely.

Question 36

Graduate programs will require you to write a personal statement (or goal statement).
This is your opportunity to discuss career aspirations as well as your research and clinical interests—all of which should fit well with the program to which you are applying.

Answer 36

Write effective personal statements.

Question 37

These interviews are a wonderful opportunity for professors in the program to get to know you and for you to get to know the program. Arrive (professionally dressed, of course) with a strong understanding of the program and your interest in it.

Answer 37

Prepare well for admissions interviews.

Question 38

Down the road,
do you see yourself as a clinician or a researcher?
Have you firmly determined your own theoretical orientation already, or do you seek a program that will expose you to a variety?
What specific areas of clinical or scientific work are most interesting to you? How much financial debt are you willing to incur?

Answer 38

Consider your long-term goals.

Question 39

it’s a good idea for future applicants to search the literature for studies on how graduate programs handle their admissions processes.

Answer 39

These researchers found that both Ph.D. and PsyD programs placed a high value on several core elements: undergraduate GPA, GRE scores, letters of recommendation, personal statement, curriculum vitae, and interview performance.

Question 40

Ph.D. programs placed much greater importance on the student–mentor research match (making sure that an incoming student has research interests that closely correspond to those of a faculty member) and research assistance experience.

Answer 40

PsyD programs were more likely to offer admission to applicants who already had a master’s degree.

Question 41

All clinical psychology doctoral programs culminate in the

Answer 41

predoctoral internship

Question 42

Typically, this internship consists of a full year of supervised clinical experience in an applied setting

Answer 42

As implied by the term predoctoral, this internship year takes place before the Ph.D. or the PsyD is awarded.

Question 43

It is generally considered a year of transition, a sort of advanced apprenticeship in which the individual begins to outgrow the role of “student” and grow into the role of “professional.”

Answer 43

The process of applying for a predoctoral internship can feel a lot like the process of applying to graduate school some years earlier. It often involves researching various internships, applying to many, traveling for interviews, ranking preferences, anxiously awaiting feedback, and relocating to a new geographic area.

Question 44

Typically lasts 1 to 2 years, and it is essentially a step up from the predoctoral internship.

Answer 44

postdoctoral internship

Question 45

Postdocs take on more responsibilities than they did as predoctoral interns, but they remain under supervision.

Answer 45

After postdoctoral interns accumulate the required number of supervised hours (and pass the applicable licensing exams), they can become licensed to practice independently.

Question 46

Once all the training requirements are met— graduate coursework, predoctoral internship, postdoctoral internship —

Answer 46

licensure

Question 47

Becoming licensed gives professionals the right to identify as members of the profession—to present themselves as psychologists (or clinical psychologists)

Answer 47

It also authorizes the psychologist to practice independently.

Question 48

Becoming licensed also requires passing licensure exams. It is a standardized multiple-choice exam on a broad range of psychology topics.

Answer 48

Examination for Professional Practice in Psychology (EPPP)

Question 49

Once licensed, clinical psychologists in many states must accumulate ______ to renew the license from year to year.

Answer 49

Continuing Education Units (CEU)

Question 50

by attending workshops, taking courses, undergoing additional specialized training, passing exams on selected professional reading material, and the like

Answer 50

The purpose of requiring CEUs is to ensure that clinical psychologists stay up to date on developments in the field, with the intention of maintaining or improving the standard of care they can provide to clients.

Question 51

Where Do Clinical Psychologists Work?

Answer 51

The short answer is that clinical psychologists work in a wide variety of settings but the private practice is the most common.
Since the 1980s, private practice has been the primary employment site of 30% to 41% of clinical psychologists

Question 52

The second-place finisher in each survey during that time has been the university psychology department, but that number has not exceeded 19%.

Answer 52

Between 2% and 9% of clinical psychologists have listed each of the following as their primary work setting: psychiatric hospitals, general hospitals, community mental health centers, medical schools, and Veterans Affairs medical centers.

Question 53

The third-place finisher (after private practice and university psychology department) in each survey since the 1980s has been the “other” category

Answer 53

In 2003, 15% of psychologists listed “other,” writing in diverse settings such as government agencies, public schools, substance abuse centers, corporations, and university counseling centers.

Question 54

What Do Clinical Psychologists Do?

Answer 54

Clinical psychologists are engaged in an enormous range of professional activities, but psychotherapy is foremost.

Question 55

Since 1973, the number of clinical psychologists reporting that they are involved in psychotherapy has always outranked that of any other professional activity and has ranged from 76% to 87%.

Answer 55

A sizable number of psychologists—more than half—have also reported that they are at least somewhat involved in each of the following activities: diagnosis/ assessment, teaching, supervision, research/writing, consultation, and administration.

Question 56

Clinical psychologists have reported that they spend between 31% and 37% of their time conducting psychotherapy.

Answer 56

Of those who practice psychotherapy, individual therapy occupies the largest percentage of their therapy time (76%), with group, family, and couples therapy far behind (6% to 9% each).

Question 57

How are clinical psychologists different from counseling psychologists?

Answer 57

Clinical psychologists were more likely to work with seriously disturbed individuals, whereas counseling psychologists were more likely to work with (“counsel”) less pathological clients.

Question 58

clinical psychologists still tend to work with more seriously disturbed populations and, correspondingly, tend to work and complete internships more often in settings such as hospitals and inpatient psychiatric units

Answer 58

counseling psychologists still tend to work with less seriously disturbed populations and, correspondingly, tend to work and complete internships more often in university counseling centers

Question 59

clinical psychologists tend to endorse behaviorism more strongly

Answer 59

counseling psychologists tend to endorse humanistic/client-centered approaches more strongly

Question 60

counseling psychologists tend to be more interested in vocational testing and career counseling

Answer 60

clinical psychologists tend to be more interested in applications of psychology to medical settings

Question 61

How are clinical psychologists different from psychiatrists?

Answer 61

Psychiatrists go to medical school and are licensed as physicians. They are allowed to prescribe medication.

Question 62

Clinical psychologists are certainly trained to appreciate the biological aspects of their client’s problems.

Answer 62

Psychiatrists’ training emphasizes biology to such an extent that disorders—depression, anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), borderline personality disorder, and so on—are viewed first and foremost as physiological abnormalities of the brain.

Question 63

Psychiatrists tend to fix the brain by prescribing medication

Answer 63

Clinical psychologists view clients’ problems as behavioral, cognitive, emotional—still stemming from brain activity, of course, but amenable to change via nonpharmacological methods

Question 64

How are clinical psychologists different from social workers?

Answer 64

Social workers have focused their work on the interaction between an individual and the components of society that may contribute to or alleviate the individual’s problems.
They saw many of their clients’ problems as products of social ills— racism, oppressive gender roles, poverty, abuse, and so on. They also helped their clients by connecting them with social services, such as welfare agencies, disability offices, or job-training sites.

Question 65

they were likely to get into the “nitty-gritty” of their clients’ worlds by visiting their homes or workplaces, or by making contacts on their behalf with organizations that might prove beneficial

Answer 65

they usually focused on issues such as arranging for clients to transition successfully to the community after leaving an inpatient unit by making sure that needs such as those for housing, employment, and outpatient mental health services were being met

Question 66

How are clinical psychologists different from school psychologists?

Answer 66

School psychologists usually work in schools, but some may work in other settings such as daycare centers or correctional facilities.

Question 67

Their primary function is to enhance the intellectual, emotional, social, and developmental lives of students.

Answer 67

They frequently conduct psychological testing (especially intelligence and achievement tests) to determine diagnoses such as learning disorders and ADHD.

Question 68

They use or develop programs designed to meet the educational and emotional needs of students.

Answer 68

They also consult with adults involved in students’ lives—teachers, school administrators, school staff, and parents—and are involved, to a limited degree, in direct counseling with students.

Question 69

How are clinical psychologists different from professional counselors?

Answer 69

Professional counselors (often called licensed professional counselors, or LPCs) earn a master’s (rather than a doctoral) degree and often complete their training within 2 years.

Question 70

Professional counselors’ work generally involves counseling of people with problems in living or mild mental illness (as opposed to serious mental illness).

Answer 70

their training programs include few if any courses on these topics, focusing instead on providing services to clients.

Question 71

They often specialize in such areas as career, school, addiction, couple/ family, or college counseling.

Answer 71

the name may vary slightly, with common alternatives including mental health counselor, licensed professional mental health counselor, licensed clinical professional counselor, and licensed counselor of mental health

Question 72

How are clinical psychologists different from professional counselors?

Answer 72

Marriage and family therapists (MFTs) earn master’s degrees. Their training focuses on working with couples and families, but sometimes they also see individuals struggling with issues related to their partners or families.