Week 1 Key Concepts

Question 1

Clinical Psychologists

Answer 1

• Requires doctorate degree
  
  • 4 years of coursework including thesis/dissertation
  • predoctoral & postdoctoral internship
  • Take the EPPP (Examination for Professional Practice in Psychology) for licensure
  • CEUs (Continuing Education Units) to maintain competence in the growing field of psychology
• Study, assess, and treat people with psychological problems/disorders (psychotherapy)
• Unique from other practictioners in that they can administer psychological assessments

Question 2

Specialties in Clinical Psychology

Answer 2

• Child Clinical Psychology
• Clinical Health Psychology
  
  • Pediatric Psychology (Child Health Psychology)
• Clinical Neuropsychology
• Forensic Psychology
• Geropsychology (older population)
• Community Psychology

Question 3

Three Models of Training in Clinical Psychology

Answer 3

• Scientist Practioner (Boulder) model
  
  • dual emphasis on practice AND research
  • receive training in applying clinical methods (assessment, psychotherapy) and research methods to study the field scientifically
  • PhD
• Practitioner Scholar (Vail) model
  
  • Leans toward practice with less extensive training in research and more in developing applied clinical skills
  • PsyD
• Clinical Scientist model
  
  • stresses scientific side of psychology with the scientific method & evidence based clinical methods
  • PhD

Question 4

Counseling Psychologists

Answer 4

• Require either PhD or PsyD
• more likely to work with less pathological clients
• Often work in university counseling centers as opposed clinical psychologists working in hospitals/inpatient psychiatric units
• Tend to endorse a humanistic/client centered approach more strongly as opposed to clinical psychologists endorsing behaviorism more strongly

Question 5

School Psychologists

Answer 5

• Enhance the intellectual, emotional, social, & developmental lives of students
• Conduct psychological testing to determine diagnoses such as learning disabilities & ADHD
  
  • Especially intelligence & achievement tests
• Use/develop programs to meet educational/emotional needs of students
• Consult with adults involved in the student’s lives
  
  • Teachers, school administrators, school staff, parents
• Limited in direct counseling with students
• Require PhD but there are MA-level school psychologists

Question 6

Social Workers

Answer 6

• Most have an MSW (masters of social work) but there are PhD options
• Focus on interaction between an individual & the components of society that may contribute to or alleviate their problems
• See client’s problems as products of social ills
  
  • Racism, oppresive gender roles, poverty, abuse, etc
• Arrange for clients to transition successfully to the community after leaving inpatient units with housing, employment, & outpatient mental health services
• Connect clients with social services
  
  • Welfare agencies, disability offices, job training sites

Question 7

Professional Counselors:

Marriage and Family Therapists (MFTs)

Licensed Professional Counselor (LPCC)

Answer 7

• Require MA degree
• Work generally involves counseling with little emphasis on psychological testing or research
• Focus on providing services to clients
• Specialze in areas such as career, school, addiction, couple/family, or college counseling

Question 8

MA training in Psychology

Answer 8

• General masters degree in psychology
• Provide a broad base of how the scientific ideologies of psychology are applied to behavioral, cognitive, and societal issues
• Do not qualify students for private practice, but can be used as a means of clarifying career options for students who are unsure, and could be used as a first step to a PhD degree

Question 9

Psychiatrists and Psychiatric Nurses

Answer 9

• Require an MD (medical degree) or DO (doctor of osteopathy)
• Licensed as physicans
• Prescribe medication
• Emphasize biology and view disorders as physiological abnormalities of the brain
  
  • Fix the brain by prescribing medication
• Psychiatric Nurses
  
  • Can prescribe medication under supervision of an MD

Question 10

“Psychotherapists”

Answer 10

• psychoanalytic approach which attends to the hidden or unconscious processes of the mind
• does not require a PhD, just an MA
• sketchy! Be careful when choosing one

Question 11

Diagnostic Approaches/Models:

The D’s of Diagnosis

Answer 11

• Distress, Deviance, Dysfunction/Disability, & Statistical Infrequency
• Normative approach
  
  • Looks at deviance- Is it normal in their culture?
  • Ex. Schizophrenia
• Subjective Distress
  
  • Does it look like they are in distress?
  • Ex. Depression, Panic Disorders
• Impaired Social Functioning
  
  • Does it stop them from functioning normal in society?
  • Ex. Social Phobia
• Satistical Infrequency
  
  • Rarer disorders
  • Ex. Dissociative Identity Disorder

Question 12

Harmful Dysfunction Theory

Answer 12

• Harmful
  
  • Subjective, based on social norms
• Dysfunction
  
  • Objective, scientific term
  • Failure of a mental mechanism to perform a natural function for which it is designed by evolution
• A disorder combines both value & scientific components
  
  • We consider both scientific data & social values in the context of which the behavior took place

Question 13

Medical Model of Psychopathology

Answer 13

• Used in the DSM
• Each disorder is defined categorically and features a specific list of symptoms

Question 14

Benefits of Diagnosis (diagnostic labels)

Answer 14

• Professionals
  
  • Leads to more funded research of the disorder to discover etiology (cause)
  • Clinicians can begin to add the disorder to their vocabulary, leading to more communication
• Clients
  
  • Lets them identify and demystify their experiences
  • Helps them feel like they share a recognized problem with other people & aren’t alone
  • Can help acknowledge the significance to their family/friends, people will take a label more seriously
  • Allows them to gain access to treatment/medication, possibly through health insurance

Question 15

Costs/Risks of Diagnosis

Answer 15

• Prejudice
  
  • labels could carry stigma that can damage self image and lead to others stereotyping that individual
• Legal issues
  
  • Diagnostic labels could affect decisions in child custody cases, sentencing decisions, & fitness to stand trail
• Cultural/Context
  
  • Is it abnormal in Western norms, but normal in their culture?
  • Is it still normal if a whole culture participates in a pathological behavior?
    
    • Would extensive rituals in a certain religion mean they all have OCD?
    • Anorexia is seen everywhere but bulimia is more tied to Western norms/ introduction of media
    • If you talk to God you’re religious, if God talks to you you’re schizophrenic
• Reliability
  
  • Diagnostic Overexpansion, diagnoses cover too much of normal life and labels that as a mental illness
  • Why 2 weeks for symptoms and not 3? Controversial cutoffs
• Power- who decides?
  
  • Mostly white, male, middle class psychiatrists
  • Creates bias
  • High prices for DSM might influence decisions made in creating it

Question 16

The emergence of treatment (rather than containment)

Answer 16

• Hippocrates- 4 humors
  
  • Ahead of his time in the sense that he attributed mental illnesses to natural causes
• Posessed by evil spirits/witchcraft
• Institutionalized in asylums, most treated patients horribly until the emergence of some with better conditions
• Criminalization of patients in prisons because there weren’t enough hospitals
• Emergence of moral treatment through a belief of dignity and equality for all men

Question 17

William Tuke

Answer 17

• Lived in England
• Opened the York Retreat, a residential treatment for the mentally ill to be treated with kindness, dignity, and decency
  
  • Became an example of humane treatment and soon similar institutions opened throughout Europe & the US

Question 18

Philippe Pinel

Answer 18

• Liberator in France
• Worked to get mentally ill out of Paris dungeons
• Created new instituions where staff included in treatment of each patient a case history, ongoing treatment notes, and an illness classification
  
  • Showed he genuinely wanted these people to improve and not just be locked away

Question 19

Eli Todd

Answer 19

• Lived in Connecticut, U.S.
• A time where only 3 states had hospitals for the mentally ill, and so the burden fell upon families to care for them with shame & embarassment
• Inspired by Pinel in France
• Opened The Retreat in Connecticut
• Led to similar institutions opening in other U.S. states

Question 20

Dorothea Dix

Answer 20

• Sunday school teacher in a jail in Boston
• Noticed mentally ill patients weren’t there because of crimes
• Travelled to cities, collected data on their treatment of the mentally ill, presented that data to community leaders, and persuaded them to give better treatment to the mentally ill
• Her efforts established more than 30 institutions for the mentally ill throughout the United States

Question 21

Clifford Beers

Answer 21

• Confined in hospitals & had first hand experience of maltreatment
• Founded the National Comittee for Mental Hygiene, now known as Mental Health America in order to reform for treatment of the mentally ill
• Opened the 1st outpatient mental health clinic in the U.S.

Question 22

Mental Disorders

(key features of contemporary definition)

Answer 22

• Syndrome (cluster of symptoms)
• Individual’s cognition (thinking), emotion regulation, or behavior reflects a dysfunction in psychological, biological, or developmental proceses underlying mental functioning
• Associated with a distress/disability in social, occupational, etc. activities

Question 23

What’s NOT a mental disorder?

Answer 23

• An expectable culturally approved response to a stressor or loss
  
  • death of a loved one
• Socially deviant behavior
  
  • could be political, religious, or sexual
  • conflicts between the individual & society
  • does NOT count as mental disorder unless it results from a dysfunction in the individual

Question 24

Lightner Witmer

Answer 24

• Earns PhD under Wilhelm Wundt (founder of experimental psychology) in Germany
• Founded 1st psychological clinic at University of Pennyslyvania
  
  • examined children whose problems arose in school settings & were related to learning/behavior (school psychology)
• Led to about 20 psychological clinics in the U.S., most modeled after Witmers
• Founded the first scholarly journal in psychology called “The Psychological Clinic” & publishes the first definition of clinical psychology in the first article titled “Clinical Psychology”

Question 25

Emil Kraepelin:

the formal introduction of diagnosis

Answer 25

• “Father of Descriptive Psychiatry”
• German psychiatrist who worked with Wundt
• Believed disorders were caused by biological & genetic dysfunctions
  
  • Challenged the psychological/psychoanalytic causes proposed by Freud
• Wrote Clinical Psychiatry: A textbook for Students & Physicians

Question 26

Kraepelinean Diagnostic Theory

Answer 26

• 2 category system
  
  • Exogenous (external, easier to treat)
  • Edogenous (internal)
• Assigned specific terminology
  
  • Psychosis was seperated into either:
    
    • Dementia Praecox (schizophrenia)
    • Manic Depression (bipolar disorder)
• Classified based on syndromes (pattern of symptoms)
• Used the Medical Model of Illness (not psychoanalytical)
• Focused on the course of illness to tease apart similar syndromes

Question 27

Symptom Versus Syndrome

Answer 27

• Symptom- used to diagnose a medical condition
• Syndrome- cluster of symptoms