Exam 2 study Guide

Chapter 2: Historical Foundation of Clinical Psychology

Lightner Witmer: Pioneering Clinical Psychology

• Background:

  • Born and raised in Philadelphia, USA.

  • Educated at the University of Pennsylvania.

  • Studied under Wilhelm Wundt at the University of Leipzig, Germany.

  • Earned his doctorate in 1892, the founding year of APA.

• Contributions:

  • First clinical psychologist.

  • Established the first psychological clinic in 1896, marking the origin of clinical psychology.

  • Offered a 4-week course on applied child psychology in 1897.

  • Founded and edited the first clinical psychology journal, The Psychological Clinic, in 1907.

• Innovations in Clinical Psychology:

  • Focused on child clients.

  • Pioneered a pairing of assessment and diagnosis.

  • Advocated for a multidisciplinary team approach.

  • Introduced early intervention to prevent future issues.

  • Promoted the use of science and experimental methods in treatment.

• Influence Beyond Psychology:

  • Emphasized the importance of early intervention.

  • Frederick Douglass quote: "It is easier to build strong children than to repair broken adults."

Impact of WWI and WWII on Clinical Psychology

• World War I:

  • Expanded the role of clinical psychologists, particularly in assessment.

  • Psychologists treated veterans, focusing on head trauma and brain injuries.

  • Recognized the phenomenon of shell shock (now PTSD), showing the need for psychological intervention.

• World War II:

  • Further expanded roles in treating psychological trauma.

  • Increased demand for psychological assessment and treatment.

Assessment in the Early 20th Century

• Clinical psychologists emerged as key players in the assessment and treatment of psychological conditions post-world wars.

Psychologists at Veteran's Administration (VA) Hospitals

• VA hospitals became crucial for psychologists providing care to returning soldiers.

• Expanded the clinical psychologist's role in assessing and treating PTSD.

Importance of the American Psychological Association (APA) in Clinical Psychology

• APA’s Role:

  • Clinical psychology is the largest subdiscipline within the APA.

  • Established an official clinical psychology interest group in 1909.

• Influence in the 1940s:

  • Key role in officially recognizing clinical psychology as a profession.

• Founding of APA:

  • Founded in 1892, the APA led the development of clinical psychology and other subfields.

Chapter 3: Recent History of Clinical Psychology

Key Conferences of the Post-WWII Era

• Boulder Conference (1949):

  • Influential in clinical psychology development.

• Key Recommendations and Results:

  1. Training of Clinical Psychologists:

     • Should train as scientists first, then as professionals.

     • Emphasize scientific rigor similar to non-clinical psychology.

  2. Doctoral Training Requirements:

     • Emphasis on a four-year doctorate with an additional supervised clinical internship year.

  3. Core Areas for Clinical Psychologists:

     • Focus on Assessment, Research, and Treatment.

     • Curriculum includes general psychology, psychodynamics, assessment techniques, research methods, and therapy.

  4. Clinical Training Model:

     • The Boulder model emphasizes integration of science and practice in training.

• Shakow and Boulder Contribution:

  • Gordon Paul Shakow promoted the Boulder model, balancing scientific training and hands-on experience.

Chapter 5: Major Theoretical Models in Clinical Psychology

Freud's Life and Background

• Time Period:

  • Freud (1856-1939), originally a neurologist, pursued a career in practice after earning an M.D. in Vienna.

• Context:

  • Treatments during Freud’s time were primarily medical, focusing on bedrest, baths, and sedatives for conditions like anxiety.

Psychoanalytic (Psychodynamic) Model

• Core Concepts:

  • Psychic Determinism: No random actions; all determined by unconscious forces.

  • Tripartite Model of Personality:

    1. Id: Unconscious; pleasure principle.

    2. Ego: Rational; reality principle mediating between id and reality.

    3. Superego: Moral conscience; societal values.

• Personal Development:

  • Early childhood experiences significantly shape personality and conflicts later in life.

• Psychoanalytic Techniques:

  • Intellectual and Emotional Insight: Helps clients achieve awareness of their unconscious conflicts.

  • Techniques:

    1. Free Association

    2. Dream Analysis

    3. Transference Analysis

    4. Resistance Analysis

Key Terms Related to Psychoanalysis

• Psychosexual Stages of Development:

  1. Oral Stage: Birth to 1 year - oral activities.

  2. Anal Stage: 1-3 years - control of bladder and bowel.

  3. Phallic Stage: 3-6 years - focus on genitals; Oedipus complex.

  4. Latency Stage: 6-puberty - dormant sexual energy.

  5. Genital Stage: Puberty onward - mature sexual relationships.

Behavioral Model of Therapy

• Main Concepts:

  • Operant Conditioning and Social Learning.

  • Cognitive Approaches (A-B-C Model):

    • A: Antecedent

    • B: Behavior

    • C: Consequence

Contemporary Behavior Therapy Techniques

1. Contingency Management:

   • Understanding antecedents and consequences; uses reinforcement and extinction.

2. Token Economy:

   • Targets behaviors reinforced through tokens exchanged for rewards.

3. Behavioral Contracting:

   • Formal agreement detailing target behaviors, consequences, and monitoring.

4. Counterconditioning:

   • Replacing undesirable behaviors with desirable ones.

5. Participant Modeling & Behavioral Rehearsal:

   • Therapists demonstrate behaviors and clients practice in controlled settings.

6. Thought Stopping:

   • Interrupts negative thoughts using verbal cues.

Negative Automatic Thoughts (NATs)

• Automatic, distorted, negative thoughts contributing to emotional distress (e.g., "I’m not good enough").

Collaborative Empiricism

• Definition:

  • A CBT technique where therapist and client collaboratively challenge distorted thinking against evidence.

• Goal:

  • Adjust inaccurate thoughts leading to healthier patterns.

Treatment of Phobias

1. Hierarchy Construction:

   • Create a ranked list of feared situations.

2. Systematic Desensitization:

   • Gradual exposure to fears using relaxation techniques.

3. In Vivo Exposure:

   • Real-life exposure to feared objects/situations.

4. Subjective Units of Distress (SUDs):

   • A scale for assessing anxiety level in response to stimuli.

Rational Emotive Behavior Therapy (REBT)

• Theorist: Albert Ellis

• Model: Challenging irrational beliefs to facilitate emotional well-being.

• Irrational Beliefs: Unrealistic thoughts causing emotional distress (e.g., “Life should always be fair”).

Treatment of Obsessive-Compulsive Disorder (OCD)

1. Exposure and Response Prevention (ExRp):

   • Exposure to fears while preventing compulsive responses.

Humanistic Therapy: Principles of Rogerian Therapy

• Definition:

  • Emphasizes therapeutic relationships promoting self-actualization.

• Three Key Ingredients:

  1. Unconditional Positive Regard:

     • Acceptance and support without judgment.

  2. Empathy:

     • Deep understanding of client's feelings.

  3. Congruence:

     • Authenticity and genuine connection.

Three Aspects of “Self” in Humanistic Theory

• Real self

• Ideal self

• Self-concept

Comparison Models: Mary’s Case

• Approaches:

  • Compare Contingency Management, Cognitive Behavioral Therapy (CBT), and Humanistic Therapy regarding Mary."