Clinical Psychology: Alternatives to Current Models

Overview of Clinical Psychology
  • Recap on diagnostic processes in mental health
  • Discuss socio-political aspects affecting mental health
  • Explore the role of clinical psychology and its potential solutions
The Medical Model of Mental Health
  • Concept: Views mental illness similarly to physical illnesses like cancer or diabetes.
    • Language: Utilizes medical terminology: symptoms, disorders, illness, treatment.
    • Practice: Involves diagnosis, hospitalization, and medication.
    • Research Focus: Investigates genetic and biological causes.
    • Underlying Assumption: Mental illnesses stem from physical factors (e.g., neurotransmitter levels, brain structure, infections).
Diagnosis in Mental Health
  • Diagnostic Manuals:
    • DSM (Diagnostic and Statistical Manual of Mental Disorders):
    • Currently in its fifth edition, listing over 400 mental health disorders.
    • Generated significant revenue (estimated $100 million from DSM-IV).
    • ICD (International Classification of Diseases):
    • Currently in version 11, encompasses all medical diseases, with mental health as one chapter.
    • Some diagnostic criteria vary from DSM.
Problems with DSM and ICD (Kotov et al., 2017)
  • Issues include:
    • Arbitrary boundaries between psychopathology and normality.
    • Unclear distinctions between disorders.
    • High rates of disorder co-occurrence.
    • Heterogeneity within diagnosed disorders.
    • Diagnostic instability.
Consequences of Medicalization
  • Neglects the context of individuals’ experiences.
  • Quote: "Don’t ask what is wrong with me. Ask what has happened to me." – Jacqui Dillon
Critiques of Medicalization
  • UN Human Rights Council (2017): Critiques include:
    • Biomedical model's concepts often unsupported by further research.
    • Misleading notion that medications are the primary solution to mental health issues.
    • Encourages viewing mental health issues as societal crises rather than individual conditions.
Socio-Economic Factors in Mental Health
  • Prevalence of mental illness higher in unequal wealthy countries.
  • Higher risk in low-income populations due to factors like:
    • Entrapment and powerlessness.
    • Exposure to unpredictable events.
    • Reduced cognitive capacity.
    • Coping through substance misuse.
    • Increasing physical health issues.
Gender and Mental Health
  • Gender-Based Statistics:
    • Women predisposed to diagnoses like anxiety, depression, PTSD.
    • Men exhibit higher suicide completion rates but women report higher suicide attempts.
    • Gender-based violence significantly impacts mental and physical health of women.
LGBTQ+ Mental Health
  • LGBTQ+ individuals experience:
    • Higher rates of suicidal ideation (2x higher than cisgender counterparts).
    • Increased rates of suicide attempts compared to heterosexual peers (5-32% vs. 2%).
Childhood Adversity
  • Factors Impacting Mental Health:
    • Bullying (11-32% of children, disproportionately affecting marginalized groups).
    • Neglect (1 in 7 UK children).
    • Rates of sexual abuse (11-46% for girls, 3-10% for boys).
Importance of Addressing Childhood Adversity
  • Eradication of childhood adversities could reduce:
    • 22.9% mood disorders.
    • 31.0% anxiety disorders.
    • 41.6% behavioral disorders.
Intersectionality in Mental Health
  • Recognition required for overlapping identities and their impacts on mental health outcomes.
Clinical Psychologist Role
  • Need for clinical psychologists to address traumas and ask pertinent questions.
Historical Context
  • Homosexuality classified as a mental illness until 1973, with ongoing issues like conversion therapy affecting LGBTQ+ individuals.
Whiteness in Clinical Psychology
  • Dominated by white, middle-class practitioners, creating systemic barriers for BAME applicants in training and practice.
Targets for Change
  • Proposal for an integrative approach focusing on individual problems rather than therapy modalities.
    • Need to shift from "fitting clients to therapist training" to "training therapists to fit clients".
Model Updates
  • Advocacy for new diagnostic protocols and frameworks to meet the needs of diverse populations:
    • HITOP (Hierarchical Taxonomy Of Psychopathology): A comprehensive model of psychopathologies addressing all types of disorders.
    • RDoC (Research Domain Criteria): Aiming to understand mental disorders based on behavioral constructs rather than categorical diagnoses.
    • Power Threat Meaning Framework: Analyzing the interplay between power dynamics and mental health.