Chapter 2

Chapter 2: Clinical Psychology's Past, Present, and Future

Overview

• Clinical psychology gained recognition as a discipline in the early 20th century.

• Significant growth began after World War II in 1945.

• The field has evolved substantially in both science and practice since its inception.

The Roots of Clinical Psychology

Empirical Tradition

• Wilhelm Wundt: Established the first psychology laboratory in 1879, crucial in starting psychology as a science.

• Influencers include:

  • Johannes Mueller

  • Herman Helmholtz

  • Ernst Weber

  • Gustav Fechner

  • Lightner Witmer

Psychometric Tradition

• Foundations in psychometric assessments laid by:

  • Plato: Theoretical ideas on human psychology.

  • Franz Gall: Phrenology, the belief that skull shape correlates with mental faculties.

  • Charles Darwin: Evolutionary perspectives on behavior.

  • Sir Francis Galton: Linked psychology with the study of intelligence.

  • James McKeen Cattell: Introduced psychological testing.

  • Alfred Binet & Théodore Simon: Developed the first practical IQ test.

  • Lewis Terman: Expanded on Binet's work with the Stanford-Binet test.

Clinical Tradition

• Historical figures and movements:

  • Hippocrates: Early medical insights on mental health.

  • Philippe Pinel: Advocated for humane treatment of mental illness.

  • Benjamin Rush: Pioneering American psychiatrist.

  • Emil Kraepelin: Known for his classification of mental disorders.

  • William James: Brought psychological understanding into functional realms.

  • Sigmund Freud: Introduced psychoanalytic theory, explaining unconscious influences on behavior.

Clinical Psychology Begins to Grow

Historical Tests & Assessments

• Intelligence Testing for WWI: Developed Army Alpha and Army Beta tests under Robert Yerkes.

• Psychometric tools:

  • Carl Jung: Word Association Test.

  • Rorschach Inkblot Test: Measures underlying thought processes.

  • Thematic Apperception Test (TAT): Assesses imagination and storytelling ability.

  • Wechsler-Bellevue Intelligence Scale: Individual performance evaluation.

Demand for Psychotherapy

• Post-WWII, psychotherapy needs surged for veterans.

• Community Mental Health Clinics emerged, meeting the growing demand for mental health services.

Professional Organizations

• Key organizations formed to support clinical psychology:

  • American Psychological Association (APA): Founded in 1892.

  • American Association of Clinical Psychologists (AACP): Established in 1917.

  • Association of Consulting Psychologists (ACP): Formed in the 1930s.

  • American Board of Examiners in Professional Psychology (ABPP): Promoted professional standards.

Clinical Psychology Branches Out

Psychodynamic Approach

• Conflicts between internal and external sources create psychological issues.

• Foundations laid by:

  • Freudian Psychoanalysis: Focus on unconscious motivations.

  • Psychodynamic Theory: Emphasizes the influence of childhood experiences.

Humanistic Approach

• Personality development influenced by how individuals perceive their experiences.

• Key figure: Carl Rogers, emphasized self-actualization.

Behavioral Approach

• Emphasizes learning and environmental factors in shaping behavior.

• Notable contributors:

  • John Watson: Pioneer of behaviorism.

  • Rosalie Rayner: Behavioral conditioning experiments.

  • B.F. Skinner: Operant conditioning and reinforcement principles.

Cognitive Approach

• Focus on clients' thoughts and cognitive processes.

• Key theorists:

  • John Rotter and George Kelly: Concepts of social learning and personal constructs.

  • Albert Ellis: Rational-Emotive Behavior Therapy (REBT).

  • Aaron Beck: Cognitive Behavioral Therapy (CBT), addressing distorted thinking.

Social Systems Approach

• Recognizes that psychological problems are influenced by social and cultural contexts.

Biological Approach

• Explores how biological factors (hormones, genes, brain activity) influence behavior.

• Diathesis-stress model: Proposes that predisposition (diathesis) plus stressors may trigger mental disorders.

Looking Ahead

Mechanisms of Change

• Traditional disorder-specific treatments are often ineffective.

• Transdiagnostic approaches: Focus on common mechanisms that may help treat various disorders.

Structural Influences on Mental Health

• Collaborative efforts with other disciplines to understand broader factors affecting mental health.

Burden of Mental Illness & Practice Gap

• Nearly half of individuals needing mental health treatment do not receive care.

• A disparity exists between research findings and clinical practice.

Changing Landscape of Mental Health Treatment

• 1960s Advent of deinstitutionalization led to more individuals with mental illness ending up homeless or in prison.

• Clinical psychologists are now in the minority within mental health services, with sub-doctoral counselors and therapists taking up more roles.

New Approaches to Diagnosing Mental Disorders

Emerging Concerns

• Growing dissatisfaction with DSM and ICD's symptom-based diagnosis approach.

• Advocates for Research Domain Criteria (RDoC), conceptualizing disorders as brain diseases rooted in neural circuit failures.

• Proposes Hierarchical Taxonomy of Psychopathology (HiTOP): conceptualizes mental disorders as extremes of personality traits.