TheNewandProgressingProfessionofClinicalPsychology

MeganJackson

English3Honors
Mrs.Kopp
February25,2015

MeganJackson
Mrs.Kopp
English3Honors
25February2015
TheNewandProgressingProfessionofClinicalPsychology
Thewordpsychologytranslatestomeanthescienceofthesoul.Sincethetimeof
Aristotle,psychologyhasdevelopedintobothascienceandaprofession.Theprofessionof
ClinicalPsychologyprimarilyappliesunderstandingindividualsandtheirbehavioralpatternsto
assistinsolvingmentaldysfunction.Thosewhotakeaninterestinworkinginthisfieldmust
displaycompassion,patience,sensitivityandleadershipskills.ClinicalPsychologistsreceive
significantpersonalgratificationfromutilizingskillstoconductresearch,assessments,observe
behavior,andadministertreatmenttoensurethewellbeingoftheirpatients.
OnecanbestdefinetherelativelynewandprogressingscienceofClinicalPsychologyas
abroadfieldofpracticeinvolvingresearchandservicesrelatedtounderstandingandalleviating
psychologicalorbehavioralmaladjustment.ClinicalPsychologistsapplypsychological
principlestotheassessment,prevention,andrehabilitationofpsychologicaldistressand
dysfunction(Martin96).Theytreatmental,emotional,andbehavioraldisordersby
administeringandinterpretingtests,providingcounseling,andconductingbothbasicandapplied
research(Myers13).Whenassessingapatient,aClinicalPsychologistaimstoachievefour
things:anadequatediagnosis,analysisoftheetiologicalbackground,thedeviationthedisorder
hascausedintheindividualsbehavior,andthedegreeofmodifiability(Wallin896).These
professionalsdistinguishthemselvesfromotherpsychologistsbytheiraptnessinareasof

psychopathologyandpersonality.ThemajorityofClinicalPsychologistsworkinprivate
practice,althoughthesecondtomostcommonemploymentlocationisinUniversitysettings.
OtherprevalentprofessionalscenesinClinicalPsychologyincludepsychiatrichospitals,
outpatientclinics,communitymentalhealthcenters,medicalschools,andgeneralhospitals
(Trull814).ClinicalPsychologiststypicallycompleteabachelorsdegreeandseveral
additionalyearsofgraduateeducation,culminatingineitheraMastersorPh.D.Doctorallevel
cliniciansareinhigherdemandthanmasterslevelclinicians,whoreceivelesscommissionand
areperceivedaslesscompetent.ClinicalPsychologistswhoobtainaPh.DorPsy.Dhavethe
greatestchanceofachievingprofessionalindependence.Clinicianscurrentlyinthepracticehave
theopportunitytoshapethescienceasitsmethodsandframeworkcontinuetodevelopand
change.
ThefoundingoftheAmericanPsychologicalAssociationinthelate1800smarkedthe
establishmentofthescienceofPsychology,althoughinterestsinstudyingthemindhaveexisted
since2500B.C.Sincethefirstpsychologicaltheoriesarose,theexaminationofmentalhealth
involvedsupernatural,religious,andmedicalaspects.TheAncientGreekphilosophers
Hippocrates,PlatoandAristotlecreatedtheoriesof:howphysicalhealthaffectsonesmentality,
howdifferentemotionalstatesimpactonesbody,andhowmalfunctionsofthesoulcause
mentaldeviations.DuringtheMiddleAges,ratherthanthebodyorsoul,peoplebelievedthat
supernaturalforcescausedabnormalbehavior.TheRenaissanceerabroughtaboutthe
reemergenceofhumanemedicaltreatmentsofpatients.Centurieslater,in1892,StanleyHall
andlessthanonehundredotherpsychologistsfoundedtheAmericanPsychologicalAssociation
todispelmisconceptionsofthepsyche.Soonafter,LightningWitmerestablishedthefirst

psychologicalclinicattheUniversityofPennsylvaniain1896.Witmertaughtthefirstcourse
focusedspecificallyonClinicalPsychologyandestablishedthefieldsfirstjournal,
The
PsychologicalClinic
(Trull47).ThoughthefounderofClinicalPsychologybeganthe
profession,hedidnotcontributemanynewtheoriesormethods.
Theearly1900sbroughtaboutnewjournals,clinics,andinternshipsastheprofessionof
ClinicalPsychologybegantotakeshape.Twooftheearliestandmostinfluentialclinics
establishedinclude:theJuvenilePsychopathicInstituteofChicagoandtheIowaPsychological
Clinic.Astheprofessioncontinuedtogrow,publicschoolssoughtoutpsychologicaltesting
servicesandmanyuniversitiesrespondedtothiswithcoursesandstudiesonthosewithcognitive
limitations.In1919,theAmericanPsychologicalAssociationcreatedadivisionspecificallyfor
ClinicalPsychology.Bytheendofthe1920s,ClinicalPsychologistsstruggledtogain
recognitionoftheirdifferentinterestsanduniquecapabilitiesfromothersectionsofthe
AmericanPsychologicalAssociation(Trull48).Manyclinicianspublishedtheirresearchand
findingsinthe
JournalofConsultingandClinicalPsychology
afteritsfoundingin1937.The
endofWorldWarIIbroughtaboutmanyopportunitiesforClinicalPsychologiststoputtowork
theuniqueresearchmethodsandtestingtechnologythatdifferentiatedthemfrompsychiatrists.
Forexample,PsychologistswereneededtoscreensoldiersenteringintotheU.S.militaryfor
theiraptnesstocompletemilitarytasks.Attheendofthewar,therewasagreatneedforthe
psychologicaltreatmentofmenandwomenwhosufferedemotionaltraumathroughoutthe
durationoftheirmilitaryservice.In1945,ClinicalPsychologyofficiallybecameitsowndistinct
practice(JerromandSimpson1185).Thehigherdemandforclinicalprofessionalsallowedfor
psychologiststoreceivegreatersalariesfortheirservicesandincreasedthenumberofgraduate

programsinClinicalPsychology(Trull50).Eventhoughtragedysurroundedthewar,Clinical
Psychologistswereabletogivebackintheirownexclusiveways.
By1949,largenumbersofqualifiedstudentsattendedthefortytwoschoolsthatoffered
doctoralprogramsinClinicalPsychology.TheBoulderConferenceof1949explicatedthe
ScientistPractitionerModel
,whichsettheguidelinesfortraininginClinicalPsychology
primarilyusedtoday.Sincethe1960s,thefocusofassessingpatientsshiftedfromanalyzing
theirthoughtstoevaluatingtheirbehaviorpatterns.Cognitivebehavioralmethodsbegantobe
seenasthemostcommonlyacceptedandeffectivetreatmentaswellasoneofthemostcommon
practices(Trull52).SomemembersoftheAmericanPsychologicalAssociationfeltthat
occupationalissueswouldreplacescientificinterestsandthattheacademicscientificneedsof
manywerenolongerfulfilled.In1988,contentionscametoaclimaxwhentwentytwo
dissatisfiedAmericanPsychologyAssociationpresidentsformedaneworganization,the
AmericanPsychologicalSociety.ThegoalsoftheAmericanPsychologicalSocietyinclude:
advancingofthedisciplineofpsychology,preservingthescientificbaseofthescience,
enhancingthequalityofeducation,andpromotingandencouragingpsychologicalscienceandits
applications.TheAmericanPsychologicalAssociationannouncedin1995thattheywould
pursueprescriptionprivilegesforproperlytrainedpsychologistsintheU.S.NewMexicowas
thefirststatetoenactalawallowingpsychologiststoprescribemedicationsfortheirdiagnostics
ofmentalhealthconditions(Trull53).Atthebeginningofthenewcentury,theAmerican
PsychologicalAssociationpublishedanewcopyofthe
EthicalPrinciplesofPsychologistsand
CodeofConduct
.Thisnewmodelwasnecessaryduetotheextentofchangesinresearch,
treatmentsandviewpointsinClinicalPsychology.

Clinicalresearchinthelateeighteenthcenturylaunchedwiththetwopsychological
laboratoriesfoundedbyWilhelmWundtinLeizpig,Germanyin1879andWilliamJamesin
1890.Jamesalsopublished
PrinciplesofPsychology
,thefirsttextonClinicalPsychology.
SeveraldecadesfollowingJamesaccomplishments,WWIandWWIIbroughtaboutinfluential
researchregardingtestdevelopment.Duringthistime,personalitytestingresearch,suchasthe
WechslerBellevueandStanfordBinettests,wereintroduced.Thenextfewdecadesfollowing
thewarsmarkedtheunlikelydecreaseintheinterestofdiagnosisandassessmentinClinical
Psychology.Muchoftheresearchpublishedduringthistimerevolvedaroundthereliabilityand
validityofprojectivetestssuchastheRorschachInkblotTestandtheThematicApperception
Test.Theappearanceofstudiesontheprocessandefficiencyofthecontroversialtreatmentof
psychotherapyalsoinfluencedresearchmethodsduringthistimeperiod(Trull44).Thisera
producedthepublicationofJulianRotters
SocialLearningandClinicalPsychology
in1954.
ThereportpresentedasociallearningtheoryandseveralcontrolledstudiesthatRotterperformed
inordertosetafoundationforthisnewproposal.Duringthistime,thenumberofbehavioral
interventionsandtherapiesincreaseddrastically.Despitethestudieswhichconcluded
psychotherapyineffective,MarySmithandGeneGlasspublishedasurveyin1977supporting
thesufficiencyofpsychotherapy.Thissetthebasisforconsiderablestudiesthathaveenhanced
theunderstandingoftheeffectstherapeuticmethodshaveonpatients.Researchondiagnosis,
classification,psychologicaltesting,andmeasurementdevelopedtremendouslyfromthe
publicationofthethirdeditionofthe
DiagnosticandStatisticalManualofMentalDisorders
in
1980.Thestudiesaimedtotestthereliability,validity,andutilityofthecriterialistedfor
classifiedmentaldisorders(Trull56).Thoughthetypesofresearchvariedastheprofession

progressed,thegoalremainedthesame:toapplyknowledgeandskillstothementalhealthneeds
ofindividualsuniversally.
AllClinicalPsychologistsmustpossessaknowledgeandmasteryofvariousresearch
methodstoevaluatetheefficiencyofdifferentapproachestoassessmentandintervention.
Researchalsoallowsfortheextensionandmodificationoftreatmentsandtheoriesaswellasthe
establishmentoftheirutility.Psychologistsconductbasicandpervasiveresearchregarding
observationalmethodsincluding:UnsystematicObservation,NaturalisticObservation,
ControlledObservation,andCaseStudies(Trull85).UnsystematicObservationassistsin
developingtestablehypotheses,althoughitdoesnothelptodevelopastrongbaseofknowledge
onconditions.NaturalisticObservationappliesmoresystematicandrigoroustechniquesto
bringanalystsconclusionsvoidoftheartificialityandmanipulatednatureofmostexperimental
settings.Psychologiststypicallycannotgeneralizetheseobservationstootherpeopleor
situationsduetotheirrelativityanduncertainty.ManyviewUnsystematicandNaturalistic
observationaslesssensiblemethodsduetothelackofcontroloverthefreeflowing,
uninfluencedevents.ControlledObservationenablesresearcherstogaininsightintothenature
ofindividualsreactionswhileexertingsomegradeofcontrolovertheeventscarriedoutduring
anexperiment.CaseStudiesinvolvetheextensivestudyofaparticularindividualundergoing
treatment.Thesestudiesprovideanoutletforexaminationsofabnormalbehaviorandhave
provenespeciallyusefulfordescribingrarephenomenaanddistinctivemethodsofassessingor
treatingpatients(Trull8687).ClinicalPsychologyalsoincorporatesepidemiologicalresearch,
whichstudiestheincidence,prevalence,anddistributionofillnessesordiseasesinapopulation.
Studyingthedistributionofcasesinapopulationuncoversthedistinguishingcharacteristicsof

thoseaffectedbyaparticulardisease,itscauses,andthewaysinwhichitspreadswithina
community(Trull89).Variedmethodsofresearchremainavitalpartofthescienceand
professionofClinicalPsychology.
Alongwithresearch,assessmenthasprovennecessaryinthefieldofClinical
Psychology.Assessmenthelpspsychologistsbetterunderstandanindividualsintelligence,
behavioralpatterns,andtheirpersonality.Thismethodinvolvesevaluatingonesstrengthsand
weaknesses,conceptualizingtheproblem,andprovidingamethodofalleviatingthespecified
issue(Trull142).Aclinicianmustfirstassessthenatureofthedeviationorillnesstheirclient
possesses.Onemustfirstattainanunderstandingoftheproblembeforedecidingonan
appropriatetreatmentoptiontoseekout.Theprocessofassessmentbeginswhensomeoneposes
animportantquestionregardingthepatient.Insomecases,thequestionposedmaynothavean
answerunlessthecliniciandiscoversmoreinformationaboutthepatient.Thekindof
informationsoughtoutbycliniciansdependsheavilyontheirtheoreticalfocuses.Next,the
psychologistconductscarefullyplanned,skillfullyexecuted,andgoalorientedinterviewsto
interactwiththepatient.Professionalscanexecuteinterviewsinanysetting,thougha
soundproofedofficewithminimaldistractionswillyieldthebestresults(Trull143).Inorderto
conductaproductiveinterview,theclientandtheclinicianmustformagoodrelationshipwith
eachother.Uponestablishingacomfortablerelationship,andoncetheclienthasknowledgeof
thecliniciansultimatewishtohelpthem,theinterviewermaybeginprobing,confrontation,and
expressingassertivenesswiththeirclient(Trull144149).Assessmentultimatelyservesthe
purposeofdescribingaclientinawaythatwillleadtoaneffectivesolutionortreatmentofthe
problem.

ClinicalPsychologistsusethetoolofassessmenttomeasureandgaugeintelligence.In
psychology,anexactdefinitionofintelligencedoesnotexistbecauseintelligenceisaverybroad
ideaandasubjectiveconcept.Intelligencemostcloselyreferstotheclassofcognitivebehaviors
thatreflectonesproblemsolvingcapacity,abilitytoadaptinnewsituations,andabstract
thinkingability.Whenassessingintelligence,onecapturesanindividualsability,aptitude,and
achievement.Onescurrentpowertoperformsomethingdepictstheirability,andaptitude
exemplifiesonespotentialtoperformtasksinthefuture.Successfulperformanceinthepast
measuresonesachievements(Trull178194).Testsadministeredtosurveyanindividuals
intelligenceincludetheStanfordBinetandtheWechslerScales:theWAIS,WISCandWPPSI.
Psychologistsuseassessmenttonotonlymeasureonesintelligence,butalsoonespersonality
andbehavior.
ClinicalPsychologistsuseprojectiveandobjectivepersonalityassessmentsselectively
duetotheunjustifiedbeliefthatpersonalitytestsdonotapplyasmuchtomodernPsychologyas
theyoncedid.Individualsrevealaspectsoftheirpersonalitythroughtheirchoicesandevery
singleoneoftheiractions(Rapaport290).Objectivepersonalityassessmentsinvolveselfreport
inventoriesoradministrationofastandardsetofquestionsorstatementstowhichthe
intervieweerespondsusingafixedsetofoptions.Thoughtheseinventoriescanbescoredeasily,
theresultsdonotalwaysprovidevalidinformation.Reflectionofseveralcombinationsofitems
regardingbehaviors,cognitions,andneedsinasinglescoremayprovideinaccurate
measurementsofpersonalitytraits.TheMichiganMultiphasicPersonalityInventoryhas
remainedthemostcommonlyusedobjectivepersonalityassessmentusedformorethansixty
years.TheNEOPersonalityInventorymeasuresselfreportedpersonalityfeaturesthatmakeup

theFiveFactorModel:neuroticism,extraversion,opennesstoexperience,agreeableness,and
conscientiousness(Trull202214).Projectivepersonalityassessmentsdiscoverapersons
characteristicmodesofbehaviorbyobservingtheirbehaviorinresponsetoasituationthatdoes
notelicitacertainreaction(Trull218).SuchevaluationsincludetheRorschachInkblotTestand
theThematicApperceptionTest.Inadditiontoassessingintelligenceandpersonality,Clinical
Psychologistsoftenjudgebehavioralcharacteristicsinordertobetterunderstandthecomplexity
ofanindividual.
Behavioralassessmentdiffersfromotherformsofassessmentinthattheprocessoccurs
before,during,andaftertreatment.Diagnosticformulationsofthepatientprovidedescriptions
ofdeviantbehaviors.Next,aclinicianevaluatesthepatientsenvironment,skills,beliefs,
expectations,andthelike.Afterwards,theclientandtheclinicianworkcollaborativelytoset
goalsandindicatethecriteriatodemonstrateimprovementthroughoutthetreatment.Assessing
thetreatmentprogressservesasongoingfeedbackandachannelforbuildingthepatients
selfefficacyastheymakeprogress.Afterthecompletionoftreatmentthecliniciancompares
thedataregardingthepatientsposttreatmentfunctioningabilitiestothepretreatment
assessment.Thisfinalassessmentwillprovideinsightofthelikelihoodforsymptomstorecur.
Asaforementioned,methodsofobservationincludeNaturalisticObservation,Controlled
Observation,andSelfMonitoring.Suchobservationmethodsprovideclinicianswitha
legitimatesampleoftheproblematicbehaviorcorruptingtheindividual.Inrecentyears,
Psychologistshaveincorporatedselfreportinventoriessothatpatientscanmonitortheirown
thoughts,behaviors,andemotions.Psychologistshavecometoacceptthe
Diagnosticand
StatisticalManualofMentalDisorders
asaclassificationsystemforbehavioraldisorders(Trull

238260).Infutureyears,Psychologistswilllikelytakeadvantageoftechnologicaladvancesof
thedigitalagetomakebehavioralassessmentmoreprecise,validandefficient.
Theneedformentalhealthprofessionalshasincreaseddramaticallyinrecenthistoryand
willcontinuetoexpandinthenearfuture.NumbersofClinicalPsychologistsandother
closelyrelatedmentalhealthprofessionalshaveincreasedbythethousandseachyearinthelast
fewdecadesinresponsetoescalatingdemands(Baker,McFallandShoham68).Universities
nowoffermoreClinicalPsychologyprogramsandwillcontinuetoproduceanincreasedamount
ofPsychologistsholdingadvanceddegrees.Inadditiontothedemandformoreprofessionals,
thesignificantevidenceofpersonalgratificationwithinClinicalPsychologycontributestothis
recentsurgeofinterest.LicensedClinicalPsychologist,SaraGoguen,hasfoundinher
experience,itismostrewardingtoprovidehope,insight,encouragement,information,andany
resourcesnecessarytohelppeopleofallagesandinallstagesoftheirlifetoovercometheir
obstacles(Goguen).Asurveyconductedin2010reportedthat73%oftheSocietyofClinical
PsychologymemberswouldstillchooseClinicalPsychologyastheircareerifgiventhechoice
again(Weiner14).Thestatisticpresentedinthissurveycorroboratestheheightenednumbersof
ClinicalPsychologistscurrentlypracticing.ThefutureadvancementofClinicalPsychology
dependsheavilyoncosteffectivenessvs.benefit.Ascostsofreceivingmentalhealthcare
continuetosteadilyincrease,individualsseekingtreatmentwilllookforthecheapest,most
effectivesolutions(Baker,McFall,andShoham68).Thistrendappearedwithinthelasttwenty
yearsinthemedicalfield.TheInstituteofMedicinestressesthatthementalhealthfieldmust
makesimilarqualityimprovementdecisionstobenefitthefutureofPsychology.Inadditionto
cost,technologicaladvancementsinrecenthistorywillcontinuetoaffecttreatments.Sara

Goguenpredicts,
virtualcounselingviaSkype,Facetime,etc.,willbecomemoreandmore
widelyofferedandusedinthenextfivetotenyears(Goguen).
Trendsintherecenthistoryof
ClinicalPsychologyprovideinsightintowhatonecanexpectforthefutureofthisprofession.
ThefirstideasofthescienceofPsychologyoriginatedthousandsofyearsagowiththe
theoriesoftheancientphilosophers,Aristotle,PlatoandHippocrates.Throughouthistory,
Psychologyexpandedandgraduallybecameaglorifiedscienceandprofession.Clinical
Psychologistsapplyunderstandingthecharacteristicsofanindividualandtheirbehavioral
patternstosolvingmentaldeviationsanddysfunction.Thosewhowishtosucceedinthis
professionmustpossesssensitivity,compassion,patience,andsignificantleadershipskills.
Research,theories,andmethodsofassessmenthaveundergonesignificantprogressionsincethe
foundingofClinicalPsychology,andwillcontinuetodosothroughrecenttechnological
advances.Ultimately,ClinicalPsychologistspreservethehealthofmembersinsocietywith
illnessesinvisibletotheuntrainedeye.

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