CLINICAL PSYCHOLOGY

HISTORY:
THE BEGINNING OF CLINICAL PSYCHOLOGY: WITMER AND FREUD
If we resort to the manuals of History of
Psychology, it is usually pointed out that the
beginning of what we know today as clinical
psychology took place in the United States during
the last years of the 19th century. At that time, a
psychologist named Lightner Witmer (disciple of
Wilhelm Wundt) opened the first psychological
clinic to care for people suffering from
psychological problems, at the University of
Pennsylvania.
In Europe, the honor of being considered the
precursor of clinical psychology usually falls to the
illustrious Sigmund Freud. Although many
scholars often question the advisability of
declaring Freud as one of the architects of clinical
psychology (since psychoanalysis raises a long
controversy), the fact is that the Austrian was one
of the first neurologists who came to the study and
the therapeutic intervention of people with
psychological affectations.
Freud, already in 1895, was dealing with defenders and detractors. His vision of
the therapeutic intervention and its theoretical bases focused on three levels:
study, direct therapeutic intervention and formulation of theories. This
methodology founded the basic criteria of applied clinical psychology.
TWENTIETH CENTURY
During the first decades of the twentieth century, the field of clinical psychology
focused on psychological evaluation, but put little emphasis on intervention
methodologies. It is after the Second World War when there is a boom in the
revision of treatments, due to the high number of people who were harmed
psychologically after the war.
As a result of this historical stage, the interest and the need to provide means to
the field of clinical psychology becomes evident. Faculties of psychology arise
and consultations and cabinets dedicated to dealing with mental problems are
opened. From the academic world to public institutions, they agree on the need
to promote study and clinical intervention, due to their positive effects on the
quality of life of people.
CONCEPT:
it is a strategy of approaching psychology that is responsible for the
investigation of all factors, evaluation, diagnosis, treatment and prevention that
affect mental health and adaptive behavior, in conditions that can generate
subjective discomfort and suffering to the human individual.
Psychologists who are dedicated to the clinical field can have training in
different schools, such as cognitivist, behaviorist, psychoanalyst, humanist,
gestalt or systemic family therapy, among others.
REPRESENTATIVES
Despite being mostly psychiatrists by profession, many of the following authors
can be considered as the precursors of the theory and practice of Clinical
Psychology as we know it today.
• Sigmund Freud - Austria, May 6, 1856
• Lightner Witmer - United States, Pennsylvania, June 28, 1867
• Carl Jung - Switzerland, July 26, 1875
• Fritz Perls - Germany, July 8, 1893
• Carl Rogers - United States, Illinois, January 8, 1902
• Viktor Frankl - Austria, March 26, 1905
• Albert Ellis - United States, Pennsylvania, September 27, 1913
• Joseph Wolpe - South Africa, April 20, 1915
• Hans J. Eysenck - Germany, March 4, 1916
• Julian B. Rotter - United States, New York, October 22, 1916
• Aaron T. Beck - United States, Rhode Island, July 18, 1921

CONFUSION BETWEEN CLINICAL PSYCHOLOGY AND PSYCHIATRY

In our article "What is the difference between a psychologist and a
psychiatrist?" We explain the similarities and differences between these two
disciplines. Of course, it is still a source of confusion to know the functions of
these two professional fields.
The main similarity between clinical psychology and psychiatry is that both
pursue the same goals: to treat and mitigate psychological suffering.
• Both professionals differ in their previous training: psychologists studied
psychology and psychiatrists, medicine.
• Another important difference is that psychiatrists are authorized to prescribe
psychopharmaceuticals, while psychologists do not.
• In clinical practice, it is common for psychiatrists and psychologists to work
together to treat patients who require multidisciplinary approaches.
CHARACTERISTICS OF A CLINICAL PSYCHOLOGIST
The clinical psychologist must be a basic scientific researcher, highly trained to
apply their knowledge and to face challenges you can do it efficiently if you
have the following skills profile:
Observation: analysis and detection of behavioral records, clinical files, school
records, individual and group observations.
Diagnosis: application and interpretation of psychological instruments that allow
him to have enough elements to emit a bad diagnosis. it implies the integration
of the received data
Interview: conducting interviews according to individual needs, group, family,
children, adolescents and seniors.
Communication: ability to write reports, programs, essays, reviews, articles.
intervention: selection, design and application of strategies that allow him to
offer guidance and therapies to solve problems in his field of action.
Prevention and development: participation in activities aimed at training,
updating and supervising colleagues and staff in the institutional settings.
Evaluation: select and apply methods, techniques, instruments and procedures
in the process of scientific research
Research: design and carry out applied research projects about the health risks
of the user population of clinical care services. You must be a mental health
professional to be able to diagnose and give an immediate solution to the
patient within your reach. He must be a very good observer so that he can
analyze the patient at the beginning. He must be a good counselor and set
aside the personal problems of his profession. (or involve them since it would
be anti-ethical.

THE FUNCTIONS OF THE CLINICAL PSYCHOLOGIST

Bearing in mind that psychological care is a specialized benefit of the National
Health System, the clinical psychologist has to assume and perform the
following functions:
a) Promotion, prevention, evaluation, diagnosis and treatment:
b) Identify psychosocial risk factors for mental health and general health.
c) Identify mental disorders and other problems that affect mental health.
d) Perform the diagnosis of mental disorders, according to international
classifications, and establish differential diagnoses, using all relevant
psychological assessment and diagnosis procedures.
e) Establish forecasts on the evolution of the problems identified and the related
factors, as well as their possibilities of modification.
f) Prepare an adequate programming and evaluation of the necessary
assistance, prevention and promotion interventions.
g) Develop different forms of intervention and treatment, using available
psychotherapeutic techniques and procedures and sufficiently contrasted.
h) Perform advisory activities, interconsultation and liaison with other
professionals and services.
i) Manage emergency situations.
j) Design and apply the necessary psychological interventions in the care
processes of medical diseases.
k) Identify and intervene in situations of individual, family and community crises.

FUNCTIONS IN TEACHING AND RESEARCH:

a) Participate in, and where appropriate organize, training actions for the teams
and programs: clinical sessions, bibliographic, supervision and continuing
education activities.
b) Supervise and supervise the activities of psychologists in training, and
collaborate in the training of other professionals.
c) Program and develop, at the corresponding level in each case, research
studies within the team and collaborate in those carried out by other teams,
devices and institutions.
For the proper development of these functions, the clinical psychologist must:
a) Know, relate and optimize the health and non-health resources existing in the
environment in which it operates, promoting all those initiatives that tend, with
criteria of effectiveness and efficiency, to improve the level of health.
b) Encourage actions aimed at promoting individual, social and institutional
attitudes of respect, integration, support and care for people with mental
disorders or any other kind.
c) Be willing to contribute their theoretical-technical knowledge in the different
levels of collaboration established with other professionals, as well as to receive
their contributions.
AREAS AND APPLICATIONS OF CLINICAL PSYCHOLOGY
Clinical psychology has been studied and perfected throughout the 20th century
and in recent years, and has been studied by many professionals and
academics of human behavior.
From the first years with Wilhelm Wundt in his laboratory in Leipzig, in which he
tried to find all the observable and measurable variables of behavior, clinical
psychology has been propagated to be the branch "par excellence" among
graduates or graduates in psychology. In fact, although psychology develops in
clearly differentiated branches (business, educational, forensic, social ...),
clinical psychology has always been the most popularly recognized branch.
However, there are multiple approaches and tools used by professionals in
clinical psychology, who work focusing on different fields of study according to
different criteria, such as the following:
• Intervention in families
• Adult therapy
• Children's clinical psychology
• Clinical neuropsychology
• Neuropsychological rehabilitation
• Care and intervention in certain disorders
•Evaluation
• Psycho-oncology
In short, each professional of clinical psychology can specialize in those (or
those) fields where you want to focus your professional practice. People who
may require therapeutic care are varied: from children to the elderly, from
people with basic diseases to healthy people, from people who have a strictly
psychological problem, to others whose involvement is related to a bad family or
social dynamic.
In order to achieve a better understanding of each psychological affectation,
clinical psychologists can specialize in different fields. Through the knowledge
and tools acquired, they will be able to offer more precise diagnoses and
treatments to their patients.
TYPES OF CLINICAL PSYCHOLOGY
As is well known, medicine is constantly evolving. Therefore, it is always
necessary to continue deepening in the matter to be able to conclude that
currently the clinical psychology has diverse fields of study.
Social psychology: This is a branch of psychology that revolves around the
assumption that there are psychological gender developments that establish the
way society works and how social interaction takes place in it. These social
processes are what project the characteristics of human psychology.
Community psychology: It is another branch of psychology that is responsible
for composing the social, cultural, economic, political, environmental and global
influences that promote positive changes in the psychic health of the person
and the system. This psychological branch emphasizes social problems that are
latent and not individual problems. This same takes the work of understanding
and improving the quality of life of the entities and communities through
collaborative action and research.
Clinical neuropsychology: Neuropsychology studies brain-behavior relationships
in order to explain any mental dysfunction:
• Cognitive: Memory problems, lack of attention, calculation problems ...
• Emotional: Depression, aggressiveness, anxiety, apathy ...
• Functional (consequent to brain damage): Readaptation to your family
environment, return to work ...
Psycho-oncology: It is a discipline that shares a close relationship between
medicine and psychology, this takes as a starting point the finding of a cancer in
a person. From this discovery, we begin to analyze the relationships that exist
between the patient and his environment, the treatment, the state of health and
the patient's behavior.
All this follow-up is given with the purpose of establishing, through this type of
psychology, the fact that one must also treat his family and not only the patient,
that the dignity of the patient must be encouraged at all times. that promote the
autonomy of the same and also that it is important to take care of all aspects of
their environment as this greatly influences their recovery.

WHAT DOES A CLINICAL PSYCHOLOGIST DO?

Clinical psychologists are mental health professionals

who take care of those people who feel some type of
psychological discomfort. In this sense, clinical
psychologists are responsible for diagnosing certain
psychological disorders, to later offer a personalized
intervention through psychotherapy.
Although this is the main aspect in which they intervene, psychologists also
participate in the field of research (for example, contributing their knowledge in
different scientific studies), in teaching (practicing as professors in public or
private institutions), and even in other minority areas such as sports
psychology, school psychology or as experts in clinical and forensic psychology.

THE TYPES OF CONDITIONS THAT A CLINICAL PSYCHOLOGIST SERVES

The capacity of attention varies according to the specialization of a clinical
psychologist. Most clinical psychologists are able to deal with emotional
problems such as depression, stress, phobias and panic.
Some psychologists specialize in the care of behavior problems and adaptation
in children, such as infantile aggression, attention deficit, selective mutism and
nocturnal enuresis.
Psychologists who work cooperatively with other specialists also tend to deal
with cases of obsessive-compulsive disorder, anorexia nervosa, major
depressive disorder and non-affective psychoses. Psychologists with greater
specialization can attend mood disorders secondary to epilepsy and multiple
sclerosis, secondary emotional disorders of a medical disease, and design care
programs for dementias such as Alzheimer's.
Psychotherapy is the most widely used intervention of the clinical psychologist.
However, these are not the only treatments that a clinical psychologist gives. It
is also possible to apply treatments based on the registration of journals,
telephone follow-up programs, the filling of workbooks, behavior reinforcement,
feedback systems, among others.
LEVELS OF INTERVENTION:
Psychological intervention, in the clinical field, has traditionally been linked to
individual psychotherapy. Without denying that this is the model of greatest
implantation, there is no doubt that there are other levels, which enjoy a long
tradition and acceptance among clinicians.
A classification of the different levels is:
• Individual
• Group
• community
• Institutional
•family
WHAT IS A PSYCHOTHERAPY?
The definition of psychotherapy is connoted as a model of structured clinical
intervention where the agent that addresses the intervention is psychological.
Like a drug, this treatment is administered to the patient based on symptoms,
diagnoses and scientific data that justify their choice to address a specific
pathology. The difference with the drug is that the treatment administered is not
physical, however, the importance of psychotherapy is not minor; Like all clinical
treatments, it is delicate and requires that it be administered by an expert.

DIFFERENT TYPES OF PSYCHOTHERAPY

As in all branches of medicine, in psychology there is also more than one
hypothesis that suggests a better way to treat a condition. Just as some people
respond in a positive way to one type of drug to another, in the case of
psychological care, the same thing happens depending on the type of
psychotherapy. Some may work better for one patient than for another.
A correct diagnosis and professional ethics are the best guide that a clinical
psychologist has to specify the type of psychotherapy that is the best for each
individual case. Before receiving attention from a psychologist, the psychologist
must explain what the treatment is, what other alternatives exist, and the reason
why the type of therapy proposed will be applied.
Definitely the psychologist has a very important role in the clinical area,
specifically in the field of mental health, this doctor participates in the evaluation
and diagnosis of patients with some mental disorder, to achieve this requires a
meticulous preparation and a good willingness to work as a team with other
doctors to help the patient's health.
Many times society confuses the fact that the branch of psychology only serves
to treat people called as "crazy", "maladjusted" or who treat those who are weak
of will.
By the same token, they do not take the trouble to understand the difference of
each of their types and detect which one is indicated for each symptom or
mental discomfort
CLINICAL PSYCHOLOGY AS A SPECIALTY OF PSYCHOLOGY
Clinical Psychology is a specialty of Psychology whose constitution as
professional activity of the psychologist exceeds the century of antiquity. Its
appearance derives from the stock of accumulated scientific knowledge, its
theoretical-technical nature and the need to respond to a broad set of social
demands in the field of health. Its applications are multiple and in different
fields. These include their contributions and tools for the evaluation, diagnosis,
treatment and prevention of mental disorders, as well as to improve
understanding and addressing the psychological repercussions that physical
illnesses and their treatments have on patients.
Psychology has a reference framework of its own, empirically testable, from
which the human being is considered a living system, highly complex, subject to
constant changes given its necessary interdetermination with the social
environment in which it lives, and product not only of its biological history but
also of its personal history of experiences, learning and interactions, all of which
introduces structural changes as well.
From this perspective, the health and illness of the human being are not
conceptualized as inevitable and pre-fixed situations, but as complex processes
in which psychological, social and biological factors intervene at different causal
levels. The person is thus considered an active agent in both health and
disease processes.
Psychology has revealed the connection between biological, psychological and
social factors. Has investigated the influence of behavior, knowledge processes,
emotions and affects on the functioning of the organism, on the level of
adaptation of individuals to their environment, lifestyles, and health status. This
influence had been more commonly accepted in the sense of considering that
both the behavior and the ways of being and relating of people, emanated
exclusively from their biological organization.
Psychology has shown that it is useful and scientifically feasible to establish a
new way of interpreting human life, based on the recognition of the existence of
a dialectical interaction between biological, psychological and social factors.
From this perspective, health is conceived as the best possible level of balance
and biopsychosocial adjustment of each individual in its context.
WHAT TOOLS DOES THE PSYCHOLOGIST USE AT HIS WORK?
Psychologists work by following the classical scientific method of collecting
information, formulating hypotheses, testing hypotheses, results, evaluation and
monitoring. But to be able to carry out our work, like other professionals, we
need tools and tools that help us in the diagnosis and intervention.
In the first contact with the patient, we are forming an idea of what is the
possible problem / s that it presents. In the successive consultations with the
patient we will continue to gather more information about the patient, but also
about the evaluation process, about the intervention itself and its effectiveness,
about our professional performance, etc. For this we need techniques and tools
that facilitate the collection of information.
PSYCHOLOGICAL TOOLS:
The tools used by psychologists could be divided as follows:
1. Observational techniques: these can be included from the observation itself
in the natural environment of the client, to the use of the video camera for the
recording of behaviors or the use of observational records.
2. Objective techniques: the famous tests, questionnaires, inventories, checklist,
electroencephalograms, polysomnographies, analytics ... Any test that gives us
objective data necessary for the evaluation, diagnosis and / or monitoring of the
patient.
3. Interviews: these allow the collection of information about the patient's data
and, on occasion, their relatives, teachers, partners, partners, etc. They can be
structured, when an established script is followed and we do not get out of
there, semi-structured or free. They can be general or focused on one or
several specific problems, in order to discard or confirm them.
4. Self-report techniques: they must be completed by the patient himself, to
record his own behaviors, physiological changes, thoughts, etc. Very useful in
people's unobservable behaviors.
5. Subjective techniques: allow the classification of people based on certain
attributes or verbal descriptions, in order to give us an orientation to the
clinician.
6. Projective techniques: widely used in the field of psychoanalysis for example,
are techniques with different degrees of destructuring, with the aim of people to
build and complete, to infer from that construction of the person, characteristics
or attributes of it
OTHER TOOLS:
1. Empathy is a weapon that in many cases we must use with great care, since
in some cases it can be beneficial and in others harmful, not only for ourselves,
but also for the patient's own treatment.
2. The established therapeutic relationship with the patient is another
tremendously useful tool, which in itself favors the intervention and the result.
But it must be an appropriate relationship, and with each person and with each
pathology, the characteristics of the relationship must necessarily be different.
3. Interdisciplinarity, as in other professions, is completely necessary. The
psychologist is trained to work on many aspects, but request the collaboration
of other professionals such as the doctor, the psychiatrist, the speech therapist,
the psycho-pedagogue, the social worker ... sometimes it is convenient. And
within psychology itself there are many different specialties, work psychologist,
educational psychologist and clinical psychologist (within this there are many
subspecialties).