Table Of ContentIntroduction to Clinical
Psychology
Science, Practice, and Ethics
Jeffrey E. Hecker
University of Maine
Geoffrey L. Thorpe
University of Maine
J.E.H.: To Lee and Olivia
G.L.T.: To Beth and Tim
First published 2005 by Pearson Education, Inc.
Published 2016 by Routledge
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ISBN : 9780205277742 (hbk)
Library of Congress Cataloging-in-Publication Data
Hecker, Jeffrey E., 1959–
Introduction to clinical psychology : science, practice, and ethics / Jeffrey E. Hecker,
Geoffrey L. Thorpe
p. cm.
Includes bibliographical references and index.
ISBN 0-205-27774-8
1. Clinical psychology. I. Thorpe, Geoffrey L. II. Title.
RC467.H388 2004
616.89–dc22
2003063232
Please visit the companion website at www.routledge.com/9780205277742
C O N T E N T S
Preface xiii
P A R T O N E Introduction and Foundations 1
1
Definition and Training 3
Definition 3
Characteristics of Clinical Psychology 4
Emphasis on Science 4
Emphasis on Maladjustment 5
Emphasis on the Individual 5
Emphasis on Helping 6
Activities and Work Settings of Clinical Psychologists 6
Research 6
Teaching 7
Psychotherapy 10
Assessment 11
Consultation 12
Administration 13
Distinguishing Clinical Psychology from Related Professions 16
Psychiatry 17
Counseling Psychology 19
School Psychology 19
Social Work 20
Other Related Professions 20
Training in Clinical Psychology 21
Undergraduate Preparation 25
Graduate Training 27
Post-Doctoral Training 29
Continuing Professional Education in Psychology 31
Ethics and the Development of a Clinical Psychologist 34
iii
iv CONTENTS
2
History and Recent Developments 37
Ancient Roots 37
Eighteenth and Nineteenth Centuries: Laying the Groundwork for Clinical
Psychology 39
Understanding of Mental Disorders 40
Measurement of Individual Differences 42
Emergence of Scientific Psychiatry 43
Hysteria and the Ascendance of Psychological Determinism 44
The Birth of a Discipline: 1890–1910 45
Childhood: World War I through World War II 48
Assessment 49
Theory 51
Professional Developments 53
Adolescence: Post WWII and the Development of an Identity 55
Adulthood: Milestones and Growing Pains 58
Training 58
Psychotherapy 59
Psychological Testing 62
Professional Practice 64
Specialization 67
Growth 68
Concluding Remarks 71
3
Psychological Models in Clinical Psychology 73
The Role of Theoretical Models 73
How Models Help 73
Dangers of Models 73
Psychoanalysis 74
Development 75
Key Assumptions 77
Influences on Clinical Psychology 82
Current Status 83
Interpersonal Models 84
Development 84
Key Assumptions 86
Influences on Clinical Psychology 87
Current Status 87
CONTENTS v
Humanism 87
Development 87
Key Assumptions 90
Influences on Clinical Psychology 92
Current Status 93
The Behavioral Model 94
Development 95
Key Assumptions 97
Influences on Clinical Psychology 99
Current Status 100
The Cognitive Model 101
Development 102
Key Assumptions 102
Influences on Clinical Psychology 103
Current Status 104
4
Biological Models in Clinical Psychology 106
Development 107
Electricity and the Nervous System 107
Phrenology 108
The Case of Phineas Gage 108
Key Assumptions 109
The Brain and the Nervous System 109
Brain Structure and Function 112
Behavioral Genetics 116
Family, Twin, and Adoption Studies 118
Influences on Clinical Psychology 120
Medical Imaging Techniques 120
Current Status 121
Integrating Biological and Psychological Models 121
Biological and Behavioral Processes 122
P A R T T W O Psychological Assessment 125
5
General Issues in Psychological Assessment 127
Stage I: Planning the Assessment 127
Classification 128
vi CONTENTS
Description 133
Prediction 134
Stage II: Data Collection 142
Stage III: Processing Assessment Data 143
Clinical Judgment 145
Computer-Assisted Assessment 149
Stage IV: Communicating Assessment Findings 151
Goals 151
Writing Style 152
Organization of the Report 153
Concluding Comment: Testing versus Assessment 155
6
Clinical Interviewing 159
Types of Clinical Interviews 160
Intake 160
Case History 162
Diagnostic 165
Mental Status Exam 165
Crisis 167
The Importance of Rapport 168
Communication Strategies 169
Verbal Strategies 169
Nonverbal Strategies 170
Listening Skills 171
Diagnostic Interviewing 172
Structured Interviews 176
Research on Diagnostic Interviewing 177
Interviewing with Children 180
Developmental Considerations 183
Interview Techniques 184
Issues of Cultural Diversity in Clinical Interviewing 187
7
Intellectual and Educational Assessment 192
Intelligence 192
Definition 192
Theories of Intelligence 194
Measurement 199
CONTENTS vii
Interpretation of Individually Administered Tests of Intelligence 207
Screening Measures 209
Issues and Controversies 210
Correlates of IQ 211
Heritability of IQ 211
Malleability of IQ 215
Intellience over the Life Span 217
Educational Assessment 218
Tests of Aptitude and Test of Achievement 218
Tests of Aptitude 220
Tests of Achievement 220
Learning Disabilities 221
8
Personality Assessment 226
Projective Methods 227
Rorschach 228
Thematic Apperception Test 235
Projective Drawings 239
Objective Methods 242
MMPI/MMPI-2/MMPI-A 243
The Millon Scales 251
NEO-Personality Inventory 256
The Place of Personality Assessment in Contemporary
Clinical Psychology 258
9
Behavioral Assessment 262
Conceptual Basis 262
Typical Procedures 263
Traditional Approaches to Assessment 264
Syndrome-Based Diagnosis 264
Empirically Based (Dimensional) Classification 266
Traditional Psychodynamic Approaches 267
Defining Features of Behavioral Assessment 267
Development of Behavioral Assessment 268
Current Views 269
viii CONTENTS
Functional Analysis 270
Problem Description 271
Identifying Controlling Variables 272
Adaptive Significance of the Problem Behavior 272
Selection of Treatment 273
Evaluation of Treatment Progress and Outcome 273
Behavioral Assessment Methods 274
Behavioral Interviews 274
Structured Interviews 275
Questionnaires 276
Behavior Rating Scales 276
Analogue Techniques 277
Self-Monitoring 277
Direct Observation 278
Psychophysiological Recording Methods 279
Assessment of Dysfunctional Cognitions 279
Self-Statements 279
Automatic Thoughts and Cognitive Schemas 280
Irrational Beliefs 281
P A R T T H R E E Intervention 285
10
Psychotherapy: Research Issues and Efficacy 287
What Is Psychotherapy? 287
The Psychotherapy Client 288
The Psychotherapist 289
The Psychotherapy Relationship 290
Research Issues 291
Goals of Psychotherapy Research 293
Psychotherapy Research Studies 294
Psychotherapy Research Designs 295
Analogue Research 304
Validity of Psychotherapy Research 305
Does Psychotherapy Work? 309
Eysenck’s Challenge and Meta-Analysis 309
Empirically Supported Treatments 313
Efficacy versus Effective Research 318
Are All Psychotherapies the Same? 319
Concluding Comments 323
CONTENTS ix
11
Psychodynamic Psychotherapy 326
Psychoanalysis 326
Background and Basic Principles 326
The Technique of Freudian Analysis 331
The Course of a Therapeutic Analysis 332
Psychoanalytic Theory since Freud 335
Carl Jung’s Analytical Psychotherapy 336
Alfred Adler’s Individual Psychology 340
The Neo-Freudians 343
The Ego Psychologists 344
The Object Relations Theorists 344
Brief Psychodynamic Theory 346
Interpersonal Psychotherapy 349
The Place of Psychodynamic Psychotherapy in Contemporary
Clinical Psychology 350
12
Humanistic, Experiential, and Family Therapies 356
Humanistic Psychotherapy 356
Existential Psychotherapies 356
Gestalt Therapy 357
Client-Centered Therapy 359
Eclectic Treatment Combinations 363
A Three-Stage Model of Helping 363
Process-Experiential Therapy 364
Family Therapy 367
Systems Perspective 368
Development of Family Therapy 369
Schools of Family Therapy 370
Criticisms 373
Group Therapy 373
Group Analytic Psychotherapy 374
Behavior Therapy in Groups 375
Humanistic Group Therapy 375
Common Features of Group Therapy 376
13
Cognitive-Behavioral Interventions 379
Behavior Therapy Techniques 379
