Instructor: Sara Barnett, M.S., Ed.M., M.A.
Unit 2: Evolution of Clinical Psychology
S

S What stigma exists regarding those who attend therapy?
S Why is said stigma existent in some communities and not in others?

S What are some differences in the treatment of the mentally ill today versus 100 years ago?

S Announcements
S Discussion of Chapter 1: Evolution of Clinical Psychology
S Mini-Discussion of Chapter 2: Current Controversies
S Questions, Comments, Reflections

S Nice job on the discussion boards!
S Stay committed to the practicum assignments

S Psychology dates back to scientific revolutions in Europe
(16 th – 19 th centuries), and arguably back to the Greek philosophers (5 th century BC) and Confucius (6 th century
BC)
S Clinical psychology did not exist until the late 1800s/early
1900s (when study of psychology was complemented by applied practice)

S For much of history, the mentally ill were:
S
S
Considered to be possessed by evil spirits/devil, stricken with illness due to bad behavior and/or as dangerous as criminals
Shunned by society, discarded by family, locked away and/or dehumanized
S Early pioneers of the modern mental health movement helped to change the above…

S Who were some of the early pioneers of clinical psychology?

S
-
-
England: William Tuke (1732-1822)
Visited asylums and argued that patients should be treated with greater dignity, kindness and decency
Raised funds to establish “retreats”, which then spread throughout Europe and the United States

S
-
-
-
-
France: Philippe Pinel (1745-1826)
Challenged the imprisonment of the mentally ill
Argued that the mentally ill deserved compassion (empathy rather than cruelty)
Created new institutions wherein the mentally ill were given healthy food and allowed activities v. kept in a dungeon, beaten and chained to walls and beds
Required staff to conduct case histories, complete progress notes, and maintain case files

S
-
-
-
America: Eli Todd (1768-1832)
Physician who saw greater need for humane facilities for the mentally ill (only 3 existed in America)
Recognized burden/shame felt by families
Opened “retreats” and encouraged staff to focus on/promote patients strengths versus weaknesses

S
-
-
-
America: Dorothy Dix (1802-1887)
Worked as Sunday school teacher in Boston jail – argued many inmates were mentally ill, not criminal
Traveled through cities, collected data on mentally ill and their treatment, presented findings to community leaders
Ultimately contributed to the opening of 30 mental institution in U.S. wherein patients were deserving of understanding and help

S
-
-
-
-
Germany: Lightner Witmer (1867-1956)
Opened first clinical psychology clinic (1896) at the
University of Pennsylvania and encouraged others to do the same (1914 – 20 clinics; 1935 – 150 clinics)
Aimed to “throw light upon the problems that confront humanity”
Largely focused on children (learning and behavioral struggles)
* Did not keep comprehensive records

S Stage was set by the pioneers… now there was work to be done!
S Early diagnostic terminology included:
Neurosis and Psychosis
Exogenous Disorders and Endogenous Disorders
Emil Kraeplin (1855-1926) identified more specific disorders
(paranoia, depressive psychosis, autistic personality), ultimately leading to the creation of the Diagnostic and
Statistical Manual of Mental Disorders (DSM)

S What is the DSM?
S What are its benefits?

S
S
S
Manual of psychological disorders published by the
American Psychiatric Association

S Major Depressive Episode the symptoms is either (1) depressed mood or (2) loss of interest or pleasure ( condition, or mood-incongruent delusions or hallucinations)
S report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).
Note: In children and adolescents, can be irritable mood.
S
S by others).
Significant weight loss when not dieting or weight gain (e.g., a change of more than
5% of body weight in a month), or decrease or increase in appetite nearly every day.
Note: In children, consider failure to make expected weight gains.

S
S
S
S
S
S
(4) insomnia or hypersomnia nearly every day. psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down). fatigue or loss of energy nearly every day. feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick). diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others). recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

S
S
S
S
The symptoms do not meet criteria for a Mixed Episode.
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The symptoms are not due to the direct physiological effects of a substance or a general medical condition
The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

The Intelligence Testing Movement and Clinical Psychology
S
S
S
Emergence of clinical psychology coincided with rise of study of intelligence (late 1800s/early 1900s)
General intelligence was thought to overlap with physical and mental abilities (link between low IQ and mental health struggles – now known not always the case)
Assessments created for intelligence… then created for mental health testing/personality testing

S What do you know about assessment as it pertains to the field of psychology?
S What are some different types of assessment?
S What are some commonly used assessments?

S Clinical psychologists were largely academicians w/ small practices until the mid 1900s when number of practices grew… Why did this boom occur?

S
-
-
-
The Influence of WWII
Mental tests used to position military and better understand human mind; Ultimately additional tests were created for personality, etc.
US veterans returned home “shell shocked” and in need of mental health care
Influential figures such as Freud forced to flee home countries and ideas on psychology in turn spread throughout Europe and the world

S Early 1900s: Psychodynamic theories proposed
S 1950s: Behaviorism gained popularity
* 1953: APA Ethical Code established
S 1960s: Humanistic approach gained popularity
S 1970s: Family therapy and other specialties developed
* Cognitive psychology meanwhile grew (arguably most popular today)
S 1970s/80s: Insurance coverage, more diversity among professionals
S Today – Clinical psychology stands as an accepted profession and practice

S Prescriptions
S Manualized Therapy
S Insurance Coverage
S Diagnosis
S Cultural Issues

S ???