Chapter I.
Clinical Psychology: Definition and
History
What is Clinical Psychology
 It is a subfield of the larger discipline of psychology. Clinical
psychologists interest in behavioural and mental process,
especially human behaviour and mental process
 They conduct research on behaviour and mental process. Their
main focus is human subjects, however sometimes they use
animal subjects too (ethical concerns-i.e. learned hopelessness)
 Clinical psychology involves in the assessment or measurement
of the abilities and characteristics of human beings
 Another characteristic of clinical psychology is the effort to help
people who are psychologically distressed
 What distinguishes clinical psychologists from other mental
health professionals is a “clinical attitude/approach”
 Clinical attitude is the tendency to combine knowledge from
research on human behaviour and mental process with efforts on
individual assessment in order to understand and help a particular
person
 Clinical psychologist wants to learn general principles that apply
to human behaviour problem in general, but also they also want
to know how general principles shape lives, problems, and
treatments on an individual level
Legal, Educational, and Ethical Requirements to Be a
Clinical Psychologist
 Education
 Experience
 Testing of competence
 Good character
Clinical psychology and the related mental health
professions
 Counseling psychologists and school psychologists
 Social workers
 Psychiatrists
 Psychiatric nurses
 Marriage and family therapists
 Paraprofessionals
 Other specialists and caregivers
Clinical Psychologists at Work
 Assessment: collecting information about people (behaviour,
characteristics, abilities, intellectual functioning). This
information is used in to diagnose the problems, to guide the
client toward optimal vocational choice, to facilitate the
selection of job candidates, to describe the personality
characteristics, to select treatment techniques, to help legal
decision and so on
 Treatment: offering treatments designed to help people better
understand and solve distressing psychological problems. These
interventions may be called psychotherapy, behaviour
modification, psychological counselling. Treatment may be
outpatient basis or inpatient, may be as brief as one session or
may extend over several years. Treatment goal may be finding a
specific solution to a particular problem or reconstruction of
one’s personality. It can be offered free of charge, for a fixed fee.
The results of the treatment may be positive, neutral or even
negative

Research: by training and tradition clinical psychologist are
research oriented and the research activity makes clinicians to
stand out among other professionals. Clinical psychologist
devote time to develop their research skills because:
a.
b.
c.
d.
They can be critically evaluate the published research and
decide which assessments and treatment strategy is more
appropriate for their clients
Research training help them to objectively evaluate the
results of their own practice
Research help to evaluate the effectiveness of mental health
centres’ or service agencies’ effectiveness
Academics should evaluate and supervise research projects
by their students
 Teaching:They generally teach classes like abnormal psychology,
clinical psychology, personality, psychotherapy, research design,
assessment and etc. as well as supervising hours
 Consultation: They advice organisations about variety of problems
(such as education, advice, direct service, or reducing the conflict)
 Administration: Such as a head of a college or university psychology
department, director of a graduate programme, dean of a faculty, etc.
 What clinicians do in their working time varies with their position at
the work place or work setting
Clinical Psychology Training
 The Boulder Model:
 First training conference in 1949
 Scientist-practitioner model
 Proficiency in research and professional practice
 Vail Model:
 Less emphasis on scientific training, more on preparation for
the delivery of clinical services
 PsyD
Brief history…
 The Roots of Clinical Psychology

Clinical psychology did not emerged as a discipline until the
beginning of the 20th century and did not really developed until
the end of the 2nd WW

Three sets of social and historical factors shaped and continue
to influence the field are
1. The use of scientific methods in psychology
2. The study of human individual differences
3. Changes in how behaviour disorders have been viewed and
treated over the years
The Research Tradition:
 The first psychology lab is opened by Wilhelm Wundt at Leipzig in
1879
 Attention to Individual Differences: Plato’s Republic, Pythagoras’s
Brotherhood, in China for government employees at 4000 years
ago, etc.
 Darwin’s master piece Origin of Species offers two ideas:
a. Variation of individual characteristics occurs within and between
species,
b. natural selection takes place in part on the basis of those
characteristics
 Galton applied Darwin’s notions to individual differences,
especially in mental abilities
 Cattell applied psychological method to the study of individual
differences. He opened up a psychology lab in US after William
James and Stanley Hall
 In 1895 Alfred Binet began to develop measures of complex
mental ability in normal and defective children
Changing Conception of Behaviour
Disorder:
1.
2.
3.
Magical forces and supernatural events (possessed by
demons or spirits, treatment methods like exorcism)
In 4th century B.C. Hippocrates suggested these aberrations
stem from natural causes (distribution of bodily fluids:
blood, black bile, yellow bile, and phlegm)
In the Middle Ages, demonological explanation regained
prominence by the influence of the Church and religious
personnel again took over responsibility for dealing with all
cases of deviance
4.
5.
6.
7.
In 16th century hospitals and asylums started to treat deviant
individuals (St Mary of Bethlehem Hospital in London, i.e.
Bedlam)
In 18th and early 19th centuries more humane living
conditions and treatment begun to appear
Organic causes of mental disorders
Ironically, at the same time, psychological causes of mental
disorders. Anton Mesmer animal magnetism
Between the Wars: 1918-1941
 Large numbers of military recruits had to be classified in terms of
intellectual prowess and psychological stability
 To measure mental abilities Army Alpha and Army Beta
intelligence tests and to measure behaviour problems Robert
Woodworth’s Psychoneurotic Inventory were produced
 In these period Jung’s Word Association Test, the Rorschach
Inkblot Test, Goodenough Draw-A-Man Test, TAT, Bender-Gestalt
Test and etc. were also introduced
 Slowly, clinicians added treatment function to their assessment,
training and research roles
The Post War Explosion
 Mass testing of the intelligence, ability, and personality of the
military personnel became important again in WW2
 Arm General Classification Test, Personal Inventory, short
forms of Rorschach and TAT as well as several ability tests
 Psychologies involved far deeper than WW I this time
 So many psychologists hooked in the area of treatment after
the war
 David Shakow’s Committee on Training in Clinical
Psychology recommended that:
1. Clinical psychologist should be trained first as a psychologists
(i.e. as a scientist first and second as a practising professional)
2. Clinical training should be as rigorous as that given to nonclinicians and thus should consist of a four year doctorate,
including a year supervised clinical internship experience
3. Clinical training should focus on Holly Trinity (assessment,
research, and treatment)
Clinical Psychology in the 21st Century
 The Challenges of Health Care Reform: for many years
clinical psychology operated on a fee-for-service basis.
 The last 15 years there is a dramatic change to managed care
service for insurance companies
 Fundamental changes because of the economic reasons
occurred and we expect further changes, such as:
1.
2.
3.
4.
5.
6.
7.
More clinicians join group practices to cut the costs
An increase in the use of brief therapies that focuses on problem
solving skills and rapid symptom reduction
An emphasis on prevention, so that fewer clients in extended and
expensive psychotherapy
A demand to use only empirically effective methods
A larger role for clinicians at BA or MA level (cheaper than
PhDs)
More involvement with people with serious or chronic diseases
Pressure to obtain privilege to prescribe cost-effective
psychoactive drugs
Integrated Theories and Interdisciplinary Work
 Clinicians are becoming increasingly aware that mental
disorders can often best be understood and treated by focusing
on a combination of biological, sociocultural, and psychological
factors
 Diathesis-stress theories
 Fewer psychologists maintain strict adherence to traditional
theoretical approaches and many of them started to refer
themselves as eclectic
 Boundaries between psychological and other conceptions of
human behaviour are fading. Physical and psychological
disturbances co-occur in a great many illnesses, and changes in
psychological functioning can often have dramatic effects in
physical functioning (and vice versa)
 Increasing levels of employment in medical setting
The Challenge of Cultural Diversity
 Diversity refers to variations in ethnic and racial background,
sexual and religious orientations, or other dimensions that create
psychological experiences that are significantly different from
experiences of persons in other cultures or groups
 Clinical psychologists need to be more aware of how diversity
affects clinical practice
 Psychological disorders sometimes manifest themselves very
differently across cultural groups
 Culturally bounded syndromes
 Clinicians who are not aware of the specific symptoms and cultural
context can make inaccurate diagnosis and assessments