METHODOLOGICAL INSTRUCTION
for the lesson
Theme : Subject, objectives and methods of psychological study of the human
condition. Definition of mental health.
For 4-th year students of medical faculty
1. Actuality Aim
Medical psychology includes the scientific study and application of psychology for
the purpose of understanding, preventing, and relieving psychologically-based
distress or dysfunction and to promote subjective well-being and personal
development. Central to its practice are psychological assessment and psychotherapy,
although clinical psychologists also engage in research, teaching, consultation,
forensic testimony, and program development and administration.
2. Hours: 2
3. Teaching goal
The students must know:
- the subject and objectives of medical psychology;
- the history of world and national medical psychology, current state of
Ukrainian medical psychological service and the outlook for its
development;
- physiological mechanisms of consciousness, materialist understanding of
psychic processes;
- research methods of psychological processes and personality.
and be able to:
- objectively and scientifically determine the place and role of medical
psychology among other clinical disciplines;
- interpret conditions to create healthy psychological climate in the medical
environment;
- analyze psychological peculiarities of patients with various pathologies;
- to determine the way of communication with patients with accentuated
personality;
- know methods of research in medical psychology;
- evaluate the results of experimental-psychological research of particular
psychological processes and patient’s personality.
Assimilate practical skills
- analyze psychological peculiarities of patients with various pathologies;
- communication with patients;
- methods of research in medical psychology;
- experimental-psychological research of particular psychological processes and
patient’s personality.
4. List of disciplines necessary
for learning theme 1
Title of the discipline
Anatomy
General psychology
Neuropsychology
Normal physiology
Content of the discipline necessary for learning medical
psychology
Brain construction
Psychic functions of a normal person. Consciousness and
self-consciousness. Psychology of personality.
Functions of different brain structures.
Brain functions. Physiology of high nervous activity.
5. Content of the theme
Clinical psychology includes the scientific study and application of
psychology for the purpose of understanding, preventing, and relieving
psychologically-based distress or dysfunction and to promote subjective well-being
and personal development. Central to its practice are psychological assessment and
psychotherapy, although clinical psychologists also engage in research, teaching,
consultation, forensic testimony, and program development and administration.
The field is often considered to have begun in 1896 with the opening of the
first psychological clinic at the University of Pennsylvania by Lightner Witmer. In
the first half of the 20th century, clinical psychology was focused on psychological
assessment, with little attention given to treatment. This changed after the 1940s
when World War II resulted in the need for a large increase in the number of trained
clinicians. Since that time, two main educational models have developed—the PhD
(focusing on research) and the PsyD (focusing on practice). Clinical psychologists are
now considered experts in providing psychotherapy, and generally train within four
primary theoretical orientations—Psychodynamic, Humanistic, Cognitive Behavioral,
and Systems or Family therapy. Clinical psychology can be confused with psychiatry,
which generally has similar goals (e.g. the alleviation of mental distress) with a
similar client group, but is unique in that psychiatrists are medical practitioners,
licensed to prescribe medication as the primary treatment modality.
Although modern, scientific psychology is often dated at the 1879 opening of
the first psychological laboratory by Wilhelm Wundt, attempts to create methods for
assessing and treating mental distress existed long before. The earliest recorded
approaches were a combination of religious, magical and medical perspectives. In the
early 1800s, one could have his or her head examined, literally, using phrenology, the
study of personality by the shape of the skull. Other popular treatments included
physiognomy—the study of the shape of the face—and mesmerism, Mesmer's
treatment by the use of magnets. Spiritualism and Phineas Quimby’s "mental
healing" were also popular.
While the scientific community eventually came to reject all of these methods,
academic psychologists also were not concerned with serious forms of mental illness.
That area was already being addressed by the developing fields of psychiatry and
neurology within the asylum movement. It wasn't until the end of the 19th century,
around the time when Sigmund Freud was first developing his "talking cure” in
Vienna, that the first scientifically clinical application of psychology began.
By the second half of the 1800s, the scientific study of psychology was
becoming well established in university laboratories. Although there were a few
scattered voices calling for an applied psychology, the general field looked down
upon this idea and insisted on "pure" science as the only respectable practice. This
changed when Lightner Witmer (1867-1956), a past student of Wundt and head of the
psychology department at the University of Pennsylvania, agreed to treat a young boy
who had trouble with spelling. His successful treatment was soon to lead to Witmer's
opening of the first psychological clinic at Penn in 1896, dedicated to helping
children with learning disabilities. Ten years later in 1907, Witmer was to found the
first journal of this new field, The Psychological Clinic, where he coined the term
"clinical psychology," defined as "the study of individuals, by observation or
experimentation, with the intention of promoting change."
The field began to organize under the name "clinical psychology" in 1917 with
the founding of the American Association of Clinical Psychology. This only lasted
until 1919, after which the American Psychological Association (founded by G.
Stanley Hall in 1892) developed a section on Clinical Psychology, which offered
certification until 1927. Growth in the field was slow for the next few years when
various unconnected psychological organizations came together as the American
Association of Applied Psychology in 1930, which would act as the primary forum
for psychologists until after World War II when the APA reorganized. In 1945 APA
created what is now called Division 12, its division of clinical psychology, which
remains a leading organization in the field. Psychological societies and associations
in other English-speaking countries developed similar divisions, including in Britain,
Canada, Australia and New Zealand.
When World War II broke out, the military once again called upon clinical
psychologists for their assessment expertise. As soldiers began to return from
combat, psychologists started to notice symptoms of psychological trauma labeled
"shell shock" (eventually to be termed Post-Traumatic Stress Disorder that were best
treated as soon as possible. Because physicians (including psychiatrists) were overextended in treating bodily injuries, psychologists were called to help treat this
condition. At the same time, female psychologists (who were excluded from the war
effort) formed the National Council of Women Psychologists with the purpose of
helping communities deal with the stresses of war and giving young mothers advice
on child rearing.
WWII helped bring dramatic changes to clinical psychology, not just in
America but internationally as well. Graduate education in psychology began adding
psychotherapy to the science and research focus based on the 1947 scientistpractitioner model, known today as the Boulder Model, for PhD programs in clinical
psychology. Clinical psychology in Britain developed much like in the U.S. after
WWII, specifically within the context of the National Health Service with
qualifications, standards, and salaries managed by the British Psychological Society.
Clinical psychologists can offer a range of professional services, including:

Provide psychological treatment (psychotherapy)
 Administer and interpret psychological assessment and testing
 Conduct psychological research
 Teach
 Development of prevention and treatment programs
 Consultation (especially with schools and businesses)
 Program administration
 Provide expert testimony (forensic psychology)
In practice, clinical psychologists may work with individuals, couples,
families, or groups in a variety of settings, including private practices, hospitals,
mental health organizations, and non-profit agencies. Most clinical psychologists
who engage in research and teaching do so within a college or university setting.
Clinical psychologists may also choose to specialize in a particular field—common
areas of specialization, include:
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Specific disorders (e.g. trauma, addiction, eating, sleep, sex, depression,
anxiety, or phobias)
Neuropsychological disorders
Child and adolescent
Family and relationship counseling
Health
Sport
Forensic
The field of clinical psychology in most countries is strongly regulated by a
code of ethics. The Code generally sets a higher standard than that which is required
by law as it is designed to guide responsible behavior, the protection of clients, and
the improvement of individuals, organizations, and society. The Code is applicable to
all psychologists in both research and applied fields.
The Code is based on five principles: Beneficence and Nonmaleficence,
Fidelity and Responsibility, Integrity, Justice, and Respect for People's Rights and
Dignity. Detailed elements address how to resolve ethical issues, competence, human
relations, privacy and confidentiality, advertising, record keeping, fees, training,
research, publication, assessment, and therapy.
An important area of expertise for many clinical psychologists is
psychological assessment, and there are indications that as many as 91% of
psychologists engage in this core clinical practice. Such evaluation is usually done in
service to gaining insight into and forming hypotheses about psychological or
behavioral problems. As such, the results of such assessments are usually used to
create generalized impressions (rather than diagnoses) in service to informing
treatment planning. Methods include formal testing measures, interviews, reviewing
past records, clinical observation, and physical examination.
A basic method of research is clinical method. It include clinical interview and
observation (Pose (natural – unnatural; symmetric – asymmetric, closed – opened).
Gestures: communicative and expressive. Mimicry is the co-coordinated motions of
muscles persons, which represent emotions, mood, sense).
After that we use experimental-psychological research, which include tests,
questionnaires.
Tests – the methods of purposeful, specialized, identical for all explored
psychological diagnostic research, which is conducted in the severely controlled
terms and at application of which it is possible to get exact quantitative and highquality description of the phenomenon which is studied.
There exist literally hundreds of various assessment tools, although only a few
have been shown to have both high validity (i.e., test actually measures what it claims
to measure) and reliability (i.e., consistency). These measures generally fall within
one of several categories, including the following:

Intelligence & achievement tests. These tests are designed to measure certain
specific kinds of cognitive functioning (often referred to as IQ) in comparison
to a norming-group. These tests, such as the WISC-IV, attempt to measure
such traits as general knowledge, verbal skill, memory, attention span, logical
reasoning, and visual/spacial perception. Several tests have been shown to
predict accurately certain kinds of performance, especially scholastic.
 Personality tests. Tests of personality aim to describe patterns of behavior,
thoughts, and feelings. They generally fall within two categories: objective and
projective. Objective measures, such as the MMPI, are based on restricted
answers—such as yes/no, true/false, or a rating scale—which allow for
computation of scores that can be compared to a normative group. Projective
tests, such as the Rorschach inkblot test, allow for open-ended answers, often
based on ambiguous stimuli, presumably revealing non-conscious
psychological dynamics.
 Neuropsychological tests. Neuropsychological tests consist of specifically
designed tasks used to measure psychological functions known to be linked to
a particular brain structure or pathway. They are typically used to assess
impairment after an injury or illness known to affect neurocognitive
functioning, or when used in research, to contrast neuropsychological abilities
across experimental groups.
 Clinical observation. Clinical psychologists are also trained to gather data by
observing behavior. The clinical interview is a vital part of assessment, even
when using other formalized tools, which can employ either a structured or
unstructured format. Such assessment looks at certain areas, such as general
appearance and behavior, mood and affect, perception, comprehension,
orientation, insight, memory, and content of communication. One common
example of a formal interview is the mental status examination, which is often
used as a screening tool for treatment or further testing
The TAT is popularly known as the picture interpretation technique because it
uses a standard series of 30 provocative yet ambiguous pictures about which the
subject must tell a story. In the case of adults and adolescents of average intelligence,
a subject is asked to tell as dramatic a story as they can for each picture, including:
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what has led up to the event shown
what is happening at the moment
what the characters are feeling and thinking, and
what the outcome of the story was.
5.2. Theoretical questions:
1.
2.
3.
4.
5.
6.
7.
8.
What does medical psychology study?
Methods of psychological assessment of man?
Describe historical periods of the development of medical psychology.
Tasks of medical psychology.
What is the basic method of research on medical psychology?
What tests do you know?
Describe personality tests.
Clinical observation.
5.3. Practical training during the tutorial
1. Clinical observation of the behavior of the patient.
2. Clinical interview and plan of psychological research.
5.4. Materials for self-control
A. Questions for self-control:
1) What does medical psychology study?
2) Methods of psychological assessment of man?
3) Describe historical periods of the development of medical psychology.
4) Tasks of medical psychology.
5) What is the basic method of research on medical psychology?
6) What tests do you know?
7) Describe personality tests.
8) Clinical observation.
B. Tasks for self-control
1. Typical, ordinary – II level.
2. Untypical, no ordinary – III level.
C. Tests for self-control.
Literature
1. R.J.Gatchel An introduction to health psychology. – New York: Random
house. – 386 p.
2. Lectures.
3. Internet resource.
4. Вітенко І.С., Вітенко Т.І. Основи психології: Підручник для студентів
вищих медичних навчальних закладів ІІІ – ІV рівнів акредитації. –
Вінниця, 2001.
5. Вітенко І.С., Чабан О.С., Бусло О.О. Сімейна медицина: психологічні
аспекти діагностики, профілактики і лікування хворих. – Тернопіль,
”Укрмедкнига”, 2002.
6. Гавенко В.Л., Вітенко І.С., Самардакова Г.О. Практикум з медичної
психології. – Харків: Регіон-інформ, 2002.
7. Загальна та медична психологія (практикум) /Під заг. ред. професора
І.Д.Спіріної, професора І.С.Вітенка. – Дніпропетровськ, АРТ ПРЕС, 2002.
8. Квасенко А.В., Зубарев Ю.Т. Психология больного. М., 1980.
9. Лакосина Н.Д., Ушаков Г.К. Медицинская психология. М., 1984.
10.Менделевич В.Д. Клиническая и медицинская психология. – М.:
Мед.прес., 1998.
11.Мягков И.Ф., Боков С.Н. Медицинская психология: основы
патопсихологии и психопатологии: Учебник для вузов.- М.: Издательская
корпорация „Логос”, 1999.
Prepared by assistant
V.A. Herasymuk