Contemporary Clinical
Psychology
Third Edition
Thomas Plante, Ph.D., ABPP
Santa Clara University and
Stanford University School of
Medicine
Chapter 1
What Is Contemporary
Clinical Psychology?
Clinical Psychology
Activities
Research
Assessment
Treatment
Teaching
Consultation
Administration
Clinical Psychology
Employment Settings
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Private and Group Practices
Colleges and Universities
Hospitals
Medical Schools
Outpatient Clinics
Business and Industry
Military
Other Locations
Clinical Psychology Subspecialties
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Child Clinical Psychology
Health Psychology
Neuropsychology
Forensic Psychology
Geropsychology
Clinical Psychology Organizations
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American Psychological Association
American Psychological Society
State and County Psychological Associations
National Register of Health Care Providers
American Board of Professional Psychology
Other Organizations
Related Fields
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Counseling Psychology
School Psychology
Psychiatry
Social Work
Psychiatric Nursing
Marriage and Family Counseling
Other Counselors
Other Psychologists
Chapter 2
Foundations and
Early History of
Clinical Psychology
Early Conception of Mental Illness:
Mind and Body Paradigms
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Greeks
Middle Ages
Renaissance
19th Century
Birth of Psychology
The Founding of Clinical Psychology
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Lightmer Witmer
Binet's Intelligence Test
Mental Health and Child Guidance
Movement
Sigmund Freud in America
The Influence of World War I
Clinical Psychology Between World Wars I
and II
Significant events in the history of
clinical psychology
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2,500–500 BC Supernatural, magic, herbs, and reason approaches to
illness
470–322 BC Greeks use holistic approach
130–200 AD Galen develops foundation of Western medicine
500–1450
Middle Ages: supernatural forces influence health and
illness
1225–1274
Saint Thomas Aquinas uses scientific thinking
1490–1541
Paracelsus uses movements of the stars, moon, sun, and
planets to understand behavior
1500–1700
Renaissance and scientific discoveries suggesting
biological factors influence health and illness
1596–1650
René Descartes develops mind/body dualism
1745–1826
Pinel developed humane moral therapy to treat mentally
ill
1802–1887
Dorothea Dix advocates for humane treatment of
mentally ill
1848
New Jersey becomes first state to build a hospital for
mentally ill
Significant events, continued
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1879
1879
1883
1888
1890
1890
1892
1895
1896
1900
1904
1905
1905
1907
1908
1909
1909
Wundt develops first laboratory in psychology
William James develops first American psychology laboratory at Harvard
G. Stanley Hall develops second psychology laboratory at John Hopkins
James McKeen Cattell develops third American psychology laboratory
James publishes Principles of Psychology
James McKeen Cattell defines “mental test”
American Psychological Association founded
Breuer and Freud publish Studies on Hysteria
Witmer establishes first psychological clinic at U. Penn
Freud publishes The Interpretation of Dreams
Binet begins developing an intelligence test
Binet and Simon offer Binet-Simon Scale of Intelligence
Jung creates a word association test
Psychological Clinic, first clinical journal published
Beers begins mental hygiene movement
Clinical psychology section formed at APA
Freud’s only visit to America at Clark University
Significant events, continued
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1909 Healy develops child guidance clinic in Chicago
1916 Terman develops Stanford-Binet Intelligence Test
1917 Clinicians of APA leave to form American Association of Clinical
Psychologists (AACP)
1917 Yerkes and committee develop Army Alpha test
1919 AACP rejoins APA
1921 James McKeen Cattell develops Psychological Corporation
1921 Rorschach presents his inkblot test
1924 Mary Cover Jones uses learning principles to treat children’s fears
1935 APA Committee on Standards and Training define clinical psychology
1935 Murray and Morgan publish the TAT
1936 Louttit publishes first clinical psychology textbook
1937 Clinicians leave APA again to form American Association of Applied
Psychology (AAAP)
1937 Journal of Consulting Psychology begins
1939 The Wechsler-Bellevue Intelligence Scale is published
1943 Hathaway publishes MMPI
1945 AAAP rejoins APA
Chapter 3
Recent History of
Clinical Psychology
Significant events:
1940s and 1950s
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1940s
1945
1945
1946
1947
1949
1949
1950s
1950
1951
1952
1952
1953
1953
1955
1956
1958
1958
1959
AAAP rejoins APA
Connecticut passes first certification law for psychology
VA and NIMH fund clinical psychology training
ABEPP is founded to certify clinicians
Halstead presents neuropsychological testing battery
Boulder Conference defines scientist-practitioner model of training
Dollard and Miller publish Personality and Psychotherapy: An Analysis in
Terms of Learning, Thinking, and Culture
Rogers publishes Client-Centered Therapy
Eysenck publishes The Effects of Psychotherapy: An Evaluation
American Psychiatric Association publishes diagnostic categories in
Diagnostic and Statistical Manual (DSM - I )
APA publishes Ethical Standards
Skinner presents operant principles
Joint Commission on Mental Health and Illness founded
Stanford University training conference
Wolpe publishes Psychotherapy by Reciprocal Inhibition
Miami training conference
Mental Research Institute (MRI) founded
Significant events:
1960s and 1970s
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1960s
1960 Eysenck publishes Handbook of Abnormal Psychology: An Experimental
Approach
1963 Congress passes legislation creating community mental health centers
1965 Chicago training conference
1965 Conference at Swampscott, MA, starts community psychology movement
1967 Association for Advancement in Behavior Therapy founded
1968 First PsyD program founded at the University of Illinois
1969 First freestanding professional school of psychology founded at
California School of Professional Psychology
1970s
1970 DSM II published
1973 Vail training conference
1976 National Council of Schools of Professional Psychology (NCSPP) founded
1977 George Engel publishes paper in Science defining biopsychosocial model
1977 Wachtel publishes Psychoanalysis and Behavior Therapy: Toward an
Integration
Significant events:
1980s and 1990s
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1980s
1980
1981
1982
1986
1987
1987
1988
1989
1990s
1990
1991
1992
1994
1995
1998
1999
DSM III published
APA ethical standards revised
Health psychology defined
NCSPP Mission Bay training conference
Salt Lake City training conference
DSM III-R published
American Psychological Society founded
NCSPP San Juan training conference
NCSPP Gainesville training conference
NCSPP San Antonio training conference
Michigan Conference on postdoctoral training
DMS IV published
APA publishes a list of empirically validated treatments
International Society of Clinical Psychology founded in San Francisco
Guam authorizes psychologists to prescribe psychotropic medication
Significant recent events in 2000s
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2001 APA alters mission statement to reflect psychology as a
health care discipline
2002 APA ethics code revised
2002 New Mexico allows psychologists medication prescription
authority
2003 Health Insurance Portability and Accountability Act
(HIPAA) becomes law
2004 Louisiana allows psychologists prescription authority
2006 APA publishes findings from a Presidential Task Force on
Evidence-Based Practice
2008 The U.S. Congress passes the Paul Wellstone Mental Health
and Addiction Equity Act of 2007 allowing mental health parity
in health care
Chapter 4
Research:
Design and Outcome
Research Methods and Designs
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Experiments
Quasi-Experimental Designs
Case Studies
Correlational Methods
Epidemiological Methods
Cross-Sectional and Longitudinal Designs
Treatment Outcome Research
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Treatment Package Strategy
Dismantling Treatment Strategies
Constructive Treatment Strategies
Parametric Treatment Strategy
Comparative Treatment Strategy
Client-Therapist Variation Strategy
Process Research Strategy
Examples of Threats to Internal
and External Validity
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Threats to internal validity
History
Maturation
Testing
Instrumentation
Statistical Regression
Selection Bias
Experimental Mortality
Threats to external validity
Testing
Reactivity
Multiple-Treatment Interference
Interaction of Selection Biases
Different Levels of Research
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Level 1
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Level 2
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Level 3
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Level 4
Basic laboratory research on factors
associated with behavior change
Analogue treatment research to
identify effective ingredients of
therapeutic procedures under
controlled laboratory conditions
Controlled clinical research with patient
populations
Clinical practice. Therapists may
measure outcome in case studies or
clinical series.
Questions and Challenges Conducting
Treatment Outcome Research
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Is the treatment provided in a research program similar to
the treatment provided in actual clinical practice?
Are the patients and therapists used in a research study
typical of patients and therapists in actual practice?
How and when is treatment outcome measured?
Statistical versus clinical significance.
How can treatment outcome decisions be made when some
studies might conclude one thing and other studies
conclude something different?
What is a program of research and how is it conducted?
Contemporary Issues in
Clinical Psychology Treatment
Outcome Research
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Biopsychosocial approaches to psychopathology
research
Meta-analysis
Empirically supported treatments
Comprehensive and collaborative multi-site
clinical trial research projects
Community-wide interventions
Ethical issues
Multicultural issues
Chapter 5
The Major Theoretical Models:
Psychodynamic,
Cognitive-Behavioral,
Humanistic, and
Family Systems
The Four Major Theoretical
Models in Clinical Psychology
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Psychodynamic Approach
Cognitive-Behavioral Approach
Humanistic Approach
Family Systems Approach
Alternatives to the
Psychodynamic Approach
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Behavioral Approach
Cognitive Approach
Humanistic Approach
Family Systems Approach
Psychotropic Medication
Community Mental Health Movement
Integrative Approaches
Biopsychosocial Approach
The Psychodynamic Approaches
Freud’s Psychoanalytic
Perspective
 The Revisionist or Neo-Freudian
Perspective
 The Object Relations Perspective
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The Behavioral and CognitiveBehavioral Approaches
The Classical Conditioning
Perspective
 The Operant Perspective
 The Social Learning Perspective
 The Cognitive Perspective: Beliefs,
Appraisals, and Attributions
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The Humanistic Approach
The Client-Centered Perspective
 Maslow’s Humanistic Perspective
 The Gestalt Perspective
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The Family Systems Approach
The Communication Approach
 The Structural Approach
 The Milan Approach
 The Strategic Approach
 The Narrative Approach
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Chapter 6
Integrative and
Biopsychosocial
Approaches in
Contemporary Clinical
Psychology
A Call to Integration
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Commonalities among
Approaches
Efforts toward Integration
Eclectism
Beyond Psychological Models
Biopsychosocial Factors
Diathesis-stress perspective
 Reciprocal-gene-environment
perspective
 Psychosocial factors influencing
biology
 Development of the biopsychosocial
perspective
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Biopsychosocial Applications
Obsessive-Compulsive Disorder
 Anxiety and Panic
 Cardiovascular Disease
 Cancer
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Chapter 7
Contemporary Psychological
Assessment I:
Interviewing and Observing
Behavior
Interviewing
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Rapport
Effective Listening Skills
Effective Communication
Observation of Behavior
Asking the Right Questions
Types of Interviews
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Initial Intake or Admissions Interview
Mental Status Interview
Crisis Interview
Diagnostic Interview
Structured Interviews
Computer-Assisted Interviews
Exit or Termination Interviews
Standard Clinical Interview
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Identifying Information
Referral Source
Chief Complaint or Presenting Problems
Family Background
Health Background
Educational Background
Employment Background
Developmental History
Sexual History
Previous Medical Treatment
Previous Psychiatric Treatment
History of Traumas
Current Treatment Goals
Chapter 8
Contemporary Psychological
Assessment II:
Cognitive and Personality
Assessment
Halstead-Reitan Neuropsychological
Test Battery
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Category Test
Tactual Performance Test
Rhythm Test
Speech Sounds Perception Test
Finger Oscillation Test
Trail Making Test
Strength of Grip Test
Sensory-Perceptual Examination
Tactile Perception
Modified Halstead-Wepman Aphasia Screening Test
Wechsler Adult Intelligence Scale—IV (WAIS-IV)
Minnesota Multiphasic Personality Inventory—2 (MMPI-2)
MMPI-2 Scales
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Validity Scales
?
(Cannot Say)
L
(Lie)
F
(Validity)
K
(Correction)
Clinical Scales
1
Hypochondriasis
2
Depression
3
Conversion Hysteria
4
Psychopathic Deviate
5
Masculinity-Femininity
6
Paranoia
7
Psychasthenia
8
Schizophrenia
9
Hypomania
0
Social Introversion
(Hs)
(D)
(Hy)
(Pd)
(Mf)
(Pa)
(Pt)
(Sc)
(Ma)
(Si)
MCMI-III Scales
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Clinical Personality Patterns Scales
Scale 1
Schizoid
Scale 2A
Avoidant
Scale 2B
Depressive
Scale 3
Dependent
Scale 4
Histrionic
Scale 5
Narcissistic
Scale 6A
Antisocial
Scale 6B
Aggressive (Sadistic)
Scale 7
Compulsive
Scale 8A
Passive-Aggressive (Negativistic)
Scale 8B
Self-Defeating
Clinical Syndrome Scales
Scale A
Anxiety
Scale H
Somatoform
Scale N
Bipolar: Manic
Scale D
Dysthymia
Scale B
Alcohol Dependence
Scale T
Drug Dependence
Scale R
Post-Traumatic Stress Disorder
MCMI-III Scales, continued
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Severe Syndrome Scales
Scale SS Thought Disorder
Scale CC Major Depression
Scale PP Delusional Disorder
Severe Personality Pathology Scales
Scale S
Schizotypal
Scale C
Borderline
Scale P
Paranoid
Modifying Indexes (Correction Scales)
Scale X
Disclosure
Scale Y
Desirability
Scale Z
Debasement
16PF (Fifth Edition)
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A
B
C
E
F
G
H
I
L
M
N
O
Q1
Q2
Q3
Q4
Warmth
Reasoning
Emotional Stability
Dominance
Liveliness
Rule Consciousness
Social Boldness
Sensitivity
Vigilance
Abstractedness
Privateness
Apprehension
Openness to Change
Self-Reliance
Perfectionism
Tension
Rorschach Sample
Rorschach Sample
Chapter 9
Psychotherapeutic
Interventions
Common Denominators
in Psychotherapy
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Professional Person
Professional Manner
Professional Setting
Duration of Sessions
Frequency of Sessions
Stages of Psychotherapy
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Initial Consultation
Assessment
Development of Treatment Goals
Implementation of Treatment
Evaluation of Treatment
Termination
Follow-Up
Modes of Psychotherapy
Individual Treatment
 Group Psychotherapy
 Couples Psychotherapy
 Family Therapy
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Chapter 10
Psychotherapeutic
Issues
Ten Issues about Psychotherapy
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Does Psychotherapy Work?
Long-Term Therapy versus Short-Term Treatment
Psychotherapy Dropouts
Is One Type of Therapy Better than Another?
Enduring Psychotherapy Effects
Common Factors Associated with Positive Psychotherapy
Outcome
Change Is Challenging
Level of Training for Psychotherapists
Health Care Costs and Psychotherapy
Psychotherapy Harm
Chapter 11
Areas of Specialization
in Contemporary
Clinical Psychology
Clinical Health Psychology
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Smoking
Obesity
Alcohol Consumption
Stress Management
Acquired Immune Deficiency Syndrome
(AIDS)
Chronic Pain
Child Clinical Psychology
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Attention Deficit/Hyperactivity Disorder
(ADHD)
Learning Disorders
Child Abuse and Neglect
Anorexia Nervosa
Clinical Neuropsychology
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Epilepsy
Brain Injuries
Degenerative Diseases
Forensic Psychology
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Involuntary Commitment
Insanity Defense
Child Custody
Jury Selection
Geropsychology
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Degenerative Diseases
Vascular Diseases
Parkinson’s Disease
Psychiatric Issues (Anxiety, Depression,
Substance Abuse)
Chapter 12
Consultative, Teaching,
and Administrative
Roles in Contemporary
Clinical Psychology
Consultation
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Consultation Defined
Consultation Roles
Types of Consultation
Stages of Consultation
To Whom Do Clinical Psychologists Offer
Consultation?
Effective Consultation
Problems in Consultation
Teaching
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Teaching in Academic Settings
1. Psychology Departments
2. Medical Schools and Hospitals
Teaching in Nonacademic Settings
1. Clinics
2. Workshops
3. Business and Industry
4. General Public
Chapter 13
Ethical Standards
in Contemporary
Clinical Psychology
Ethical Principles
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Competence
Integrity
Professional and Scientific Responsibility
Respect for People’s Rights and Dignity
Concern for Others’ Welfare
Social Responsibility
Ethical Standards
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Advertising and Other Public Statements
Therapy
Teaching, Training, Supervision, Research,
and Publishing
Forensic Activities
Chapter 14
Current and Future
Trends and Challenges
in Contemporary
Clinical Psychology
Trends in Society
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Contemporary Changes in the American
Family
Multicultural and Diversity Issues
Advances in Science, Technology, and
Medicine
Money
Gender Shifts in Professions
Research and Practice Issues
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Managed Health Care
Prescription Privileges
Medical Staff Privileges
Private Practice
Specialization
Empirically Supported Treatments
Reaching Beyond Mental Health in
Contemporary Clinical Psychology
Training Issues
Chapter 15
Becoming a Clinical
Psychologist:
A Road Map
Ten Important Goals During the
College Experience
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High Grade Point Average
High Graduate Record Examination Scores
Quality Research Experience
Quality Clinical Experience
Excellent Verbal Skills
Excellent Interpersonal Skills
Reliability and Dependability
Excellent Productivity
Excellent Letters of Recommendation
High Motivation
Applying to Graduate Programs
in Clinical Psychology
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PhD versus PsyD versus MA
University versus Freestanding Professional
School
Accreditation
Training Curriculum and Emphasis
After Graduate School
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Clinical Internship
Postdoctoral Fellowship
Specialization
Certification and/or Licensure
Employment