1
Chapter 1
Foundations and Fundamentals
What is contemporary clinical psychology?
Definition:
Clinical psychology is a complex field that parallels the complexity of human behavior and
emotion.
Clinical psychology focuses on the assessment, treatment, and understanding of
psychological and behavioral problems and disorders. In fact, clinical psychology focuses
its efforts on the ways in which the human psyche interacts with physical, emotional, and
social aspects of health and dysfunction. According to the APA, clinical psychology
attempts to use the principles of psychology to better understand, predict, and alleviate
“intellectual, emotional, biological, psychological, social, and behavioral aspects of human
functioning”
Clinical psychology is “the aspect of psychological science and practice concerned with
the analysis, treatment, and prevention of human psychological disabilities and with the
enhancing of personal adjustment and effectiveness”
Perspective and Philosophy:
Clinical psychology uses the scientific method to approach and understand human problems in
behavior, emotions, thinking, relationships, and health. Rigorous scientific inquiry is used to select
and evaluate assessment and treatment approaches and activities.
Contemporary clinical psychology uses integrative approaches to understand and address
problems in human behavior. Although individual clinical psychologists may be closely aligned
with particular theoretical perspectives on human behavior, most contemporary clinical
psychologists also appreciate the integral roles of bio psychological factors in health and illness.
The biopsychosocial perspective emphasizes the interaction of biological, psychological, and
social influences on behavior and psychological functioning.
, 2
Education and Training:
The road to becoming a clinical psychologist is a long one divided by a number of distinct stages
and phases that include college, graduate school, clinical internship, postdoctoral fellowship,
licensure, and finally employment, continuing education, and advanced certification.
Graduate training in clinical psychology involves course work as well as clinical and research
experiences and training. Graduate school in clinical psychology takes at least five years to
complete, including a one-year clinical internship. However, many students find that they need
more than five years to complete their graduate education. Dissertation projects and other factors
often extend the training process to an average of six to eight years. A student interested in
obtaining a doctorate in clinical psychology can choose between two types of degrees: the
traditional PhD (Doctor of Philosophy) or the PsyD (Doctor of Psychology). Although the APA
recommends a core curriculum of courses and activities (APA, 1987b), each program maintains
its own unique orientation based on the faculty and traditions of the program. In researching
graduate programs, you will find that each program has its own unique balance on emphasizing
the roles of biological, psychological, and social factors in human behavior.
Research:
Research programs help to determine which assessment or treatment approach might be most
effective for a particular clinical problem such as depression, anxiety, eating disorders, or
substance abuse problems. Projects may help identify those at risk for the development of certain
psychological problems.
Assessment:
Many clinical psychologists use psychological tests and procedures to assess or diagnose various
psychiatric (e.g., depression, psychosis, personality disorders, dementia) as well as non-psychiatric
issues (e.g., relationship conflicts, learning differences, educational potential, career interests, and
skills). There are numerous components to psychological assessment, including cognitive,
personality, behavioral, neuropsychological, and observational measures.
Treatment:
Contemporary psychological interventions address a tremendous range of human problems
through a diversity of approaches. Psychotherapy may involve individuals, couples, families, and
, 3
groups, and address an endless array of target problems. Various treatment approaches and
theoretical models are utilized to treat psychological and behavioral problems. Most psychologists
use an eclectic strategy, defined as integrating a variety of perspectives and clinical approaches in
their treatment Efforts to develop empirically supported or evidence-based treatments to assist
clinicians and researchers in providing structured treatments and the use of treatment manuals that
are based on treatment outcome research findings has received a great deal of attention and support
from the APA and others (
Teaching:
Clinical psychologists teach in a variety of settings. Some are full-time professors in colleges and
universities across the United States and elsewhere. These professionals teach undergraduates,
graduate students, and/ or postgraduate students. Other psychologists might teach on a part-time
basis at local colleges and universities as adjunct professors or lecturers Teaching may also occur
in hospitals, clinics, or business environments. For example, a clinical psychologist might offer a
stress management course for attorneys, business executives, nurses, clergy, police officers, or
others
Consultation:
Many clinical psychologists provide consultation to churches, health care professionals, business
persons, schools, lawmakers, organizations, and even to other mental health professionals.
Consultation might involve an informal discussion, a brief report, or a more ongoing and formal
consultation arrangement.
Administration:
In administration, these psychologists generally manage a budget, lead a multidisciplinary
professional and support staff, make hiring and firing decisions, and develop policies and
procedures for clinical or research operations.
Employment Settings
Clinical psychologist working in many different employment settings including hospitals, medical
schools, outpatient clinics, colleges and universities, businesses and industry, and private or group
practices.
, 4
A clinical psychologist may be a full time professor teaching and conducting research while also
creating a small private practice and offering consultation services to various clinics options,
hospitals or businesses. The diversity of experiences available to sociologists is quite appealing
and offers tremendous flexibility and options.
Private or Group Practices
About 35% of clinical psychologists primarily work in solo or group private practices.
Professionals in private practice may provide clinical services in their own solo practice or in
conjunction with other mental health or health care practitioners in a multidisciplinary setting.
In fact, private practitioners report more job satisfaction and less job stress than psychologists
employed in other settings like academia.
Cummings predicted that these clinicians will be employed primarily in multidisciplinary health
settings such as health maintenance organizations and comprehensive medical group.
Others disagree with Cummings pessimistic view concerning the future of private practice, stating
that managed care still accounts for only about 23% of the fees collected by private practitioners.
Colleges and Universities
About 20% of clinical psychologists are employed in academia environments. They teach
psychology courses, supervise the clinical or research work of psychology students and conduct
both independent and collaborative research. Some clinical psychologists work in academia
clinical settings such as students counseling centers, providing direct clinical services to students.
Hospitals
Chapter 1
Foundations and Fundamentals
What is contemporary clinical psychology?
Definition:
Clinical psychology is a complex field that parallels the complexity of human behavior and
emotion.
Clinical psychology focuses on the assessment, treatment, and understanding of
psychological and behavioral problems and disorders. In fact, clinical psychology focuses
its efforts on the ways in which the human psyche interacts with physical, emotional, and
social aspects of health and dysfunction. According to the APA, clinical psychology
attempts to use the principles of psychology to better understand, predict, and alleviate
“intellectual, emotional, biological, psychological, social, and behavioral aspects of human
functioning”
Clinical psychology is “the aspect of psychological science and practice concerned with
the analysis, treatment, and prevention of human psychological disabilities and with the
enhancing of personal adjustment and effectiveness”
Perspective and Philosophy:
Clinical psychology uses the scientific method to approach and understand human problems in
behavior, emotions, thinking, relationships, and health. Rigorous scientific inquiry is used to select
and evaluate assessment and treatment approaches and activities.
Contemporary clinical psychology uses integrative approaches to understand and address
problems in human behavior. Although individual clinical psychologists may be closely aligned
with particular theoretical perspectives on human behavior, most contemporary clinical
psychologists also appreciate the integral roles of bio psychological factors in health and illness.
The biopsychosocial perspective emphasizes the interaction of biological, psychological, and
social influences on behavior and psychological functioning.
, 2
Education and Training:
The road to becoming a clinical psychologist is a long one divided by a number of distinct stages
and phases that include college, graduate school, clinical internship, postdoctoral fellowship,
licensure, and finally employment, continuing education, and advanced certification.
Graduate training in clinical psychology involves course work as well as clinical and research
experiences and training. Graduate school in clinical psychology takes at least five years to
complete, including a one-year clinical internship. However, many students find that they need
more than five years to complete their graduate education. Dissertation projects and other factors
often extend the training process to an average of six to eight years. A student interested in
obtaining a doctorate in clinical psychology can choose between two types of degrees: the
traditional PhD (Doctor of Philosophy) or the PsyD (Doctor of Psychology). Although the APA
recommends a core curriculum of courses and activities (APA, 1987b), each program maintains
its own unique orientation based on the faculty and traditions of the program. In researching
graduate programs, you will find that each program has its own unique balance on emphasizing
the roles of biological, psychological, and social factors in human behavior.
Research:
Research programs help to determine which assessment or treatment approach might be most
effective for a particular clinical problem such as depression, anxiety, eating disorders, or
substance abuse problems. Projects may help identify those at risk for the development of certain
psychological problems.
Assessment:
Many clinical psychologists use psychological tests and procedures to assess or diagnose various
psychiatric (e.g., depression, psychosis, personality disorders, dementia) as well as non-psychiatric
issues (e.g., relationship conflicts, learning differences, educational potential, career interests, and
skills). There are numerous components to psychological assessment, including cognitive,
personality, behavioral, neuropsychological, and observational measures.
Treatment:
Contemporary psychological interventions address a tremendous range of human problems
through a diversity of approaches. Psychotherapy may involve individuals, couples, families, and
, 3
groups, and address an endless array of target problems. Various treatment approaches and
theoretical models are utilized to treat psychological and behavioral problems. Most psychologists
use an eclectic strategy, defined as integrating a variety of perspectives and clinical approaches in
their treatment Efforts to develop empirically supported or evidence-based treatments to assist
clinicians and researchers in providing structured treatments and the use of treatment manuals that
are based on treatment outcome research findings has received a great deal of attention and support
from the APA and others (
Teaching:
Clinical psychologists teach in a variety of settings. Some are full-time professors in colleges and
universities across the United States and elsewhere. These professionals teach undergraduates,
graduate students, and/ or postgraduate students. Other psychologists might teach on a part-time
basis at local colleges and universities as adjunct professors or lecturers Teaching may also occur
in hospitals, clinics, or business environments. For example, a clinical psychologist might offer a
stress management course for attorneys, business executives, nurses, clergy, police officers, or
others
Consultation:
Many clinical psychologists provide consultation to churches, health care professionals, business
persons, schools, lawmakers, organizations, and even to other mental health professionals.
Consultation might involve an informal discussion, a brief report, or a more ongoing and formal
consultation arrangement.
Administration:
In administration, these psychologists generally manage a budget, lead a multidisciplinary
professional and support staff, make hiring and firing decisions, and develop policies and
procedures for clinical or research operations.
Employment Settings
Clinical psychologist working in many different employment settings including hospitals, medical
schools, outpatient clinics, colleges and universities, businesses and industry, and private or group
practices.
, 4
A clinical psychologist may be a full time professor teaching and conducting research while also
creating a small private practice and offering consultation services to various clinics options,
hospitals or businesses. The diversity of experiences available to sociologists is quite appealing
and offers tremendous flexibility and options.
Private or Group Practices
About 35% of clinical psychologists primarily work in solo or group private practices.
Professionals in private practice may provide clinical services in their own solo practice or in
conjunction with other mental health or health care practitioners in a multidisciplinary setting.
In fact, private practitioners report more job satisfaction and less job stress than psychologists
employed in other settings like academia.
Cummings predicted that these clinicians will be employed primarily in multidisciplinary health
settings such as health maintenance organizations and comprehensive medical group.
Others disagree with Cummings pessimistic view concerning the future of private practice, stating
that managed care still accounts for only about 23% of the fees collected by private practitioners.
Colleges and Universities
About 20% of clinical psychologists are employed in academia environments. They teach
psychology courses, supervise the clinical or research work of psychology students and conduct
both independent and collaborative research. Some clinical psychologists work in academia
clinical settings such as students counseling centers, providing direct clinical services to students.
Hospitals
