CLINICAL
PSYCHOLOGY I
Fall 2022
Aslıhan Koyuncu, MS.c.
Chapter 1
The Evolution of Clinical
Psychology
What is mental
health?
“Mental health is a state of well-being
in which the individual realizes his or
her own abilities, can cope with the
normal stresses of life, and is able to
make a contribution to his or her
community.”
World Health Organization (2007)
• About half of mental disorders begin before age 14.
• Worldwide 800,000 people commit suicide every year.
• In emergencies, the number of people with mental disorders is estimated to
increase by 6–11%.
• Mental disorders increase the risk for physical disorders.
• Many health conditions increase the risk of mental disorders.
• Stigma prevents many people from seeking mental health care.
• There are great inequities in the availability of mental health professionals
across the world.
World Health Organization (2007)
• 1 in 4 adult Americans suffers from a mental disorder (NCMRS, 2002).
• Half the cases of mental disorder begin by age 14, and three quarters have
begun by age 24 (Kessler, Berglund, Demler, Jin, & Walters, 2005).
• The onset of anxiety disorders often occurs in late childhood, mood disorders
in late adolescence, and substance abuse in the early 20s (Kessler, Berglund,
et al., 2005).
• Most mental disorders are overlooked or misdiagnosed, and only a small
percentage of those who suffer from a mental disorder ever receive treatment.
Defining the Nature and Scope of Clinical
Psychology
Defining the Nature and Scope of
Clinical Psychology
Clinical psychology
• is based on scientifically supported psychological theories and
principles.
• uses scientifically based methods to reliably and validly assess
both normal and abnormal human functioning.
• involves gathering evidence regarding optimal strategies for
delivering health care services.
Defining the Nature and Scope of
Clinical Psychology
Over the decades the nature and definition of clinical psychology has
shifted, expanded, and evolved.
Now includes numerous approaches to intervention and prevention
services.
also covers indirect services that do not involve contact with those who
have a mental disorder (e.g., consultation activities, research, program
development, program evaluation)
Can clinical psychology be
based solely on the science
of psychology?
Defining the Nature and Scope of
Clinical Psychology
Group-based data cannot be used in working with an individual.
Clients have problems now and we cannot afford to wait for the research.
Each individual has unique constellation of life experience, culture, and societal
context.
So, general psychological principles cannot provide useful guidance in alleviating
emotional distress or interpersonal conflict.
No research evidence on how to understand or treat many of the human problems
confronted by clinical psychologists on a daily basis.
Do you think clinical
practise should base on
clinicians’ gut feelings,
intuition or experience?
Defining the Nature and Scope of
Clinical Psychology
People are prone to make errors and have biases.
Clinicians can make serious mistakes in evaluating and treating clients.
So, they should balance professional experience and use general
orientation toward understanding human functioning.
Defining the Nature and Scope of
Clinical Psychology
The evidence-based practice (EBP) model:
A clinician should
o use information drawn from current research
o use systematically collected data on the patient,
o use professional experience, and
o consider patient’s preferences when considering health care options for
assessment, prevention, or intervention services.
The EBP model is now being integrated into many health and human service
systems
Mental Health Professions
Counselling Psychology
• provides services to individuals who were dealing with normal
challenges in life (e.g., leaving home to work or to attend college,
changes in work or interpersonal roles)
• most commonly employed in educational settings (such as
university counseling clinics) or general community clinics in which
various social and psychological services are available
• also promotes the use of scientifically based interventions.
Mental Health Professions
Psychiatry
• Physicians who specialize in the diagnosis, treatment, and prevention of
mental illnesses.
• deals extensively with physiological and biochemical systems and
emphasizes biological functioning and abnormalities.
• evaluate whether psychological symptoms result from or are
exacerbated by medications used to treat physical ailments and chronic
illnesses.
• emphasizes psychopharmacological treatment over psychological
treatment.
• An important distinction between clinical psychologists and psychiatrists
à only psychiatrists could prescribe medication.
• Psychiatrists were among the pioneers
in the development of evidence-based
psychological treatments.
• Aaron Beck was the primary developer
of Cognitive Therapy for depression (and
subsequently other disorders).
Mental Health Professions
Social Work
• focus on ways to assist individuals, families, groups, and
communities to restore or enhance their social functioning.
• emphasize the importance of social conditions that facilitate
optimal development.
• includes many activities (e.g., policy development, program
planning, program management, research consultation) (National
Association of Social Workers [NASW], 2008).
• are employed in diverse settings (e.g., hospitals, community mental
health centers, mental health clinics, schools, advocacy
organizations) (NASW, 2008).
A Brief History of Clinical Psychology
The Roots of Clinical Psychology
• Hippocrates (psychosocial
approach)à imbalances in the levels
of blood, black bile, yellow bile, and
phlegm are responsible for
emotional disturbance.
A Brief History of Clinical Psychology
The Roots of Clinical Psychology
• Plato à the role of societal forces and psychological needs in the
development and alleviation of mental disorders
• Aristotle à emphasized the biological determinants of mental
disorders.
A Brief History of Clinical Psychology
The Roots of Clinical Psychology
• St. Vincent de Paul (1500s) à mental and physical illnesses were
caused by natural forces. Extreme manifestations of mental
disturbances such as psychotic behavior were not caused by
witchcraft or by satanic possession
• Those suffering from severe mental illness were isolated in asylums.
Often chained to walls
A Brief History of Clinical Psychology
The Roots of Clinical Psychology
• Reformer Philippe Pinel (Paris, 1700s) à chains must be removed
from all mental patients and patients should be treated humanely.
• William Tuke (England) à developed modern ideas of appropriate
care and established a country retreat in which patients lived and
worked.
• Benjamin Rush (USA) à the use of moral therapy with the mentally
ill.
A Brief History of Clinical Psychology
The Roots of Clinical Psychology
Within European medicine the specialty of neurology was growing
rapidly.
• Jean Martin Charcot (France) à the primary developer of clinical
neurology.
• Pierre Janet and Sigmund Freud à develop their own theories to
account for hysteria (i.e., extreme, dramatic, and often odd behavior
including limb paralysis).
A Brief History of Clinical Psychology
The Future
Clinical psychology will
• be influenced by application of psychological services to different
health problems, not just mental health problems;
• develop services that respond to the health care needs of an ageing
population
• Ensure that psychological assessments, prevention programs, and
treatments are both evidence-based and appropriate for the
diverse range of people who receive these services;
• Enhance the impact of concurrent use of psychological and
pharmacological interventions.
Thank you!
Any Questions?
