LECTURE 1: INTRO TO CLINICAL
PSYCHOLOGY
CLINICAL PSYCHOLOGY
 first used in 1907 by Lightner
Witmer
 Tremendous growth has resulted in a
very broad, hard-to-define field
 Brief definitions emphasize the study,
assessment, and treatment of people
with psychological problems
APA Division 12 Definition of Clinical
Psychology
 “The field of Clinical Psychology
integrates science, theory, and
practice to understand, predict, and
alleviate maladjustment, disability,
and discomfort as well as to promote
human adaptation, adjustment, and
personal development. Clinical
Psychology focuses on the
intellectual, emotional, biological,
psychological, social, and behavioral
aspects of human functioning across
the life span, in varying cultures, and
at all socioeconomic levels.” (APA,
2012)
Education and Training in Clinical
Psychology
 Commonalities among most training
programs
 Doctoral degree
 Most enter with bachelor’s,
some with master’s degree
 Required coursework
 Thesis/dissertation
 Pre-doctoral internship
Education and Training: Specialty Tracks
 In recent decades, specialty tracks
have emerged, including:
 Child
 Health
 Forensic
 Family/Couple
 Neuropsychology
THREE MODELS OF TRAINING
1. Scientist-practitioner model (or
Boulder model): Balancing Practice
and Science
 Created in 1949 at a
conference in Boulder,
Colorado of directors of
clinical psychology training
programs
 Emphasizes both practice
and research
 Graduates should
be able
competently
practice (e.g.,
therapy,
assessment) and
conduct research
 A balanced
approach
2. Practitioner-scholar model (or Vail
model): Emphasizing Practice
 Created in 1973 in a
conference in Vail,
Colorado
 Also known as practitioner-
scholar model
 Emphasizes practice over
research
 Yields the Psy.D. degree
(not the traditional Ph.D.)
 Higher acceptance rates
and larger classes
 Proliferated in recent years  Licensure enables independent
Ph.D. Psy.D. practice and identification as a
Emphasize Emphasize practice member of the profession
practice and over research  Requires appropriate graduate
research coursework, postdoctoral internship,
Smaller classes Larger classes and licensing exams
Lower acceptance Greater acceptance  Each state has its own licensing
rate rate requirements
Typically in Often in free-  To stay licensed, most states require
university standing continuing education units (CEUs)
departments professional schools  RPm- BS/AB PSYCH
Offer more Offer less funding to  RPsy- MA/MS grad
funding to students  RGC-maed,magc
students WHERE DO CLINICAL PSYCHOLOGISTS
Greater success Less success in WORK?
in placing placing students in  A variety of settings, but private
students in APA- APAaccredited practice is most common
accredited internships  True since 1980s
internship  Other common work settings include
 Universities
3. Clinical scientist model:  Psychiatric and general
Emphasizing Research hospitals
 Emerged in 1990s,  Community mental health
primarily as a reaction centers
against the trend toward  Other settings
practice represented by HOW ARE CLINICAL PSYCHOLOGISTS
Vail model DIFFERENT FROM OTHER
 Richard McFall’s 1991 PROFESSIONALS?
“Manifesto for a Science of 1. Counseling Psychologists:
Clinical Psychology”  Tend to see less seriously
sparked this movement disturbed clients
 A subset of Ph. D.  Tend to work less often in
institutions who strongly settings like inpatient
endorse empiricism and hospitals or units
science  Tend to endorse humanism
 Tend to train researchers more and behaviorism less
rather than practitioners  Tend to be more interested
EMERGING TRENDS IN TRAINING in vocational and career
1. Technology counseling
 Use of webcams for 2. Psychiatrists:
supervision  Go to medical school and
 Computer-based are physicians
assessment  Have prescription
2. Competencies privileges (this is changing
 Skills that a student must for clinical psychologists)
demonstrate  Increasingly emphasize
 Ex. Intervention, biological/ pharmaceutical
assessment, research, etc. rather than “talk therapy”
INTERNSHIPS: PRE-DOC AND POSTDOC intervention
A. Predoctoral internship 3. Social Workers
 Takes place at the end of  Tend to emphasize social
doctoral training programs factors in client’s problems
(before Ph.D. or Psy.D. is  Earn a master’s degree
awarded) rather than a doctorate
 A full year of supervised  Training emphasizes
to clinical experience in an treatment and fieldwork
applied setting over research or formalized
 An apprenticeship of sorts, assessment
to transition from student to 4. School Psychologists:
professional  Tend to work in schools
 Local- 200 clinical,120  Tend to have a more limited
indus 120 school -old professional focus than
360hrs clinical psychologists
 300 hrs.-new (student wellness and
 200 hrs- internship - learning)
(MA/MS)  Frequently conduct school-
B. Postdoctoral internship related testing and
 Takes place after the determine LD and ADHD
doctoral degree is awarded diagnoses
 Typically lasts 1-2 years  Consult with adults in
 Still supervised, but more children’s lives (e.g.,
independence teachers, staff, parents)
 Often specialized training 5. Professional Counselors:
 Often required for state  Earn a master’s degree
licensure  Complete training in two
GETTING LICENSED years
  Little emphasis on
psychological testing or
research
 May specialized in career,
school, college counseling
 RGC- MA in GC /MAED in
GC -2.5yrs non thesis track
 RPSY-MS /MA PSYCH - 3
yrs
LECTURE 2: EVOLUTION
EVOLUTION OF CLINICAL PSYCHOLOGY
 The emergence of clinical
psychology around the turn of the
20th century was preceded by
numerous important historical events
 These events “set the stage” for
clinical psychology.
EARLY PIONEERS
1. William Tuke
 1732-1822
 Lived in England
 Appalled by deplorable
conditions in “asylums”
where mentally ill lived
 Devoted much of his life to
improving their treatment
 Raised funds to open the
York Retreat, a model of
humane treatment
2. Phillippe Pinel
 1745-1826
 Lived in France
 Advocated for more
humane
compassionate treatment
of the mentally ill in France
 Also introduced ideas of a
case history, treatment
notes, and illness
classification, indicating
care about their well-being
3. Eli Todd
 1762-1832
 A physician in Connecticut
 At the time, there were very
few hospitals for the
mentally ill
 Burden for their
care fell
families
 Using Pinel’s efforts as a
model, he opened humane
treatment centers in US
4. Dorothea Dix
 1802-1887
 Worked in a prison in
Boston, and observed that
many inmates were
mentally ill rather than
criminals
 Traveled to various cities to
persuade leaders to build
facilities for humane
treatment of mentally ill
 Resulted in over 30 state
institutions in US and other
countries
5. Lightner Witmer
 1867-1956
 Lightner Witmer and the
Creation of Clinical
Psychology
 Received doctorate in 1892
in Germany
 Psychology was essentially Binet Intelligence Scales, which is
academic; no practice, just still widely used today
study  Binet’s test was intended for children
 In 1896, Witmer founded  David Wechsler published the
the first psychological clinic Wechsler-Bellevue in 1939, which
at the U. of Pennsylvania was designed for adults
 By 1914, there were about  Wechsler later created tests for
20 clinics in US schoolage and preschool children
 By 1935, there were over  Revisions of Wechsler’s tests are
150 among the most commonly used
 Witmer also founded the today
first scholarly clinical EVOLUTION OF ASSESSMENT:
psychology journal, The ASSESSMENT OF PERSONALITY
Psychological Clinic, in  Projective tests were among the
1907 first to emerge—clients “project”
EVOLUTION OF ASSESSMENT: personality onto ambiguous stimuli
DIAGNOSTIC ISSUES  Rorschach Inkblot
 Diagnosis and categorization of Method
mental illness has been central to  1921
clinical psychology from the start  Clients respond
 Emil Kraepelin (1855-1926) is to ambiguous
considered a pioneer of diagnosis inkblot
 Coined some of the earliest  Thematic Apperception
terms to categorize mental Test (TAT)
illness  1935
 Kraepelin’s work set the stage for  Clients respond
the Diagnostic and Statistical Manual to ambiguous
(DSM), which continues to dominate interpersonal
diagnosis today scenes
 Published by American Psychiatric  Objective tests soon followed
Association, originally in 1952 projectives
 Typically paper-and-pencil,
 DSM—1952 self-report, and more
 scientifically sound
DSM-II—1968
 DSM-III—1980  MMPI (1943)—
and
 DSM-III-R—1987 comprehensive personality
test measuring various
 DSM-IV—1994
pathologies
 DSM-IV-TR—2000-ADHD -Type
 MMPI-2 (1989)—revised
 DSM-5—2013-Presentation and re-standardized
 MMPI-A (1992)—for
 Most drastic change in DSMs is from adolescents
DSM-II to DSM-III Sample MMPI and Rorschach Stimuli
 Larger, including more  T/F I like magazines about
disorders motorcycles.
 Specific diagnostic criteria
 T/F Sometimes I lie to get what I
 Multi-axial system
want.
 DSM-IV-TR to DSM-5
 Removal of the multi-axial
system
on  As a general trend, as the DSM has
been revised, it has expanded to
include a greater number of disorders
 “Scientific discovery” or

“social invention?” EVOLUTION OF PSYCHOTHERAPY
Psychotherapy
 Currently, numerous disorders are  the most common activity of clinical
under consideration for inclusion in psychologists today, but before the
next DSM (“proposed criteria sets”) 1940s/1950s, it was not a significant
 Internet gambling disorder professional activity
 Attenuated psychosis  Treatment was by medical
syndrome doctors, not psychologists
 Persistent complex  World War II created a demand for
bereavement treatment of psychologically affected
 Non-suicidal self-injury soldiers
 Others  Wars have had many other
EVOLUTION OF ASSESSMENT: influences on the evolution
ASSESSMENT OF INTELLIGENCE of assessment and
 Assessment of intelligence psychotherapy
characterized the profession in early  When psychotherapy became a more
years common activity in the mid 1900s, the
 Early debates about the definition of psychodynamic approach dominated
intelligence focused on “g” (a single,  In the decades that followed,
general intelligence) vs. ”s” (specific numerous other approaches arose:
intelligences)  Behaviorism
 Alfred Binet’s early intelligence test  Humanism
(1905) later became the Stanford-  Family Therapy
 Most recently, cognitive therapy WHY PSYCHOLOGISTS SHOULD NOT diagnosis of normal life
(CBT) has risen to become the most PRESCRIBE: experiences
widely endorsed singular orientation A. Training issues  If diagnoses continue to
DEVELOPMENT OF THE PROFESSION  Which courses? When? expand, can anyone be
 At the historic Boulder conference in Taught by whom? diagnosed with a mental
1949, directors of graduate training B. Threats to psychotherapy disorder?
programs agreed on a dual emphasis  Would medications replace NEW DISORDERS, NEW DEFINITIONS
on practice and research talk therapy?  Disorders
 In the 1950s, 1960s, and 1970s, C. Identity confusion  Premenstrual dysphoric
 Therapy approaches  Especially when only some disorder
proliferated prescribe  Severe versions
 More minorities entered the D. Influence of pharmaceutical of the symptoms
field industry of premenstrual
 Psy.D./Vail model syndrome
programs emerged 2. Evidence-Based Practice/  Binge eating disorder
Manualized Therapy  Out-of-control
 In the 1980s,  When researchers overeating at
 Psychotherapy thrived, in measure therapy outcome, least once per
part due to increasing they often use therapy week
respect from medical manuals  Definitions
professionals and  To ensure  ADHD
insurance companies uniformity across  Age by which
 The number of training therapists symptoms appear
programs and new clinical  To minimize raised from 7 to
psychologists increased variability 12
 When outcome data RISKS OF OVERDIAGNOSIS
 In the 1990s and 2000s, supports the use of a  Unnecessary medication – harmful
 The size and scope of the manualized therapy, the side effects
field continues to grow treatment is known as  Unnecessary therapy – undermine
 Multiple training model “evidence based” coping skills
options are available  Treatments formerly called  Negatively impact self-image and
 Empirical support of clinical “empirically validated” and self-efficacy via stigma
techniques, prescription “empirically supported”  Adversely affect health insurance
privileges, and new  “Evidence-based enrollment and rates
technologies are among practice” includes  Legal ramifications
major contemporary issues the treatment and OVERDIAGNOSIS AND THE
LECTURE 3: CURRENT CONTROVERSIES factors related to PHARMACEUTICAL INDUSTRY
IN CLINICAL PSYCHOLOGY people providing  More mental disorders = more
CURRENT CONTROVERSIES and receiving the potential pharmaceutical customers?
1. Prescription Privileges treatment  Significant numbers of psychiatrists
 Historically, prescribing has ADVANTAGES OF EVIDENCE-BASED involved in the creation of the DSM
distinguished psychiatrists PRACTICE/ MANUALIZED THERAPY had financial ties to major
from psychologists  Scientific legitimacy pharmaceutical companies
 However, in recent  Establishing minimal levels of  69% for DSM-5
decades, clinical competence
psychologists have actively  Training Improvements 4. Payment Methods: Third-Party
pursued prescription  Decreased reliance on clinical Payment vs. Self-Payment
privileges judgment  Early in the history of
 Since 2002, two states DISADVANTAGES OF EVIDENCE-BASED clinical psychology, clients
have agreed to grant PRACTICE/ MANUALIZED THERAPY paid for services directly out
prescription privileges to  Threats to the psychotherapy of pocket
appropriately trained relationship  With time, health insurance
psychologists  Diagnostic complications companies began covering
 New Mexico  “Textbook” cases vs. “real mental health
 Louisiana world” cases  Today, many clients use
 Other states have  Restrictions on practice health insurance/ managed
considered similar  Mandated manuals vs. care benefits to pay for
legislation, and may pass it creatively customized services
soon treatments  Often called
 55  Debatable criteria for empirical “third-party
WHY PSYCHOLOGISTS SHOULD evidence payers”
PRESCRIBE: EFFECT OF THIRD-PARTY PAYMENT ON
A. Shortage of psychiatrists 3. Overexpansion of Mental THERAPY
 Especially in rural areas Disorders  Surveys of psychologists suggest
 Important factor in NM and  DSM size and scope has that third-party payment can result in
LA decisions increased from 1950s to  Negative impact on quality
B. CPs more expert than primary care present  Too little control over
docs  Overdiagnosis, diagnostic clinical decisions
C. Other non-physicians have privileges expansion, diagnostic  Surveys of psychologists suggest
 Dentists, podiatrists, inflation, diagnostic creep, that third-party payment can result in
optometrists, and some medicalization of everyday  Increased likelihood of
nurses, among others problems, false positives, being diagnosed with a
D. Convenience for clients false epidemics? mental disorder
E. Professional autonomy  Minimizing the chance that EFFECT OF THIRD-PARTY PAYMENT ON
F. Professional identification people struggling with PSYCHOLOGISTS’ EXPERIENCE
G. Evolution of the profession mental illness fall through  Lower pay
H. Revenue for the profession the cracks vs. over
  Time required for paperwork, phone Confidentiality: Tarasoff and the Duty to C. Test data
calls, Warn (cont.)  Raw data collected during
 How credible are clients’ threats? assessment
5. The Influence of Technology:  What kinds of threats merit  Should generally be shared
Cybertherapy and More warnings? at client’s request
 In recent years, clinical Confidentiality: When the Client is a Child Contemporary Ethical Issues: Managed
psychologists have  Often, children will confide more if Care
increasingly used they can be assured that  Managed care companies’ emphasis
technology in the direct psychologists will not repeat on financial bottom line can cause
delivery of psychological everything to their parents ethical conflicts
services  Parents, of course, have a right to be  Perhaps include info about managed
 Assessment informed care in the informed consent process
 Treatment  Psychologists often make  Diagnostic decisions can be
 Cybertherapy can replace arrangements by discussing this with influenced by managed care
or supplement face-to-face families up front companies’ requirements
meetings  Some issues, such as child abuse, Contemporary Ethical Issues: Technology
 Benefits can include require breaking of confidentiality to  “Psychological tests” on Internet
accessibility, affordability, protect the child  Many have questionable reliability
and anonymity, and more Informed Consent and validity
APPLICATIONS OF TECHNOLOGY IN  Required for research, assessment,  Other issues include
CLINICAL PSYCHOLOGY: EXAMPLES therapy, and other professional ψ Identity of client
 Videoconferencing to interview or activities ψ Testing conditions
treat  For therapy, informed consent is an ψ Inability to observe
 Email or text psychotherapy ongoing process rather than a one- behavior during testing
 Interactive Internet sites time event ψ Similar concerns about
 Online psychotherapy programs  As psychologist learns more about online therapy
 Virtual reality therapeutic client, more information can be Contemporary Ethical Issues: Small
experiences shared Communities
 Computer-based self-instruction  Informed consent for therapy must  Small communities can be rural
 Therapist/client interaction via hand- allow client the opportunity to ask areas or defined by ethnicity, religion,
held devices (e.g., iPhones, cell questions and receive answers or other variables
phones, Blackberries)  Informed consent process can be an  Multiple relationships can be
 katatagan.com/ early part of a strong therapeutic unavoidable
HOW WELL DOES CYBERTHERAPY relationship  Discuss up front with clients
WORK? Boundaries and Multiple Relationships  Clarify boundaries
 Appears to work about as well as 1. Knowing someone professionally and  Avoid impaired judgment and
inperson psychotherapy in some other way exploitation
 Specific examples include ψ Romantic/sexual, PART 2 OF LECTURE 4
 CBT for anxiety disorders friendship, business, etc. The U.S. Population
 Health psychology 2. Unethical when:  The U. S. population is increasingly
 Headaches ψ Psychologist’s objectivity, diverse, particularly in certain areas/
 Pain competence, or judgment cities
TECHNOLOGY: SUGGESTIONS FOR can be impaired ψ 20% of U. S. schoolchildren
EMERGING PROFESSIONAL ISSUES Exploitation or harm could speak a language other
 Obtain informed consent about the result than English at home
technology 3. Boundary crossings (minor, often ψ In Miami, Detroit, and
 Follow relevant telehealth laws harmless) can lead to boundary Washington DC, a single
 Follow APA ethical code violations (major, often harmful) ethnic minority group
 Ensure confidentiality via encryption Competence represents over half of the
 Make efforts to appreciate culture  Sufficiently capable, skilled, population
 Obtain relevant training experienced, and expert to complete Multiculturalism as the “Fourth Force”
 Know client’s local emergency the professional tasks they undertake  Some argue that multiculturalism is
resources  Boundaries of competence the defining issue of the current
TECHNOLOGY: ADDITIONAL POTENTIAL ψ Psychologists should know generation of psychology
PROBLEMS their limits and seek  Defining paradigms of previous
 Confirming the identity of the client additional training or generations have included
 Confidentiality across electronic supervision when ψ Psychoanalysis
transmission necessary
ψ Behaviorism
 Making interpretations in the absence  Continuing education can maintain
ψ Humanism/person-
of nonverbal cues that would be competence
centered
 Importance of cultural competence
present face-to-face  Multiculturalism can enhance any of
 Competence in technical as well as  Burnout can impair competence previous “forces”
clinical skills ψ Burnout can be minimized Culture and Clients
TECHNOLOGY: EFFECTIVENESS OF by efforts by the  Culture shapes how clients
TREATMENT psychologist to keep job understand their problems
 varied, keep life balanced,
Early research is beginning to  Questions to assess client
demonstrate that it can work keep expectations
understanding:
 Success depends on many factors: reasonable, and keep self-
ψ What do you call your
 Which cybertherapy, healthy
problem (illness, distress)?
disorder, device? Ethics in Clinical Assessment
A. Test selection ψ What do you think your
 What setting? problem does to you?
 How clients found or were  Consider competence,
culture, test’s reliability and ψ What do you think the
referred to cybertherapy? natural cause of your
LECTURE 4: ETHICAL ISSUES AND validity
B. Test security problem is?
CONDUCTING RESEARCH IN CLINICAL ψ How do you think this
PSYCHOLOGY  Don’t allow test materials to
enter public domain problem should be treated?
 ψ Who else (e.g., family,
religious leaders) do you
turn to for help?
Recent Professional Efforts to Emphasize
Issues of Culture
 Journals and books on cultural topics
 New APA divisions
ψ Division 35—Society for
the Psychology of Women
ψ Division 36—Psychology
of Religion
ψ Division 44—Society for
the Psychological Study of
Lesbian, Gay, and Bisexual
Issues
ψ Division 45—Society for
the Study of Ethnic Minority
Issues
ψ Division 51—Society for
the Psychological Study of
Men and Masculinity
 DSM efforts toward
multiculturalism
ψ Text describing cultural
variations of disorders
ψ General guidance for
cultural competence
 “Outline for
Cultural
Formulation”
 “Cultural
Formulation
Interview”
ψ Cultural concepts of
distress glossary
 Some related to
DSM disorders;
others unique
 Examples. Taijin
kyofusho, susto,
maladi moun
 Revisions of prominent
assessment methods
ψ MMPI-2- 567items t/f
ψ Wechsler intelligence tests
Cultural Competence
 The counselor’s acquisition of
awareness, knowledge, and skills
needed to function effectively in a
pluralistic democratic society
 3 main components:
ψ Awareness
ψ Knowledge
ψ Skills
Cultural Competence: Self-Awareness
 Learning about one’s own culture
ψ Values, assumptions,
biases
ψ By doing so, become less
egocentric
ψ Realize that differences are
not deficiencies
Cultural Competence: Knowledge of
Diverse Cultures
 Can gain knowledge by
ψ Reading, especially
regarding history
ψ Direct experiences
ψ Relationships with people
of various cultures
 therapy in a controlled
Acculturation
ψ Response to new cultural
environment
ψ Balance between adopting
new and retaining original
culture
Cultural Competence: Culturally
Appropriate Clinical Skills
 Techniques should be consistent with
the values and life experiences of
each client
 “Talk therapy” may work better for
some cultural groups than for others
 Some cultural groups may respond
more positively to “action” than
“insight”
 Microaggressions
 Comments or actions made
in cultural context that
(often unintentionally)
convey negative beliefs
Cultural Adaptation
 Modifying treatments with empirical
evidence for members of a cultural
group
Etic vs. Emic Perspective
Etic
 Emphasizes similarities between all
people
 Assumes universality
 Downplays culture-based differences
Emic
 Emphasizes culture-specific norms
 Appreciate clients in the context of
their own culture
Tripartite Model of Personal Identity
 Three levels of identity
1. Individual level
 Every person is totally
unique
2. Group level
 Every person is like some
others
3. Universal level
 Every person is like all
others
What Constitutes a Culture?
 Narrow vs. broad definitions
ψ Some argue that ethnicity
and race are the defining
characteristics of culture
ψ Others argue that many
other variables can define a
culture, such as
 Socioeconomic
status, Religion,
Gender, Age,
Geography/regio
n, Political
affiliation,
Disability status
Training Psychologists in Cultural Issues
 Educational alternatives
ψ Courses
ψ Readings
ψ Real-world experiences
ψ Recruit and retain diverse
students and faculty
ψ Encourage cultural self-
knowledge, curiosity, and
humility
Lecture 5 AND 6: Conducting Research in
Clinical Psychology
Research on Treatment Outcome
1. Efficacy
 The success of a particular
study conducted with
clients who meet specific
criteria
 how well a therapy works
“in the lab”
2. Effectiveness
 The success of a therapy in
actual clinical settings in
which client problems are
not limited to
predetermined criteria
 how well a therapy works
“in the real world”
 1995 Consumer Reports survey of
readers is an example
 Generally positive toward
psychotherapy, but
scientific rigor is
questionable
Research on Treatment Outcome
 Statistical vs. clinical (“real world”)
significance
 Statistical significance doesn’t
necessarily mean clinical significance
Internal validity
 The extent to which change in the DV
is due to change in the IV
 Generally high in efficacy studies
External validity
 Generalizability of result
 Generally high in effectiveness
studies
Research on Assessment Methods
Examples can include:
 Validation or expanded use of
assessment tools
 Establishing psychometric data for
assessment tools
 Comparing multiple assessment
tools to each other
 Others
Research on Diagnostic Issues
Examples can include:
 Examine reliability or validity of
diagnostic constructs
 Examine relationships between
disorders
 Prevalence or course of disorders
 Others
Research on Professional Issues
Examples can include psychologists’:
 Beliefs
 Activities
 Practices
 Other aspects of their professional
lives
Research on Teaching and Training Issues
Examples can include:
 Training philosophies
 Specific coursework
 Opportunities for specialized training
 Outcome of training efforts
 Comparison to training in similar
disciplines
 Others
How Do Clinical Psychologists Do
Research?
The Experimental Method
 Observation of events
 Hypothesis
 Define independent and dependent
variables
 Empirically test the hypothesis
 Alter hypothesis as necessary per
results
Quasi-experiments
 Used in place of true experiments
when practical, ethical, or other
issues limit manipulations
 Less scientifically sound than true
experiments, but common in clinical
psychology
Between-group designs  Nine subsequent revisions  Cases involving
 Participants in different conditions  Applies to all specialities child abuse
receive entirely different treatments ψ Especially relevant to Informed Consent
 Often, an experimental condition vs. clinical psychologists  Facilitates an educated decision
a control group Aspirational and Enforceable  Required during
Within-group designs  Aspirational – General Principles ψ Research
 Compare participants in a single  Enforceable – Ethical Standards ψ Assessment
condition to selves at different points General Principles: ψ Therapy
in time  Describe an ideal level of ethical Boundaries and Multiple Relationships (1 of
Mixed-group designs functioning or how psychologists 3)
 Combination of between- and within- should strive to conduct themselves.  Multiple relationships
group They don’t include specific definitions ψ Can be problematic
Analogue designs of ethical violations; instead, they ψ The claim of their
 Used when actual clinical populations offer more broad descriptions of nonexistence would be
or situations can’t be accessed exemplary ethical behavior. false
 An approximation or simulation of the 1. Beneficence and Nonmaleficence.  Defining Multiple Relationships
“real thing” 2. Fidelity and Responsibility. ψ Ethical Standard
Correlational designs 3. Integrity. ψ Sexual multiple
 Examine relationship between two or 4. Justice. relationships
more variables 5. Respect for People’s Rights and ψ Nonsexual multiple
 Causality cannot be determined Dignity. relationships
 Often used when experimental or Ethical Standards:
 What Makes Multiple
quasi-experimental designs are not  If a psychologist is found guilty of an Relationships Unethical?
feasible ethical violation, it is a standard (not
ψ Criteria for impropriety
Case studies a principle) that has been violated.
 Impairment in the
 Detailed examination of a single These standards are written broadly
psychologist
person or situation; often very enough to cover the great range of
activities in which psychologists  Exploitation or
clinically relevant harm to the client
 Often qualitative rather than engage, but they are nonetheless
ψ Need for caution and
quantitative more specific than the general
principles. Although each general foresight
 Demonstrates the idiographic
approach to research (vs. nomothetic principle could apply to almost any
approach) task a psychologist performs, each
 Can inspire more systematic ethical standard typically applies to a
research more targeted aspect of professional
 ABAB design is one example activity.
1. Resolving Ethical Issues.
 Alternately apply and remove a
2. Competence.
treatment
3. Human Relations.
Meta-analysis
4. Privacy and Confidentiality.
 Statistical method of combining
5. Advertising and Other Public
results of separate studies into a
Statements.
single summary finding
6. Record Keeping and Fees.
 Findings are translated into effect 7. Education and Training.
sizes 8. Research and Publication.
 Can quantitatively capture the trends 9. Assessment.
of many individual studies 10. Therapy.
 Examples include meta-analyses of Ethical Decision Making
psychotherapy outcome  Models have been recommended by
Cross-sectional designs expert
 Compare participants at a single  Best preparation to deal with
point in time dilemmas
 More efficient than longitudinal Psychologists’ Ethical Beliefs
designs  Based on survey of American
Longitudinal designs Psychological Association members
 Compare participants at different  Based on studies by other
points in time researchers
 Less efficient than cross-sectional Confidentiality [1 of 2)
designs, but can be more valid in  Specifically mentioned in
assessing change across time ψ General principles
Ethical Issues in Research in Clinical
ψ Ethical standards
Psychology
 Reason for emphasis
Numerous APA ethical standards
specifically address research:  Tarasoff and the Duty to Warn
 Obtain informed consent ψ Tarasoff case
 Don’t coerce participation  Duty to warn and
duty to protect
 Use deception only when justified
and necessary ψ Challenges faced by clinical
psychologists
 Minimize harm to participants
ψ Interpretations vary from
 Don’t fabricate or falsify data
state to state
 Assign authorship appropriately
 When the Client Is a Child or
 Share data with other researchers for
Adolescent
verification
ψ Dilemma: How much to
LECTURE 5 AND 6: PART 2
reveal to parents?
American Psychological Association Code
of Ethics  Possible
arrangements
 First published in 1953