BY DIVYA DEVI ANAND, M.SC COUNSELING PSYCHOLOGY, ASST.

PROFESSOR,
DEPT OF PSYCHOLOGY
UNIT 1: INTRODUCTION TO CLINICAL PSYCHOLOGY

CONTENTS

• Definition of Clinical Psychology,

• Historical development of Clinical Psychology in India
• Professional Activities of Clinical Psychologists,
• Clinical psychology in practice, Employment settings for Clinical Psychologists,
• Ethics and values of the profession

DEFINITION OF CLINICAL PSYCHOLOGY

Clinical psychology is the branch of psychology and it can be defined as the

assessment, treatment, and study of human behavior in the context of biological,
psychological, and social factors.

According to the APA, clinical psychology uses the principles of psychology to better
understand, predict, and improve “intellectual, emotional, biological, psychological,
social, and behavioral aspects of human functioning”.

In 1907, American psychologist Lightner Witmer first coined the term and defined
clinical psychology as the study of individuals through observational or experimental
methods to promote change in individuals.

Clinical psychologists also examine the causes of abnormal behavior in order to predict
and prevent maladjustment.

Who is a Clinical Psychologist?

A clinical psychologist is a professional who applies principles and procedures to

understand, predictand alleviate intellectual, emotional, psychological and behavioral
problems

HISTORICAL DEVELOPMENT OF CLINICAL PSYCHOLOGY

Early influences on the field of clinical psychology include the work of the Austrian
psychoanalyst Sigmund Freud. He was one of the first to focus on the idea that mental
illness was something that could be treated by talking with the patient, and it was the
development of his talk therapy approach that is often cited as the earliest scientific use
of clinical psychology.

American psychologist Lightner Witmer opened the first psychological clinic in 1896 with
a specific focus on helping children who had learning disabilities. It was also Witmer
who first introduced the term "clinical psychology" in a 1907 paper.

By 1914, 26 other clinics devoted to the practice of clinical psychology had been
established in the United States.

Evolution During the World Wars

Clinical psychology became more established during the period of World War I as
practitioners demonstrated the usefulness of psychological assessments. In 1917, the
American Association of Clinical Psychology was established

During World War II, clinical psychologists were called upon to help treat, what was then
known as shell shock, now referred to as post-traumatic stress disorder

During the 1940s, though the United States had no programs that offered a formal
degree in clinical psychology, by 1950 more than half of all the Doctor of Philosophy
(Ph.D.)-level degrees in psychology were awarded in the area of clinical psychology.

In 1947, the organization presently known as the American Board of Professional

Psychology was estab-lished and soon began to examine candidates for its diploma
signifying advanced competence in clinical psychology.

Carl R. Rogers in the 1940s helped move the field of clinical psychology from an overly
exclusive preoccu-pation with mental testing toward a more balanced em-phasis on
psychotherapeutic intervention as well (Rog-ers. 1951).

Rogers’ client-centered or person-centered approach to psychotherapy was original with

him but was indirectly influenced by Freud

Historical development of Clinical Psychology in India

• 1945 - CU introduced a certificate course in Applied and Abnormal Psychology

• In 1951, a 1-year program in clinical psychology was introduced in INDIA.
 • The first postgraduate course in clinical psychology, started in 1955, was diploma
in medical psychology (DMP) and was later termed a diploma in medical and
social psychology (DM & SP) (now M.Phil Clinical Psychology) in AIIMH (now
NIMHANS).
• Since the 1970s, clinical psychology has continued growing into a robust
profession and academic field of study in India

PROFESSIONAL SKILLS / ACTIVITIES OF A CLINICAL PSYCHOLOGISTS

The fundamental skill areas that are essential for competent functioning as a clinical
psychologist within the areas of mental health include the following:

1.Assessment & Diagnosis

2.Intervention & Therapy

3.Teaching

4.Clinical Supervision

5.Research

6.Consultation

7.Program Development

8.Administration

Assessment & Diagnosis

Assessment has long been a critical part of the clinical psychologist's role. Clinical
psychologists most commonly administer psychological tests for the purposes of
assessing a person's mental health.

Assessment, whether through observation, testing or interviewing, is a way of gathering

information so that an important question can be solved.
Assessment of an individual's development, behavior, intellect, interests, personality,
cognitive processes, emotional functioning, and social functioning are performed by
clinical psychologists, as are assessment activities directed toward couples, families,
and groups.

Interpretation of assessment results, and integration of these results with other

information available, in a way that is sensitive to the client, and particularly clients of
special populations, is an essential skill of clinical psychologists

Diagnosis

To formulate an effective method of treatment, clinical psychologists must not only

determine that there is a problem but also must make a specific diagnosis. That is, they
must identify the specific disorder or problem affecting the patient.

For this purpose, the most widely used diagnostic scheme in the India is the Diagnostic
and Statistical Manual of Mental Disorders, a reference book published by the American
Psychiatric Association & ICD 10

INTERVENTION & THERAPY

A major activity of clinical psychologists is intervention or treatment.

Many clinical psychologists work directly with people who have

a mental illness or psychological disorder.By choosing an appropriate
treatment, clinical psychologists can help such people overcome their problem or, at minimum
, manage their symptoms.

All psychological intervention rests on the ability to develop and maintain functional
therapeutic relationships with clients.

All interventions require skill in the following tasks: conceptualization of the problem;
formulation of a treatment plan; implementation of the treatment plan; and evaluation of
the accuracy and completeness of the above-mentioned tasks, as well as outcome of
the intervention
Psychotherapy is the activity that most frequently engages the typical clinician's efforts
and to which the most time is devoted.

Most often therapy involves a one- to- one relationship, but today couple's therapy,
family therapy and group therapy are also very common.

The therapist and client meet regularly, typically (but not necessarily) in weekly
sessions, to work out the solution of the client's problems until both agree that the client
has substantially improved and does not need further treatment.

Although clinical psychologists cannot prescribe medication, they often combine

psychotherapy with drug treatment by working in collaboration with the client's physician

TEACHING

Clinical psychologists who have full or part- time academic appointments obviously
devote a considerable amount of time to teaching. Those, whose responsibilities are
primarily in the area of graduate education, teach courses in advanced
psychopathology, psychological testing, interviewing, intervention, personality theory
and so on. Some also teach abnormal psychology, introduction to clinical psychology.
Much of this teaching is of the familiar class- room lecture type.

In some cases the clinician may go out into the community and lead workshops on
various topics for police officers, volunteers, ministers, probation officers and others

CLINICAL SUPERVISION

This activity is another form of teaching. However, it typically involves more one- to- one
teaching, small group approaches, and other less formal, non class room varieties of
instruction. Clinical psychologists often spend significant portions of their time
supervising students, interns and others.

During supervision, clinical psychologists discuss the trainee's clinical cases in depth
while providing therapeutic guidance as they learn psychotherapy or psychological
testing skills.
RESEARCH

Clinical psychologists are in a unique position both to evaluate research conducted by

others and to conduct their own research.

Clinical psychology research can be both basic and applied. Among the health care
professions, clinical psychology is one of the few to provide extensive research training.

Thus, clinical psychologists are well suited to design, implement, and evaluate research
and conduct program evaluation/quality assurance programs as part of their activities

Research is an integral activity of clinical psychologists working in academic and clinical

settings. The range of research projects carried out by clinicians is enormous.

Clinical studies include search for the causes of mental disorders, development and
validation of assessment devices, evaluation of therapy techniques and so on. By virtue
of their training in research, clinical psychologists have the ability both to consume and
produce new knowledge.

Consultation

A growing number of clinical psychologists serve as consultants. It takes innumerable

forms, in many different settings.

For example, companies might consult with a clinical psychologist to help reduce co-
worker conflicts or provide stress management strategies for high stress employees
such as business executives, firefighters, police officers, or prison guards.

Consultation might involve helping a physician to better manage patient non-

compliance with unpleasant medical procedures.

Consultation might also include assessment, teaching, research, and brief

psychotherapy activities.

Consultation can run the gamut from clinical cases to matter of business, personnel and
profit. It can deal with individuals or entire organizations. Sometimes it is remedial, other
times it is oriented toward prevention
PROGRAM DEVELOPMENT

Clinical psychologists are often asked to contribute to the development of

treatment/evaluation programs, and should obtain appropriate supervised experience in
such activities during their training.

They typically work with other professionals, either directly or indirectly, who are also
providing professional services to the client.

As such, clinical psychologists must be skilled in interacting with other professionals in a

respectful and helpful manner to develop successful programs

ADMINISTRATION

every clinical psychologist spends time on administrative tasks. For example, client
records must be maintained, the clients' clinical reports must be maintained, the policies
and procedures for clinical or research operations are to be developed, etc.

Some clinicians become full- time administrators. It would be difficult to list all the sorts
of administrative posts held by clinical psychologists.

However, here are a few examples: Head of a university psychology department,

director of a veterans administration clinic, vice president of a consulting firm, director of
the clinical training program, chief psychologist in the hospital etc

CLINICAL PSYCHOLOGY IN PRACTICE

A career as a clinical psychologist usually requires a doctoral degree, although in some
cases a MPhil degree is sufficient, especially for those who intend to work solely in
counseling.
Those who do earn a doctorate, however, often have more choices of where and how
they would like to work in the field.
Clinical psychologists ( CPs) work in many employment settings including:
• Hospitals
• Medical schools
• Outpatient clinics
• Colleges and Universities
• Business and industry
• Private or group practices
 • Military setting
• Other locations

Hospitals
• Many clinical psychologists work in hospitals.
• They may conduct psychological testing in hospitals.
• They may provide individual, family or group psychotherapy.
• They may act as consultant to other mental health or medical professional in
psychiatry or general medical hospital units.
• They may serve as administrative role such as unit chief in psychiatry ward, etc.

Medical schools
• They serve as faculties of many medical schools.
• They may be “Clinical faculty” which includes several hours to be contributed to
medical center trainees. These trainees may be medical students, nursing
students, psychiatry residents or other medical residents or the trainees maybe
non-medical hospital trainees like psychology interns or postdoctoral fellows,
social work interns, etc.
• They might teach a seminar or may provide case supervision or consultation.
• They may be academic or research faculty at a medical school.
Outpatient clinics
• Many CPs work in outpatient clinic such as community mental health centers
providing wide range of clinical services to other professionals and organizations.
• Psychologists in these settings may conduct research but direct clinical service is
their primary activity and priority, for example, they provide psychotherapy to
children or educational classes to parents.
Colleges and universities
• About 20 % of CPs are employed in academic environments.
• They generally teach psychology courses, supervise clinical or research work of
psychology students and conduct both independent and collaborative research.
• Some of them work in academic clinical settings such as student counselling
centers providing direct clinical services to students

Business and industry

• Many clinical psychologists employed in this setting offer consultation services to
management or may offer brief psychotherapy to employees.
 • They may conduct research on various psychological issues related to company
functioning and performance.
• They may help managers learn to improve their abilities to motivate and
supervise employees and they may also assess in developing strategies for
interviewing and hiring applicants.
Legal Setting
• There are plenty of opportunities for clinical psychologists working in a legal
setting.
• This could range from working with people incarcerated in prisons or on parole
as well as working with victims of crime.
• When working within some aspect of the legal system, the clinical psychologist
could decide to work with clients ranging from very young people to senior
citizens.
• You may also be able to find work within the court system performs court
appointed assessment and therapy with a variety of clients.

Private or group practices

• About 35 % of CPs primarily work in solo or group private practices
• They may provide clinical services in their solo practice or in conjunction with
other mental health or healthcare practitioners in a multidisciplinary setting.
• Those who offer psychotherapy prefer private practice.
• Many provide direct clinical, consultation and other services to their patients and
clients
• Private practitioners report more job satisfaction and less stress than others and
hence the percentage of psychologists engaged in part time practices has not
decreased even 20 years after the onset of managed healthcare.

Military settings
• Being part of military can be very hard on people. Recent studies have shown
that most men and women are affected by some kind of emotional or mental
disorder and they are often in need of services provided by military
psychologists.
• CPs evaluate military personnel and their families and help to resolve their issues
and offer counselling.
Other locations
• Clinical psychologists are employed in various other settings like police stations,
prison ,juvenile hall, detention center, rehabilitation centers for disabled
children or adults, schools, other work environment.
• They may be employed to tackle substance abuse or other mental illness
IMPORTANT QUESTIONS
4 MARKS
1. Define Clinical Psychology
2. List out the potential work settings of a clinical psychologists
3. Write notes on the evolution of clinical psychology in India
4. Write notes on the role of clinical psychologists in academic settings
5. What are the professional skills of a clinical psychologists?

6 MARKS
1. What are the professional skills of a clinical psychologists? [any 3]
2. Write notes on the role of clinical psychologists in the following settings
a. academic settings
b. legal settings
c. hospitals
3. Describe any 3 areas of scope for clinical psychologist
4. Write short notes on the evolution of clinical psychology in India
5. Discuss briefly on any 3 of the activities carried by a professional clinical
psychologist
6. How did clinical psychology evolve during the world war? Illustrate the important
works of the pioneers of this field

10 MARKS
1. Describe the activities carried by a professional clinical psychologist
2. Describe the scope of clinical psychology
3. Write an essay on professional skills of a clinical psychologist
4. Elaborate on any 5 employment settings where a clinical psychologist can render
their services
5. Define clinical psychology. Write a note on the history of clinical psychology
6. Discuss on the history of clinical psychology