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Encyclopedia > Clinical psychology

The Greek letter Psi is often used as a symbol of psychology.
The Greek letter Psi is often used as a symbol of psychology.

Clinical psychology includes the scientific study and application of psychology for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development.[1][2] Central to its practice are psychological assessment and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration.[3] In many countries it is a regulated mental health profession. {redirect|Psychological science|the journal|Psychological Science (journal)}} Not to be confused with Phycology. ... A mental illness or mental disorder refers to one of many mental health conditions characterized by distress, impaired cognitive functioning, atypical behavior, emotional dysregulation, and/or maladaptive behavior. ... Mental health is a term used to describe either a level of cognitive or emotional wellbeing or an absence of a mental disorder. ... Psychological testing is a field characterized by the use of samples of behavior in order to infer generalizations about a given individual. ... Psychotherapy is an interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living. ... A mental health professional is a person who offers services for the purpose of improving an individuals mental health and/or researches in the field of mental health. ...


The field is often considered to have begun in 1896 with the opening of the first psychological clinic at the University of Pennsylvania by Lightner Witmer. In the first half of the 20th century, clinical psychology was focused on psychological assessment, with little attention given to treatment. This changed after the 1940s when World War II resulted in the need for a large increase in the number of trained clinicians. Since that time, two main educational models have developed—the Ph.D. (focusing on research) and the Psy.D. (focusing on practice). Clinical psychologists are now considered experts in providing psychotherapy, and generally train within four primary theoretical orientations—Psychodynamic, Humanistic, Cognitive Behavioral, and Systems or Family therapy. A clinic or outpatient clinic is a small medical facility that provides health care for ambulatory patients - as opposed to inpatients treated in a hospital. ... This article is about the private Ivy League university in Philadelphia. ... Lightner Witmer Lightner Witmer (1867-1956) is regarded as the inventor of the term Clinical Psychology and the co-founder of the worlds first Psychological Clinic in 1896 at the University of Pennsylvania. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... The Psy. ... It has been suggested that Psychodynamic psychology be merged into this article or section. ... Humanistic psychology is a school of psychology that emerged in the 1950s in reaction to both behaviorism and psychoanalysis. ... A Cognitive Behavioral Therapy (CBT) is a psychotherapy based on modifying cognitions, assumptions, beliefs and behaviors, with the aim of influencing disturbed emotions. ... Family therapy, also referred to as couple and family therapy and family systems therapy, is a branch of psychotherapy that works with families and couples in intimate relationships to nurture change and development. ...


Clinical psychology may be confused with psychiatry, which generally has similar goals (e.g. the alleviation of mental distress), but is unique in that psychiatrists are medical practitioners. The most obvious difference is they are licensed to prescribe medication. Perhaps more subtly psychiatrists' training allows them to take a multi-dimensional biological, psychological and social perspective of mental health problems. In practice psychologists and psychiatrists often work closely together in multidisciplinary teams with other professionals such as occupational therapists and social workers to bring a multimodal approach to complex patient problems. An MRI scan of a human brain and head. ... For the chemical substances known as medicines, see medication. ... An assortment of psychoactive drugs A psychoactive drug or psychotropic substance is a chemical substance that acts primarily upon the central nervous system where it alters brain function, resulting in temporary changes in perception, mood, consciousness and behavior. ...

Contents

History

Further information: Eastern philosophy and clinical psychology and Islamic psychology
Many 18th c. treatments for psychological distress were based on pseudo-scientific ideas, such as Phrenology.
Many 18th c. treatments for psychological distress were based on pseudo-scientific ideas, such as Phrenology.

Although modern, scientific psychology is often dated at the 1879 opening of the first psychological laboratory by Wilhelm Wundt, attempts to create methods for assessing and treating mental distress existed long before. The earliest recorded approaches were a combination of religious, magical and/or medical perspectives.[4] The history of psychology as a scholarly study of the mind and behavior dates, in Europe, back to the Late Middle Ages. ... Many 18th c. ... Like body and mind, East and West are false dichotomies. ... Image File history File links Phrenology1. ... Image File history File links Phrenology1. ... Phrenology (from Greek: φρήν, phrēn, mind; and λόγος, logos, knowledge) is a theory which claims to be able to determine character, personality traits and criminality on the basis of the shape of the head (i. ... Wilhelm Maximilian Wundt (August 16, 1832-August 31, 1920) was a German psychologist, physiologist, and professor who is, along with William James, regarded as the father of psychology. ...


In the early 1800s, one could have his or her head examined, literally, using phrenology, the study of personality by the shape of the skull. Other popular treatments included physiognomy—the study of the shape of the face—and mesmerism, Mesmer's treatment by the use of magnets. Spiritualism and Phineas Quimby's "mental healing" were also popular.[5] Phrenology (from Greek: φρήν, phrÄ“n, mind; and λόγος, logos, knowledge) is a theory which claims to be able to determine character, personality traits and criminality on the basis of the shape of the head (i. ... Physiognomy (Gk. ... Hypnosis, as defined by the American Psychological Association Division of Psychological Hypnosis, is a procedure during which a health professional or researcher suggests that a client, patient, or experimental participant experience changes in sensations, perceptions, thoughts, or behavior. ... Franz Anton Mesmer. ... For other uses, see Magnet (disambiguation). ... This article is about the religion. ... Phineas Parkhurst Quimby Phineas Parkhurst Quimby (February 16, 1802 – January 16, 1866), was a New England philosopher, magnetizer, mesmerist, healer, and scientist, who resided in Belfast, Maine, and had an office in Portland, Maine. ...


While the scientific community eventually came to reject all of these methods, academic psychologists also were not concerned with serious forms of mental illness. That area was already being addressed by the developing fields of psychiatry and neurology within the asylum movement.[4] It was not until the end of the 19th century, around the time when Sigmund Freud was first developing his "talking cure" in Vienna, that the first scientifically clinical application of psychology began. An MRI scan of a human brain and head. ... Neurology is a branch of medicine dealing with disorders of the nervous system. ... A psychiatric hospital (also called, at various places and times, mental hospital or mental ward, historically often asylum, lunatic asylum, or madhouse), is a hospital specialising in the treatment of persons with mental illness. ... Sigmund Freud (IPA: ), born Sigismund Schlomo Freud (May 6, 1856 – September 23, 1939), was an Austrian neurologist and psychiatrist who founded the psychoanalytic school of psychology. ... Today psychoanalysis comprises several interlocking theories concerning the functioning of the mind. ... For other uses, see Vienna (disambiguation). ...


Early clinical psychology

Lightner Witmer, the father of modern clinical psychology.
Lightner Witmer, the father of modern clinical psychology.

By the second half of the 1800s, the scientific study of psychology was becoming well established in university laboratories. Although there were a few scattered voices calling for an applied psychology, the general field looked down upon this idea and insisted on "pure" science as the only respectable practice.[4] This changed when Lightner Witmer (1867-1956), a past student of Wundt and head of the psychology department at the University of Pennsylvania, agreed to treat a young boy who had trouble with spelling. His successful treatment was soon to lead to Witmer's opening of the first psychological clinic at Penn in 1896, dedicated to helping children with learning disabilities.[6] Ten years later in 1907, Witmer was to found the first journal of this new field, The Psychological Clinic, where he coined the term "clinical psychology," defined as "the study of individuals, by observation or experimentation, with the intention of promoting change."[7] The field was slow to follow Witmer's example, but by 1914 there were 26 similar clinics in the U.S.[8] Image File history File links Witmer. ... Image File history File links Witmer. ... Lightner Witmer Lightner Witmer (1867-1956) is regarded as the inventor of the term Clinical Psychology and the co-founder of the worlds first Psychological Clinic in 1896 at the University of Pennsylvania. ... Lightner Witmer Lightner Witmer (1867-1956) is regarded as the inventor of the term Clinical Psychology and the co-founder of the worlds first Psychological Clinic in 1896 at the University of Pennsylvania. ... This article is about the private Ivy League university in Philadelphia. ... This article is about the use of the term in the United States and Canada. ...


Even as clinical psychology was growing, working with issues of serious mental distress remained the domain of psychiatrists and neurologists.[9] However, clinical psychologists continued to make inroads into this area due to their increasing skill at psychological assessment. Psychologists' reputation as assessment experts became solidified during World War I with the development of two intelligence tests, Army Alpha and Army Beta (testing verbal and nonverbal skills, respectively), which could be used with large groups of recruits.[5][6] Due in large part to the success of these tests, assessment was to become the core discipline of clinical psychology for the next quarter century, when another war would propel the field into treatment. For other uses, see Psychiatrist (disambiguation). ... Neurology is the branch of medicine that deals with the nervous system and disorders affecting it. ... This article or section does not cite its references or sources. ... “The Great War ” redirects here. ...


Early professional organizations

The field began to organize under the name "clinical psychology" in 1917 with the founding of the American Association of Clinical Psychology. This only lasted until 1919, after which the American Psychological Association (founded by G. Stanley Hall in 1892) developed a section on Clinical Psychology, which offered certification until 1927.[8] Growth in the field was slow for the next few years when various unconnected psychological organizations came together as the American Association of Applied Psychology in 1930, which would act as the primary forum for psychologists until after World War II when the APA reorganized.[10] In 1945 APA created what is now called Division 12, its division of clinical psychology, which remains a leading organization in the field. Psychological societies and associations in other English-speaking countries developed similar divisions, including in Britain, Canada, Australia and New Zealand. The American Psychological Association (APA) is a professional organization representing psychology in the US. It has around 150,000 members and an annual budget of around $70m. ... Granville Stanley Hall, circa 1910. ...


World War II and the integration of treatment

The U.S. army conducts a group psychological test developed by clinical psychologists for selection purposes.
The U.S. army conducts a group psychological test developed by clinical psychologists for selection purposes.

When World War II broke out, the military once again called upon clinical psychologists for their assessment expertise. As soldiers began to return from combat, psychologists started to notice symptoms of psychological trauma labeled "shell shock" (eventually to be termed Post-Traumatic Stress Disorder) that were best treated as soon as possible.[6] Because physicians (including psychiatrists) were over-extended in treating bodily injuries, psychologists were called to help treat this condition.[11] At the same time, female psychologists (who were excluded from the war effort) formed the National Council of Women Psychologists with the purpose of helping communities deal with the stresses of war and giving young mothers advice on child rearing.[7] After the war, the Veterans Administration in the U.S. made an enormous investment to set up programs to train doctoral-level clinical psychologists to help treat the thousands of veterans needing care. As a consequence, the U.S. went from having no formal university programs in clinical psychology in 1946 to over half of all PhDs in psychology in 1950 being awarded in clinical psychology.[7] Image File history File links No higher resolution available. ... Image File history File links No higher resolution available. ... The United States Army is the largest, and by some standards oldest, established branch of the armed forces of the United States and is one of seven uniformed services. ... Combatants Allied powers: China France Great Britain Soviet Union United States and others Axis powers: Germany Italy Japan and others Commanders Chiang Kai-shek Charles de Gaulle Winston Churchill Joseph Stalin Franklin Roosevelt Adolf Hitler Benito Mussolini Hideki Tōjō Casualties Military dead: 17,000,000 Civilian dead: 33,000... Post-traumatic stress disorder (PTSD) is a term for certain severe psychological consequences of exposure to, or confrontation with, stressful events that the person experiences as highly traumatic. ... The United States Department of Veterans Affairs (VA) is a Cabinet department of the United States government responsible for administering programs of veterans benefits for veterans, their families, and survivors. ...


WWII helped bring dramatic changes to clinical psychology, not just in America but internationally as well. Graduate education in psychology began adding psychotherapy to the science and research focus based on the 1947 scientist-practitioner model, known today as the Boulder Model, for PhD programs in clinical psychology.[12] Clinical psychology in Britain developed much like in the U.S. after WWII, specifically within the context of the National Health Service[13] with qualifications, standards, and salaries managed by the British Psychological Society.[14] To meet Wikipedias quality standards, this article or section may require cleanup. ... NHS redirects here. ... The British Psychological Society (BPS) is the representative body for psychologists and psychology in the United Kingdom. ...


Development of the Doctor of Psychology degree

By the 1960s, psychotherapy had become imbedded within clinical psychology, but for many the Ph.D. educational model did not offer the necessary training for those interested in practice rather than research. There was a growing argument that said the field of psychology in the U.S. had developed to a degree warranting explicit training in clinical practice. The concept of a practice-oriented degree was debated in 1965 and narrowly gained approval for a pilot program at the University of Illinois starting in 1968.[15] Several other similar programs were instituted soon after, and in 1973, at the Vail Conference on Professional Training in Psychology, the Practitioner-Scholar Model of Clinical Psychology—or Vail Model—resulting in the Doctor of Psychology (Psy.D.) degree was recognized.[16] Although training would continue to include research skills and a scientific understanding of psychology, the intent would be to produce highly trained professionals, similar to programs in medicine, dentistry, and law. The first program explicitly based on the Psy.D. model was instituted at Rutgers University.[15] Today, about half of all graduate students in clinical psychology are enrolled in Psy.D. programs.[16] The University of Illinois is the set of three public universities in Illinois. ... The Psy. ... Rutgers redirects here. ...


A changing profession

Since the 1970s, clinical psychology has continued growing into a robust profession and academic field of study. Although the exact number of practicing clinical psychologists is unknown, it is estimated that between 1974 and 1990, the number in the U.S. grew from 20,000 to 63,000.[17] Clinical psychologists are still experts in assessment and psychotherapy, and have expanded their focus to address issues of prevention, gerontology, and even sports and the criminal justice system. The fastest growing area appears to be health psychology, which is reflected in hospitals being the fastest-growing employment setting for clinical psychologists in the past decade.[5] Other major changes include the impact of managed care on mental health care, an increasing understanding of the importance of multicultural knowledge, a growing pressure to give limited prescription privileges to psychologists, and the shift in the majority of practitioners of psychotherapy now having masters-level training. Managed care is a concept in U.S. health care. ... “RxP” redirects here. ...


Professional practice

Clinical psychologists can offer a range of professional services, including:[7] The Greek letter Psi is often used as a symbol of psychology. ...

  • Provide psychological treatment (psychotherapy)
  • Administer and interpret psychological assessment and testing
  • Conduct psychological research
  • Teach
  • Development of prevention and treatment programs
  • Consultation (especially with schools and businesses)
  • Program administration
  • Provide expert testimony (forensic psychology)

In practice, clinical psychologists may work with individuals, couples, families, or groups in a variety of settings, including private practices, hospitals, mental health organizations, schools, businesses, and non-profit agencies. Most clinical psychologists who engage in research and teaching do so within a college or university setting. Clinical psychologists may also choose to specialize in a particular field—common areas of specialization, some of which can earn board certification,[18] include:

A mental illness or mental disorder refers to one of many mental health conditions characterized by distress, impaired cognitive functioning, atypical behavior, emotional dysregulation, and/or maladaptive behavior. ... Psychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event. ... This article is about the concept of addiction. ... An eating disorder is a complex compulsion to eat, or not eat, in a way which disturbs physical and mental health. ... A sleep disorder (somnipathy) is a disorder in the sleep patterns of a person or animal. ... Sexual dysfunction or sexual malfunction (see also sexual function) is difficulty during any stage of the sexual act (which includes desire, arousal, orgasm, and resolution) that prevents the individual or couple from enjoying sexual activity. ... On the Threshold of Eternity. ... Anxiety is a physiological state characterized by cognitive, somatic, emotional, and behavioral components[1]. These components combine to create the feelings that we typically recognize as anger and known as fear, apprehension, or worry. ... For other uses, see Phobia (disambiguation). ... Clinical neuropsychology is a subdiscipline of psychology that specialises in the clinical assessment and treatment of patients with brain injury or neurocognitive deficits. ... Child psychopathology is a term referring to children and adolescents with a psychological disorder. ... Family therapy, also referred to as couple and family therapy and family systems therapy, is a branch of psychotherapy that works with families and couples in intimate relationships to nurture change and development. ... Relationship counseling is the process of counseling the parties of a relationship in an effort to recognize and to better manage or reconcile troublesome differences. ... This article or section does not cite any references or sources. ... Industrial and organizational psychology (also known as I/O psychology, work psychology, work and organizational psychology, W-O psychology, occupational psychology, personnel psychology or talent assessment) concerns the application of psychological theories, research methods, and intervention strategies to workplace issues. ... Educational psychology is the study of how humans learn in educational settings, the effectiveness of educational interventions, the psychology of teaching, and the social psychology of schools as organizations. ...

Training and certification to practice

The University of Pennsylvania was the first to offer formal education in clinical psychology.
The University of Pennsylvania was the first to offer formal education in clinical psychology.

Clinical psychologists undergo many hours of graduate training—usually 4 to 6 years post-Bachelors—in order to gain demonstrable competence and experience. About half of all clinical psychology graduate students are being trained in Ph.D. programs—a model that emphasizes research and is usually housed in universities—with the other half in Psy.D. programs, which has more focus on practice (similar to professional degrees for medicine and law).[16] Both models are accredited by the American Psychological Association[19] and many other English-speaking psychological societies. A smaller number of schools offer accredited programs in clinical psychology resulting in a Masters degree, which usually take 2 to 3 years post-bachelors. Image File history File linksMetadata Download high resolution version (1024x541, 681 KB) Licensing I, the creator of this work, hereby grant the permission to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License, Version 1. ... Image File history File linksMetadata Download high resolution version (1024x541, 681 KB) Licensing I, the creator of this work, hereby grant the permission to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License, Version 1. ... This article is about the private Ivy League university in Philadelphia. ... The training and licensing of clinical psychologists generally requires successfully going through a doctorate program, which is typically 90-credits and takes 4 to 6 years to complete. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... The Psy. ... The American Psychological Association (APA) is a professional organization representing psychology in the US. It has around 150,000 members and an annual budget of around $70m. ... A masters degree is an academic degree usually awarded for completion of a postgraduate course of one or two years in duration. ...


In the U.K., clinical psychologists nearly always undertake a D.Clin.Psychol./Clin.Psy.D, which is a practitioner doctorate with both clinical and research components. This is a three-year full-time salaried program sponsored by the National Health Service (N.H.S.) and based in universities and the N.H.S. Entry into these programs is highly competitive, and requires at least a three-year undergraduate degree in psychology approved by the British Psychological Society or an approved conversion course, plus some form of experience, usually in either the NHS as an Assistant Psychologist or in academia as a Research Assistant. It is not unusual for applicants to apply several times before being accepted onto a training course as only about a fifth of applicants are accepted each year.[20] More information about the path to training in the UK can be found at the central clearing house for clinical psychology training applications, and at www.ClinPsy.org.uk where questions can also be answered on the forum, which is run by qualified clinical psychologists. NHS redirects here. ... The British Psychological Society (BPS) is the representative body for psychologists and psychology in the United Kingdom. ...


The practice of clinical psychology requires a license in the United States, Canada, the United Kingdom, and many other countries. Although each of the U.S. states is somewhat different in terms of requirements and licenses, there are three common elements:[21]

  1. Graduation from an accredited school with the appropriate degree
  2. Completion of supervised clinical experience
  3. Passing a written examination and, in some states, an oral examination

All U.S. state and Canada province licensing boards are members of the Association of State and Provincial Psychology Boards (ASPPB) which created and maintains the Examination for Professional Practice in Psychology (EPPP). Many states require other examinations in addition to the EPPP, such as a jurisprudence (i.e. mental health law) examination and/or an oral examination.[21] Most states also require a certain number of continuing education credits per year in order to renew a license, which can be obtained though various means, such as taking audited classes and attending approved workshops. Clinical psychologists require the Psychologist license to practice, although similar licenses can be obtained with a masters-level degree, such as Marriage and Family Therapist (MFT), Licensed Professional Counselor (LPC), and Licensed Psychological Associate (LPA). Licensed Professional Counselor (LPC) is a licensure for mental health professionals. ...


In the UK, registration is only now becoming statutory and administered by the HPC. Previously there has been a voluntary scheme through which the BPS award practising certificates to qualified Clinical Psychologists who have completed sufficient continuing professional development activities and agree to abide by their professional Code of Conduct. The Health Professions Council (HPC) is a UK health regulator. ... The British Psychological Society (BPS) is the representative body for psychologists and psychology in the United Kingdom. ...


Assessment

Main article: Psychological testing
Example of an inkblot used in the Rorschach projective personality test
Example of an inkblot used in the Rorschach projective personality test

An important area of expertise for many clinical psychologists is psychological assessment, and there are indications that as many as 91% of psychologists engage in this core clinical practice.[22] Such evaluation is usually done in service to gaining insight into and forming hypotheses about psychological or behavioral problems. As such, the results of such assessments are usually used to create generalized impressions (rather than diagnoses) in service to informing treatment planning. Methods include formal testing measures, interviews, reviewing past records, clinical observation, and physical examination.[2] Psychological testing is a field characterized by the use of samples of behavior in order to infer generalizations about a given individual. ... Image File history File links This is a lossless scalable vector image. ... Image File history File links This is a lossless scalable vector image. ... A black outline of the first of the ten cards in the Rorschach inkblot test. ... A projective test, in psychology, is a personality test designed to let a person respond to ambiguous stimuli, presumably revealing hidden emotions and internal conflicts. ... This article or section does not adequately cite its references or sources. ...


There exist literally hundreds of various assessment tools, although only a few have been shown to have both high validity (i.e., test actually measures what it claims to measure) and reliability (i.e., consistency). These measures generally fall within one of several categories, including the following: In psychometrics a valid measure is one which is measuring what it is supposed to measure. ... In psychometrics reliability is the accuracy of the scores of a measure. ...

  • Intelligence & achievement tests. These tests are designed to measure certain specific kinds of cognitive functioning (often referred to as IQ) in comparison to a norming-group. These tests, such as the WISC-IV, attempt to measure such traits as general knowledge, verbal skill, memory, attention span, logical reasoning, and visual/spacial perception. Several tests have been shown to predict accurately certain kinds of performance, especially scholastic.[22]
  • Personality tests. Tests of personality aim to describe patterns of behavior, thoughts, and feelings. They generally fall within two categories: objective and projective. Objective measures, such as the MMPI, are based on restricted answers—such as yes/no, true/false, or a rating scale—which allow for computation of scores that can be compared to a normative group. Projective tests, such as the Rorschach inkblot test, allow for open-ended answers, often based on ambiguous stimuli, presumably revealing non-conscious psychological dynamics.
  • Neuropsychological tests. Neuropsychological tests consist of specifically designed tasks used to measure psychological functions known to be linked to a particular brain structure or pathway. They are typically used to assess impairment after an injury or illness known to affect neurocognitive functioning, or when used in research, to contrast neuropsychological abilities across experimental groups.
  • Clinical observation. Clinical psychologists are also trained to gather data by observing behavior. The clinical interview is a vital part of assessment, even when using other formalized tools, which can employ either a structured or unstructured format. Such assessment looks at certain areas, such as general appearance and behavior, mood and affect, perception, comprehension, orientation, insight, memory, and content of communication. One common example of a formal interview is the mental status examination, which is often used as a screening tool for treatment or further testing.[22]

IQ redirects here. ... The Wechsler Intelligence Scale for Children (WISC), developed by David Wechsler, is an intelligence test for children between the ages of 6 and 16 inclusive that can be completed without reading or writing. ... This article or section does not adequately cite its references or sources. ... Objective tests are different from obtrusive tests, because objective tests are not projective in nature. ... A projective test, in psychology, is a personality test designed to let a person respond to ambiguous stimuli, presumably revealing hidden emotions and internal conflicts. ... The Minnesota Multiphasic Personality Inventory (MMPI) is one of the most frequently used personality tests in the mental health fields. ... A black outline of the first of the ten cards in the Rorschach inkblot test. ... Neuropsychological tests are specifically designed tasks used to measure a psychological function known to be linked to a particular brain structure or pathway. ... For other uses, see Brain (disambiguation). ... Neurocognitive is a term used to describe cognitive functions closely linked to the function of particular areas, neural pathways, or cortical networks in the brain. ... Mental status examination, or MSE, is a medical process where a clinician working in the field of mental health (usually a social worker, psychiatrist, psychiatric nurse or psychologist) systematically examines a patients mind. ...

Diagnostic impressions

See also: Mental disorder

After assessment, clinical psychologists often provide a diagnostic impression. Many countries use the International Statistical Classification of Diseases and Related Health Problems, while the U.S. uses the Diagnostic and Statistical Manual of Mental Disorders (the DSM version IV-TR). Both assume medical concepts and terms, and state that there are categorical disorders that can be diagnosed by set lists of descriptive criteria.[23] Most American HMO and insurance companies require a diagnosis from the DSM before they will approve payment for treatment. Mental disorder or mental illness are terms used to refer psychological pattern that occurs in an individual and is usually associated with distress or disability that is not expected as part of normal development or culture. ... In general, diagnosis (plural diagnoses) has two distinct dictionary definitions. ... The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ... The Diagnostic and Statistical Manual published by the American Psychiatric Association The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a handbook for mental health professionals that lists different categories of mental disorder and the criteria for diagnosing them, according to the publishing organization the American Psychiatric Association. ... HMO can mean the following: Health maintenance organization Houses in multiple occupation Home Media Option (Tivo) This is a disambiguation page — a navigational aid which lists other pages that might otherwise share the same title. ... The Metropolitan Life Insurance Company is one of the largest New York based life insurance companies Insurance, in law and economics, is a form of risk management primarily used to hedge against the risk of a contingent loss. ...


The DSM uses a categorical medical model and views psychological problems in terms of discrete illnesses that can be defined by a minimum set of criteria—such as self-reported symptoms, intensity, behaviors, duration, onset, et cetera. There is a growing awareness that this model is not the only way to understand or describe psychological impairment. Moreover, there is little empirical justification for the cutoff criteria, which are based on clinical consensus and are therefore essentially arbitrary.[24] As such, there is a debate in the field regarding alternative methods of diagnosing psychological problems.


Several conceptual models are being discussed, including a "dimensional model" based on empirically validated models of human differences (such as the five factor model of personality[24][23]) and a "psychosocial model", which would take changing, intersubjective states into greater account.[25] The proponents of these models claim that they would offer greater diagnostic flexibility and clinical utility without depending on the medical concept of illness. However, they also admit that these models are not yet robust enough to gain widespread use, and should continue to be developed. In psychology, the Big Five personality traits are five broad factors or dimensions of personality discovered through empirical research (Goldberg, 1993). ...


British clinical psychologists do not tend to diagnose, but rather use formulation—an individualized map of the difficulties that the patient or client faces, encompassing predisposing, precipitating and perpetuating (maintaining) factors.[26]


Clinical theories and interventions

Clinical psychologists work with individuals, children, families, couples, or small groups.
Clinical psychologists work with individuals, children, families, couples, or small groups.
Main article: Psychotherapy

Generally speaking, psychotherapy involves a formal relationship between professional and client—usually an individual, couple, family, or small group—that employs a set of procedures intended to form a therapeutic alliance, explore the nature of psychological problems, and encourage new ways of thinking, feeling, or behaving. Image File history File links Grouptherapy. ... Psychotherapy is an interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living. ...


Clinicians have a wide range of individual interventions to draw from, often guided by their training—for example, a CBT clinician might use worksheets to record distressing cognitions, a psychoanalyst might encourage free association, while an expressive therapist would employ forms of artistic expression. Clinical psychologists generally seek to base their work on research evidence and outcome studies as well as on trained clinical judgment. Although there are literally dozens of recognized therapeutic orientations, their differences can often be categorized on two dimensions: insight vs. action and in-session vs. out-session.[7] A Cognitive Behavioral Therapy (CBT) is a psychotherapy based on modifying cognitions, assumptions, beliefs and behaviors, with the aim of influencing disturbed emotions. ... Psychoanalysis is the revelation of unconscious relations, in a systematic way through an associative process. ... A Free Association is an association which meets certain mostly negative criteria. ... Expressive therapy know alse as art therapy provides the means and support to express and explore feelings, thought problems and potentials through the use of art media and imagery. ...

  • Insight—emphasis is on gaining greater understanding of the motivations underlying one's thoughts and feelings (e.g. Psychodynamic therapy)
  • Action—focus is on making changes in how one thinks and acts (e.g. Solution Focused Therapy, Cognitive Behavioral Therapy)
  • In-session—interventions center on the here-and-now interaction between client and therapist (e.g. Humanistic therapy, Gestalt therapy)
  • Out-session—a large portion of therapeutic work is intended to happen outside of session (e.g. Bibliotherapy, Rational Emotive Behavior Therapy)

The methods used are also different in regards to the population being served as well as the context and nature of the problem. Therapy will look very different between, say, a traumatized child, a depressed but high-functioning adult, a group of people recovering from substance dependence, and a ward of the state suffering from terrifying delusions. Other elements that play a critical role in the process of psychotherapy include the environment, culture, age, cognitive functioning, motivation, and duration (i.e. brief or long-term therapy). Brief therapy, sometimes also known as strategic therapy, is an umbrella term for a type of approach to psychotherapy. ...


Four main perspectives

The field can be seen as recognizing essentially four major perspectives: Psychodynamic, Humanistic, Cognitive Behavioral, and Systems or Family therapy. It has been suggested that Psychodynamic psychology be merged into this article or section. ... Humanistic psychology is a school of psychology that emerged in the 1950s in reaction to both behaviorism and psychoanalysis. ... A Cognitive Behavioral Therapy (CBT) is a psychotherapy based on modifying cognitions, assumptions, beliefs and behaviors, with the aim of influencing disturbed emotions. ... Family therapy, also referred to as couple and family therapy and family systems therapy, is a branch of psychotherapy that works with families and couples in intimate relationships to nurture change and development. ...


Psychodynamic

The Psychodynamic perspective developed out of the psychoanalysis of Sigmund Freud. The core object of psychoanalysis is to make the unconscious conscious—to make the client aware of his or her own primal drives (namely those relating to sex and aggression) and the various defenses used to keep them in check.[27] The essential tools of the psychoanalytic process are the use of free association and an examination of the client's transference towards the therapist, defined as the tendency to take unconscious thoughts or emotions about a significant person (e.g. a parent) and "transfer" them onto another person. Major variations on Freudian psychoanalysis practiced today include Self Psychology, Ego Psychology, and Object Relations Theory. These general orientations now fall under the umbrella term psychodynamic psychology, with common themes including examination of transference and defenses, an appreciation of the power of the unconscious, and a focus on how early developments in childhood have shaped the client's current psychological state.[27] It has been suggested that Psychodynamic psychology be merged into this article or section. ... Today psychoanalysis comprises several interlocking theories concerning the functioning of the mind. ... Sigmund Freud (IPA: ), born Sigismund Schlomo Freud (May 6, 1856 – September 23, 1939), was an Austrian neurologist and psychiatrist who founded the psychoanalytic school of psychology. ... In psychoanalytic theory, a defence mechanism is an unconscious way to protect ones personality from unpleasant thoughts which may otherwise cause anxiety. ... Free association (Psychodynamic theory) is a technique used in psychology, devised by Sigmund Freud. ... Transference is a phenomenon in psychology characterized by unconscious redirection of feelings for one person to another. ... Self psychology is a school of psychoanalytic theory and therapy developed in the United States. ... Ego psychology is a school of psychoanalysis that originated in Freuds ego-id-superego model. ... In psychodynamics, Object relations theory is the idea that the ego-self exists only in relation to other objects, which may be external or internal. ...


Humanistic

Main article: Humanistic psychology

Humanistic psychology was developed in the 1950s in reaction to both behaviorism and psychoanalysis, largely due to the person-centered therapy of Carl Rogers (often referred to as Rogerian Therapy) and existential psychology developed by Victor Frankl and Rollo May.[2] Rogers believed that a client needed only three things from a clinician to experience therapeutic improvement—congruence, unconditional positive regard, and empathetic understanding.[28] By using phenomenology, intersubjectivity and first-person categories, the humanistic approach seeks to get a glimpse of the whole person and not just the fragmented parts of the personality.[29] This aspect of holism links up with another common aim of humanistic practice in clinical psychology, which is to seek an integration of the whole person, also called self-actualization. According to humanistic thinking, each individual person already has inbuilt potentials and resources that might help them to build a stronger personality and self-concept. The mission of the humanistic psychologist is to help the individual employ these resources via the therapeutic relationship. Humanistic psychology is a school of psychology that emerged in the 1950s in reaction to both behaviorism and psychoanalysis. ... Person-Centered Therapy (PCT), also knwn as Client-centered therapy, was developed by the humanist psychologist Carl Rogers in the 1940s and 1950s. ... For other persons named Carl Rogers, see Carl Rogers (disambiguation). ... This page has been suggested to meet Wikipedias criteria for speedy deletion. ... Mans search for meaning Viktor Emil Frankl, M.D., Ph. ... Rollo May (April 21, 1909, Ada, Ohio - October 22, 1994, Tiburon, California) was the best known American existential psychologist, authoring the influential book Love and Will in 1969. ... Use of the word phenomenology in modern science is described in the separate article phenomenology (science). ... The term Intersubjectivity is used in three ways. ...


Cognitive behavioral

Cognitive Behavioral Therapy (CBT) developed from the combination of Cognitive psychology and Behaviorism, and from more specific earlier therapies known as cognitive therapy and rational emotive behavior therapy. CBT is based on the theory that how we think (cognition), how we feel (emotion), and how we act (behavior) all interact together. In this perspective, certain thoughts or ways of interpreting the world (often called schemas) can cause emotional distress or result in behavioral problems. Certain behaviors, such as avoidance of feared situations, can also maintain distress. The object of CBT is to discover the biased or irrational thinking that leads to emotional problems and to help the client take control over his or her thinking processes and behaviors in such a way that will lead to increased well-being.[30] There are many techniques used, such as systematic desensitization, socratic questioning, and keeping a cognition observation log. Modified approaches that fall into the category of CBT have also developed, including Dialectic Behavior Therapy and Mindfulness-based Cognitive Therapy.[31] A Cognitive Behavioral Therapy (CBT) is a psychotherapy based on modifying cognitions, assumptions, beliefs and behaviors, with the aim of influencing disturbed emotions. ... Cognitive Psychology is the school of psychology that examines internal mental processes such as problem solving, memory, and language. ... Behaviorism (also called learning perspective) is a philosophy of psychology based on the proposition that all things which organisms do — including acting, thinking and feeling—can and should be regarded as behaviors. ... This article is about Becks Cognitive Therapy. ... Rational Emotive Behavior Therapy (REBT) is a comprehensive, active-directive, philosophically and empirically based psychotherapy which focuses on resolving cognitive, emotional, and behavioral problems in human beings. ... Systematic desensitization is a type of behavioral therapy used in the field of psychology to help effectively overcome phobias and other anxiety disorders. ... Socratic Questioning is disciplined questioning that can be used to pursue thought in many directions and for many purposes, including: to explore complex ideas, to get to the truth of things, to open up issues and problems, to uncover assumptions, to analyze concepts, to distinguish what we know from what... Dialectical behavior therapy (DBT) is a psychosocial treatment developed by Marsha M. Linehan specifically to treat Borderline Personality Disorder. ... To meet Wikipedias quality standards, this article or section may require cleanup. ...


Systems or Family Therapy

Main article: Family therapy

Systems or Family therapy works with couples and families, and emphasizes family relationships as an important factor in psychological health. The central focus tends to be on interpersonal dynamics, especially in terms of how change in one person will affect the entire system.[32] Therapy is therefore conducted with as many significant members of the "system" as possible. Goals can include improving communication, establishing healthy roles, creating alternative narratives, and addressing problematic behaviors. Important contributors include John Gottman, Jay Haley, Susan Johnson, and Virginia Satir. Family therapy, also referred to as couple and family therapy and family systems therapy, is a branch of psychotherapy that works with families and couples in intimate relationships to nurture change and development. ... John Gottman is known for his work on marital stability and divorce prediction. ... Jay Douglas Haley, ((July 19, 1923 - February 13, 2007)[1] was one of the more influential psychotherapists of the 20th century [2] He was one of the founding figures of brief and family therapy and one of the more accomplished teachers, supervisors, and authors in these disciplines. ... Susan Johnson is a member of the dance-pop group Company B. Mean Creek (2004) Nearing Grace (2005) Eye of the Dolphin (2006) Wieners (2007) Category: ... Virginia Satir (26 June 1916 - 10 September 1988) was a noted psychotherapist, known especially for her approach to family therapy. ...


Other major therapeutic orientations

See also: List of psychotherapies

There exist literally dozens of recognized schools or orientations of psychotherapy—the list below represents those that have been pivotal in the development of clinical psychology. Although they all have some typical set of techniques practitioners employ, they are generally better known for providing a framework of theory and philosophy that guides a therapist in his or her working with a client. This is an alphabetical List of Psychotherapies. ...

  • Existential. Existential psychotherapy postulates that people are largely free to choose who we are and how we interpret and interact with the world. It intends to help the client find deeper meaning in life and to accept responsibility for living. As such, it addresses fundamental issues of life, such as death, aloneness, and freedom. The therapist emphasizes the client’s ability to be self-aware, freely make choices in the present, establish personal identity and social relationships, create meaning, and cope with the natural anxiety of living.[33] Important writers in existential therapy include Rollo May, Victor Frankl, James Bugental, and Irvin Yalom.

    One influential therapy that came out of Existential therapy is Gestalt Therapy, primarily founded by Fritz Perls in the 1950s. It is well-known for techniques designed to increase various kinds of self-awareness—the best-known perhaps being the empty chair technique—which are generally intended to explore resistance to authentic contact, resolve internal conflicts, and help the client complete "unfinished business".[34] Existential psychotherapy is partly based on the existential belief that human beings are alone in the world. ... Rollo May (April 21, 1909, Ada, Ohio - October 22, 1994, Tiburon, California) was the best known American existential psychologist, authoring the influential book Love and Will in 1969. ... Mans search for meaning Viktor Emil Frankl, M.D., Ph. ... Elizabeth & Jim Bugental James Bugental is one of the predominant theorists and advocates of the Existential-Humanistic Therapy movement. ... Image:Yalom. ... Gestalt Therapy is an existential and experiential psychotherapy that focuses on the individuals experience in the present moment, the therapist-client relationship, the environmental and social contexts in which these things take place, and the self-regulating adjustments people make as a result of the overall situation. ... Friedrich (Frederick) Salomon Perls (July 8 1893, Berlin - March 14, 1970, Chicago), better known as Fritz Perls, was a noted German-born psychiatrist and psychotherapist of Jewish descent. ...

  • Postmodern. Postmodern psychology says that the experience of reality is a subjective construction built upon language, social context, and history, with no essential truths.[35] Since "mental illness" and "mental health" are not recognized as objective, definable realities, the postmodern psychologist instead sees the goal of therapy strictly as something constructed by the client and therapist.[36] Forms of postmodern psychotherapy include Narrative Therapy, Solution-Focused Therapy, and Coherence Therapy.

Narrative Therapy was initially developed during the 1970s and 1980s, largely by Australian Michael White (Dulwich Centre) and his friend and colleague, David Epston, of New Zealand. ... Solution focused brief therapy (SFBT) (often referred to as simply solution focused therapy or brief therapy) is a type of talking therapy that is based upon social constructionist philosophy. ... This article is being considered for deletion in accordance with Wikipedias deletion policy. ... Transpersonal psychology is a school of psychology that studies the transpersonal, the transcendent or spiritual aspects of the human mind. ... Spirituality, in a narrow sense, concerns itself with matters of the spirit. ... This list of topics is related to spirituality, esotericism, mysticism, religion and/or parapsychology. ... In religion, transcendence is a condition or state of being that surpasses, and is independent of, physical existence. ... Ken Wilber Kenneth Earl Wilber Jr. ... Abraham (Harold) Maslow (April 1, 1908 – June 8, 1970) was an American psychologist. ... Stanislav Grof (born 1