Clinical Psychology: Integrating Science and Practice - Hardcover

Freeman, Arthur

Hardcover

ISBN 10: 0471414999 ISBN 13: 9780471414995

Publisher: Wiley, 2008

Synopsis

An accessible introduction to the field of clinical psychologyfocused on the roles both science and clinical experience play intoday's evidence-based practice environment

Clinical psychology has been undergoing a revolution--driven byresearch and the need to identify and develop scientifically proveninterventions that improve client care. By the time a studentcompletes his or her graduate work, the field will have evolvedeven more. With the role of clinical psychologists and theenvironment in which they work rapidly evolving, the trainingchallenge has never been so great.

Thorough and realistic in presentation, Clinical Psychology:Integrating Science and Practice helps students gain the tools theyneed to become thoughtful and effective clinicians. This accessiblywritten text provides a foundation of the basics of thepsychotherapy process, grounded in an integration of its science,theory, and, ultimately, practice.

Filled with case examples that illustrate realistic clinicalscenarios, this text offers:
* A detailed look at basic clinical tasks and skills that comprisethe nuts and bolts of a practitioner's work
* Chapters on research, working with cultural diversity, interviewingand assessment, developing evidence-based treatment plans,practicing ethically, and caring for yourself and colleagues
* A consistent format in each chapter made up of learning objectives;chapter introductions; orienting headings and subheadingsthroughout; figures, tables, and boxes; chapter summaries; andhelpful chapter appendixes
* An online Instructor's Manual featuring chapter-by-chapter quizzes,essay questions, supporting materials, key words, and PowerPointslides

Clinical Psychology: Integrating Science and Practice paints avivid portrait of the work of the clinical psychologist anduniquely illustrates clinical psychology's richness and historicalsignificance, as well as its leadership in the scientificdevelopment of methods and techniques for clinical assessment andintervention.

About this title

About the Author

Arthur Freeman, EdD, ABPP, is Visiting Professor at GovernorsState University and Clinical Psychologist and Director of Trainingat Sheridan Shores in Chicago. He is a Fellow of the APA, APS, andthe Academy of Clinical Psychology. Dr. Freeman is a past presidentof the Association for Behavioral and Cognitive Therapies.

Stephanie H. Felgoise, PhD, ABPP, is Vice Chair and AssociateProfessor in the Department of Psychology and Director of the PsyDProgram in Clinical Psychology at Philadelphia College ofOsteopathic Medicine. Dr. Felgoise is a licensed psychologist andhas a private clinical practice.

Denise D. Davis, PhD, is Assistant Professor and AssistantDirector of Clinical Training in the Psychology Department atVanderbilt University in Nashville, Tennessee. Dr. Davis is alicensed psychologist and has a private clinical practice.

From the Back Cover

An accessible introduction to the field of clinical psychology focused on the roles both science and clinical experience play in today's evidence-based practice environment

Clinical psychology has been undergoing a revolution driven by research and the need to identify and develop scientifically proven interventions that improve client care. By the time a student completes his or her graduate work, the field will have evolved even more. With the role of clinical psychologists and the environment in which they work rapidly evolving, the training challenge has never been so great.

Thorough and realistic in presentation, Clinical Psychology: Integrating Science and Practice helps students gain the tools they need to become thoughtful and effective clinicians. This accessibly written text provides a foundation of the basics of the psychotherapy process, grounded in an integration of its science, theory, and, ultimately, practice.

Filled with case examples that illustrate realistic clinical scenarios, this text offers:

• A detailed look at basic clinical tasks and skills that comprise the nuts and bolts of a practitioner's work

• Chapters on research, working with cultural diversity, interviewing and assessment, developing evidence-based treatment plans, practicing ethically, and caring for yourself and colleagues

• A consistent format in each chapter made up of learning objectives; chapter introductions; orienting headings and subheadings throughout; figures, tables, and boxes; chapter summaries; and helpful chapter appendixes

• An online Instructor's Manual featuring chapter-by-chapter quizzes, essay questions, supporting materials, key words, and PowerPoint slides

Clinical Psychology: Integrating Science and Practice paints a vivid portrait of the work of the clinical psychologist and uniquely illustrates clinical psychology's richness and historical significance, as well as its leadership in the scientific development of methods and techniques for clinical assessment and intervention.

From the Inside Flap

An accessible introduction to the field of clinical psychology focused on the roles both science and clinical experience play in today's evidence-based practice environment

Clinical psychology has been undergoing a revolution—driven by research and the need to identify and develop scientifically proven interventions that improve client care. By the time a student completes his or her graduate work, the field will have evolved even more. With the role of clinical psychologists and the environment in which they work rapidly evolving, the training challenge has never been so great.

Thorough and realistic in presentation, Clinical Psychology: Integrating Science and Practice helps students gain the tools they need to become thoughtful and effective clinicians. This accessibly written text provides a foundation of the basics of the psychotherapy process, grounded in an integration of its science, theory, and, ultimately, practice.

Filled with case examples that illustrate realistic clinical scenarios, this text offers:

• A detailed look at basic clinical tasks and skills that comprise the nuts and bolts of a practitioner's work

• Chapters on research, working with cultural diversity, interviewing and assessment, developing evidence-based treatment plans, practicing ethically, and caring for yourself and colleagues

• A consistent format in each chapter made up of learning objectives; chapter introductions; orienting headings and subheadings throughout; figures, tables, and boxes; chapter summaries; and helpful chapter appendixes

• An online Instructor's Manual featuring chapter-by-chapter quizzes, essay questions, supporting materials, key words, and PowerPoint slides

Clinical Psychology: Integrating Science and Practice paints a vivid portrait of the work of the clinical psychologist and uniquely illustrates clinical psychology's richness and historical significance, as well as its leadership in the scientific development of methods and techniques for clinical assessment and intervention.

Excerpt. © Reprinted by permission. All rights reserved.

Clinical Psychology

Integrating Science and PracticeBy Arthur Freeman

John Wiley & Sons

Copyright © 2008 Arthur Freeman
All right reserved.
ISBN: 978-0-471-41499-5

Chapter One

The History, Politics, and Social Environment of Clinical Psychology

This chapter sets forth our theme of integrating clinical science and clinical practice. We discuss the philosophical and practical or applied aspects of clinical psychology and place clinical psychology in perspective relative to the historical, social, gender, cultural, and scientific environments in which it was created and in which it and we, as clinical psychologists, exist.

Our model is based on clinical psychology as a general treatment model, with the clinical psychologist serving as a primary care practitioner: the "psychological family doctor." This chapter also delineates the direction and plan for the book.

Learning Objectives

At the end of this chapter, the reader should be able to:

List five historical markers in the conceptualization and treatment of clinical phenomena.

Identify three scientific eras that have influenced the development of clinical psychology.

Describe the contemporary organizational environment of the field of clinical psychology.

Explain the concept of the clinical psychologist as a primary care practitioner.

List at least 10 learning objectives for reading the chapters ahead.

Mary, a doctoral-level psychologist, was at a party where the hostess introduced her to someone by saying, "This is Mary. She's a psychologist." The other person smiled and said, "Whoops. I better be careful what I say so you won't be analyzing me." Mary's response was that she was not a clinical psychologist, but an experimental psychologist working on aspects of language acquisition in chimpanzees.

It is of more than passing interest to know that many people who hear the word psychologist assume that the person so identified is a clinical psychologist. Many people use variations of the term psychology to denote motivation ("I am really psyched for that date"), readiness ("I am psyched for that exam"), intimidation ("I really psyched him out"), or a person who appears to be out of touch with reality or with societal norms ("That guy is really psycho"). The range of psychology applications and practice is discussed in Chapter 2. In this introductory chapter, we discuss the history and development of clinical psychology as a practice, a science, and a treatment; and we place clinical psychology in perspective relative to the historical, social, gender, cultural, and scientific environments from which it emerged.

Writing a text such as this one takes a great deal of thought and discussion among the authors. We have had to decide what to include, what to exclude, and how to present the material in as scientific, readable, and useful way as possible. We have, between us, over a century of experience, first as students and then as university faculty members and practitioners. We are aware of the challenges in developing a text. Will it hold your interest? Will it allow your instructor to elaborate on the ideas we present? Will it provide the requisite information? The latter two points are in fact relatively easy to fulfill. To keep you interested is a much harder job. For this reason, we have decided to talk to you directly and to think of you as one of our students.

The clinical psychologist, in the simplest definition, works in a clinical setting, with clinical populations, and uses clinical interventions. But what does that mean? Clinics are usually for people needing treatment of one sort or another. A look at a hospital directory might list the hours of operation for the spine clinic, the asthma clinic, the well-baby clinic, or the mood clinic. That is where you would expect to find clinical psychologists. Although this has been true for much of the existence of clinical psychology, the appellation of clinical has now been affixed to other terms such as clinical health psychology, clinical child psychology, or clinical neuropsychology.

The notion that people have emotional problems is not new. That some people act unacceptably within their social or family group and are thought to be deviant from their fellows is, instead, an ancient belief. Rather than dazing (or amazing) you with the historical or prehistorical experience of psychology, we have decided to make it easy.

We are going to take you for a ride on an incredible magic carpet. Not only can it fly though the air, it allows you to board without going through a metal detector. Second, it can travel through time so that we can view many experiences, circumstances, and situations. Third, it renders us invisible so that we can observe others and not be seen. Fourth, it is soundproof so that we can discuss what we are seeing without being heard. Fifth, if, for any reason, our trip is interrupted, you can climb aboard again and take up where you left off. Sixth, this magic carpet has a universal translator that allows us to listen in to what is going on in front of us. Finally, it will safely return us to our starting point. Please note that no snacks will be served on this flight so before embarking, collect your favorite snacks to take along.

A Flying Carpet Tour of Clinical Psychology

If you are safely aboard, our first stop is prehistory. We can feel the heat. We are on a plain in Africa. A formerly social and well-adjusted member of the tribe has been howling at the moon, attacking other members of the tribe, and having uncontrolled seizures or other acts against the best interest of the tribe, clan, or group. He has been caught and subdued by other members of the tribe and has been rendered unconscious by being forced to drink a potion the tribal healer has concocted from herbs and flowers. The healer is about to perform a surgical procedure still used today, called trephining. She is using sharpened flints to bore a hole in the person's skull to release the demons and spirits that have been trapped there. Releasing the demons should relieve the patient of their "possession."

Although we might expect the patient to die from what we see as a barbaric operation, skulls dating back thousands of years have been found with holes drilled in the skull, and the regrowth of bone indicates that the person survived. Scientists think that the holes were drilled to release demons that inhabited the individual causing aberrant behavior. In other cases, the clan healer might simply offer potions made from roots, barks, or leaves of plants as prescriptions for various disorders. Some combinations of drugs calmed the angry patient, and others likely energized the inactive individual. What we now call "folk" remedies were the earliest attempts at dealing with the broad range of illnesses, including those that we now label as psychological disorders. If we listen carefully, we might hear the healer give the man's wife a bag of herbs and leaves, and instruct her to brew a tea with them when the man awakens from his surgery.

If you will hold on tight, we are going to move on to ancient Greece. Before we fly into the office of a healer, there are some things that you need to know. The Greeks posited that there were four basic elements; fire, water, earth, and air. As all persons were constructed of these elements, their balance within the body was of major importance. Each element would correspond with a particular characteristic that would create a humor within the body: fire = blood humor; earth = black bile humor; water = yellow bile humor, and air = phlegm humor. Fire, of course, was hot. Water was wet. Earth was dry, and air was cold. The particular humoral mix could be seen in the person's personality and behavioral style. These ideas seem quaint to us today, but we still refer back to them. An angry person is said to be "hot-blooded" or to have a "fiery temper." The old term for depression, melancholy, stems from the terms melan (black, as in melanin) and choli (bile, as in colon). Melan + Coli = melancholy. We may describe someone as phlegmatic, meaning "subdued."

In the quarters of the ancient Greek healer, we have an opportunity to watch a treatment. The healer is assessing the patient's humoral mix and will then prescribe a treatment. The patient reports that he is often angry, and the anger involves him in physical fights with family, friends, and even strangers. The healer is recommending bloodletting as the treatment of choice to lower the force of the blood humor that is obviously creating the problem. The patient lies on a couch and the healer cuts into the patient's arm and blood flows copiously into a bowl held by the healer's assistant. When the healer has seen enough blood flow, she will stanch the bleeding with folded linen and pressure. The patient will then rest. Other treatments might include enemas to relieve the excess of black bile, forced purging or the use of emetics for yellow bile, or compression of the chest for too much air.

If you found that scene a bit unpleasant, be forewarned that the next stop may be even more visceral. We are now in medieval France. We are flying over a walled town, and in the middle of the town square workers are preparing for an execution. They are piling branches and wood around a stone column. Set high in the column is an iron ring. We are all thinking the same thing. They are planning on burning someone to death. There, off to the right we can see a woman being dragged toward the post. We can hear the charges against her being read.

Fortunately our carpet allows us to understand medieval French. The prisoner was found guilty of practicing the black arts, witchcraft. The court, a church court it seems, has sentenced her and two other women to be burned as witches. Her hands are tied to the iron ring and her feet secured. She is gagged so she cannot say anything or cast a spell. A torch is lit. I think it is time for us to leave this place.

In the Middle Ages, the church developed as an arbiter of both what is normal and what is abnormal, and then offered "cures" for the abnormal behavior. These cures ranged from prayer and meditation to exorcism and execution. The inquisition brought with it the beating, flogging, burning, hanging, and drowning of those suspected of trafficking in the black arts. Interestingly, those black arts included healing and midwifery. If a town was unfortunate enough to have a disease manifestation such as the plague, it was considered the work of witches. Only a concerted search for the witches and their immediate eradication could cleanse and heal the community.

Our next stop is going to be the seventeenth-century town of Salem, Massachusetts. We think that you know what we will find. We are in a courtroom. As you can see, everyone is dressed just like the Pilgrims in the pictures of the first Thanksgiving. This, however, is no celebration. A woman is dragged into the courtroom and brought before the two judges. The charges against her involve witchcraft. The accusers are three teenage girls who report having seen the woman muttering "spells" and having a conversation with her cat. Some of the woman's neighbors testify that they, too, saw her "acting strangely," though other townspeople testify that she is a harmless person who caused no problems for anyone.

At that moment, we see something incredible. The teenage accusers fall to the floor of the courtroom and seem to be having spasms and convulsions. They point to the woman as they are doing it. Amazingly, the girls' behavior is entered as "evidence" against the woman and she is pronounced a witch and sentenced to burn. We would later learn of the death of several women based on the report of these teenage girls. Interestingly, when it was decided to stop using the girls' behavior as evidence, the girls' spasms ceased.

Our next stop on this magic carpet is outside Paris on a sunny Sunday afternoon. The year is about 1785. It is before the French Revolution, and the wealthy and elite of Paris are obvious. We can see carriages arriving, and well-dressed men and women are emerging from the carriages. It seems that their destination is a mental hospital called Salpetrire. The visitors do not seem intent on seeing a relative who might be residing in this particular hospital, but rather they are strolling along and viewing the inmates as if visiting a zoo. We can see some inmates posed in postures that they seem to hold for exceedingly long periods. Other inmates are playing with pieces of wood. A woman is cradling a rag as if it were a baby. The onlookers delicately cover their noses with perfumed handkerchiefs to block the odor coming from feces-encrusted inmates, rotting food, and inadequate hygiene facilities. Servants are setting a picnic lunch for some of the sightseers ... far away from the hospital building.

A quick trip over the English Channel takes us to an English hospital for lunatics: St. Mary Bethlehem, also known as the Bethlem Royal Hospital. Coming from within the walls of this building we hear the rumble of human voices. Some are shouting, some are crying, and some are making noises that we cannot interpret. When we hear the cacophony, we think that this place sounds as if it is out of control. It seems to exist without any sense of order. There is confusion and uproar everywhere. It is, in fact, pure bedlam-a contraction of the hospital's name still used to denote what we are witnessing. Bedlam is the uncontrolled and confusing events and actions we see in the midst of crises. We see visitors touring the hospital who, like their Parisian counterparts, are laughing and mocking the residents. Some are even carrying long poles to prod the patients and make them angry within their cages so that they will react with outrage and produce a better "show." The guardians of these patients do nothing to protect their charges.

We fly back to eighteenth-century Paris and stop at the salon of a physician, Dr. Franz Anton Mesmer. He was born in 1734 and died in 1815. He was credited by some as having accidentally discovered the idea of group therapy. Mesmer argued that health or illness was a result of the harmony or discord between the bodily fluids and the planets (e.g., "lunacy" was a result of the gravitational pull of the moon). He later redefined his theory and suggested that harmony or discord within the individual was a result of some distortion of the internal magnetic fields.

Let's observe Mesmer at work. Several patients are sitting around an oak tub, and the "magnetic fluid" is sending magnetic forces through iron bars that patients are holding as extensions from the tub. Mesmer is walking around and speaking soothingly and quietly to the patients. He lays his hands on them and evaluates the balance of their magnetic fluid. Some of the patients in his treatments appear to faint or swoon and others seem to sit transfixed during their treatment. We would later learn that in the spirit of the time, scientific support was deemed to be the mark of any treatment. After an investigation by the Paris Academy of Sciences, Mesmer's model of treatment was found to be without merit and the academy would not support it. Although Mesmer later died in obscurity, his name lingers far beyond his treatment to describe someone who is mesmerized as being fixed on an object or in a trancelike state.

We now fly ahead to Vienna in the early twentieth century, where a young neurologist has been building quite a reputation for himself. Dr. Sigmund Freud, frustrated at not getting the faculty appointment that he so badly wanted in the Department of Neurology at the University of Vienna, is about to give a lecture. He has abandoned his academic quest and has started a practice to treat patients who have what he calls "nervous disorders." Freud has not yet come to the podium and we can hear comments and discussion by members of the audience. "I'm aghast at some of the things that I heard about him," commented a lawyer. "Well, he writes rather nicely, but some of his statements are a bit, how shall I say this? Over the edge," responded an accountant sitting nearby. A businessman commented, "His work is unsavory, at the least." A fourth commented, "Well, he is one of us, so we should listen respectfully."

(Continues...)

Excerpted from Clinical Psychologyby Arthur Freeman Copyright © 2008 by Arthur Freeman. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

Edition details

• Publisher: Wiley
• Publication date: 2008
• ISBN 10: 0471414999
• ISBN 13: 9780471414995
• Binding: Hardcover
• Language: English
• Edition number: 1
• Number of pages: 502