Lesson 1

OVERVIEW OF CLINICAL PSYCHOLOGY AND ITS EVOLUTION

Learning Objectives:

1. to demonstrate in-depth understanding of the meaning, nature and

characteristics of Clinical Psychology;
2. to appreciate the applications of Clinical Psychology;
3. to understand different competencies in the Clinical Psychology as a
profession; and
4. to describe different mental-health related professions.

I. Overview of Clinical Psychology

What is Clinical Psychology?

✓ Definitions

✓ As cited in Trull and Prinstein (2012), a more recent definition of

clinical psychology appears on the Web page of the American
Psychological Association’s Division 12 (Society of Clinical
Psychology; www.div12.org/aboutclinical-psychology):

“The field of Clinical Psychology integrates science,

theory, and practice to understand, predict, and alleviate
maladjustment, disability, and discomfort as well as to
promote human adaptation, adjustment, and personal
development. Clinical Psychology focuses on the
intellectual, emotional, biological, psychological, social,
and behavioral aspects of human functioning across the
life span, in varying cultures, and at all socioeconomic
levels.”

“The field of clinical psychology involves research,

teaching, and services relevant to the applications of
principles, methods, and procedures for understanding,
predicting, and alleviating intellectual, emotional,
biological, psychological, social and behavioral
maladjustment, disability and discomfort, applied to a
wide range of client populations.”

2
 ✓ The nature of Clinical Psychology is often misunderstood.
It is important to note that not all practioners who are
doing therapy, psycholoanalyis, assessment, counseling,
teaching jobs, or even psychiatrists can be considered as
clinical psychologists.

✓ Clinical psychologists are highly specialized group of

people in the field of psychology.

✓ Clinical psychologists work with a range of individuals, from infants

to the elderly. Their work can involve individuals themselves,
families/ partners, school personnel, other health care workers, and
communities. Clinical psychologists often work in a large range of
settings, including universities, hospitals, private practice offices, or
group medical practices. Of all of the possible mental health degrees
and fields available, some have described the doctoral (Ph.D.)
degree in clinical psychology to be the most versatile, since it can
lead to a very wide range of possible job opportunities.

Who are related mental health professionals?

Psychiatrists are medical physicians who specialize in the diagnosis, treatment, and
prevention of mental illnesses, including substance use disorders. Psychiatrists are
qualified to assess both the mental and physical aspects of psychological disturbance. A
psychiatrist has completed medical school (is an M.D. or D.O.) and an additional four
or more years of residency training in psychiatry. Psychiatrists can order or perform a
full range of medical laboratory and psychological tests which, combined with
interviews/discussions with patients, help provide a picture of a patient’s physical and
mental state. Their education and years of clinical training and experience equip them to
understand the complex relationship between emotional and other medical illnesses, to
evaluate medical and psychological data, to make a diagnosis, and to work with a
patient to develop a treatment plan.

Counseling psychologists work involve group counseling or counseling with

individuals. Their principal method of assessment is usually the interview, but
counseling psychologists also do testing (e.g., assessment of abilities, personality,
interests, and vocational aptitude). Historically, these professionals have focused on
conducting educational and occupational counseling, often from a person-centered or
humanistic orientation. Currently, however, it is much more common to encounter
counseling psychologists representing a wide range of theoretical orientations (e.g.,
cognitive-behavioral, psychodynamic) and treating clients across the life span.
counseling psychologists see themselves providing the following services: (a)
preventive

3
treatment, (b) consultation, (c) development of outreach programs, (d) vocational
counseling, and e) short-term counseling/therapy of from one to fifteen sessions.
However, more and more counselors are engaged in activities, such as individual
psychotherapy and even psychological testing, that are
traditionally in the clinical province.

Clinical social workers assist individuals, groups, or communities to restore or enhance

their capacity for social functioning, while creating societal conditions favorable to their
goals. The practice of social work requires knowledge of human development and
behavior, of social, economic and cultural institutions, and of the interaction of all these
factors. The professional activities of clinically trained social workers often seem
similar to those of psychiatrists and clinical psychologists. Many social workers
conduct psychotherapy on an individual or group basis and contribute to the diagnostic
process as well.

School psychologists work with students, educators, parents, and school administrators
to promote the intellectual, social, and emotional growth of school-age children and
adolescents. Toward this end, school psychologists may conduct psychological and
educational assessments, develop learning programs and evaluate their effectiveness,
and consult with teachers, parents, and school officials.

Health psychologists are those who, through their research or practice, contribute to the
promotion and maintenance of good health. They are also involved in the prevention
and treatment of illness. They may design, execute, and study programs to help people
stop smoking, manage stress, lose weight, or stay fit. Because this is an emerging field,
those in it come from a variety of backgrounds, including clinical psychology,
counseling psychology, social psychology, and others.

The focus of rehabilitation psychologists is on people who are physically or cognitively

disabled. The disability may result from a birth defect or later illness or injury.
Rehabilitation psychologists help individuals adjust to their disabilities and the
physical, psychological, social, and environmental barriers that often accompany them.

Psychiatric nurses are working in close collaboration with the psychiatrist or the
clinical psychologist, they (along with those they supervise—attendants, nurse’s aides,
volunteers, etc.) implement therapeutic recommendations.

It is important to note that these professionals should have document(s) to prove that
they obtained appropriate professional training, pass licensing exam, and maintain
current knowledge on the field.

4
 The Clinical Psychologist

A clinical psychologist performs myriad roles which cut across facets of the field.
Below is a diagram of these roles:

Therapy/Intervention
• Most frequent activitiy
• therapy may involve a search for insight on a problem; a change in a
behavior

Diagnosis/Assessment
• Critical part of the clinical psychologist role
• to better understand client for a more-informed decision

Teaching
• lecture type; graduate school; community workshops
• advance courses

Clinical Supervision
• form of teaching but one-to-one/small group approaches
• learning y doing; practicum

Research
• scientist/practioner
• for the expansion of scientific knowledge on clinical psych.

Consultation
• psychological services given to an organization or office
• maybe remedial or preventive

Administration
• more of administrative and support side

5
Who gets to be a clinical psychologist?

Coursework Practicum Qualifying Internship

Work Exam
These are It allows the
the basic Combination It measures student to
courses of academic how well apply
essential for and practical students can academic
psychology knowledge apply what and
they learned practicual
through knowledge
written from in an
exams. indepndent
professional
setting.

6
 CERTIFICATIONS/
TRAININGS
Doctorate Degree
(Ph D in Clinical
Master's Degree Psych)
(ex. MA Clinical

CERTIFICATIONS/
Bachelor's Degree Psych

TRAININGS
(ex. BS/AB MA Psych)
Psych)

In the Philippines, Republic Act 10029, otherwise known as the “Philippine Psychology Act of 2009”, states
that those who aspire to practice psychology must possess at least Master’s degree in Psychology duly
accredited by the Commission on Higher Education (CHEd), and should pass the licensure exam given by the
Professional Regulation Commission (PRC). However, for those who want to pursue this sub-discipline, it is
ideal to pursue higher degrees aligned to Clinical Psychology. It is also important to note that Psychological
Association of the Philippine (PAP) is a professional certifying body for those who wish to practice Clinical
Psychology on top of license given by the PRC.

7
 II. Evolution of Clinical Psychology

Why do we even have to bother ourselves to go back to the past? The answer probably lies
with the need to reflect on the things that were right and, also the things that went wrong.
Because only by doing these will we truly move forward in science and in practice. It is also
essential to pay respects to the early proponents, theorists, practioners, and luminaries that
paved the way where we are right now.

Historical Roots

✓ Thales, Hippocrates, or Aristotle speculating about human beings and the nature of
thought, sensation, and pathology;
✓ Prior to 1890, Clinical Psychology was attached to Abnormal Psychology;
✓ More appropriate look into the reform movements of the 19th century towards the
improvement of mental health care;
✓ Philippe Pinel—early beginning of mental health profession as we all know today
from the perspective of humanitarian values;
✓ Dorothea Dix—campaigned for better facilities for the mentally ill
✓ Zeitgeist—spirit or atmosphere of the times was that 19th century philosophers and
writers were proclaiming dignity and equality of all including those with mental
disorders.

On Assessment

✓ Aldred Binet and Theodore Simon were commissioned by French Government to

develop a means of ensuring that children with cognitive limitations were properly
educated; Henry Goddard introduced the Binet tests to America while Lewis
Terman created an American version of it;
✓ When the United States entered World War I in 1917, the use of Clinical Psychology
was magnified. Hordes of military recruits were needed to screen. The application of
psychological theories to the practices of the U.S. military started the gradual
emphasis in this sub-field;
✓ Robert Yerkes—chairperson of the committee that was tasked of creating a system
for classifying men according to their levels. This committee also designed the Army
Alpha Test (with verbal version) and Beta Alpha Test (non-verbal version);
✓ Robert Woodworth—developed Psychoneurotic Inventory, perhaps the 1st
questionnaire to measure abnormal behavior;
✓ Wechsler-Bellevue Test as a satisfactory individual adult intelligence measure;
✓ Personality Testing started through the development of Woodsworth’s Personal Data;
✓ Projective Testing also started through Rorschach and Thematic Apperciation Test;

On Interventions

✓ Emil Kraepelin (classification of disorders); Jean Charcot (investigation of hysteria)

8
 ✓ Josef Breuer and Sigmund Freud on the Case of “Anna O” who was diagnosed with
hysteria; served as the birth of psychoanalysis;
✓ Clifford Beers initiated the mental hygiene movement after experiencing abuses
during his hospitalization because of manic-depression;
✓ Elwood Worcester and Joseph Pratt began to use a method of supportive discussion
among hospitalized mental patients which is now the precursor of group therapy.
✓ Interests on the works on children; play therapy
✓ William Healy founded a child guidance clinic in Chicago
✓ Carl Rogers publishes Client-centered Therapy in 1951
✓ BF Skinner outlined application of operant principles in 1953
✓ Joseph Wolpe described method of systematic desensitization in 1958
✓ Aaron Beck introduced cognitive therapy in 1967
✓ Rise of health psychology, increasing focus on brief psychotherapy, increase
psychotherapy research in the 1980s

On Research

✓ Wundt established the 1st psychological laboratory in Leipzig, Germany in 1879;

✓ William James published Principles of Psychology (how people adapt to the
environment in 1890
✓ Effectiveness of psychotherapy
✓ Psychopathology research grows following publication of DSM-III in the 1980s
✓ Interest in behavioural genetics increases in 1990s
✓ Increasing amount of research using brain imaging techniques in 2000s

On Profession

✓ Lightmer Witmer established the first psychological clinic at the University of

Pennsylvania in 1896 with the referral of a boy who showed an odd spelling problem.
✓ His early works led him to name this sub-discipline as Clinical Psychology. It was
also he who founded the first journal in Clinical Psychology, The Psychological
Clinic.
✓ Several publishing journals were founded
✓ James McKeen Catell founded the Psychological Corporation in 1921to develop and
market psychological tests especially for industries
✓ World War II paved the way for clinical psychologists to have more professional
opportunities such as in the recruitment of military officers up to the aftermath of the
war for those who were inflicted with emotional problems
✓ Scientist-practioner was the most accepted model for Clinical Psychology:
1. Training in university departments
2. Be trained as psychologists first and clinicians second
3. Required to serve a clinical internship
4. Achieve competence in diagnosis, psychotherapy, and research

9
 5. Ph. D as culmination of the training which involves an original research
contribution to the field

✓ 1988 Schism: American Psychological Association (APA) and American

Psychological Society (APS)
✓ Psychological Association of the Philippines: (https://www.pap.ph/)
-this is a professional organization that aims to promote excellence in teaching,
research, and practice of Psychology in the Philippines and its recognition as a
scientifically-oriented discipline for human and social development. It is the oldest
and largest professional organization of psychologists in the country and is duly
accredited by the PRC. It has seven areas of expertise: Assessment Psychology,
Clinical Psychology, Counseling Psychology, Developmental Psychology,
Educational Psychology, I/O Psychology, and Social Psychology. Members of this
organization can take part in four (4) special interest groups (SIG): Teaching SIG,
Mental Health and Psychosocial Services (MHPSS), LGBT Psychology SIG, Sports
and Exercise SIG.

Brief History of Clinical Psychology in the Philippines:

✓ Our pre-colonial help-seeking means through superstition, reliance on elders, faith

healers, fortune tellers, and belief in the supernatural;
✓ Psychology was probably first introduced as early as 17th century at the University of
San Carlos (USC) and University of Sto. Tomas (UST)
✓ The Americans had strong influences on education and training. In 1990s, they
established the Philippine Normal School (PNS) which later on became University of
the Philippines. Psychology was initially part of Department of Philosophy.
✓ The United States had significant impact on Counseling and Clinical Psychology in
the Philippines since most Filipino scholars came back to the country with newfound
knowledge
✓ UST was the first school to offer BS, Master’s, and Ph. D. in Psychology;
✓ Psychology was heavily reliant to education because of its dependence of education.
✓ Returning Filipino scholars created a new era in the field of Psychology such as
Virgilio Enriquez, Alfredo Lagmay, and Fr. Jaime Bulatao.
✓ In 2004, the R.A. 9258 or Philippine Guidance and Counseling Act was passed which
professionalized guidance counselors in the Philippines. This institutionalized
programs on mental health in the Philippines.
✓ In 2009, the R.A. 10029 was passed which professionalized psychometricians (RPMs)
and psychologists (RPsys) in the Philippines. The 1st board exam for RPMs and
RPsychs was held in October 2014.
✓ The landmark R.A. 11036 or Mental Health Act of the Philippines was passed in
2018. This is a very good welcome to the practice of Clinical Psychology in the
Philippine.

10
Exercise 1:

1. Read.

11
12
13
Source: https://www.cnnphilippines.com/lifestyle/2021/1/5/Mental-health-biggest-pandemic-
issues-2021.html

14
2. Answer:

a. What are the psychological issues of the articles?

b. Based on what Clinical Psychology is all about, how can this course respond to these
psychological issues?

15
Quiz 1:

1. What is the difference between Psychiatrist and Clinical Psychologist? Give

CONCRETE answers.

2. Rona, 29 years old, was referred to your clinic because of a very low mood which was
observed to have started less than 2 months ago. She does not want to go out of her
room which affected her performance at work as bank teller, even basic self-care is
almost absent. Her parents started to panic when she started refusing to eat for a
week. Rona, as a result, became ill and weak. As a psychology major, to whom will
you refer Rona—clinical psychologist or psychiatrist? Why?

16