Historical Roots

  • Individuals that altered the field of clinical psychology and began viewing mental illness as treatable—Pinel, Tuke, Todd, Dix
  • The development of clinical psychology slowly expanded in the fields of diagnosis, assessment, intervention, research and professional matters.

Diagnosis and Assessment

The Beginnings (1850-1899)

  • James Keen Cattell, a student of William Wundt believed that studying reaction time differences would help to understand intelligence—mental tests.
  • Witmer founded the current model of treatment by forming the first psychological clinic & a journal called the Psychological Clinic.
  • Initial emphasis focused on the youth population of children and adolescents who were unable to functionally adapt to society.

The Advancement of the Modern Era (1900-1919)

  • Binet and Simon developed the Binet-Simon Scale—measures intelligence.
  • Carl Jung developed testing methods around word-associations and 1910 brought the arrival of the Kent-Rosanoff Free Association Test.
  • WWI brought the screening of individuals entering the military, marking the movement away from children and youth towards adults.

Between the Wars (1920-1939)

  • By the late 1920's psychologists had individual and group testing tools at their disposal.
  • The field of intelligence was being expanded with work by Spearman, Thorndike, Thurstone
  • Wechsler-Bellevue test—first adult intelligence test; created in 1939 and since then modified & adapted.
  • Rorschach—inkblot tests that attempted to bring people to reveal their real-life experiences by looking at ambiguous stimuli. He published this in his book Psychodiagnostik.
  • Projective Techniques—Designed to allow a person to respond to ambiguous stimuli, and reveal hidden emotions and internal conflicts projected by the person into the test.
  • Thematic Appreciation Test (TAT)—Requires an individual to make up stories reflecting activities, thoughts and feelings of the people in the picture.

World War II and Beyond (1940-Present)

  • More complex tests began to develop. Minnesota Multiple Personality Inventory (MMPI)-self-report test, and unique because no interpretation of scores was needed.

  • Wechsler Intelligence Scale for Children—Alternative to Stanford-Binet scale.
  • Clinical psychologists were viewed as experts of psychodiagnosis—use of interpretation of test scores as a basis of diagnosis and treatment.
  • Different approaches—objective nomothetic approach (empirically tested rules) vs. projective idiographic approach (focused more on the individual and interpretations).
  • Radical Behaviorism: Only overt behavior can be measured and psychological trait measurement is not useful. It brought the era of behavioral assessment—behaviors were understood in the context of the stimuli or situation in which they occurred.
  • First DSM appeared in 1952, focused mostly on adult psychopathology and post-war symptoms.
  • Structured Diagnostic Interviews: Standard list of questions that are used as criteria to assess different disorders.
  • Health care insurers became more interested in managed health because it controlled and reduced costs and required mental health professionals to be more efficient.

Interventions

The Beginnings (1850-1899)

  • Jean Charcot focused on interventions for hysteria using hypnosis
  • Freud and Breuer collaborated on a patient Anna O's whose treatment was challenging

o Psychoanalysis (most influential theoretical and treatment development for clinical psychology)

The Advent of the Modern Era (1900-1919)

  • 1900's—psychoanalytic movement began with Freud's publication of The Interpretation of Dreams.

o Terms like Oedipus complex, ego, id began part of psychological terminology.

  • Healey's establishment of the child guidance center in Chicago in 1909 reflected a movement towards looking at juvenile offenders and not simply learning problems of children.

Between the Wars (1920-1939)

  • Psychoanalytic therapy was viewed as being the sole right of a medical practitioner but psychologists soon began to use it in their work with children (child guidance clinics).
  • Adler's emphasis on family relationships instead of sexuality grew prominent with
  • Play Therapy: Release of anxiety or hostility through expressive play (Freudian Principle based).
  • Behavior Therapy: Encompassing the works of Watson, Jones, Levy and others it focused on conditioning.

World War II and Beyond (1940-Present)

  • As psychiatrists and physicians were too few to help WWII men, psychologists began to fill the role and aid with psychotherapy, assisting men to return to combat and help with rehabilitation.
  • Shifting away from intelligence and focusing on personality, psychoanalytic intervention grew.
  • Carl Rogers publication, Client-Centered Therapy was the first alternative to psychoanalytic therapy.
  • Therapy was a growing field with the introduction of rational-emotive therapy (RET), cognitive-behavioral therapy (CBT), and behavioral therapy work by B.F. Skinner and Joseph Walope

o Looked at desensitization, operant principles and conditioning.

Research

The Beginnings (1850-1899) and the Advent of the Modern Era (1900-1918)

  • William Wundt and William James, both of whom formed research laboratories and influenced the scientist-practitioner model.
  • Ivan Pavlov's classical conditioning theories became important
  • 1905-Binet-Simon improved their intelligence tests and in 1916 development of the Army Alpha and Beta tests appeared.

Between the Wars (1920-1939) + World War II and Beyond (1940-Present)

  • Behaviorism (power of conditioning) and Gestalt psychology (emphasized patient's unique perceptions) were prominent.
  • By the 1960's diagnosis and assessment were less important, but in the 1950's it was largely hyped up.
  • Focus on effectiveness of psychotherapy (Carl Rogers and Dymond)
  • Wolpe (1958)—developed systematic desensitization
  • DSM-III published focused on reliability, validity of criteria used for mental disorders in the DSM manual.
  • Focus on etiological factors or causes for many mental disorders.
  • Behavioral Genetics: Both environmental and genetic factors influence development of behavior.
  • Brain imaging: Allows us to view both the structure and function of the brain.

The Profession

The Beginnings (1850-1899)

  • 1892—Founding of the American Psychological Association (APA)

o President: G. Stanley Hall

  • 1896—Lightner Witmer—first Psychological Clinic establishment at U of Pennsylvania. He named the field clinical psychology

The Advent of the Modern Era (1900-1919)

  • 1909—Establishment of the Psychopathic Institute in Chicago (Healy)
  • 1910—222 APA members, $1 membership.
  • Focus on APA was psychology as a science not a profession.
  • 1919—First Clinical Psychology Section was created within APA

Between the Wars (1920-1939)

  • APA 1935 Clinical Psychology---art and technology that deals with adjustment & problems of human beings.
  • 1937—Journal of Consulting Psychology was founded

World War II and Beyond (1940-1969)

  • Psychologists experience in research and tools for testing differentiated them from psychiatrists.
  • With the end of WWII soldiers that were returning experienced extensive emotional trauma/
  • The Veterans Administration (VA) increased availability of mental health professionals by providing financial support for training.
  • VA's needs to deal with the psychological problems of adults resulted in a shift from children.
  • 1945—Connecticut first state to institute certification examination for psychologists.
  • 1949—Conference on graduate education in Clinical Psychology held at Boulder, Colorado.

o Focused on the scientist-practitioner model for training

The Growth of the Profession (1970-Present)

  • 1960's—shift towards focusing on conditioning and altered reinforcement contingencies.
  • Key focus was looking at patient's behaviors and not their thoughts. People began to question this and turned towards cognitive-behavioral orientation.

The 1988 Schism

  • Many critics felt that the APA was being controlled by practitioners that were using it for their own interests; no longer focused on scientific needs.
  • Plan to reorganize APA so that it lessened the gap between the clinical wing and academic-scientific wing failed by a 2-1 vote of membership.
  • American Psychological Society (APS)/Association of Psychological Science—focused on the scientific aspect of psychology. First conference held in June 1988.
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