Introduction to Clinical Psychology: An Evidence-Based Approach, 4th Edition by University of Ottawa authors Catherine M. Lee and John Hunsley introduces students to the theories and practices of clinical psychology and conveys the important work done by clinical psychologists. This text is designed to be helpful not only to those who will go on to careers in clinical psychology, but also to those who will choose other career paths.
Table of Contents
PREFACE iv
ACKNOWLEDGEMENTS vii
ABOUT THE AUTHORS viii
1 The Evolution of Clinical Psychology 1
Introduction 1
Defining the Nature and Scope of Clinical Psychology 3
Evidence-Based Practice in Psychology 7
Mental Health Professions 8
Counselling Psychology 8
School Psychology 10
Psychiatry 10
Clinical Social Work 11
Other Mental Health Professions 12
Availability of Mental Health Service Providers 13
A Brief History of Clinical Psychology 14
The Roots of Clinical Psychology 14
The History of Assessment in Clinical Psychology 15
The History of Intervention in Clinical Psychology 20
The History of Prevention in Clinical Psychology 25
The Future 25
Summary and Conclusions 25
2 Contemporary Clinical Psychology 27
Introduction 27
Activities of Clinical Psychologists 28
Assessment and Diagnosis 29
Intervention 32
Prevention 35
Consultation 35
Research 37
Teaching and Supervision 38
Administration 39
Employment Settings 39
The Two Pillars of Clinical Psychology: Science and Ethics 40
Training in Clinical Psychology 43
Models of Training in Clinical Psychology 43
Accreditation of Clinical Psychology Programs 45
Licensure in Clinical Psychology 47
Summary and Conclusions 49
3 Classification and Diagnosis 50
Introduction 50
Defining Abnormal Behaviour and Mental Disorders 52
Developmental Psychopathology 53
Diagnosis 53
Defining Disorder 54
Prevalence of Mental Disorders 55
Understanding the Development of Mental Disorders 58
The Diagnostic and Statistical Manual of Mental Disorders (DSM) System 61
The Evolution of the DSM 61
The DSM-5 63
The International Statistical Classification of Diseases and Related Health Problems (ICD) System 67
Limitations of Diagnostic Systems 68
Defining Abnormality (Revisited) 68
Diagnostic Reliability 69
Heterogeneity of Symptom Profiles 70
Diagnostic Validity 71
Comorbidity 72
Categorical versus Dimensional Classification 73
Summary and Conclusions 74
4 Research Methods in Clinical Psychology 75
Introduction 75
Generating Research Hypotheses 78
Ethics in Research 80
Research Designs 83
Case Studies 86
Single Case Designs 87
Correlational Designs 88
Quasi-Experimental Designs 90
Experimental Designs 91
Selecting Research Participants and Measures 93
Selecting the Sample 93
Selecting the Sampling Strategy 93
Setting the Sample Size 94
Measurement Options and the Importance of Psychometric Properties 95
Analyzing the Data 96
Statistical and Clinical Significance 97
Research Syntheses 98
Systematic Reviews 98
Meta-Analysis 99
Summary and Conclusions 100
5 Assessment: Overview 102
Introduction 102
Psychological Assessment 103
Evidence-Based Assessment 104
The Purposes of Psychological Assessment 105
Psychological Testing 112
Assessment versus Testing 114
Psychometric Considerations 116
Testing Practices in Clinical Psychology 120
Ethical Considerations 121
Summary and Conclusions 122
6 Assessment: Interviewing and Observation 124
Introduction 124
Ethical Issues: Limits of Confidentiality 126
Unstructured Assessment Interviews 127
Semi-Structured Diagnostic Interviews 129
General Issues in Interviewing 131
Attending Skills 131
Contextual Information 132
Culturally Sensitive Interviewing 133
Defining Problems and Goals 135
Assessing Suicide Risk 137
Interviewing Couples 138
Interviewing Families 138
Interviewing Children and Adolescents 139
Observations 141
Self-Monitoring 144
Summary and Conclusions 147
7 Assessment: Intellectual and Cognitive Measures 148
Introduction 148
Defining Intelligence 149
Theories of Intelligence 149
Assessing Intelligence: The Clinical Context 151
The Wechsler Intelligence Scales 153
Background Issues 153
Administration, Scoring, and Interpretation Issues 157
Canadian Normative Data 158
Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV) 160
Wechsler Intelligence Scale for Children - Fifth Edition (WISC-V) 162
Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition (WPPSI-IV) 163
Other Intelligence Scales 164
Selected Cognitive Assessment Scales 165
Wechsler Memory Scale - Fourth Edition (WMS-IV) 165
Wechsler Individual Achievement Test - Third Edition (WIAT-III) 167
Summary and Conclusions 168
8 Assessment: Self-Report and Projective Measures 169
Introduction 169
The Person-Situation Debate 170
Self-Presentation Biases 172
Developing Culturally Appropriate Measures 172
The Clinical Utility of Self-Report and Projective Measures 175
Self-Report Personality Measures 176
MMPI-2 and MMPI-A 177
Other Clinical Measures of Personality Functioning 182
Self-Report Checklists of Behaviours and Symptoms 184
Achenbach System of Empirically Based Assessment 184
SCL-90-R 187
Outcome Questionnaire 45 187
Beck Depression Inventory-II 188
Children’s Depression Inventory 2 189
Projective Measures of Personality 189
Rorschach Inkblot Test 190
Summary and Conclusions 192
9 Assessment: Integration and Clinical Decision-Making 194
Integrating Assessment Data 196
Case Formulation 198
Threats to the Validity of Assessments and Case Formulations 202
Patient/Client Factors 202
Clinician Factors 203
Improving the Accuracy of Clinical Judgment 205
Psychological Assessment Reports and Treatment Plans 207
Assessment Feedback 209
Summary and Conclusions 211
10 Prevention 213
Introduction 213
Approaches to Prevention 217
Promoting Evidence-Based Parenting 220
Home Visiting Programs 221
Incredible Years 221
Triple P 222
Prevention of Violence 222
Physical Abuse of Children 222
Youth Violence: Bullying and Conduct Disorder 223
Prevention of Internalizing Disorders 225
Anxiety Disorders 225
Depression 226
Prevention of Substance Abuse 226
Prevention of Problems in those Exposed to Trauma or Loss 228
Summary and Conclusions 229
11 Intervention: Overview 231
Introduction 231
The Ethics of Intervention 232
Theoretical Approaches 236
Short-Term Psychodynamic Psychotherapies 237
Interpersonal Psychotherapy for Depression 239
Process-Experiential Therapies 240
Cognitive-Behavioural Therapies 241
Seeking Psychological Treatment 244
The Duration and Impact of Psychotherapy 247
Alternative Modes of Service Delivery 249
Summary and Conclusions 254
12 Intervention: Adults and Couples 256
Introduction 256
Does Psychotherapy Work? A Controversy and Its Impact 256
Meta-Analysis and Psychotherapy Research 257
Evidence-Based Treatments: Initiatives and Controversies 261
Clinical Practice Guidelines 268
Examples of Evidence-Based Treatments 270
CBT for Depression 270
Prolonged Exposure CBT for PTSD 273
EFT for Couple Distress 274
Effectiveness Trials 274
Adoption of Evidence-Based Treatments 276
Summary and Conclusions 278
13 Intervention: Children and Adolescents 280
Introduction 280
Who Is the Client in Psychological Services for Children and Adolescents? 280
Landmarks in the Evolution of Evidence-Based Psychological Services for Children and Adolescents 283
Do Psychological Treatments for Children and Adolescents Work? 284
Which Treatments Work for Specific Disorders? 285
Clinical Practice Guidelines 288
Examples of Evidence-Based Treatments 289
Disruptive Behaviour Disorders 289
Adolescent Depression 295
Efficacy, Effectiveness, and the Dissemination of Evidence-Based Treatments 296
Summary and Conclusions 300
14 Intervention: Identifying Key Elements of Change 302
Introduction 302
Psychotherapy Process and Process-Outcome Research 303
Examining Client Factors 305
Examining Therapist Factors 307
Examining Treatment Factors 309
Some Methodological Cautions 312
Common Factors in Psychotherapy 313
Research Perspectives on Common Factors: The Therapeutic Alliance 314
Research Perspectives on Common Factors: Psychotherapy Equivalence 315
Evidence-Based Psychotherapy Relationships 318
Task Force Recommendations 319
Empirically Based Principles of Therapeutic Change 320
Summary and Conclusions 323
15 Clinical Health Psychology, Clinical Neuropsychology, and Forensic Psychology 324
Introduction 324
Clinical Health Psychology 325
Definitions of Health and Disability 326
Activities of Clinical Health Psychologists 327
Assessment and Intervention Related to Pain 330
Clinical Neuropsychology 333
Activities of Clinical Neuropsychologists 333
Assessment 335
Intervention 337
Forensic Psychology 339
Activities of Forensic Psychologists 340
Assessment 342
Intervention 343
Summary and Conclusions 344
APPENDIX 1 Major Journals Relevant to Clinical Psychology 346
APPENDIX 2 Applications to Graduate School 352
REFERENCES 361
NAME INDEX 391
SUBJECT INDEX 403
