Chapter 1, The Evolution of Clinical Psychology

Question 1

Mental health commission of Canada

Answer 1

Provinces provide health services, however, federal initiatives as directed by Out of the Shadows at Last (2006) about the reports of the senate commission on mental health chaired by senator Michael Kirby, advised the establishment of the MHCC.

Question 2

The messages of the MHCC about people living with mental disorders

Answer 2

• They have the right to receive the services and support they need.
• They have the right to be treated with the same dignity and respect as those struggling to recover from any kind of illness.

Question 3

The initiatives of the MHCC

Answer 3

1. Opening Minds
2. Mental Health First Aid
3. Mental Health Strategy of Canada
4. Knowledge Exchange Centre
5. Housing First
6. Peer Project

Question 4

David J. A. Dazois

Answer 4

A professor of psychology and director of the Clinical Psychology Graduate Program at Western University. I am registered as a psychologist in the Province of Ontario and certified by the Academy of Cognitive Therapy (ACT) and the Canadian Association of Cognitive and Behavioural Therapies (CACBT).

Question 5

International psychological boards

Answer 5

• American Psychological Association, Society of Clinical Psychology (APA)
• British Psychological Society (BPS)
• New Zealand Psychologists Board (NZPB)

Question 6

Evidence-Based Practice in Psychology

Answer 6

a practice model that involves the synthesis of information drawn from research and systematically collected data on the patient in question, the clinician’s professional experience, and the patient’s preferences when considering healthcare options.

1. requires the clinician to synthesize information drawn from research and systematically collected data on the patient in question, the clinician’s professional experience, and the patient’s preferences when considering health care options.
2. emphasizes the importance of informing patients, based on the best available research evidence, about viable options for assessment, prevention, or intervention services.

Question 7

Criticism of EBP

Answer 7

1. group-based data cannot be used in working with an individual
2. clients have problems now, and we cannot afford to wait for the research
3. each individual’s unique constellation of life experience, culture, and societal context makes it unlikely that general psychological principles can ever provide much useful guidance in alleviating emotional distress or interpersonal conflict
4. there is simply no research evidence on how to understand or treat many of the human problems confronted by clinical psychologists on a daily basis.

Question 8

Areas of psychology

Answer 8

cognitive, developmental, learning, personality, physiological, and social

Question 9

Counselling Psychology

Answer 9

Historically, the distinction between clinical and counselling psychology was in terms of the severity of problems treated. Traditionally, the focus of clinical psychology was on the assessment and treatment of psychopathology—that is, manifestations of anxiety, depression, and other symptoms that were of sufficient severity to warrant a clinical diagnosis. On the other hand, counselling psychologists provided services to individuals who were dealing with normal challenges in life: predictable developmental transitions, such as leaving home to work or to attend university or college, dealing with changes in work or interpersonal roles, and handling the stress associated with academic or work demands.

Counselling psychology is best for educational settings.

Question 10

School Psychology

Answer 10

Historically, school psychology emphasized services related specifically to the learning of children and adolescents, including the assessment of intellectual functioning; the evaluation of learning difficulties; and consultation with teachers, students, and parents about strategies for optimizing students’ learning potential. Clinical child psychology focused on the treatment of a diagnosable mental disorder.

Question 11

Psychiatry

Answer 11

Psychiatric training deals extensively with physiological and biochemical systems and emphasizes biological functioning and abnormalities. Psychiatrists are well qualified to determine whether mental disorders are the result of medical problems and to unravel the possible interactions between physical illnesses and emotional disturbances.
They also utilize psychopharmacological treatments. Cognitive-behavioural and interpersonal therapies.

Question 12

Examples of Psychiatrists

Answer 12

Aaron Beck was the primary developer of cognitive therapy for depression (and subsequently other disorders), Gerald Weissman was the primary developer of the interpersonal treatment of depression, and Isaac Marks has played a prominent role in the development of cognitive-behavioural treatments for anxiety disorders.

Question 13

Clinical social work

Answer 13

Social work practice includes activities such as policy development, program planning, program management, research consultation, case management, discharge planning, counselling, therapy, and advocacy. Social workers are employed in diverse settings, including hospitals, community mental health centres, mental health clinics, schools, advocacy organizations, government departments, social service agencies, child welfare settings, family service agencies, correctional facilities, social housing organizations, family courts, employee assistance programs, school boards, and private counselling and consultation agencies.

Question 14

Psychiatric Nurses

Answer 14

Offer services to individuals with needs related to mental and developmental health.

Question 15

Child and Youth Care Workers

Answer 15

Child and youth care workers and counsellors have the least training and are the least likely to be members of a regulated profession.

Question 16

Hippocrates

Answer 16

(often called the father of medicine) emphasized what is now known as a biopsychosocial approach to understanding both physical and psychological disorders (i.e., that biological, psychological, and social influences on health and illness must be considered). In abnormal psychology and personality textbooks, you will have learned about Hippocrates’ “bodily fluid” theory that imbalances in the levels of blood, black bile, yellow bile, and phlegm are responsible for emotional disturbance.

Question 17

Plato

Answer 17

emphasized the role of societal forces and psychological needs in the development and alleviation of mental disorders.

Question 18

Aristotle

Answer 18

Aristotle emphasized the biological determinants of mental disorders.

Question 19

Biopsychosocial Approach

Answer 19

a theoretical framework that takes into account biological, psychological, and social influences on health and illness.

Question 20

St. Vincent de Paul

Answer 20

In the late 1500s, St. Vincent de Paul proposed that mental and physical illnesses were caused by natural forces and that the extreme manifestations of mental disturbances such as psychotic behaviour were not caused by witchcraft or satanic possession.

Question 21

Philippe Pinel

Answer 21

Reformer Philippe Pinel, the director of a major asylum in Paris in the late 1700s, ordered that the chains be removed from all mental patients and that patients be treated humanely.

Question 22

William Tuke

Answer 22

In England, William Tuke advocated for the development of hospitals based on modern ideas of appropriate care and established a country retreat in which patients lived and worked.

Question 23

Benjamin Rush

Answer 23

In the United States, Benjamin Rush promoted the use of moral therapy with the mentally ill (a treatment philosophy that encouraged the use of compassion and patience rather than physical punishment or restraints).

Question 24

Jean-Martin Charcot

Answer 24

Jean-Martin Charcot, in France, is credited with being the primary developer of clinical neurology. As his fame grew, so did his emphasis on the role of psychological factors in hysteria.
Notable members of this group include Pierre Janet and Sigmund Freud, who initially embraced Charcot’s theories and his use of hypnosis, but later went on to develop their own theories to account for hysteria.

Question 25

Wundt 1879

Answer 25

measurements of sensory processes

Question 26

Kraeplin 1899

Answer 26

develops first diagnosis system

Question 27

Binet and Simon 1905

Answer 27

Intelligence testing. Binet and Simon develop a test to assess intellectual abilities in school children.

Question 28

Army Alpha and Army Beta 1917

Answer 28

Intelligence testing. Army Alpha and Army Beta tests are developed to assess select soldiers.

Question 29

Rorschach 1920s

Answer 29

Projective testing of personality. Rorschach publishes a book on the interpretation of inkblots.

Question 30

Wechsler 1939

Answer 30

Intelligence testing. Wechsler develops the Wechsler-Bellevue test of adult intelligence

Question 31

Murray and Morgan 1940s

Answer 31

projective testing of personality. Thematic apperception test

Question 32

revised examination M 1940s

Answer 32

intelligence testing. Revised Examination M is used for selection and assignment in the military

Question 33

Hathaway 1943

Answer 33

Actuarial assessment of personality. Hathaway publishes Minnesota Multiphasic Personality Inventory.

Question 34

APA 1952

Answer 34

APA publishes Diagnostic and Statistical Manual of Mental Disorders

Question 35

Meehl 1954

Answer 35

Challenge to clinical decision-making. Meehl distinguishes between statistical and clinical decision-making.

Question 36

Mischel 1968

Answer 36

Challenge to personality assessment. Mischel proposes an alternative behavioural approach to assessment.

Question 37

1968 APA 2nd edition

Answer 37

APA published 2nd editon of DSM

Question 38

Quay, Achenback and Conners 1970s

Answer 38

A dimensional approach to child problems. Quay, Achenbach, and Conners publish empirically based rating scales of child problems.

Question 39

APA 3RD EDITON 1980

Answer 39

DSM 3RD EDITION

Question 40

1990s behavioural assessment techniques

Answer 40

Increasing incorporation of behavioural assessment techniques into typical assessment practices.
Widespread use of computers for scoring and interpreting psychological test results.

Question 41

APA 4TH EDITION 1994

Answer 41

DMS 4TH EDITION

Question 42

2000s

Answer 42

Increased attention to the development of country-specific norms for commonly used measures of intelligence. Increased attention to principles of evidence-based assessment in the selection and use of assessment instruments.

Question 43

2010s awareness of systematic treatment

Answer 43

Increasing awareness that systematic treatment monitoring can dramatically enhance treatment outcomes.

Question 44

APA 5TH EDITION 2013

Answer 44

DSM 5TH EDITION

Question 45

International classification of diseases 2018

Answer 45

The scheduled release of International Classification of Diseases, 11th revision.

Question 46

James McKeen Cattell

Answer 46

The American James McKeen Cattell, who at one time worked with Wundt, focused scientific attention on the connection between reaction time and intelligence. He is credited with coining the term mental tests to describe the battery of tests and tasks he developed to evaluate people’s cognitive functioning.

Question 47

Francis Galton

Answer 47

In England, Francis Galton studied individual differences among people, especially differences in motor skills and reaction times, which he believed were related to differences in intelligence.

Question 48

Wilhelm Wundt

Answer 48

In Germany, Wilhelm Wundt, who studied sensation and perception, established the first psychology laboratory and was a central figure in advocating for psychology as the study of human experience.

Question 49

Emil Kraepelin

Answer 49

all mental disorders were due to biological factors. Accordingly, he devoted his career to the study and classification of mental disorders in the hope that his work would result in a scientifically based classification system that would have treatment implications. Consistent with scientific approaches of the time, a key component of Kraepelin’s approach to classification was to examine the way in which various symptoms covaried. Kraepelin assumed that by examining the symptomatic behaviour of a large number of patients, it would be possible to discern the kinds of disturbances of affect, thought, and behaviour that typically co-occurred. In Kraepelin’s view, this would provide insights into the nature of mental disorders. Kraepelin called these groups of symptoms that frequently co-occurred syndromes, and his classification system was built around identifying the ways in which these syndromes related to and differed from each other.

Question 50

Alfred Binet

Answer 50

Binet and his colleague Theodore Simon were invited to develop a strategy to measure mental skills that could yield information relevant to the identification of children with limited intelligence. By 1908, the two colleagues had developed the Binet-Simon scale of intelligence that consisted of more than 50 tests of mental skills that could be administered to children between the ages of 3 and 13 years. Binet and Simon gathered extensive data on a large number of children—that is, they established norms.

Question 51

Lewis Terman

Answer 51

Thus, by comparing the intelligence test score obtained by a particular child with norms for children of the same age, the child’s level of intelligence could be determined. In 1916, Lewis Terman published a modification of this scale for use in the United States, the Stanford-Binet Intelligence Test, which was the first widely available, scientifically based test of human intelligence.

Question 52

Robert Yerkes

Answer 52

With the entry of the United States into the First World War, the American government needed procedures to quickly determine the fitness of many thousands of recruits to serve in the military. Physicians were employed to evaluate the physical fitness of the recruits for various military activities. In addition, it was necessary to find a way to evaluate mental fitness and mental abilities. Therefore, a committee of the recently established American Psychological Association (APA, established in 1892) was struck to develop a system for classifying the men in terms of their mental functioning. This committee was chaired by Robert Yerkes, APA president. Within a short time, the committee developed a measure of verbal mental abilities, called the Army Alpha test, which could be administered in a group format (thus minimizing the cost and time of administration). They also developed a test of non-verbal mental abilities, the Army Beta test, for assessing recruits who were unable to read or who had limited English language skills. This involvement of psychologists in a key American government initiative set the stage for psychologists to be recognized in North America for their expertise in test construction and the measurement of individual differences. A second legacy of this process was the establishment of the first standards for the development of scientifically sound psychological tests. A third legacy was that, as a result of the value placed on these testing-related skills, the discipline of clinical psychology was officially recognized within the APA by the creation of the Section on Clinical Psychology in 1919.

Question 53

The Army Alpha Test

Answer 53

a measure of verbal mental abilities, called the Army Alpha test, which could be administered in a group format (thus minimizing the cost and time of administration).

Question 54

The Army Beta Test

Answer 54

a test of non-verbal mental abilities, the Army Beta test, for assessing recruits who were unable to read or who had limited English language skills.

Question 55

Wechsler-Bellevue test 1939

Answer 55

David Wechsler, subsequently developed intelligence tests for the entire age range (Wechsler Preschool and Primary Scale of Intelligence, Wechsler Intelligence Scale for Children, Wechsler Adult Intelligence Scale) and the most commonly used general measure of memory (Wechsler Memory Scale). Although other intelligence scales have since been developed for children and adults, the Wechsler scales are considered the gold standard in the assessment of intellectual abilities.

Question 56

Rorschach Inkblot Test

Answer 56

Swiss psychiatrist Hermann Rorschach in 1921. Although the test received a decidedly cool reception among psychiatric and psychological circles in Europe, it received a new lease on life when German psychologist Bruno Klopfer, who emigrated to the United States in 1934, began instructing psychology students at Columbia University on the use of the inkblots. The Rorschach Inkblot Test was also used in assessing children.

Question 57

House-Tree-Person Test

Answer 57

Another projective technique that was considered suitable for both adults and children was the House-Tree-Person Test that involved interpretation of the psychological meaning of qualities of a person’s drawing.

Question 58

Thematic Apperception (TAT)

Answer 58

American psychologists Henry Murray and Christina Morgan, working at the Harvard Psychological Clinic, published the Thematic Apperception Test (TAT), which comprised 20 pictures. Strongly opposed to the growing tendency to study psychological phenomena with experimental methods, Murray distanced himself from the mainstream of academic psychology, but he was greatly influenced in his thinking by the psychoanalytic writings of Sigmund Freud and Carl Jung.

Question 59

Revised Examination M

Answer 59

In Canada, the Test Construction Committee of the Canadian Psychological Association was responsible for the development of the Revised Examination M that consisted of both verbal and non-verbal ability tests used in the selection and assignment of military personnel.

Question 60

Minnesota Multiphasic Personality Inventory (MMPI) 1940s

Answer 60

by psychologist Starke Hathaway in 1943. The MMPI was, for many years to come, the epitome of the criterion-oriented approach to psychological test construction. The goal of the MMPI was to provide an easily administered test that could effectively screen for psychological disturbances among adults. To this end, Hathaway generated hundreds of test items that were administered to psychiatric patients. Items that were strongly associated with specific diagnoses were retained and then combined to make scales within the test. The ability of these scales to distinguish between people with and without psychiatric diagnoses was examined, and modifications to the scales were made based on these data. Evidence for the final scales’ reliability and validity was gathered, and normative data (although rather poor) were obtained. Thus, in contrast to the projective tests, the development and interpretation of MMPI relied extensively on attention to statistical procedures and test development criteria.

Question 61

Paul Meehl

Answer 61

in the 1950s and 1960s. Paul Meehl’s 1954 review of the relative strengths of clinically and statistically based assessment highlighted a number of problems that plagued the assessment enterprise in clinical psychology. found that a purely clinical approach to assessment was typically inferior to a more statistically oriented approach to accurately describing or diagnosing adults. By clinical, Meehl referred to the typical collection of interview and other information that was then used, sometimes with standardized test data, to generate descriptions and predictions of behaviour. The statistical approach, in contrast, involved the use of basic demographic information (such as age, gender, and health information) and data from standardized tests that were entered into statistical equations to yield descriptions and/or predictions.

Question 62

Walter Mischel 1968

Answer 62

Mischel’s work illustrated that these personality traits had more to do with how a person was viewed by others than with what a person actually did. Moreover, research on the predictive validity of personality traits typically yielded results of only moderate strength—in other words, knowing someone’s personality traits provided very little useful information if you wished to know what someone would actually feel, think, or do in a particular situation. Much more accurate predictions of psychological experience could be obtained by considering both the person’s past experiences in similar situations and the environmental influences on the person’s behaviour in the situation

Question 63

For most assessment purposes, it is generally accepted that assessment data should be obtained from

Answer 63

(a) multiple methods, such as interviews, observations, and self-reports; and, increasingly, (b) multiple informants (i.e., not just from the client).

Question 64

clinical utility

Answer 64

does having assessment data on a patient actually provide information that leads to a clinical outcome that is better (or faster or less expensive) than would be the case if the psychologist did not have the assessment data?

Question 65

service evaluation

Answer 65

ut bluntly, individual clinical psychologists are under increasing pressure to demonstrate that their services work. This has resulted in renewed attention to the role of clinical assessment in documenting progress and outcome in treatment. However, this need to demonstrate treatment effectiveness leads to a different type of clinical assessment than has often been used in the past. Whereas many clinical psychology measures were developed to give a broadly based psychological picture of the whole person, current assessment practices require that measures focus on specific problems (or strengths), be brief, and be amenable to repeated use. The measurement tools that are useful for generating an individual’s psychological profile are not necessarily the ones that are relevant to the repeated assessment of someone receiving treatment.

Question 66

Lighter Witmer

Answer 66

The first credited with the use of the term clinical psychology
learning and memory

Question 67

John Watson

Answer 67

demonstrated that it was possible to use conditioning principles to explain the development of phobias.

Question 68

Carl Rogers

Answer 68

the book Counselling and Psychotherapy 1942an assumption that people were inherently capable of developing in a positive, healthy manner. The primary goal of therapy, therefore, was to provide a supportive environment in which clients could reconnect with their emotions, their losses, and their aspirations and thereby discover their true potential for growth. Rogers’ work was crucial in the development of humanistic approaches to the understanding and treatment of human problems, an approach that has been termed the third force in psychotherapy (with psychodynamic and behavioural approaches being the first two)

Question 69

The 3 forces of psychotherapy

Answer 69

1. psychodynamic
2. behavioural
3. humanistic
   approaches

Question 70

Hans Eysenck

Answer 70

Hans Eysenck’s (1952) critique of the effectiveness of psychotherapy was a turning point for psychotherapy research and training. Eysenck argued that the rates of improvement among clients receiving either psychodynamic or eclectic (i.e., an unspecified mix of theories and techniques) therapy were comparable to rates of remission of symptoms among clients receiving no therapy at all. He contended, therefore, that there was no evidence that the most commonly used forms of psychotherapy had any demonstrable effect