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Clinical psychology is one of the most important and fascinating areas of psychology, and we have the pleasure of introducing it to you in the pages of this book. Our opening chapter provides a broad overview of the field. We’ll describe what clinical psychology is, what clinical psychologists do, where they work, how they are trained, and how clinical psychology is related to other domains of psychology, including other mental health fields. Whether you have only a casual interest in the field or you are thinking about becoming a clinical psychologist yourself, this chapter’s overview will set the stage for the others that focus on more specific topics.
In this chapter, we describe how clinical psychologists work with medical professionals to treat disorders, help patients to cope with the stress of medical conditions, and to increase patients’ adherence to medical treatment recommendations. We also describe how psychological factors contribute to disease, focusing on relationships between psychosocial factors (such as stress, patterns of thinking) and physical factors (such as nervous system activity, circulation, immune system functioning). Next we describe psychological risk factors and treatment interventions for illnesses such as cardiovascular disease, chronic pain, and cancer.
Here we describe a series of approaches to psychotherapy that grew from learning theory and from cognitive psychology, as well as acceptance approaches that have a long history in Eastern faiths and philosophies. We group them together because they are frequently combined in practice and because they share a strong record of empirical support for their efficacy. Behavior therapists rely on techniques designed to identify and change maladaptive behavior. Cognitive therapists view unhelpful thinking patterns as key to maintaining many disorders, so cognitive therapy is designed to change how clients think about events and themselves. Despite certain differences, the behavioral and cognitive approaches are compatible and are often combined into various forms of cognitive behavior therapy, one of today’s most popular approaches to psychological treatment. Acceptance-based approaches, which are central to acceptance and commitment therapy, dialectical behavior therapy, and mindfulness treatments emphasize the value of accepting thoughts, feelings, and experiences (even negative ones) as part of the human experience and learning how to observe reactions without judging them.
In this chapter, we describe features common to most clinical interventions, focusing primarily on psychotherapy. We begin by examining what psychotherapy is and contrasting it with how it is portrayed in popular media. We describe what research tells us about clients and therapists and which of their characteristics influence therapy outcomes. Next, we examine the goals and basic processes involved in clinical interventions, as well as the professional and ethical codes that help guide practitioners in conducting treatment. Finally, we consider certain practical aspects of treatment such as treatment duration, fees, record keeping, treatment planning, therapist self-disclosure, and termination.
In this chapter, we describe a variety of interview and observation techniques. We begin with interviews, categorized first by their goals and then by their structure. We also address stages of the interview process and what research has revealed about the reliability and validity of differing types of interviews. We treat clinical observations in much the same manner, discussing their goals and types as well as research on their strengths and limitations. Throughout, we discuss how various factors—particularly interview and observation structure, client diversity, and clinicians’ biases—can affect the results of interviews and observations.
Clinical neuropsychologists perform assessments and design interventions for patients who experience neurological dysfunction because of brain injury or illness. They also conduct research on both normal and abnormal brain functioning. That research has helped to shed light on psychological disorders such as depression and schizophrenia, and on neurological disorders such as Alzheimer’s disease or the effects of a concussion. Clinical neuropsychology is a relatively new and growing field, and its practitioners must understand brain–behavior relationships and be trained in a variety of assessment and intervention techniques unique to the field.