Abstract
BackgroundA taxonomy of the objects of study, theory, assessment, and intervention is critical to the development of all clinical sciences. Clinical psychology has been conceptually and administratively dominated by the taxonomy of an adjacent discipline – psychiatry’s Diagnostic and statistical manual of mental disorders (DSM). Many have called for a ‘paradigm shift’ away from a medical nosology of diseases toward clinical psychology’s own taxonomy of clinical psychological problems (CPPs), without being able to specify what is to be listed and classified.Main textAn examination of DSM’s problems for clinical psychology, especially its lack of clinical utility, and a search for the essence of CPPs in what clinical psychologists actually do, leads to the proposal that: The critical psychological-level phenomenon underlying CPPs is the occurrence of ‘problem-maintaining circles’ (PMCs) of causally related cognitions, emotions, behaviours, and/or stimuli. This concept provides an empirically-derived, theory-based, treatment-relevant, categorical, essentialist, parsimonious, and nonstigmatizing definition of CPPs. It distinguishes psychological problems in which PMCs have not (yet?) formed, and which may respond to ‘counseling’, clinical psychological problems in which active PMCs require clinical intervention, and psychopathological problems which are unlikely to be ‘cured’ by PMC-breaking alone.ConclusionA subsequent classification and coding system of PMCs is proposed, and expected benefits to research, communication, and the quality of case formulation in clinical psychology are described, reliant upon a development effort of some meaningful fraction of that which has been devoted to the DSM.
Highlights
An examination of DSM’s problems for clinical psychology, especially its lack of clinical utility, and a search for the essence of clinical psychological problem (CPP) in what clinical psychologists do, leads to the proposal that: The critical psychologicallevel phenomenon underlying clinical psychological problems (CPPs) is the occurrence of ‘problem-maintaining circles’ (PMCs) of causally related cognitions, emotions, behaviours, and/or stimuli
If it comprises a ‘harmful dysfunction’ (Wakefield, 1992), its harmfulness must be a matter of subjective judgement, but its dysfunction must be defined objectively; And according to only one or two criteria, not a hodgepodge of them; (c) Categorical, rather than merely dimensional; (d) Encompassing of all problems currently appropriately and successfully addressed by clinical psychologists; not merely diagnosed mental disorders; And (e) better at avoiding the stigma and responsibility-confusion problems which have been exacerbated rather than ameliorated by the disease model
Seeking the essence of clinical psychological problems By examining what clinical psychologists research and address in their clinical practice, we have come quite close to uncovering the essence of CPPs
Summary
An examination of DSM’s problems for clinical psychology, especially its lack of clinical utility, and a search for the essence of CPPs in what clinical psychologists do, leads to the proposal that: The critical psychologicallevel phenomenon underlying CPPs is the occurrence of ‘problem-maintaining circles’ (PMCs) of causally related cognitions, emotions, behaviours, and/or stimuli. It distinguishes psychological problems in which PMCs have not (yet?) formed, and which may respond to ‘counseling’, clinical psychological problems in which active PMCs require clinical intervention, and psychopathological problems which are unlikely to be ‘cured’ by PMC-breaking alone
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
