Practice Of Clinical Psychology Research Articles

Phenomenological and Participatory Research on Schizophrenia: Recovering the Person in Theory and Practice

This article describes the application of phenomenological and participatory research methods in understanding the problem of recurrent inpatient admissions for individuals diagnosed with serious mental illness. Conventional approaches to understanding and addressing inpatient recidivism in serious mental illness have neglected to invite the perspective or input of the person with the disorder, further exacerbating the passive and helpless role of mental patient into which these individuals have become socialized by virtue of prevailing patterns of cultural stigma and clinical practice. These approaches have focused exclusively on the disorder and its signs and symptoms and have attempted to prevent readmission through early detection and intervention to prevent relapse. This paper describes the failure of one attempt to institute such an approach to addressing the problem of recidivism, and the use of phenomenological and participatory research methods to involve recidivist patients themselves in exploring the reasons for this failure and to suggest alternative approaches. These methods involved patients' describing their experiences of hospitalization, discharge, and readmission, identifying the precipitants and reasons for their readmissions, and participating in the design of a new intervention that has proven more successful in assisting them in establishing more satisfying lives for themselves in the community as an alternative to returning to the hospital. The authors suggest that such participatory methods provide an antidote to the passive and helpless role of mental patient often encouraged by conventional modes of clinical practice and research, allowing for a recovery of an active role for the person with the disorder both in the theory and practice of clinical psychology.

Phenomenological and Participatory Research on Schizophrenia: Recovering the Person in Theory and Practice

This article describes the application of phenomenological and participatory research methods in understanding the problem of recurrent inpatient admissions for individuals diagnosed with serious mental illness. Conventional approaches to understanding and addressing inpatient recidivism in serious mental illness have neglected to invite the perspective or input of the person with the disorder, further exacerbating the passive and helpless role of mental patient into which these individuals have become socialized by virtue of prevailing patterns of cultural stigma and clinical practice. These approaches have focused exclusively on the disorder and its signs and symptoms and have attempted to prevent readmission through early detection and intervention to prevent relapse. This paper describes the failure of one attempt to institute such an approach to addressing the problem of recidivism, and the use of phenomenological and participatory research methods to involve recidivist patients themselves in exploring the reasons for this failure and to suggest alternative approaches. These methods involved patients' describing their experiences of hospitalization, discharge, and readmission, identifying the precipitants and reasons for their readmissions, and participating in the design of a new intervention that has proven more successful in assisting them in establishing more satisfying lives for themselves in the community as an alternative to returning to the hospital. The authors suggest that such participatory methods provide an antidote to the passive and helpless role of mental patient often encouraged by conventional modes of clinical practice and research, allowing for a recovery of an active role for the person with the disorder both in the theory and practice of clinical psychology.

Making psychology incorruptible

This paper is a response to criticisms, by Peterson (1995) and others, of positions I took in an earlier article, “Manifesto for a science of clinical psychology” (McFall, 1991). I had argued that professional practice and training in clinical psychology must be governed by a scientific epistemology, and had outlined some of the specific reasons and implications. In this article, I attempt to correct misinterpretations of my previous arguments, to clarify ambiguities, and to fill any serious omissions. The fundamental points of the original Manifesto are defended, buttressed, and extended. In response to issues highlighted by the criticisms, two new corollaries are added to those offered in the original article. These summarize the arguments presented in this paper, with special emphasis on the essential role of skepticism as the best protection against the corruption of knowledge and practice in psychology.

Methods for overcoming methodological problems in the measurement of client satisfaction in a clinical psychology practice

This study surveyed client satisfaction with an outpatient service in clinical psychology at a university-based clinic in New Zealand. In an effort to collect honest opinions rather than "grateful testimonials" from clients, special consideration was given to the methodology used. In the absence of guidelines on how to analyze client satisfaction data, a variety of techniques was developed. These methods and analyses are reviewed and recommendations made with regard to future use.

Bridging scientist and practitioner perspectives in clinical psychology.

Literature suggests that a complex and often hostile relationship exists between the science and practice of clinical psychology. Contributors to this conflict of viewpoints are reconsidered within the proposition that there are different roads to discovery and that there may be good reasons to keep the science and practice of clinical psychology somewhat separate. Results of a national survey of 325 psychologists are reviewed that support the view that psychological practitioners value research and consider their practices to be augmented by scientific findings. However, they are in need of vehicles of communication that will help them translate scientific findings into practice. Results suggest that practitioners do more to understand scientific findings than scientists do to understand the problems that face clinical practitioners. Ways to facilitate communication between and among these groups are considered.

The effects of legislation on clinical psychology practice standards in Australia

The effects of legislation on clinical psychology practice standards in Australia

Bridging scientist and practitioner perspectives in clinical psychology.

Literature suggests that a complex and often hostile relationship exists between the science and practice of clinical psychology. Contributors to this conflict of viewpoints are reconsidered within the proposition that there are different roads to discovery and that there may be good reasons to keep the science and practice of clinical psychology somewhat separate. Results of a national survey of 325 psychologists are reviewed that support the view that psychological practitioners value research and consider their practices to be augmented by scientific findings. However, they are in need of vehicles of communication that will help them translate scientific findings into practice. Results suggest that practitioners do more to understand scientific findings than scientists do to understand the problems that face clinical practitioners. Ways to facilitate communication between and among these groups are considered.

House of Cards: Psychology and Psychotherapy Built on Myth

The disorders called mental illnesses afflict many persons with distress and disability and, in aggregate, constitute substantial social, personal, and economic problems in our culture. Psychotherapists assert the skills to provide alleviation and solutions, and often do. Professor Dawes' book is not a derisory exposé, as the title might suggest, but a thoughtful scrutiny of the present state of scientific thinking and the lack of it in clinical practice. Up to about 1950 most professional therapists were physicians. Since then, attracted by status and salaries, professing therapists without medical training have increased exponentially in number. The clinical practice of psychology has increasingly divorced itself from its research base, while the rigor of training in scientific method has diminished. There are now more clinical psychologists than psychiatrists and more psychiatric social workers than clinical psychologists. Treatment is provided in the main by nonphysicians. Almost anyone can open an office and solicit

Current integration of theory and practice in clinical psychology: four abstracts

Current integration of theory and practice in clinical psychology: four abstracts

Psychopharmacology treatment research in depression: Implications for clinical psychology practice

Psychopharmacology treatment research in depression: Implications for clinical psychology practice

Personal therapy in the training of psychologists.

AbstractClinical and counselling psychologists in B.C. were surveyed about their opinions on as a component of professional training, and about the circumstances under which had been provided to them while they were in graduate school. Respondents identified potential benefits and risks of therapy. The majority, 88%, saw at least one benefit for the experience, and 83% saw at least one risk. About half (41%) of them had undergone as part of their clinical training, and in many cases this experience was provided in a manner inconsistent with ethical guidelines. Of those receiving therapy, 46% reported that was required rather than optional, 62% were not able to choose their therapist, and 69% received from an academic colleague. Several ethical issues concerning therapeutic interventions in the of psychotherapists are discussed.When being trained to work in the helping professions, many future therapists undergo some type of psychotherapeutic treatment as part of their preparation. This personal therapy experience has been used in psychoanalysts (Caligor, 1985), other psychodynamic therapists (Battegay, 1983; Strupp, Butler, & Rosser, 1988), family therapists (Forman, 1984; Francis, 1988; Guldner, 1978), group therapists (Salvendy, 1985), behaviour therapists (McNamara, 1986) and clinical psychologists (Garfield & Kurtz, 1976; Guy, Stark, & Poelstra, 1988).Although psychoanalysis has traditionally asserted that therapy, the training analysis, is a necessary prerequisite for developing professional competence (Caligor, 1985), opinion varies concerning the importance of this experience for psychologists. In their survey of 87 APA - approved clinical programs, Wampler and Strupp (1976) found that 4% of the programs required therapy, 67% encouraged it, and the rest neither encouraged nor discouraged it. As a result, not all psychologists receive the same exposure to therapy. A recent survey of APA members working in the areas of clinical psychology, psychotherapy, and independent practice (Guy et al., 1988), showed that 70% had received before completing their degree.The presumed benefits of this experience include mastery of technique as a result of exposure to a role model, increased self - awareness, a sense of conviction aboutthe validity of the therapeutic model, and resolution of problems or baggage which could interfere with the therapist's effectiveness in the treatment situation (Nierenberg, 1972). Arguments against such experiences include the risk of limiting the trainees' openness to a variety of therapeutic models, emotional and financial stress on trainees, and the lack of conclusive evidence that is an effective method of professional helpers (Clark, 1986; Macaskill, 1988).A variety of ethical issues can also be raised if is mandatory for students, or if it is provided by faculty members who are also serving as instructors of those students. However, these issues are seldom addressed in the literature on therapy, and most of the published studies deal with the format and content of the experience (e.g., Francis, 1988; McNamara, 1986) rather than with the ethical implications (e.g., Newman, 1981). In contrast, the current study examines some of the potentially problematic ethical issues that can arise when is included in graduate programs.In response to concerns that a CPA member raised about the use of encounter sessions in a group process course, the Committee on Ethics of the Canadian Psychological Association (CECPA) considered the potentially serious ethical ramifications of providing therapeutic processes within the context of an educational setting. The Committee recommended several guidelines (CECPA, 1988) for the inclusion of experiences as part of any program, and its suggestions are congruent with a report from the Ethics Committee of the American Psychological Association (APA, 1987) on the ethical issues raised by required psychotherapy for trainees. …

Striving towards the ethical practice of clinical psychology

Striving towards the ethical practice of clinical psychology

Surviving in the Hospital: Clinical Practice of Psychology in Medical Settings

Surviving in the Hospital: Clinical Practice of Psychology in Medical Settings

Informed consent: legal issues and applications to clinical practice.

AbstractThe professional literature on informed consent has been critically reviewed and its implications for clinical psychology practice are discussed. The legal and ethical rights of patients and obligations of psychologists are detailed. Specific examples of possible problem areas in professional practice are highlighted, and practical recommendations are suggested for guiding the practitioner through issues on which legal doctrine is sometimes vague, ambiguous, or yet to be established.Courts have traditionally deferred to the presumed expertise of the professionals when complained against on issues of patient rights (Bloom & Asher, 1982, p. 19). Recent years, however, have brought increases in litigation, court decisions and legislative statutes bearing on the rights of psychiatric patients. These changes have provided the impetus behind a proliferation of mental health and legal professional literature dedicated to patient rights, which has, in turn, led to the re - evaluation of patient care policies in mental health facilities (Bloom & Asher, 1982). One of the most important patient rights is that of informed consent (Ludlam, 1978). It must be noted that the law of informed consent is inherently medically oriented; explicit reference to the duties and rights of physicians and patients and to medical procedures is typical in most legislation and case law. This orientation derives from the prevalence of medical litigation in the case law defining the requirements of informed consent. Concomitantly, much of the professional literature discusses consent in a medical context.Despite its emphasis on medicine, however, the legalities of informed consent are equally applicable to mental health care. This discussion will focus specifically on the legal doctrine of consent to treatment. Its implications for mental health professions, generally, and clinical psychology practice, specifically, will be highlighted. It will be argued that ensuring sound consent practices is both a legal and ethical obligation. Moreover, to the extent that consent is based on regard for autonomy, observing proper informed consent is consistent with fundamental goals for offering psychological services.Informed ConsentThe definition of informed consent is a highly complex issue involving law, ethics, and morality (Ludlam, 1978); it is also a source of continuing controversy in the professional literature. Informed consent has been described as a myth, a fiction, and an unattainable goal that has become a legal requirement (Sprung & Winick, 1989). Less cynically, it has been typically construed as a process ideally involving the mutual participation of both the professional and the client in a shared decision making process regarding treatment (President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, 1982; cited in Sprung & Winick, 1989).The philosophical or moral basis of informed consent relies on an assumption of a fundamental right of autonomy, or self - determination (Arboleda - Florez, 1988). The legal right of autonomy, however, is not absolute, and each society has an obligation to set appropriate restrictions that balance the rights of the individual with the rights of society (Eth & Robb, 1986; Rozovsky & Rozovsky, 1990). In regards to the consent issue, there are five typical exceptions to the rule requiring that informed consent be obtained from the patient prior to treatment. They include: 1) medical emergencies, where there is immediate danger to life and the delay that would be necessary to obtain consent might be harmful; 2) incompetency, where the patient is unable to give a legally valid consent; 3) therapeutic privilege, where there is discretion to withhold information which might have a detrimental effect on patient health if disclosed; 4) waiver, where the patient can waive his or her right to be informed, to make the treatment decision, or both; and 5) mentally ill and dangerous, where mentally ill patients who are imminently in danger of harming themselves or others may be involuntarily committed and treated (Faden & Beauchamp, 1986; Sprung & Winick, 1989; Alberta Mental Health Act, 1990). …

Confidence in the practice of clinical psychology.

Confidence in the practice of clinical psychology.

Confidence in the practice of clinical psychology.

Confidence in the practice of clinical psychology.

A Short History of the Future: Feminism and Clinical Psychology

Since the 19th century, feminists have criticized the mental health establishment and its treatment of women. Issues include the sexist use of psychoanalytic concepts and psychiatric diagnoses, the misuse of medication, and sexual misconduct in therapy. Feminists have also called attention to psychological problems arising from gender inequality in everyday life. Physical and sexual abuse of women is of special concern. Feminist innovations in therapy include consciousness-raising, sex-role resocialization, and new approaches to psychoanalysis and family therapy. We urge feminists to develop a fuller understanding of gender and power, and to use this knowledge to challenge the established theory and practice of clinical psychology.

Clinical psychology and general practice

General practitioners who secure the collaboration of a clinical psychologist in treating patients, especially in a community setting, are likely to benefit the patients and themselves. Transfer of skills may be an important way for the two professions to collaborate. Health promotion could be a fruitful field for collaboration but has so far been little explored.

Estimation of verbal intelligence in an elderly community: An epidemiological study using NART

The National Adult Reading Test (NART) has become widely used by psychologists in clinical practice as part of the assessment of cognitive decline in organic mental disorders. Some normative data have been presented on community samples from a wide range of ages, but little is known of the instrument's performance in true community samples of the elderly. This study presents data on NART from an epidemiological study of dementia and cognitive impairment in elderly women. The contribution of educational level and social class to performance on the scale was examined. NART was found to be strongly related to current level of cognitive function as measured by the Mini Mental State Examination and CAMCOG-the neuropsychological battery of the Cambridge Examination for Mental Disorders in the Elderly. For most subjects in the community the NART was found acceptable as a measure of premorbid intelligence.

Who gets attacked? A national survey of patient violence directed at psychologists in clinical practice.

Who gets attacked? A national survey of patient violence directed at psychologists in clinical practice.