Clinical Psychology: Understanding and Practice
What is Clinical Psychology?
Clinical psychology is the field of psychology dedicated to the research, teaching, and services related to understanding, predicting, and alleviating cognitive, emotional, biological, social, and behavioral maladjustment, impairment, distress, and discomfort. This is applied to a wide range of client populations.
Goals of Clinical Psychology
- Integrate science and practice.
- Apply integrated knowledge to alleviate suffering and promote health.
- Meet these goals for clients from diverse backgrounds and life stages.
Education and Training
This field emphasizes the integration of science and practice. Clinical psychologists typically hold PhDs or PsyDs and are licensed professionals. They engage in various combinations of research, teaching, assessment, clinical work, administration, supervision, and consulting.
Understanding Empathy vs. Sympathy
Empathy: Compassion-driven, involves taking the other person’s perspective, a more active feeling, and shared emotion.
Sympathy: May be influenced by pity, involves taking your own perspective, can be a more passive feeling, and feeling bad for someone.
Strategies for Expressing Empathy
Both verbal and nonverbal responses contribute to expressing empathy, including body language and tone. Key strategies involve taking the client’s point of view and honoring their feelings.
Cultural Differences and Empathy
Cultural values can influence a client’s therapy experience and treatment, impacting expectations during sessions. Cultural bias can affect the dialect used in therapy, potentially hindering understanding and proper treatment. It’s crucial to remember that cultural values can change and not to make assumptions about their impact on a client.
Cultural Issues in Clinical Psychology
Etic Approach
Emphasizes similarities between all people, assumes universality, and downplays culture-based differences (e.g., universality of emotions, habituation response).
Emic Approach
Emphasizes culture-specific norms and appreciates clients within the context of their own culture.
Cultural Competence
Multicultural counseling and therapy involve helping roles and processes that use modalities and goals consistent with clients’ life experiences and cultural values. It recognizes client identities, including social group and universal dimensions, and advocates for universal and culture-specific strategies. It balances individualism and collectivism in assessment, diagnosis, and treatment.
What makes a psychologist culturally competent:
- Awareness: Of own assumptions, values, and biases.
- Knowledge: Understanding the worldview of the culturally different client.
- Skills: Developing appropriate intervention strategies and techniques.
Cultural Formulation Interview
A structured set of questions used by clinicians to assess how a patient’s cultural background impacts their presenting problems, thoughts, behaviors, and help-seeking behaviors, allowing for more culturally sensitive diagnosis and treatment plans.
Impact of Ethnic Matching in Therapy
Russell et al. (1996) Study: Examined the impact of ethnic matching between therapists and clients on the assessment of client functioning. Findings indicated that therapists rated clients’ overall functioning more favorably when they shared the same ethnicity. This suggests ethnic matching may positively influence therapists’ perceptions and assessments.
Broader Context (Cabral & Smith Meta-analysis, 2011): While clients generally prefer therapists of the same race/ethnicity and view them more positively, the actual impact of ethnic matching on treatment outcomes (e.g., symptom reduction) is minimal. This meta-analysis suggests that ethnic matching should not be the sole factor in improving therapy outcomes; therapeutic rapport, competence, and other factors should be prioritized. Ethnic matching might help clients feel more comfortable initially but doesn’t necessarily enhance the long-term therapeutic process.
Cultural Adaptations of Treatment
This is the process of modifying a standard psychological treatment to fit the cultural context and values of a specific client population.
Therapist Self-Disclosure
Therapist self-disclosure involves a therapist intentionally revealing personal information, thoughts, or feelings about themselves to a client during a therapy session.
Clinical and Diagnostic Interviewing
Types of Interviews
- Intake interviews
- Diagnostic interviews
- Mental status exams
- Problem-referral interviews
- Crisis interviews
Interview Structure
Interviews can be unstructured (non-directive) or a guided conversation, primarily using open-ended questions.