Clinical Psychology

• William Tuke (1732–1822)

  • Raised funds to open the York Retreat, a residential treatment center for people with mental illness in England
  • Patients at the York Retreat were cared for with kindness, dignity, and decency
  • The York Retreat became an example of humane treatment and inspired similar institutions in Europe and the United States
• Philippe Pinel (1745–1826)

  • Liberated people with mental illness in France from dungeons and chains
  • Advocated for compassionate treatment and created new institutions with healthy food and benevolent care
  • Introduced written case histories and ongoing treatment notes for patients
• Eli Todd (1762–1832)

  • Physician in Connecticut who opened The Retreat in Hartford in 1824 for people with mental illness
  • Emphasized patients' strengths and allowed them to have input in their treatment decisions
  • The Retreat's successful treatment plan inspired similar institutions in other U.S. states
• Dorothea Dix (1802–1887)

  • Worked to improve treatment of people with mental illness in the United States
  • Established more than 30 state institutions for people with mental illness
  • Advocated for more decent and compassionate treatment for individuals with mental illness
• Lightner Witmer (1867–1956)

  • Founded the first psychological clinic at the University of Pennsylvania in 1896
  • Applied psychology to people's problems for the first time
  • Emphasized the need for clinical psychology and encouraged others to open clinics
  • Established the first scholarly journal in the field, The Psychological Clinic, in 1907
• Witmer defined clinical psychology as related to medicine, education, and social work
• Physicians, teachers, and social workers would not be qualified to practice clinical psychology
• Clinical psychology represented a hybrid of these fields, requiring a specially trained professional
• Witmer's definition of clinical psychology was uninfluenced by Sigmund Freud's ideas
• Psychotherapy was not explicitly discussed in Witmer's original definition of clinical psychology
• Treatments discussed by Witmer did not include a plan for empirically measuring their effectiveness
• Tuke, Pinel, Todd, Dix, and others set the stage for the birth of clinical psychology
• Clinical psychology in the 1890s was described as a new field drawing its life from the new science of psychology
• Racism and Prejudice in the History of Clinical Psychology
• Physician Samuel A. Cartwright proposed the mental disorder category "drapetomania" to explain slaves' attempts to free themselves
• Prominent figures in psychology aligned with the eugenics movement, promoting controlled reproduction opportunities to increase racially desirable qualities
• G. Stanley Hall described people of African, Indigenous, and Chinese heritage as inferior races
• Lewis Terman described Black people as dull and recommended different education for them
• Carl Jung described African people as primitive and inferior compared to White people
• Results of a survey showed psychologists' beliefs in the inferior mental ability of Black people compared to White people
• Arthur Jensen claimed Black people had lower IQs due to genetic factors
• Harvard psychologist Richard J. Herrnstein coauthored a book arguing that Black people were genetically inferior in intelligence
• Research shows Black therapy clients often experience microaggressions from White therapists, undoing therapy benefits
• APA published a formal apology for promoting racism and discrimination in psychology, committing to work towards dismantling systematic racism
• Society of Clinical Psychology has a Diversity Committee working towards providing equitable services to underrepresented groups
• Assessment
• Categorizing mental illness has been central to clinical psychology since Witmer defined the field
• In the 1800s in Europe, mental illnesses were often categorized as neurosis and psychosis
• Emil Kraepelin differentiated exogenous disorders (caused by external factors) from endogenous disorders (caused by internal factors)
• Kraepelin assigned names to specific examples of disorders in the exogenous and endogenous categories
• The DSM has been revised multiple times, with DSM-5-TR being the current edition
• DSM-III provided specific diagnostic criteria for each disorder, a departure from previous editions
• The number of disorders in the DSM has significantly increased over editions, covering a wider scope of human behavior
• The increase in size of the DSM may be due to scientific discovery recognizing previously unlabeled disorders
• The first two editions of the DSM were brief, while the current DSM is over 1,000 pages long
• New DSM editions typically include more disorders than the previous editions, with DSM-III having the largest jump in disorders
• Debates in psychology regarding the creation of disorders:

  • Scientific discovery explanation: new disorders are recognized due to scientific advancements
  • Social invention explanation: psychology may create disorders from aspects of human experience previously considered normal
  • Ongoing debates about the truth of both explanations
• Debates about the DSM (Diagnostic and Statistical Manual of Mental Disorders):

  • Continual debates about the expanding range of the DSM
  • Inclusion and exclusion of specific disorders
  • Factors other than empirical data influencing DSM authors' decisions
• DSM revisions:

  • Authors decide whether to add new experiences or symptoms as official diagnoses
  • Implications of classification decisions affect clients, mental health professionals, insurance companies, and researchers
  • Examples of new disorders added in DSM revisions, such as prolonged grief disorder in DSM-5-TR in 2022
• DSM decisions on disorders:

  • Authors may decide not to include proposed symptoms as official disorders
  • Reversal of previous decisions to include disorders, like the removal of "homosexuality" as a disorder in DSM-III
  • Proposed disorders for further study in DSM-5-TR, including Internet gaming disorder, attenuated psychosis syndrome, and nonsuicidal self-injury disorder