PSYC3140 Clinical Psychology

• Setting by age group

  • Children and adolescents
  • Working aged adults
  • Older adults
• Setting by presentation


  • Eating Disorders (ED) – can be all age or separated into ages
  • Learning Disabilities/Intellectual Disabilities (LD)
  • Health Psychology (e.g. oncology, diabetes, HIV/sexual health, child health)
  • Personality Disorder (adults)
  • Forensic – divided by age
  • Neuropsychology – also typically divided by age
• Difficulties with mental health are seen as a growing public health concern
• Estimates: 1 in 6 people in the past week experienced a common mental health problem
• Training


  • Undergraduate degree with
  • Graduate Basis for Chartered Membership (GBC)
  • Experience
  • Doctoral training course
  • four key areas and specialist placement
• Graduate Basis for Chartered Membership (GBC, or GBR as it was previously known)

  A standard set by the British Psychological Society (BPS) to ensure that, before anyone can start a clinical psychology course, they have already studied psychology in sufficient breadth and depth to provide a sound basis for their postgraduate training
• The BPS uses a process called accreditation to assess whether degrees offered by UK universities cover enough psychology for GBC
• Professional Bodies


  • The Clearing House - applications to clinical psychology training are made this organisation
  • British Psychological Society (BPS) – this is the professional body that supports clinical psychologists. The BPS hold the standard/title of Chartered Psychologist
  • The Health & Care Professions Council (HCPC) – is the registering body for clinical psychology and other allied health professions. This organisation also audits of Continuing Professional Development (CPD)
  • There are Clinical Psychologists that are members of the HCPC and not be members of the BPS
  • To be a practicing Clinical Psychologist and to use this protected title you have to be a member of the HCPC. This means being registered with the HCPC
• The British Psychological Society (BPS) sets the standard for undergraduate courses for accreditation
• Routes


  • Minimum: 7 years
  • with only one year experience
  • Experience can be drawn from a variety of roles caring, research or any work with people
• Population


  • Children and adolescents (0 – 18) – there is some movement to expand to 25!
  • Working aged adults (18 - 65)
  • Older people (65+)
  • Learning Disabilities (LD)
• Learning Disability


  • A person with an IQ of less than 20 would be described as having a profound learning disability
  • A person with an IQ of 20-34, a severe learning disability
  • A person with an IQ of 35-49, moderate learning disability
  • A person with an IQ of 50-70, mild learning disability
• Services are configured/set up by local and national NHS services
• Not one organisation – hence the concept of a post code lottery
• There has at times been huge variation in how services are provided and set up such as how the local Child and Adolescent Mental Health Services (CAMHS) were set up historically
• Where Clinical Psychologists Work


  • Hospitals
  • Health centres
  • Community mental health teams
  • Social services
• Clinical psychologists often work as part of a team with other health professionals and practitioners
• Most clinical psychologists are employed by the National Health Service (NHS), but some work for private organisations or in private practice
• Classification systems of Mental Health


  • International Statistical Classification of Diseases and Related Health Problems (ICD) (WHO)
  • Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (APA)
• Process of diagnosis


  1. Based on symptoms (what patient says and does)

  2. Classified 'disorder' is based on a cluster of symptoms

  3. Match symptoms to classifications in ICD-10/ICD-11 or DSM-5
• Models of Mental Health


  • Biomedical model – Psychiatry
  • Biopsychosocial model
• Biopsychosocial Model


  Proposed by George Engel in 1977, a more holistic approach to well-being. Mental illness occurs through the complex interaction of biological, psychological and social factors
• ICD-10 (WHO, 2016)


  Mental, behavioural and neurodevelopmental disorders are syndromes characterized by clinically significant disturbance in an individual's cognition, emotional regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes that underlie mental and behavioural functioning.

  
  

  These disturbances are usually associated with distress or impairment in personal, family, social, educational, occupational, or other important areas of functioning
• DSM-5 (APA, 2013)


  A mental disorder is a behavioural or psychological syndrome characterized by clinically significant disturbance or disability in an individual's cognition, emotion regulation, or behaviour.

  
  

  Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities
• The two classification systems are using a definition that fits best with the biopsychosocial model of mental health, with the definitions drawing upon biological, psychological and social factors to explain mental health difficulties
• Diagnosis


  1. Collection of symptoms – like a 'check list'

  2. Over an extended time period

  3. Being present from a set age

  4. When the individual reports set of symptoms that meet the criteria the mental professional typically a psychiatrist will then give a diagnosis
• A diagnosis is given by when the cluster of symptoms match the 'check list' alongside using their clinical judgement
• Burrhus Skinner

  developed concepts like reinforcement and operant conditioning – considering behaviours that are repeated due to positive or negative consequences. Skinner Box
• Ivan Pavlov


  known for the theory of classical conditioning.

  
  

  Known for a famous experiment(s) with a dog and feeding with a bell to denote that the food was present
• Sigmund Freud


  Founder of psychoanalysis.

  
  

  Developed therapeutic techniques such as the use of free association and discovered transference, establishing its central role in the analytic process.

  
  

  Developed a theory of unconscious with a model of psychic structure – comprising id, ego and super-ego. Known for the topographic theory of personality
• David Wechsler


  Developed standardised intelligence assessments. Currently widely used intelligence and memory tests
• John Bowlby


  Known for his work on attachment. Key theory used/borrowed from by most modern psychological models
• Aaron Beck


  known as the father of both cognitive therapy and Cognitive Behavioural Therapy (CBT).

  
  

  His theories are widely used in the treatment of clinical depression and various anxiety disorders
• Michael White


  Founder of narrative therapy.

  
  

  A number of the techniques he developed have been adopted by other approaches
• Marsha Linehan


  developed Dialectical Behaviour Therapy (DBT) – seen as part of the third wave of CBT
• Interventions


  • Cognitive Behavioural Therapy (CBT)
  • Psychodynamic
  • Systemic
  • Third wave CBT: Dialectical Behavioural Therapy (DBT)
  • Acceptance and Commitment Therapy (ACT)
  • Inter- Personal Therapy (IPT)
• Cognitive Behavioural Therapy (CBT)


  A talking therapy that can help you manage your problems by changing the way you think and behave. It is most commonly used to treat anxiety and depression, but can be useful for other mental and physical health problems. CBT is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle. CBT aims to help you deal with overwhelming problems in a more positive way by breaking them down into smaller parts. You're shown how to change these negative patterns to improve the way you feel. Unlike some other talking treatments, CBT deals with your current problems, rather than focusing on issues from your past
• Psychodynamic Psychotherapy


  Psychodynamic psychotherapy or psychoanalytic psychotherapy is a form of depth psychology, the primary focus of which is to reveal the unconscious content of a client's psyche in an effort to alleviate psychic tension. There is a range of therapeutic interventions that draw upon this model, including Psychodynamic Psychotherapy, Art Psychotherapy, Play Therapy
• Systemic Therapy


  Systemic therapy seeks to address people not only on the individual level, as had been the focus of earlier forms of therapy, but also as people in relationships, dealing with the interactions of groups and their interactional patterns and dynamics. Systems can be family, school, residential settings, wider community networks, etc. "Systemic therapy neither attempts a 'treatment of causes' nor of symptoms; rather it gives living systems nudges that help them to develop new patterns together, taking on a new organizational structure that allows growth"
• Third Wave CBT


  Third wave Cognitive Behavioural Therapies (CBT) are a group of emerging approaches to psychotherapy that represent both an extension of and deviation from traditional cognitive behavioural treatment approaches. The third wave of CBT looks at changing behaviour and the context of cognitions, by adopting mindfulness, acceptance and compassion approaches