Editing Psychology (section)

=== Mental health care ===
{{see also|Clinical psychology}}
The provision of psychological health services is generally called clinical psychology in the U.S. Sometimes, however, members of the school psychology and counseling psychology professions engage in practices that resemble that of clinical psychologists. Clinical psychologists typically include people who have graduated from doctoral programs in clinical psychology. In Canada, some of the members of the abovementioned groups usually fall within the larger category of [[professional psychology]]. In Canada and the U.S., practitioners get bachelor's degrees and doctorates; doctoral students in clinical psychology usually spend one year in a predoctoral internship and one year in postdoctoral internship. In Mexico and most other Latin American and European countries, psychologists do not get bachelor's and doctoral degrees; instead, they take a three-year professional course following high school.<ref name=HallHurley /> Clinical psychology is at present the largest specialization within psychology.<ref name=StrickerWidiger /> It includes the study and application of psychology for the purpose of understanding, preventing, and relieving psychological distress, dysfunction, and/or [[mental illness]]. Clinical psychologists also try to promote subjective well-being and personal growth. Central to the practice of clinical psychology are psychological assessment and psychotherapy although clinical psychologists may also engage in research, teaching, consultation, forensic testimony, and program development and administration.<ref name="brain">Brain, Christine. (2002). ''Advanced psychology: applications, issues and perspectives.'' Cheltenham: Nelson Thornes. {{ISBN|0-17-490058-9}}</ref>

Credit for the first psychology clinic in the United States typically goes to [[Lightner Witmer]], who established his practice in Philadelphia in 1896. Another modern psychotherapist was [[Morton Prince]], an early advocate for the establishment of psychology as a clinical and academic discipline.<ref name=StrickerWidiger>George Stricker & Thomas A. Widiger, "Volume Preface", in Weiner (ed.), ''Handbook of Psychology'' (2003), Volume 8: ''Clinical Psychology''.</ref> In the first part of the twentieth century, most mental health care in the United States was performed by psychiatrists, who are medical doctors. Psychology entered the field with its refinements of mental testing, which promised to improve the diagnosis of mental problems. For their part, some psychiatrists became interested in using [[psychoanalysis]] and other forms of [[psychodynamic psychotherapy]] to understand and treat the mentally ill.<ref name=Tomes2008 /><ref>[[Nancy McWilliams]] and Joel Weinberger, "Psychodynamic Psychotherapy", in Weiner (ed.), ''Handbook of Psychology'' (2003), Volume 8: ''Clinical Psychology''.</ref>

Psychotherapy as conducted by psychiatrists blurred the distinction between psychiatry and psychology, and this trend continued with the rise of [[Community mental health service|community mental health facilities]]. Some in the clinical psychology community adopted [[behavioral therapy]], a thoroughly non-psychodynamic model that used behaviorist learning theory to change the actions of patients. A key aspect of behavior therapy is empirical evaluation of the treatment's effectiveness. In the 1970s, [[cognitive-behavior therapy]] emerged with the work of [[Albert Ellis]] and [[Aaron Beck]]. Although there are similarities between behavior therapy and cognitive-behavior therapy, cognitive-behavior therapy required the application of cognitive constructs. Since the 1970s, the popularity of cognitive-behavior therapy among clinical psychologists increased. A key practice in behavioral ''and'' cognitive-behavioral therapy is exposing patients to things they fear, based on the premise that their responses (fear, panic, anxiety) can be deconditioned.<ref>W. Edward Craighead & Linda Wilcoxon Craighead, "Behavioral and Cognitive-Behavioral Psychotherapy" in Weiner (ed.), ''Handbook of Psychology'' (2003), Volume 8: ''Clinical Psychology''.</ref>

Mental health care today involves psychologists and social workers in increasing numbers. In 1977, National Institute of Mental Health director [[Bertram S. Brown|Bertram Brown]] described this shift as a source of "intense competition and role confusion."<ref name=Tomes2008>Nancy Tomes, "The Development of Clinical Psychology, Social Work, and Psychiatric Nursing: 1900–1980s", in Wallace & Gach (eds.), ''History of Psychiatry and Medical Psychology'' (2008).</ref> Graduate programs issuing doctorates in clinical psychology emerged in the 1950s and underwent rapid increase through the 1980s. The PhD degree is intended to train practitioners who could also conduct scientific research. The PsyD degree is more exclusively designed to train practitioners.<ref name=HallHurley />

Some clinical psychologists focus on the clinical management of patients with brain injury. This subspecialty is known as [[clinical neuropsychology]]. In many countries, clinical psychology is a regulated mental health profession. The emerging field of ''disaster psychology'' (see [[crisis intervention]]) involves professionals who respond to large-scale traumatic events.<ref>Teri L. Elliott, "Disaster Psychology: Keep Clients out of Your Office—Get into the Field!" in Morgan et al. (ed.), ''Life After Graduate School in Psychology'' (2005). "...it is the disaster psychologist's role to utilize crisis intervention processes with the goal of preventing natural distress due to the critical event from developing into a more harmful, long-term psychological condition."</ref>

The work performed by clinical psychologists tends to be influenced by various therapeutic approaches, all of which involve a formal relationship between professional and client (usually an individual, couple, family, or small group). Typically, these approaches encourage new ways of thinking, feeling, or behaving. Four major theoretical perspectives are psychodynamic, cognitive behavioral, existential–humanistic, and systems or family therapy. There has been a growing movement to integrate the various therapeutic approaches, especially with an increased understanding of issues regarding culture, gender, spirituality, and sexual orientation. With the advent of more robust research findings regarding psychotherapy, there is evidence that most of the major therapies have equal effectiveness, with the key common element being a strong [[therapeutic relationship|therapeutic alliance]].<ref>{{cite journal |author1=Leichsenring, Falk |author2=Leibing, Eric |year=2003 |title=The effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders: A meta-analysis |journal=The American Journal of Psychiatry |volume=160 |issue=7 |pages=1223–1233 |doi=10.1176/appi.ajp.160.7.1223 |pmid=12832233}}</ref><ref>{{cite journal |author=Reisner, Andrew |year=2005 |title=The common factors, empirically validated treatments, and recovery models of therapeutic change |journal=The Psychological Record |volume=55 |issue=3 |pages=377–400 |doi=10.1007/BF03395517 |s2cid=142840311 |url=https://opensiuc.lib.siu.edu/cgi/viewcontent.cgi?article=1192&context=tpr |access-date=21 July 2019 |archive-date=6 August 2020 |archive-url=https://web.archive.org/web/20200806165820/https://opensiuc.lib.siu.edu/cgi/viewcontent.cgi?article=1192&context=tpr |url-status=dead }}</ref> Because of this, more training programs and psychologists are now adopting an [[Integrative Psychotherapy|eclectic therapeutic orientation]].<ref>{{cite journal |author1=Jensen, J.P. |author2=Bergin, A.E. |author3=Greaves, D.W. |year=1990 |title=The meaning of eclecticism: New survey and analysis of components |journal=Professional Psychology: Research and Practice |volume=21 |issue=2 |pages=124–130 |doi=10.1037/0735-7028.21.2.124}}</ref><ref>Palmer, S.; Woolfe, R. (eds.) (1999). ''Integrative and eclectic counselling and psychotherapy.'' London: Sage.</ref><ref>Clarkson, P. (1996). The eclectic and integrative paradigm: Between the Scylla of confluence and the Charybdis of confusion. In ''Handbook of Counselling Psychology'' (R. Woolfe & W.L. Dryden, eds.). London: Sage, pp. 258–283. {{ISBN|0-8039-8991-1}}</ref><ref>{{cite journal |author1=Goldfried, M.R. |author2=Wolfe, B.E. |year=1998 |title=Toward a more clinically valid approach to therapy research |journal=Journal of Consulting and Clinical Psychology |volume=66 |issue=1 |pages=143–150 |doi=10.1037/0022-006X.66.1.143 |pmid=9489268 |url=http://www.personal.kent.edu/~dfresco/CRM_Readings/Goldfried_1998.pdf |citeseerx=10.1.1.475.7156 |access-date=25 October 2017 |archive-date=9 August 2017 |archive-url=https://web.archive.org/web/20170809053356/http://www.personal.kent.edu/~dfresco/CRM_Readings/Goldfried_1998.pdf |url-status=live }}</ref><ref>{{cite journal |author=Seligman, M.E.P. |year=1995 |title=The effectiveness of psychotherapy: The ''Consumer Reports'' study |journal=American Psychologist |volume=50 |issue=12 |pages=965–974 |doi=10.1037/0003-066X.50.12.965 |pmid=8561380 |url=http://www.dearshrink.com/psychotherapy_consumer_report1995_seligman.pdf |access-date=25 October 2017 |archive-date=21 July 2018 |archive-url=https://web.archive.org/web/20180721231945/http://www.dearshrink.com/psychotherapy_consumer_report1995_seligman.pdf |url-status=dead }}</ref>

Diagnosis in clinical psychology usually follows the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM).<ref>Peter E. Nathan & James Langenbucher, "Diagnosis and Classification", in Weiner (ed.), ''Handbook of Psychology'' (2003), Volume 8: ''Clinical Psychology''.</ref> The study of mental illnesses is called [[abnormal psychology]].