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The Greek letter Psi is often used as a symbol of psychology.
The Greek letter Psi is often used as a symbol of psychology. The Greek alphabet (Ελληνικό αλφάβητο is a set of twenty-four letters that has been used to write the Greek language since the late 9th or early For other uses see Psi. Psi (uppercase Ψ, lowercase ψ) is the 23rd letter of the Greek alphabet and has a Psychology (from Greek grc ψῡχή psȳkhē, "breath life soul" and grc -λογία -logia) is an Academic and

Clinical psychology includes the scientific study and application of psychology for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development. Psychology (from Greek grc ψῡχή psȳkhē, "breath life soul" and grc -λογία -logia) is an Academic and Mental disorder or mental illness is a psychological or behavioral pattern that occurs in an individual and is thought to cause distress or disability that is not expected as Mental health is a term used to describe either a level of cognitive or Emotional wellbeing or an absence of a Mental disorder. [1][2] Central to its practice are psychological assessment and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration. Psychological testing is a field characterized by the use of samples of behavior in order to infer generalizations about a given individual Psychotherapy is an Interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living [3] In many countries it is a regulated mental health profession. A mental health professional is a person who offers services for the purpose of improving an individual's Mental health or to treat Mental illness.

The field is often considered to have begun in 1896 with the opening of the first psychological clinic at the University of Pennsylvania by Lightner Witmer. A clinic (or an outpatient clinic) is a small private or public health facility that is devoted to the care of Outpatients, often in a community in contrast The University of Pennsylvania (also known as Penn) is a private University located in Philadelphia, Pennsylvania, USA. Lightner Witmer (1867-1956 is regarded as the inventor of the term " Clinical Psychology " and the co-founder of the world's first Psychological Clinic in 1896 at the In the first half of the 20th century, clinical psychology was focused on psychological assessment, with little attention given to treatment. This changed after the 1940s when World War II resulted in the need for a large increase in the number of trained clinicians. Since that time, two main educational models have developed—the Ph.D. (focusing on research) and the Psy.D. (focusing on practice). The Scientist-Practitioner model, often called the Boulder model, is a training model for graduate programs that focuses on creating a foundation of research and scientific practice The Doctor of Psychology (PsyD degree is a Professional doctorate, which is earned through one of two established training models for Clinical Psychology. Clinical psychologists are now considered experts in providing psychotherapy, and generally train within four primary theoretical orientations—Psychodynamic, Humanistic, Cognitive Behavioral, and Systems or Family therapy. Psychodynamic 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 Humanistic psychology is a school of psychology that emerged in the 1950s in reaction to both Behaviorism and Psychoanalysis. See also Cognitive Therapy Cognitive Behavioral Therapy ( CBT) is an umbrella-term for psychotherapeutic systems that deal with cognitions interpretations Family therapy, also referred to as couple and family therapy and family systems therapy, is a branch of Psychotherapy that works with families

Clinical psychology may be confused with psychiatry, which generally has similar goals (e. Psychiatry is a medical specialty which exists to study, prevent, and treat Mental disorders in Humans Psychiatric g. the alleviation of mental distress), but is unique in that psychiatrists are physicians. The most obvious difference is psychiatrists and, in some jusridictions, medical psychologists, an emerging specialty of psychology, are licensed to prescribe medication. A psychoactive drug or psychotropic substance is a Chemical substance that acts primarily upon the Central nervous system where it alters Brain In practice psychologists and psychiatrists often work closely together in multidisciplinary teams with other professionals such as occupational therapists and social workers to bring a multimodal approach to complex patient problems.

Contents

History

Further information: Eastern philosophy and clinical psychology and Islamic psychology
Many 18th c. treatments for psychological distress were based on pseudo-scientific ideas, such as Phrenology.
Many 18th c. The History of Psychology as a scholarly study of the mind and behavior dates back to the Middle Ages. Although modern scientific psychology is often dated at the 1879 opening of the first psychological clinic by Wilhelm Wundt, attempts to create methods for assessing and treating mental Like body and mind East and West are false dichotomies Travel and trade along the Silk Road brought ancient texts and mind practices deep into the West treatments for psychological distress were based on pseudo-scientific ideas, such as Phrenology. Phrenology (from Greek: φρήν phrēn, "mind" and λόγος Logos, "knowledge" is a defunct field of study once

Although modern, scientific psychology is often dated at the 1879 opening of the first psychological laboratory by Wilhelm Wundt, attempts to create methods for assessing and treating mental distress existed long before. Wilhelm Maximilian Wundt ( August 16 1832 - August 31 1920) was a German medical doctor psychologist physiologist and professor The earliest recorded approaches were a combination of religious, magical and/or medical perspectives. [4]

In the early 1800s, one could have his or her head examined, literally, using phrenology, the study of personality by the shape of the skull. Phrenology (from Greek: φρήν phrēn, "mind" and λόγος Logos, "knowledge" is a defunct field of study once Other popular treatments included physiognomy—the study of the shape of the face—and mesmerism, Mesmer's treatment by the use of magnets. Physiognomy ( Gk physis, nature and gnomon, judge interpreter is the assessment of a person's character or personality from their outer appearance especially The term's most common usage today refers to a person's sexual attractiveness or raw Charisma. Franz Anton Mesmer (born Friedrich Anton Mesmer; May 23, 1734 &ndash March 5, 1815) was a German physician and astrologist who A magnet (from Greek grc μαγνήτης λίθος " Magnesian stone" is a material or object that produces a Magnetic field. Spiritualism and Phineas Quimby's "mental healing" were also popular. Spiritualism is a Religion founded in part on the writings of the Swedish mystic Emanuel Swedenborg (1688-1772 Phineas Parkhurst Quimby ( February 16, 1802 – January 16, 1866) was a New England philosopher magnetizer mesmerist healer [5]

While the scientific community eventually came to reject all of these methods, academic psychologists also were not concerned with serious forms of mental illness. That area was already being addressed by the developing fields of psychiatry and neurology within the asylum movement. Psychiatry is a medical specialty which exists to study, prevent, and treat Mental disorders in Humans Psychiatric A psychiatric hospital (previously called insane asylum, mental hospital; or derogatorily looney bin, nut house or Funny Farm) is [4] It was not until the end of the 19th century, around the time when Sigmund Freud was first developing his "talking cure" in Vienna, that the first scientifically clinical application of psychology began. Sigmund Freud (ˈziːkmʊnt ˈfʁɔʏt born Sigismund Shlomo Freud (May 6 1856 &ndash September 23 1939 was an Austrian Psychiatrist who founded Psychoanalysis is a body of ideas developed by Austrian physician Sigmund Freud and his followers which is devoted to the study of human psychological functioning and behavior Vienna ( in Wien; see also other names) is the Capital of Austria, and is also one of the nine States of Austria.

Early clinical psychology

Lightner Witmer, the father of modern clinical psychology.
Lightner Witmer, the father of modern clinical psychology. Lightner Witmer (1867-1956 is regarded as the inventor of the term " Clinical Psychology " and the co-founder of the world's first Psychological Clinic in 1896 at the

By the second half of the 1800s, the scientific study of psychology was becoming well established in university laboratories. Although there were a few scattered voices calling for an applied psychology, the general field looked down upon this idea and insisted on "pure" science as the only respectable practice. [4] This changed when Lightner Witmer (1867-1956), a past student of Wundt and head of the psychology department at the University of Pennsylvania, agreed to treat a young boy who had trouble with spelling. Lightner Witmer (1867-1956 is regarded as the inventor of the term " Clinical Psychology " and the co-founder of the world's first Psychological Clinic in 1896 at the The University of Pennsylvania (also known as Penn) is a private University located in Philadelphia, Pennsylvania, USA. His successful treatment was soon to lead to Witmer's opening of the first psychological clinic at Penn in 1896, dedicated to helping children with learning disabilities. In the United States and Canada, the term learning disability (LD refers to a group of disorders that affect a broad range of academic and functional skills including [6] Ten years later in 1907, Witmer was to found the first journal of this new field, The Psychological Clinic, where he coined the term "clinical psychology," defined as "the study of individuals, by observation or experimentation, with the intention of promoting change. "[7] The field was slow to follow Witmer's example, but by 1914 there were 26 similar clinics in the U. S. [8]

Even as clinical psychology was growing, working with issues of serious mental distress remained the domain of psychiatrists and neurologists. A psychiatrist (also archaically called an alienist) is a Physician who specializes in Psychiatry and is certified in treating Mental disorders [9] However, clinical psychologists continued to make inroads into this area due to their increasing skill at psychological assessment. A psychological evaluation or mental examination is an Examination into a person's Mental health by a mental health professional such as a Psychologist Psychologists' reputation as assessment experts became solidified during World War I with the development of two intelligence tests, Army Alpha and Army Beta (testing verbal and nonverbal skills, respectively), which could be used with large groups of recruits. World War I (abbreviated WWI; also known as the First World War, the Great War, and the War to End All [5][6] Due in large part to the success of these tests, assessment was to become the core discipline of clinical psychology for the next quarter century, when another war would propel the field into treatment.

Early professional organizations

The field began to organize under the name "clinical psychology" in 1917 with the founding of the American Association of Clinical Psychology. This only lasted until 1919, after which the American Psychological Association (founded by G. Stanley Hall in 1892) developed a section on Clinical Psychology, which offered certification until 1927. The American Psychological Association (APA is a professional organization representing psychologists in the U [8] Growth in the field was slow for the next few years when various unconnected psychological organizations came together as the American Association of Applied Psychology in 1930, which would act as the primary forum for psychologists until after World War II when the APA reorganized. [10] In 1945 APA created what is now called Division 12, its division of clinical psychology, which remains a leading organization in the field. Psychological societies and associations in other English-speaking countries developed similar divisions, including in Britain, Canada, Australia and New Zealand.

World War II and the integration of treatment

The U.S. army conducts a group psychological test developed by clinical psychologists for selection purposes.
The U.S. army conducts a group psychological test developed by clinical psychologists for selection purposes. The United States Army is a military organization whose primary mission is to "provide necessary forces and capabilities.

When World War II broke out, the military once again called upon clinical psychologists for their assessment expertise. World War II, or the Second World War, (often abbreviated WWII) was a global military conflict which involved a majority of the world's nations, including As soldiers began to return from combat, psychologists started to notice symptoms of psychological trauma labeled "shell shock" (eventually to be termed Post-Traumatic Stress Disorder) that were best treated as soon as possible. Post traumatic stress disorder It is a severe and ongoing emotional reaction to [6] Because physicians (including psychiatrists) were over-extended in treating bodily injuries, psychologists were called to help treat this condition. [11] At the same time, female psychologists (who were excluded from the war effort) formed the National Council of Women Psychologists with the purpose of helping communities deal with the stresses of war and giving young mothers advice on child rearing. [7] After the war, the Veterans Administration in the U. The United States Department of Veterans Affairs ( VA) is a government-run military Veteran benefit system with Cabinet -level status S. made an enormous investment to set up programs to train doctoral-level clinical psychologists to help treat the thousands of veterans needing care. As a consequence, the U. S. went from having no formal university programs in clinical psychology in 1946 to over half of all PhDs in psychology in 1950 being awarded in clinical psychology. [7]

WWII helped bring dramatic changes to clinical psychology, not just in America but internationally as well. Graduate education in psychology began adding psychotherapy to the science and research focus based on the 1947 scientist-practitioner model, known today as the Boulder Model, for PhD programs in clinical psychology. The Scientist-Practitioner model, often called the Boulder model, is a training model for graduate programs that focuses on creating a foundation of research and scientific practice [12] Clinical psychology in Britain developed much like in the U. The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom, the UK or Britain,is a Sovereign state located S. after WWII, specifically within the context of the National Health Service[13] with qualifications, standards, and salaries managed by the British Psychological Society. The National Health Service is the name commonly used to refer to the four Publicly-funded healthcare systems of the United Kingdom collectively or individually (although The British Psychological Society (BPS is the representative body for Psychologists and Psychology in the United Kingdom. [14]

Development of the Doctor of Psychology degree

By the 1960s, psychotherapy had become imbedded within clinical psychology, but for many the Ph. D. educational model did not offer the necessary training for those interested in practice rather than research. There was a growing argument that said the field of psychology in the U. S. had developed to a degree warranting explicit training in clinical practice. The concept of a practice-oriented degree was debated in 1965 and narrowly gained approval for a pilot program at the University of Illinois starting in 1968. This article is about the flagship campus For other uses and locations of University of Illinois, see University of Illinois (disambiguation The University of [15] Several other similar programs were instituted soon after, and in 1973, at the Vail Conference on Professional Training in Psychology, the Practitioner-Scholar Model of Clinical Psychology—or Vail Model—resulting in the Doctor of Psychology (Psy. The Doctor of Psychology (PsyD degree is a Professional doctorate, which is earned through one of two established training models for Clinical Psychology. D. ) degree was recognized. [16] Although training would continue to include research skills and a scientific understanding of psychology, the intent would be to produce highly trained professionals, similar to programs in medicine, dentistry, and law. The first program explicitly based on the Psy. D. model was instituted at Rutgers University. Rutgers The State University of New Jersey (also known as Rutgers University) is the largest institution for higher education in the state of New Jersey [15] Today, about half of all graduate students in clinical psychology are enrolled in Psy. D. programs. [16]

A changing profession

Since the 1970s, clinical psychology has continued growing into a robust profession and academic field of study. Although the exact number of practicing clinical psychologists is unknown, it is estimated that between 1974 and 1990, the number in the U. S. grew from 20,000 to 63,000. [17] Clinical psychologists are still experts in assessment and psychotherapy, and have expanded their focus to address issues of prevention, gerontology, and even sports and the criminal justice system. The fastest growing area appears to be health psychology, which is reflected in hospitals being the fastest-growing employment setting for clinical psychologists in the past decade. [5] Other major changes include the impact of managed care on mental health care, an increasing understanding of the importance of multicultural knowledge, an emerging practice of medical psychology in which practitioners receive the extensive additional education and training necessary for them to safely and effectively prescribe medications used in the management of psychological disorders, and the shift in the majority of practitioners of psychotherapy now having masters-level training. The term " managed care " is used to describe a variety of techniques intended to reduce the cost of providing health benefits and improve the quality of care ("managed care

Professional practice

Clinical psychologists can offer a range of professional services, including:[7]

  • Provide psychological treatment (psychotherapy)
  • Administer and interpret psychological assessment and testing
  • Conduct psychological research
  • Teach
  • Development of prevention and treatment programs
  • Consultation (especially with schools and businesses)
  • Program administration
  • Provide expert testimony (forensic psychology)

In practice, clinical psychologists may work with individuals, couples, families, or groups in a variety of settings, including private practices, hospitals, mental health organizations, schools, businesses, and non-profit agencies. Clinical psychology includes the scientific study and application of Psychology for the purpose of understanding preventing Most clinical psychologists who engage in research and teaching do so within a college or university setting. Clinical psychologists may also choose to specialize in a particular field—common areas of specialization, some of which can earn board certification,[18] include:

Training and certification to practice

The University of Pennsylvania was the first to offer formal education in clinical psychology.
The University of Pennsylvania was the first to offer formal education in clinical psychology. Psychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event. The term " addiction " is used in many contexts to describe an obsession compulsion or excessive Physical dependence or psychological dependence such as An eating disorder is a compulsion to eat or avoid eating that negatively affects both one's physical and mental health A sleep disorder (somnipathy is a medical disorder of the Sleep patterns of a person or animal Sexual dysfunction or sexual malfunction (see also Sexual function) is difficulty during any stage of the Sexual act (which includes desire, Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression Anxiety is a physiological and psychological state characterized by Cognitive, Somatic, Emotional and Behavioral components Phobias Phobias (in the clinical meaning of the term are the most common form of Anxiety disorders An American study by the National Institute of Mental Health Clinical neuropsychology is a sub-specialty of clinical Psychology that specialises in the diagnostic assessment and treatment of patients with Brain injury or Child psychopathology is the manifestation of Psychological disorders in children and adolescents. Family therapy, also referred to as couple and family therapy and family systems therapy, is a branch of Psychotherapy that works with families Relationship counseling is the process of Counseling the parties of a relationship in an effort to recognize and to better manage or reconcile troublesome differences Health psychology is concerned with understanding how Biology, behavior and social context influence Health and Illness. Sport psychology (or sports psychology) is the study of a people's behaviour in sport Forensic psychology is the intersection between Psychology and the Legal system. Industrial and Organizational Psychology (also known as I/O psychology, work psychology, work and organizational psychology, occupational psychology, Educational psychology is the study of how Humans learn in Educational settings the effectiveness of educational interventions the psychology of teaching and the The University of Pennsylvania (also known as Penn) is a private University located in Philadelphia, Pennsylvania, USA.

Clinical psychologists undergo many hours of graduate training—usually 4 to 6 years post-Bachelors—in order to gain demonstrable competence and experience. The training and licensing of clinical psychologists generally requires successfully going through a doctorate program which is typically 90-credits and takes 4 to 6 years to About half of all clinical psychology graduate students are being trained in Ph.D. programs—a model that emphasizes research and is usually housed in universities—with the other half in Psy.D. programs, which has more focus on practice (similar to professional degrees for medicine and law). The Scientist-Practitioner model, often called the Boulder model, is a training model for graduate programs that focuses on creating a foundation of research and scientific practice The Doctor of Psychology (PsyD degree is a Professional doctorate, which is earned through one of two established training models for Clinical Psychology. [16] Both models are accredited by the American Psychological Association[19] and many other English-speaking psychological societies. The American Psychological Association (APA is a professional organization representing psychologists in the U A smaller number of schools offer accredited programs in clinical psychology resulting in a Masters degree, which usually take 2 to 3 years post-bachelors.

In the U. K. , clinical psychologists nearly always undertake a D. Clin. Psychol. /Clin. Psy. D, which is a practitioner doctorate with both clinical and research components. A doctorate is an Academic degree that indicates the highest level of academic achievement This is a three-year full-time salaried program sponsored by the National Health Service (N. The National Health Service is the name commonly used to refer to the four Publicly-funded healthcare systems of the United Kingdom collectively or individually (although H. S. ) and based in universities and the N. H. S. Entry into these programs is highly competitive, and requires at least a three-year undergraduate degree in psychology approved by the British Psychological Society or an approved conversion course, plus some form of experience, usually in either the NHS as an Assistant Psychologist or in academia as a Research Assistant. The British Psychological Society (BPS is the representative body for Psychologists and Psychology in the United Kingdom. It is not unusual for applicants to apply several times before being accepted onto a training course as only about a fifth of applicants are accepted each year. [20] More information about the path to training in the UK can be found at the central clearing house for clinical psychology training applications, and at www.ClinPsy.org.uk where questions can also be answered on the forum, which is run by qualified clinical psychologists.

The practice of clinical psychology requires a license in the United States, Canada, the United Kingdom, and many other countries. Although each of the U. S. states is somewhat different in terms of requirements and licenses, there are three common elements:[21]

  1. Graduation from an accredited school with the appropriate degree
  2. Completion of supervised clinical experience
  3. Passing a written examination and, in some states, an oral examination

All U. S. state and Canada province licensing boards are members of the Association of State and Provincial Psychology Boards (ASPPB) which created and maintains the Examination for Professional Practice in Psychology (EPPP). Many states require other examinations in addition to the EPPP, such as a jurisprudence (i. e. mental health law) examination and/or an oral examination. [21] Most states also require a certain number of continuing education credits per year in order to renew a license, which can be obtained though various means, such as taking audited classes and attending approved workshops. Clinical psychologists require the Psychologist license to practice, although similar licenses can be obtained with a masters-level degree, such as Marriage and Family Therapist (MFT), Licensed Professional Counselor (LPC), and Licensed Psychological Associate (LPA). Licensed Professional Counselor (LPC is a Licensure for Mental health professionals The exact title varies by state but the other most frequently used title

In the UK, registration is only now becoming statutory and administered by the HPC. The Health Professions Council (HPC is a UK health regulator It was created by the Health Professions Order 2001 to protect the public by setting and maintaining standards Previously there has been a voluntary scheme through which the BPS award practising certificates to qualified Clinical Psychologists who have completed sufficient continuing professional development activities and agree to abide by their professional Code of Conduct. The British Psychological Society (BPS is the representative body for Psychologists and Psychology in the United Kingdom.

Assessment

Main article: Psychological testing
Example of an inkblot used in the Rorschach projective personality test
Example of an inkblot used in the Rorschach projective personality test

An important area of expertise for many clinical psychologists is psychological assessment, and there are indications that as many as 91% of psychologists engage in this core clinical practice. Psychological testing is a field characterized by the use of samples of behavior in order to infer generalizations about a given individual Please do not add more images or reposition the current onePlease do not remove the image A projective test, in Psychology, is a Personality test designed to let a person respond to ambiguous stimuli presumably revealing hidden Emotions and internal A personality test aims to describe aspects of a person's character that remain stable throughout that person's lifetime the individual's character pattern of behavior thoughts and feelings [22] Such evaluation is usually done in service to gaining insight into and forming hypotheses about psychological or behavioral problems. As such, the results of such assessments are usually used to create generalized impressions (rather than diagnoses) in service to informing treatment planning. Methods include formal testing measures, interviews, reviewing past records, clinical observation, and physical examination. [2]

There exist literally hundreds of various assessment tools, although only a few have been shown to have both high validity (i. In Psychology, validity has two distinct fields of application e. , test actually measures what it claims to measure) and reliability (i. In Statistics, reliability is the consistency of a set of measurements or measuring instrument often used to describe a test. e. , consistency). These measures generally fall within one of several categories, including the following:

Diagnostic impressions

See also: Mental disorder

After assessment, clinical psychologists often provide a diagnostic impression. Mental disorder or mental illness is a psychological or behavioral pattern that occurs in an individual and is thought to cause distress or disability that is not expected as Diagnosis is the identification by Process of elimination, of the nature of anything Many countries use the International Statistical Classification of Diseases and Related Health Problems, while the U. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases S. uses the Diagnostic and Statistical Manual of Mental Disorders (the DSM version IV-TR). The Diagnostic and Statistical Manual of Mental Disorders' ( DSM) is published by the American Psychiatric Association Both assume medical concepts and terms, and state that there are categorical disorders that can be diagnosed by set lists of descriptive criteria. [23] Most American HMO and insurance companies require a diagnosis from the DSM before they will approve payment for treatment. "HMO" redirects here For other uses see HMO (disambiguation. Insurance, in Law and Economics, is a form of Risk management primarily used to hedge against the Risk of a contingent loss

The DSM uses a categorical medical model and views psychological problems in terms of discrete illnesses that can be defined by a minimum set of criteria—such as self-reported symptoms, intensity, behaviors, duration, onset, et cetera. There is a growing awareness that this model is not the only way to understand or describe psychological impairment. Moreover, there is little empirical justification for the cutoff criteria, which are based on clinical consensus and are therefore essentially arbitrary. [24] As such, there is a debate in the field regarding alternative methods of diagnosing psychological problems.

Several conceptual models are being discussed, including a "dimensional model" based on empirically validated models of human differences (such as the five factor model of personality[24][23]) and a "psychosocial model", which would take changing, intersubjective states into greater account. In Psychology, the "Big Five" personality traits are five broad factors or dimensions of personality developed through lexical analysis [25] The proponents of these models claim that they would offer greater diagnostic flexibility and clinical utility without depending on the medical concept of illness. However, they also admit that these models are not yet robust enough to gain widespread use, and should continue to be developed.

British clinical psychologists do not tend to diagnose, but rather use formulation—an individualized map of the difficulties that the patient or client faces, encompassing predisposing, precipitating and perpetuating (maintaining) factors. [26]

Clinical theories and interventions

Clinical psychologists work with individuals, children, families, couples, or small groups.
Clinical psychologists work with individuals, children, families, couples, or small groups.
Main article: Psychotherapy

Generally speaking, psychotherapy involves a formal relationship between professional and client—usually an individual, couple, family, or small group—that employs a set of procedures intended to form a therapeutic alliance, explore the nature of psychological problems, and encourage new ways of thinking, feeling, or behaving. Psychotherapy is an Interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living

Clinicians have a wide range of individual interventions to draw from, often guided by their training—for example, a CBT clinician might use worksheets to record distressing cognitions, a psychoanalyst might encourage free association, while an expressive therapist would employ forms of artistic expression. See also Cognitive Therapy Cognitive Behavioral Therapy ( CBT) is an umbrella-term for psychotherapeutic systems that deal with cognitions interpretations Psychoanalysis is a body of ideas developed by Austrian physician Sigmund Freud and his followers which is devoted to the study of human psychological functioning and behavior Expressive therapy, also known as creative arts therapy is the use of the Creative arts as a form of Therapy. Clinical psychologists generally seek to base their work on research evidence and outcome studies as well as on trained clinical judgment. Although there are literally dozens of recognized therapeutic orientations, their differences can often be categorized on two dimensions: insight vs. action and in-session vs. out-session. [7]

The methods used are also different in regards to the population being served as well as the context and nature of the problem. Therapy will look very different between, say, a traumatized child, a depressed but high-functioning adult, a group of people recovering from substance dependence, and a ward of the state suffering from terrifying delusions. Other elements that play a critical role in the process of psychotherapy include the environment, culture, age, cognitive functioning, motivation, and duration (i. e. brief or long-term therapy).

Four main perspectives

The field can be seen as recognizing essentially four major perspectives: Psychodynamic, Humanistic, Cognitive Behavioral, and Systems or Family therapy. Psychodynamic 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 Humanistic psychology is a school of psychology that emerged in the 1950s in reaction to both Behaviorism and Psychoanalysis. See also Cognitive Therapy Cognitive Behavioral Therapy ( CBT) is an umbrella-term for psychotherapeutic systems that deal with cognitions interpretations Family therapy, also referred to as couple and family therapy and family systems therapy, is a branch of Psychotherapy that works with families

Psychodynamic

The Psychodynamic perspective developed out of the psychoanalysis of Sigmund Freud. Psychodynamic 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 Psychoanalysis is a body of ideas developed by Austrian physician Sigmund Freud and his followers which is devoted to the study of human psychological functioning and behavior Sigmund Freud (ˈziːkmʊnt ˈfʁɔʏt born Sigismund Shlomo Freud (May 6 1856 &ndash September 23 1939 was an Austrian Psychiatrist who founded The core object of psychoanalysis is to make the unconscious conscious—to make the client aware of his or her own primal drives (namely those relating to sex and aggression) and the various defenses used to keep them in check. [27] The essential tools of the psychoanalytic process are the use of free association and an examination of the client's transference towards the therapist, defined as the tendency to take unconscious thoughts or emotions about a significant person (e. Free association (Psychodynamic theory is a technique used in Psychology, devised by Sigmund Freud. Transference is a phenomenon in Psychoanalysis characterized by unconscious redirection of feelings for one person to another g. a parent) and "transfer" them onto another person. Major variations on Freudian psychoanalysis practiced today include Self Psychology, Ego Psychology, and Object Relations Theory. Self psychology is a school of Psychoanalytic theory and therapy created by Heinz Kohut and developed in the United States. Ego psychology is a school of Psychoanalysis rooted in Sigmund Freud 's structural -- id-ego-superego -- model of the mind Object relations theory is a psychodynamic theory within Psychoanalytic psychology. These general orientations now fall under the umbrella term psychodynamic psychology, with common themes including examination of transference and defenses, an appreciation of the power of the unconscious, and a focus on how early developments in childhood have shaped the client's current psychological state. [27]

Humanistic

Main article: Humanistic psychology

Humanistic psychology was developed in the 1950s in reaction to both behaviorism and psychoanalysis, largely due to the person-centered therapy of Carl Rogers (often referred to as Rogerian Therapy) and existential psychology developed by Victor Frankl and Rollo May. Humanistic psychology is a school of psychology that emerged in the 1950s in reaction to both Behaviorism and Psychoanalysis. Person-Centered Therapy (PCT also known as Client-centered therapy or Rogerian Psychotherapy, was developed by the humanist Psychologist Carl Rogers Carl Ransom Rogers ( January 8, 1902 – February 4, 1987) was an influential American Psychologist and among the founders of the Existential psychotherapy is partly based on the Existential belief that human beings are alone in the world Viktor Emil Frankl MD, PhD, ( March 26, 1905 - September 2, 1997) was an Austrian neurologist Rollo May ( April 21, 1909 – October 22, 1994) was an American existential psychologist. [2] Rogers believed that a client needed only three things from a clinician to experience therapeutic improvement—congruence, unconditional positive regard, and empathetic understanding. [28] By using phenomenology, intersubjectivity and first-person categories, the humanistic approach seeks to get a glimpse of the whole person and not just the fragmented parts of the personality. Intersubjectivity is something which is shared by two or more subjects. [29] This aspect of holism links up with another common aim of humanistic practice in clinical psychology, which is to seek an integration of the whole person, also called self-actualization. According to humanistic thinking, each individual person already has inbuilt potentials and resources that might help them to build a stronger personality and self-concept. The mission of the humanistic psychologist is to help the individual employ these resources via the therapeutic relationship.

Cognitive behavioral

Cognitive Behavioral Therapy (CBT) developed from the combination of Cognitive psychology and Behaviorism, and from more specific earlier therapies known as cognitive therapy and rational emotive behavior therapy. See also Cognitive Therapy Cognitive Behavioral Therapy ( CBT) is an umbrella-term for psychotherapeutic systems that deal with cognitions interpretations Cognitive psychology is a branch of Psychology that investigates internal mental processes such as problem solving memory and language Behaviorism or Behaviourism, also called the learning perspective (where any physical action is a behavior is a philosophy of Psychology based on the Cognitive Therapy (CT is a type of Psychotherapy developed by American Psychiatrist Aaron T Rational Emotive Behavior Therapy ( REBT) is a comprehensive active-directive philosophically and empirically based psychotherapy which focuses CBT is based on the theory that how we think (cognition), how we feel (emotion), and how we act (behavior) all interact together. In this perspective, certain thoughts or ways of interpreting the world (often called schemas) can cause emotional distress or result in behavioral problems. Certain behaviors, such as avoidance of feared situations, can also maintain distress. The object of CBT is to discover the biased or irrational thinking that leads to emotional problems and to help the client take control over his or her thinking processes and behaviors in such a way that will lead to increased well-being. [30] There are many techniques used, such as systematic desensitization, socratic questioning, and keeping a cognition observation log. Systematic desensitization is a type of behavioral therapy used in the field of Psychology to help effectively overcome Phobias and other Anxiety disorders Socratic Questioning is disciplined questioning that can be used to pursue thought in many directions and for many purposes including to explore complex ideas to get to the truth of Modified approaches that fall into the category of CBT have also developed, including Dialectic Behavior Therapy and Mindfulness-based Cognitive Therapy. Dialectical behavioral therapy (DBT is a psychological method developed by Marsha M Mindfulness-Based Cognitive Therapy ( MBCT) is a method of therapy which blends features of two disciplines Cognitive therapy aims to identify [31]

Systems or Family Therapy

Main article: Family therapy

Systems or Family therapy works with couples and families, and emphasizes family relationships as an important factor in psychological health. Family therapy, also referred to as couple and family therapy and family systems therapy, is a branch of Psychotherapy that works with families The central focus tends to be on interpersonal dynamics, especially in terms of how change in one person will affect the entire system. [32] Therapy is therefore conducted with as many significant members of the "system" as possible. Goals can include improving communication, establishing healthy roles, creating alternative narratives, and addressing problematic behaviors. Important contributors include John Gottman, Jay Haley, Susan Johnson, and Virginia Satir. John Gottman (* 1942 PhD is known for his work on marital stability and relationship analysis through scientific direct observations Jay Douglas Haley ( July 19, 1923 – February 13, 2007) was one of the more influential psychotherapists of the 20th century Susan Johnson is the name of Susan Johnson (novelist, US romance novelist Susan Johnson (psychotherapist, co-founder of Emotionally Virginia Satir ( 26 June 1916 - 10 September 1988) was a noted American author and psychotherapist, known especially for

Other major therapeutic orientations

See also: List of psychotherapies

There exist literally dozens of recognized schools or orientations of psychotherapy—the list below represents those that have been pivotal in the development of clinical psychology. This is an alphabetical List of Psychotherapies. It is an incomplete list and new or minor approaches are still being added Although they all have some typical set of techniques practitioners employ, they are generally better known for providing a framework of theory and philosophy that guides a therapist in his or her working with a client.

Other perspectives

Integration

In the last couple of decades, there has been a growing movement to integrate the various therapeutic approaches, especially with an increased understanding of cultural, gender, spiritual, and sexual-orientation issues. Integrative Psychotherapy involves the fusion of different schools of Psychotherapy. Clinical psychologists are beginning to look at the various strengths and weaknesses of each orientation while also working with related fields, such as neuroscience, genetics, evolutionary biology, and psychopharmacology. Neuroscience is a field devoted to the scientific study of the nervous system Genetics (from Ancient Greek grc-Latn genetikos, “genitive” and that from grc-Latn genesis, “origin” a discipline of Biology, is Evolutionary biology is a sub-field of Biology concerned with the origin of Species from a Common descent, and Descent of species Psychopharmacology (from Greek grc ψῡχή psȳkhē, "breath life soul" grc φάρμακον pharmakon, "drug" and grc -λογία The result is a growing practice of eclecticism, with psychologists learning various systems and the most efficacious methods of therapy with the intent to provide the best solution for any given problem. [45]

Professional ethics

The field of clinical psychology in most countries is strongly regulated by a code of ethics. In the U. S. , professional ethics are largely defined by the APA Code of Conduct, which is often used by states to define licensing requirements. The APA Code generally sets a higher standard than that which is required by law as it is designed to guide responsible behavior, the protection of clients, and the improvement of individuals, organizations, and society. [46] The Code is applicable to all psychologists in both research and applied fields.

The APA Code is based on five principles: Beneficence and Nonmaleficence, Fidelity and Responsibility, Integrity, Justice, and Respect for People's Rights and Dignity. [46] Detailed elements address how to resolve ethical issues, competence, human relations, privacy and confidentiality, advertising, record keeping, fees, training, research, publication, assessment, and therapy.

Comparison with other mental health professions

See also: Mental health professional

Psychiatry

Fluoxetine hydrochloride, branded by Lilly as Prozac, is a common antidepressant drug prescribed by psychiatrists. There is a small but growing movement to give prescription privileges to qualified psychologists.
Fluoxetine hydrochloride, branded by Lilly as Prozac, is a common antidepressant drug prescribed by psychiatrists. A mental health professional is a person who offers services for the purpose of improving an individual's Mental health or to treat Mental illness. Eli Lilly and Company ( is a global Pharmaceutical company and one of the world's largest corporations An antidepressant is a Psychiatric medication used for alleviating major depression or Dysthymia ('milder' depression A psychoactive drug or psychotropic substance is a Chemical substance that acts primarily upon the Central nervous system where it alters Brain A psychiatrist (also archaically called an alienist) is a Physician who specializes in Psychiatry and is certified in treating Mental disorders There is a small but growing movement to give prescription privileges to qualified psychologists.

Although clinical psychologists and psychiatrists can be said to share a same fundamental aim—the alleviation of mental distress—their training, outlook, and methodologies are often quite different. A psychiatrist (also archaically called an alienist) is a Physician who specializes in Psychiatry and is certified in treating Mental disorders Perhaps the most significant difference is that psychiatrists are physicians with four years of medical school and another four years of residency in a medical setting where they may specialize in certain age groups or specific conditions. Being physicians, tend to use the medical model to assess psychological problems (i. The medical model describes the approach to illness that is dominant in Western medicine. e. those they treat are seen as patients with an illness) and some rely on psychotropic medications as the chief method of addressing them[47]— although many also employ psychotherapy as well. A psychoactive drug or psychotropic substance is a Chemical substance that acts primarily upon the Central nervous system where it alters Brain Psychotherapy is an Interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living Psychiatrists and medical psychologists (who are clinical psychologists that are also trained to prescribe), enables them to conduct physical examinations, order and interpret laboratory tests and EEGs, and may order brain imaging studies such as CT or CAT, MRI, and PET scanning. Medical Psychology refers to an emerging specialty of clinical psychological practice in which psychologists who have undergone additional specialized education and training may prescribe Computed tomography (CT is a Medical imaging method employing Tomography. Computed tomography (CT is a Medical imaging method employing Tomography. Positron emission tomography ( PET) is a Nuclear medicine imaging technique which produces a three-dimensional image or map of functional processes in the

Clinical psychologists do not prescribe medication, although there is a growing movement for psychologists to have prescribing privileges. A prescription (℞ is a health-care program implemented by a Physician or other medical practitioner in the form of instructions that govern the plan of care for an individual The Prescriptive authority for psychologists (RxP movement is a political effort to give prescriptive authority to Clinical psychologists, enabling them to [48] These medical privileges require extensive additional, supervised training and education. To date, medical psychologists may prescribe psychotropic medications in Guam, New Mexico, and Louisiana. Guam ( Chamorro: cha Guåhån) officially the Territory of Guam, is an island in the western Pacific Ocean and is an organized unincorporated New Mexico ( is a state located in the southwestern region of the United States of America. The State of Louisiana ( or, État de Louisiane, pronounced) is a state located in the southern region of the United States of America [49].

Unless a psychiatrist voluntarily chooses to get extra training beyond medical school—such as at a psychoanalytic institute or Cognitive Therapy studies —they will have less training in psychological assessment and psychotherapy than will a licensed clinical psychologist. Psychoanalysis is a body of ideas developed by Austrian physician Sigmund Freud and his followers which is devoted to the study of human psychological functioning and behavior [50]

There are fewer counseling psychology graduate programs than those for clinical psychology and they are more often housed in departments of education rather than psychology. The two professions can be found working in all the same settings but counselors are more frequently employed in university counseling centers compared to hospitals and private practice for clinicians. [51] There is considerable overlap between the two fields and distinctions between them continue to fade.

School psychology

School psychologists are primarily concerned with the academic, social, and emotional well-being of children and adolescents within a scholastic environment. School Psychology is a field that applies principles of Clinical psychology and Educational psychology to the diagnosis and treatment of children's and adolescents' In the U. K. , they are known as 'educational psychologists'. Like clinical (and counseling) psychologists, school psychologists with doctoral degrees are eligible for licensure as health service psychologists, and many work in private practice. Unlike clinical psychologists, they receive much more training in education, child development and behavior, and the psychology of learning. The majority of school psychologists possess a Professional Specialist training, Educational Specialist Degree (Ed. The Education Specialist, also referred to as Educational Specialist, Specialist in Education, or Ed S. ), with a minority holding the Doctor of Philosophy (Ph. "PhD" redirects here for other uses see PhD (disambiguation. D. ) or Doctor of Education (Ed. The Doctor of Education degree ( EdD or DEd) is a discipline-based doctorate that prepares the student for academic administrative clinical or research positions D. ) degree. Traditional job roles for school psychologists employed in school settings have focused mainly on assessment of students to determine their eligibility for special education services in schools, and on consultation with teachers and other school professionals to design and carry out interventions on behalf of students. Other major roles also include offering individual and group therapy with children and their families, designing prevention programs (e. g. for reducing dropout), evaluating school programs, and working with teachers and administrators to help maximize teaching efficacy, both in the classroom and systemically. [52][53]

Clinical social work

Social workers provide a variety of services, generally concerned with social problems, their causes, and their solutions. Social work is a discipline involving the application of Social theory and research methods to study and improve the lives of people groups and societies With specific training, clinical social workers may also provide psychological counseling (in the US and Canada), in addition to more traditional social work. The Masters in Social Work in the U. S. is a two-year, sixty credit program that usually includes at least a one year practicum. Unlike the PhD, which is a third level academic degree, the MSW is considered a professional degree (a second level university degree).

Clinical psychology journals

Cover of The Psychological Clinic, the first journal of clinical psychology, published in 1907 by Lightner Witmer
Cover of The Psychological Clinic, the first journal of clinical psychology, published in 1907 by Lightner Witmer

The following represents an (incomplete) listing of significant journals in or related to the field of clinical psychology. Lightner Witmer (1867-1956 is regarded as the inventor of the term " Clinical Psychology " and the co-founder of the world's first Psychological Clinic in 1896 at the

  • American Journal of Psychotherapy
  • Annual Review of Clinical Psychology [1]
  • Annual Review of Psychology [2]
  • British Journal of Psychotherapy
  • British Journal of Clinical Psychology
  • Clinical Psychology and Psychotherapy
  • Clinical Psychology Review
  • Clinical Psychology: Science and Practice
  • In Session: Psychotherapy in Practice
  • International Journal of Psychopathology,
    Psychopharmacology, and Psychotherapy
  • International Journal of Psychotherapy
  • Journal of Abnormal Psychology
  • Journal of Affective Disorders
  • Journal of Anxiety Disorders
  • Journal of Child Psychotherapy
  • Journal of Clinical Child Psychology
  • Journal of Clinical Psychology
  • Journal of Clinical Psychology in Medical Settings
  • Journal of Clinical Psychopharmacology
  • Journal of Consulting and Clinical Psychology
  • Journal of Contemporary Psychotherapy
  • Journal of Family Psychotherapy
  • Journal of Psychotherapy Integration
  • Journal of Psychotherapy Praxis & Research
  • Journal of Rational-Emotive and Cognitive Behaviour Therapy
  • Journal of Social and Clinical Psychology
  • Psychopathology
  • Psychotherapy & Psychosomatics
  • Psychotherapy Research

Major influences

Criticisms and controversies

[60]

See also

References

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  2. ^ a b c Plante, Thomas. A mental health professional is a person who offers services for the purpose of improving an individual's Mental health or to treat Mental illness. Psychiatric nursing or mental health nursing is the specialty of Nursing that cares for people of all ages with Mental illness or mental distress This is an alphabetical List of Psychotherapies. It is an incomplete list and new or minor approaches are still being added This list includes notable Clinical Psychologists and contributors to Clinical psychology, some of whom may not have thought of themselves primarily as Clinical psychologists This list is of professional and academic credentials in the field of Psychology and allied fields including Psychotherapy, Counseling and Social work. See also Psychiatry See also Biopsychiatry controversy Anti-psychiatry refers to a post-1960s configuration of groups and theoretical constructs Clinical neuropsychology is a sub-specialty of clinical Psychology that specialises in the diagnostic assessment and treatment of patients with Brain injury or In the United Kingdom, a Clinical Associate is a shortened designation for a Clinical Associate in Applied Psychology (CAAP. (2005). Contemporary Clinical Psychology. New York : Wiley. ISBN 047147276X
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    Counseling psychology

    Comparison of mental health professionals
    Occupation Degree Common Licenses Prescription Privilege Ave. 2004
    Income
    Clinical Psychologist PhD/PsyD Psychologist Mostly no $75,000
    Counselor/Psychotherapist (Doctorate) PhD MFT/LPC No $65,000
    School Psychologist PhD, EdD Psychologist No $78,000
    Counselor/Psychotherapist (Masters) MA/MS/MC MFT/LPC/LPA No $49,000
    Psychiatrist MD/DO Psychiatrist Yes $145,600
    Clinical Social Worker PhD/MSW LCSW No $36,170
    Psychiatric Nurse PhD/MSN/BSN APRN/PMHN No $53,450
    Psychiatric and mental health Nurse Practitioner DNP/MSN MHNP Yes (Varies by state) $75,711
    Expressive/Art Therapist MA ATR No $45,000

    Sources:<ref>APA. Psychotherapy is an Interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living School Psychology is a field that applies principles of Clinical psychology and Educational psychology to the diagnosis and treatment of children's and adolescents' Psychotherapy is an Interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living A psychiatrist (also archaically called an alienist) is a Physician who specializes in Psychiatry and is certified in treating Mental disorders Social work is a discipline involving the application of Social theory and research methods to study and improve the lives of people groups and societies Psychiatric nursing or mental health nursing is the specialty of Nursing that cares for people of all ages with Mental illness or mental distress For information about the field see Psychiatric and mental health nursing. Expressive therapy, also known as creative arts therapy is the use of the Creative arts as a form of Therapy. (2003). [http://research. apa. org/03salary/homepage. html Salaries in Psychology 2003: Report of the 2003 APA Salary Survey]</ref><ref>NIH: Office of Science Education. (2006). [http://science. education. nih. gov/LifeWorks. nsf/Alphabetical+List/Psychiatrist Lifeworks: Psychiatrist]</ref><ref>U. S. Department of Labor: Bureau of Labor Statistics. (2004). [http://www. bls. gov/oco/ocos060. htm Occupational Outlook Handbook: Social Workers]</ref><ref>U. S. Department of Labor: Bureau of Labor Statistics. (2004). [http://www. bls. gov/oco/ocos083. htm Occupational Outlook Handbook: Registered Nurses]</ref><ref>NIH: Office of Science Education. (2006). [http://nurse-practitioners. advanceweb. com/resources/np010106_p34table4. pdf] Advance News Magazines. (2005). </ref><ref>{{cite web|url=http://science. education. nih. gov/LifeWorks. nsf/Alphabetical+List/Art+Therapist|title=Lifeworks: Art Therapist|accessdate=2007-02-17}}</ref>

    Counseling psychologists study and use many of the same interventions and tools as clinical psychologists, including psychotherapy and assessment. Psychotherapy is an Interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living Traditionally, counselors help people with what might be considered normal or moderate psychological problems—such as the feelings of anxiety or sadness resulting from major life changes or events. <ref></ref><ref></ref> Many counselors also receive specialized training in career assessment, group therapy, and relationship counseling, although some counselors also work with the more serious problems that clinical psychologists are primarily trained for, such as dementia or psychosis. Dementia (from Latin de- "apart away" + Mens ( genitive mentis) "mind" is the progressive decline Psychosis (from the Greek ψυχή "psyche" for mind or soul and -οσις "-osis" for abnormal condition with adjective psychotic In the United States, all but two states license or certify counselors for private practice. <ref>American Mental Health Counselors Association. (2004). "[http://www. amhca. org/why/ Why use a mental health counselor?]". Retrieved July 21, 2007. </li> <li id="cite_note-50">'''[[#cite_ref-50|^]]''' Norcross, John. (2000). [http://www. psichi. org/pubs/articles/article_73. asp Clinical versus counseling psychology: What's the diff?] ''Eye on Psi Chi, 5(1),'' 20-22. </li> <li id="cite_note-51">'''[[#cite_ref-51|^]]''' Silva, Arlene. (2003). ''[http://www. nasponline. org/about_sp/whatis. aspx Who Are School Psychologists?]''. National Association of School Psychologists. </li> <li id="cite_note-52">'''[[#cite_ref-52|^]]''' American Psychological Association (n. d. ). ''[http://www. apa. org/crsppp/schpsych. html Archival Description of School Psychology]''. American Psychological Association. </li> <li id="cite_note-observing-53">^ [[#cite_ref-observing_53-0|<sup>'''''a'''''</sup>]]&#32;[[#cite_ref-observing_53-1|<sup>'''''b'''''</sup>]] Pilgram, D. & Treacher, A. (1992) Clinical Psychology Observed. Routledge: London & USA/Canada. ISBN 0415046327</li> <li id="cite_note-54">'''[[#cite_ref-54|^]]''' Leichsenring, Falk & Leibing, Eric. (2003). The effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders: A meta-analysis. ''The American Journal of Psychiatry, 160(7),'' 1223-1233. </li> <li id="cite_note-55">'''[[#cite_ref-55|^]]''' Reisner, Andrew. (2005). The common factors, empirically validated treatments, and recovery models of therapeutic change. ''The Psychological Record, 55(3),'' 377-400. </li> <li id="cite_note-56">'''[[#cite_ref-56|^]]''' Lilienfeld, Scott and Lynn, Steven and Lohr, Jeffrey. (2002). ''Science and Pseudoscience in Clinical Psychology. '' New York : Guilford Press. ISBN 1572308281</li> <li id="cite_note-57">'''[[#cite_ref-57|^]]''' Kyuken, W. (1999) [http://www. ncbi. nlm. nih. gov/entrez/query. fcgi?cmd=Retrieve&db=PubMed&list_uids=11657486 Power and clinical psychology: a model for resolving power-related ethical dilemmas. ] ''Ethics Behav. '' 1999;9(1):21-37. </li> <li id="cite_note-58">'''[[#cite_ref-58|^]]''' Smail, D. [http://www. davidsmail. freeuk. com/introfra. htm Power, Responsibility and Freedom. ] Internet Publication. </li>

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