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Clinical Counseling STUDY NOTES OVERVIEW Clinical Counseling is concerned with the assessment and treatment of mental illness, abnormal behavior and psychiatric problems. This field integrates the science of psychology with the treatment of complex human problems, the purpose of clinical counseling is to Diagnose and treat mental disorders; learning disabilities; and cognitive, behavioral, and emotional problems, using individual, child, family, and group therapies. Clinical counselors also design and implement behavior modification programs, they understand, prevent, relieve psychologically-based distress or dysfunction, promote subjective well-being and personal development for clients. Central to the clinical counseling practice are two major elements, the psychological assessment and psychotherapy. Dysfunction or Mental health Disorder: is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture. Such a disorder may consist of a combination of affective, behavioral, cognitive and perceptual components. The recognition and understanding of mental health conditions have changed over time and across cultures, and there are still variations in the definition, assessment, and classification of mental disorders, although standard guideline criteria are widely accepted. A few mental disorders are diagnosed based on the harm to others, regardless of the subject's perception of distress. Over a third of people in most countries report meeting criteria for the major categories at some point in their lives. The causes are often explained in terms of a diathesis-stress model or biopsychosocial model. In biological psychiatry, mental disorders are conceptualized as disorders of brain circuits likely caused by developmental processes shaped by a complex interplay of genetics and experience. Services are based in psychiatric hospitals or in the community. Diagnoses are made by psychiatrists, clinical psychologists, or psychiatric social workers using various methods, often relying on observation and questioning in interviews. Treatments are provided by various mental health professionals. Psychotherapy and psychiatric medication are two major treatment options, as are social interventions, peer support and self-help. In some cases there may be involuntary detention and involuntary treatment where legislation allows. Stigma and discrimination add to the suffering associated with the disorders, and have led to various social movements attempting to increase acceptance. Well – Being( in Mental health) is described as either a level of cognitive or emotional free of a mental disorder. From perspectives of the discipline of positive psychology or holism mental health may include an individual's ability to enjoy life and procure a balance between life activities and efforts to achieve psychological resilience. Mental health is an expression of emotions and signifies a successful adaptation to a range of demands. The World Health Organization defines mental health as "a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”. It was previously stated that there was no one "official" definition of mental health. Cultural differences, subjective assessments, and competing professional theories all affect how "mental health" is defined. There are different types of mental health problems, some of which are common, such as depression and anxiety disorders, and some not so common, such as schizophrenia and Bipolar disorder. Most recently, the field of Global Mental Health has emerged, which has been defined as 'the area of study, research and practice that places a priority on improving mental health and achieving equity in mental health for all people worldwide'. Psychological assessment or mental examination. Is an examination into a person's mental health by a mental health professional such as a psychologist. A psychological evaluation may result in a diagnosis of a mental illness. It is the mental equivalent of physical examination Psychological assessment may come in two forms: formal and informal. Formal assessment involves the use of tools such as questionnaires, checklists and rating scales, while in informal assessment the interview/evaluation usually lacks such structure or organization.[1] The psychologist or related licensed professional will sometimes start by asking questions of the person being evaluated, but not always. In psychological evaluations the administration of standardized psychological tests either by a psychologist, or by someone the psychologist supervises, are often a component of the evaluation. Situations requiring psychological evaluations. Applicants to sensitive jobs, such as jobs in intelligence or other jobs handling state secrets, may be required to submit to a psychological evaluation before they can be employed, although usually a background check is much more important. Courts may order a competency evaluation of a defendant to determine competency to stand trial. An insanity defense will also usually require the defendant to undergo a psychological evaluation. Psychotherapy: or personal counseling with a psychotherapist is an intentional interpersonal relationship used by trained psychotherapists to aid a client or patient in problems of living. It aims to increase the individual's sense of their own well-being. Psychotherapists employ a range of techniques based on experiential relationship building, dialogue, communication and behavior change that are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family). Psychotherapy may also be performed by practitioners with a number of different qualifications, including psychiatry, clinical psychology, counseling psychology, clinical or psychiatric social work, mental health counseling, marriage and family therapy, rehabilitation counseling, school counseling, play therapy, music therapy, art therapy, drama therapy, dance/movement therapy, occupational therapy, psychiatric nursing, psychoanalysis and those from other psychotherapies. It may be legally regulated, voluntarily regulated or unregulated, depending on the jurisdiction. Requirements of these professions vary, but often require graduate school and supervised clinical experience. Psychotherapy in Europe is increasingly being seen as an independent profession, rather than being restricted to being practiced only by psychologists and psychiatrists as is stipulated in some countries. CLINICAL PRACTICE: Clinical counselors often work in medical settings, private practice or in academic positions at universities and colleges, private therapeutic settings offering short-term and long-term outpatient services to clients who need help coping with psychological distress or working directly with clients, often those who suffer from severe psychiatric disorders. Clinical Counselors need to have excellent communication skills. It is also important to be creative when developing treatment plans and approaches. Some of the job roles performed by those working in clinical counseling include: Assessment and diagnosis of psychological disorders Treatment of psychological disorders Teaching Conducting research Drug and alcohol treatment Creating and administering program to treat and prevent social problems HISTORICAL BACKGROUND OF CLINICAL COUNSELING (Clinical Psychology) 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. 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. Clinical Counselors are considered to be experts in providing psychotherapy, psychological testing, and in diagnosing mental illness. They generally train within four primary theoretical orientations—psychodynamic, humanistic, behavior therapy/cognitive behavioral, and systems or family therapy. Many 18th c. 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 pseudoscience primarily focused on measurements of the human skull, based on the concept that the brain is the organ of the mind, and that certain brain areas have localized, specific functions or modules. Following the materialist notions of mental functions originating in the brain, phrenologists believed that human conduct could best be understood in neurological rather than philosophical or religious terms. Developed by German physician Franz Joseph Gall in 1796, the discipline was very popular in the 19th century, especially from about 1810 until 1840. The principal British centre for phrenology was Edinburgh, where the Edinburgh Phrenological Society was established in 1820. In 1843, François Magendie referred to phrenology as "a pseudo-science of the present day." Phrenological thinking was, however, influential in 19thcentury psychiatry and modern neuroscience. Gall's assumption that character, thoughts, and emotions are located in the brain is considered an important historical advance toward neuropsychology. Phrenologists believed that the mind has a set of different mental faculties, with each particular faculty represented in a different area of the brain. These areas were said to be proportional to a person's propensities, and the importance of the given mental faculty. It was believed that the cranial bone conformed in order to accommodate the different sizes of these particular areas of the brain in different individuals, so that a person's capacity for a given personality trait could be determined simply by measuring the area of the skull that overlies the corresponding area of the brain. As a type of theory of personality, phrenology can be considered to be an advance over the old medical theory of the four humors. Phrenology, which focuses on personality and character, should be distinguished from craniometry, which is the study of skull size, weight and shape, and physiognomy, the study of facial features. 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. The earliest recorded approaches were a combination of religious, magical and/or medical perspectives. Early examples of such physicians included Patañjali, Padmasambhava, Rhazes, Avicenna, and Rumi In the early 19th century, one could have his or her head examined, literally, using phrenology, the study of personality by the shape of the skull. Other popular treatments included physiognomy—the study of the shape of the face—and mesmerism, Mesmer's treatment by the use of magnets. Spiritualism and Phineas Quimby's "mental healing" were also popular. 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. 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. Early clinical counseling and psychology Lightner Witmer, the father of modern clinical psychology. By the second half of the 1800s, the scientific study of psychology was becoming wellestablished 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. 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. 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. 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." The field was slow to follow Witmer's example, but by 1914, there were 26 similar clinics in the US. Even as clinical psychology was growing, working with issues of serious mental distress remained the domain of psychiatrists and neurologists. However, clinical psychologists continued to make inroads into this area due to their increasing skill at psychological assessment. 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. Due in large part to the success of these tests, assessment was to become the core discipline of clinical counseling 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 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. In 1945, the 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 US army conducts a psychological test developed by clinical psychologists for selection purposes. When World War II broke out, the military once again called upon clinical psychologists. As soldiers began to return from combat, psychologists started to notice symptoms of psychological trauma labeled "shell shock" (eventually to be termed posttraumatic stress disorder) that were best treated as soon as possible. Because physicians (including psychiatrists) were over-extended in treating bodily injuries, psychologists were called to help treat this condition. 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. After the war, the Veterans Administration in the US 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 US went from having no formal university programs in clinical psychology in 1946 to over half of all Ph.D.s in psychology in 1950 being awarded in clinical psychology. WWII helped bring dramatic changes to clinical counseling, 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 Ph.D. programs in clinical psychology. Clinical psychology in Britain developed much like in the U.S. after WWII, specifically within the context of the National Health Service with qualifications, standards, and salaries managed by the British Psychological Society. A changing profession Since the 1970s, clinical counseling has continued growing into a robust profession and academic field of study. Although the exact number of practicing clinical counselors is unknown, it is estimated that between 1974 and 1990, the number in the US grew from 20,000 to 63,000. Clinical counselors continue to be experts in assessment and psychotherapy while expanding their focus to address issues of gerontology, sports, and the criminal justice system to name a few. One important field is health psychology, the fastest-growing employment setting for clinical psychologists in the past decade. Other major changes include the impact of managed care on mental health care; an increasing realization of the importance of knowledge relating to multicultural and diverse populations; and emerging privileges to prescribe psychotropic medication. In the UK psychology is now one of the most popular degree subjects, and over 15,000 people graduate in psychology each year, many with the hope of developing this into a career, although only around 600 places for doctoral training in clinical psychology means there is intense competition for these places. Professional Clinical Counseling Practice Clinical Counselors can offer a range of professional services, including: Administer and interpret psychological assessment and testing Conduct psychological research Consultation (especially with schools and businesses) Development of prevention and treatment programs Program administration Provide expert testimony (forensic psychology) Provide psychological treatment (psychotherapy) Teach In practice, clinical Counselors 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. Most clinical counselors who engage in research and teaching do so within a college or university setting. Clinical counselors may also choose to specialize in a particular field—common areas of specialization, some of which can earn board certification, include: Child and adolescent Family and relationship counseling Forensic Health Neuropsychological disorders Organization and business School Specific disorders (e.g. trauma, addiction, eating, sleep, sex, clinical depression, anxiety, or phobias) Sport Assessments in Clinical Counseling. An important area of expertise for many clinical Counselors is psychological assessment, and there are indications that as many as 91% of psychologists engage in this core clinical practice. 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. There exist literally hundreds of various assessment tools, although only a few have been shown to have both high validity (i.e., test actually measures what it claims to measure) and reliability (i.e., consistency). These measures generally fall within one of several categories, including the following: Intelligence & achievement tests – These tests are designed to measure certain specific kinds of cognitive functioning (often referred to as IQ) in comparison to a norming-group. These tests, such as the WISC-IV, attempt to measure such traits as general knowledge, verbal skill, memory, attention span, logical reasoning, and visual/spatial perception. Several tests have been shown to predict accurately certain kinds of performance, especially scholastic. Personality tests – Tests of personality aim to describe patterns of behavior, thoughts, and feelings. They generally fall within two categories: objective and projective. Objective measures, such as the MMPI, are based on restricted answers—such as yes/no, true/false, or a rating scale—which allow for computation of scores that can be compared to a normative group. Projective tests, such as the Rorschach inkblot test, allow for open-ended answers, often based on ambiguous stimuli, presumably revealing non-conscious psychological dynamics. Neuropsychological tests – Neuropsychological tests consist of specifically designed tasks used to measure psychological functions known to be linked to a particular brain structure or pathway. They are typically used to assess impairment This is a SAMPLE (Few pages have been extracted from the complete notes:-It’s meant to show you the topics covered in the full notes and as per the course outline. 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