Journal
josely27
HS-13-PsychologyPractitioners2week12.pptxContemporary Issues: Historical Framework of Contemporary Psychology
Unit 13
Psychology’s Practitioners
Medical Approach to Mental Illness
Great and Desperate “Cures”
Pyrotherapy (fever therapy) (Wagner-Jauregg)
Noted that high fever may cure syphilis (Nobel 1927)
malaria parasites to treat dementia paralytica (end stage syphilis)
Had treatment for malaria
Insulin Shock Therapy (Sakel)
low (sub-coma) doses of insulin helped drug addicts and psychopaths
Blood sugar lowered (20 times over months) to treat schizophrenia
Metrazol shock therapy (Meduna)
Epilieptics had high brain glia; schizophrenics had low
Induced multiple seizures in schizophrenics to increase glia
schizophrenics rarely epileptic; few who had seizures less schizo
Those with epilepsy were seldom mentally ill
Electroshock therapy (Cerletti)
Worked with electroshock to induce epileptic fits in dogs
Schizo prevented/cured by seizures
Induce brief seizure; Temporary relief (severe depression)
Remains in use today
Shell Shock in World War I
Defensive psychological reaction to extreme war trauma
Helplessness / disoriented behavior
first thorough description by C. S. Myers of Cambridge in 1915
Trained in Psychophysics
Physical injury: shock waves from shells creating a cerebral lesion
i.e., a concussion
BUT many showed with no exposure to explosives
Realized it was a Psychological Injury
Estimated 80,000 cases in British army (250,000 all told)
1917, "shell shock" banned as a diagnosis in the British Army
Early on: a weakness not found in "good" units
Treatment
Psych: few days' rest by his local medical officer: if no improve
"NYDN – Not Yet Diagnosed Nervous" & evac to special centers
10/1916 - 3/1919 Craiglockhart Hospital
W. H. R. Rivers
men of unquestioned bravery could succumb to overwhelming fear
Arthur John Brock
‘cure by functioning’ reestablish links with their environment
not purely a wartime phenomenon
Umbrella term for operations that purposely damaged brain tissue in order to treat mental illness
Undesired behaviors in neurological connections – break connections & you could stop the behaviors
Pioneered in Portugal by Egas Moniz 1935
Fulton & Jacobsen 1935 lobotomy on chimpanzees at Yale
Human: Through temple, sever connections between frontal lobes (rational control) and emotional centers (Nobel 1949)
Procedures:
Cut hole in the skull & injecting ethanol to destroy the fibers
Surgical wire - when rotated creates circular lesion in brain.
Improvement in procedure by
Amarro Fiamberti (Italy) transorbital approach
Walter Freeman and James Watts (US) refined Transorbital lobotomy (quicker, less medical recovery time)
Disappeared in 1950s 2nd improved drug approaches
50,000 done in US
The Lobotomy (highly controversial)
Clinical Psychology
Lightner Witmer (1867-1956)
“Clinical Psychology” ; 1st Psych Clinic
Note: born right after Civil War
U Penn brought Cattell as 1st Psych Prof in US
Worked on individ diff in RT; Witmer became Cattell’s assistant
Witmer – trained in finance & poly-sci; U Penn for Law
Cattell left for Columbia
Cattell sent him to Wundt; PhD 1892
returned to U Penn as laboratory director & teaching Child Psych
began seeing cases of students with various school-related problems (e.g., poor spelling)
1896: introduced term Clinical Psych & created 1st clinic
Orthogenics: science of normal development of mind & body
Human potential
1907: found journal, The Psychological Clinic
Lead essay coins term “clinical psychology”
Work in the clinic similar to modern school psychology
APA Division 16 (School Psychology) - annual Witmer Award
Clinical Psychology
WWI: Army testing for mental fitness of soldiers
Psych = Psychometrics; limited to administering tests
Psychiatric control
Therapy done by MDs/Psychiatry
need for Tx with returning soldiers; clinical psych called in
Difficult to gain recognition in APA
1917: American Association of Clinical Psychologists
Short-lived – APA created “clinical section” and associate member status in the 1920s
1937 – American Association for Applied Psychology
1943 – “intersociety” convention led to new APA
brought together various societies representing psychology
Division structure
APA 1o Academic; expand to include clinicians & applied
1988: APS founded (Psychological Science)
APA too clinical
Overwhelming # of WWII psychiatric casualties
44,000 veterans suffered from various mental disorders
Produced increased need for psychological services
Psychiatry could not manage caseload
Standardized Training programs (gov. pushed)
Boulder conference (1949)
Develop process to eval & approve doctoral training programs in applied psychologies (clinical, school, counseling)
Scientist-practitioner (Bolder) model (David Shakow)
Worcester State Hospital (1932); research on schizophernia
1st clinical internship program; Degree PhD (1946)
Ph.D. in Psychology
Scientists/practice vs. practitioners with science background
Expertise in diagnosis and treatment
Research-based dissertation
Critique of the Boulder Model
Basically a ‘Neither Fish Nor Fowl’ criticism
Students don’t become excellent scientists nor excellent practitioners
They study research methods that they will not use in professional practice
This takes time away from formal training and apprenticeship in the art and craft of psychotherapy
Stress data gathering over critical thinking & theory-building
thus an uncritical approach to empiricism
Short-cycle research (within the timeframe of training cycle)
vs longitudinal & more intricate studies more typical of researchers
Basically, skills needed for clinical practice are different (& incompatible) re: needed for research
The Psy.D.
Criticism of Boulder Model
Training in both research and practice, not enough emphasis was placed on either
Few publications by graduates of Ph.D.
Students not trained effectively for practice
1964 APA committee
Science & Practice though related - not the same
Create doctorate of practice (like M.D./ D.D.S./ O.D.)
The Vail conference (1973)
Proposed Practitioner-Scientist model
More emphasis on practice, less on research
Doctor of Psychology (Psy.D.)
2,000 hour supervised internship vs dissertation
Does Psychotherapy Work?
Many case histories but no scientific assessment
Same as in medicine
Eysenck study (1952) on neurosis (n=19)
Traditional therapies (primarily analytic) not effective
Psychoanalysis: 44% improvement over 5 years
“Eclectic” therapy: 64% improvement
No therapy (Tx by GPs): 72% improvement
1961 similar results
1963 Eysenck-Strupp debate
E – behavioral therapist (critic of psychotherapy)
S – psychoanalysis – blasted study (methods & alt. interpretations)
Eysenck-Strupp debate, 50 years later
Original Debate introduced psychotherapy outcomes research
case histories were no longer enough and outcome studies using randomized trials with control groups became more common.
Since orig debate, tremendous boom in research articles examining the psychotherapy process and measuring treatment effectiveness.
Yet still strong resistance to the type of evidence-based treatment that E & S both endorsed.
Still, general consensus that some treatments are better than others for specific disorders based on scientific psychological principles.
Psychotherapists recognize that actual evidence is more important than opinion in determining what works and what does not.
Q (Cf): is Psychotherapy amenable to strict scientific assessment?
How do we Operationalize; Control; DV; IV; etc?
New Approaches To Psychotherapy
Behavior Therapy
Conditioning principles applied to therapy
Systematic Desensitization
Origins: Mary Jones (1924) study, eliminating fear in “Peter”
Joseph Wolpe (1950s): fear in cats
Hans Eysenck (1950s): coined term
Underlying cause irrelevant; get rid of problem
Behaviour Research and Therapy (first journal—1963)
Humanistic psychology rejects this behavior only approach
Humanistic Psychology (3rd Force)
Psychodynamic (problem)
Ignore Critical Human Aspect: Potential Development
How we achieve Selfhood & Actualize Potential
Humanistic
Emphasis on free will and responsibility
People not tied to their pasts
People strive for meaningful lives
Natural tendency is growth toward self-actualization
Reaching potential
Abraham Maslow (1908-1970)
Ph.D. 1934 Columbia w/ Alfred Adler (Freudian)
1951-1969 Brandeis
Each person’s unique perspective based on their construal
how individuals perceive, comprehend, & interpret world
Self-Actualization vs. Deficiency Needs
Studied attributes of self-actualizers (e.g., Wertheimer)
Hierarchy of needs; Peak experiences
Carl Rogers (1902-1987)
Columbia PhD (1931) – Teachers College
w/ Leta Hollingworth (gifted children)
Not impressed with psychoanalysis
U Chicago: Counseling Center
Client-centered therapy (1951)
Emphasis on therapeutic atmosphere to help client take responsibility for change
unconditional positive regard
Empathy
congruence (ideal self = actual experience)
Therapist genuineness
Client has unconditional worth
Empathy (reflection technique)
Emphasized Research on therapy effectiveness
Psychology in Business and Industry
Significant growth in 1920s and 1930s
Scott Company (Walter Dill Scott)
Consulting service to business and industry
Psychological Corporation (James McKeen Cattell)
Organization of applied psychologists available to business
Only succeeded after Cattell ousted in 1926
Morris Viteles (1898-1996)
Major text naming the field Industrial Psychology (1932)
Hawthorn Effect (1920)
Q: Are our employees more productive in a well-lit environment than they are in a poorly-lit environment
A: yes along with having a clear workstation, breaks, teams, etc.
Increased productivity regardless of changes in conditions
Positive effects of being in an experiment
“Human factor” more important than working conditions
Lots of controversy even today
