PSY 650 Literature Review

“Literature Review”

Introduction to Clinical and Counseling Psychology: PSY650

“Literature Review”


Physicians carry out tests to diagnose diseases in patients; in most cases, one or two tests can easily enable the physician to identify the source or the cause of the problem. Similarly, clinical and counseling psychologists go to an extent of using several tools commonly known as psychological tests to help in diagnosing mental disorders. These psychological tools are used in various problems caused by psychological disorders such as difficulty in learning. Nevertheless, in complex medical psychological conditions, tests always do not give all the solutions required, therefore, clinical and counseling psychologists rely much on broader education tools known as assessments to accurately diagnose a particular psychological condition (Gone, 2014). Through psychological assessments, the psychologist come up and applies credible therapeutic treatments and interventions. In the current society, clinical and counseling psychologists are using several psychological assessments in diagnosing the problems (Ryder, Ban &Yulia, 2011). Studies reveal that 91% of the clinical and counseling psychologists employ psychological tests to investigate a psychological problem. However, the complexity of the assessment tends to depend on various factors.


Clinical interview assessment is the most widely used psychological assessment by the psychologists in the modern days. A clinical interview is a form of dialogue between a psychologist and the patient; it is usually called conversation with purpose meaning the clinical interviewer has a purpose of diagnosing the patient through the conversation. The clinical interview occurs within a particular defined time frame, In clinical interview assessments; the interviewer is always keen on the answers the patient gives on to the questions asked. The interviewer also looks at the patient’s behavior, attitude appearance and even movements (Ryder et al, 2011). When the patient is suffering from an extreme psychological problem, the interviewer would easily notice the problem by looking at these characteristics.

Moreover, when conducting a clinical interview assessment, the psychologist not only need to listen to the words of the patient, but also he should observe some non-verbal clues, such as patient’s posture when being interviewed, and the tone of the voice (Gone, 2014). This implies that clinical interview assessment can be best conducted through face to face conversation with the client rather than using phone call or online interviewing.

Personality assessment is another clinical and counseling assessment that is used by the psychologists to diagnose patients with psychological problems. Personality assessment is a form of a questionnaire designed to display individual’s psychological makeup (Ryder et al, 2011). The questionnaire has different specific questions aimed to reveal particular information about the patient. A personality test can for example ask the patient to rate the degree of his understanding or agreement with a particular claim. The response score shows the level of psychology disturbance the patient has gone through. For example when a particular patient who has gone through marital violence by the spouses is asked if she/she would get married again; the answer to this question would reveal the degree psychological trauma the patient might have gone through in the past. Thus, the psychologist would actually know how to treat the patient since he would unders6tand the level of destruction the patient would have gone through. Thus, personality assessment is one of the reliable clinical psychology assessments that most psychologists use to diagnose the problems their patients are suffering from.

The trends towards cultural and clinical psychology have emerged in that most psychologists are following them when diagnosing and treating patients. It important for psychologists to understand the trends in this filed since tin their caree5r, they would be dealing with different patients from different cultural backgrounds. Patients from different cultural backgrounds cannot be effectively diagnosed and treated in using similar assessment technique. Therefore, the psychologists need to broadly understand the cultural and historical aspect of the specific clients for them to accurately interpret the problems they would be suffering from

. One of the notable trends in the cultural and clinical psychology is that the psychologists are aiming to measure culture in a multi-method. They capture some of the complexities of certain cultures. Patients from one particular culture can easily be diagnosed and treated in similar ways because of the similarity in historical and cultural aspects. Therefore, psychologists are applying multi-methods in diagnosing different patients and the method chosen suit patients from specific cultures.

Secondly, psychologists in cultural and clinical psychology are paying attention to cultural scripts rather than assuming the cultural context of the patients is not important. Initially, the psychologists neglected the patients’ cultures when diagnosing and treating those (Gone, 2014). However, the modern psychologists are considering the cultural identity of every patient because they now understand that culture plays a central role in an individual’s life hence, knowing the culture of a patient can easily enable the psychologists to identify the problem and administer an appropriate treatment.

Another trend that is seen in the current cultural and clinical psychology is that psychologists are treating patients basing on the study by study on how each cultural group is defined. Ryder et al (2011) state that nowadays major cultural groups have been studied and the assessment s for each group are now known. Gone, (2014) noted that psychologists just identify the specific cultural group where the patient belongs and then applies the appropriate treatment s identified with that particular cultural group. They no longer struggle to administer different assessment since they know well that a particular cultural group can be treated with certain kind of treatment.

Clinical Work

Technical eclecticism is a type of integration psychotherapy that designed in a manner that tent to improve psychotherapists’ ability to select the best treatments for the patients. The selection process using this type of psychotherapy is guided by primary data that has proved to work on certain patients in the past. Thus, the psychotherapist identifies certain methods that have the history of working on some patients pools them together and applies to the treatment of another patient. Assimilative integration approach is a kind of integration psychotherapy approach where the psychotherapist the theatrical orientation the that act as their foundation of the process where they have good experience and makes an effort of incorporating other ideas and strategies that suit the patient’s situation. Most Psychotherapists are increase applying this approach because they prefer the security of one foundation theory. Theatrical integration on the other hand is the a type of integration psychotherapy where two or more therapies are integrated with the hope that the results would be great given the fact that each of the therapy has successfully work on other patients.

Clinical psychology is a branch of psychology that deals with the provision of comprehensive and continuous behavioral and mental healthcare services for communities, families and individuals within the confines of an evidence-based practice. The causes of mental illnesses are unknown, however, several factors are known to predispose, precipitate, or prolong the course of mental diseases. Most mental illnesses are caused by interplays between genetic, physical, and environmental factors. Clinical psychology currently pays a significant role in the management of psychological and behavioral problems (Hage et al., 2011). The scientific field is based on the integration of scientific theory and practice for the purpose of comprehending, controlling and preventing psychological disorders and enhances a general mental wellbeing. Central to the practice of clinical and counseling psychology are the concepts of psychotherapy, clinical work and formulations as well as psychological assessment. The psychological assessment enables the clinical psychologists to develop an impression of the mental problem and plan for interventional clinical work.

Historical background

The earliest approaches in clinical psychology particularly regarding the assessment and management of psychological disorders were a blend of medical, magical, and religious strategies. In the past, mentally disturbed people were excommunicated from the society, restrained or considered as outcasts. Many religious groups considered mental illnesses as a form of demon possession that could only be managed through special prayers (Rivera et al., 2007). The management of such people involved chaining them in isolated places or even excommunicating them from the society. The management of mentally people changed considerably during the scientific stage. By the early 19th century, most mental health practitioners had adapted the use of phrenology to assess behavior and mental status of individuals by examining the skull shape to predict personality. Some of the theorists that advanced the practices were Rumi, Avicenna and Rhazes.

Other forms of treatment that took centre stage in clinical psychology at the time included physiognomy that involved the examination of the shape of the face, and mesmerism that focused on the use of magnets to treat mental conditions. The aforementioned strategies were then preceded by spiritualism. All the above strategies were eventually rejected at the wake of scientific advancements (Norcross, 2005). The scientific community was largely accepted as they were able to explain certain concepts that could not be explained by the conventional methods. By mid 20th century clinical psychology was already being practiced by the neurologists and psychiatrists at the time within the confines of asylum movement. The first application of scientific clinical psychology was adapted towards the close of the 19th century during the era of Sigmund Freud.

Technical eclecticism, assimilative integration and theoretical integration

There are three broad categories of psychotherapy integration, that is, technical eclecticism, assimilative integration and theoretical integrations. One variant of the assimilative integration is technical eclecticism. The practitioners who apply the approach are broadly referred to as eclectics. The assimilative integration strategy adopts a solid footing in a particular theory accompanied by the move to incorporate other therapeutic techniques and approaches (Lampropoulous, 2001). The same form of diversity is seen in technical eclecticism but devoid of a binding theoretical basis. One of the relevant strategies of assimilative integration is the psychodynamic approach that enables the clinicians to predict the course of treatment of psychological illnesses. Another sort of a two-chair technique under the assimilative integration is the occasional humanistic and the cognitive behavioral approaches. The approaches account for an easy flow of psychological set of interventions.

The seamless approach ensures that the clients does not understand the process of integration but rather enjoys the consistency of the approach in their management. Technical eclecticism is an integrative approach that is designed to enhance the ability of the clinical psychologists to pick on the best possible treatment for a particular individual with a specific psychological problem (American Psychological Association, 2014). The advantage of the approach is that it promotes the utilization of diverse approaches in managing psychological problems devoid of the theoretical hindrances. One misgiving of the strategy is that there lacks a precise conceptual framework to explain how the approaches from the divergent theories may conflict. The theoretical integration is the most complex level of psychotherapy integration because it blends diverse theories from fundamentally differing world views unlike the assimilative psychotherapy. Winokur and Messer attempted to decipher through the approach but latter characterized it as a comic behavioral approach.

Pros and Cons for Each Perspective

  Advantages Disadvantages
Technical eclecticism -Does not restrict to one perspective hence allows new ideas-It seeks to treat the entire disorder rather than one symptom-The strengths of one technique can easily offset the weakness of the other technique It does not allow the prediction and behavior control hence rigid-it does not allow hypothesis testing-It a bit difficult to identity specific contribution for each method used.
Assimilative integration -It allows therapists to continue practicing in the their preferred framework of their theoretical orientation-It offers the much required framework that guide practiceOne can change the peripheral ideas and opinions to include new ones -Danger of increased number of psychotherapies —
Theoretical integration. -It is a comprehensive approach that when applied successful, it gives a new framework that helps in treating complex problems. -It is too pragmatic -It is the most difficult since its requires integration of theoretical concepts from various approaches.

Trends in psychotherapy integration

The six primary trends that have been proposed in psychotherapy include; cultural considerations and the integration of diversity into psychotherapy, the integration of neuroscience and biological concepts, the increase in psychological reviews that are more specific and integrative, the heightened efforts in the integration of clinical practice and research, the increased attention on theoretical integration, as well as the increased integration of therapeutic techniques and their relationship (Gelso, 2011). Roy’s model of adaptation is significant to this study as it helps the care givers understand how best they could help the schizophrenic patients to effectively adapt to their environment.

Illness and health are viewed as inevitable aspects of human’s life. To respond effectively to the changing environment, then humans must adapt depending on the environmental stimuli and his or her adaptation level. The four modes of adaptations are the self-concept, physiological needs, inter-dependence, and role function. The most significant trend in psychotherapy integration was the emphasis on context. The most appreciated personality traits such as forgiveness, compassion and being mindful of others are rather counterproductive in particular instances (Gelso, 2011). The negative emotions that are not valued such as anger, envy and guilt are the factors that ought to be expressed and experienced for best possible clinical outcomes. Studies on the negative and positive emotions allowed the comprehension and appreciation of the full spectrum of human personality.


Clinical psychology plays a significant role in the prevention of psychological problems. With the increasing burden of psychological disorder and the treatment limitations of the same, the most significant way of minimizing the burden is through preventive psychology. Biological, behavioral and social sciences provide great insight into the protective factors and the role of the risk factors in the developmental pathways of psychological disorders (Conyne et al., 2013). Most of the factors are potential targets and malleable for prevention psychology. The implementation of evidence-based strategies and policies is central to the implementation of preventive psychology. Prevention psychology should be integrated within the community approach policy within the confines of a horizontal action across diverse sectors. State and international initiatives are significant in enhancing prevention awareness and developing appropriate policies to respond to psychological needs.


American Psychological Association. (2014). Guidelines for prevention in psychology. American Psychologist, 69(3), 285-296. doi:10.1037/a0034569

Conyne, R. K., Horne, A. M., & Raczynski, K. A. (2013). Prevention in psychology: An introduction to the prevention practice kit. Thousand Oaks, Calif: SAGE Publications.

Gelso, C. J. (2011). Emerging and continuing trends in psychotherapy: Views from an editor’s eye. Psychotherapy, 48(2), 182-187. doi:10.1037/a0023448

Hage, S. M., Romano, J. L., Conyne, R. K., Kenny, M., Schwartz, J. P., & Waldo, M. (2007). Walking the talk: Implementing the prevention guidelines and transforming the profession of psychology. The Counseling Psychologist, 35(4), 594-604. doi:10.1177/0011000006297158

Lampropoulos, G. K. (2001). Bridging technical eclecticism and theoretical integration: Assimilative integration. Journal Of Psychotherapy Integration, 11(1), 5-19. doi:10.1023/A:1026672807119

Norcross, J. C., Karpiak, C. P., & Lister, K. M. (2005). What’s an integrationist? A study of self-identified integrative and (occasionally) eclectic psychologists. Journal of Clinical Psychology, 61(12), 1587-1594. doi:10.1002/jclp.20203

Rivera-Mosquera, E., Dowd, E. T., & Mitchell-Blanks, M. (2007). Prevention activities in professional psychology: A reaction to the prevention guidelines. The Counseling Psychologist, 35(4), 586-593. doi:10.1177/0011000006296160

Ryder, A. G., Ban, L. M., & Chentsova-Dutton, Y. E. (2011). Towards a cultural-clinical psychology. Social & Personality Psychology Compass, 5(12), 960-975. doi:10.1111/j.1751-9004.2011.00404.x