1 Advanced Issues: One giant Critical Thinking Moment

2 Being a Consumer of Psychotherapy Selecting a Psychotherapist: Issues and Considerations

3 of 22 Reviewing the Homework California Board of Psychology: consumer guide Trull: p Humphreys: Clinical psychologists… (article)

4 of 22 Being Selective Shopping for therapists Important decision about with whom you work Remember the issue of being critical How does this impact our decision? What would being critical look like in this situation? Could it be we can work with someone we are not initially comfortable with? How can we be critical about this?

5 of 22 What Do We Look For? All of what we have been talking about over the semester Science, Art, and Philosophy The science of clinical psychology How important is it to the client Role of science in assessment Role of the art of therapy Role of the therapist’s and client’s philosophy of what treatment is

6 of 22 Training What is the training of the psychologist (Masters, Ph.D.) Does this matter? When does it matter? What are the specializations/limitations of this training for the client?

7 of 22 The Main Ingredients of Psychotherapy Interventions Ingredients that cut across therapy for all clients Is the therapy Specifiable? Plausible? Replicable? Were they trained in this therapy?

8 of 22 Assessment Is the therapy based on some assessment Is the assessment thorough enough to do a treatment? Is the assessment tied to treatment? Is the assessment on-going? Is there a targeted set of goals? Does the therapist share assessment data with the client? How will the client and therapist know when the treatment is complete?

9 of 22 Models and Paradigms Choice of model of therapy is up to the client and match to the therapist Some data indicate that certain therapies have more support than others for outcome Match may or may not actually matter How much does experience matter? Compassion, active focus may be essential

10 of 22 The Science in Practice Empirically Supported Treatments and Evidenced Based Practice Some therapies have good data to suggest this is where to start Identify specific problems Is the therapist up on the empirical literature? Does this matter in this case?

11 of 22 Medications and Psychotherapy Consideration of medication as Not involved Adjunctively involved Only mode of therapeutic intervention

12 of 22 Cultural Context Variables Does the therapist have an understanding of the client as an individual? Is the therapist sensitive to issues of Culture/Ethnicity? Gender? Sexual orientation? Is the therapist using stereotypes of cultures to understand this client with these problems?

13 of 22 Ethics of Good Treatment Client needs to know his or her rights in therapy Client needs to know what limitations are of therapist Client needs to know what limitations are for confidentiality

14 of 22 Remember the Paul Question "What treatment, by whom, is most effective for this individual with that specific problem, under which set of circumstances, and how does it come about?" (Paul, 1969, p. 44). How can we apply this to ourselves or others selecting a psychotherapist and/or a treatment?

15 The Future of Clinical Psychology Where the heck are we going?

16 of 22 The Future of the Field Again, being critical What do we consider when we think about the future of the field? Have we arrived? Remember presentism Is the sky falling? (C. Little, ca. 1900) Do we need to run?

17 of 22 Where the Field is (headed) Managed Behavioral Health Care Changing the face of clinical practice Why did this come into existence? Is this good or bad? What is going to happen from here?

18 of 22 Where the Field is (headed) Prescription Privileges Homework: DeLeon & Wiggins Prescription (article) DeNelsky The case against (article) Also known as part of the biologization of psychology Psychologists (PhDs) have the right in New Mexico and Louisiana

19 of 22 Where the Field is (headed) Prescription Privileges Definitely will change the face of clinical practice Why did this come into existence? Think about the contingencies of practice here Is this good or bad? What is going to happen from here?

20 of 22 Where the Field is (headed) Empirically Supported Treatments Many want only these trained and disseminated What will the consequences of this be? Why does this present challenges to the field? How does this relate to Evidence Based Practice?

21 of 22 Where the Field is (headed) Pathologization of everything Giving a name and disorder to many, many mood states Minor depression, Depressive Personality, Premenstrual Dysphoric Disorder, etc. Is this good or bad? Who wins on this? Who loses? How does this benefit the field of psychology? What are the roots of a science of behavior? A science of psychology?

22 of 22 You Are the Future Future mental health service providers, researchers, consumers of service YOU will make the difference Remember the role of consensus This is on your side Remember the importance of theory It’s your field! GO and make a difference!