Attached.

Running Head: CLINICAL PSYCHOLOGY

CLINICAL PSYCHOLOGY
Student’s Name:
Course Name & Number:
Professor’s Name:
Date of Submission:

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CLINICAL PSYCHOLOGY

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Overview of the Research Topic – Clinical Psychology
Clinical psychology specializes in continuous and comprehensive behavioral and mental
health care for individuals, families, and communities. The field also provides consulting
services to agencies that offer training, education, supervision for the case of research-based
practices. In a broad spectrum, the area is also inclusive of severe psychopathology, in which
professionals deploy comprehensive knowledge and skills from a wide array of disciplines to
handle complex human problems. In a nutshell, both theoretical and scientific knowledge in this
specialty focus on understanding psychopathology and diagnostic interventions. Clinical
psychologists deal more especially with mental issues affecting humankind across their lifetime.
In practice, they assess any given condition by integrating and synthesizing personality test data
with the existing standardized measures of assessment. In an unusual situation, these
professionals are mandated to consult one another concerning maybe, severe psychopathology,
violence or suicide. Besides that, they also engage in continuous specific research and critical
review of scientific knowledge and methods that pertain to distinct areas in clinical psychology.
Some of the health issues that clinical psychology usually tackle include; disability and
discomfort, emotional, intellectual, social, psychological and behavioral imbalances. They also
extend their scope to severe psychopathology. Many scholars as yet to be disclosed in this paper
have comprehensive but similar information regarding clinical psychology. This writing will,
therefore, give highlights on the information existing about the field at hand, as reported by
scientific researchers.
In his journal, Trzebińska (2017) focuses on the need for integration in clinical
psychology. He clearly distinguishes good mental health from psychopathology. These two
differ from one another with respect to diagnosis procedure and interventions. Despite the

CLINICAL PSYCHOLOGY

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existence of this variation, psychotherapy as a form of intervention is almost similar for the two.
However, Trzebińska (2017) argues that there are hundreds of methods of intervention with each
of them focusing on specific concepts and problems while overlooking all the rest. Integrative
approach as one of the latest responses in psychotherapy aims to identify the most effective and
efficient agents of therapeutic movement and to offer adequate principles to incorporate them
into various methods and even have them combined in complementary ways that are applicable
in latest psychotherapy approaches. According to Trzebińska (2017), integration in
psychotherapy involves encompassing many methods into one convergent approach by seeking
conceptualizations that lead to a systemic combination of skills from a number of techniques.
The primary of the concept of integration is to achieve unified psychotherapy which is applied in
the universal methods from psychopathology and treatment.
On the grounds of emotional health as one of the critical areas in clinical psychology,
Trzebińska (2017) claims that the integration of psychotherapy is an expansive movement in the
clinical field that has come with a significant impact on developing concrete solutions towards
human health problems. Most of the practical scientific achievements in the domain of clinical
psychology focus on human emotions, and for this reason, then, there are sufficient reasons to
address every issue about emotional health. Trzebińska (2017) asserts that emotions play a
prominent role in both the mental and physical health of an individual. Mental state originates
from a complex allostatic brain system which ensures there is an appropriate response to
opportunities and financial demands encompassed in a variety of psychological and physical
changes. Emotions, on the other hand, are a result of the brain response to a positive or negative
stimulus. They also relate to the achievement of both social and personal goals since they reflect
either failure or success or both at the same time. In general, Trzebińska (2017) focuses on

CLINICAL PSYCHOLOGY

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ongoing research and knowledge advancement in assessing, diagnosing, treating, and preventing
psychotic disorders among human beings.
Aside from clinical health, another group of authors, Dimoff et al. (2017) discuss the
concept of clinical psychology from the perspective of addition which is currently emerging as a
severe health crisis in public. Dimoff et al. (2017) argue that clinical psychology is well-tailored
to provide multifaceted management and treatment of people struggling with disorders
associated with substance abuse. In their study, this group of researchers surveyed all the
American accredited APA clinical programs from 1999 to 2013. The primary objective of the
survey was to investigate all the existing information regarding addiction and how best to
manage it. The team found out most of the Americans are addicted to alcohol and illegal drugs
including heroin, cocaine, most of all marijuana. According to the Centers for Diseases Control
and Prevention, up to 47, 200 Americans engaged in addictive drug abuse in 2014 along.
Additionally, the trend has been rising gradually. Following the shocking research
outcomes, the only hope of reviving such addicts and potential drugs abusers a clinical
intervention program which involves enhancing understanding, assessment, treatment, and
prevention of addiction. Dimoff et al. (2017) conclude that clinical psychology is well suited for
contributing to this effort. Clinical psychologists are equipped with technical knowledge and
evidence-based practice to handle cases of addiction; however severe they may be. Psychologists
emphasize strong self-help along with along clinical therapies for treating addicted individuals.
Generally, the authors of this material emphasize the prominent role that clinical psychology
plays in handling addiction.
In addition to the former researchers of clinical psychology, Waters et al. (2017) discuss
experimental psychopathology in various forms and how such structures have contributed to the

CLINICAL PSYCHOLOGY

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continuous creation and updating of evidence-based psychology. They assert that clinical
psychology resonates about assessing and treating the behavioral and psychological disorder and
problems facing humankind. There is often a common belief that psychological dysfunction is
not fully reversible, but the frameworks that guide clinical psychopathology and its integration
outdo the commonality. Combining various methods into convergent or complementary
psychotherapy yields practical results that have been experimented and reported to treat
individuals to the latter. In their review, Waters et al. (2017) concluded that there is a close
relationship between clinical psychology and experimental psychopathology. In that regard then,
they modeled a guide that integrates experimental psychopathology as an area of informed
science into the clinical practice by demonstrating the underlying relevance.
In a broader view, Waters et al. (2017) define clinical psychology as the integration of
theoretical as well as practical science with the aim of understanding and alleviating discomfort
and seek to promote human adjustment and adaptation as well personal development. With
functional utility as opposed to basic psychology, clinical psychology, especially in the context
of the American Psychological Association focus on answering pressing public problems
associated with mental health. In this pursuit, Waters et al. (2017) indicate that experimental
psychopathology bridges the gap between research in basic psychology and applied areas of
psychology. Collectively, this integration will yield a better framework for handling not only the
primary but also severe mental and behavioral disorders affecting humankind.

CLINICAL PSYCHOLOGY
List of References
Dimoff, J. D., Sayette, M. A., & Norcross, J. C. (2017). Addiction training in clinical
psychology: Are we keeping up with the rising epidemic? American Psychologist, 72(7),
689.
Trzebińska, E. (2017). Emotional health: on the applicability of affective science to the
integration of clinical psychology. Current Issues in Personality Psychology, 5(3), 172182
Waters, A. M., LeBeau, R. T., & Craske, M. G. (2017). Experimental psychopathology and
clinical psychology: An integrative model to guide clinical science and
practice. Psychopathology Review, 4(2), 112-128.

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current issues in personality psychology · volume 5(3), 7
doi: https://doi.org/10.5114/cipp.2017.70145

review paper

Emotional health: on the applicability of affective
science to the integration of clinical psychology
Ewa Trzebińska E,F,G
University of Social Sciences and Humanities, Warsaw, Poland

The aim of the article is to outline the concept of emotional health and its integrative potential in the field of
clinical psychology. It is a well-known fact that the transdiagnostic approach and psychotherapy integration – the
two most influential integrative movements in clinical psychology – search for a sound conceptual foundation of the
efforts to organize a plethora of theories and data relating
to the psychological aspects of physical and mental health.
Following a short presentation of general discrepancies af-

flicting clinical psychology and the main ideas of both the
transdiagnostic approach and psychotherapy integration,
the notion of emotional health is introduced and its unifying convenience, as well as limitations, is discussed.

key words
emotions; transdiagnostic processes; psychotherapy integration

corresponding author – Prof. Ewa Trzebińska, SWPS University of Social Sciences and Humanities,
19/31 Chodakowska Str., 03-815 Warsaw, Poland, e-mail: ewa.trzebinska@swps.edu.pl
authors’ contribution – A: Study design · B: Data collection · C: Statistical analysis · D: Data interpretation ·
E: Manuscript preparation · F: Literature search · G: Funds collection
to cite this article – Trzebińska, E. (2017). Emotional health: on the applicability of affective science to the integration
of clinical psychology. Current Issues in Personality Psychology, 5(3), 172–182.
received 19.05.2017 · reviewed 03.07.2017 · accepted 13.07.2017 · published 22.09.2017

Ewa Trzebińska

The need for integration
in clinical psychology
The dispersion within the area of clinical psychology has several facets. The most fundamental among
them is the well-established view of mental health
that separates psychopathology and good mental
health as two qualitatively different aspects of human functioning, with distinctive procedures of diagnosis and intervention involving mental disorders
and well-being. Additionally, according to the traditional classification based on symptoms and exact
thresholds of psychopathology, various mental disorders are also viewed as totally independent entities,
despite the fact that they share symptoms, co-occur,
rarely appear in entirely “pure” forms, and the same
interventions are effective for many of them (Kring &
Mote, 2016). Since mental disorders are diagnosed on
the basis of the occurrence of a relatively small part of
the clusters of assigned symptoms, great variance of
diagnosed disorders is observed, i.e. patients presenting quite different sets of functional abnormalities
receive the same diagnosis (Eaton, Rodriguez-Seijas,
Carragher, & Krueger, 2015). On the other hand, due
to the lack of continuity in the functional normality
versus abnormality concept, persons with functional
abnormalities which are only slightly above the psychopathology threshold are diagnosed with mental
disorders regardless of their apparent similarity to
those categorized as healthy.
The other integration problems are the more or
less remote consequences of the first one. There is
a gap between diagnosis and therapy, because disorder oriented diagnosis has little use for interventions intended for causal improvement. The empirically supported treatment approach (EST) multiplies
treatment protocols because, according to the rules,
there is an obligation to prepare specific protocols for each treatment and each disorder involved
(Laska, Gurman, & Wampold, 2014). These two core
assumptions, about treatment specificity and disorder specificity, cause the EST paradigm to generate
a multitude of separate protocols, despite the fact
that treatments targeting different mechanisms of
change together can be more efficacious in curing
multi-symptom conditions than each of them alone,
and that the treatment for a particular symptom can
also be effective in curing different disorders sharing that symptom. The communication between
psychological science and clinical practice is weak,
as research is concerned with explaining functional
deficiency and well-being, while diagnosis and therapy are concerned mainly with symptoms and mental
disorders. Psychology of mental and physical health
are quite remote fields, regardless of the commonalities in the etiology of both kinds of health problems
and their ubiquitous co-occurrence. Mental health

is analyzed predominantly as psychopathological
symptoms and classified disorders, while the psychological aspects of physical health are analyzed at
the level of the involved processes. Similarly, youth
and adult health problems are different areas of clinical theory and practice, despite common underlying
factors and their continuality across the life span. In
the effort to break through these problems, two wellknown integrative movements in clinical psychology
emerged: the transdiagnostic approach and psychotherapy integration.

Transdiagnostic approach
The primary aim of the transdiagnostic approach is to
overcome some of the clinical psychology divisions
by loosening the rigid rules of the traditional categorization of mental disorders. That aim is achieved
by shifting the focus from mental disorders as separate entities to common processes across different
disorders that serve to maintain or worsen their
symptoms. That new diagnostic perspective can reduce the problem of comorbidity of traditionally diagnosed disorders and inform interventions towards
health processes, i.e. the causes of malfunctioning
or well-being, no matter whether they involve the
body or the mind. The very first account of identifying commonalities between disorders was the
well-known dimensions of exteriorization and internalization (Achenbach & Edelbrock, 1978), which
turned out to differentiate two broad categories of
psychopathology. That model of two transdiagnostic factors evolved over time into three-factor models (Eaton, Rodriguez-Seijas, Carragher, & Krueger,
2015). One of them includes externalization, internalization and a new factor of psychosis, while another
contains externalization and two new factors originating from internalization: fear and distress. Subsequently, numerous other common psychopathology
factors were proposed (Harvey, Watkins, Mansell,
& Shafran, 2004) in cognitive processes (such as disruptions in attention, memory and reasoning) and in
behavior (such as avoidance or sexual dysfunctions).
As the number and heterogeneity of transdiagnostic factors is still growing, there emerge integrative
models explaining their interconnections and specific roles on different paths towards psychopathology,
e.g. the categorization of transdiagnostic factors into
distal and proximal causes of symptoms, and moderators between proximal causes and symptoms (Nolen-Hoeksema & Watkins, 2011).
The recent advance in transdiagnostic classification is the Research Domain Criteria (RDoC), a research framework created by the US National Institute of Mental Health as a “road map” intended
to guide a summary of already available data and
further systematic investigation in neuroscience,

volume 5(3),  173

Emotional health

genetics and psychology, on neurobiological, psychological and behavioral mechanisms that underlie
real facts of malfunctioning, including psychopathological symptoms, rather than the made-up categories of mental disorders (Cuthbert, 2014). The RDoC
approach promotes multiple units of analysis (including genes, molecules, cells, circuits, physiology,
behavior and self-report), across the domains of: (1)
negative valence systems, (2) positive valence systems, (3) cognitive systems, (4) social processes, and
(5) arousal/regulatory systems. As additional variables, the social and developmental phenomena are
recommended to be included in the studies’ agenda.
That research strategy assumes dimensional nature
of mental health with a full range of variation, from
normal to abnormal facts about fundamental mental health components (i.e. typical versus bizarre), as
well as equal importance of all the units and domains
of analysis.
Besides the broad appreciation for systemic and
consequent transdiagnostic position, the RDoC is
criticized for the inadequacy of the list of domains
of transdiagnostic factors, which overlap at the level
of units (e.g. brain circuits) and are incomplete (e.g.
lacking in the domain of dispositional traits), for
fragmentation of analysis into separate units and domains without any rules how to synthesize the data
into a comprehensive picture of mechanisms underlying the symptoms, for an ambiguous relationship
between the proposed new paradigm and the old one,
for the lack of precise definitions of domains and included variables, and for leaving out physical health
problems (Kring & Mote, 2016; Watson, Stanton, &
Clark, 2016). Those defending the RDoC argue that
the most innovative and promising part of the project is the idea of multidisciplinary study identifying
in detail real mental health phenomena, so the possibility to alternate the RDoC matrix of domains and
units, e.g. to redefine the already included elements
or add new ones, is entirely open (Cuthbert, 2014).

Psychotherapy integration
The movement of psychotherapy integration is a reaction to the emergence of hundreds of different
psychotherapy methods. Any particular method is
naturally focused on the limited scope of concepts
and problems, and neglects other. Thus, it seems
reasonable to exchange between methods some useful ideas and techniques. The aim of the integrative
approach is then to strengthen the practice of psychotherapy by identifying the most efficient agents
of therapeutic improvement and providing the adequate principles of incorporating them into different
methods and even eventually combining convergent
or complementary methods into new psychotherapy
systems. Integration in psychotherapy can be traced

174 current issues in personality psychology

back to the 1930s, since when bridges between psychoanalysis and behavior therapy have been sought,
subsequently encompassing many other methods and
approaches. It has changed from the eclectic use of
techniques belonging to different methods, through
searching for conceptualizations that can guide
a more systematic and theoretically grounded combination of techniques from different methods, to the
most advanced goal of unifying psychotherapy into
universal models based on the general theory of psychopathology, treatment and change (Fernández-Álvarez, Consoli, & Gómez, 2016).
However, after dismissing technical eclecticism
as too messy and disappointment with general theories of psychotherapy as always not comprehensive
enough, currently the most promising solution seems
to be the common factors approach, which relies
on empirically identified aspects of psychotherapy
shared by all methods that explain therapeutic improvement (Laska, Gurman, & Wampold, 2014). Despite vital diversity in theories of mental health and
treatment, all methods of psychotherapy are proven
to be efficient and in that respect close enough, which
means that their effects result more from their commonalties than specificity. A variety of factors, such
as catharsis, advice, cognitive mastery, exposure to
critical emotional experience, feedback, insight, reassurance, mitigation of isolation, success experiences,
therapeutic alliance, therapist’s expertise, trust, variety of affective experiencing, new emotional experiences, empathy, confronting and resolving emotional
ambivalence have been empirically identified as potentially common, curative aspects of psychotherapy (Laska, Gurman, & Wampold 2014; Brown, 2015).
Although the reality of common factors in psychotherapy as well as their restorative impact seems
unquestionable on the basis of empirical data, which
satisfies the EST’s requirements, as critics argue, the
common factors approach needs serious conceptual
integrative work itself because the catalog of common curative aspects of psychotherapy is too extended and profoundly inconsistent at the theoretical level (Lambert & Ogles, 2014).

Emotional health
The transdiagnostic approach and the integration
of psychotherapy are expansive professional movements and have a significant impact on the development of concrete practical solutions as well as on the
overall handling and understanding of health problems at the theoretical and scientific ground. As they
originated in different fields of clinical practice, they
have been expanding rather independently so far,
but the need for their alliance is becoming evident,
which can be seen in the example of some practical
junctions such as the emergence of various “unified

Ewa Trzebińska

treatment protocols” (Laska, Gurman, & Wampold,
2014). Since both the transdiagnostic approach and
integration of psychotherapy are concerned with
health-related interpersonal and psychological processes, the fusion of their objectives could benefit
from a common theoretical model of those processes.
While no general theory of mind is available at the
present time, the medium-range concepts can be of
use. As affective processes constitute a large part of
transdiagnostic factors and common psychotherapy factors, the notion of emotional health comes to
mind (Trzebińska, 2012).
Affective science is a field of multidisciplinary
study of all possible forms of affective phenomena
and explains them at psychological, physiological,
neural, and genetic levels of the human organism
in the effort to gain a consistent perspective on the
specificity of the affective appraisal. A large part of
affective science achievements focuses on emotions,
i.e. the most comprehensive form of affective appraisal, a phenomenon whose adaptivity determines
human mental and physical wellness to a great extent. Taken together, these data can form a concept
of emotional health.
There are several reasons to address the concept
of emotional health in the context of integration
within the domain of clinical psychology. First, emotions play a prominent role in practically all mental
and physical processes. They are emergent mental
states which arise from the activity of the complex
allostatic brain system facilitating the most appropriate response to the momentary demands and opportunities, composed as sets of various bodily and
mental changes. Emotion starts with a core affect
– the brain response to a salient negative or positive stimulus – which is the basic building block
of emotional processing (Genzel, Rarick, & Morris,
2016), followed by the crucial substrate of the feeling, i.e. a conscious experience of emotion (Barrett,
2005). The core affect is accompanied by physiological, psychological and behavioral components organized into a coherent and complete whole, partly by
situational circumstances, partly by innate affective
programs, and partly by cultural concepts of emotions (Clore & Robinson, 2012). The affective workspace system in the brain, which is viewed as the
generator of the core affect, appears to be connected
to all other networks in the brain; therefore emotions engage countless non-emotional psychological
processes and thus are considered to be primary to
the entire mental activity (Clark-Polner, Wager, Satpute, & Barrett, 2016), and to determine health by
shaping physiological responses, guiding health-related knowledge, attitudes, decisions and behavior
(DeSteno, Gross, & Kubzansky, 2013; Tryon, 2016).
Accordingly, the most effective strategy of initiating
major improvement in a person’s functioning with
respect to health seems to be the correction of faulty

emotional processing first (Trzebińska, 1998; Epstein
& Epstein, 2016; Hofmann, 2016).
Second, emotions are highly functional, but can
also be dysfunctional. Emotions relate to attainment
of personal and social goals as they reflect successes, failures or anticipations of both, and motivate
a person to change or maintain relations between the
organism and the environment depending on their
meaning for the goals’ achievement (Thompson &
Winer, 2013; Fisher & Manstead, 2016). From that
point of view emotions may be seen as states of action readiness (Frijda, 2008), but they influence functioning indirectly via information more often than
directly via behavioral activation (Clore & Robinson,
2012). Particular emotions (such as fear, sadness, joy,
shame, pride, nostalgia) arise in specific circumstances for the sake of specific adaptive purposes. However, in the case of inadequate emotional generation or
emotional regulation, resulting emotional states can
cause suboptimal action or harm (Frijda, 2008).
Third, the level of emotional maturity allows one
to predict health problems and thus set goals and
procedures of psychological prevention or intervention. The character of emotional processing changes
during the life span. There is a firm genetic base of affectivity, mainly in reactivity to signs of threat (negative affectivity) and signs of reward (positive affectivity) which, together with cognitive development, real
life emotional experiences and social training, form
a personal style of emotional functioning (McAdams,
2016). The human baby has an inborn capacity for
several types of elementary affective responses to
universal problems concerning survival and nurture
– called action patterns or, more traditionally, primary emotions – but growing cognitive abilities and
social training allow for the widening of emotional
processing and increasingly experiencing more complex emotions and a more diverse scope of emotions
(Lewis, 2016). As emotional life becomes more mature in that sense, its functions expand and are performed more effectively; thus the person grows to be
more and more emotionally competent, which promotes happiness and flourishing. On the other hand,
emotional shortcomings resulting in lowering of any
aspect of the quality of life are omnipresent in all categories of psychopathology and underlie a number of
medical conditions. Since there is an apparent genetic contribution to the potential for emotional maturation (Nikolova, Davis, & Hariri, 2016), the genetic
background of emotional processing can, to some extent, explain the heritability of mental and physical
health problems, and a certain emotional deficiency
can limit the scale of cure. On the other hand, the
principles of emotional development through social learning and emotional training can explain the
health problems in the context of familial factors and
life events, and can be applied in psychological diagnosis and interventions.

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Emotional health

Fourth, the plasticity of emotional processing allows one to improve health through the procedures
of emotion modification. Emotional processi...