Significant Dates and Events in the
History of Clinical Psychology
Wilhelm Wundt establishes first formal psychology laboratory at the
University of Leipzig.
Sir Francis Galton establishes first mental testing center at the South
Kensington Museum, London.
1890 James McKeen Cattell coins the term mental test.
1892 American Psychological Association (APA) founded.
1895 Breuer and Freud publish Studies in Hysteria.
Lightner Witmer founds first psychological clinic, University of
1905 Binet-Simon Intelligence Scale published in France.
1907 Witmer founds first clinical journal, The Psychological Clinic.
1908 First clinical internship offered at Vineland Training School.
William Healy founds first child-guidance center, the Juvenile
Psychopathic Institute, Chicago.
Freud lectures at Clark University.
Goddard's English translation of the 1908 revision of the Binet-Simon
Intelligence Scale published.
1912 J.B. Watson publishes Psychology as a Behaviorist Views It.
1916 Terman's Stanford-Binet Intelligence Test published.
Clinicians break away from APA to form American Association of
Clinical Psychology (AACP).
1919 AACP rejoins APA as its clinical section.
1920 Watson and Rayner demonstrate that a child's fear can be learned.
1921 James McKeen Cattell forms Psychological Corporation.
1924 Mary Cover Jones employs learning principles to remove children's fears.
1931 Clinical section of APA appoints committee on training standards.
1935 Thematic Apperception Test (TAT) published.
Clinical section of APA breaks away to form American Association for
Applied Psychology (AAAP).
1938 First Buros Mental Measurement Yearbook published.
1939 Wechsler-Bellevue Intelligence Test published.
Carl Rogers publishes Counseling and Psychotherapy, outlining an
alternative to psychodynamic therapy.
1943 Minnesota Multiphasic Personality Inventory (MMPI) published.
1945 AAAP rejoins APA.
Journal of Clinical Psychology published.
Connecticut State Board of Examiners in Psychology issues first
certificate to practice psychology.
Veterans Administration and National Institute of Mental Health begin
support for training of clinical psychologists.
1947 American Board of Examiners in Professional Psychology organized.
Shakow Report recommends clinical training standards to APA.
Colorado conference on training in clinical psychology convenes,
recommends “Boulder Model.”
APA publishes first standards for approved internships in clinical
American Psychiatric Association's Diagnostic and Statistical Manual
1953 APA's Ethical Standards for Psychologists published.
1955 Wechsler Adult Intelligence Test published.
1956 Stanford Training Conference.
1958 Miami Training Conference.
Clinical Division of APA holds NIMH-sponsored conference about
research on psychotherapy.
1959 The first psychotherapy benefit in a prepaid insurance plan appears.
1965 Chicago Training Conference.
Psy.D. training program begins at the University of Illinois, Urbana1968
Second edition of DSM (DSM-II) published.
Committee on Health Insurance begins campaign to allow payment of
clinical psychologists' services by health insurance plans without requiring
1969 California School of Professional Psychology founded.
APA begins publication of the journal, Professional Psychology.
Department of Defense health insurance program authorizes payment of
clinical psychologists' services without medical referral.
Classes begin at California School of Professional Psychology, the first
independent clinical psychology training program in the United States
Council for the Advancement of Psychological Professions and Sciences,
a political advocacy group for clinical psychology, is organized.
Journal of Clinical Child Psychology published.
1972 Menninger Conference on Postdoctoral Education in Clinical Psychology.
1973 Vail, Colorado, Training Conference.
1974 National Register of Health Service Providers in Psychology established.
Federal government allows payment for clinical psychologists' services to
its employees without medical supervision or referral.
APA establishes Standards for Providers of Psychological Services.
First Inter-American Congress of Clinical Psychology held in Porto
All fifty U.S. states have certification or licensing laws for clinical
1980 Third edition of DSM (DSM-III) published.
Smith, Glass, and Miller publish The Benefits of Psychotherapy.
Blue Shield health insurance companies in Virginia successfully sued for
refusing to pay for clinical psychologists' services to people covered by
1981 APA publishes its revised Ethical Principles of Psychologists.
Joint Commission for the Accreditation of Hospitals allows clinical
psychologists to become members of hospital medical staffs.
1987 DSM-III-R published.
Conference on graduate education in psychology, Salt Lake City, Utah.
1988 American Psychological Society formed.
California Supreme Court affirms right of clinical psychologists to
1990 independently admit, diagnose, treat, and release mental patients without
Dick McFall publishes “Manifesto for a Science of Clinical Psychology.”
Commander John L. Sexton and Lt. Commander Morgan T. Sammons
1993 complete psychopharmacology program at Walter Reed Army Medical
Center, becoming first psychologists legally permitted to prescribe
1994 DSM-IV published.
Amendment to Social Security Act guarantees psychologists the right to
independent practice and payment for hospital services under Medicare.
Academy of Psychological Clinical Science is established.
APA task force of clinical psychologists publishes list of empirically
1995 validated psychological therapies and calls for students to be trained to use
Dorothy W. Cantor becomes first president of APA to hold the Psy.D.
rather than the Ph.D.
2000 DSM-IV-TR published.
New Mexico grants prescription privileges to specially trained clinical
2005 APA sponsors a Presidential Task Force on evidencebased practice.
Psychologists win a second settlement in two years in federal court
2006 alleging that managed care companies conspired to reduce and delay
provider payments in violation of federal law.
The U.S. House of Representatives passes legislation requiring mental
2008 health parity: The Paul Wellstone Mental Health and Addiction Equity Act
of 2007 .
2009 University of Illinois becomes the first PCSAS accredited program.
2013 DSM-5 published.
Introduction to Clinical Psychology
Geoffrey P. Kramer
Douglas A. Bernstein
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Library of Congress Cataloging-in-Publication Data
Kramer, Geoffrey P.
Introduction to clinical psychology / Geoffrey P. Kramer, Douglas A. Bernstein,
Vicky Phares. — Eighth edition.
Includes bibliographical references and indexes.
ISBN 0-205-87185-2 (alk. paper)
1. Clinical psychology. I. Bernstein, Douglas A. II. Phares, Vicky. III. Title.
1. Preface vii
2. Acknowledgments viii
1. Section I Basic Concepts 1
1. Chapter 1 What Is Clinical Psychology? 1
1. An Overview of Clinical Psychology 2
2. Clinical Psychologists at Work 8
3. Clinical Psychology in the 21st Century 14
1. Chapter Summary 18
2. Chapter 2 Clinical Psychology’s Past and Present 22
1. The Roots of Clinical Psychology 22
2. Clinical Psychology Begins to Grow 29
3. The Major Approaches Develop 33
4. The Pros and Cons of Taking a Specific Approach 44
1. Chapter Summary 46
2. Section II Assessment 49
1. Chapter 3 Basic Features of Clinical Assessment 49
1. An Outline of the Assessment Process 50
2. The Goals of Clinical Assessment 54
3. Clinical Judgment and Decision Making 63
4. Psychometric Properties of Assessment Instruments 67
5. Other Factors Affecting Assessment Choices 70
6. Communicating Assessment Results 73
7. Ethical Considerations in Assessment 76
1. Chapter Summary 77
2. Chapter 4 Interviewing and Observation in Clinical Psychology 82
1. Clinical Interview Situations 82
2. Interview Structure 87
3. Stages in the Interview 91
4. Research on the Interview 97
5. Observational Assessment: Goals and Benefits 100
6. Observational Assessment: Approaches 102
7. Research on Observational Assessment 108
1. Chapter Summary 110
3. Chapter 5 Testing in Clinical Psychology 116
1. Basic Concepts in Psychological Testing 116
2. Cultural Fairness and Bias in Psychological Tests 122
3. Tests of Intellectual Functioning 124
4. Tests of Attitudes, Interests, Preferences, and Values 131
5. Tests of Psychopathology and Personality 132
6. The Current Status of Psychological Testing 142
7. The Future of Psychological Testing 144
1. Chapter Summary 144
3. Section III Clinical Interventions 151
1. Chapter 6 Basic Features of Clinical Interventions 151
1. Overview of Clinical Interventions 151
2. The Participants in Psychotherapy 153
3. The Goals of Clinical Interventions 162
4. Ethical Guidelines for Clinical Interventions 164
5. Some Practical Aspects of Clinical Intervention 167
1. Chapter Summary 171
2. Chapter 7 Psychodynamic and Humanistic Psychotherapies 176
1. Psychoanalysis 176
2. Psychodynamic Psychotherapy 187
3. Humanistic Psychotherapy 193
4. Other Humanistic Approaches 200
1. Chapter Summary 204
3. Chapter 8 Behavioral and Cognitive-Behavior Psychotherapies 208
1. Behavior Therapy 208
2. Cognitive Therapy 218
3. Cognitive-Behavior Therapy 227
4. The Current Status of Cognitive-Behavior Therapy 232
1. Chapter Summary 232
4. Chapter 9 Other Modes of Clinical Intervention 236
1. Group Therapy 237
2. Couples and Family Therapy 240
3. Community Psychology 246
4. Prevention 247
5. Self-Help 250
6. Other Approaches 251
7. Technological Innovations Influencing Psychological Treatment
8. Psychotherapy Integration 256
1. Chapter Summary 257
5. Chapter 10 Research on Clinical Intervention 263
1. Studying Individual Psychological Treatments 264
2. Studying Other Modes of Intervention 274
3. Issues and Concerns About Research on Therapy 276
1. Chapter Summary 279
4. Section IV Some Clinical Specialties 284
1. Chapter 11 Clinical Child Psychology 284
1. A Brief History of Clinical Child Psychology 285
2. Characteristics Unique to Clinical Child Psychology 286
3. Clinical Assessment of Children 292
4. Specific Childhood Disorders 296
5. Treatment and Prevention of Childhood Disorders 302
6. The Future of Clinical Child Psychology 305
1. Chapter Summary 308
2. Chapter 12 Health Psychology 315
1. What is Health Psychology? 315
2. Risk Factors for Illness 322
3. Illness Prevention and Treatment Programs 324
4. A Health Psychology Case Example 328
5. Improving Adherence to Medical Treatment Regimens 329
1. Chapter Summary 331
3. Chapter 13 Clinical Neuropsychology 337
1. A Brief History of Neuropsychology 338
2. Basic Principles of Neuropsychology 340
3. Patterns of Neuropsychological Dysfunction 344
4. Neuropsychological Assessment 349
5. Neuropsychological Approaches to Psychopathology 351
6. The Current Status of Clinical Neuropsychology 354
1. Chapter Summary 355
4. Chapter 14 Forensic Psychology 359
1. The Scope of Forensic Psychology 359
2. Criminal Competence and Responsibility 360
3. Predicting Dangerousness 367
4. Assessing Psychological Status in Civil Trials 368
5. Psychological Autopsies and Criminal Profiling 370
6. Child Custody and Parental Fitness 372
7. Mental Health Experts in the Legal System 376
1. Chapter Summary 378
5. Section V The Future of Clinical Psychology 382
1. Chapter 15 Professional Issues in Clinical Psychology 382
1. Professional Training 383
2. Professional Regulation 390
3. Professional Ethics 393
4. Professional Independence 399
5. Professional Multicultural Competence 403
6. The Future of Clinical Psychology 406
1. Chapter Summary 409
2. Chapter 16 Getting into Graduate School in Clinical Psychology 415
1. What Types of Graduate Programs Will Help Me Meet My Career
2. Am I Ready to Make the Commitment Required by Graduate
Programs at this Time in My Life? 419
3. Are My Credentials Strong Enough for Graduate School in
Clinical Psychology? 421
4. Given My Credentials, to What Type of Program Can I
Realistically Aspire? 423
5. I Have Decided to Apply to Graduate School in Clinical
Psychology. What Should I Do First? 424
6. Should I Apply to a Master’s Degree Program and Complete It
Before I Apply to a Doctoral Program? 424
7. If I Choose to Terminate My Training After Earning a Master’s
Degree, Will My Opportunities for Doing Clinical Work Be
8. Application Procedures 425
9. Other Important Questions 440
1. Chapter Summary 441
1. References 445
2. Name Index 493
3. Subject Index 507
4. Credits 515
In the seven previous editions of this book, we tried to accomplish three goals.
First, we wanted a book that, while appropriate for graduate students, was
written especially with sophisticated undergraduates in mind. Many
undergraduate psychology majors express an interest in clinical psychology
without having a clear understanding of what the field involves and requires. An
even larger number of nonmajors also wish to know more about clinical
psychology. We felt that both groups would benefit from a thorough survey of
the field which does not go into all the details typically found in graduate study
Second, we wanted to present a scholarly portrayal of the history of clinical
psychology, its scope, functions, and future that reviewed a full range of
theoretical perspectives. Our goal is to present approaches to clinical psychology
—psychodynamic, relational, humanistic, cognitive-behavioral, systems, group,
etc.—fairly, highlighting the strengths and weaknesses of the empirical evidence
supporting each of them. We do champion the empirical research tradition of
clinical psychology throughout the book because we believe it is a necessary and
useful perspective for all clinicians to follow, regardless of their theoretical
Third, we wanted our book to be interesting and enjoyable to read. Because we
like being clinical psychologists and because we enjoy teaching, we tried to
create a book that communicates our enthusiasm for its content.
Though we are still guided by the above goals, we sought to make some
significant changes in the eighth edition. Since our last edition, numerous
changes have occurred in clinical psychology and in the health care delivery
system, both in the United States and internationally. Accordingly, we have
undertaken a comprehensive updating of research and other material in all
chapters. With over 900 new references, we have described how research has led
to new ways to conceptualize, assess, and treat psychological dysfunction. Some
of the other significant changes are listed below.
New To This Edition
New pedagogical features. In addition to the updated study/discussion
questions, and updated websites, the new features include suggestions for
movies and memoirs, and bibliographical references at the end of each
New case material. Cases have been updated and their number increased in
order to make the material more compelling for students.
Updated diagnostic criteria. The new edition discusses changes made in the
DSM-5 and the controversies that continue to surround diagnostic
Greater integration of research and practice. Rather than presenting these
topics pitted against one another, we stress the importance of both and
highlight the growing consensus created by focusing on clinical utility; we
synthesize the Common Factors and Evidence-Based approaches to
effectiveness research and update discussion of treatment planning.
Discussion of new mental health delivery models. We discuss how
technologies have affected the options for delivering mental health services,
including going well beyond the traditional individual psychotherapy
Revised presentation of several assessment instruments. We have included
discussion of the PAI, MMPI-2, and MMPI-2 Restructured Clinical Scales
and others; expanded discussion of cultural fairness and bias in
psychological testing; revised and integrated our presentation of clinical
versus actuarial prediction.
Updated topics of relevance to students. Many topics that are of particular
interest to students have been updated, including the evolving roles of
technology and social media, information on careers within clinical
psychology, the use of evidence-based practices; new techniques such as
mindfulness which have become integral to the field; the status of
complementary and alternative medicine.
Updated information on getting into graduate school. This edition informs
students about the new GRE scoring system and provides updated
information on how to apply to graduate school, with special focus on new
hardcopy and on-line resources.
Updated discussion of clinical psychology training. We’ve added
information on the new PCSAS accreditation system, the current internship
crisis in clinical psychology, new choices in graduate training, and the
increasing importance of multicultural competence.
Updated discussion of popular therapies such as relational psychodynamic
approaches, motivatinal interviewing, and emotion-focused therapy.
This text is available in a variety of formats—digital and print. To learn more
about our programs, pricing options, and customization, visit
We want to thank several people for their valuable contributions to this book. We
wish to express our appreciation to Catherine Stoney for her help in updating the
health psychology chapter, to Joel Shenker for his help in updating the
neuropsychology chapter, and to Elaine Cassel for her help in updating the
chapter on forensic psychology. We would also like to thank Lauren Snoeyink
for her comments on chapter drafts.
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