The models of clinical psychology PDF

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The best clinical models are those whose implications and hypotheses can be rigorously investigated in a wide variety of situations. A good model should include a complete, efficient and verifiable explanation of the development, maintenance and modification of both problematic and non-problematic a...

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THE MODELS OF CLINICAL PSYCHOLOGY

Introduction Clinical psychologists generally adopt a similar strategy when searching for various types of information to obtain a customer evaluation from different sources. In this respect, clinical psychologists share operational characteristics similar to those of private detectives, investigative reporters and others who are interested in trying to fully understand a particular topic. The same open and comprehensive orientation can be of great value to the student who starts in clinical psychology, because this discipline looks a lot like a statue: There are many ways to look at it and in each way some aspects are discovered and others are obscured. The purpose is to analyze three of the most important points of view: the psychodynamic, social learning and phenomenological models of clinical psychology. We refer to them as models because they offer small-scale descriptions of the ways in which several thinkers have addressed the issue of human behavior in general and clinical psychology in particular. Each model describes how behavior develops and becomes problematic and everyone has exerted a great influence on the styles of evaluation, treatment and research of their followers.

The importance of models Even if a model is ultimately discredited, it can be very valuable in helping the clinician organize both his or her ideas and actions and communicate them in a "language" common to his colleagues. Human behavior is extremely complex and can be explored from several levels, from cell activity to cognitive functioning and social interaction. Adding to this the recognition that there are an almost infinite number of ways in which behavior can be interpreted, evaluated, described, investigated and altered, the claim that the clinical psychologist "carries a continuous struggle against confusion" is not surprising. A systematic model or approach can help guide us into these decisions about complicated phenomena that it cannot confuse, and provides some peace of mind for the clinician to introduce some order into what might have been a conceptual chaos. The personal usefulness of clinical models must be distinguished from their scientific value, which is evaluated from dimensions other than comfort, superficial attractiveness or number of followers. The best clinical models are those whose implications and hypotheses can be rigorously investigated in a wide variety of

situations. A good model should include a complete, efficient and verifiable explanation of the development, maintenance and modification of both problematic and non-problematic aspects of human behavior. Models that meet these characteristics enable experimental evaluation and systematic review of clinical application.

The psychodynamic model The roots of the psychodynamic model are found in the works of Sigmund Freud in the late 19th century. The model is based on the following main assumptions: Human behavior and its development is determined primarily by the facts, impulses, desires, motives and conflicts that lie within the mind. Intrapsychic factors provide the underlying causes of behaviors that manifested openly, whether problematic or not. Therefore, as well as incapacitating anxiety or delusions of persecution of a patient would be attributed to unresolved conflicts or unmet needs. The origins of behavior and its problems are established in childhood through the satisfaction or frustration of basic needs or impulses. Special emphasis and attention is given to relationships with parents, siblings, grandparents, peers and people with authority at an early age. Clinical evaluation, treatment and research activities should be directed to the search and functions of the subtle aspects of intraptic activity which, although often hidden from direct observation, should be treated if we are to understand the behavior and alleviate behavioral problems.

Freudian psychoanalysis The Freudian approach, called psychoanalysis is considered a type of clinical model, because it pays special attention to abnormality and appeared at a time when there was a strong interest in the discovery of the organic causes of "mental illness". From a Freudian point of view, the "disease" of people with problems was considered to be caused by a disorder that even though it was not actually an infectious disease, dysfunction of an organic system, or physical harm, could still be classified or classified as the other diseases. The psychodynamic Freudian model was based on a small number of fundamental principles. One of these is psychic determinism, a belief that behavior does not occur randomly but according to identifiable causes that are sometimes manifest and in others hidden from the view of both external observers and the same individual that is shared in a certain way. From this perspective, most if not all

behaviors are considered significant as they can provide clues to conflicts and latent motivations. Freud referred to the belief that patterns of human behavior stem from a continuous struggle between the individual's desire to satisfy his sexual and aggressive innate instincts and the need to consider the demands, norms and realities of the outside world. He considered that each individual faced a lifelong quest to find a way to express socially inappropriate instinctive tendencies without contracting physical punishment or other negative consequences. Freud considered the human mind to be a kind of arena where what the person wants to do (instinct) must deal with the most limiting opinions than he can or should do (reason and morality) and where certain solutions have to be achieved painfully. The mental structure: In Freud's system, unconscious primitive instincts constitute the id, which is present from birth and contains all the psychic energy or libido available to motivate behavior. The id seeks the gratification of desires if to tolerate delay, and therefore is said to operate based on the principle of pleasure. As the newborn grows the world puts limitations on it and then the ego develops as a partially conscious and partially unconscious branching of the id and begins to find escape valves for instinctive expression, the ego acts on the principle of reality. A third mental component, called superego, is also the result of the socializing influence of reality, equivalent to what we call "consciousness", since the term implies family and cultural teachings about ethics, morals and values. Defense mechanisms: Freud's tripartite mental structure is constantly embedded in internal conflicts and as a result anxiety is generated. The ego keeps away from conflicts of consciousness, for this it uses the mechanisms of defenses. One of the most well-known mechanisms is repression in which the ego "stops" the entry into the consciousness of a thought, memory, feeling or impulse, which are considered unacceptable. Repression requires constant effort, and undesirable content can threaten to "surface" at certain times. Another defense that uses the ego is reactive formation, in which the person thinks and acts in a way completely opposite to the unconscious impulse. The displacement mechanism actually allows a degree of expression of the id's impulses, but directs that expression towards less dangerous objects or people. The defence mechanism that for Freud was more socially adaptable is sublimation. In this, the expression of the forbidden impulses is channeled through productive and even creative activities, such as writing, painting, acting or dancing. Unlike the other models this does not do so much expenditure of psychic energy and the others in a situation of "stress" can fail and force the relapse. Development stages. Freud postulated, that as a newborn develops, he or she goes through several psychosexual stages; each of these stages gets its name from the part of the body that receives the most pleasure. The stage comprising

the first year is called oral stage because activities such as eating, sucking and others of an oral nature are those that predominate as sources of pleasant stimulation. If, due to bottle or chest weaving, premature or delayed, oral needs are thwarted or overly consented, the child may be prevented from crossing the oral stage without clinging to, or is fixed on the behavior patterns that belong to this stage. Adults who manifest or improperly rely on patterns of "oral" behavior such as smoking, overfeeding, over-talking, or emitting "scathing" sarcasms may be considered as orally fixed. Freud's second stage of development was known as the anal stage, because he judged that the anus and stimuli associated with the elimination and retention of faeces became the most important factors after the oral stage. The most important feature of this period is training in sphincter control and it was thought that anal fixation could be the result of overly strict or especially forgiving practices in this regard. Adult behaviors that are associated with a possible anal fixation include excessively "tight", controlled or "loose" or disordered habits: people who are stingy, stubborn, very orderly, interested in cleanliness or small details, and those who are scruffy, disorganized and exaggeratedly generous with their money could be considered as individuals who manifest anal characteristics. The child enters the phase stage according to Freud when the genital organs become his first forehead of pleasure, at approximately the age of four. As the name he gave to this period suggests, Freud paid more attention to the psychosexual development of the male sex. He theorized that during the plic stage, the little one begins to experience sexual desires for his mother and wants to set aside his father's competition. He was called to this Oedipal situation because he offers a recap of the argument of the Greek tragedy, Oedipus, King. Because the child fears being castrated as punishment for his incestuous and murderous desires, the Oedipal complex and its concomitant anxiety is resolved through the suppression of sexual desires towards the mother and imitation or identification with the father, and in the future by meeting the appropriate female partner. Freud outlined a parallel process in girls, called the Electra conflict, which in ideal terms concludes in identifying the female role and selecting an approved male partner. The period following the phase stage in Freud's system was called dormant and he thought it persisted until the onset of adolescence in which the physical and sexual maturity of the individual is announced in the genital stage. In this final "stage", pleasure focuses on the genital area again, but, if development during the previous phases has been adequate, sexual pleasure is not limited only to the typical autoeroticism of the phallic period, but is directed towards the establishment of a stable heterosexual relationship over the long term in which the needs of the other person are valued and taken into account.

The model of social learning The model of social learning focuses directly on behavior and its relationship to the environmental conditions that affect it. The basic assumption of all versions of this model is that behavior is influenced by learning that takes place in a social context. Behavioral differences between individuals are largely attributed to each person's unique learning history in relation to the specific people and situations to which they were subjected to "mental illness" or "mental health." Each individual's cultural or subcultural background is considered as part of their unique learning history and play a significant role in both the emergence of "normal" and problematic behaviors. The similarities between individuals, within the model of social learning, are explained by pointing out the factors that have in common the norms, values and stories of learning and shared by most people who belong to the same culture. The same principles of learning that are invoked in explaining the differences and similarities between individuals are used to explain the circumstances and discrepancies within each individual. From the perspective of the model of social learning, it is considered that behavioral consistency, to which the psychodynamic model could refer to as the "personality" is caused by generalized learning and/or the similarities of stimulus that may exist in a group of related situations. There are several formulations of the social learning model, which, although they differ considerably in terms of certain specific factors, share a number of common characteristics: The importance of measurable behavior is underlined and taken as the object of Clinical Psychology. Clinical psychologist with social learning-based guidance can be interested in behaviors ranging from objective to subtle and covert. Almost any behavior can be the object of the approach of social learning; the only requirement is that there is an acceptable way of measuring. The importance of environmental influence on behavior as opposed to other "alleged" or hereditary influences is emphasized. This does not mean that these factors are completely ignored. The limits imposed by inheritance are explored, rather than simply presupposing them. Experimental science methods and procedures are used as the primary means to expand knowledge about behavior and its evaluation, development and modification. The importance of deliberate and systematic manipulation of independent variables and careful observation is underlined. Clinical evaluation and treatment functions are closely linked to the results of experimental research conducted on humans and animals. Most clinical procedures in the social learning model are mainly derived from the principles of

learning and social behavior that come from laboratory-led studies that are subjected to the continuous filter of evaluating research conducted in the laboratory and clinical environments. In addition, the social learning model encourages its practitioners to meticulously analyze experimental evidence that supports a particular form of evaluation or treatment procedure before making the decision to adopt it and to proceed with the utmost caution where there is little or no experimental history. Clinical evaluation and treatment functions are intimately integrated. The model of social learning assumes that the same learning principles determine both problematic or non-problematic behavior and that, therefore, clinical evaluation should be planned in order to determine how the client learned his current difficulties and how they are being maintained in order to prepare a new, more adaptive and individualized learning. The main differences between specific versions of the social learning model of Clinical Psychology are usually shown in the type of learning they underscore and the degree to which cognitive variables play a role in evaluation, treatment and research. A brief review of the most notable variations of social learning will exemplify this aspect.

The Link of Learning to Clinical Problems: Dollard and Miller's Contributions One of the first approximations of social learning theory to behavior evolved from the attempt to translate or reconstruct the concepts that Freud derived from his clinical practice to a language that was consistent with experimental data on human and animal learning. This formidable task was dedicated in the 1940s by John Dollard, a sociologist, and Neal Miller, a psychologist, and culminated in the publication of a book in 1950 entitled Personality and Psychotherapy. Dollard and Miller proceeded from the assumption that human beings are not born into the world with instincts, but with primary needs that must be met. They also assumed that each person learns to meet these needs somewhat differently, which therefore led to the development of individualized patterns of behavior. Dollard and Miller used Freudian concepts as environmentally determined phenomena that it was feasible to investigate and not as intrapsychitic structures. From their point of view, conflict exists when a person must choose between two or more optional responses. Among these conflicts, the most difficult and potentially problematic is the "double avoidance-approximation" variant, in which each option to act has very clear positive and negative characteristics.

B. F. Skinner and Functional Behavioral Analysis While The Dollard and Miller system removed some of Freud's intrapsical notions, it retained other inferred constructs such as "pulsion," "motive" and "anxiety" and therefore to some extent relied on internal hypothetical processes and mechanisms to explain various aspects of human behavior. A rather different approach to social learning that also conceives of behavior as learned is the one that presents B. F. Skinner argues that unobservable constructs such as "necessity" and "pulse" are not necessary for behavioral understanding. Skinner states that careful observation and experimentation of functional relationships, and learned between environmental stimuli and observable behavior will ultimately provide a complete picture of human behavior development, maintenance and alteration. Instead of introducing invisible factors into evaluation, treatment and research activities, Skinner advocates for observing and describing the ways behavior relate to their background and consequences. Because it focuses primarily on functional relationships, this approach is called functional analysis.

Wolpe and Eysenck: The Classic Conditioning While Skinner's approach underscores the importance of opera learning and its application to clinical psychology, a different formulation of the social learning model can be found in the works of Joseph Wolpe and Hans Eysenck. These authors study the application of the principles of Pavlov's classical conditioning, to the understanding and elimination of human suffering, especially anxiety. This approach does not negate the importance of operating reinforcement and punishment in the "shaping" of "normal" and problematic behavior, but does accentuate the learning that occurs through the association of conditioned and unconditional stimuli. It would be argued, for example, that a partial reason why a man fearfully avoids social events is that he has had negative experiences in the past, but another reason is also that the discomfort caused by those experiences has been associated withmeetings.

Albert Bandura and observational learning Skinner, Wolpe, Eysenck and other related theorists of the social learning model focus almost entirely on manifest behavior and take it as the object of clinical evaluation and treatment, although there are some slight degree variations between each. However, they have not been universally accepted. Some members of the "field" of social learning consider that very little attention has been paid to the role of cognitive or symbolic processes in the development, maintenance and

modification of behavior. One of the most distinguished representatives of this view is Albert Bandura, a psychologist at Stanford University who has generated a wealth of research and literature on how cognitive activity contributes to learning.

Bandura is probably most famous for the work he has done on observational learning, through which he has shown that humans acquire new behaviors without an obvious booster and even when they lack the opportunity to practice behavior. The only requirement for learning may be that the person observe another individual, or model, perform a certain behavior. A notable aspect of Bandura's theory is the attention he pays to vicar cognitive processes. According to its point of view, behavior is not developed exclusively through what the individual learns directly through operative and classical conditioning, but also through what he learns indirectly through the observation and symbolic representation of other people and situations. According to Bandura, the effects of vicar processes can be as broad and significant as the effects of direct learning. Symbolic processes can lead to the acquisition of new responses, inhibition and disinhibition of responses that have already been learned,...