Foundations of Professional Psychology: The End of Theoretical Orientations and the Emergence of the Biopsychosocial Approach

Foundations of Professional Psychology......Page 3
Copyright
......Page 4
Preface......Page 5
Foundations of Professional Psychology......Page 10
Copyright
......Page 11
Preface......Page 12
 Introduction......Page 15
1 The Need for a Unified Conceptual Framework in Professional Psychology......Page 16
Traditional Approaches to Professional Psychology Education and Practice......Page 18
Two Critical Questions Facing the Profession......Page 20
Organization of This Volume......Page 21
Biopsychosocial Approach......Page 23
Evidence-based Practice......Page 24
Professional Psychology......Page 25
Therapist......Page 26
 Conceptual and Theoretical Foundations of Professional Psychology......Page 27
Traditional Approaches to Defining Professional Psychology......Page 28
Defining Professional Psychology......Page 33
Discussion......Page 36
3 The Public We Serve: Their Mental Health Needs and Sociocultural and Medical Circumstances......Page 38
Behavioral Health Needs......Page 39
Medical Conditions......Page 43
Educational Attainment, Vocational and Financial Status......Page 45
Family Characteristics and Relationships......Page 46
History of Child Maltreatment......Page 47
Implications for Professional Psychology as a Health Care Profession......Page 48
The Complicated Theoretical Setting Within Professional Psychology......Page 50
The Evolution of Psychology and the Natural Sciences......Page 52
Kuhnian Scientific Revolutions......Page 53
Availability of Conceptual and Technological Tools......Page 55
Clarifying Conceptual Confusion in Psychology......Page 57
Is it Time to Leave Behind the Pre-paradigmatic Era of Psychology?......Page 59
Basic Requirements for a Paradigmatic Conceptual Framework for Psychology......Page 61
Complexity of Human Psychology......Page 62
Strength of Scientific Foundations of Professional Psychology......Page 63
Conclusions......Page 65
5 The Biopsychosocial Approach: General Systems, Nonlinear Dynamical Systems, and Complexity Theory......Page 68
Introduction to General Systems, Nonlinear Dynamical Systems, and Complexity Theory......Page 69
Statistical Interaction......Page 71
Newtonian Mechanics Versus Thermodynamics......Page 72
Definition of Nonlinear Dynamical Systems and Complexity Theory......Page 73
Nonlinear Dynamical Systems and Complexity Theory as Metatheory......Page 74
Historical Origins of Complexity Theory: Chaos Theory......Page 75
“Logistic Map” and Attractors......Page 76
Bifurcation......Page 77
Other Important Nonlinear Dynamical Systems Concepts......Page 78
Fractals......Page 79
Emergence......Page 82
How Effective Are Nonlinear Dynamical Systems and Complexity Theory in Psychology?......Page 83
Conclusions......Page 84
6 Ethical Foundations of Professional Psychology......Page 88
Confusing What Is for What Ought to Be......Page 90
The Universality of Ethics......Page 92
The Question of Moral Status......Page 93
Ethical Theory......Page 94
Consequentialist Approaches......Page 95
Liberal Individualism......Page 96
Communitarian Approaches......Page 97
An Integrative Approach......Page 98
Respect for Autonomy......Page 100
Informed Consent......Page 101
Nonmaleficence......Page 102
Beneficence......Page 104
Justice......Page 105
Moral Character......Page 106
Integrity......Page 107
Conclusions......Page 108
7 A Unified Conceptual Framework for Professional Psychology......Page 110
Underlying Assumptions of the Proposed Unified Framework......Page 111
A Unified Framework......Page 114
Implications of a Unified Biopsychosocial Framework for Professional Psychology......Page 117
Discussion......Page 121
 Conceptualizing Psychological Treatment from a Biopsychosocial Perspective......Page 124
8 Assessment......Page 125
Overall Purposes of Psychological Assessment......Page 126
Areas Included in Psychological Assessment......Page 129
Sources of Assessment Information......Page 133
Thoroughness of the Assessment Information......Page 137
Assessing Severity of Patient Needs......Page 138
Prioritizing Needs......Page 143
Overall Complexity of Needs......Page 145
Integrating Assessment Information......Page 146
Conclusions......Page 148
9 Treatment Planning......Page 156
A Critical Preliminary Issue......Page 157
Starting at the Beginning: Deciding Whether to Intervene......Page 160
Addressing Severity and Complexity of Need......Page 162
Level of Care Decision Making......Page 163
Graduated, “Stepped” Models of Intervention......Page 164
Contextual Factors......Page 166
Range of Alternative Interventions......Page 167
10 Treatment......Page 176
Is Psychotherapy Effective?......Page 177
Are the Benefits of Psychotherapy Clinically Significant?......Page 178
How Does the Effectiveness of Psychotherapy Compare with Medications?......Page 179
Does Psychotherapy Work for All Patients?......Page 180
What Factors Account for the Effectiveness of Psychotherapy?......Page 181
How Important Are the Skills of the Individual Therapist in Explaining Therapy Effectiveness?......Page 183
Can the Number of Treatment Failures Be Reduced?......Page 184
A Biopsychosocial Perspective on Treatment......Page 185
Broadening of Case Conceptualization......Page 186
Broadening of Treatment Options......Page 187
Systematic Monitoring of Treatment Outcomes......Page 188
Conclusions......Page 189
Growing Importance of Outcomes Assessment......Page 192
Outcomes Assessment in Health Care Generally......Page 195
Condition-Specific Measures......Page 196
Selecting Outcome Measures......Page 197
Condition-Specific Measures......Page 198
Individualized Measures......Page 199
Sources of Outcome Data......Page 200
The Biopsychosocial Approach to Outcomes Assessment......Page 201
Cost Effectiveness......Page 204
Conclusions......Page 206
 Additional Implications for Professional Psychology......Page 208
The Importance of a Public Health Perspective on Behavioral Health......Page 209
Basic Concepts......Page 212
Risk and Protective Factors......Page 213
Effectiveness of Preventive Interventions......Page 215
Conclusions......Page 216
13 Conclusions and Implications for Professional Psychology Education, Practice, and Research......Page 219
Conclusions Regarding the Two Critical Issues Needing Resolution in Professional Psychology......Page 220
Professional Psychology in the Midst of Remarkable Scientific Progress......Page 222
Implications for Education and Licensure......Page 224
Implications for Professional Practice......Page 227
Implications for Research and Science......Page 228
Conclusions......Page 229
References......Page 232