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Table of Contents

Part I          FOUNDATIONS

Chapter 1       Clinical Psychology in Context  

Professionals Working in the Fields of
Mental Health
Psychiatrists
Social Workers
Licensed Professional Counselor
Psychiatric Nurses
Marriage and Family Therapists
“Psychotherapist,” “Life Coach,” and Other Unregulated Terms
Psychologists
Counseling and School Psychologists
Counseling Psychology
School Psychologists
Clinical Psychology
Incorporating a Multicultural Perspective
In Historical Perspective: A Brief History
Activities of Clinical Psychologists
In Practice   Introductions to Shane and Kiara 
Chapter Summary 
Key Terms 

Chapter 2       Who Is a Clinical Psychologist?  

Clinical Psychology Training Models 
The Scientist-Practitioner Model (The Boulder Model) 
The Practitioner-Scholar Model (The Vail Model) 
Emergence of Professional Schools 
A Closer Look    The Argosy Disaster and Professional Schools of Psychology 
The Clinical Scientist Model 
Components of Doctoral Training 
Licensing and Credentialing 
Specialties within Clinical Psychology 
Clinical Child/Adolescent Psychology 
Clinical Health Psychology and Pediatric Psychology 
Clinical Adult Psychology 
Board Certification 
Chapter Summary 
Key Terms 

Chapter 3       Ethics in Clinical Psychology       

General Principles and Ethical
Standards 
Competence 
In Historical Perspective: Ethical Standards Reflect the Times 
Privacy and Confidentiality 
Harm to Others 
Others Harming a Client 
Clients’ Self-Harm 
Working with Youth 
Relating with Clients 
Consenting 
Ethics and Clinical Psychology
Research 
Informed Consent 
Confidentiality 
Deception 
Debriefing 
Fraudulent Data 
Ethics and Diversity 
Chapter Summary 
Key Terms 

Part II         CLINICAL ASSESSMENT

Chapter 4       Psychological Assessment: Science and Practice

Psychological Assessment in Practice 
The Referral and Presenting Problem 
Choosing What to Assess 
Selecting the Method of Assessment 
Reliability 
Validity 
Standardization 
In Historical Perspective: Psychological Assessment 
Gathering Assessment Data 
Drawing Conclusions 
Communicating the Results 
In Practice   A Case Illustration of a Clinical Report 
Assessment and Diverse Populations 
Clinical Judgment Versus Actuarial (Statistical) Prediction 
Clinical Judgment 
Actuarial Prediction 
Which Approach Is Better (and Why)? 
Psychological Assessment in Research 
Epidemiology Research 
Correlational Research 
A Closer Look   False Causation Assumptions and the Dubious “Serotonin Imbalance” Theory 
A Closer Look   Neuroimaging Research:
Hope or Hype? 
Cross-Sectional Versus Longitudinal Approaches 
Experimental Research 
Chapter Summary 
Key Terms 

Chapter 5       The Clinical Interview

General Characteristics of Clinical Interviews 
Where to Conduct a Clinical Interview 
How to Develop Rapport 
How to Use Verbal and Nonverbal Language 
The Use of Questions 
Active Listening 
Silence 
Consideration of Client Strengths 
Psychologists’ Stimulus Value 
Psychologists’ Own Multicultural Lenses 
Different Types of Clinical Interviews 
Intake-Admission Interview 
In Practice   Sample Intake Report, Kiara 
The Social History Interview 
The Mental Status Examination 
In Practice   Excerpt from a Sample Mental Status Interview 
The Diagnostic Interview 
Chapter Summary 

Chapter 6       Personality

Assessment                                            
Perspectives on the Concept of Personality 
The Five-Factor Model 
In Historical Perspective: Personality and ­Personality Testing 
The Situational Perspective 
The Middle Ground 
Personality Tests 
Types of Personality Tests 
Projective Tests 
The Rorschach Inkblot Test 
Description 
Administration 
Scoring 
Interpretation 
Reliability and Validity 
The Thematic Apperception Test 
Description 
Administration 
Scoring and Interpretation 
Reliability and Validity 
Objective Tests 
Constructing Objective Tests 
Content Validation 
Empirical Criterion Keying 
Factor Analysis 
Construct Validity Approach 
The MMPI 
Description, Scoring, and Interpretation 
Validity Scales 
Reliability and Validity 
The Revised NEO-Personality Inventory 
Description and Administration 
Scoring and Interpretation 
Reliability and Validity Limitations 
In Practice   The NEO-PI-R, Kiara 
Discrimination and Bias in Personality Testing 
Chapter Summary 
Key Terms 

Chapter 7       Behavioral Assessment                                            

How Does Behavioral Assessment Differ from Other Forms of Assessment? 
Sample Versus Sign 
Functional Analysis 
In Historical Perspective: Behavioral Assessment 
Behavioral Assessment as an Ongoing Process 
Behavioral Interviews 
In Practice   Excerpt from a Behavioral Interview with Kiara 
Behavioral Observation 
Observation Methods 
Interval Coding 
Event Recording 
Observation Settings 
Naturalistic Observation 
In Practice   Naturalistic Observation, Shane 
Controlled Observation 
Self-Monitoring 
The Use of Technology: Ecological Momentary Assessment 
Checklists and Inventories 
Cognitive-Behavioral Assessment 
A Closer Look    Assessing Cognitions about Private Experiences 
Chapter Summary 

Chapter 8       The Assessment of Intelligence

The Concept of Intelligence 
Definitions of Intelligence 
Theories of Intelligence 
The IQ: Its Meaning and Its Correlates 
The Intelligence Quotient (IQ) 
Ratio IQ 
Deviation IQ 
Correlates of IQ 
School Success 
Occupational Status and Success 
Demographic Group Differences 
Heredity and Stability of IQ Scores 
Is Intelligence Heritable? 
A Closer Look   Behavioral Genetics 
Is Intelligence Fixed or Changeable? 
Intelligence Tests 
The Stanford-Binet Scales 
In Historical Perspective: Intelligence Testing: Yesterday and Today 
The Wechsler Scales 
The Wechsler Adult Intelligence Scale-IV 
The Wechsler Intelligence Scale for Children-V 
In Practice   Intelligence Tests, Shane 
The Wechsler Preschool and Primary Scale for Intelligence-IV 
IQ, Intelligence Tests, and Cultural Bias 
Using Intelligence Tests in Clinical Practice 
Estimating General Intelligence 
Predicting Academic Success 
The Appraisal of Style 
Chapter Summary 

Part III            CLINICAL INTERVENTIONS

Chapter 9       Diagnosis, Case Formulation, and Treatment Planning

Beyond Normal and Abnormal 
Abnormal as Socially or Statistically Deviant 
Abnormal as Distressing 
Abnormal as Dysfunctional 
Where Does This Leave Us? 
Psychiatric Diagnosis and Classification of Mental Disorders 
DSM-5-TR 
In Historical Perspective: The DSM and ­Psychiatric Diagnosis 
Advantages of the DSM-5-TR 
Communication 
Research 
Treatment 
Limitations of the DSM-5-TR 
Reliability Issues 
Use of Descriptive Criteria 
Ambiguous Criteria 
Sociocultural Context 
Categories Versus Dimensions 
Overinclusiveness 
Additional Concerns 
Research Domain Criteria (RDoC) 
Case Formulation 
Components of Case Formulation 
Problem List 
Hypotheses about Mechanisms 
Predisposing Factors 
Precipitants 
Applying Case Formulation 
In Practice   Sample Case Formulation 
Multicultural Considerations 
An Iterative Approach 
Evaluation of the Case Formulation Approach 
Developing and Communicating the Treatment Plan 
Treatment Planning 
In Practice   Treatment Planning 
Communicating the Treatment Plan 
In Practice   Communicating the Treatment Plan for Kiara 
Monitoring Progress 
Chapter Summary 

Chapter 10    Psychological Treatment: Science and Practice               

Defining Psychotherapy and Psychological Treatment 
A Closer Look   “Psychological Treatment” Versus “Psychotherapy”: What’s in a Name? 
Do Psychological Treatments Work? 
Whom Should We Ask? 
How Should We Ask? 
In Historical Perspective: The Study of ­Psychological Treatments 
When Should We Ask? 
Treatment Efficacy 
Treatment Effectiveness 
Multicultural Considerations 
How Do Psychological Treatments Work? 
Common Factors 
Specific Factors 
The Interactional Perspective 
The Course of Psychological Treatment 
Initial Contact 
Informed Consent 
Assessment, Conceptualization, and Treatment Planning 
Implementing Treatment 
Providing Psychoeducation 
Managing Emotional Distress 
Assigning Work and Practice between Sessions 
Fostering Optimism and Self-Efficacy 
Termination, Evaluation, and Follow-up 
Evidence-Based Treatment, ­Evidence-Based Practice, and Dissemination 
What Are Evidence-Based Treatment and Evidence-Based Practice? 
A Closer Look    The Pros and Cons of Treatment Manuals 
EBT and EBP Effectiveness 
Resistance to EBTs and EBP 
Dissemination of EBTs 
A Closer Look    Technology and Dissemination of Psychological Treatments 
Overcoming Complications with Dissemination 
Chapter Summary 

Chapter 11    Behavioral Interventions                                        

What Is Behavioral Treatment? 
The Process of Behavioral Treatment 
Stages of Behavioral Interventions 
Target Definition and Baseline Assessment 
In Historical Perspective: Behavioral Treatment 
Functional Analysis and Treatment Planning 
Implementation 
Outcome Assessment 
Reformulation (as necessary) 
In Practice   The Process of Behavioral Treatment, Shane 
The Client–Practitioner Relationship 
Multicultural Competence and Behavioral Interventions 
Applications of Behavioral Interventions 
Addressing Skill Deficits 
Social Skills Training 
Assertiveness Training 
Modifying Behavior with Rewards and Consequences 
Behavioral Modification/Parent Training 
Token Economies 
Reducing Clinical Anxiety and Fear 
Exposure Therapy 
A Closer Look   But What If the Feared Outcome Actually Happens? 
In Practice   Exposure and Response Prevention, Kiara 
Progressive Muscle Relaxation 
Improving Depressed Mood 
Modifying Habit Behaviors 
Habit Reversal Training 
Cue Exposure 
Aversive Conditioning 
Improving Sexual Functioning 
Evaluating the Behavioral Approach 
Strengths 
Efficacy 
Efficiency 
Breadth of Application 
Criticisms 
Chapter Summary 

Chapter 12    Cognitive-Behavioral Interventions        

What Is Cognitive-Behavioral Treatment? 
Theoretical Basis of CBT 
In Historical Perspective: The Evolution of Cognitive-Behavioral Treatment 
Treatment Implications 
The Process of CBT 
Defining the Target Problem 
Explaining the ABC Model 
Assessing A, B, and C 
Implementation 
Outcome Assessment 
Client–Practitioner Relationship 
Multicultural Considerations 
Applications of CBT 
Rational Emotive Behavior Therapy 
In Practice   Disputing Kiara’s Irrational Beliefs 
Beck’s Cognitive Therapy 
A Closer Look    The Pie Graph Technique 
Cognitive Bias Modification 
Multicomponent CBT Programs 
Evaluating the Cognitive-Behavioral Approach 
Effectiveness 
Efficiency 
Scope of Use 
Criticisms 
Chapter Summary 

Chapter 13    Acceptance and Dialectical Interventions            

In Historical Perspective: Acceptance and Dialectics in Psychological Treatment 
Acceptance and Commitment Therapy 
Theoretical Basis 
A Closer Look    ACT and Relational Frame Theory 
Implementing ACT 
Acceptance 
Cognitive Defusion 
In Practice   Kiara’s Defusion Metaphor 
Contact with the Present Moment 
The Observing Self 
Values 
In Practice   Shane’s Values 
Committed Action 
Client–Practitioner Relationship 
Dialectical Behavior Therapy 
Theoretical Basis 
Implementing DBT 
Mindfulness 
Distress Tolerance 
Emotion Regulation 
Interpersonal Effectiveness 
Client–Practitioner Relationship 
Multicultural Considerations 
Evaluating Acceptance, Mindfulness, and Dialectical Approaches 
Scientific Support 
Criticisms 
Chapter Summary 

Chapter 14    Early Approaches to ­Psychotherapy: Psychodynamic and Client-Centered Perspectives    

Psychoanalysis and Psychodynamic Therapy 
Freudian Psychoanalytic Theory 
Psychic Determinism and the Unconscious 
Instincts 
Personality Structures 
In Historical Perspective: A Brief Biography of Sigmund Freud 
Psychosexual Stages 
Defense Mechanisms 
The Process of Psychoanalysis 
Free Association 
Dream Analysis 
Interpretation 
Resistance 
Transference and Countertransference 
Process Stages 
Contemporary Psychodynamic Psychotherapy 
Research Support 
A Closer Look   Features of Interpersonal Psychotherapy (IPT) 
Client-Centered Therapy 
In Historical Perspective: Carl Rogers and Client-Centered Therapy 
Theoretical Basis 
Empathy 
Unconditional Positive Regard 
Congruence 
The Process of Client-Centered Therapy 
In Practice   Therapist–Client Interactions in Client-Centered Therapy 
Research Support 
Multicultural Considerations 
Chapter Summary 
Key Terms 

Chapter 15    Group, Family, and Couple-Based Interventions      Group Interventions 

Types of Groups 
Directive Groups 
In Historical Perspective: The Group Therapy Movement 
A Closer Look    The Unified Protocol 
Nondirective Groups 
Group Composition 
Confidentiality 
Efficacy and Effectiveness 
The Future of Group Treatment 
Family-Based Interventions 
Emphasis on Communication 
The Process of Family Therapy 
In Historical Perspective: The Inauspicious Beginnings of Family Therapy 
Types of Family Therapy 
Conjoint Family Therapy 
A Closer Look   Conjoint Family Therapy 
Other Common Types 
Ethical and Multicultural Considerations 
Confidentiality 
Culture and Family Therapy 
Efficacy and Effectiveness 
Couple-Based Interventions 
Types of Couples Therapy 
In Historical Perspective: The Transformation of Couples Therapy 
Cognitive-Behavioral Couples Therapy 
A Closer Look   Emotional Expressiveness Training 
Emotion-Focused Couples Therapy 
Multicultural Considerations 
Efficacy and Effectiveness 
Chapter Summary 
Key Terms 

Part IV       SPECIALTIES

Chapter 16    Clinical Psychology and Medical Health

The Mind–Body Link 
Stress 
In Historical Perspective: The Evolution of Health Psychology 
A Closer Look   COVID-19’s Disproportional Impact on Black Americans 
Behavior and Cognition 
Personality 
Social Support 
Intervention Methods 
A Closer Look   Health Psychology and Cardiovascular Disease 
Biofeedback and Relaxation 
Behavioral Techniques 
Cognitive-Behavioral Methods 
Acceptance 
Prevention Strategies 
Reducing Cigarette Smoking 
Decreasing Problem Drinking 
Addressing Obesity 
Health and Pediatric Psychology in Medical Settings 
Coping with Medical Procedures 
Increasing Compliance with Medical Instructions 
In Practice   Consultation/Liaison Psychology 
Multicultural Competence 
Professional and Ethical Issues 
Professional Issues 
Verbal and Written Communication 
Medical and Pharmacological
Knowledge 
Ethics 
Informed Consent 
Confidentiality 
Chapter Summary 
 
Chapter 17    Clinical Psychology and the Law                                           \

What Is Forensic Psychology? 
Activities of Forensic Psychologists 
Providing Expert Testimony 
In Historical Perspective: The Origins and Growth of Forensic Psychology 
Testifying in Criminal Cases 
The Insanity Plea 
Competency to Stand Trial 
Testifying in Civil Cases 
Commitment to Mental Institutions 
Domestic Issues 
Predicting Dangerousness and Psychological Criminal Profiling 
Predicting Dangerousness 
Psychological Criminal Profiling 
A Closer Look    Profiling the “Unabomber” 
Conducting Psychological Autopsies 
Consulting with Lawyers about Their Cases 
Jury Selection 
Jury Shadowing 
Witness Preparation 
Helping Attorneys Present Their Arguments 
Research in Forensic Psychology 
Eyewitness Identification and
Testimony 
Jury Behavior 
Multicultural Considerations 
Ethical Considerations 
Chapter Summary 
Key Terms 

Appendix  

Glossary 

Authors

Jonathan S. Abramowitz

Jonathan S. Abramowitz is Professor of Psychology and Neuroscience, and Director of Clinical Training at the University of North Carolina at Chapel Hill (UNC-CH). He also serves as Direc-tor of the UNC-CH Anxiety Clinic. Jon earned his PhD in clinical psychology at the University of Memphis in 1998 and has been at UNC-CH since 2006. His research and clinical interests focus on anxiety and related disorders, including obsessive-compulsive disorder (OCD), and he has received international recognition, honors, and awards for his scientific, clinical, and professional contributions in these areas. Most recently, he was awarded the University of North Carolina Faculty Award for Excellence in Doctoral Mentoring. Working with many students and collaborators, he has published over 300 research articles, book chapters, encyclopedia entries, and books. Jon served as President of the Association for Behavioral and Cognitive Therapy (ABCT) from 2015 to 2016 and founded (and served as the first Editor-in-Chief of ) the Journal of Obsessive-Compulsive and Related Disorders. His previous positions include Assistant/Associate Professor at the Mayo Clinic and Mayo School of Medi-cine (2000-2006), and Postdoctoral Fellow and Instructor at the University of Pennsylvania (1999–2000).

Mitchell Prinstein

Dr. Mitchell J. Prinstein is the Chief Science Officer of the American Psychological Association and John Van Seters Distinguished Professor of Psychology and Neuroscience at the University of North Carolina at Chapel Hill. For over 25 years, Mitch’s research has examined interpersonal models of internalizing symptoms and health risk behaviors among adolescents, with a specific focus on the unique role of on- and off-line peer relationships in the developmental psycho-pathology of depression and self-injury. He has published over 150 peer-reviewed papers and 9 books, including graduate volumes on assessment and treatment in clinical child and adoles-cent psychology, a set of encyclopedias on adolescent development, and the acclaimed trade book, “Popular: Finding Happiness and Success in a World That Cares Too Much About the Wrong Kinds of Relationships.” He is a past Editor for the Journal of Clinical Child and Adoles-cent Psychology, a past-president of the Society for the Science of Clinical Psychology and the Society of Clinical Child and Adolescent Psychology, and served on the Board of Directors of the American Psychological Association. Mitch has received several national and university-based awards recognizing his contributions to research, classroom instruction, for profes-sional development training, as a mentor, and for his national contributions to education and training at the local, state, and national level. Mitch and his work have been featured in over 200 pieces in The New York Times, The Wall Street Journal, National Public Radio, the Los Angeles Times, CNN, U.S. News & World Report, Time magazine, New York magazine, News-week, Reuters, Family Circle, Real Simple, All Things Considered, and in two TEDx talks.

Timothy Trull

Dr. Timothy Trull is the Curator’s Professor of Psychological Sciences and Byler Distinguished Professor at the University of Missouri–Columbia. He enjoys teaching a variety of courses in clinical psychology, particularly Introduction to Psychopathology and Introduction to Clin-ical Psychology, as well as supervising clinical psychology graduate students in their research, assessment, and clinical work. Tim earned his MA and PhD in clinical psychology at the University of Kentucky. Tim publishes much of his research in the Journal of Abnormal Psychology (now called Journal of Psychopathology and Clinical Science), Psychological Assessment, and the Journal of Personality Disorders. Sponsored through grants from the National Institute of Health, the National Institute on Alcohol Abuse and Alcoholism, and the Borderline Personality Disorder Research Foundation, his research projects include evaluating etiological models of borderline personality disor-der, exploring the relations between personality disorders and substance use disorders, assessing genetic and environmental influences on personality and psychopathology, and using ambulatory assessment in clinical psychology. In addition to his work at the university, Tim is a member of the scientific faculty at the Missouri Center for Addiction Research and Engagement (MOCARE) and is a practicing clinical psychologist. He has won a number of awards that include Outstanding Alumnus, University of Kentucky; the Graduate Faculty Mentoring Award, University of Missouri; the Robert S. Daniels Junior Faculty Teaching Award; and the Psi Chi Professor of the Year. Tim is a Fellow of the American Psychological Association and the Association for Psychological Science.

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