Assignment: Understanding PsychoPathology

Assignment: Understanding PsychoPathology

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Assignment: Understanding PsychoPathology

see whether they work. They are accountable not only to their patients but also to the government agencies and insurance companies that pay for the treatments, so they must demon- strate clearly whether their treatments are effective or not. Third, scientist-practitioners might conduct research, often in clinics or hospitals, that produces new information about disorders or their treatment, thus becoming immune to the fads that plague our field, often at the expense of patients and their families. For example, new “miracle cures” for psy- chological disorders that are reported several times a year in popular media would not be used by a scientist-practitioner if there were no sound scientific data showing that they work. Such data flow from research that attempts three basic things: to describe psychological disorders, to determine their causes, and to treat them (see E Figure 1.3). These three categories compose an organizational structure that recurs throughout this book and that is formally evident in the discussions of specific disorders beginning in Chapter 5. A general overview of them now will give you a clearer perspective on our efforts to understand abnormality.

clinical description In hospitals and clinics, we often say that a patient “presents” with a specific problem or set of problems or we discuss the presenting problem. Presents is a traditional shorthand way of indicating why the person came to the clinic. Describing Judy’s presenting problem is the first step in determining her clinical description, which represents the unique combination of behav- iors, thoughts, and feelings that make up a specific disorder. The word clinical refers both to the types of problems or disorders that you would find in a clinic or hospital and to the activities connected with assessment and treatment. Throughout this text are excerpts from many more individual cases, most of them from our personal files.

Clearly, one important function of the clinical description is to specify what makes the disorder different from normal behav- ior or from other disorders. Statistical data may also be relevant.

For example, how many people in the population as a whole have the disorder? This figure is called the prevalence of the dis- order. Statistics on how many new cases occur during a given period, such as a year, represent the incidence of the disorder. Other statistics include the sex ratio—that is, what percentage of males and females have the disorder—and the typical age of onset, which often differs from one disorder to another.

Psychiatrists first earn an M.D. degree in medical school and then specialize in psychiatry during residency training that lasts 3 to 4 years. Psychiatrists also investigate the nature and causes of psychological disorders, often from a biological point of view; make diagnoses; and offer treatments. Many psychiatrists emphasize drugs or other biological treatments, although most use psychosocial treatments as well.

Psychiatric social workers typically earn a master’s degree in social work as they develop expertise in collecting information relevant to the social and family situation of the individual with a psychological disorder. Social workers also treat disorders, often concentrating on family problems associated with them. Psychi- atric nurses have advanced degrees, such as a master’s or even a Ph.D., and specialize in the care and treatment of patients with psychological disorders, usually in hospitals as part of a treat- ment team.

Finally, marriage and family therapists and mental health counselors typically spend 1 to 2 years earning a master’s degree and are employed to provide clinical services by hospitals or clin- ics, usually under the supervision of a doctoral-level clinician.

the scientist-Practitioner The most important development in the recent history of psy- chopathology is the adoption of scientific methods to learn more about the nature of psychological disorders, their causes, and their treatment. Many mental health professionals take a scientific approach to their clinical work and therefore are called scientist-practitioners (Barlow, Hayes, & Nelson, 1984; Hayes, Barlow, & Nelson-Gray, 1999). Mental health practitio- ners may function as scientist-practitioners in one or more of three ways (see E Figure 1.2). First, they may keep up with the latest scientific developments in their field and therefore use the most current diagnostic and treatment procedures. In this sense, they are consumers of the science of psychopathology to the advantage of their patients. Second, scientist-practitioners evaluate their own assessments or treatment procedures to

E FIgUre 1.2 Functioning as a scientist-practitioner.

Consumer of science • Enhancing the practice

Evaluator of science • Determining the effectiveness of the practice

Creator of science • Conducting research that leads to new procedures useful in practice

Mental health

professional