Clinical Psychology
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This is an electronic version of the print textbook. Due to electronic rights restrictions, some third party content may be suppressed. Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. The publisher reserves the right to remove content from this title at any time if subsequent rights restrictions require it. For valuable information on pricing, previous editions, changes to current editions, and alternate formats, please visit www.cengage.com/highered to search by ISBN#, author, title, or keyword for materials in your areas of interest. CLINICAL PSYCHOLOGY EIGHTH EDITION TIMOTHY J. TRULL University of Missouri–Columbia MITCHELL J. PRINSTEIN University of North Carolina at Chapel Hill Australia • Brazil • Japan • Korea • Mexico • Singapore • Spain • United Kingdom • United States Clinical Psychology, Eighth Edition © 2013, 2005 Wadsworth, Cengage Learning Timothy J. Trull and Mitchell J. Prinstein ALL RIGHTS RESERVED. 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Purchase any of our products at your local college store or at our preferred online store www.cengagebrain.com. Printed in the United States of America 12345671615141312 About the Authors Dr. Timothy Trull is the Curator’s Professor of Psychological Sciences and Byler Distinguished Professor at the University of Missouri–Columbia. He enjoys both teaching a variety of courses in clin- ical psychology, particularly abnormal psychology and clinical psychology, and supervising clinical psychology graduate students in their research, assessment, and clinical work. Tim earned his M.A. and Ph.D. in clinical psychology at the University of Kentucky. He is a co-author of the Structured Inter- view for the Five-Factor Model of Personality (SIFFM), which assesses both adaptive and maladaptive per- sonality features. Tim publishes much of his research in the Journal of Abnormal Psychology, 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 disorder, exploring the relations between personality disorders and substance use disorders, assessing genetic and environmental influ- ences on personality and psychopathology, and using of ambulatory assessment in clinical psychology. In addition to his work at the university, Tim is a mem- ber of the scientific faculty at the Midwest Alcoholism Research Center (MARC) and is a practicing clinical psychologist. He has won a number of awards that include Outstanding Alumnus, University of Kentucky; the Graduate Faulty 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. iii iv ABOUT THE AUTHORS Dr. Mitchell J. Prinstein is a Bowman and Gordon Gray Distinguished Term Professor and the Director of Clinical Psychology at the University of North Carolina at Chapel Hill. He received his Ph.D. in clinical psychology from the University of Miami and completed his internship and postdoctoral fellow- ship at the Brown University Clinical Psychology Training Consortium. Mitch’s research examines interpersonal models of internalizing symptoms and health risk behaviors among adolescents, with a spe- cific focus on the unique role of peer relationships in the developmental psychopathology of depression and self-injury. He is the PI on several past and active grants from the National Institute of Mental Health, the National Institute of Child and Human Development, and several private foundations. He serves as the Editor for the Journal of Clinical Child and Adolescent Psychology, and an editorial board member for several developmental psychopa- thology journals. Mitch has received several national and university-based awards recognizing his contributions to research (American Psychological Association Society of Clinical Psychology Theodore Blau Early Career Award, Columbia University/Brickell Award for research on suicidality, APA Fellow of the Society of Clinical Child and Adolescent Psychology and the Society of Clinical Psychology), teaching (UNC Chapel Hill Tanner Award for Undergraduate Teaching; Psi Chi Professor of the Year), professional development of graduate students (American Psychological Association of Graduate Students Raymond D. Fowler Award), and undergraduate students (Psychology Club Department Research Mentor Award). This edition is dedicated to the memory of my father-in-law Armin Klein, an inspiring clinical psychologist whose life, compassion, wit, and intellect touched many of us. (TJT) Dedicated to my amazing wife, to my happy baby daughter, and to future students of clinical psychology who are looking for inspiration. (MJP) Brief Contents PART I Foundations of Clinical Psychology 1 1 Clinical Psychology: An Introduction 3 2 Historical Overview of Clinical Psychology 32 3 Current Issues in Clinical Psychology 59 4 Research Methods in Clinical Psychology 93 5 Diagnosis and Classification of Psychological Problems 128 PART II Clinical Assessment 159 6 The Assessment Interview 161 7 The Assessment of Intelligence 191 8 Personality Assessment 218 9 Behavioral Assessment 255 10 Clinical Judgment 283 PART III Clinical Interventions 309 11 Psychological Interventions 311 12 Psychotherapy: The Psychodynamic Perspective 343 13 Psychotherapy: Phenomenological and Humanistic-Existential Perspectives 370 14 Psychotherapy: Behavioral and Cognitive-Behavioral Perspectives 397 15 Group Therapy, Family Therapy, and Couples Therapy 431 PART IV Specialties in Clinical Psychology 457 16 Community Psychology 459 17 Health Psychology and Behavioral Medicine 485 18 Neuropsychology 513 19 Forensic Psychology 539 vi Contents PREFACE xxiii PART I Foundations of Clinical Psychology 1 1 Clinical Psychology: An Introduction 3 What Is Clinical Psychology? 4 Closely Related Mental Health Professions 5 Psychiatrists 5 BOX 1.1 Professional Issues: But Is It the Right Prescription for Clinical Psychology? 6 Counseling Psychologists 7 Other Mental Health Professionals 8 Professions and Titles Not Regulated by the Government 12 The Clinical Psychologist 12 Activities of Clinical Psychologists 12 Employment Sites 17 A Week in the Life of Dr. Karen C 17 Some Demographic Notes 20 Research and the Scientific Tradition 21 Training: Toward a Clinical Identity 21 An Overview 22 Clinical Psychology Training Programs 22 A Profession in Movement 25 Women in Clinical Psychology 25 BOX 1.2 A Graduate Student Perspective: Julia Martinez 26 vii viii CONTENTS Training Models 27 Clinical Practice 28 A Tolerance for Ambiguity and a Thirst for New Knowledge 28 CHAPTER SUMMARY 29 KEY TERMS 29 WEB SITES OF INTEREST 31 2 Historical Overview of Clinical Psychology 32 Historical Roots 33 Diagnosis and Assessment 34 The Beginnings (1850–1899) 34 The Advent of the Modern Era (1900–1919) 35 Between the Wars (1920–1939) 35 World War II and Beyond (1940–Present) 36 Interventions 39 The Beginnings (1850–1899) 39 The Advent of the Modern Era (1900–1919) 40 Between the Wars (1920–1939) 41 World War II and Beyond (1940–Present) 42 Research 45 The Beginnings (1850–1899) 45 The Advent of the Modern Era (1900–1919) 46 Between the Wars (1920–1939) 46 World War II and Beyond (1940–Present) 46 The Profession 49 The Beginnings (1850–1899) 49 The Advent of the Modern Era (1900–1919) 50 Between the Wars (1920–1939) 51 World War II and Beyond (1940–1969) 52 The Growth of a Profession (1970–Present) 53 The 1988 Schism 54 CHAPTER SUMMARY 56 KEY TERMS 56 WEB SITES OF INTEREST 58 3 Current