PAPER – I: Psychosocial Foundations of

Behavior and Psychopathology

Submitted by:- Submitted to:-

Name: - Savi Bansal Ms. Sunanda Rana
Course: - Mphil in Clinical Psychology

Semester: - First
 CONTENT

SR. NO. TOPIC

1 Introduction

2 Scope Of Clinical Psychology

3 Overview Of The Profession And Practice

4 History And Growth

5 Professional Role And Functions

6 Current Issues And Trends

7 Areas Of Specialization

8 Ethical And Legal Issues

9 Code Of Conduct
CLINICAL PSYCHOLOGY
INTRODUCTION
Clinical Psychology is an important and popular applied branch of Psychology. It is related to the
description, classification, diagnosis and prognosis of the mental diseases. The diagnosis and
treatment of various mental diseases are based on psychological methods and therapies.
The official definition of Clinical Psychology by The Division of Clinical Psychology of American
Psychological Association, as by Resnick (1991) is as follows: “The field of Clinical Psychology
involves research, teaching and services relevant to the applications of principles, methods and
procedure for understanding, predicting and alleviating intellectual, emotional, biological,
psychological, social and behavioral maladjustment, disability and discomfort, applied to a wide
range client populations.”
According to Saccuzzo & Kaplan (1994), “Clinical Psychology is an applied branch of psychology
devoted to helping adjust, solve problems, change, improve and achieve their highest
potential.”
According to APA (American Psychological Association) “Clinical psychology is the psychological
specialty that provides continuing and comprehensive mental and behavioral health care for
individuals, couples, families, and groups; consultation to agencies and communities; training,
education and supervision; and research-based practice.”
It is a specialty in breadth — one that addresses a wide range of mental and behavioral health
problems— and marked by comprehensiveness and integration of knowledge and skill from a
broad array of disciplines within and outside of psychology proper. The scope of clinical
psychology encompasses all ages, multiple diversities, and varied systems.
Thus, Clinical psychology is the branch of psychology concerned with the assessment and
treatment of mental illness, abnormal behaviour, and psychiatric problems.

SCOPE OF CLINICAL PSYCHOLOGY

1. Psychotherapy- According to Rotter (1971), “Psychotherapy…is a planned activity of the
psychologists, the purpose of which is to accomplish changes in the individual that make
his life adjustment potentially happier, more constructive or both.” Clinical psychologists
who work as psychotherapists often utilize different treatment approaches when
working with clients.
2. Diagnosis and treatment- Various types of diagnostic tools, such as observation,
interview, psychological tests, etc. are used for assessment of psychological disorder
and treatment is done using various therapies.
 Assessment using interviewing, behavioral assessment, administration and
interpretation of psychological test measures. In helping restore mental health,
 clinical psychologists follow much the same progression that medical doctors follow
in restoring physical health. They must first find out what the problem is and what’s
causing it. So the clinical psychologist assesses the client in order to diagnose the
mental health issue. This is done in multiple ways.
a) In a diagnostic interview, the clinical psychologist asks questions that give the
client opportunities to talk about himself or herself. These questions probe into
what the client is thinking, feeling and doing, and how the past influences the
present.
b) A behavioral assessment allows a clinical psychologist to observe and evaluate a
client’s behavior. This assessment may reveal a pattern of behavior that indicates
the presence of mental disorder and illness.
c) Standardized psychological tests may be given in order to measure a mental
disorder. These are formal tests often given in the form of checklists and
questionnaires.
 Intervention using a range of evidence-based approaches for individuals, families, and
groups. Based on what the assessments reveal, the practitioner will recommend a may
be employed in treating a client. Regardless of which approach is used, treatments
require multiple sessions. Occasional follow-up visits are also concluded. psychological
intervention, or treatment. There are different approaches to treatment. Some clinical
psychologists favor one method over the others, but multiple approaches.
a) The cognitive behavioral approach focus on person's negative thoughts and
behaviors. These are often exposed through "talk therapy" with the mental health
counselor which involves confronting potentially uncomfortable and painful past
topics through honest dialogue. The goal is to help the client recognize emotional
triggers and teach them how to respond to them positively.
b) The psychodynamic approach also helps the client become aware of negative
thoughts, but emphasizes the unconscious mind. Through psychoanalysis, the
clinical psychologist helps the client explore and sort out hidden conflicts from the
past.
c) The humanistic approach is also known as “client-centered therapy.” It promotes
acceptance, empathy and the idea that the client knows himself or herself better
than anyone else. It also holds that focusing on the present is more important than
digging up events from one’s past.
3. Teaching- Clinical psychologists usually have a doctorate in psychology and also have
receive training in clinical settings. Many psychologists engage in teaching often at the
university level.
4. Research- There is always scope of conducting more researches to gain more
information and utilizing the gained knowledge for the welfare of the needy.
5. Consultation- To strengthening the client’s motivation to do the right things and help in
reducing emotional pressure as well as to facilitate in decision making.
 6. Administration and management- One of the scope and function of clinical psychology
is also to administer and manage to treat and prevent social problems.

OVERVIEW OF THE PROFESSION AND PRACTICE

Specialized Knowledge
 Understanding of psychopathology and mental health across the lifespan
 Ability to assess cognitive, behavioral, emotional, and interpersonal functioning, and to
integrate and synthesize test data with observations, interviews, and other data
sources
 Ability to conduct psychological and behavioral intervention to improve health and
functioning using a wide range of evidence-based interventions
 Ability to conduct, disseminate, and implement research on a range of clinical
psychological processes
 Establishment and maintenance of therapeutic relationships and communication with a
broad diversity of populations
 Ability to recognize and respond to ethical, legal, regulatory issues as they
pertain(related) to the practice of clinical psychology
 Understanding of professional expectations that guide behavior, promote self-
reflection, integrity, and accountability
 Awareness and understanding of how developmental stages and life transitions
intersect with the larger biosociocultural context, how identity evolves as a function of
such intersections, and how these different socialization and maturation experiences
influence worldview and identity.
Problems Addressed
The specialty of clinical psychology addresses behavioral and mental health issues faced by
individuals across the lifespan including:
 Adjustment issues and traumatic stress reactions.
 Emotional and psychological problems, including serious mental illness and crisis
intervention.
 Interpersonal or social problems and dysfunction.
 Behavioral problems including substance abuse and dependence
 Intellectual, cognitive, and neurological conditions.

Populations Served
Clinical psychologists provide services to individuals, couples, and families across the lifespan,
and populations from all ethnic, cultural, and socioeconomic backgrounds. The problems or
needs addressed range from minor adjustment issues to serious mental health problems.
Clinical psychologists work with groups and communities to address or prevent problems and
intervene in organizations, institutions, and communities to enhance people’s effectiveness and
well-being.
HISTORY AND GROWTH
Early influences on the field of clinical psychology include the work of the Austrian
psychoanalyst Sigmund Freud. He was one of the first to focus on the idea that mental illness
was something that could be treated by talking with the patient.
 The field of Clinical Psychology is generally considered to have begun in 1896 with the
opening of the first psychological clinic at the University of Pennsylvania by Lightner
Witmer.
Psychology: The Early Years
• The study and treatment of mental illness can be traced back to at least 2100 B.C., Much
of history shows that, the mentally ill have been treated very poorly. It was believed
that mental illness was caused by demonic possession, witchcraft, or an angry god
(Szasz, 1960). For example, in medieval times, abnormal behaviors were viewed as a
sign that a person was possessed by demons. If someone was considered to be
possessed, there were several forms of treatment to release spirits from the individual.
The most common treatment was exorcism, often conducted by priests or other
religious figures.
• Exorcism :- It is the religious or spiritual practices of evicting demons from a person or
an area that is believed to be possessed.
In 18th century. Unfortunately, treatment modes had not advanced beyond confinement and
cruel practice. Patients were locked up, confined to restrictive cribs, shackled, placed in
spinning chairs, purged, and left hungry- all in the name of a "cure" for their mental illness.
Due to a lack of awareness, misinformation, and plain indifference, individuals who are
experiencing any type of mental health issue are erroneously labelled as “maniacs” by the
general public
• .Dorothea Dix was a social reformer who became an advocate for the indigent insane
and was instrumental in creating the first American mental asylum.
• Willard Psychiatric Center in upstate New York, for example, one treatment was to
submerge patients in cold baths for long periods of time. Electroshock treatment was
also used, and the way the treatment was administered often broke patients’ backs;
(Willard Psychiatric Center, 2009). (Electroshock is now called electroconvulsive
treatment, and the therapy is still used, but with safeguards and under anesthesia.
• Many of the wards and rooms were so cold that a glass of water would be frozen by
morning (Willard Psychiatric Center, 2009).
• Starting in 1954 and gaining popularity in the 1960s, antipsychotic medications were
introduced. These proved a tremendous help in controlling the symptoms of certain
psychological disorders, such as psychosis. Psychosis was a common diagnosis of
individuals in mental hospitals, and it was often evidenced by symptoms like
hallucinations and delusions, indicating a loss of contact with reality
Profound and influential reforms were taking place in Europe during this time as well. William
Tuke founded the York Retreat in England, an institution devoted to humaneness and respect
for the mentally ill patients under care. Exercise, discussion, kindness, and hobbies replaced the
prior emphases on punishment and control, making the York Retreat a model institution for
others to follow. In France, Philippe Pinel worked to free patients from the senseless brutality,
and instead provided patients with attention, kindness, and a structured, positive, and
productive environment .
By the late 19th century, scientists began using experimentation to study human behavior.
Wilhelm Wundt and William James led this shift. Sir Francis Galton explored individual
differences through quantitative methods, setting up an anthropometric lab in 1882 to
investigate intelligence. James McKeen Cattell, inspired by Galton, studied; reaction time and
introduced the term "mental tests" to describe intelligence measures, contributing significantly
to measurement theory. It was in this period (1892) that the first professional society of
psychologists, the American Psychological Association (APA), was formed.
In the first half of the 20th century, clinical psychology was focused psychological assessment,
with little attention given to treatment.
 Alfred Binet - was appointed by minister to help children who were not performing well.
He developed Intelligence test and Indian adaptation test.
After the 1940s when World War I resulted in the need for a large increase in the number of
trained clinicians.
 In military and army, psychological tests usage started for recruitment.
 Another important postwar development was the recognition of clinical psychology as a
distinct discipline. Although disgruntled clinicians broke away from the more scientific
APA in 1917 to form the American Association of Clinical Psychology (AACP), this group
rejoined the APA in 1919 as its Section of Clinical Psychology. In 1921, according to
Hilgard (1987), a new organization called the Association of Consulting Psychologists
(ACP) was independently founded in New York. This group was notable for its
publication of the Journal of Consulting Psychology and for its adoption of a code of
ethics for professional psychology, the first organization to do so.
 In 1921, Thematic Apperception Test (TAT) was developed. It is a projective test that
involves describing ambiguous scenes. Popularly known as the "picture interpretation
technique". TAT was developed by American psychologists Henry A. Murray and
Christina D. Morgan at Harvard University. The TAT involves showing people a series of
picture cards depicting a variety of ambiguous characters (that may include men,
women, and/or children), scenes, and situations. The complete version of the TAT
 includes 31 cards. Murray originally recommended using approximately 20 cards and
selecting those that depicted characters similar to the subject.
 Wechsler - In 1939 gave Wechsler Intelligence Test, involving two categories: verbal and
non-verbal (performance).
 MMPI - The test was developed by clinical psychologist Starke Hathaway and
neuropsychiatrist J.C. McKinley (1943), two faculty members at the University of
Minnesota. The Minnesota Multiphasic Personality Inventory (MMPI) is a psychological
test that assesses personality traits and psychopathology. It is primarily intended to test
people who are suspected of having mental health or other clinical issues.
 Shakow committee in 1947, decided what all is to be taught to become a clinical
psychologist. Example- Research, dynamics, behavior, etc.
 In 1949, National Institute of Mental Health conducted a conference and noted down
clinical requirements for Clinical Psychology.
In 1940's and 1950's, psychological testing was not given much of a preference.
The number of clinical psychologists engaged in the medically dominated activity of treatment
increased in the years between World War I and World War II. Most clinical psychologists were
working primarily with children's educational problems in child guidance clinics under the
supervision of psychiatrists. Some, however, were extending their work to children with
psychiatric problems, while others were moving out of the clinic setting into private practice.
Psychologists' role in treatment was a natural extension of their assessment and consultative
functions.
 Although psychodynamic theory was associated primarily with the practice of
psychiatry, the writings of Freud and Adler were particularly useful to clinical
psychologists in their work with children. Play therapy techniques derived from Freudian
principles developed during this period (e.g., A. Freud, 1928), as did other therapies.
 Carl Rogers began to formulate client-centered therapy, his therapeutic alternative to
psychoanalytic treatment during these pre-World War II years (Watson, 1953), although
his ideas would not come into prominence until the 1940s and 1950s (Rogers, 1951).
 Behavior therapy, which would not become an integral part of clinical psychology until
the 1960s, was also beginning to receive some recognition. Interest in behavioral
applications was fueled by the fear conditioning work of John B. Watson and Rosalie
Rayner (1920) and Mary Cover Jones.

Table 1-1. Significant Dates and Events in the History of Clinical Psychology
Date Event
1793 Pinel introduces "humane care" in France
1848 Dorothea Dix facilitates construction of hospital for the insane in the United States
1879 Wilhelm Wundt creates first psychology laboratory in Germany
1882 Galton establishes anthropometric laboratory in England
1890 Cattell coins term mental tests to describe measures of intelligence
1892 APA founded with G. Stanley Hall as first president
1895 Breuer and Freud publish studies on hysteria
1896 Lightner Witmer founds first psychological clinic at the University of Pennsylvania
1904 University of Pennsylvania offers course of study in clinical psychology
1905 Binet-Simon scale developed
1907 First clinical psychology journal, The Psychological Clinic, is published
1909 Freud gives invited address at Clark University in Worcester, Massachusetts Healy founds
Juvenile Psychopathic Institute in Chicago, Illinois
1916 Stanford-Binet developed at Stanford University by Terman
1917 Psychoneurotic Inventory (Personal Data Sheet) developed by Woodworth Clinicians break
away from APA and form AACP
1919 AACP rejoins APA as Section of Clinical Psychology
1921 Army Alpha and Beta tests developed by Yerkes. ACP founded Rorschach's Psychodiagnostic
published
1924 David Levy brings Rorschach Test to United States
1935 TAT developed
1936 Clinicians leave APA to form AAAP
1937 ACP and AAAP merge APA's Section of Clinical Psychology abolished
1938 Bender-Gestalt introduced Buros publishes Mental Measurements Yearbook
1939 L. K. Frank coins term projective technique Wechsler-Bellevue developed
1943 MMPI developed
1945 AAAP rejoins APA
1946 Shakow Report published
1949 Boulder model outlined at APA Conference on Graduate Training in Boulder, Colorado
1951 Ethical guidelines developed by APA
1952 American Psychiatric Association's Diagnostic and Statistical Manual (DSM-I) published.
1953 Skinner publishes Science and Human Behavior Term behavior therapy coined by Lindsley,
Skinner, and Solomon
1955 Wechsler Adult Intelligence Test published
1958 Joseph Wolpe publishes Psychotherapy by Reciprocal Inhibition
1963 Community Mental Health Act signed by President Kennedy
1965 First professional school of psychology-Graduate School of Psychology at Fuller Theological
Seminary in Pasadena, California
1968 First Psy.D. Program-University of Illinois. Second edition of DSM (DSM-II) published.
1973 National Conference on Levels and Patterns of Professional 'fraining in Psychology (Vail,
Colorado)
1980 Third edition of DSM (DSM-III) published
1988 APS formed
1990 California Supreme Court affirms right of clinical psychologists to independently admit,
diagnose, treat, and release mental patients without medical supervision.
1994 DSM-IV published.
Academy of Psychological Clinical Science is established.
2000 DSM-IV-TR published.
2013 DSM-5 published.
PROFESSIONAL ROLE AND FUNCTIONS
Clinical psychologists are trained to study individuals' mental and behavioral challenges and
disorders with the intention of promoting change. They treat individuals who suffer from
mental disorders and other psychological health conditions.
Core responsibilities of psychological services include providing assessments and evaluations of
individuals, integrating psychological tests and treatment methods, and providing follow-up
care and resources.
Common responsibilities of clinical psychologists on the job may include:

1. Identify psychological, emotional or behavioral issues

2. Help clients define goals and plan action to achieve personal, social, educational and
vocational development and adjustment
3. Diagnoses or evaluates mental and emotional disorders of individuals and administers
treatment;
4. interviews patients in clinics, hospitals, and other settings
5. studies medical and social case histories.
6. Assesses patient progress and modifies treatment programs accordingly;
7. communicates with and counsels family members as appropriate.
8. May instruct and direct students serving psychological internships in hospitals and
clinics.
9. Provides psychological consultations to other mental health professionals within
hospitals, clinics, and other community based agencies.
10. May develop and implement clinical research programs.
11. May serve as Campus Security Authority as outlined by the Clery Act.
12. Performs variety of job-related duties as assigned.
13. Monitor client progress through regular meetings or sessions
14. Teach classes
15. Conduct research
16. Publish research findings in industry journals

Given the diversity of psychiatric settings, it is not surprising that psychologists perform
numerous activities in psychiatric hospitals. The roles of the psychologist can be grouped into
four broad categories: clinical, research, administrative, and teaching/supervision.
Table 1·2. Roles of Psychologists in Psychiatric Settings
Role Typical activities and responsibilities
Clinician Crisis intervention
Psychotherapy (individual, family, group)
Psychological testing
Consultation
 Researcher Principal investigator or collaborator on research studies
Consultant on methodological and statistical issues
Teacher/Supervisor Instructor for small, clinically oriented seminars
Clinical supervision (individual or group)
Administrator Management of clinical or training programs
Serving on or chairing hospital committees or divisions Utilization review

Although clinical psychologists may see similar cases throughout their years of practice, each is
uniquely based on a person’s background, current support system, and other factors that aid or
inhibit progress. It’s essential for a clinical psychologist to have a diverse background in
education and experience in order to apply the right kind of treatment and techniques
appropriate for the situation and person.

The clinical psychologist job description requires research, coursework, and field training in
professional psychology. It also calls for determination, passion, and a desire to guide people
through their mental health issues and struggles on a daily basis. Clinical psychologist duties are
challenging, but the work can be rewarding.

CURRENT ISSUES AND TRENDS IN INDIA

Changing health and lifestyle patterns in India have pushed mental, substance and behavioral
disorders in focus of health systems. According to the National Mental Health Survey (2015-
2016), almost 15% of Indian adults are in need of active intervention due to one or more
mental health issue. For a population of 1.3 billion (Government of India, 2011) the estimated
number of mental health professionals in India is 3800 psychiatrists, 898 clinical psychologists,
850 psychiatric social workers and 1500 psychiatric nurses (Ministry of Health and Family
Welfare, 2015). World Health Organization (2005) estimated 0.03 psychologists per 100,000
people in India (0.2 psychiatrists and 0.05 psychiatric nurses). The shortage of mental health
professionals has resulted in people with different qualifications—like diplomas, master’s
degrees, and certifications—providing care (Isaac, 2009). We urgently need to attract qualified
professionals to improve both the number and quality of mental health services.
Systemic and practice-based issues are discussed in this section.
 Loose licensing process: Rehabilitation Council of India was setup in 1993 for registering
qualified professionals but has failed to effectively achieve this in 24 years. Practicing
without certification is punishable by the law (RCI Act, 2000), but no punitive actions are
actively taken. Only 10% of clinical psychologists are certified, which affects pay,
insurance, and the profession's status.
 Lack of a regulatory body: While ethical guidelines exist, they are not well enforced.
The Indian Association of Clinical Psychologists (IACP) has less comprehensive laws
than those of the American Psychological Association (APA). The U.S. made significant
changes to its ethics code after past abuses, but India lacks similar development.

 Inadequate training facilities: It is RCI’s role to standardize, regulate, and develop
training programs/courses The number of institutes and seats offered within these
 affiliated centers is insufficient to meet the current demand of qualified professionals
Training often focuses on grades rather than evaluating students' suitability for practice.
‘
 Issue related to remuneration and status
 In India, Clinical Psychologist salaries vary drastically based on experience, skills, or
location.
 The issue related to starts right from the training days, where students are paid a
stipend per
 month as low as 2500, after spending 8 hours daily on the training. This has not financial
 consequences but is much more emotional and psychological; compared to other
professional
 trainees, this amount stays nowhere. It impacts a trainee's confidence and esteem and
makes
 them question their worth and value of the course they are pursuing. Good pay is
eventually a
 source of extrinsic as well as intrinsic motivation. After seven years of extensive
education and
 training, there is a gap in reality and expectation, making many reconsider their career
choices
 and multiple professionals moving abroad. As per PayScale, December 2017, the median
salary
 of a clinical psychologist in India is INR 3 71 411 per year. Below a comparison is drawn
to
 other countries (USA, UK, and Australia), relative to them and for a specialized course
the
 compensation is low.
 Issue related to remuneration and status
 In India, Clinical Psychologist salaries vary drastically based on experience, skills, or
location.
 The issue related to starts right from the training days, where students are paid a
stipend per
 month as low as 2500, after spending 8 hours daily on the training. This has not financial
 consequences but is much more emotional and psychological; compared to other
professional
 trainees, this amount stays nowhere. It impacts a trainee's confidence and esteem and
makes
 them question their worth and value of the course they are pursuing. Good pay is
eventually a
 source of extrinsic as well as intrinsic motivation. After seven years of extensive
education and
 training, there is a gap in reality and expectation, making many reconsider their career
choices
 and multiple professionals moving abroad. As per PayScale, December 2017, the median
salary
 of a clinical psychologist in India is INR 3 71 411 per year. Below a comparison is drawn
to
 other countries (USA, UK, and Australia), relative to them and for a specialized course
the
 compensation is low.
 Issue related to remuneration and status
 In India, Clinical Psychologist salaries vary drastically based on experience, skills, or
location.
 The issue related to starts right from the training days, where students are paid a
stipend per
 month as low as 2500, after spending 8 hours daily on the training. This has not financial
 consequences but is much more emotional and psychological; compared to other
professional
 trainees, this amount stays nowhere. It impacts a trainee's confidence and esteem and
makes
 them question their worth and value of the course they are pursuing. Good pay is
eventually a
 source of extrinsic as well as intrinsic motivation. After seven years of extensive
education and
 training, there is a gap in reality and expectation, making many reconsider their career
choices
 and multiple professionals moving abroad. As per PayScale, December 2017, the median
salary
 of a clinical psychologist in India is INR 3 71 411 per year. Below a comparison is drawn
to
 other countries (USA, UK, and Australia), relative to them and for a specialized course
the
 compensation is low.
 Low remuneration and status: In India, Clinical Psychologist salaries vary drastically
based on experience, skills, or location. The issue related to starts right from the training
days, where students are paid a stipend per month as low as 2500, after spending 8
hours daily on the training. This has not financial consequences but is much more
emotional and psychological; compared to other professional trainees, this amount
stays nowhere. It impacts a trainee's confidence and esteem and makes them question
their worth and value of the course they are pursuing. Good pay is eventually a source
of extrinsic as well as intrinsic motivation. After seven years of extensive education and
training, there is a gap in reality and expectation, making many reconsider their career
choices and multiple professionals moving abroad. As per PayScale, December 2017, the
median salary of a clinical psychologist in India is INR 3 71 411 per year. Below a
comparison is drawn to other countries (USA, UK, and Australia), relative to them and
for a specialized course the compensation is low.
 Unclear boundaries between terms: Identity and acknowledgment is a significant
concern clinical psychologists are facing at present. Multiple terms are widely
misunderstood and mixed while addressing individuals who provide psychological
 services. Counselor is a word that is loosely used as synonyms to clinical psychologists,
misleading people to consider their services to be those of on desk service providers.
Counseling is limited to providing short-term guide and support, whereas psychologists
are the people who provide a long-term solution for recurring problems.
 Lack of acknowledgment: There is a lack of understanding of who a psychologist is and
what they do? For a layman in India, a psychologist reads the mind and predicts the
future; hence they are most of the time served and asked the question, "can you tell
what is there in my mind?", "what am I going to do next?" Furthermore, many more
similar following questions and the belief that if they cannot answer these questions,
what do they do?
The tiny population who is relatively aware of psychotherapy benefits and takes
collaborative treatment (pharmacotherapy and psychotherapy) also show the
propensity towards tagging the treatment success to pharmacotherapy. This is the
genesis of a professional identity crisis, and it is a long due challenge that need to be
addressed at multiple levels. This trend has also led to a professional shift among clinical
psychologists. More and more professionals are looking for more stable career options,
teaching, and other relevant options, leaving the core job, and being trained.
 Less clinical research work: There is a lack of research in clinical psychology due to the
unavailability of funds and lack of needful intellectual support, which is discouraging and
creating obstructions in growth. This reduces studies conducted on the Indian
population, and indigenized practices without sufficient empirical data are adopted as
reported by Misra and Rizvi, in a meta-analysis conducted in the year 2012.
 Lack of indigenous psychotherapies: Lack of research leads to a lack of culture-based
empirically evident psychotherapies, which comes as a challenge to the practicing
clinical psychologists; there is a need for language specific therapy and relatable
concepts. Standard manual production will improve the conduction of therapies, which
can be time and cost-effective and more helpful to both parties. This will also help in
improving the reliability of the treatment.
 Lack of assessment tools: Case formulation is both a creative and scientific job. There
are multiple requirements to reach a suitable formulation. A good, precise formulation
is the founder stone of a clear treatment plan. Culture-specific/ or culture-free tools are
essential for reaching a conclusive formulation. There is a lack of such tools, which leads
to using a west-influenced tool with self-modification in the questions, which hamper
the scientific spirit of the tool and the whole process. The challenge is to develop tools
for relatively accurate assessments, precise formulation, and relevant treatment plans.

TRENDS OF CLINICAL PSYCHOLOGY

The pandemic era has changed attitudes toward science and mental health. The urgent need
for mental health services will be a trend for years to come. That is especially true among
children: Mental health–related emergency department visits have increased 24% for children
between ages 5 and 11 and 31% for those ages 12 to 17 during the COVID-19 pandemic.

 The rise of psychologists : Psychological expertise is in demand everywhere

  Reworking work: Industrial and organizational psychologists are helping employers and
employees navigate as COVID-19 reshapes the world of work
 Open science is surging: Open science is becoming the norm in psychology—a trend
spurred on by the COVID-19 pandemic
 Prominent issues in health care: How psychologists are working for positive change
 Mental health, meet venture capital: Private equity firms are funneling unprecedented
funds into mental health apps and related interventions. How will this trend affect
mental health care and the field?
 Kicking stigma to the curb: Celebrities publicly attending to their mental health
struggles may liberate others to do the same
 New frontiers in neuroscience: Recent discoveries about the biological underpinnings of
human behavior are helping psychologists find new ways to improve people’s lives
 Millions of women have left the workforce. Psychology can help bring them back: The
COVID-19 pandemic has pushed millions of women out of the workforce, but psychology
can help
 Children’s mental health is in crisis: As pandemic stressors continue, kids’ mental health
needs to be addressed in schools
 Burnout and stress are everywhere: Burnout and stress are at all-time highs across
professions, and among already strained health care workers, they are exacerbated by
the politicization of mask-wearing and other unrelenting stressors
 Climate change intensifies: Psychologists are learning how to bolster the health of
humans and the environment as the planet warms
 Big data ups its reach: More and more psychologists are incorporating big data
techniques into research and related business ventures.
 Psychology’s influence on public health messaging is growing: Psychologists are playing
increasingly vital roles in medical and public health settings
 Telehealth proves its worth: Psychologists are seeing the benefits of telehealth and
hoping payers continue to support it

RECENT TRENDS IN CLINICAL PSYCHOLOGICAL INTERVENTION

Psychoanalysis and short term dynamic psychotherapies
There are very few, if any, clinical psychologists in India who are using purely Freudian
psychoanalysis - saturated and unadulterated - without some modifications. While some clinical
psychologists are almost allergic to it - many go for short-term, focused, dynamic
psychotherapy or, an eclectic therapy with different degrees of utilization of dynamic principles
as advocated by Freud, Post Freudians, Neo-Freudians, with additions / modifications of their
own. Shorter, briefer and focussed models are there, more so in actual practice although
published material is limited – almost negligible, in this area and any hard data on it is really
hard to get now-a-days.
 Cultural influences: Conventional Western-model psychotherapy is based on a number
of premises, regarding its rationale and techniques, the universality of which is being
questioned and challenged with greater emphasis on a flexible approach taking into
account the socio-cultural reality. Some of these cultural variables have been identified
 as : Dependence, Attachment, Autonomy, Social distance, Concept of Sin, Belief in
karma, Dharma, Reincarnation, Guru-chela relationship. Detached observation, Prayers,
Recitation of Gurbani, etc. Indian introspectionists have produced a rich harvest of
profound psychological insights which need to be incorporated into psychotherapy with
our patients. e.g. "Nirvana" (burning out of passions, mental impurities), "Moksha"
(freedom from conditioning constraints of all types), "Sahaja" (one's nature born with
oneself), "Yoga". "Meditation", Samadhi", "Atman", "Maya", etc. Combining the Eastern
and Western psychotherapy in his own way, Dosajh, has reported good results with his
eclectic approach emphasizing the importance of establishing good rapport with the
patient, using psychoanalysis with the help of projective tests and in depth interviews,
followed by psychosynthesis using various methods of yoga, analysis, and even shock
therapy, drug therapy, group therapy, occupational therapy, recreational therapy, music
therapy, biblio therapy, environmental manipulation, etc. with the help of experts in
each area (e.g. psychiatrist for E.C.T. and drug therapy. Transcendental Mediation has
been reported useful in reducing anxiety.
 Religious psychotherapy: Finding western psychotherapy based on Freudian
psychoanalytical concepts as untenable in non-western cultures, many have turned to
what could be termed as "Religious psychotherapy". In this practical and useful
alternative to traditional psychoanalytical therapy, use is made of religious concepts
deeply engrained in one's culture to help the patients get over their problems. For
example, "Karma" is a Hindu philosophical viewpoint, the essence of which is that work
should be done for the sake of doing as a duty and not for result(s) which may be
effected by the large number of uncontrolled factors - as described in "Gita" - an ancient
Hindu document and a "master-piece in psychotherapy. A Guru-Chela model is more
acceptable and effective to many Indian patients although the role of a Guru is more
difficult than that of a western psychotherapist. The message of Gita was delivered in
the battlefield of Mahabharat by Lord Krishna (a master healer and true Guru) to Arjun
(symbolically the patient) to "arise" meaning arousal from 3 states of activity - from
ignorance to knowledge, from apathy to positive feeling and from inertia to purposeful
activity (representing the cognitive, affective and conative aspects of the mind). Work
(duty) is yoga (worship) which needs to be carried out for its own sake.
Similarly the religious concepts of death, rebirth / reincarnation / avtar, nirvana, moksha
etc., are utilized to foster a death acceptance view in terminally ill patients and the
bereaved families. Catholic charismatic healings have been reported. Praying, recitation
form religious books (Gita, Koran, Bible, Ramayana, etc) have been found useful to bring
peace and solace to many.
 Yoga techniques: Yoga is a system by which a person can enhance his physical and
mental abilities so that he can develop a deeper insight into the meaning of existence. It
was mainly meant for spiritual aspirants but recently yoga has been recognized
worldwide as a treatment procedure. The first written treatise on Yoga dates back to 5
BC and Patanjali Yoga Sutra has eight steps:
(1) Yama (Rules for morality such as non-stealing, non-converting, truthfulness, non-
violence):
 (2) Niyama (Rules of Self-discipline such as purity, austerity, study of scriptures,
continence);
(3) Asana (Postural patterns);
(4) Pranayam (Regulated breathing);
(5) Pratyahar (Withdrawal of senses from external objects);
(6) Dharana (Effortful concentration);
(7) Dhyana (Spontaneous concentration);
(8) Samadhi (State of super consciousness in which there is oneness with object of
concentration).
The first two steps guide passions and emotions and keep man in harmony with others
in society: the third keeps body healthy and strong; the fourth stills the restless minds; -
all these are "outer" quests of yoga, while the last four constitute the "inner" yoga
which keeps man in harmony with himself and his creator.
 Vipassana: Vipassana mediation is a scientific technique of self-observation, a system of
self-transformation by self-exploration, a healing by observation of a participation in the
Universal laws of nature. Also known as Awareness, Mindfulness Mediation, Insight, etc.
Vipassana is an ancient Indian meditation technique rediscovered by Gautama the
Buddha about 2500 years ago. It is Pali term which means "insight" - seeing things as
they really are and requires residential course under a; qualified teacher. To begin with,
one has to take a vow of observing certain rules of moral conduct (SILA) - e.g. abstention
from killing any sentient being, stealing, sexual misconduct, telling lies, and taking
intoxicant. This first step itself is likely to bring about positive changes in one's life style.
It is followed by Anapana (awareness of respiration). The individual observes the natural
flow of incoming and outgoing breath, just breath. Then the mind gets concentrated on
the neutral activity and the person assumes greater control over his mind. It promotes
the awareness of present moment and equanimous observation, since the act of
breathing is free from any craving, or aversion. The third step is Panya, i.e. purification
of mind through enhanced awareness. The individual engages himself in choice less and
effortless observation of body sensations and tries to develop an attitude of non-
judgment and non-reaction. This is supposed to have corrective influence on psychic
disturbances (anger, fear, insecurity, passion, sadness.
 Homeostasis Reality Therapy (HRT): HRT is a new school of psychotherapy rooted in
Indian psychology and culture. According to this theory 59% intensity of dominant
positive emotions (courage, gain, reality and justice) and 50% intensity of dominant
negative emotions (fear, loss anger and guilt) are essential for the survival and self-
actualization. The reason for all the stress induced disorders (like tension, headache,
essential hypertension, low back pain, etc.) are according to this theory, caused by
disequilibrium between two groups of emotions of the individual. The disequilibrium is
experienced as problems and by way of problem diffusion technique, it is possible to
restore an equilibrium or homeostasis by re-experiencing these events in present time
while modulating alpha waves in the brain. The individual is thus freed of his problems.
 Projective Psychotherapy: Although known to be in use in earlier days also, the newer
projective techniques, particularly the Somatic Inkblot Series (Booklet, Card, Video
forms) are increasingly being used as a powerful media to take the person back in time,
 creating hypnotic like effect, helping the person in catharsis, using responses through
content analysis and psychoanalytic interpretations, thus proving them to be an
effective therapeutic tool to release somatised grief, unprocessed unconscious material
in transsexuals, in depression and panic attacks, in coronary cases, etc.
 Creative use of leisure: Intelligent and creative use of leisure has been variously
described and recommended as a "human right", "mother of philosophy", "best of all
possession", "supremely desirable object of all sane and good men", "the final test of
civilization", "the best product of civilization", etc. A man is known by the company he
keeps, the books he reads, the occupation he selects, the habits / hobbies he develops -
as well as the way he spends his leisure time. Recreation is one form of such activities.
We often hear of "laughing meditation", and its effects on mental health. Also though
less known, is the "pleasure neurotic" - the one who is lost if he has no work to do.
There is a deep fear of relaxation / leisure that he must remain in harness as long as
possible - a kind of "work-addict". We in fact all need some leisure to do things we want
to do, to enjoy pleasures of life. It is good for our mental health. Even the handicapped
persons have a lot to benefit from leisure activities, be it those with serious physical
illness, addicts, and delinquents, criminals, mal-adjusted, old or mentally handicapped.
 Family therapy: Family therapy was started in the 1950's at Amitsar, India - at about the
same time that it was initiated in the west. Later it was taken up at Vellore and
Bangalore. The experience shows that involvement of families cuts down hospital stays,
increases acceptance of the patients and enhances family copings. It has been found
effective in the management of patients with schizophrenia, with alcohol and drug
addiction, those with marital and sexual problems, with mentally retarded children and
to a lesser extent with personality and conduct disorders. Often it is combined with
individual psychotherapy and drug therapy.
 Crisis intervention: In order to help the subjects to cope with the psychological distress,
mainly of sudden origin, a brief psychotherapy such as "crisis intervention" have been
used effectively. Crisis may be due to a loss (e.g. of vision, of hearing, death, financial
loss, serious illness, accident, still birth, a major surgery, etc.) which may be real or
imagined. The minimum therapeutic goal of crisis intervention is psychological
resolution of the individual's immediate crisis and restoration of at least the level of
functioning that existed before the crisis period. It has been effectively used to reduce
death anxiety, depression, enhance sense of well-being in head and neck cancer
patients, menstrual distress in adolescent girls, sudden loss of vision (T.B. Singh, NIVH,
Dehradun, and personal communication), etc.
 Other methods: These include use of hypnotherapy in cases of psychogenic impotence,
sex counselling in cases of masturbatory guilt, after care programs (including alcoholic
anonymous) following detoxification, etc.

AREAS OF SPECIALIZATION
There are various types of clinical psychology careers. There are numerous career options clinical
psychology offers. There are various psychologist types. Individuals can also opt for the various types of
clinical psychology careers mentioned below.
  Psychometric Assessment And Psychodiagnostics :- Assessment using interviewing,
behavioral assessment, administration and interpretation of psychological test
measures.
 Treatment and intervention :- Intervention using a range of evidence-based approaches
for individuals, families, and groups.
 Psychotherapy :- Psychotherapy, or talk therapy, is a way to help people with a broad
variety of mental illnesses and emotional difficulties. Psychotherapy can help eliminate
or control troubling symptoms so a person can function better and can increase well-
being and healing. (APA)
 Neuropsychology: Students who are willing to enter the field of neuropsychology need
an advanced qualification in clinical psychology. The research focuses on attitudes and
brain functions. The key task would be to assess the severity of brain injury or brain
damage by measuring the cognitive capacity of a patient. Patients with impaired brain
function/activity and cognitive disabilities should be assessed, examined, tested,
diagnosed, and treated using a range of clinical tests, tools, and techniques.

 Geropsychology: Geropsychology is a specialization of psychology that aims to address

older adults' issues. Mental health problems, anxiety and ageing, stress, and age-related
illnesses also expand for neuropsychologists to provide psychological counselling for
older individuals. Geropsychologist helps older people to lead healthy lives even into
their older years by delivering psychotherapy and approaches to address a range of
disabilities, ageing problems, and difficulties.

 Child Psychology: Clinical psychologists for children concentrate on diagnosing and

treating mental illnesses ranging from addiction to anxiety. Such practitioners work in a
clinical environment, typically in private practice, and sometimes in a hospital, and
therefore are qualified to offer techniques to deal with difficult disabilities. They
evaluate individuals and carry out tests, and also provide cognitive behavioural therapy
for the patient. If drug abuse is suspected, a child therapist may develop a course of
treatment or action; if a child suffers from any kind of fear, a diagnosis and treatment
strategy may be initiated by the psychologist. Child psychologist jobs can be found in
hospitals, schools, rehabilitation centers and juvenile homes.

ETHICAL AND LEGAL ISSUES

The Ethical Principles of the APA consist of a Preamble, a set of General Principles, and a large
number of specific Ethical Standards. The Preamble and General Principles, are not enforceable
rules; they are statements of the aspirations of psychologists to attain their highest ideals, and
they provide guidance to psychologists who are evaluating what would be ethically desirable
behavior in certain situations. The Preamble provides an overview of the ethics code and the
General Principles are as follows:

 Principle A: Beneficence and Non maleficence. The essence of this principle is that
psychologists should “do no harm.”

 Principle B: Fidelity and Responsibility. This principle states that psychologists must be
trustworthy and uphold the highest ethical standards in their professional relationships.

 Principle C: Integrity. This principle encourages psychologists to remain accurate,

honest, and truthful in their professional work.

 Principle D: Justice. This principle focuses on the need to treat all individuals, but
especially clients, fairly and justly.

 Principle E: Respect for People’s Rights and Dignity. This principle highlights the need for
psychologists to treat individuals with the utmost respect for their dignity and individual
freedoms.

Although these General Principles are not legally enforceable, they do set the tone for
psychologists to maintain the highest ethical standards. The Ethical Standards, however, are
enforceable. They apply to members of APA and may be used by other organizations, such as
state boards of psychology and the courts, to judge and sanction the behavior of a psychologist,
whether or not the psychologist is an APA member. The Ethical Standards are organized under
the following headings:

1. Resolving Ethical Issues- This section of the code explains how psychologists should
resolve ethical conflicts between professional organizations, how to cooperate with
professional ethics committees, and how to report ethical violations.

2. Competence- This ethical standard establishes the fact that psychologists must work
within the boundaries of their own competence, based on their training, experience,
consultation, and supervision. The different types of mental health–related problems
and potential treatments are highly varied. It is impossible for psychologists to be
competent in all areas, and in fact, unethical to attempt to portray themselves as such.
If a psychologist feels that he/she has not been trained to ensure competence in a
 specific area to treat a client, they should make an appropriate referral, which is the act
of directing a patient to a therapist, physician, agency, or institution for evaluation,
consultation, or treatment. This ethical standard also provides psychologists with
guidelines on providing services in emergency situations.

3. Human Relations. The human relations section of the Ethics Code provides criteria for
psychologists on how to approach situations related to the process of working with
people in a helping field; how to identify and avoid unfair discrimination, sexual or other
harassment, multiple relationships, conflict of interest, providing informed consent, and
avoiding termination of clinical services when it is not in the best interest of the client.
These types of behavior have strong adverse influences on mental health. As such,
psychologists must be particularly vigilant in identifying and avoiding these kinds of
behavior.
Some treatments have been shown to cause harm, and as such, should be avoided.
Situations where a clinician has more than one relationship with the client, beyond just
being a client, can be difficult to navigate and should be avoided as multiple
relationships can also lead to conflicts of interest. A psychologist refrains from entering
into a multiple relationship if the multiple relationship could reasonably be expected to
impair the psychologist’s objectivity, competence, or effectiveness in performing their
functions as a psychologist, or otherwise risks exploitation or harm to the person with
whom the professional relationship exists. The APA Ethics Code definition states that
a multiple relationship arises when a psychologist is in a professional role with an
individual, and (1) at the same time is in another role with the same person, (2) at the
same time is in a relationship with a person closely associated with or related to the
person with whom the psychologist has the professional relationship, or (3) promises to
enter into another relationship in the future with the person or a person closely
associated with or related to the person.
This section also provides guidance for cooperating with other professionals, which is
often a situation faced in multidisciplinary treatment teams. Guidance is provided for
providing and obtaining informed consent for treatment. Another section outlines how
to provide psychological services to or through organizations. And lastly, guidance is
provided for how to navigate situations in which there is an interruption of
psychological services for various reasons.
4. Privacy and Confidentiality- The privacy and confidentiality section is written to help
provide psychologists with guidelines for maintaining appropriate confidentiality and
respecting the privacy of the clients and patients under their care. Specific guidelines are
 provided for maintaining confidentiality for the psychologist’s patients as well as
discussing the limits of confidentiality with them. In certain situations where the safety
of the patient or others is at risk, confidentiality must be broken as law enforcement
needs to be notified. Sections on disclosures and consultations provide guidance on how
and when psychologists should disclose information and how to ethically consult with
other professionals while maintaining appropriate levels of confidentiality.

5. Advertising and Other Public Statements- Standards that control the way psychologists
publicize their services and their professional credentials are presented under this
category.

6. Record Keeping and Fees- The record-keeping and fees standard is developed to guide
psychologists in maintaining records of professional and scientific work in
confidentiality. This standard states that maintaining records allow professionals to
share information with other professionals if needed, help replicate research findings,
and abide by the requirements of the institution and the law.

7. Education and Training- The education and training standard is designed to help
psychologists create high-quality programs that train future psychologists with
appropriate knowledge and practice.

8. Research and Publication- The research and publication standard is developed to

highlight research and publication ethics that psychologists are expected to adhere to.
This standard emphasizes the necessity of approval by the institute prior to carrying out
the research, providing accurate information about the research study, and carrying out
the research in accordance with the approval. When obtaining informed consent, details
of the study should be presented to the participants, including but not limited to, the
objective of the study, the procedures, benefits, and potential risks associated with the
study, and the participants’ right to decline to participate and withdraw from the study
without any penalty. However, for studies that are not expected to cause any harm,
such as observing in a naturalistic environment, using anonymous questionnaires, or if
permitted by the law, it may not be necessary to obtain informed consent.
Compensation for participation should not be used to persuade an unwilling participant.
At the conclusion of the study, each participant should be presented with a summary of
the study and the participant should be provided with an opportunity to ask any
 questions they have. Further, if there has been some harm caused to the participant due
to participation in the study, necessary steps should be followed to minimize the harm.
This standard also provides guidelines and instructions on animal research.
Psychologists are responsible for reporting accurate findings and taking the necessary
steps to correct any errors in research and publication. Psychologists are also required
to only present original data as their work and share publication credits based on the
contributions rather than authority. Psychologists are also expected to be willing to
share research data when required for verification and maintain the confidentiality of
the participants during the review process.
9. Assessment- The assessment standard is developed to broadly address guidelines on
assessments. This standard states that the psychologist’s views should be supported by
findings from assessments while reporting the limitations of assessments. Psychologists
are responsible for using valid and reliable assessments that are administered in a
preferred language by the client. Informed consent is expected to be obtained in
accordance to the guidelines on the “Informed Consent” standard, unless the
assessment is required by the law, a routine practice, or required to test for the ability
to make decisions. Psychologists are required to be appropriately trained in order to
administer assessments and are responsible for using current tests.

10. Therapy. Rules about the structuring, conduct, and termination of therapy are identified
here. Specific standards prohibit psychologists from having sexual intimacies with
current clients or the relatives and significant others of current clients and from
accepting persons as clients if they have had previous sexual intimacies with them.
Furthermore, psychologists should not have sexual intimacies with former therapy
clients for at least 2 years after the termination of therapy, and even then only if the
psychologist can demonstrate that no exploitation of the client has occurred.

Ethical Decision Making

8-step model
1. Before facing any ethical issues, promise to act in a way that is morally right.
2. Become familiar with the APA ethical code.
3. Consult any law or professional guidelines relevant to the situation at hand.
4. Try to understand the perspectives of various parties affected by the actions you may
take. Consult with colleagues (always protecting confidentiality) for additional input and
discussion.
5. Generate and evaluate your alternatives.
6. Select and implement the course of action that seems most ethically appropriate.
7. Monitor and evaluate the effectiveness of your course of action.
 8. Modify and continue to evaluate the ethical plan as necessary.

LEGAL ISSUES IN PRACTICING

1. Confidentiality
 In general, psychologists are ethically obligated to maintain confidentiality
 Some situations can arise in which breaking confidentiality is appropriate
Confidentiality: Tarasoff and the Duty to Warn
Tarasoff is a court case regarding a college student client who told his therapist he
was going to kill his girlfriend (Tatiana Tarasoff). Therapist contacted campus police
who detained him, but after he was released, he killed her. Her family sued and won
Tarasoff v/s The Regents of the University of California. The finding was that
the therapist had the “duty to warn” the potential victim. This finding now sets a
precedent for all therapists for breaking confidentiality
 Confidentiality: When the Client is a Child
 When working with children, psychologists often assure them that not everything
they share will be told to their parents. This helps children feel more comfortable
and open during sessions. Parents, of course, have a right to be informed.
Psychologists often make arrangements by discussing this with families up front.
Some issues, such as child abuse, require breaking of confidentiality to protect the
child.
2. Informed Consent
 Clinical psychologists obtain informed consent for assessments, evaluations, or
diagnostic services. Informed Consent, except when
(1) Testing is mandated by law or governmental regulations;
(2) Informed consent is implied because testing is conducted as a routine
educational, institutional, or organizational activity (e.g., when participants
voluntarily agree to assessment when applying for a job); or
(3) Informed consent includes an explanation of the nature and purpose of the
assessment, fees, involvement of third parties, and limits of confidentiality and
sufficient opportunity for the patient to ask questions and receive answers.
 Clinical psychologists using the services of an interpreter obtain informed consent
from the patient to use that interpreter, ensure that confidentiality of test results
and test security are maintained, and include in their recommendations, reports,
and diagnostic or evaluative statements, including forensic testimony, discussion of
any limitations on the data obtained.
3. Boundaries and Multiple Relationship
In general, it can be problematic for clinical psychologists to know someone
professionally. as, say, a therapy client or student-and also to know that person in
another way- as, say, a friend, business partner, or romantic partner. The term used to
describe such situations is multiple relationships (although the term dual relationships
has also been used). It would be nice to state that psychologists never engage in such
relationships, but such a claim would be false. In fact, a significant portion of complaints
 to the American Psychological Association Ethics Committee involve “incidents of
blurred boundaries"
Defining Multiple Relationships
Ethical Standard APA (American Psychological Association, 2002) states that a multiple
relationship occurs when a psychologist is in a professional role with a person and
 At the same time is in another role with the same person,
 At the same time is in a relationship with a person closely associated with or related
to the person with whom the psychologist has the professional relationship
 Promises to enter into another relationship in the future with the person or a person
closely associated with or related to the person.

CODE OF CONDUCT
Considerations of the good of humanity and society, benefiting clients and not doing them
harm, providing a competent service, the importance of the individual, equal and fair
treatment, mutual respect, promoting justice, respecting responsible for education and training
programs seek to ensure that there is a current and accurate description of the program
content, the rights and dignity of other human beings, as well as personal happiness and
fulfilment are the important principles.
The Indian Association of Clinical Psychologists has also adopted a code of conduct. This is
based on the APA code and, though shorter, covers similar areas. This includes:
a) Professional competence and services: The interest of the client is paramount and
clinical psychologists should keep abreast of recent developments in the field.
b) Referrals: If proper assessment is not possible this should be communicated to the
referral source. If referral to a physician, psychiatrist or other health professional is
necessary, this referral should be made.
c) Opinion: Clinical psychologists should take full responsibility for their opinions under all
circumstances.
d) Consent: It includes all information about the nature of illness, method of treatment,
factors associated with efficacy and risk factors.
e) Client welfare: This is paramount. Therefore clinical psychologists should not take up
any case which is not within their competence.
f) Court Testimony: This should be based purely on findings and observations and should
not include bias and prejudice.
g) Confidentiality: Information should not be disclosed except to a concerned co-
professional or an appropriate authority. Test material should not be taken out of the
clinic or laboratory except for teaching purposes