PSYCH 694 Week 2 Clinical and Counseling Psychology Example

Panic in Exam Room Two: How Clinical and Counseling Psychology Would Each Help a Fifteen-Year-Old in Flagstaff

[Student Name]

University of Phoenix

PSYCH/694: Specialty Areas in Applied Psychology

Week 2 Assignment

[Instructor Name]

[Date]

The health center, the patient and the treatment are composites written for a model paper; training data and research findings come from the sources listed.

Last week I mapped five problems in our health center to applied specialties. This week I follow the first of them, a teenager's panic attacks, to compare clinical and counseling psychology in practice.

Maya

Maya, fifteen, visited our clinic on three occasions over two months complaining of chest pain, racing heart and shortness of breath. Her pediatrician ruled out heart and lung problems and referred her to our integrated behavioral health team. Our clinical psychologist met her the same day during her medical visit, a warm handoff that our center uses to reduce missed referrals.

Two Specialties, One Patient

Clinical psychology grew from testing and treatment of mental disorders in clinics and hospitals. Counseling psychology grew from vocational guidance and the Veterans Administration's need to help returning soldiers adjust to civilian life, and it has historically emphasized development, strengths and the person in context. Today both are accredited by the American Psychological Association, both lead to the psychologist license and both work in hospitals, clinics and private practice. Counseling psychologists more often work in university counseling centers; clinical psychologists more often in medical and serious mental illness settings.

How Clinical Psychologists Train

Norcross et al. (2018) compared doctoral clinical psychology programs across twenty-three years. Doctor of psychology programs, built on the practitioner-scholar model, grew in number and size and accepted much larger proportions of applicants, while doctor of philosophy programs, rooted in the scientist-practitioner model, remained more selective, emphasized research and more often funded students fully. Cognitive behavioral orientations became more common among faculty, while psychodynamic orientations declined. Both program types require an internship before graduation, usually a full year in a hospital, clinic or counseling center.

Our psychologist holds a PhD from a scientist-practitioner program and completed her internship at a children's hospital, which shapes how she approaches Maya: with standardized assessment and a treatment chosen for its research support.

Assessment

She used a structured interview and a standardized anxiety questionnaire completed by Maya and her mother, confirming panic disorder with no other major condition. She asked about stressors: Maya's father had left the family the previous year, she had changed schools and she worried constantly that she would have an attack in class. She also asked about family and cultural context. Maya's family is Navajo, and her grandmother wanted her to see a traditional healer, which Maya and her mother also wanted.

Treatment

Cognitive behavioral treatment for panic teaches clients to understand the physical sensations of anxiety, challenge catastrophic thoughts and gradually face feared sensations and situations without escaping. Maya's plan includes eight to twelve sessions, some with her mother, and practice between sessions, such as deliberately raising her heart rate on stairs to learn that the sensations are not dangerous.

Evidence-Based Practice

An APA task force defined evidence-based practice in psychology as integrating the best available research with clinical expertise in the context of patient characteristics, culture and preferences (American Psychological Association Presidential Task Force on Evidence-Based Practice, 2006). The policy emphasized that research evidence alone does not determine treatment and that psychologists must consider the person's values, background and goals.

For Maya, that meant welcoming her family's plan to see a traditional healer alongside therapy, asking how her family understood her symptoms and arranging sessions around her school schedule and the family's long drive from a rural chapter house.

Evidence-based treatment for Maya includes the research on panic and her grandmother's wish for a traditional ceremony.

The Relationship

Lambert and Barley (2001) summarized research on what accounts for improvement in psychotherapy. Drawing on decades of outcome studies, they concluded that factors common across therapies, especially the therapeutic relationship, including empathy, warmth and the working alliance between therapist and client, were consistently and substantially related to outcome, more so than differences among specific techniques. They urged therapists and training programs to treat the relationship as central rather than as a backdrop for technique.

Maya's first session spent as much time on trust as on symptoms. She said later that she came back because the psychologist "didn't act like I was crazy."

How a Counseling Psychologist Might Frame It

A counseling psychologist would likely use the same evidence-based treatment, but might place more emphasis on Maya's developmental context, her strengths, her adjustment to her parents' separation and new school and her identity as a Navajo teenager in a mostly non-Native school. The difference would be one of emphasis, not of competence or method.

Confidentiality With a Minor

Maya is a minor, so her mother consented to treatment. Our psychologist explained at the start what she would share with Maya's mother, progress and safety concerns, and what would stay private, such as details Maya shared about friends. Making the limits clear helped Maya speak openly.

Where Master's-Level Clinicians Fit

Our center's licensed professional counselor, trained at the master's level, could also treat Maya's panic with cognitive behavioral methods. Counselors are not psychologists, but they provide much of the country's psychotherapy, especially in rural areas. The psychologist's added training shows most in complex assessment and supervision.

Working With the Traditional Healer

With the family's permission, our psychologist spoke briefly with the healer the family consulted, not to evaluate the ceremony but to make sure the two approaches did not send Maya conflicting messages. The healer described the ceremony as restoring balance after the disruption in Maya's family, and the psychologist described cognitive behavioral treatment as teaching Maya that her body's alarm was not dangerous. Maya said the two fit together: one helped her feel connected to her family again, the other gave her tools for the moment an attack began. Our center has learned that respecting traditional practices keeps many Navajo families in care who would otherwise drop out.

What the Case Taught Me

Following Maya showed me how much of a psychologist's work happens outside the therapy hour: coordinating with the pediatrician, explaining limits of confidentiality, speaking with a healer and adjusting schedules for a long drive. It also showed me that the specialty labels matter less to patients than whether the person in the room listens. Maya never asked whether her psychologist was clinical or counseling; she asked whether she could come back.

Progress

After ten sessions, Maya's panic attacks dropped from several a week to one in the last month, and her questionnaire scores fell into the mild range. She has not returned to the emergency room, has rejoined her school's cross-country team and now attends sessions monthly to keep her skills sharp. Her mother reports that Maya explains her breathing exercises to her younger brother, a small sign that the treatment has become her own.

Conclusion

Clinical and counseling psychology share training standards, methods and many settings, differing mostly in emphasis. Maya's treatment shows what both value: research-supported methods, attention to culture and preferences and a relationship that makes treatment possible.

References

American Psychological Association Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practice in psychology. American Psychologist, 61(4), 271-285. https://doi.org/10.1037/0003-066X.61.4.271

Lambert, M. J., & Barley, D. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy: Theory, Research, Practice, Training, 38(4), 357-361. https://doi.org/10.1037/0033-3204.38.4.357

Norcross, J. C., Sayette, M. A., & Pomerantz, A. M. (2018). Doctoral training in clinical psychology across 23 years: Continuity and change. Journal of Clinical Psychology, 74(3), 385-397. https://doi.org/10.1002/jclp.22517