Andrew Pomerantz Discusses Clinical Psychology/Psychopathology

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    • 00:04

      [How would you describe clinical psychology and psychopathologyto your students?What are the areas of difference or similarity between these twoterms?]

    • 00:10

      DR. ANDREW POMERANTZ: Clinical psychology and psychopathologyare [Andrew Pomerantz, PhD, Professor of Psychology,Southern Illinois University] closely related,but clinical psychology is more broad, in my opinion.Psychopathology is the study of psychological problems--disorders-- usually the DSM termsare what are used for defining psychopathology.But clinical psychology is the study of those disorders

    • 00:33

      DR. ANDREW POMERANTZ [continued]: as well as the study of the treatment of those disordersand the assessment of those disorders.So it's a more applied science and also coversa lot more ground.[What first inspired you to start research in the fieldof clinical psychology and psychopathology?]When I started-- when I was in graduate school--actually when I was an undergraduate-- my goal,my aspiration was to be a practicing psychologist.

    • 00:54

      DR. ANDREW POMERANTZ [continued]: I was not set on becoming an academic or a researcherfrom the very beginning, so when I did go to graduate schooland realized how enjoyable research and teaching can be,that steered me in a more academic direction,but I still had those roots in direct practice.So for that reason, a lot of the research that I've done,

    • 01:15

      DR. ANDREW POMERANTZ [continued]: both when I began and still today,focuses on very practice-relevant issues.Things that are very applicable to peoplewho are practicing psychology, particularly practicingpsychotherapy, so a lot of it hasfocused on ethical issues-- ethical and professionalissues.What is ethically appropriate?

    • 01:35

      DR. ANDREW POMERANTZ [continued]: What is professionally accepted for psychologists to do?What's the psychologist's perspective on that?What's the non-psychologist or perhaps the client'sperspective on that?Other sorts of ethical and professional issuesalong the lines of informed consent.In other words, when someone comes to psychotherapy,and they need to learn the ground rules,

    • 01:57

      DR. ANDREW POMERANTZ [continued]: sort of understand how all this works, whatis the process that psychologistsuse to inform people and get their consent or their approvalto move forward.The effect of the method of payment on psychotherapy.In other words, people often pay for therapyusing their health insurance or their managed care benefits.

    • 02:20

      DR. ANDREW POMERANTZ [continued]: Others may pay out of pocket, and does that decision,whether a third party pays or the client payshimself or herself, does that makea difference in how things go?So those are a few examples of howI've tried to do research that has direct clinical relevance.[Which key thinkers have inspired you,and who continues to influence you?]

    • 02:43

      DR. ANDREW POMERANTZ [continued]: I've been inspired by a number of different peoplein the clinical psychology field.Early on and now, I find myself inspiredby some of the big names.Carl Rogers certainly, Freud, Skinner,the cognitive psychologists like Aaron Beck and Albert Ellis.So those are people who influenced

    • 03:04

      DR. ANDREW POMERANTZ [continued]: many, many clinical psychologists,and I would include myself among those who have been influenced.Today there are quite a few researcherswhose work I find really interesting,and I draw some inspiration from.John Norcross is a big name in the field,who has published a lot of very important and relevantresearch.Gerry Koocher has done a lot of interesting workin the field of ethics.

    • 03:24

      DR. ANDREW POMERANTZ [continued]: So has Ken Pope.So those are some of the names that I follow these days.[Are there any major academic debates in this field?What are the principal areas of contention, and why?]Yes, there are quite a few big debatesgoing on within the field of clinical psychology these days.I'll try to list a few of them.One has to do with evidence based or manualized therapies.

    • 03:49

      DR. ANDREW POMERANTZ [continued]: In other words, to what extent should a client seekingpsychotherapy receive a therapy that comes from a manual,and the manual has been empirically supported to work.There are those who believe that that style of therapy--that model-- should be followed quite rigidlyand that anything that falls short of that

    • 04:13

      DR. ANDREW POMERANTZ [continued]: could be labeled malpractice.That's sort of an extreme view, but that's the viewtaken at the extreme end.There are others who say, no, that's notat all how therapy should go.It should be more customized, personalized,and manuals really don't have a place in it.I would say that many clinical psychologists land somewherein between, but those are two sides of the issue.

    • 04:36

      DR. ANDREW POMERANTZ [continued]: Another development in recent years that has been on the riseis the increase in the number of PsyD programs as opposed to PhDprograms.Not only the number of programs but the number of peoplethey admit, to the point where now the number of PsyDgraduates is about equal to the number of PhD

    • 04:59

      DR. ANDREW POMERANTZ [continued]: graduates and is growing.So it changes the shape of the field whenyou consider the different emphases of PsyD degreeas compared to a PhD degree.So the difference between the PhD and the PsyDis a pretty significant difference,in that the PhD is the traditional degree in ClinicalPsychology, and traditionally-- as it was defined according

    • 05:23

      DR. ANDREW POMERANTZ [continued]: to the Boulder Model back in mid 1900s--it was intended to be a degree of balance,balancing both science and practice,so that a person with that degreemight be able to perhaps do science--at least appreciate science-- and at the same time practicepsychology.As time went by, in the 1970s, 1980s,

    • 05:44

      DR. ANDREW POMERANTZ [continued]: there was an increasing movement by peoplewho wanted to earn a doctoral degree in Clinical Psychologybut had no interest in the research sideand a very strong research in the clinical side.What began as a grassroots movement evolved into the PsyDprogram and has grown into a much larger PsyD movement now

    • 06:06

      DR. ANDREW POMERANTZ [continued]: that is represented primarily by standalone institutions.In other words, PsyD programs thatare not affiliated with a larger universitybut are essentially training programs in and of themselvesthat emphasize the clinical side of clinical psychologyy--the practice side-- and de-emphasize the research side.

    • 06:27

      DR. ANDREW POMERANTZ [continued]: That's one of the differences.There are other differences as well in terms of funding,in terms of the orientations of the facultythere, in terms of a number of other factors,but that's where the differences beganis the emphasis on clinical work as opposed to a more

    • 06:48

      DR. ANDREW POMERANTZ [continued]: balanced approach that emphasizesboth clinical and the research side.[What new research directions do you find most exciting?]So one other interesting debate or development within the fieldright now involves cyber therapy or any sort of online therapy.This is something that is definitely on the rise now,

    • 07:10

      DR. ANDREW POMERANTZ [continued]: and there's a bit of a debate about its efficacy,the ethics surrounding it, the pragmatic surrounding it,but increasingly psychologists are looking to practice online.Some form of video chatting, some form of texting, emailing.

    • 07:31

      DR. ANDREW POMERANTZ [continued]: That is certainly a hot topic right nowand is only going to get hotter as time goes on.[Where would you like to take your own researchin the future?]I'd like to keep doing some of the same studiesthat I've done.I've done a number of studies on ethics and professional issues,but one interesting new directionthat I've started to pursue and would like to pursue more

    • 07:53

      DR. ANDREW POMERANTZ [continued]: has to do with the categorizationof psychological disorders.Especially with the publication of the DSM-5,there's been a lot of talk and a lot of controversyover what constitutes a disorder and howspecific disorders are defined.And I recently conducted a study in which

    • 08:14

      DR. ANDREW POMERANTZ [continued]: we examined the overlap between depression and anxiety,two disorders that have traditionally been thoughtof as distinct disorders but havetremendous levels of comorbidity or overlap,and there's some evidence to suggestthat they may be two manifestationsof the same underlying negative affect or neuroticism.

    • 08:36

      DR. ANDREW POMERANTZ [continued]: There's different terms for that underlying negativity,but our study suggested that if youtake that underlying negativity and you point ittoward the future and think negatively about the future,you're much more likely to be anxious.If you take that same underlying negativityand you point it toward the past,

    • 08:56

      DR. ANDREW POMERANTZ [continued]: think about what has happened to you,you're much more likely to be depressed.But the essence of the two disordersremains largely the same.Oh and by the way, if you think some about the past,some about the future, and some about the present,you are likely to have both depression and anxiety.So it's interesting to understand those distinctions

    • 09:16

      DR. ANDREW POMERANTZ [continued]: perhaps, but perhaps even more interestingis the fact that all of them representsome sort of negative reaction to circumstances in one's lifethat could go in a number of different directions.[How important are research methodology and methodsfor a rigorous analysis of clinical psychologyand psychopathology?What are the key research methods that you employ?]Research methodology is hugely important

    • 09:37

      DR. ANDREW POMERANTZ [continued]: in clinical psychology.In fact, you can probably infer from the factthat graduate students in clinical psychologyare required to take one, if not two, coursesin research methodology.You can infer from that that it's important to our field,and there's a whole lot to learn.So there are a wide variety of research methods that are used.

    • 10:00

      DR. ANDREW POMERANTZ [continued]: Among them would be randomized clinical trialsfor psychotherapies that are being tested,any number of different experimental orquasi-experimental methods.Personally, I have done a lot of survey research,surveying the general public, surveyingpeople who are seeking psychotherapy,

    • 10:21

      DR. ANDREW POMERANTZ [continued]: those kinds of things.But that's just a small fraction of the wide rangeof research methods that clinical psychologists use.[Are there any classic or seemingly 'untouchable' studiesin this field that have been reevaluated in light of recentacademic developments?]There was a big study-- at least big at the time-- in 1952by Hans Eysenck, and in his studyhe reviewed all of the psychotherapy outcome research

    • 10:46

      DR. ANDREW POMERANTZ [continued]: that he could get his hands on.There wasn't a whole lot at that time,but he accessed what he could, read through all of itand summarized it, and his summarywas that psychotherapy does not work,that going into psychotherapy does notbenefit a person any more than not going into psychotherapy.You can overcome your depression or your anxiety

    • 11:07

      DR. ANDREW POMERANTZ [continued]: just as fast by not going into therapy as you couldby going into therapy.So that was a rather stunning findingand controversial finding, and it reallyserved as a motivation for peoplethrough the 1950s, 1960s, 1970s, 1980s,to do more outcome studies, do more studies of how

    • 11:31

      DR. ANDREW POMERANTZ [continued]: well psychotherapy works.And what they found overwhelminglywas the opposite of what Hans Eysinck concluded,that psychotherapy does work.There is now a mountain of research suggestingthat psychotherapy is efficaciousfor a wide, wide range of psychological problems.

    • 11:55

      DR. ANDREW POMERANTZ [continued]: Actually, once they established that psychotherapy works,the researchers have moved on to study more specific questionslike, which therapies might work better than others?Which therapies might work best for particular disorders?So it's interesting that that old 1952 study really

    • 12:17

      DR. ANDREW POMERANTZ [continued]: kick started this movement that continues todayand continues to produce huge amounts of researchon the outcome of psychotherapy, almost all of whichis quite positive.[What are the strengths and weaknesses of the current DSM?]The DSM-5 has been criticized for a number of reasons.

    • 12:38

      DR. ANDREW POMERANTZ [continued]: The number one criticism-- at least that I've come across--has to do with its overexpansiveness, whichis kind of a fancy way of saying that it includes too much.It defines too much of human experienceas psychological disorder.It's really interesting, if you go back and lookat the old DSMs-- the original DSM-- they were thin

    • 13:00

      DR. ANDREW POMERANTZ [continued]: little books with a much smaller number of disorders in them,and then as the years went by, they grew and grew,particularly DSM-3 was a lot biggerthan DSM-2, and from that point on, DSM-4-- DSM-3R, 4,and now 5 have continued increase in size and scope,

    • 13:22

      DR. ANDREW POMERANTZ [continued]: not just the number of pages, but the number of disordersthat are included in there.And a lot of those disorders-- the thingsthat are defined as disorders now--were not defined as disorders in the past.So that is one big criticism that a lot of what people wouldcall problems in living, just sort of struggles that peoplehave, are now being defined as psychological disorders,

    • 13:45

      DR. ANDREW POMERANTZ [continued]: and people are under the impressionor are coming under the impressionthat they need to seek treatment or perhapsmedication for those problems.So that's one big drawback of the DSM-5.Another one that hasn't been quite as widely publicized,but has been publicized to a limited extent,has to do with the relationships between people who essentially

    • 14:11

      DR. ANDREW POMERANTZ [continued]: write the DSM, the authors of the DSM--or at least the people responsible for revisingit-- the connections that they haveto the pharmaceutical industry.To say it in simplest terms, a lot of themare financially connected to the pharmaceutical industry.They work as consultants or speakersor in some other capacity for a big drug company,

    • 14:33

      DR. ANDREW POMERANTZ [continued]: and when you think about how much the drug companies standto gain from the inclusion of new disorders in the DSM--and I'm not talking about obscure little disorderswhere there might be a few dozen people who getdiagnosed with some new form of schizophreniaor some other relatively uncommon disorder--

    • 14:55

      DR. ANDREW POMERANTZ [continued]: but new disorders that would capturebig swaths of the population, anythingfrom premenstrual dysphoric disorder, whichis a new disorder in DSM-5.Another controversy that surrounds the DSM-5hasn't received quite as much attention as the other,

    • 15:18

      DR. ANDREW POMERANTZ [continued]: but is still significant nonetheless,has to do with the people who write the DSM, the people whorevise it, and their connections to the pharmaceutical industry,and simply put, a lot of them have financial tiesto the pharmaceutical companies.They work as consultants or speakersor in some other capacity.They've done research that has been funded by them.In some capacity they have received money

    • 15:39

      DR. ANDREW POMERANTZ [continued]: from the pharmaceutical companies.When you think about how much moneythe pharmaceutical companies standto gain from the inclusion of new disordersor from re-definitions of disordersthat are more inclusive, it does raise questionsabout how objective these people can

    • 15:59

      DR. ANDREW POMERANTZ [continued]: be when they make the decisions about this being a disorderor that being a disorder.That's especially true when you considerthat many of the new disorders that have been includedin the DSM-5 are not obscure disorders that would onlycapture a dozen or a real small number of peoplebut will capture large swaths of the population.

    • 16:22

      DR. ANDREW POMERANTZ [continued]: Premenstrual dysphoric disorder, for example.Disruptive mood disregulation disorder, for example.Binge eating disorder as another example.These are disorders that in many waysare extensions of very common everyday problemsfor many, many, many people, and those have not

    • 16:43

      DR. ANDREW POMERANTZ [continued]: been defined as psychological disorders in the past,but they are now.So it'll be interesting to see how that affects our societyand what the ramifications of that will be as time goes on.[If a student could read one book,journal article or bulletin in this field to inspireor motivate them, what would it be, and why?]So if a student was going to read something

    • 17:03

      DR. ANDREW POMERANTZ [continued]: in the field of clinical psychology with the hopesthat it would motivate them to learn more,one thing I hope that they would considerwould be a journal, a good journal in the field,and the Journal of Clinical Psychology is a great start.There are a number of good journals in the field,but the Journal of Clinical Psychologyis a high-quality journal with a lot of interesting articles,and its scope is as broad as the field of clinical psychology.

    • 17:28

      DR. ANDREW POMERANTZ [continued]: A lot of the other good journals are more specialized than that,into assessment or a certain kind of treatment or treatmentin general or other kinds of issues,but the Journal of Clinical Psychologyis broad, covers all of those things and, as I mentioned,is a high-quality journal with good articles in it.So that's a good place to start.

    • 17:49

      DR. ANDREW POMERANTZ [continued]: I've also come across the Oxford Handbookof Clinical Psychology, which is just a compendium of chapterswritten by experts.Very well written, pretty accessible,and could really, again, give a studenta good idea of the scope, the range of the field,and the current state of any of those specialty areas.

    • 18:11

      DR. ANDREW POMERANTZ [continued]: So that's another good start, and one other book that I'llmention, for students who are perhaps a little more advanced,and I guess I'm thinking of undergraduateswho are considering graduate schoolor starting to consider graduate school,there's a book called The Insider'sGuide to Clinical and Counseling Psychology Graduate Programs.It actually comes out every couple of years,

    • 18:32

      DR. ANDREW POMERANTZ [continued]: and it is a gold mine of informationabout individual programs.Most of the book, actually, are the resultsof a survey of the directors of the doctoral programsaround the country.But even the pages before those resultsinclude a whole lot of information-- background

    • 18:54

      DR. ANDREW POMERANTZ [continued]: information-- about clinical psychology, how it comparesto other fields, what graduate school is like and evensome strategies about applying and getting in to whatis a difficult field to enter.So those are some of the books and journalsthat I would recommend.[What are the practical benefits of studying clinical psychology

    • 19:14

      DR. ANDREW POMERANTZ [continued]: and psychopathology for a student's academicor professional future?]I think one of the great benefitsof a degree in Clinical Psychology is its versatility.If a person earns a doctoral degree in Clinical Psychology,they can go in so many different directions.First of all, they can practice--assuming they become licensed, they can practice--

    • 19:35

      DR. ANDREW POMERANTZ [continued]: and that direction alone includes so many optionsfrom various kinds of psychotherapy,various kinds of assessment, in all kindsof different settings.So the practice option is there.The research option is there as well.Teaching is there as well, perhaps in some sortof academic position.So that is perhaps one of the great benefits

    • 19:59

      DR. ANDREW POMERANTZ [continued]: of a clinical psychology education,and it may be a little bit differentthan a lot of other doctoral degrees--or maybe a lot different than a lot of other doctoral degreesin that it doesn't lead to one pathbut sort of leads to a door that opensand can lead to many paths.[What would you identify as the key challenges of a course

    • 20:20

      DR. ANDREW POMERANTZ [continued]: in this field for a student, and what strategies would youadvise to counter these challenges?]For a graduate student in clinical psychology,I think one of the big challengesis the range of skills that the various classesin graduate school are going to require.If anyone mistakenly enters graduate school

    • 20:41

      DR. ANDREW POMERANTZ [continued]: in clinical psychology or appliesfor graduate school in clinical psychology,thinking that all of the classes are goingto focus on psychotherapy, or all of the classesare going to focus on assessment,or even that all the classes are going to focus on practice,they're sadly mistaken.There will be classes on psychotherapyof different kinds, there will beclasses on psychological assessment,

    • 21:03

      DR. ANDREW POMERANTZ [continued]: but there will also be classes on research methods,statistics, biopsychology, issues of culture,and a variety of other topics that canbe challenging for a person.It's the breadth of these courses that can reallyprove challenging, so my suggestion

    • 21:24

      DR. ANDREW POMERANTZ [continued]: would be that students first of all educatethemselves and actually look aheadand see-- do some research and find outwhat classes they'll be taking in graduate school.What is actually going to be required of themand then be open minded about it.Make a wise choice.If this is the field you want to enter,recognize up front that these are the kinds of classes

    • 21:44

      DR. ANDREW POMERANTZ [continued]: you'll take, and these are the expectations your professorswill have of you.[How do you think about the public impact of your ownresearch, and how do you assess the contribution of clinicalpsychology and psychopathology research to society at large?]Well, regarding my own research, I'dlike to think that it has a positive impact on the wayclinical psychologists practice, which in turn would havea positive impact on people's lives

    • 22:05

      DR. ANDREW POMERANTZ [continued]: and, more broadly speaking, I thinkthat is a vital role for clinical psychologyresearch in general, whether it'sdirectly focused on the practice of psychology--therapy, assessment, those kinds of things--or perhaps a bit further removed from that.Ultimately, it should inform clinical psychologists

    • 22:26

      DR. ANDREW POMERANTZ [continued]: and help clinical psychologists do their job well,which in turn would help their clients.So ultimately I think research and clinical psychologycan benefit society.

Andrew Pomerantz Discusses Clinical Psychology/Psychopathology

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Professor Andrew Pomerantz discusses his work in clinical psychology and psychopathology. He studies ethical and professional issues of psychological practice. He also expresses concern about the breadth of the new Diagnostic and Statistical Manual of Mental Disorders, both because it medicalizes everyday life and because its creators have strong ties to the pharmaceutical industry.

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Andrew Pomerantz Discusses Clinical Psychology/Psychopathology

Professor Andrew Pomerantz discusses his work in clinical psychology and psychopathology. He studies ethical and professional issues of psychological practice. He also expresses concern about the breadth of the new Diagnostic and Statistical Manual of Mental Disorders, both because it medicalizes everyday life and because its creators have strong ties to the pharmaceutical industry.

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