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 Psikoterapi Kenabian : ilmu yg

membahas tentang proses
penyembuhan atau proses penyehatan
gangguan mental dan spiritual yg
dilakukan oleh para nabi/rasul,
khususnya Nabi Muhammad SAW dan
ahli waris mereka (auliya) yg bersumber
kepada Al Qur’an, As Sunnah dan
Ijtihad para ahli.
 Penyimpangan-penyimpangan sikap
dan perilaku yang dapat
membahayakan eksistensi diri, baik
antara diri dengan dirinya sendiri, orang
lain, lingkungan maupun antara dirinya
dg Tuhannya.
 Penyimpangan-penyimpangan yang
bersifat kejiwaan seperti : sikap, pola
pikir dan perilaku yang negatif dan
 Keadaan tsb akan dapat
membahayakan diri sendiri dan orang
lain atau lingkungannya.
 Penyimpangan-penyimpangan yang
bersifat ruhaniyah atau keyakinan.
 Penyekutuan (syirik)
 Pengingkaran (kufur)
 Inkonsistensi (nifaq)
 Pengabaian (fasiq).
 Alat pengukur gejala-gejala jiwa
(mental) adalah ilmu Akhlak, sedangkan
gejala-gejala ruhaniyah (spiritual)
adalah ilmu Tauhid atau ilmu Akidah.
 Kedua ilmu tersebut bersumber dari
Ketuhanan (Al Qur’an) dan Kenabian
(As Sunnah).
1. Sumber pengetahuan tentang proses
terapi kenabian yang telah dilakukan
oleh para nabi/rasul secara umum dan
Nabi Muhammad SAW secara khusus
terhadap gejala gangguan mental dan
spiritual yang bersumber dari ajaran
Ketuhanan (Al Qur’an) dan Kenabian
(As Sunnah).
 2. Memberikan pemahaman praktis
kepada para ilmuwan muslim yang
konsen kepada masalah kejiwaan,
agar lebih menyempurnakan ilmu dan
pengetahuannya tentang hakikat
manusia dan problematikanya.
 3. Memberikan pemahaman yang
praktis tentang cara/proses
penyehatan atau penyembuhan
gangguan mental dan spiritual secara
baik dan benar dengan konsep
Ketuhanan yang telah dilakukan oleh
para nabi dan ahli waris mereka.
 1. Mengantarkan individu atau kelompok
kepada sehat secara mental (psikologis),
agar dapat bersikap, berpikir dan berperilaku
dengan baik dan benar menurut ajaran Islam.
 2. Mengantarkan individu atau kelompok
kepada sehat secara spiritual (ruhani) agar
dpt beriman dan bertaqwa kpd Tuhannya dg
melakukan ketaatan dlm melaksanakan
perintahNya dan menjauhi laranganNya dg
baik dan benar.
 Dengan kekuatan lisan (nasihat dan
membaca beberapa ayat atau surat dari
Al Qur’an).
 Dengan kekuatan permohonan atau
doa khusus dan langsung kepada Allah
 Dengan media (tangan dan air).
 Tahap Penyadaran dengan jalan
pemberian nasehat yang dapat
menyentuh jiwa dan ruhani atau dengan
jalan menghilangkan hal-hal yang
menutupi jiwa dan ruhani yang
membuat hilangnya kondisi kesadaran
dan keingatan diri.
 Tahap bimbingan penyucian diri melalui
praktek pertaubatan dg pengamalan
aqidah, ibadah dan akhlaq.
 Tahap penanaman nilai-nilai Ketuhanan
dengan mengajarkan pesan-pesan
wahyu (Al Qur’an) dan hakikat
kehidupan yang paling hakiki (Al
Where do C/C’s work? (cont)
 Consulting
– Business/ Industry
– Larger Consulting firms (e.g.,RHR)
– Private Practice/ Executive coaching
 Administration
– Hospitals, VA’s
– Community Mental Health
– Schools and Universities
– Professional organizations
– Non-profits, Government
How are C/C’s trained?

 Two training models

 Boulder Model (1949, APA)
– Scientist-Practitioner Model
– Research/academic + applied skills
 Vail Model (1973, APA)
– Professional Model
– Emphasizes practice, much less research focus
– Development of free-standing professional
Degrees in Clinical and
 Master of Arts (M.A.) or Master of
Science (M.S.)
– 2 years, with completion a of Thesis
– Often obtained in route to Ph.D.
– Can teach at community college, see
clients under a supervisor
Degrees in Clinical and
 Ph.D., Doctor of Philosophy
– Scientist-practitioner (Boulder Model)
– 3 years related course work
– 1year Dissertation
– 1year Internship (APA approved)
– Totaling a minimum 5 years postgraduate
– APA accredited programs in universities
– Typically in Psychology Department or School of
Degrees in Clinical and
 Psy.D (sigh-dee), Doctor of Psychology
– Professional Model (Vail Model)
– 4 to 6 years
– Applied focus
– Not researched driven, some will do
– Completion of year internship
– Typically at professional schools
Licensure and Certification

 Motivating forces:
– Protect public from untrained/ incompetent
– Need to establish independent professional
 License- demonstrated competence
 Certification- verify completed education
 Registration- inform state that practicing
Professional Organizations
 American Psychological Association (APA)
– Formed 1892 by G. Stanley Hall
– Over 50 specialty Divisions
– Division 17: Counseling Psychology (1952)
– Division 12: Clinical Psychology (1944)
– Journals, Conferences, Professional Standards,
Ethics Code
 American Psychological Society (APS)
– Dissatisfied scientists broke off from APA in 1988
– Advancement of scientific psychology
History of
Clinical and Counseling
 Modern academic psychology developed in
Western Europe and American
 Psychology born 1879 in Leipzig, Germany
– Wilhelm Wundt
 William James- 1st American Psychologist
– Laboratory at Harvard in 1875
 Shift from structuralism, to functionalism, and
to behaviorism
– Person-centered/ Humanism: 3rd force
– Multi-culturism: 4th force
History: Explanation of Deviant
 Supernatural forces
 Demonology
– Invasion of spirits, Gods, or demons
– Priests were appropriate treatment
 Medical Model
– Define and discover solutions
– Helped to remove stigma
– Note symptoms, reveal disease process,
treatment and prevention
 Psychological Model: Freud
History: Treatment of Deviant
 Dark and Middle Ages
– Often involved cruelty, tortured until
confessed, execution
– Monasteries were refuges
 19th Century
– Treatment shifted to asylums
– Often chained, poorly fed, various
History: Reform

 Advocates of mentally ill

– Phillip Pinel- release from restraints and treat with
– Benjamin Rush- Advocated humane treatment in
– Dorothea Dix- (1841- 1881 campaign)
• improved conditions in U.S. and Europe
• 32 new mental hospitals
– Clifford Beers- 1908 published book about
experience in asylum: “A mind that found itself”
Bridging Academic and Applied
 Early 1900s, Emil Kraeplin developed 1st
diagnostic system for mental disorders
– Mental illnesses separate and distinct disorder
– Course and outcome predetermined
 Historical events shaping psychology
– World War I
• Army Alpha IQ test to screen recruits
• Army Beta- non-verbal test for illiterates
• Norms, standards, reliability, validity established for tests
– Discipline of Clinical Psychology recognized
Historical Summary:
Take Homes!
 Shift in focus of cause and treatment of
deviant members
– Supernatural Medical Psychological
 Development and merge of academic and
applied psychology
– Facilitated by World Wars
– Need for testing and psychological services
– Development of assessments
– Struggle still seen in models (Boulder vs. Vail)
 Clinical and counseling psychology had
similar and different routes
– Remnants are seen today
Ethics in psychology

 Clinical practice
 Teaching
 Research
 Assessment
 Consulting
 Professional portrayal/ Media
Ethical Dilemma

 Ethical Dilemma: a situation where no

course of action is satisfactory, reasons
for both sides
– Prima Facia- follow principles unless
conflicted with a higher principle (Kitchener,
 Prevalent ethical issues (Pope & Vetter, 1992):
– Confidentiality
– Dual relationships
Ethical Terminology
 Confidentiality-
– Ethical responsibility to not reveal information
– 3 circumstances when must break confidentiality
– Tarasoff Liability (1971) – Duty to warn, protect

 Privilege-
– Legal right of consumers to control information
– Protected relationship (husband-wife; lawyer-
– Laws vary by state, no partial waiving
Ethical Terminology (cont)

 Assumptions:
– Success treatment requires full disclosure
– Clients will not disclose unless assured privacy

 Informed Consent
– Fully informed about the treatment ($,timing,
Xments, therapist qualifications,etc.)
– Limits of confidentiality
APA Ethics Code
 Rationale
– Protect public and psychologists
– Agreed upon professional standards
– Framework for decisions and grievances
 Revisions
– First code published 1953
– Four extensive revisions since 1953
– Currently use 1992 code, but new revision draft
out by APA
 Format
– Introduction and preamble
– 6 General Principles
– Standards
General Principles
 Principle A: Competence
– Knowledgeable and practice within expertise
 Principle B: Integrity
– Honest and fair, aware how beliefs affect work,
clarify roles
 Principle C: Professional and Scientific
– Uphold professional standards of conduct,
collaborate when necessary, recognize the effect
personal actions have on view of psychology
General Principles (cont)
 Principle D: Respect for People’s Rights and
– Value worth/dignity of all people, aware of
differences (i.e., age, gender, race,religion, sexual
orientation, etc), eliminate biases/ prejudices
 Principle E: Concern for Other’s Welfare
– Respect integrity, protect welfare, aware of power
differences, do not exploit or mislead
 Principle F: Social Responsibility
– Work to benefit society (i.e., share knowledge,
pro-bono), work to alleviate suffering, avoid
misuse of work
Higher Order Ethical Principles
 Autonomy
– Responsibility/ freedom for own behavior, not at
the expense of others and must be competent
 Beneficence
– “do good”, contribute to health and welfare
 Non-maleficence
– Above all “do no harm”,
 Justice
– Fairness and equality, equal treatment of all
 Fidelity
– Truthfulness, loyalty and trust
Ethical Misconduct
 Psychologist personal vs. professional roles
– Consider public view of psychology
 APA Ethics Review Board
 Report to state licensing board
 Malpractice
– Professional relationship existed
– Negligent Act
– Client harmed
– Negligent act caused harm
The Changing Environment

 Diversity and changing population

– Increased diversity, fewer diverse counselors
– Population is aging
 The era of Managed Care, HMOs
 Efficacy, Accountability, and Cost-
 Defining roles & Competition with other MHPs
 Medical Model vs. Wellness/ Prevention
Era of Managed Care
 Health care controlled by corporations
– Conflict of interest: profit vs. care
– Competition ($ focus, accountability)
 Changes in health care system
– Driven by increasing costs
– Increased accountability
 Accountability
– Demonstrate services accomplish what they claim
– Peer review- judgment of services by peers
– OQ45.2- outcome tracking instrument
Era of Managed Care (cont)

 Cost-effectiveness
– Treatments that work and cost less
– Role of prevention????
 Cost cutting strategies
– Reimburse low cost Dr.’s
– Contract for specific services
– Prospective Payment System (PPS)
– Diagnose Related Groups
– Limit payment to certain “proven” treatments
Empirically Supported
 Efficacy vs. Effectiveness
– Efficacy- Does therapy work under controlled
– Effectiveness- Does it work in real life?
 Treatment guidelines
– Specify what Xments used for particular disorder
 Manuals to treat symptoms
 Impact on training, education, research
Division 12 list of ESTs
 Division 12 empirically “validated” treatments
– Effective in 2 control/ analogue studies
– Compared to control or other therapy
– Treatment must be manualized
– Population with same disorder
 Treatment manuals
– Facilitate research
– Effective in the “real world”?
 Treatment planning based on diagnosis
– Movement towards medical model
Criticisms of Division 12 List

 Almost all CBT

 Fear that list supercede clinical judgment
 Findings just justified since not “real- world”
 Concerns about therapy manuals
 Use of specific DSM diagnoses
 Limited to therapies that align with medical
Who will provide services?

 Master level services

 PhD’s
– Supervise
– Create Manuals
– Administration
 What is cost-effective?
Who gets services?

 HMOs determine what services and who gets

– Permission for services, “gatekeeper”
– Who you see
• Provider Panels
• Provider Profiling
– How much $$
– How many sessions
 Managed Care and ethical considerations
Defining Roles in the New Era

 Specialties fighting for niche

– Facilitates definition of clinical and
– Relationship with physicians
• Prescription Privileges???
 Medical Model vs. Prevention/ Wellness
– How does it fit into managed care??
Prescription Privileges
(Gutierrez & Silk, 1998)

 Arguments For  Arguments Against

– Integrated care – Against developmental
– Cost-effective framework
– Help underserved – Improve collaboration
– Not enough Psychiatrists – Split the profession
– Different levels of – Increase in premiums
training, licenses, – Specialists better
insurances – Changes in training
– Control of MEDS
– Precedent of other fields
Medical Model vs. Wellness

 Medical Model  Wellness

– Sick-well dichotomy – Developmental
– Labels, diagnosis – Prevention
– Remedial, not – Focus on holism
preventative – Synergistic
– Focus more – Continuum
pathology – Focus on assets
– Focus on deficits
Wellness and Counseling
 Definition and Dimensions of Wellness
 Wellness as a paradigm for counseling
 Prevention
– Psychology should work to put itself “out of
– Cost-effective in era of cost containment
Definition & Dimensions
 “Wellness in not just absence of illness”
– WHO (1967)
 Dimensions:
– Social, Physical, Emotional,Intellectual, Spiritual,
Environmental/ Occupational
 Integrative, Synergistic parts
– “sum is greater than whole”
 Wellness as a continuum
– Movement towards higher levels
Wellness: Paradigm for
Counseling Psychology
 Myers (1991)
– Wellness as the paradigm for counseling
– Label what we already do
– Aligns with developmental focus and
emphasis on positive psychology and
Section 1 Wrap-Up!!

 Understand the context of helping

 Know where psychologists work, what they
do, and necessary training
 Basic history/ development
 Ethical Considerations
 Current/Future Professional Issues
– HMOs, ESTs, Prevention, Medical vs. Wellness