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SOCIAL PSYCHOLOGICAL FOUNDATIONS

OF CLINICAL PSYCHOLOGY

SOCIAL PSYCHOLOGICAL FOUNDATIONS OF

A Division of Guilford Publications, Inc.

72 Spring Street, New York, NY 10012

www.guilford.com

All rights reserved

No part of this book may be reproduced, translated, stored in

a retrieval system, or transmitted, in any form or by any means,

electronic, mechanical, photocopying, microfilming, recording,

or otherwise, without written permission from the publisher.

Printed in the United States of America

This book is printed on acid-free paper.

Last digit is print number: 9 8 7 6 5 4 3 2 1

Library of Congress Cataloging-in-Publication Data

Social psychological foundations of clinical psychology / edited by James E Maddux,

June Price Tangney.

p cm.

Includes bibliographical references and index.

ISBN 978-1-60623-679-6 (hardcover : alk paper)

1 Clinical psychology 2 Social psychology I Maddux, James E II Tangney, June Price RC467.S63 2010

616.89—dc22

2010015992

About the Editors

James E Maddux, PhD, is University Professor of Psychology at George Mason University in

Fairfax, Virginia, and former director of its clinical doctoral program A Fellow of the can Psychological Association’s Divisions of General, Clinical, and Health Psychology, Dr

Ameri-Maddux is coauthor (with David F Barone and C R Snyder) of Social Cognitive ogy: History and Current Domains and coeditor (with Barbara A Winstead) of Psychopa- thology: Foundations for a Contemporary Understanding He is former Editor of the Journal

Psychol-of Social and Clinical Psychology and has served on the editorial boards Psychol-of the Journal Psychol-of Applied Social Psychology, Self and Identity, and the International Journal of Cognitive Psy- chotherapy Dr Maddux’s major interest is the integration of theory and research from clini-

cal, social, and health psychology His research is concerned primarily with understanding the influence of beliefs about personal effectiveness and control on psychological adjustment and health-related behavior

June Price Tangney, PhD, is University Professor of Psychology at George Mason University

A Fellow of the American Psychological Association’s Division of Personality and Social Psychology and of the American Psychological Society, Dr Tangney is coauthor (with Ronda

L Dearing) of Shame and Guilt, coeditor (with Jessica L Tracy and Richard W Robins) of The Self-Conscious Emotions: Theory and Research, and coeditor (with Mark R Leary) of the Handbook of Self and Identity She is Associate Editor of American Psychologist and has served as Associate Editor of Self and Identity and Consulting Editor of the Journal of Personality and Social Psychology, Personality and Social Psychology Bulletin, Psychological Assessment, the Journal of Social and Clinical Psychology, and the Journal of Personality

Her research on the development and implications of moral emotions has been funded by the National Institute on Drug Abuse, the National Institute of Child Health and Human Development, the National Science Foundation, and the John Templeton Foundation Dr Tangney’s current work focuses on moral emotions among incarcerated offenders A recipi-ent of George Mason University’s Teaching Excellence Award, she strives to integrate service, teaching, and clinically relevant research in both the classroom and her lab

Contributors

Jonathan M Adler, PhD, Department of Psychology, Franklin W Olin College of

Engineering, Needham, Massachusetts

Lauren B Alloy, PhD, Department of Psychology, Temple University, Philadelphia,

Pennsylvania

Susan M Andersen, PhD, Department of Psychology, New York University,

New York, New York

Roy F Baumeister, PhD, Department of Psychology, Florida State University,

Ronda L Dearing, PhD, Research Institute on Addictions, University at Buffalo, The State

University of New York, Buffalo, New York

Rene Dickerhoof, PhD, ICON Clinical Research, Lifecycle Sciences Group, San Francisco,

Donelson R Forsyth, PhD, Jepson School of Leadership Studies, University of Richmond,

Richmond, Virginia

Howard N Garb, PhD, Psychology Research Service, Medical Center, Lackland Air Force

Base, San Antonio, Texas

Frederick X Gibbons, PhD, Department of Psychology, Iowa State University, Ames, Iowa Robyn L Gobin, MS, Department of Psychology, University of Oregon, Eugene, Oregon Peter M Gollwitzer, PhD, Department of Psychology, New York University, New York,

New York, and University of Konstanz, Konstanz, Germany

Gregory Haggerty, PhD, Department of Psychology, Nassau University Medical Center,

Syosset, New York

Gordon C Nagayama Hall, PhD, Department of Psychology, University of Oregon,

Eugene, Oregon

Martin Heesacker, PhD, Department of Psychology, University of Florida, Gainesville,

Florida

Brian M Iacoviello, PhD, Mental Illness Research, Education and Clinical Center, James J

Peters VA Medical Center, and Mount Sinai School of Medicine, Bronx, New York

Neil P Jones, PhD, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Ethan Kross, PhD, Department of Psychology, University of Michigan, Ann Arbor,

Mark R Leary, PhD, Department of Psychology and Neuroscience, Duke University,

Durham, North Carolina

Sonja Lyubomirsky, PhD, Department of Psychology, University of California, Riverside,

Riverside, California

James E Maddux, PhD, Department of Psychology, George Mason University, Fairfax,

Virginia

Dan P McAdams, PhD, Department of Psychology, Weinberg College of Arts and Sciences,

Northwestern University, Evanston, Illinois

Megan C McCrudden, MA, Department of Psychology and Neuroscience, Duke

University, Durham, North Carolina

Regina Miranda, PhD, Department of Psychology, Hunter College, New York, New York Walter Mischel, PhD, Department of Psychology, Columbia University, New York,

New York

Janet Ng, MS, Department of Psychology, University of Oregon, Eugene, Oregon

Gabriele Oettingen, PhD, Department of Psychology, New York University, New York,

New York, and University of Hamburg, Hamburg, Germany

contributors ix

Chandylen Pendley, BS, Department of Social and Behavioral Sciences, University of

Florida, Gainesville, Florida

Paul B Perrin, MS, Department of Psychology, University of Florida, Gainesville, Florida James O Prochaska, PhD, Cancer Prevention Research Center, University of Rhode Island,

Kingston, Rhode Island

Janice M Prochaska, PhD, Pro-Change Behavior Systems, Inc., West Kingston,

Rhode Island

John Riskind, PhD, Department of Psychology, George Mason University, Fairfax, Virginia Peter Salovey, PhD, Department of Psychology, Yale University, New Haven, Connecticut William G Shadel, PhD, RAND Corporation, Pittsburgh, Pennsylvania

Yuichi Shoda, PhD, Department of Psychology, University of Washington, Seattle,

Durham, North Carolina

June Price Tangney, PhD, Department of Psychology, George Mason University, Fairfax,

Virginia

Eleanor B Tate, MA, Department of Psychology, University of Southern California,

Los Angeles, California

Cheryl Twaragowski, MS, Research Institute on Addictions, University at Buffalo,

The State University of New York, Buffalo, New York

Joel Weinberger, PhD, Derner Institute, Hy Weinberg Center, Adelphi University,

Garden City, New York

a textbook for graduate students in psychology and related fields who are interested in this topic This book is an attempt to meet this need.

This book had its beginning 7 years ago when our clinical doctoral program made some major changes in its focus and curriculum in an attempt to design a clinical psychology training program emphasizing social psychology and community psychology—both nontra-ditional and nonmedical model approaches to clinical psychology One of the new courses that we developed as a result of this change in focus was one dealing specifically with the social psychological foundations of clinical psychology, a course that each of us has now taught several times We realized that there was no suitable textbook for such a course and that the only previous book that might have been suitable at one time, Snyder and Forsyth’s

(1991) Handbook of Social and Clinical Psychology, was out of date In addition, we had

our own ideas of the topics that we wanted to address in the course, and nothing out there seemed to fill the bill We first constructed the course around journal articles, and then after getting a clearer sense of what we believed such a course should cover, we decided to design our own book to meet the needs of this course Because coverage of social bases of behavior

is required of all clinical programs that wish to be accredited by the American cal Association, we hoped and believed that such a book would be useful to programs other than ours

Psychologi-We designed the book specifically to be a textbook for graduate students in clinical and counseling psychology, although we believe that it will also find a home in other types of programs, especially programs in social psychology that have an applied focus Although not explicitly designed for advanced researchers or experienced practitioners, we believe that these audiences will find its up-to-date summaries of the empirical literature useful as sources for research ideas and clinical interventions We also did not design this volume to be

an update of Snyder and Forsyth’s groundbreaking and comprehensive book, which includes every possible topic at the interface of social and clinical, abnormal, and counseling psychol-ogy Instead, based on our combined 50 years of experience working with clinical doctoral students, we selected for coverage those topics that we believe are most relevant to clinical and counseling psychology training Our goal was not to cover everything but to cover the

basics—hence the word foundations in the title Our ideas about what these foundations are

were shaped not only by our experience in working with clinical students over the years but also our experience in teaching this course and getting input from the students concerning what they found relevant and useful

Our experience has been that clinical students often have difficulty initially seeing the connections between the various broad subfields of psychology and applied clinical work This book was an attempt to make more explicit the connections between social psychology and clinical practice We hope that the book will be especially welcome in clinical and coun-seling psychology programs that adhere to the emerging clinical science model of training The book is organized around the three basic questions that confront clinical and coun-seling psychologists:

1 How do psychological problems develop? (Part II: Psychological Health and logical Problems)

2 How can we understand and evaluate them? (Part III: Social Psychology of logical Assessment and Diagnosis)

Psycho-3 How can we design effective interventions for ameliorating them? (Part IV: Social Psychology of Behavior Change and Clinical Interactions)

Each section offers a selection of chapters that take an important social psychological theory or concept that offers an answer to one of these questions We asked our chapter authors not only to be scholarly in approaching their topics but also to keep in mind the need

to make their chapters accessible to and of value to students and practitioners We believe that they have succeeded admirably, and we hope that the readers will agree

James e maddux

June Price Tangney

RefeRence

Snyder, C R., & Forsyth, D R (Eds.) (1991) Handbook of social and clinical psychology: The health

perspective New York: Pergamon.

Contents

PaRt I IntRoductIon

History and Orienting Principles

James E maddux

PaRt II PsychologIcal health and PsychologIcal PRoblems

self and Identity

Patterns of Thought, Emotion, and Behavior

mark r Leary and Eleanor B Tate

Theory, Research, and Clinical Implications

dan P mcadams and Jonathan m adler

Public and Self-Stigma Models

Patrick W corrigan, Jonathan E Larson, and sachiko a Kuwabara

self-Regulation

Implications of the Limited Resource Model of Self-Regulation

celeste E doerr and roy F Baumeister

Timothy J strauman, megan c mccrudden, and neil P Jones

7 Strategies of Setting and Implementing Goals: Mental Contrasting 114 and Implementation Intentions

gabriele Oettingen and Peter m gollwitzer

carol s dweck and Elaine s Elliott-moskwa

Interpersonal Processes

Framework for the Practice of Psychotherapy

Hal s shorey

10 Social Support: Basic Research and New Strategies for Intervention 177

Brian Lakey

11 Social Comparison Theory 195

Pieternel dijkstra, Frederick x gibbons, and abraham P Buunk

12 Self-Disclosure and Psychological Well-Being 212

denise m sloan

social cognition and emotion

13 A Construal Approach to Increasing Happiness 229

sonja Lyubomirsky and rene dickerhoof

14 Emotions of the Imperiled Ego: Shame, Guilt, Jealousy, and Envy 245

June Price Tangney and Peter salovey

15 Social Cognitive Vulnerability to Depression and Anxiety 272

John riskind, Lauren B alloy, and Brian m iacoviello

PaRt III socIal Psychology

of PsychologIcal assessment and dIagnosIs

16 The Social Psychology of Clinical Judgment 297

Howard n garb

17 Sociocultural Issues in the Diagnosis and Assessment 312

of Psychological Disorders

sopagna Eap, robyn L gobin, Janet ng, and gordon c nagayama Hall

18 Clinical Assessment of Personality: Perspectives from Contemporary 329 Personality Science

William g shadel

contents xv

19 Interpersonal Assessment and Treatment of Personality Disorders 349

Lorna smith Benjamin

PaRt IV socIal Psychology

of behaVIoR change and clInIcal InteRactIons

20 Enabling Self-Control: A Cognitive–Affective Processing 375 System Approach to Problematic Behavior

Ethan Kross, Walter mischel, and yuichi shoda

21 The Social Psychology of Help Seeking 395

ronda L dearing and cheryl Twaragowski

22 Social Cognitive Theories and Clinical Interventions: 416 Basic Principles and Guidelines

James E maddux

23 Self-Directed Change: A Transtheoretical Model 431

James O Prochaska and Janice m Prochaska

24 Social Influence Processes and Persuasion 441

in Psychotherapy and Counseling

Paul B Perrin, martin Heesacker, chandylen Pendley, and mary B smith

25 Implicit Processes in Social and Clinical Psychology 461

Joel Weinberger, caleb siefert, and gregory Haggerty

26 The Social Psychology of Transference 476

regina miranda and susan m andersen

27 Group Processes and Group Psychotherapy: Social Psychological 497 Foundations of Change in Therapeutic Groups

donelson r Forsyth

PaRt V cuRRent status and futuRe dIRectIons

28 Social Psychological Foundations of Clinical Psychology: 517 Initial Trends, Current Status, and Future Directions

June Price Tangney

SOCIAL PSYCHOLOGICAL FOUNDATIONS

OF CLINICAL PSYCHOLOGY

PART I

INTRODUCTION

ciation, [APA] www.apa.org/divisions/div12/aboutcp.html), the field of clinical psychology

“integrates science, theory, and practice to understand, predict, and alleviate maladjustment, disability, and discomfort as well as to promote human adaptation, adjustment, and personal development [and] focuses on the intellectual, emotional, biological, psychological, social, and behavioral aspects of human functioning across the life span, in varying cultures, and at all socioeconomic levels.”

Both of these definitions are wide-ranging and cover a lot of territory In fact, it is ficult to imagine a situation involving any human being that does not involve the “actual, imagined, or implied presence” of another human being Likewise it is difficult to imagine a situation involving any human being that does not involve some aspect or another of “the intellectual, emotional, biological, psychological, social, and behavioral aspects of human functioning.” Can we, therefore, draw any meaningful distinctions between social and clini-cal psychology? Perhaps not Although social psychology traditionally has been concerned with more or less “normal” social and interpersonal behavior, and clinical psychology tra-ditionally has been concerned with “abnormal” or “pathological” social and interpersonal behavior, the differences between the fields depend largely on our ability to draw distinc-

dif-tions between normal and abnormal behavior As discussed below, research strongly suggests that this distinction is difficult, if not impossible, to draw The field of social psychology has become more difficult to define as social psychologists have become more concerned with topics traditionally viewed as “clinical” (e.g., the cognitive and interpersonal aspects of depression and anxiety) In addition, the field of clinical psychology has become increasingly difficult to define over the past several decades as we have learned more about the generality

of psychological change processes, the relationship between normal and maladaptive opment, and the continuity between “normal” and “abnormal” and between healthy and unhealthy psychological functioning

devel-A History of tHe interfdevel-Ace between sociAl And clinicAl PsycHology

For most of the 20th century, social and clinical psychology remained separate enterprises Not only were they concerned with what seemed to be different human phenomena (normal social behavior vs psychological disorders), but they also employed different methods of investigation (controlled experiments vs case studies) Philosophical and conceptual differ-ences hindered attempts to bridge the two disciplines Although these differences remain today, to some degree, since the late 1970s theorists and researchers from both sides have focused more on the commonalities between social and clinical psychology than on the dif-ferences The result has been a wealth of conceptual and empirical articles, chapters, and books that have attempted to describe and empirically explore an interpersonal and cogni-tive approach to understanding psychological adjustment and to developing psychological interventions

The term clinical psychology was first used by Lightner Witmer (1907/1996), who

founded the first psychological clinic in 1896 at the University of Pennsylvania Witmer and the other early clinical psychologists worked primarily with children who had learning

or school problems These early practitioners were influenced more by developments in the new field of psychometrics, such as tests of intelligence and abilities, than by psychoanalytic theory, which did not begin to take hold in American psychology until after Freud’s visit to Clark University in 1909 (Korchin, 1976) Soon after Freud’s visit, however, psychoanalysis and its derivatives came to dominate not only psychiatry but also the fledgling profession

of clinical psychology During most of the first half of the 20th century, psychoanalytic and derivative psychodynamic models of personality, psychopathology, and psychotherapy were the predominant perspectives By midcentury, however, behavioral voices (e.g., Skinner; Dol-lard & Miller) and humanistic voices (e.g., Carl Rogers) were beginning to speak

The two World Wars greatly hastened the development of the practice of clinical chology During World War I, psychologists developed group intelligence tests, which were needed by military services to determine individual differences in abilities Woodworth devel-oped his Psychoneurotic Inventory to identify soldiers with emotional problems (Korchin, 1976) Clinical psychology was given an even bigger boost by World War II because of the unprecedented demand for mental health services for military personnel during and after the conflict (Korchin, 1976) Of particular concern was the treatment of “shell shock,” which had become recognized by the early 1920s as a psychological response to stress (Reisman, 1991) In the mid-1940s, the Veterans Administration recognized clinical psychology as a

psy-History and Orienting Principles 5

health care profession, and this recognition spurred the development of doctoral training programs in the field By 1947, 22 universities had such programs, and by 1950, about half

of all doctoral degrees in psychology were being awarded to students in clinical programs (Korchin, 1976) In 1946 Virginia became the first state to regulate the practice of psychol-ogy through certification

In 1949 a conference on the training of clinical psychologists was held at Boulder, Colorado (Maher, 1991) An outgrowth of earlier reports by APA committees in 1945 and

1947, it included representatives from the APA, the Veterans Administration, the National Institute of Mental Health, university psychology departments, and clinical training centers (Raimy, 1950) At this conference, the concept of the clinical psychologist as a

scientist-professional or scientist-practitioner—first developed in 1924 by the APA’s

Divi-sion of Clinical Psychology—was officially endorsed According to the new standards, a clinical psychologist was to be a psychologist and a scientist first and a practicing clinician second Clinical programs were to provide training in both science and practice Clinical practitioners were to devote at least some of their efforts to the development and empirical evaluation of effective techniques of assessment and intervention However, the integration

of research and clinical work often has been more an ideal than a reality For example, a

1995 survey (Phelps, Eisman, & Kohout, 1998) found that less than one-third of ing psychologists bother to measure treatment outcome A more recent survey (Boisvert & Faust, 2006) found that, despite the increasing emphasis over the past decade on empirically supported treatments and evidence-based practice (APA, 2006), practicing psychologists in general have only a “modest familiarity with research findings” (p 708)

practic-When the scientist-practitioner model was adopted, social psychology was a required part of the training of clinical psychologists and remains so today Several social cognitive and interactional approaches to personality and adjustment were available during clinical psychology’s early years, including the theories of Julian Rotter (1954), George Kelly (1955), Harry Stack Sullivan (1953), and Timothy Leary (1957) Despite these alternatives, clinical psychology remained, for the most part, wedded to psychoanalytic notions Social psychol-ogy had a limited influence on clinical practice because the academic training of clinical students took place in universities, whereas their clinical skills training (in particular, their internships) occurred mostly in psychiatric hospitals and clinics In these setting, clinical psychologists worked primarily as psychodiagnosticians under the direction of psychiatrists, whose training was primarily biological and psychoanalytic Therefore, despite required exposure to social, cognitive, and interpersonal frameworks, clinical psychology adopted the individualist, intrapsychic, and medical–biological orientations of psychiatry rather than an interpersonal and contextual orientation grounded in social psychology (Sarason, 1981)

By midcentury the practice of clinical psychology had become characterized by at least four assumptions about the scope of the discipline and the nature of psychological adjustment and maladjustment First, clinical psychology is the study of psychopathology That is, clinical psychology is concerned with describing, understanding, and treating psychopathology—deviant, abnormal, and obviously maladaptive behavioral and emo-tional conditions Psychopathology is a phenomenon distinct from normal psychological functioning and everyday problems in living Clinical problems differ in kind from non-clinical problems, and clinical populations differ in kind from nonclinical populations.Second, psychological dysfunction is analogous to physical disease This medical anal-ogy does not hold that psychological dysfunctions are caused by biological dysfunctions,

although it does not reject this possibility Instead, it holds that painful and dysfunctional emotional states and patterns of maladaptive behavior, including maladaptive interpersonal behavior, should be construed as symptoms of underlying psychological disorders, just as a fever is a symptom of the flu Therefore, the task of the psychological clinician is to identify (diagnose) the disorder (disease) exhibited by a person (patient) and prescribe an intervention (treatment) that will eliminate (cure) the disorder.

Third, psychological disorders exist in the individual Consistent with both intrapsychic

and medical orientations, the locus of psychological disorders is within the individual rather

than in his or her ongoing interactions with the social world

Fourth, the primary determinants of behavior are intrapersonal People have fixed and stable properties (e.g., needs or traits) that are more important than situational features

in determining their behavior and adjustment Therefore, clinical psychologists should be concerned more with measuring these fixed properties (e.g., by intellectual and personality assessment) than with understanding the situations in which the person functions

An early union between social and clinical psychology was attempted in 1921 when the

Journal of Abnormal Psychology, founded by Morton Prince in 1906, was transformed into the Journal of Abnormal and Social Psychology Clinical psychologist Prince (the journal’s

editor) and social psychologist Floyd Allport (its managing editor) envisioned an integrative journal that would publish research bridging the study of normal interpersonal processes and abnormal behavior The vision, however, did not become a reality In the revamped journal’s first two decades, few of its articles dealt with connections between social and abnormal psy-chology (Forsyth & Leary, 1991) The social psychological research published by the journal became increasingly theory-driven, whereas the clinical research was primarily professional

in nature and usually had little relevance to theory (Hill & Weary, 1983)

The failure of this early attempt at integration is not surprising in light of the ent paths taken by social and clinical psychologists during this time Clinical psychology was developing as a discipline with scientific ambitions, but it continued to be dominated

differ-by psychodynamic perspectives that did not lend themselves to empirical testing and that emphasized the individual’s inner life over interpersonal, situational, and sociocultural influ-ences For example, despite the best efforts of Kurt Lewin and the Yale Institute of Human Relations (IHR) group, psychoanalysis resisted efforts to be integrated with research-based general psychology Maher (1991) wrote that, in the 1950s, “as a contributing discipline

to psychopathology, psychoanalysis was scientifically bankrupt” (p 10) At the same time, social psychology, however, was becoming more rigorously empirical and experimental, and thus increasingly irrelevant to the practice of clinical psychology

Thus, by the 1950s, social psychologists and clinical psychologists were pursuing ferent paths that rarely crossed, even in the journal devoted to their integration The ques-tions raised by social psychologists focused largely on the situational determinants of normal social behavior and the cognitive constructions of presumably normal people The questions raised by clinical psychologists dealt with the intrapsychic determinants of abnormal behav-ior (psychopathology) and the treatment of clinical disorders Social psychologists conducted research from a nomothetic perspective that attempted to develop and test elementary prin-ciples of social behavior Practicing clinical psychologists typically employed an idiographic approach with their clients and were concerned with what works with what client and what problem and were less concerned with trying to determine the independent influences of these various factors that seemed to explain a client’s problems and of the various strategies

dif-History and Orienting Principles 7

that seemed to work Social psychologists were concerned with the discovery of general ciples of social behavior through the use of objective and empirical methods and the analysis

prin-of group data Clinical practitioners were concerned with the subjective experiences prin-of vidual clients and with using their own subjective experiences as a tool for understanding clients Social psychologists were concerned with quantitative descriptions of people; clinical psychologists’ descriptions of people were largely qualitative Finally, social psychologists emphasized internal validity through controlled experiments Clinical psychologists preferred naturalistic research with high external and ecological validity (Leary & Maddux, 1987)

indi-As a result of these differences, Prince’s experiment in social–clinical integration was

aborted in 1965 when the Journal of Abnormal and Social Psychology was split into Journal

of Abnormal Psychology and the Journal of Personality and Social Psychology Thirty years

later it was remarked that “no act better symbolizes the increasing specialization and mentation of psychological science” than this dissolution (Watson & Clark, 1994, p 3) Like

frag-its predecessor, even the new Journal of Personality and Social Psychology gave first billing

to the traditional study of fixed properties of the individual and second billing to the study

of the individual’s social world

Despite this split, some social, clinical, and counseling psychologists continued to sue integration As noted previously, clinical psychology began to be influenced by learning theory and research (Dollard & Miller, 1950; Rotter, 1954) Many clinical psychologists, however, were skeptical of the animal-conditioning models on which learning theories were based, and so the influence of these models was limited In the 1960s several attempts were made to construct connections between social psychology (as opposed to learning theory) and clinical psychology Frank (1961) argued that all psychological change—including faith healing, religious conversion, and psychotherapy—could be explained by a few basic inter-personal and cognitive processes, such as a trusting relationship with a helping person and positive expectations of help Goldstein (1966) described the relevance to psychotherapy of research on expectancy, attraction, authoritarianism, cognitive dissonance, norm setting, and role theory Goldstein, Heller, and Sechrest (1966) offered a social and cognitive analysis of the therapist–client relationship and group psychotherapy and interpreted resistance in psy-chotherapy as being similar to reactions against attempts at attitude change Strong (1968, 1982; Strong & Claiborn, 1982) presented an analysis of psychotherapy and counseling as a social influence process and later conducted a program of research on interpersonal processes

pur-in psychotherapy Carson (1969) described the role of disordered social pur-interactions pur-in the origin of psychological problems and argued that psychological difficulties are best explained

by interpersonal rather than intrapersonal processes This theme was also central to Ullman

and Krasner’s (1969) influential abnormal psychology text

Three publications in the 1970s contributed much to the definition of the emerging face of social and clinical psychology Two were chapters on social psychological approaches

inter-to psychotherapy (Goldstein & Simonson, 1971; Strong, 1978) in the first and second

edi-tions of the Handbook of Psychotherapy and Behavior Change (Garfield & Bergin, 1971,

1978) The third was a 1976 book by Sharon Brehm that focused on the clinical tions of the theories of reactance, dissonance, and attribution Since 1976, social and clinical research on the first two theories has declined, but research on attributions has flourished, such as research on the role of attributions in depression (see Riskind, Alloy, & Iacoviello, Chapter 15, this volume) The wave of interest sparked by these publications continued into the 1980s with work on the interpersonal origins of psychological problems, interpersonal

implica-approaches to psychological assessment, and interpersonal influence in psychotherapy (Leary

& Miller, 1986; Maddux, Stoltenberg, & Rosenwein, 1987; Weary & Mirels, 1982) At the same time, social psychological researchers increasingly studied topics of clinical relevance, such as self-concept, self-regulation, persuasion, and cognitive processes in a variety of psy-chological problems, as is evident throughout this volume

A milestone in the development of a more “social” clinical psychology was the

pub-lication of the of the first issue of the Journal of Social and Clinical Psychology in 1983

Founded by social psychologist John H Harvey, this new journal provided an outlet cifically for research at the interface of social and clinical psychology A few years later,

spe-Brehm and Smith’s (1986) chapter in the third edition of the Handbook of Psychotherapy and Behavior Change (Garfield & Bergin, 1986) broadened the perspective offered in

Strong’s 1978 chapter (Unfortunately, the most recent edition of this handbook does not

include a chapter on social psychological approaches.) An American Psychologist article

by M Leary and Maddux (1987) provided a set of basic assumptions for the social–

clinical interface and summarized the major developments and issues in the field The Handbook of Social and Clinical Psychology: The Health Perspective (Snyder & Forsyth,

1991) provided the most comprehensive compendium at that time of the application of social psychological theory and research to clinical issues and problems More recent

but less comprehensive volumes include Social Cognitive Psychology: History and rent Domains (Barone, Maddux, & Snyder, 1997) and Kowalski and Leary’s The Social Psychology of Emotional and Behavioral Problems (2000) and Key Readings in Social- Clinical Psychology (2003).

Cur-In tandem with the publications noted above, professional developments during the past several decades have led to a greater awareness and appreciation by social and clinical psychologists of each others’ work and greater opportunities for collaboration

First, counseling psychology established itself as a field specializing in normal ment problems rather than severe psychopathology, and it shifted gradually from intrapsy-chic to interpersonal models (Tyler, 1972) As a result, counseling psychologists found many concepts and models in social psychology compatible with their approaches to understand-ing adjustment and psychological interventions Many important studies on crucial psycho-therapy issues, such as therapist–client matching, therapist credibility, the client–therapist relationship, and interpersonal influence, have been published in the past several decades in counseling psychology journals Clinical psychologists interested in these issues were thus exposed to many psychotherapy-related studies based on social psychological models and concepts

adjust-Second, behavior therapy, the part of clinical psychology most closely linked with eral experimental psychology, became more cognitive A glance at any recent clinical journal

gen-or book with behavigen-or gen-or behavigen-oral in the title provides evidence of the cognitive evolution

of behavioral clinical psychology In fact, behavior therapy became so “cognitive” that several years ago the Association for the Advancement of Behavior Therapy changed its name to the Association for Cognitive and Behavioral Therapy Cognitive and cognitive-behavioral psy-chotherapies, developed in the 1950s by psychoanalytically trained psychotherapists Albert Ellis and Aaron Beck, are concerned with many of the same basic issues of concern to social psychological theorists and researchers, such as the relationships among cognition, affect, and behavior and the impact of the situation on behavior Cognitive-behavioral case for-mulations draw largely on social psychological principles and constructs In fact, clinical

History and Orienting Principles 9

and counseling psychologists trained in cognitive-behavioral models may feel greater monality with theorists and researchers in social psychology than with psychodynamic and humanistic clinical and counseling psychologists

com-Third, the emergence and tremendous growth of health psychology expanded the ditional boundaries of both social and clinical psychology and provided a forum for the collaboration of researchers and practitioners from both areas Basic theoretical questions about the relationship between emotional health and physical health and the practical prob-lem of getting people to change their behavior in health-enhancing ways are ideal material for social–clinical collaboration In fact, most health psychologists are social, clinical, or counseling psychologists who are interested in problems encountered in health and medical settings The emphasis on health psychology extends beyond the traditional topics of psy-chopathology, and now much mainstream social psychology is concerned, once again, with understanding and solving important human problems

tra-Fourth, social psychology has changed in ways that have moved it toward integration with clinical psychology The “crisis of confidence” in social psychology about the eco-logical validity of its laboratory findings (Sarason, 1981) resulted in a renewal of interest

in applied research and real-world problems This crisis and renewal set the stage for the entry of social psychologists into the study of clinical problems and issues Social psycho-logical research increasingly has merged the study of cognitive processes with the study

of emotional interpersonal processes and the self Social psychologists have become more

concerned with understanding social cognition—how people construe social situations and

the effects of these construals on social behavior, as evidenced throughout this volume The study of social cognition has become central to current approaches to understanding personality, individual differences, interpersonal behavior, and emotions (Fiske & Taylor, 2007; Moskowitz, 2004; Kross, Mischel, & Shoda, Chapter 20, this volume; Shadel, Chap-

ter 18, this volume), as revealed in any recent issue of the Journal of Personality and Social Psychology, Personality and Social Psychology Bulletin, or the Journal of Social and Clini- cal Psychology This cognitive evolution includes cognitive approaches to understanding

relationships The study of relationships has shifted from concern with bargaining between strangers in the laboratory to concern with real-life intimacy, love, and marriage Much of this recent work involves the study of psychological adjustment and dysfunctional behav-ior As a result, the relevance of social psychological theory and research to clinical theory, research, and practice has increased immensely, along with the collaborations of social and clinical psychologists

Fifth, disorders of personality, as formal diagnostic categories, were introduced into the official nosology of psychiatric and psychology disorders with the publication of the third

edition of the American Psychiatric Association’s (1980) Diagnostic and Statistical Manual

of Mental Disorders, Third Edition (DSM-III) The inclusion of these categories reflects the

notion that personality can be disordered or dysfunctional and is worthy of attention pendent of the broad traditional clinical notions of neuroses (e.g., depressive disorders, anxi-ety disorders) and psychoses (e.g., the schizophrenic disorders; Millon, 1981) Of course, the very notion that we can separate personality into normal and abnormal types (disorders) and the notion that we can neatly categorize types of abnormal personalities are largely incon-sistent with a social psychological perspective However, the definition of this new general category and the diagnostic criteria for the various specific disorders rely heavily on the

inde-interpersonal (rather than the intrapersonal) manifestations of the individual’s dysfunction

Personality disorders are noted more for the disruption they cause in the individual’s tionships and social world than for the inner turmoil of the individual Thus, this new set of

rela-diagnostic entities gave a greater official recognition to the importance of the social aspects

of psychological dysfunction than ever before

Since the publication of the DSM-III, hundreds of studies have been published ing various aspects of personality disorders Because of the emphasis on interpersonal func-tioning in these disorders, research in social psychology and personality has assumed a new and greater relevance to the understanding of psychological adjustment and dysfunction For example, research on the relationship between “normal” personality and these personality

examin-“disorders” strongly suggests that so-called personality disorders are extreme variants of normally distributed dimensions of individual difference rather than disorders discontinuous with normal personality (e.g., Widiger, 2007) This research supports the notion that the study of normal interpersonal behavior and dysfunctional interpersonal behavior involves the study of essentially the same problems and processes

orienting PrinciPles

It has been over 40 years since the partitioning of the Journal of Abnormal and Social Psychology and the symbolic partitioning of social and clinical psychology It also has been 25 years since the publication of the first issue of the Journal of Social and Clini- cal Psychology During this time, clinical psychology has become more rigorously empiri-

cal while maintaining its focus on understanding psychological adjustment and problems

in living; social psychology has become more concerned with psychological adjustment and problems in living while maintaining its empirical rigor Thus have the fields come to complement one another both in content (what they study) and method (how they study

it) Social psychological journals such as the Journal of Personality and Social Psychology and the Journal of Social and Clinical Psychology regularly publish studies that are relevant

to clinical issues, and some clinical and counseling journals (e.g., Cognitive Therapy and Research, Journal of Counseling Psychology) publish studies that deal with basic social

psychological processes

The following set of implicit assumptions regarding the nature of psychological lems and their treatment, which can be gleaned from the work of numerous theoreticians and researchers over the past several decades, provides a foundation for the application of social psychology to clinical psychology

prob-Psychological Problems Are interpersonal Problems

Behavioral and emotional problems are essentially interpersonal problems The majority

of people who seek psychological services do so because they are concerned about their relationships with other people Common adjustment problems such as depression, anxiety, marital discord, loneliness, and hostility consist primarily of interpersonal beliefs and behav-iors that are expressed in interpersonal settings and make little sense when examined outside

an interpersonal context This assumption does not deny that some psychological problems may have strong biological roots, but it affirms that even biologically based problems are influenced by interpersonal forces

History and Orienting Principles 11

“normal” behavior is sometimes dysfunctional

Because much of social psychological research and theory deals with how people ceive, misattribute, and subsequently “misbehave” in their relations with others, much of social psychology involves the study of what Freud (1901/1965) called “the psychopathology

misper-of everyday life.” Cognitive dissonance theory, reactance theory, and attribution theories, for example, each describes cognitive and motivational processes of normal people, processes that are often illogical, unreasonable, or biased and that lead to poorly reasoned decisions Therefore, even “normal” social cognitions and their affective and behavioral consequences are sometimes dysfunctional The clinical or counseling psychologist with an in-depth knowl-edge of the social cognition literature, especially the errors made by normal people in social perception and judgment, is likely to have a greater awareness of the normality of seem-ingly pathological thought and behavior Because the terminology in social psychology is less pathological and less dispositional in connotation, such awareness should lead to a decreased tendency to overpathologize

social norms determine the distinction between normality

and Abnormality

The distinction between normality and abnormality is essentially arbitrary and is the product

of social norms that are derived from, and enforced in, social settings Thus, understanding how attitudes and beliefs become norms, how they change and how they are acquired and enforced, is essential to understanding how and why certain behaviors (including those with biological etiologies) are viewed as abnormal and others are not

Abnormal social behaviors Are distortions of normal behaviors

The vast majority of so-called abnormal social behaviors are essentially distortions or gerations of normal patterns that are displayed at times and in places considered by others to

exag-be inappropriate Thus, many exag-behaviors given pathological laexag-bels are governed by the same interpersonal processes that determine behaviors that escape the stigma of being labeled as deviant

clinical Judgment involves the same Processes as everyday

social Judgment

Clinical judgment is a process of social cognition and person perception that involves the same processes as everyday social and person perception Most important, clinicians make errors in clinical judgment that are similar to errors made by nonclinicians in nonclinical contexts (Leary & Miller, 1986) Thus, the study of social inference, problem solving, and decision making is crucial to understanding clinical assessment and diagnosis (e.g., Garb, Chapter 16, this volume.)

clinical interventions focus on social cognitions

Most, and possibly all, clinical interventions, regardless of theoretical foundation, focus

on changing what people think about, how they feel, and how they behave toward

oth-ers Marital therapy, family therapy, parenting skills training, assertiveness training, social skills training, interpersonal and cognitive therapies, and other interventions are concerned primarily with helping people get along with other people and feel better about their inter-personal relationships Indeed, most clinical and counseling psychologists trained in the last 20 years or so (i.e., those trained in social learning or cognitive-behavioral models) are essentially “applied social psychologists” in the sense that they are concerned with the reciprocal interactions of social cognitions (attitudes, self-beliefs, attributions, expectancies), emotion, and behavior.

Psychotherapy is a social encounter

Psychotherapy, counseling, and other behavior change strategies, either dyadic or group, are interpersonal encounters, first and foremost, albeit social encounters with a specific goal—one person trying to help another This assumption dictates that the foundation for psycho-logical intervention is an understanding of interpersonal behavior, particularly relationship development and interpersonal influence processes (e.g., Brehm & Smith, 1986; Strong & Claiborn, 1982)

social Psychological theories Provide a basis for Models

of behavior change

Successful psychotherapy and behavior change strategies, regardless of theoretical tion, have in common a relatively small number of features that explain their effectiveness (Frank, 1961) Because they propose general explanations for a broad range of human behav-ior, social psychological theories can provide the foundation on which to build an inclusive and comprehensive model of therapeutic behavior change

founda-overview of book

This book deals with the three basic challenges that confront clinical and counseling ogists: (1) understanding the causes of psychological problems, (2) evaluating and assessing psychological problems, and (3) designing effective interventions for ameliorating them The chapters are organized not around psychiatric diagnoses (e.g., depression, anxiety, personal-ity disorders) but around social psychological theories and concepts Each chapter focuses

psychol-on an important social psychological theory or cpsychol-oncept that can offer a fresh framework for addressing clinically relevant questions

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PART II

PSYCHOLOGICAL HEALTH AND PSYCHOLOGICAL PROBLEMS

Self and Identity

and Self-Evaluation in Dysfunctional Patterns of Thought, Emotion,

of our lives—such as government, philosophy, science, religion, and education—would not

be possible without the capacity for conscious relevant thought Yet, the ability to reflect also sets the stage for a variety of emotional and behavioral problems that arise from the ways in which people think about themselves (Leary, 2004a) The goal of this chapter is

self-to examine theory and research in social psychology that deal with the processes involved in self-awareness, self-representation, and self-evaluation, with an emphasis on self-processes that may contribute to psychological difficulties

Self-AwAreneSS And emotion

For animals that lack self-awareness, emotional experiences are elicited by features of their physical or social environment Emotions occur when threats, opportunities, harms, or ben-efits are perceived, and they abate when the threat or opportunity is no longer present, often because the animal has taken some kind of action (e.g., by fleeing, hiding, or attacking)

Of course, human beings also respond emotionally to stimuli in their immediate ments, but, unlike animals without self-awareness, people also generate emotions in their own minds through self-relevant thought By consciously thinking about past experiences, their current situation, the future, or their own qualities, people can evoke almost any emo-tion in their own minds (Leary, 2007) Sometimes these self-generated emotions are pleasant and beneficial, as when people are motivated to pursue success by anticipating its positive emotional consequences or make judicious decisions by imagining how a current action will make them feel at some future time However, many of these self-created emotions are not only functionally useless, in that they do not prepare people to respond to actual threats and opportunities, but many imagined events that cause strong emotions never actually come to pass As a result, a great deal of unhappiness is fueled by self-relevant thoughts that do not contribute to people’s physical, psychological, or social well-being (Leary, 2004a)

environ-Self-discrepancies

Duval and Wicklund (1972) are usually credited with initiating contemporary research on self-awareness Their original version of self-awareness theory proposed that people who are in a state of self-attention automatically and invariably evaluate themselves according

to salient standards Furthermore, because people often find that their current actions and outcomes fall short of their standards, their self-evaluations are typically unfavorable, result-ing in negative affect Subsequent research has shown that self-awareness does not neces-sarily reveal discrepancies between one’s behaviors and standards, nor does it always result

in negative emotion Even so, it is certainly true that perceiving discrepancies between one’s standards, goals, or values, on one hand, and one’s behavior or outcomes, on the other, can elicit a variety of emotions

Although ideas regarding self-discrepancy have had a long history in psychology (e.g., Rogers, 1954), the role of self-discrepancies in emotion has been developed most fully by Higgins (1987) According to his self-discrepancy theory, people sometimes experience dis-crepancies between their actual self (their representation of the attributes that they actually possess) and either their ideal self (their representation of the attributes they would like to possess) or their “ought self” (their representation of the attributes that they should or ought

to possess due to their duties, obligations, or responsibilities) According to the theory, crepancies between one’s actual and ideal selves are associated with dysphoric emotions (e.g., sadness, hopelessness), whereas discrepancies between the actual and ought selves result in agitation-related emotions (e.g., anxiety)

dis-Several studies have supported the general prediction that actual–ideal self-discrepancies tend to lead to dejection-related emotions (e.g., depression) and that actual–ought self-discrepancies lead to agitation-related emotions (e.g., anxiety) (Higgins, 1987, 1999; Hig-gins, Klein, & Strauman, 1985; Moretti & Higgins, 1990; Scott & O’Hara, 1993; Strauman, 1989) However, other predictions of the theory have not been supported For example, a

The Role of Self-Awareness and Self-Evaluation 21

study by Tangney, Neidenthal, Covert, and Barlow (1998) did not confirm the predictions

of self-discrepancy theory regarding the nature of the self-discrepancies that underlie shame versus guilt, and they also failed to replicate earlier studies showing that particular types

of self-discrepancies were uniquely related to particular emotions (Higgins et al., 1985) In response, Higgins (1999) acknowledged that unique relationships between particular self-discrepancies and emotions are not always found

A second approach to self-discrepancies was offered by Ogilvie (1987), who proposed that people also use the undesired self—the self at its worst—as a standard for self-evaluation (see also, Carver, Lawrence, & Scheier, 1999) For example, Ogilvie and Clark (1992) found that discrepancies between people’s actual and undesired selves operated separately from discrepancies between their actual and ideal selves More importantly, actual–undesired self-discrepancies correlated more strongly with people’s life satisfaction than actual–ideal dis-crepancies (Ogilvie, 1987; Rahakrishnan & Chan, 1997) Put simply, people’s evaluations

of how they are faring, compared to feared outcomes and identities, exert a stronger impact

on their emotions than their evaluations of how they are faring compared to their ideal comes and identities

out-Overall, research supports the general idea that people’s self-relevant beliefs are tied to their emotional well-being and that discrepancies between their self-beliefs and what they desire, ought, and fear to become predict particular patterns of emotion The details of these processes are open to debate, but the importance of self-beliefs and self-discrepancies is not

Self-rumination

Typically, self-reflective emotions wax and wane as people’s self-related thoughts change However, when people cannot stop themselves from thinking emotionally laden thoughts, they may become locked in a particular emotion Rumination involves unintentional, repeti-tive, perseverative thoughts on a particular theme that occur despite the fact that the imme-diate environment does not cue the thoughts (Martin & Tesser, 1996) Although not all rumination is self-focused, a great deal of it involves recurrent thoughts about one’s own behaviors, characteristics, life circumstances, or future At present, it is not clear whether self-focused ruminative thought involves only a high and intractable level of inner self-talk

or a motive to think about potential threats in hopes of avoiding them (Silvia, Eichstaedt, & Phillips, 2005; Trapnell & Campbell, 1999) In either case, becoming locked in ruminative thought can extend negative emotions long past the point at which they serve any function

Self-Rumination about the Present

Most investigations of rumination have focused on patterns of negative thoughts that lead to depression and then sustain depression through passive and persistent thoughts about one’s depressive symptoms (Fresco, Frankel, Mennin, Turk, & Heimberg, 2002; Nolen-Hoeksema

& Morrow, 1991) These studies suggest that rumination not only causes depression but also intensifies and prolongs depressive symptoms, because rumination about one’s depression may amplify pessimistic thinking, interfere with attention and concentration, and inhibit behaviors that might work the person out of his or her depressive episode (see Nolen-Hoeksema, 1987, 1991)

The role of rumination in depression is further supported by research showing that