Current Issues in Clinical Psychology. Volume 2
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1 Current Issues in Clinical Psychology Volume 2
2 A Continuation Order Plan is available for this series. A continuation order will bring delivery of each ncw volume immediately upon publication. Volumes arc billcd only upon actual shipment. For further in lonnalion please contact the publisher.
3 Current Issues in Clinical Psychology Volume 2 Edited by ERIC KARAS Alder Hey Hospital Liverpool, England Plenum Press New York and London
4 The Library of Congress has cataloged the first volume of this title as follows: Merseyside Course in Clinical Psychology. Current issues in clinical psychology. - Vol. 1-- New York: Plenum, cl983- v.: ill.; 26 cm. Based on lectures presented at the Annual Merseyside Course in Clinical Psychology. Editor: Eric Karas. ISSN = Current issues in clinical psychology. l. Clinical psychology- Periodicals. 2. Psychology, Pathological- Periodicals. 3. Psychotherapy-Periodicals. I. Karas, Eric. II. Title. [DNLM: I. Psychology, Clinical-congresses. W3 ME56] RC469.M45a f 005-dcI AACR 2 MARC-S Library of Congress [8503] ISBN ISBN (ebook) DOI / Based on lectures presented at the Second Annual Merseyside Course in Clinical Psychology, held September 17-19, 1982, in Merseyside, United Kingdom 1985 Plenum Press, New York Softcover reprint of the hardcover 1st edition 1985 A Division of Plenum Publishing Corporation 233 Spring Street, New York, N.Y All rights reserved No part of this book may be reproduced, 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
5 PREFACE This book is the second volume in the series "Current Issues in Clinical Psychology", which is designed to build into a composite text of the field of clinical psychology. The contents of the series are based on the post-qualification training conferences held each autumn in Merseyside. These events, organised by a sub-group of the training committee of the Mersey Regional Group of Clinical Psychologists, are unique in that they are the only annual psychology conferences in Britain focussing exclusively on clinical areas. The opening paper of Volume 1 of the series emphasised the importance of the present disposition towards sustained clinical training for practising psychologists. The series "Current Issues in Clinical Psychology" represents a contribution to this trend by offering practitioners an opportunity to assimilate innovations in clinical theory and practice, in the young but vigorously developing discipline of clinical psychology. In order to provide a forum for contemporary issues and also to produce complementary texts of lasting value, it has been necessary to carefully select both the theme of each symposium and contributors able to fulfill these aims. Following the introductory paper, Volume I covered: Legal and Forensic Issues in Psychology; Anorexia Nervosa; Computer Applications and Biofeedback; Internal Events and Depression, and finally, Long Term Care. This volume adds the following areas: Chronic Pain; Mental Handicap and Normalisation; Anxiety Based Problems; Approaches to Aggression and Violence, and Community Psychology. As in the first volume, the papers in this book are presented in the original style of their authors, each section having an introductory chapter to provide a setting for the papers that follow it. v
6 vi PREFACE Although the conferences and these books have been designed primarily with clinical psychologists in mind, they will be of value to workers in a variety of disciplines within the helping tradition. The emphasis given by psychologists to training is shared by others in the mental health professions, and there are obvious benefits to be gained from cross-fertilisation between disciplines. Co-operation between psychologists ans sociologists is currently throwing new light on traditional beliefs in mental health care, through a primary focus on the context in which their subjects, both the professionals and their clients exist. In a like manner, contextual issues in learning cannot be ignored. To study in isolation or to examine one perspective without opportunity for considered argument or dissent, is neither in the spirit of true understanding nor of progress. Hopefully, this venture, through the choice of contributors with their different traditions and through the mode of presentation can further these ideals. In spite of the shortage of training funds currently available to members of the National Health Service, the conference was attended and enjoyed by a large number of people, ranging from new trainees to senior members of the professions. It is to be hoped that this book will bring the proceedings of the second Annual Merseyside Course in Clinical Psychology to a wider audience both in recognition of the importance of, and as a further gesture towards, a more general sharing of knowledge. Eric Karas
7 ACKNOWLEDGEMENTS Thanks are due to all the members of the coordinating committee of the 1982 Annual Merseyside Course in Clinical Psychology for their unstinting efforts in making the venture once again a productive and enjoyable one. They are, Barrie Ashcroft, Bill Barnes, Eric Bromley, Graham Collins, Dorothy Fielding, Eric Ghadiali, David Glasgow, Barrie Jones, Miles Mandelson, Ray Miller, Lyn O'Sullivan, Glyn Owens, Austin Sinnott, Peter Slade and Richard Warburg. Special thanks are once more due to Ray Miller in his capacity as Chairperson and to those organizations who helped us to achieve our aims by their financial contributions. I would also like to convey my gratitude to all those whose papers appear here and also to those others, Michael Bond, Michael Craft, John Copeland, David Hawks and Sam Lipton who participated in the conference but whose contributions, for a variety of reasons, are not included. To Christine Ellis, for her invaluable practical support in producing the manuscript, I offer my grateful thanks. To my friends who, in different ways, gave assistance and advice, I remain indebted. And to Dr. Robert Andrews, Ms. Madeleine Carter and their American colleagues, all of Plenum Publishing Corporation, I wish to express my appreciation for their continued interest, not only in the production of this book, but also in the progress of VoluDle 1. vii
8 CONTENTS PSYCHOLOGICAL CONTRIBUTIONS TO PROBLEMS OF CHRONIC PAIN Psychological Contributions to Problems of Chronic Pain - An Introduction E. J. Ghadiali The Communication of Pain and Distress in Chronic Orthopaedic Conditions C. J. Main and G. Waddell The Role of the Spouse in Pain Management M. Humphrey Theories of Chronic Pain Phenomena P. Slade Psychological Treatments for Chronic Pain A. K. Broome Cognitive-Behavioral Treatment of Chronic Pain P. F. Kirby MENTAL HANDICAP: THE FEASIBILITY OF NORMALIZATION Mental Handicap: The Feasibility of Normalization - An Introduction, Normalization as an Influence on the Development of Services for People with Mental Handicap R. Blunden 91 ix
9 x The Nature and Foundations of the Concept of Normalization P. Williams Sexuality and Mental Handicap: A Review J. Sebba The Implications of the Mental Health Act 1983 for the Treatment of Mentally Handicapped People P. Edwards Putting Normalization into Practice D. Thomas CONTENTS APPROACHES TO ANXIETY BASED PROBLEMS Approaches to Anxiety Based Problems - An Introduction B. Barnes, R.B. Jones and E. Karas The Role of the Adrenals in the Psychophysiology of Stress T. Cox and S. Cox Cognitive-behavioral Models of Anxiety A. Mathews Cognitive Invalidation and the Enigma of Exposure R. Baker and M. McFadyen A Psycho-dynamic Perspective on Anxiety V. Sedlak The Free-floating Concept of Anxiety D. Bannister PSYCHOLOGICAL APPROACHES TO PROBLEMS OF AGGRESSION AND VIOLENCE Psychological Approaches to Problems of Aggression and Violence - An Introduction R. Blackburn Clinical Aspects of Sexual Violence K. Howells Patterns of Aggression - P. Marsh Not Unnaturally 265
10 CONTENTS First Steps in the Functional Analysis of Aggression R. Glynn Owens and M. Bagshaw The Control of Anger in the 'Mentally Abnormal' Offender E. A. Alves xi ISSUES IN COMMUNITY PSYCHOLOGY Issues in Community Psychology - An Introduction Community Psychology: A Challenge for the Practitioner A. Sinnott The Systems Approach to Educational Psychology: A Case History and Some Possible Implications for the Clinical Psychologist R. Burden Setting up a Community Alcohol Service: An Example of Community Psychology J. Orford Community Psychology: Some Alternative Models of Organization and Practice B. Brown Index 361
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