What is Clinical Psychology?

  • Clinical psychologists are individual trained in assessment and diagnosis, intervention or treatment, consultation, research, and the application of ethical and professional principles
  • Clinical psychologists work with a range of individuals, from infants to the elderly.
  • They work in a large range of settings, including universities, hospitals, private practice offices...
  • Little medical training, extensive training in psychotherapy or talk therapy.
  • Focus on client autonomy and collaboration with patient
  • Only New Mexico and Louisiana allow trained clinical psychologists to prescribe medication

Closely Related Mental Health Professions

Psychiatrists

  • A physician rooted in medicine
  • Regards psychopathology as an “illness” that is biologically based and its causes can be treated with medicine.
  • Complete four years of medical school (M.D.), general medical internship, 4-year residency training in psychiatry.

o Supervised work in clinical setting or outpatient facility (supervised by experienced psychiatrist)

o May thus be better able to identify medical problems for psychological distress.

  • Blurred lines between clinical psych and psychiatrists.
  • Specialization is slowly declining—economic impact, competition from other specialties like clinical psych.
  • Brief quarter-hour sessions of medication management not long psychotherapy sessions.
  • Prescription privileges are being allocated to other specialties as well and people no longer rely on psychiatrists for advice on medication treatment.
  • More authoritarian and focus on medication prescription.

Counseling Psychologists

  • Work with moderately maladjusted individuals and use assessment methods, most commonly interviews.
  • Employed in educational settings, but also employed in hospitals, mental health centers.
  • Focused on:

o Preventative treatment, consultation, development of outreach programs, vocational counseling, short-term therapy.

  • Counseling psychology is a small field (the file of clinical is bigger with 4x as many graduates from doctoral programs).
  • Most counseling psychology programs are in the School of Education.
  • Counseling doctoral program acceptance rates are higher, greater focus on minority/cross- cultural issues.
  • Only 70 Ph.D. programs are there for counseling psych but there are 360 for clinical psych.

Clinical Social Workers

  • Work to improve social functioning of individuals, groups, or communities.
  • In the past social workers focused on external or social factors contributing to patient's difficulties, while the psychiatrist prescribed medication and the clinical psychologist tested them.
  • Today social workers are more likely to deal with psychological factors that play a role in individual and family difficulties (more focus on familial factors).
  • Requires only master's degree to practice (2 years).
  • More likely to engage in home visits, workplace visits—active role
  • The social work field is rapidly growing as a result of them being low-cost alternatives to psychiatrists and psychologists.

School Psychologists

  • Work with students, educators and administrators to promote social and emotional growth of school age children and adolescents.
  • School psychologists are in high-demand, as they conduct assessment for special educational needs.
  • Workplace include schools, nurseries, daycare, hospital, clinics.
  • 60 APA programs for doctoral degrees.

Health and Rehabilitation Psychologists

  • May have a doctorate in clinical, but this is not required. This field is new and is rapidly growing.
  • Through research and practice contribute to the promotion of good health, involved with prevention and treatment of illness.

o Ex: design prevention programs to help quit smoking, reduce weight.

  • Most likely to engage in consultation with different organizations.
  • Rehabilitation psychologists focus on physical or cognitive disability.

o Help with adjustment to physical, social, psychological barriers.

  • Work at care facilities, medical centers, rehabilitation facilities, hospitals...

Psychiatric Nurses

  • Working alongside psychiatrists and clinical psychologists
  • They implement the therapeutic recommendations.
  • Have prescriptive privileges in all but a few states.

Others

  • Include occupational therapists and recreational therapists, can help teach patients skills that will help outside hospital settings.
  • Can help patients deal with feelings via art, music, dance. Can help supplement work by professionals.
  • Those who are trained to help mental health professionals—Paraprofessionals

Professionals and Titles Not Regulated by the Government

  • Clinical psychologists, counseling psychologists, school psychologists and so on all require specific educational requirements to practice.
  • Titles like psychotherapist and therapist can be used by anyone wishing to offer any service.
  • The public is not aware of such distinctions and may seek to use services offered by someone unregulated rather than a professional individual just because unregulated services use such titles.

Activities of Clinical Psychologists

Activities include psychotherapy, research, diagnosis, teaching and administration.

Therapy or Intervention

  • Client sit face-to-face across from the therapist and therapy involves either a one-to-one relationship or couples, family, child therapy.
  • Majority of therapists are women and not men
  • Therapy involving specific skills is more useful to reduce problems (ex: CBT therapy).

Diagnosis/Assessment

  • Used to better understand the individual so that a more informed decision can be made
  • Gathering information through testing so that a problem can be solved.

Teaching

  • May teach graduate courses in specific areas—advanced psychopathology, development psychopathology, testing, personality theory.or even do undergraduate testing.
  • Some clinicians may supervise doctoral students completing their degree (supervision).
  • Clinicians may also conduct workshops and seminars to teach skills to nurses, aides, probation officers and so on.

Clinical Supervision

  • A form of teaching, more one-to-one teaching that is less formal.
  • Involves supervising students and interns; people learn by doing under the guidance of a supervisor-trainee relationship.

Research

  • Scientist-Practitioner model was adapted—thinking like a scientist.
  • Clinical work is enhanced by knowledge of scientific methods and exposure to clinical practice.
  • Clinical psychologists have the ability to both consume and produce knowledge.

Consultation

  • Consultation can occur on a case by case basis with another individual in the field or for an organization looking for help in a particular domain (ex: drug addiction).
  • Clinical psychologists also serve as consultants for advertising agencies.
  • A large number of consultants work for primary care services.

Administration

  • All clinical psychologists have to engage in administrative duties like maintaining client record and filling out reports.
  • Some are drafted by colleagues as a result of their skills to perform greater admin duties
  • Ex: head of the psychology department, vice president of a consulting firm, program director of a clinic.

Employment Sites

  • Employment sites that are the biggest are: (1) private practice, (2) universities and (3) medical schools.
  • Other settings include: Psychiatric hospitals, outpatient facilities.
  • Clinical psychologists tend to engage in a diversity of both private practice and research.
  • Demographics—in 2005 only 34% of clinical psych doctoral majors were women and only 7% were racial minorities—this is slowly increasing.

Research and the Scientific Tradition

An Overview

  • Clinical Psychology is based on research tradition and the quest to acquire new knowledge
  • Typically, a clinical doctorate student engages in assessment, research, diagnosis and therapeutic skill development with an internship.
  • Psychology programs offer a two-year Master's program that some students pursue before doing the Ph.D.
  • Master level students are viewed as less competent and can't practice independently.
  • Growing Master's field with 3x as many Masters than Ph.D.'s being awarded.

Coursework and Practicum Work

  • Students have to take a series of basic courses that help found their basic knowledge of human behavior.
  • Use scientist-practitioner model
  • During the advance years of graduate school students are exposed to practica work, that involves application of theories studied.

o Acquisition of specific clinical skills

  • Practicums can be in assessment, therapy, interviewing methods or even in consulting within specific areas/agencies.

Research

  • Competence needs to be developed in computer software, technology and research methods by engaging in research projects.
  • Different universities place different emphasis on research

o Completion of Master's thesis by the end of second year

  • A research project/dissertation is required by the end of 4th/5th year that adds new information to the field.
  • When entering grad school, a student joints a “team of faculty members”—team meets 2/3 hours per week.

Qualifying Exam

  • Preliminary or comprehensive examination, it is three written exams each lasting 4-hours over the span of one-week or 5-day examinations.
  • Often taken during the 3rd year or students write an in-depth literature review or research grant.

The Internship

  • Provides experience to complete the scientist-practitioner role, required of all clinical programs.
  • Occurs at the end of graduate training, usually at an independent facility off campus or at university counseling centers or medical schools.
  • Allows the student to work full-time in a professional setting provides the students with skills that will mirror that of a professional career.
  • Women are increasingly growing in the field of clinical psych.

Training Models

  • Professional clinical psych programs use the Ph.D. scientist-practitioner model focused on research but the Psy.D. program is an alternative degree more focused on application.
  • Professional schools award 60% of doctoral degrees for clinical psych.
  • Combined Program—focuses on core of both knowledge and skills across applied psychology areas—broad skills.
  • Clinical-Science Model is focused on evidence-based approaches.

Clinical Practice

  • Clinical psychologists are slowly going into private practice and para-professionals & master's level individuals are being employed more in mental-health settings.
  • Clinical psychologists need to have a capacity to tolerate ambiguity
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