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