The term clinical psychologist is bandied about by legislators and others in general conversation when they are speaking about persons engaged in some type of psychological intervention. The primary area of confusion is between counseling psychology and clinical psychology. Clinical psychology, however, is a specialization within the field of psychology. It differs from many other types in its goals, the tools it uses, its educational requirements and its perspective.
Clinical vs. Counseling Psychology
It is understandable that there should be confusion between these two types. Both use psychotherapy techniques and do individual therapy and counseling. Originally, though, they were quite different. The term “clinical” comes from the Greek word “kline” which refers to a bed. Clinical practice of any type at first meant treatment of an ill person at his bedside. “Counsel” comes from another word, “consulere,” which is a Latin term meaning to advise or counsel.
At the end of the 1800s and the beginning of the last century, psychologists were mainly involved in scientific study. Clinics specialized in assessment and “treatment services.” Actual psychotherapy was left to psychiatrists. Gradually, psychologists began to apply the findings of their research to solving problems in behavior and learning difficulties. After WWII, these professionals were needed to address the multiple needs of traumatized military personnel, and the Veterans Administration recruited and trained them.
Counseling psychologists began as vocational and educational advisors. When the Industrial Revolution exploded in America, these psychologists provided advice on careers. It became obvious that people with certain personality traits were more successful in some jobs than others. They began using assessment tools such as aptitude tests to measure the potential for workers to succeed in their employment. These psychologists were affected by WWII as well, as their expertise in helping with behavioral issues arising from trauma led to greater satisfaction for the soldiers returning to the civilian workforce. Eventually, according to an article on the website of the Society of Counseling Psychology, the focus of counseling psychology included overall mental wellness.
The question at hand concerns clinical psychology, however, so the attention turns in that direction. What does a clinical psychologist do?
It is advisable for individuals with mental, emotional or behavioral disorders to seek the services of a clinical psychologist — a medical specialist responsible for diagnosis and treatment of such disorders. Such an individual may have expertise in one of the various areas of specialization in psychology, including child psychology, neuropsychology, geropsychology and health psychology.
Clinical psychology may overlap, and use practices from, education and medicine as well as other disciplines. Often the clinical psychologist serves on a team of professionals addressing issues such as how a child’s behavioral problems affect his learning. These psychologists may also be involved in a considerable amount of research.
Focus on Abnormality
While other branches of psychology may look at learning methods and behavioral modification in helping “normal” people achieve goals, clinical psychologists work with “abnormal psychology”. Professionals avoid using that stigmatizing term, but these areas may include psychopathologies such as depression, obsessive-compulsive disorder, and others.
According to the U.S. Bureau of Labor Statistics, an individual must obtain a bachelor’s degree in a relevant field such as psychology and clinical psychology; complete additional studies, which involve acquiring a master’s and doctoral degrees in clinical medicine; and possess essential job skills, including proper listening, patience and good problem-solving skills.
A bachelor’s degree in psychology will impart the fundamental knowledge to work as a counselor or as a life coach. People with bachelor’s degrees may work in hospitals and other facilities doing basic wellness counseling, discharge planning and other type of helping work. Becoming a clinical psychologist requires earning an advanced degree. With a Master’s in Clinical Psychology, people may begin careers as substance abuse counselors, school counselors, marriage and family therapists and other rewarding positions. The real advantage to a master’s degree in this field, however, is as a step toward a doctoral degree. As a matter of fact, professional licensing as a clinical psychologist mandates a doctorate.
Although the duties of the psychologist vary with his area of specialization, irrespective of whether he is a private or an employed medical practitioner, his three main duties include assessing patients’ conditions, diagnosing patients’ disorders and suggesting suitable treatment plans for patients.
Assessment of the Patients’ Conditions
To assess a patient, a clinical psychologist seeks information from the patient himself, his spouse, or relatives. As an interviewer, he needs to communicate well with the patient so that the patient can be free to open up his mind and provide the necessary information. Patience is also an important skill during the interview since some patients may be slow in speech or may need to be persuaded for a long time before giving the information. Out of the information retrieved from the patient, his spouse or relatives, the psychologist is able to learn the patient’s problem. Besides interviewing the patient, the psychologist can observe the patient’s actions to determine his problem. Referring to the patient’s medical history or health record is also another way of obtaining the information about the patient.
Psychological Testing and Assessment
Another tool used in assessment is psychological testing. The term sounds ominous, but APA.org says it is similar to the concept of medical testing. Medical patients displaying certain symptoms may be advised to undergo blood tests, heart stress tests and other assessments. The results help the physician decide upon a course of treatment. In the same way, psychology “patients” displaying certain symptoms are given targeted psychological tests.
For instance, a child may have learning difficulties for a variety of reasons. There may be an underlying behavioral issue, memory problems, a lack of aptitude, or a medical issue among other causes. Someone experiencing difficulties at work or in a relationship may have anger management problems, depression, anxiety or even delusions.
Testing involves using standardized, or norm-referenced tests that are evaluated in the same manner by anyone administering them. Results are then compared to the performance of similar individuals. Assessments, on the other hand, include norm-referenced testing, surveys and informal tests, medical records, input from other professionals and other material.
Just as different medical tests are ordered for patients, psychological tests are chosen for the needs of specific clients.
Diagnosing the Patient’s Conditions
The diagnosis follows the assessment and involves analyzing the information the psychologist collected from the patient during the assessment, and applying relevant diagnostic techniques to determine the exact condition the patient suffers from. One such applicable technique is the Diagnostic and Statistical Manual of Mental Disorders, or DSM-IV-R.
Arriving at a diagnosis helps the psychologist get an idea of the direction treatment will take. It saves a great deal of time “reinventing the wheel,” as the clinician can look at patterns of treatment for clients with similar diagnoses. Another purpose served by the diagnosis is that it gives the treatment plan credibility for insurance purposes. Most insurance plans require a formal diagnosis before they pay for treatment.
Treatment recommendation typically comes after the diagnosis and involves choosing a suitable treatment plan based on the results of the diagnosis. The psychologist may decide to implement the treatment plan himself or refer the patient to another doctor, who is more specialized in dealing with the condition in question. Referral is also necessary if the patient’s condition is severe. Since clinical psychology does not involve administering medications to patients, the psychologist can only administer treatments, such as family therapy, behavioral therapy and hypnotherapy, which involve counseling the patients, in order to make their condition better. However, referring patients to doctors who are qualified to administer medication treatments is a responsibility of the psychologist.
Clinical psychologists, as all psychologists, use tools in treatment. Some of these are found in the various types of psychotherapy. In fact, Psychology Today Magazine lists nearly as many types of psychotherapy as there are letters in the alphabet. For instance:
Acceptance and Commitment Therapy
This type of therapy involves helping a client to accept, rather than avoid or deny, problems in their lives and to commit to making changes that address the issues. It is used in the treatment of chronic pain, depression, stress, grief and other issues.
Applied Behavior Analysis
This strategy involves building competency in behaviors like hygiene, communication skills, academics and others. It is often used in treating clients with autism.
Clinicians monitor physical reactions to situations like stress and other situations then explain the reactions to the client. Those people experiencing extreme anxiety, for instance, can be taught to slow their breathing and heart rate. This is especially helpful in insomnia, pain management and other problems.
Cognitive Behavioral Therapy
This approach is rooted in the belief that a person’s thought patterns affect the way they react to situations. It is a problem-solving method and can help clients change the way they handle difficult life issues such as fear, pain and obsessive-compulsive behaviors.
The clinician applying this therapy uses a number of different approaches concurrently depending upon which works best with the client.
Transpersonal therapy is a holistic method of treatment that stresses honesty and emphasizes positive experiences.
There are many other therapy methods in the clinical psychologist’s toolbox, including medications like fluoxetine and sertraline which are prescribed by a medical doctor or by a psychiatrist with whom the psychologist is working.
Clinical Psychology Career Roadmap
The Bureau of Labor Statistics predicts an average job growth between 2018 and 2028. The outlook is better, however, for those with doctoral degrees and specializations. The median wage in 2019 was
$80,370. Doctoral degree graduates are not limited to client-centered psychology, however. People with degrees in this type of psychology work as consultants, in research, in healthcare facilities as integral parts of patient-care teams, in academia and in private practice. Salaries depend in a large part upon specializations and geographic locations. California and New York State top the salary list at $111,750 and $96,170 respectively.
As stated above, the first step in becoming a clinical psychologist is earning a baccalaureate degree. Afterward, students enter master’s programs in psychology specializing in clinical psychology. Most master’s degree holders, however, are supervised by those with doctoral degrees. Degrees today should contain courses in cultural diversity and stress along with written and oral communication. Statistics and mathematics are important components because research is a vital part of this career. Doctoral degrees should build upon the specialization and offer opportunities for research and internships and practicum. These programs typically take five-to-seven years of study and require graduates to pass a comprehensive examination and to write and defend a dissertation. They must generally perform at least a one-year internship as well. After graduation from an accredited doctoral program, those who want careers in this field must become licensed. The requirements for licensure vary by state but generally include at least 1,000 hours of supervised clinical hours over a minimum of twelve months. Applicants for licensure must also take the Examination for Professional Practice in Psychology and another examination particular to each state that makes certain applicants understand state laws about psychology practice. Afterward, they will apply for a license and register in the state. Once a license is granted, professionals have to pursue continuing education credits.
In summary, clinical psychology is one of the various branches of psychology that aims at helping patients with mental, emotional and psychological disorders better their condition. The disorders that the psychologist addresses include substance abuse, eating disorders, anxiety and depression. Depending with the specialty he possesses, a clinical psychologist can render services in various institutions, including hospitals, mental health facilities, police departments, military branches and universities, or may decide to practice his profession privately.
There are degree programs for people wanting to pursue careers as life coaches. There are also programs and licensure procedures for those wanting to become counselors. The path to becoming a professional clinical psychologist is longer and more involved than either of these. So, what does a clinical psychologist do? They are valued and well respected, vital practitioners in the “helping fields” of our culture. These professionals, like medical doctors, are held to a stringent course of preparation and professional conduct that ensures their competency. Additionally, like the medical field, psychology is constantly changing, and innovations are always on the horizon. Considering the longevity in the field, high pay, independence and the ability to make a real difference in the lives of clients, several studies of these psychologists have reported high levels of job satisfaction.
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