Greetings dear Contemporary Psych readers. We are going to be learning about—drum roll please—the field of clinical psychology. Clinical psychology is no doubt the largest area of professional psychology and perhaps, more broadly, the whole discipline of psychology. In fact, many lay-people erroneously view clinical psychology and psychology (as a whole) to be conceptually identical. To illustrate, when I was a younger man, a lowly grad student, just a child really, I served as a graduate fellow on a National Science Foundation grant aimed at providing science outreach to schoolchildren. Whenever meeting with students for the first time, I would ask them to describe a psychologist and what psychologists do. Invariably, the students would describe a person, usually a male with a beard (Freud, anyone?), who treats people’s mental illnesses by asking them about their relationship with their mother. I would then happily point out that many psychologists don’t do this, and that most psychologists don’t have beards. I would then pause and watch the students’ faces for visible evidence of their minds being blown. Next, I would attempt to correct all other misconceptions about psychology, with (given the number of adults who still don’t seem to understand the field) an apparently variable level of success.
Despite the fact that clinical psychology does not constitute the field of psychology as a whole, it is a big, broad area. And, we can understand and forgive children for their misunderstanding this (if you want to). So, in future issues, I will be focused on more specific areas within clinical psychology. For now, however, this is your general introduction to this fascinating area, and with that, let me introduce—drum roll please—clinical psychology.
Origins of Clinical Psychology—Thanks to the Same War That Brought Us Nuclear Weapons
Simply put, clinical psychology involves the understanding, preventing, and treatment of mental health and illness. Notably, people have been engaged in the treatment of mental illness for millennia. However, prior to the late 19th century, this was accomplished primarily using magic, religious rituals, and other dubious methods (e.g., mesmerism, phrenology, etc.). This changed around the turn of the 20th century thanks to the efforts of individuals working in medicine, neurology, and in particular, a gentleman named Lightner Witmer, faculty at the University of Pennsylvania, who documented his success treating learning disabilities, opened the first psychology clinic, founded the first clinical psychology journal, and coined the term “clinical psychology.”
From there, clinical psychology experienced relatively slow, but steady growth. This growth was driven in part by psychologists’ work with the U.S. Army, where they were tasked with the development and validation of assessment instruments used with new recruits. Then, World War II broke out, and everything changed. Many soldiers returning from the war displayed symptoms of what was at the time termed “shell shock” and is now known as posttraumatic stress disorder. Since medical doctors were overextended treating physical injuries related to the war, psychologists were called in to treat this condition. As a result of their good work, the U.S. government made an enormous investment in the training of doctoral-level clinical psychologists. Consequently, although there were no formal training programs in clinical psychology at the end of the war, by 1950, over half of all PhDs in psychology were awarded in clinical psychology. Since then, clinical psychology has grown into the large, varied, and vibrant profession and academic field of study that it is today (see Benjamin, 2005).
Contemporary Clinical Psychology—Treating More Than Learning Disabilities and PTSD
Today, clinical psychology is a multifaceted area within psychology broadly concerned with the application of psychological knowledge toward the assessment, diagnosis, prevention, and treatment of psychological distress and pathology, as well as the promotion of personal well-being and positive human functioning (Plante, 2010). Most clinical psychologists engage in some type of clinical practice and may offer many different services. Commonly, these services include the administration of clinical programs, providing psychotherapy, and performing psychological assessment. Clinical psychologists also often work with different types of clients including individuals, families, couples, and/or groups and in many different settings such as mental health organizations, hospitals, universities, private practice, business, schools, and the legal system (Pomerantz, 2016). Moreover, some clinical psychologists may specialize in the assessment and/or treatment of specific conditions such as mood disorders, substance abuse disorders, learning disorders, and everyday adjustment issues, while others may be generalists, engaging in the treatment of a variety of conditions.
At this point, you should have a good sense of what a clinical psychologist is. Let’s touch briefly on what a clinical psychologist is not. A clinical psychologist is not a psychiatrist. Although these two professions may serve the same purpose, namely making troubled people less troubled, the training and techniques for doing so are different. Psychiatrists are licensed physicians, medical doctors, who utilize the medical model to understand psychological problems and often use biological interventions to treat mental illness (e.g., pharmacotherapy). Clinical psychologists are also not counseling psychologists, but there is often significant overlap here and the distinction between the two professions is fading. Broadly, counseling psychologists are more likely to assist with nonclinical issues (e.g., coping with divorce), while clinical psychologists specialize in the treatment of full-blown clinical conditions (e.g., major depressive disorders). While we are at it, clinical psychology is not counseling, a very broad field that differs with respect to areas of emphases, required education and training, and work settings.
Speaking of Required Education and Training—Yes, You Still Have to Understand Research
Required education and training to become a clinical psychologist varies throughout the world, but we are going to focus on the requirements in the United States, where generally speaking, individuals need to complete a relevant doctorate, participate in internships and supervised practice, and be licensed to practice in the state in which they work. Most clinical psychologists receive general training in psychology at the undergraduate level and then specialize in clinical psychology at the graduate level. Following this will be the completion of supervised practice, and once receiving a sufficient number of hours of supervised experience, individuals can then take the exam to become licensed. Additionally, following licensure, most states require continuing education to maintain licensure, ensuring a well-educated field of practicing clinical psychologists in their jurisdiction.
But, let’s take a step back and talk about graduate school. Graduate programs in clinical psychology differ, with the broadest distinction concerning whether one obtains a PhD or a PsyD. Programs that award PhDs frequently adopt a “scientist- practitioner” model, whereby students are expected to both conduct research and practice in their area of emphasis. Programs that award PsyDs tend to focus more on practice (but, it is still expected that students are well-read in the current scientific literature). Also, programs may differ in their theoretical orientation, which then determines what types of therapy are taught. For example, programs that take a psychodynamic perspective are rooted in Freudian theory, and therapeutic techniques tend to emphasize developing insight into the unconscious motives for our behavior. Programs that take a behavioral or cognitive behavioral perspective focus on how maladaptive thinking and behavior lead to psychopathology, and therapeutic techniques typically involve encouraging more adaptive patterns of action. It should be noted however that increasingly, training in clinical psychology is becoming more integrative, involving exposure to many different theoretical perspectives and therapeutic techniques, such that the clinician can eventually take a more eclectic approach with clients and use whatever approach is best suited to the particular individual and their particular condition (see Hunsley & Lee, 2017; Norcross, Sayette, & Pomerantz, 2018).
Summary . . . For Now
Importantly, and as stated above, clinical psychology is a very broad area, and the types of occupations that one can pursue as a clinical psychologist are varied. In fact, many of these occupations have dedicated areas of psychology all to themselves (e.g., forensic psychology, see last issue’s column). So, rather than extend our discussion any further and upset my editors by obviously ignoring their required word limits, we will end our discussion here and focus on more specific areas within clinical psychology in future editions of your favorite column in the Eye ( . . . ahem . . . this column . . . the one you are reading right now). Until then, I encourage you to take a look at some of the resources provided below.
The American Psychological Association. Clinical Psychology Resources for Students: www.apa.org/action/science/clinical/
Division 12 of the American Psychological Association. The Society of Clinical Psychology: www.div12.org
Benjamin Jr, L. T. (2005). A history of clinical psychology as a profession in America (and a glimpse at its future). Annual Review of Clinical Psychology, 1, 1–30. https://doi.org/10.1146/annurev.clinpsy.1.102803.143758
Hunsley, J., & Lee, C. M. (2017). Introduction to clinical psychology. Hoboken, NJ: John Wiley & Sons.
Norcross, J. C., Sayette, M. A., & Pomerantz, A. M. (2018). Doctoral training in clinical psychology across 23 years: Continuity and change. Journal of Clinical Psychology, 74, 385–397. https://doi.org/10.1002/jclp.22517
Plante, T. G. (2010). Contemporary clinical psychology. Hoboken, NJ: John Wiley & Sons.
Pomerantz, A. M. (2016). Clinical psychology: Science, practice, and culture. Thousand Oaks, CA: Sage Publications.
|Ethan A. McMahan, PhD, is an associate professor in the Department of Psychological Sciences at Western Oregon University where he teaches courses in research methods, advanced research methods, and positive psychology. He is passionate about undergraduate education in psychology and has served Psi Chi members in several ways over the last few years, including as a faculty advisor, Psi Chi Western Region Steering Committee Member, Grants Chair, and most recently, as the Western Regional Vice-President of Psi Chi. His research interests focus on hedonic and eudaimonic approaches to well-being, folk conceptions of happiness, and the relationship between nature and human well-being. His recent work examines how exposure to immersive simulations of natural environments impact concurrent emotional state and, more broadly, how regular contact with natural environments may be one route by which individuals achieve optimal feeling and functioning. He has published in the Journal of Positive Psychology, the Journal of Happiness Studies, Personality and Individual Differences, and Ecopsychology, among other publications. He completed his undergraduate training at the University of Colorado at Colorado Springs and holds a PhD in experimental psychology from the University of Wyoming.
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