Clinical psychology
Clinical psychology is an integration of human science, behavioral science, theory, and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development.[1][2] Central to its practice are psychological assessment, clinical formulation, and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration.[3] In many countries, clinical psychology is a regulated mental health profession.
"Psychological medicine" redirects here. For the journal, see Psychological Medicine.
The field is generally considered to have begun in 1896 with the opening of the first psychological clinic at the University of Pennsylvania by Lightner Witmer. In the first half of the 20th century, clinical psychology was focused on psychological assessment, with little attention given to treatment. This changed after the 1940s when World War II resulted in the need for a large increase in the number of trained clinicians. Since that time, three main educational models have developed in the US—the PhD Clinical Science model (heavily focused on research),[4] the PhD science-practitioner model (integrating scientific research and practice), and the PsyD practitioner-scholar model (focusing on clinical theory and practice). In the UK and the Republic of Ireland, the Clinical Psychology Doctorate falls between the latter two of these models, whilst in much of mainland Europe, the training is at the master's level and predominantly psychotherapeutic. Clinical psychologists are expert in providing psychotherapy, and generally train within four primary theoretical orientations—psychodynamic, humanistic, cognitive behavioral therapy (CBT), and systems or family therapy.
Clinical psychology is different from psychiatry. Although practitioners in both fields are experts in mental health, clinical psychologists are experts in psychological assessment including neuropsychological and psychometric assessment and treat mental disorders primarily through psychotherapy. Currently, only seven US states, Louisiana, New Mexico, Illinois, Iowa, Idaho, Colorado and Utah (being the most recent state) allow clinical psychologists with advanced specialty training to prescribe psychotropic medications. Psychiatrists are medical doctors who specialize in the treatment of mental disorders via a variety of methods, e.g., diagnostic assessment, psychotherapy, psychoactive medications, and medical procedures such as electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS). Additionally, psychiatrists are legally authorized to prescribe psychotropic medications in all states of the U.S. and in all provinces of Canada.[5] However, Psychiatrists are not usually used for psychometric assessment. In education, clinical psychologists attend a graduate institution and have a Doctor of Philosophy (Ph.D.) or a Doctor of Psychology (Psy.D.) degree, usually following both an undergraduate and master's degree in Psychology or a related discipline. Conversely, psychiatrists complete their studies at a medical school and hold a medical degree (M.D.) or an osteopathic degree, Bachelor of Medicine, Bachelor of Surgery (with additional post-graduate training), and the (D.O.), with the latter only available in the United States.
Occupation
Professional practice[edit]
Clinical psychologists engage in a wide range of activities. Some focus solely on research into the assessment, treatment, or cause of mental illness and related conditions. Some teach, whether in a medical school or hospital setting, or in an academic department (e.g., psychology department) at an institution of higher education. The majority of clinical psychologists engage in some form of clinical practice, with professional services including psychological assessment, provision of psychotherapy, development and administration of clinical programs, and forensics (e.g., providing expert testimony in a legal proceeding).[9]
In clinical practice, clinical psychologists may work with individuals, couples, families, or groups in a variety of settings, including private practices, hospitals, mental health organizations, schools, businesses, and non-profit agencies. Clinical psychologists who provide clinical services may also choose to specialize. Some specializations are codified and credentialed by regulatory agencies within the country of practice.[20] In the United States, such specializations are credentialed by the American Board of Professional Psychology (ABPP).
Criticisms and controversies[edit]
Clinical psychology is a diverse field and there have been recurring tensions over the degree to which clinical practice should be limited to treatments supported by empirical research.[93] Despite some evidence showing that all the major therapeutic orientations are about of equal effectiveness,[94][95] there remains much debate about the efficacy of various forms of treatment in use in clinical psychology.[96]