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4- Clinical psychology and its Differences from other Professional Fields 4- Clinical psychology and its Differences from other Professional Fields

4- Clinical psychology and its Differences from other Professional Fields - PowerPoint Presentation

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4- Clinical psychology and its Differences from other Professional Fields - PPT Presentation

1 Introduction Most people are unaware of the similarities and differences between clinical psychology and related fields For example What is the difference between a psychologist and a psychiatrist ID: 911013

counseling psychologists training clinical psychologists counseling clinical training psychology school mental professionals health degree psychiatrists psychiatric social programs problems

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Slide1

4- Clinical psychology and its Differences from other Professional Fields

1

Slide2

Introduction

Most people are unaware of the similarities and differences between clinical psychology and related fields. For example, “What is the difference between a psychologist and a psychiatrist?”

It can be confusing to the public (and even to professionals in the field) to understand the similarities and differences between mental health disciplines

Since almost all of the mental health disciplines share certain activities such as conducting psychotherapy, so understanding differences between these fields can be very challenging. Many professionals and members of the public wonder how clinical psychology differs from related mental health fields such as counseling psychology, school psychology, psychiatry, nursing, social work, and counseling. An overview of these disciplines is provided in table 1.1 below.

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Table 1.1 Mental Health Professionals

Degree

Program

Years of training prior to Degree*Years of post Degree trainingLicensePhDClinical Psychology4-51-2Psychologist

Counselling Psych.

4-5

1-2PsychologistPhDSchool Psychology41-2School PsychologistPsyDClinical Psychology4-51-2PsychologistMA/MSClinical Psychology21-2MFTMA/MSCounselling Psych.21-2MFTMA/MSSchool Psychology21School PsychologistMSWSocial Work21-2Social WorkMDMedicine43-4Physician(Psychiatrist)

*While graduate school can take 4 to 5 years to complete, this is highly variable. Research projects such as dissertations as well as practicum experiences often result in a longer period of time to complete training.

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Counselling Psychologists(PhD)

Of all the different mental health professionals, counseling psychologists are perhaps the most similar to clinical psychologists in actual practice. While there are generally differences in philosophy, training emphases, and curriculum between clinical and counseling graduate programs, differences between clinical and counseling psychologists are subtle.

Like clinical psychologists, counseling psychologists generally major in psychology as undergraduates, attend a four-year graduate training program (however, in counseling psychology rather than clinical psychology), complete a one-year clinical internship and complete postdoctoral training prior to obtaining their license as a psychologist.

The differences between clinical and counseling psychology were more dramatic several decades ago in comparison to current times. Historically, counseling psychologists worked in outpatient, college, and vocational settings with people who did not experience major psychiatric difficulties. They often provided educational and occupational counseling to students and employees. Testing conducted by counseling psychologists generally involved career and vocational interests and skills.4

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Contd.

Today, counseling psychologists can be found in hospital, clinic, industry, and private practice settings. In fact, in most states, counseling psychologists practice under the same license as clinical psychologists.

Some authors have argued that distinctions between clinical and counseling psychology, along with separate training programs, may no longer be warranted (e.g.,

Beutler & Fisher, 1994). There are about three times more clinical psychologists than counseling psychologists in the United States. For example, while 1,185 doctorates were awarded in clinical psychology in 1999, 367 were awarded in counseling psychology (APA, 2000a). According to a recent survey conducted by the APA (2000a), there are about 9,100 APA members (about 11%) who identify themselves as counseling psychologists.

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School Psychologists(MA or PhD)

School psychologists usually work in schools, but some may work in other settings such as day-care centers or correctional facilities. Their primary function is to enhance the intellectual, emotional, social, and developmental lives of students.

A recent survey by the APA (2000a) revealed that about 3,300 members (about 4%) identify themselves as working in the field of school psychology. School psychologists typically work in elementary, secondary, or special education schools providing cognitive testing, brief counseling, and consultation to school teachers, administrators, parents, and students. Some school psychologists also provide tutoring help and some maintain private practices. School psychologists often work with children receiving special education services for problems such as attention deficit/ hyperactivity disorder, learning disabilities, or mental retardation.

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contd.

These professionals often provide guidance to both children and their families concerning educational and psychological concerns.

School psychologists interested in careers as research, academics, or administration usually choose PhD programs while those most interested in practice with children and families generally choose MA programs.

While doctorates in school psychology are available (e.g., 130 were awarded in 1999; APA, 2000b), a master’s degree is generally the degree of choice for school psychologists. They use or develop programs designed to meet the educational and emotional needs of students. They also consult with adults involved in students’ lives—teachers, school administrators, school staff, parents—and are involved to a limited degree in direct counseling with students.7

Slide8

Psychiatry (MD)

Unlike clinical (or counseling) psychologists, psychiatrists go to medical school and are licensed as physicians. In fact, their specialized training in psychiatry doesn’t begin until well into their training; the first several years are often identical to that of other types of physicians.

As physicians, they are allowed to prescribe medication. Until recently, psychologists could not prescribe medication, psychologists have rallied in recent years to obtain prescription privileges and have earned important victories in a small number of states. The difference between psychiatrists and clinical psychologists is more than just medication. The two professions fundamentally differ in their understanding and approach to behavioral or emotional problems. Clinical psychologists are trained to appreciate the biological aspects of their clients’ problems, but psychiatrists’ training emphasizes biology to such an extent that disorders—depression, anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), borderline personality disorder, and so on—are viewed first and foremost as physiological abnormalities of the brain. So, to fix the problem, psychiatrists tend to fix the brain by prescribing medication. This does not imply that psychiatrists don’t respect “talking cures” such as psychotherapy or counseling, but they favor medication

more

(Harris, 2011;

Manninen, 2006).8

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Contd

For clinical psychologists, the biological aspects of clients’ problems may not be their defining characteristic; nor is pharmacology the first line of defense. Instead, clinical psychologists view clients’ problems as behavioral, cognitive, emotional—still stemming from brain activity, of course, but amenable to change via

nonpharmacological

methods.There are a variety of pros and cons to being a psychiatrist. Advantages include several factors:- First, as physicians, psychiatrists have extensive training in the biological basis of behavior and behavioral problems. They are able to use this expertise to understand and treat a wide range of medical and psychiatric problems. Psychiatrists have superior knowledge of medical aspects of certain disorders, and have been trained to take a leadership role vis-à-vis these patients.

Second, psychiatrists have a much higher earning potential than any other mental health professionals.

Third, as physicians, psychiatrists generally hold greater status and positions of greater authority, especially in hospital or other medical settings. Higher salaries and prestige are due to the costs and competitiveness of medical education as well as society’s admiration of physicians in general.

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Contd.

Disadvantages

to becoming a psychiatrist:- First, the costs of medical training are extremely high compared with the training costs of other mental health professionals. Second, psychiatrists tend to have much less training in general human behavior and psychotherapy than many other mental health professionals. Third, psychiatrists also are not trained in psychological testing and assessment, and must defer to clinical psychologists in order to acquire this often critical information. Fourth, psychiatrists are rarely trained as extensively as clinical psychologists in rigorous research methodology.

Finally, fewer and fewer medical students choose psychiatry as a specialty. Psychiatric salaries, although high in comparison to non-MD mental health professionals, are very low compared with other physicians.

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Social Workers(MSW)

Social workers have focused their work on the interaction between an individual and the components of society that may contribute to or alleviate the individual’s problems. They saw many of their clients’ problems as products of social ills—racism, oppressive gender roles, poverty, abuse, and so on.

They also helped their clients by connecting them with social services, such as welfare agencies, disability offices, or job-training sites. More than their counterparts in psychology or psychiatry, they were likely to get into the “nitty-gritty” of their clients’ worlds by visiting their homes or workplaces, or by making contacts on their behalf with organizations that might prove beneficial.

When they worked together with psychologists and psychiatrists (e.g., in institutions), they usually focused on issues such as arranging for clients to transition successfully to the community after leaving an inpatient unit by making sure that needs such as housing, employment, and outpatient mental health services were in place. 11

Slide12

Contd

. In more recent years, the social work profession has grown to encompass a wider range of activities, and the similarity of some social workers (especially those conducting therapy) to clinical psychologists has increased (Wittenberg, 1997).

The training of social workers, however, remains quite different from the training of clinical psychologists. They typically earn a master’s degree rather than a doctorate, and although their training includes a strong emphasis on supervised fieldwork, it includes very little on research methods, psychological testing, or physiological psychology. Their theories of psychopathology and therapy continue to emphasize social and environmental factors.12

Slide13

Psychiatric Nursing(RN)

There are over 11,000 psychiatric nurses who have specialty training in psychiatric illnesses and treatment (American Psychiatric Nurses Association, 2003). They usually obtain both an undergraduate and master’s degree in nursing.

They are licensed as registered nurses (RN) following the completion of their undergraduate degree.

During their training, like other mental health professionals, they learn about psychiatric diagnosis and treatment. They also learn about psychopharmacology and are often involved in the dispensing of psychotropic medications to patients. Psychiatric nurses provide psychotherapy to individuals, families, and groups as well as assisting in medical management of psychotropic medications. Many psychiatric nurses are employed in hospitals and clinics, however, many maintain private practices as well.13

Slide14

Marriage and Family Therapists (MFT)

The mental health discipline of Marriage and Family Therapists is very popular in California and several other states. There are approximately 22,000 MFTs in California alone and about 46,000 nationally. The Association of Marriage and Family Therapists has about 23,000 members nationally.

MFTs typically complete a bachelor’s degree in any field (typically a social science discipline such as psychology, sociology, political science), and later pursue a master’s degree in a terminal master’s counseling or psychology program. Following up to two years of supervised experience,

MFTs can be licensed to practice independently in many but not all states. Despite the title, MFTs are not necessarily experts solely in marriage and family counseling. Often, they treat adults in individual therapy, as well. 14

Slide15

Contd

Advantages to becoming an MFT include the ease of acceptance into programs and the one to two years necessary to obtain a master’s degree.

Disadvantages include the general mixed quality and training of professionals in this field. Several states, such as Massachusetts, offer licensure as a Licensed Mental Health Counselor (LMHC) designed for master’s level practitioners. The training and experience for this profession tends to be similar to those outlined for MFTs.

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Professional Counselors

Professional counselors earn a master’s (rather than a doctoral) degree and often complete their training within 2 years.

Professional counselors attend graduate programs in counseling or professional counseling, which should not be confused with doctoral programs in counseling psychology. These programs typically have rather high acceptance rates compared with programs in many similar professions.

Professional counselors work generally involves counseling, with very little emphasis on psychological testing or conducting research. Correspondingly, their training programs include few if any courses on these topics, focusing instead on providing services to clients. Increasingly, professional counselors are among the clinicians who serve wide varieties of clients in community agencies (Norcross & Sayette, 2012), and they often enter private practice as well.

Professional counselors often specialize in areas such as career, school, addiction, couple/family, or college counseling.

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Other Counselors

Many hospitals and clinics employ a variety of counselors such as occupational therapists, activity therapists, alcohol counselors, art therapists, psychiatric technicians, and others.

These professionals provide a wide variety of services to patients including individual, family, and group counseling, and therapeutic activities such as art, dance, and music groups. Some of these professionals obtain a license or certification to practice (e.g., occupational therapists) while others do not (e.g., psychiatric technicians). Legislation in many states, such as Missouri, has been proposed or passed allowing occupational therapists, for example, to be licensed as “mental health professionals.”17