Clinical Psychology

According to the American Psychological Association's Division 12, the Society of Clinical Psychology, clinical psychology “integrates science, theory, and practice to understand, predict and alleviate maladjustment, disability and discomfort as well as to promote human adaptation, adjustment and personal development. Clinical Psychology focuses on the intellectual, emotional, biological, psychological, social and behavioral aspects of human functioning across the life span, in varying cultures, and at all socioeconomic levels.”

There are two main professional tracks for becoming a clinical psychologist: the traditional scientist-practitioner Ph.D. requiring extensive research, clinical, and assessment experience, culminating in a doctoral dissertation requiring defense. The clinical psychologist has extensive training in research methods and in techniques for diagnosing, treating, and preventing various disorders. Most psychologists earn a PhD degree in the field, which requires completion of a four-to six-year program offered by a university psychology department. The course of study includes a broad overview of the field (including courses in such areas as statistics, personality theory, and psychotherapy), as well as specialization in a particular subfield and completion of a practicum, internship, and dissertation. A newer training program for psychologists was developed and introduced at the University of Illinois, which offered the first psychology doctorate (Psy.D.) in 1968. This degree program was geared exclusively toward the training of clinicians rather than researchers. It stressed course work in applied methods of assessment and intervention and eliminated the dissertation requirement. The number of Psy.D. programs in the United States burgeoned since 1968, with some programs offered at universities and others at independent, free-standing professional schools of psychology.

Clinical psychologists may choose a theoretical framework such as transpersonal, humanistic, psychoanalytic, cognitive behavioral or family systems, although many are eclectic and combine multiple frameworks to maximize ability to be client-directed. They use a variety of treatment techniques and modalities, depending on theoretical framework and client needs, to include traditional talk therapy, assessment and diagnosis, brief solution-focused therapies, cognitive behavioral therapy, behavior change/modification, psychodrama, dialectical behavior therapy, motivational interviewing, dream analysis, free association, hypnosis, progressive relaxation and stress management, and a broad range of play therapy and child-centered techniques.

Clinical psychology is the single largest subfield of psychology, with many within-area subfields. A substantial percentage of clinical psychologists are private practitioners, either alone or in group practice with other mental health professionals. Others may practice in a variety of settings, including community mental-health centers, university medical schools, social work departments, centers for the mentally and physically disabled, prisons, state institutions and psychiatric hospitals, juvenile courts, and probation offices. Clinical psychologists use psychological assessment tools and other means to diagnose psychological disorders and may apply psychotherapy to treat clients individually or in groups. In the United States, they are governed by a code of professional practice drawn up by the American Psychological Association. Some states allow doctoral level, fully licensed clinical psychologists to prescribe psychotropic medications from a limited formulary.

Individuals consult clinical psychologists for treatment when their behaviors or attitudes interfere with everyday life, cause them significant distress, or may be harmful to themselves or others. Psychologists employ many different treatment types, depending on the setting in which they work and their theoretical orientation. The major types of therapy include psychodynamic therapies, based on uncovering unconscious processes and motivations, of which the most well known is Freudian psychoanalysis; phenomenological, or humanistic, therapies (including the Rogerian and Gestalt methods), which view psychotherapy as an encounter between equals, abandoning the traditional doctor-patient relationship; and behavior-oriented therapies geared toward helping clients see their problems as learned behaviors that can be modified without seeking to uncover unconscious motivations or hidden meanings. These therapies, derived from the work of Ivan Pavlov (1849–1936) and B. F. Skinner (1904–1990), include methods such as behavior modification and cognitive-behavior therapy, which may be used to alter not only overt behavior but also the thought patterns that drive it.

Clinical psychologists routinely contribute to the training of mental health professionals and those in other areas of health care, serving on the faculties of universities and independent institutes of psychology, where they teach courses, supervise practicums and internships, and oversee dissertation research. They also carry out administrative appointments that call for them to assist in the planning and implementation of healthcare services and are represented in international groups such as the World Health Organization.

See also Group therapy ; Psychology/psychologist; Psychotherapy .



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