CHAPTER-1_-Clinical-Psychology_-Definition-and-Training.pdf

CHAPTER 1: Clinical Psychology: Definition and “The field of Clinical Psychology integrates Training science, theory, and practice to understand, predict,...

CHAPTER 1: Clinical Psychology: Definition and “The field of Clinical Psychology integrates Training science, theory, and practice to understand, predict, and alleviate maladjustment, What Is Clinical Psychology? disability, and discomfort as well as to promote human adaptation, adjustment, and personal Original Definition development. Clinical Psychology focuses on the intellectual, emotional, biological, Lightner Witmer psychological, social, and behavioral aspects Clinical psychology – the term was first used of human functioning across the life span, in in print by Lightner Witmer in 1907 varying cultures, and at all socioeconomic First to operate a psychological clinic levels.” Envisioned clinical psychology as a discipline ○ Defined by the Division of Clinical with similarities to a variety of other fields, Psychology (Division 12) of the specifically medicine, education, and American Psychological sociology. Association (APA). Clinical psychologist – a person whose work ○ An accurate, comprehensive, with others involves aspects of treatment, contemporary definition of clinical education, and interpersonal issues. psychology that is more inclusive and While the first clients of his clinic were children descriptive. with behavioral or educational problems, ○ Reflects the rich and varied growth that Witmer foresaw clinical psychology, even in the field has seen in the century since his earliest writings, as applicable to people of Witmer originally identified it. It is all ages and with a variety of presenting observed that both the field and its problems. practitioners continue to outgrow the classic definitions. More Recent Definitions ○ Its authors do not intend to suggest that each clinical psychologist spends Defining clinical psychology is a greater challenge equal time on each component of that today than it was in Witmer’s time. The field has definition. But, collectively, the work of witnessed such tremendous growth in a wide variety clinical psychologists does indeed of directions that most simple, concise definitions fall encompass such a wide range. short of capturing the field in its entirety. As a group, “Clinical psychology involves rigorous study contemporary clinical psychologists do many different and applied practice directed toward things, with many different goals, for many different understanding and improving the people. psychological facets of the human experience, “Clinical psychology is essentially the branch including but not limited to issues or problems of psychology that studies, assesses, and of behavior, emotions, or intellect.” treats people with psychological problems or ○ A broad but somewhat more succinct disorders.” definition according to Pomerantz. ○ A “quick” definition according to various introductory psychology Education and Training in Clinical Psychology textbooks and dictionaries of psychology. Basic components of clinical psychology training ○ This definition sounds reasonable common and well-established across programs: enough, however, it doesn’t portray all Must obtain a doctoral degree in clinical that clinical psychologists do, how they psychology. do it, or who they do it for.  Most students enter a doctoral program with The multitude of specialty tracks within clinical only a bachelor’s degree, some enter with a psychology doctoral programs. More than half master’s degree. of APA-accredited doctoral programs in ○ Often, the master’s degree was earned clinical psychology offer (but may not require) from a “terminal” master’s program in training within a specialty track. clinical psychology, meaning that their ○ The most common specialty areas are program ends at the master’s level. clinical child, clinical health, forensic, ○ Some graduates of such master’s family, and clinical neuropsychology. programs go on to earn doctoral Coexistence of three distinct models of degrees, while others enter the training currently used by various graduate workforce in some capacity. programs: ○ The scientist-practitioner (Boulder) For those entering with a bachelor’s degree, training model typically consists of: ○ The practitioner-scholar (Vail) model At least 4 years of intensive, full-time ○ The clinical scientist model coursework ○ Required coursework includes courses Balancing Practice and Science: The Scientist- on: Practitioner (Boulder) Model Psychotherapy In 1949, the first conference on graduate Assessment training in clinical psychology was held in Statistics Boulder, Colorado. Research design and Training directors from around the country methodology reached an important consensus where Biological bases of behavior training in clinical psychology should jointly Cognitive-affective bases of emphasize both practice and research. behavior To become a clinical psychologist, graduate Social bases of behavior students would need to receive training and Individual differences display competence in: And other subjects ○ The application of clinical methods ○ A master’s thesis and doctoral (assessment, psychotherapy, etc.) dissertation are also commonly ○ The research methods necessary to required. study and evaluate the field ○ Also, a practicum in which students scientifically start to accumulate supervised Coursework should reflect this dual emphasis, experience doing clinical work. with classes in: Followed by a 1-year, full-time predoctoral ○ Statistics and research methods internship ○ Psychotherapy and assessment ○ They take on greater clinical Expectations for the more independent responsibilities and obtain supervised aspects of graduate training would also reflect experience on a full-time basis. the dual emphasis. Graduate students under Lastly, a postdoctoral internship occurs after supervision would conduct both: the degree is obtained. ○ Clinical work ○ Their own empirical research: thesis, Beyond these basic requirements, especially in recent and dissertation. decades, there is no single way by which someone These graduate programs would continue to becomes a clinical psychologist. Instead, there are be housed in departments of psychology at many paths to the profession. This is indicated by: universities, and graduates would be awarded the PhD degree.  The term scientist-practitioner model was fewer courses related to research and used to label this two-pronged approach to statistics. training. Since the 1970s, graduate programs offering For decades, the scientist-practitioner—or the the PsyD degree have proliferated. Between Boulder model—approach to clinical 1988 to 2001 time period alone, the number of psychology training unquestionably PsyD degrees awarded increased by more dominated the field. In fact, more programs than 160%. The growth of the PsyD (or still subscribe to the Boulder model than to any practitioner-scholar or Vail model) approach other. However, as time passed, to training in clinical psychology has developments took place that produced a influenced the field tremendously. Currently, wider range of options in clinical psychology more than half the doctoral degrees being training. The pendulum did not remain awarded in the field are PsyD degrees. stationary at its midpoint between practice and There are only 80 PsyD programs compared research; instead, it swung toward one to 250 PhD programs, but PsyD program extreme and then toward the other. accepts and graduates a much larger number of students than does the PhD program. So, Leaning Toward Practice: The Practitioner- the number of graduates with each degree is Scholar (Vail) Model about the same. In 1973, another conference on clinical psychology training was held in Vail, Colorado. Comparing PhD Programs With PsyD Programs In the years preceding this conference, some discontent has arisen regarding the Boulder, In general, compared with PhD programs, PsyD or scientist-practitioner, model of training. programs tend to: ○ In effect, many current and aspiring Place less emphasis on research-related clinical psychologists question the aspects of training and more emphasis on importance of extensive training as a clinically relevant aspects of training. scientist in their goal of clinical Accept and enroll a much larger percentage practice. It was then that only a and number of applicants. minority of clinical psychologists were Be housed in freestanding, independent (or entering academia or research as a university-affiliated) “professional schools,” as primary professional task. opposed to departments of psychology in ○ Clinical practice was the more popular universities. career choice, and many would-be Accept students with lower Graduate Record clinical psychologists sought a Examination (GRE) scores and undergraduate doctoral-level degree with less grade point averages (GPAs). extensive training in research and Offer significantly less funding to enrolled more extensive training in the students in the form of graduate development of applied clinical skills. assistantships, fellowships, tuition remission, ○ Additionally, some within the and so on. profession were questioning whether Accept and enroll a higher percentage of the quality and quantity of practitioners students who have already earned a master’s was sufficient to serve the population. degree. So the practitioner-scholar model of training Have lower rates of success placing their was born, along with a new type of doctoral students in APA-accredited predoctoral degree, the PsyD. Compared with PhD internships. programs, these programs typically offer more Produce graduates who score lower on the coursework directly related to practice and national licensing exam (EPPP).  Graduate students in a briefer time period emphasis on the scientific method and (about 1.5 years sooner). evidence-based clinical methods. Graduate students who pursue practice- There are two defining events highlight the related careers rather than academic or initial steps of this movement: research-related careers. ○ In 1991, Richard McFall, at the time a Have at least a slightly higher percentage of professor of psychology at Indiana faculty members who subscribe to University, published an article that psychodynamic approaches, as opposed to served as a rallying call for the clinical cognitive-behavioral approaches. scientist movement. In this article, “Manifesto for a Science of Clinical Leaning Toward Science: The Clinical Scientist Psychology,” McFall argued that Model “scientific clinical psychology is the After the advent of the balanced Boulder only legitimate and acceptable form of model in the late 1940s and the subsequent clinical psychology... after all, what is emergence of the practice-focused Vail model the alternative?... Does anyone in the 1970s, the more empirically minded seriously believe that a reliance on members of the clinical psychology profession intuition and other unscientific methods began a campaign for a strongly research- is going to hasten advances in oriented model of training. knowledge?” ○ A few years later, a conference of prominent leaders of select clinical psychology graduate programs took place at Indiana University which purpose was to unite in an effort to promote clinical science. From this, Academy of Psychological Clinical Science was founded in which McFall served as its president for the first several years. As time has passed, an increasing number of graduate programs and internships have In the 1990s, a movement toward increased become members. The programs in empiricism took place among numerous this academy still represent a minority graduate programs and prominent individuals of all graduate programs in clinical involved in clinical psychology training. psychology, but among the members ○ The leaders of this movement argued are many prominent and influential that science should be the bedrock of programs and individuals. clinical psychology. They sought and Considering the discrepancies between the created a model of training—the three models of training, the experience of clinical scientist model—that clinical psychology graduate students varies stressed the scientific side of clinical widely from one program to the next. Insider’s psychology more strongly than did the Guide to Graduate Programs in Clinical Boulder model. and Counseling Psychology, a valuable ○ Unlike the Vail model in the 1970s, resource used by many applicants to learn their program still awards the PhD, just about specific graduate programs in clinical as Boulder model graduate programs psychology, the first piece of information listed do. However, a PhD from a clinical about each program is that program’s self- scientist program implies a very strong rating on a 7-point scale from “practice  oriented” to “research oriented.” Applicants can find programs at both extremes and everywhere in between. Broad Trends in Training in Clinical Psychology Since the Early 1990s A shift in the theoretical orientation of faculty toward cognitive/cognitive behavioral and away from psychodynamic/psychoanalytic. Increase in the percentage of doctoral students who are: ○ Female ○ Members of racial or ethnic minorities. Technology is increasingly influential in the training of clinical psychologists. For an increasing number of students, learning psychotherapy or assessment techniques involves the use of webcams and other computer-based methods that allow supervisors to view, either live or recorded, students trying to apply what they have learned in class. Growing emphasis on specific competencies, or outcome-based skills the students must be able to demonstrate. ○ This ensures that students who graduate from clinical psychology programs will be able to apply what they have learned aside from earning good grades on exams, papers, and other academic tasks. ○ Specific competencies that may be required of students could center on: Intervention (therapy) Assessment Research Consultation/collaboration Supervision/ teaching Ethics Cultural diversity Management/administration  Personality ○ Choose electives carefully, too— classes that have direct clinical relevance. Including field studies or internships Get to know your professors. ○ Letters of recommendation are among Getting In: What Do Graduate Programs Prefer? the most important factors in clinical psychology graduate admissions Resources for Aspiring Clinical Psychology decisions. Professors (and, to some Graduate Students extent, supervisors in clinical or Insider’s Guide to Graduate Programs in research positions) can be ideal writers Clinical and Counseling Psychology of such letters—assuming the Graduate Study in Psychology professor actually knows the student. Getting In: A Step-by-Step Plan for Gaining ○ The better you know the professor, the Admission to Graduate School in Psychology more substantial your professor’s letter Admission and Application in Graduate Programs can be. Admission rates are competitive, and the For example, a professor may application process is demanding. be able to write a brief, vaguely ○ APA-accredited PhD programs admit complimentary letter for a quiet only 7% to 16% of their applicants. student who earned an A in a ○ APA-accredited PsyD programs admit large lecture course. But the about 40% to 50% of their applicants. professor would be able to write a much more meaningful, Suggestions Offered by Indicated Resouces: persuasive, and effective letter Know your professional options for the same student if the two ○ Numerous roads lead to the clinical of them had developed a strong psychologist title; moreover, numerous working relationship through professions overlap with clinical research, advising, or other psychology in terms of professional professional activities. activities. Get research experience. ○ Researching these options will allow ○ Your experience in a research for more informed decisions and better methods class is valuable, but it won’t matches between applicants and distinguish you from most other graduate programs. applicants. Take, and earn high grades in, the ○ Conducting research with a professor appropriate undergraduate courses. affords you additional experience with ○ Graduate programs want trainees the empirical process, as well as a whose undergraduate programs chance to learn about a specialized maximize their chances of succeeding body of knowledge and develop a at the graduate level. working relationship with the professor. ○ Among the most commonly required or In some cases, professors recommended courses are: seek assistants for ongoing Statistics, projects they have designed. research/experimental In others, the undergraduate methods student may approach the Psychopathology Biopsychology  faculty member with an original ○ Along with undergraduate GPA, scores idea for an independent study. on the GRE are key determinants of If your contribution is significant admission to graduate programs. enough, this research Appropriately preparing for this test experience could also yield a can boost your odds of admission. publication or presentation on ○ By learning what scores your preferred which you are listed as an programs seek author, which will further ○ Studying for the test either informally or enhance your application file. through a review course ○ Regardless of the arrangement, ○ Taking practice exams, and retaking it conducting research at the as necessary. undergraduate level improves an Select graduate programs wisely. applicant’s chances of getting into and ○ Getting in is certainly important, but succeeding in a graduate program. getting into a program that proves to be Get clinically relevant experience. a bad match benefits neither the ○ For undergraduates, the options for student nor the program. It is best to direct clinical experience (therapy, learn as much as possible about counseling, interviewing, testing, etc.) potential programs: are understandably limited. Even for What is the model of training those who have earned a bachelor’s (Boulder, Vail, or clinical degree and are considering returning scientist)? to school at the graduate level, clinical To what clinical orientations positions may be hard to find. does the faculty subscribe? ○ However, quite a few settings may What areas of specialization do offer exposure to the kinds of clients, the faculty members professionals, and issues that are represent? central to clinical psychology. These What clinical opportunities are settings include: available? Community mental health Your own preferences or centers constraints—geography, Inpatient psychiatric centers, finances, family—deserve crisis hotlines consideration as well. Alternative schools Write effective personal statements. Camps for children with ○ In addition to the many other items in behavioral or emotional issues your application file, graduate And others programs will require you to write a ○ Whether the clinical experience takes personal statement (or goal the form of an internship or practicum statement). (for which course credit is earned), a ○ This is your opportunity to discuss paid job, or a volunteer position, it can career aspirations as well as your provide firsthand knowledge about research and clinical interests—all of selected aspects of the field, and it which should fit well with the program demonstrates to admissions to which you are applying. committees that you are serious and ○ It is also a chance to explain in more well informed about clinical detail information that may have psychology. appeared only briefly on a résumé or Maximize your GRE score. vita, such as clinical experiences or  research with an undergraduate Down the road, do you see professor. yourself as a clinician or a ○ Make sure your writing ability appears researcher? strong and that you don’t make the Have you firmly determined statement overly personal or revealing. your own theoretical orientation Prepare well for admissions interviews. already, or do you seek a ○ Most doctoral programs invite high- program that will expose you to ranking applicants for an in-person a variety? interview. What specific areas of clinical ○ These interviews are a wonderful or scientific work are most opportunity for professors in the interesting to you? program to get to know you and for you How much financial debt are to get to know the program. you willing to incur? ○ Arrive (professionally dressed, of Search the literature for studies on how course) with a strong understanding of graduate programs handle their the program and your interest in it. The admissions processes. more specific, the better: Interest in ○ For example, one study surveyed the particular professors’ research directors of clinical psychology concentrations, for example, makes a doctoral programs about the better impression than the fact that the importance they place on various program has a strong reputation. components of the application ○ And don’t forget to develop a list of process. These researchers found that your own questions—good questions both PhD and PsyD programs placed can solicit more detailed information high value on several core elements: than you were able to find on the Undergraduate GPA program’s website and can impress GRE scores interviewers in the process. Some Letters of recommendation common interview questions are: Personal statement Why do you want to be a Curriculum vitae clinical psychologist? Interview performance. What attracts you to our ○ There were some differences between graduate program specifically? PhD and PsyD programs: What are your research PhD programs placed much interests? greater importance on the What approach(es) to student–mentor research psychotherapy do you prefer? match (making sure that an Which of our faculty members incoming student has research would you like to work with? interests that closely What are your long-term career correspond to those of a faculty goals? If you were a student in member) and research our program, what would you assistance experience. like to do after you graduated? PsyD programs were more Consider your long-term goals. likely to offer admission to ○ Thinking ahead about these and other applicants who already had a questions can increase the likelihood master’s degree. that you will find yourself at a graduate program at which you thrive and that Internships: Predoc and Postdoc sets you up for a fulfilling career. Predoctoral Internship per year. That number has since All clinical psychology doctoral programs decreased, but the issue remains, at culminate in predoctoral internship. least to some extent. Typically consists of a full year of supervised ○ Numerous causes have been clinical experience in an applied setting. proposed, but the factor receiving the ○ Such as in a psychiatric hospital, a most attention is the drastic increase in Veterans Affairs medical center, a the number of PsyD applicants without university counseling center, a a corresponding increase in the total community mental health center, a number of internship placements. medical school, or another agency Now, numerous strategies to improve where clinical psychologists work. the current situation are under Along with the completion of the dissertation, consideration. this takes place before the PhD or the PsyD is ○ Applicants are generally successful in awarded. finding an internship position— Generally considered a year of transition, a especially if they don’t overly restrict sort of advanced apprenticeship in which the themselves in terms of the number of individual begins to outgrow the role of applications or geographic range. “student” and grow into the role of “professional.” Postdoctoral Internship An opportunity to gain more specialized Beyond the predoctoral internship and the training than may have been available in doctoral degree that follows, most states graduate school so far. require a postdoctoral internship for Many internships are accredited by the APA; licensure as a psychologist. those that are not may be looked on less The postdoc typically lasts 1 to 2 years. favorably by state licensing boards. ○ Postdocs take on more responsibilities than they did as predoctoral interns, Process of Applying for a Predoctoral Internship but they remain under supervision. Similar to the process of applying to graduate ○ Like the predoctoral internship, the school, it often involves: postdoc often provides an opportunity ○ Researching various internships for specialized training. ○ Applying to many, traveling for ○ Some clinical psychologists obtain interviews postdoc positions that are explicitly ○ Ranking preferences designed from the start to meet ○ Anxiously awaiting feedback licensing requirements for a particular ○ Relocating to a new geographic area. state; sometimes, such positions are Some apply to 20 or more, but 10 to 15 continuations of predoctoral internship internship sites may be more reasonable and experiences. equally effective. ○ Other clinical psychologists may obtain Internship Shortage an entry-level position with an agency ○ The number of graduate students and tailor it to meet postdoctoral seeking predoctoral internships has requirements for licensure. either approached or exceeded the After postdoctoral interns accumulate the number of available slots required number of supervised hours, and ○ The shortage worsened considerably pass the applicable licensing exams, they can after roughly 2002, as the number of become licensed to practice independently. students who applied but were not Since 2008, a small but growing number of successfully placed at an internship states have decided to drop the requirement of increased dramatically, to hundreds  a postdoc for licensure. The rationale behind education units (CEUs) to renew the license this decision involves several factors: from year to year. ○ Current graduate training (including ○ In various states, psychologists can the predoctoral internship) provides far meet these ongoing requirements in a more clinical experience than it did number of ways by: years ago when postdoc requirements Attending workshops were put into place. Taking courses ○ Employers often have difficulties Undergoing additional funding postdoc positions because specialized training third-party payers (e.g., health Passing exams on selected insurance companies) who pay the professional reading material, bills for many clients can refuse to pay and the like. for services by someone who is not yet ○ The purpose of requiring CEUs is to licensed. ensure that clinical psychologists stay ○ Postdoc positions can be difficult to up to date on developments in the field, find, especially in rural areas. with the intention of maintaining or ○ Some states have a shortage of clinical improving the standard of care they psychologists to serve their residents, can provide to clients. so making licensure easier to obtain is a win-win for the psychologists and the Professional Activities and Employment Settings public. Where Do Clinical Psychologists Work? Getting Licensed Works in a wide variety of settings but private Becoming licensed gives professionals the practice is the most common. right to identify as members of the According to the surveys conducted since profession—to present themselves as 1980s: psychologists (or clinical psychologists—the ○ Private practice has been the primary terminology, as well as licensing requirements employment site of 30% to 41% of in general, differs from state to state). It also clinical psychologists. authorizes the psychologist to practice ○ University psychology departments independently. came in second, but that number has Requires passing licensure exams—typically, not exceeded 19%. the Examination for Professional Practice ○ Came in third is the “other” category. in Psychology (EPPP) and a state-specific Between 2% and 9% of clinical exam on laws and ethics. psychologists have listed each ○ The EPPP is a standardized multiple- of the following as their primary choice exam on a broad range of work setting: psychiatric psychology topics; all U.S. states and hospitals, general hospitals, most provinces of Canada establish a community mental health minimum score for licensure. The state centers, medical schools, and exams vary, of course, according to Veterans Affairs medical state regulations but tend to center on centers. legal issues relevant to the practice of In 2003, 15% of psychologists psychology in the state in question. listed “other,” writing in diverse The state exams may be written or settings such as government oral. agency, public schools, Once licensed, clinical psychologists in many substance abuse center, states must accumulate continuing  corporation, and university counseling center. ○ It is clear that although private practice remains a common destination, clinical psychologists are finding employment across an expanding range of settings. What Do Clinical Psychologists Do? They are engaged in an enormous range of professional activities, but psychotherapy is foremost. ○ Since 1973, the number of clinical psychologists reporting that they are involved in psychotherapy has always outranked that of any other Counseling Psychologists professional activity and has ranged Historically, clinical psychologists were more from 76% to 87%. likely to work with seriously disturbed ○ Clinical psychologists have reported individuals, whereas counseling psychologists that they spend between 31% and 37% were more likely to work with or counsel less of their time conducting pathological clients. psychotherapy—a percentage more Today, many clinical and counseling than double that of any other activity. psychologists see the same types of clients, ○ Of those who practice psychotherapy, sometimes as colleagues working side by individual therapy occupies the largest side. Another similarity is that their graduate percentage of their therapy time (76%), students occupy the same internship sites, with group, family, and couples therapy often earn the a PhD degree, and obtain the far behind 6% to 9% each. same licensure status. A sizable number of psychologists—more than While two professions share so much common half—have also reported that they are at least ground, a few meaningful differences remain. somewhat involved in each of the following ○ Clinical psychologists: activities: diagnosis/ assessment, teaching, Work with more seriously supervision, research/writing, consultation, disturbed populations and administration. Of these, diagnosis and Work and complete internships assessment generally occupy more of clinical more often in settings such as psychologists’ time than do the others. hospitals and inpatient Overall, it is evident that “clinical psychologists psychiatric units are involved in multiple professional pursuits Theoretical orientation across varied employment sites”. In fact, more endorses behaviorism more than half of clinical psychologists hold at least strongly two professional positions. More interested in applications of psychology to medical How Are Clinical Psychologists Different From... settings ○ Counseling psychologists: Work with less seriously disturbed populations Work and complete internships more often in university counseling centers  Theoretical orientation Traditionally, social workers have focused endorses humanistic/client- their work on the interaction between an centered approaches more individual and the components of society that strongly. may contribute to or alleviate the individual’s More interested in vocational problems. They saw many of their clients’ testing and career counseling problems as products of social ills— racism, oppressive gender roles, poverty, abuse, and Psychiatrists so on. Psychiatrists go to medical school and are ○ They also helped their clients by licensed as physicians. Their first several connecting them with social services, years are often identical to that of other types such as welfare agencies, disability of physicians, only then they receive offices, or job-training sites. specialized training in psychiatry. ○ They were likely to get into the “nitty- The two professions fundamentally differ in gritty” of their clients’ worlds by visiting their understanding of and approach to their homes or workplaces, or by behavioral or emotional problems. making contacts on their behalf with ○ Clinical psychologists: organizations that might prove Trained to appreciate the beneficial. biological aspects of their ○ When they worked together with clients’ problems psychologists and psychiatrists (e.g., Clinical psychologists view in institutions), they usually focused on clients’ problems as behavioral, issues such as arranging for clients to cognitive, emotional—still transition successfully to the stemming from brain activity, of community after leaving an inpatient course, but amenable to unit by making sure that needs such as change via those for housing, employment, and nonpharmacological methods. outpatient mental health services were It was only recently that being met. psychologists have rallied and In more recent years, the social work obtained prescription privileges profession has grown to encompass a wider in small number of states. range of activities, and the similarity of some ○ Psychiatrists: social workers, especially those conducting Psychiatrists’ training therapy, to clinical psychologists has emphasizes biology to such an increased. extent that disorders— The training of social workers, however, depression, anxiety disorders, remains quite different from the training of attention-deficit/hyperactivity clinical psychologists. disorder (ADHD), borderline ○ Typically earn a master’s degree rather personality disorder, and so than a doctorate. on—are viewed first and ○ Their training includes a strong foremost as physiological emphasis on supervised fieldwork, abnormalities of the brain. however, it includes very little on To fix the problem, research methods, psychological psychiatrists tend to fix the testing, or physiological psychology. brain by prescribing ○ Their theories of psychopathology and medication. therapy continue to emphasize social and environmental factors. Social Workers School Psychologists ○ They attend graduate programs in School psychologists usually work in schools, counseling or professional counseling, but some may work in other settings such as which should not be confused with day-care centers or correctional facilities. doctoral programs in counseling Their primary function is to enhance the psychology. These programs typically intellectual, emotional, social, and have rather high acceptance rates developmental lives of students. compared with programs in many ○ They frequently conduct psychological similar professions. testing (especially intelligence and Every state has some version of professional achievement tests) to determine counselor licensure, but the name may vary diagnoses such as learning disorders slightly, with common alternatives including and ADHD. mental health counselor, licensed professional ○ They use or develop programs mental health counselor, licensed clinical designed to meet the educational and professional counselor, and licensed emotional needs of students. counselor of mental health. ○ They also consult with adults involved in students’ lives—teachers, school Marriage and Family Therapists administrators, school staff, parents— Marriage and family therapists, or MFTs, earn and are involved, to a limited degree, master’s degrees. in direct counseling with students. Their training focuses on working with couples In many states, the title of school psychologist and families, but sometimes they also see requires only a master’s degree rather than a individuals struggling with issues related to doctorate. their partners or families. About half of MFTs work in private practice, Professional Counselors and most of the others practice in other types Often called licensed professional counselors, of work settings like clinics or agencies. or LPCs Compared to the training of clinical Professional counselors’ work generally psychologists, the training of MFTs places involves counseling of people with problems in relatively little emphasis on research and living or mild mental illness (as opposed to assessment. serious mental illness). Professional counselors are among the clinicians who serve wide varieties of clients in community agencies, and they often enter private practice as well. They often specialize in such areas as career, school, addiction, couple/ family, or college counseling. Their training typically includes: ○ 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. ○ Earn a master’s rather than a doctoral degree and often complete their training within 2 years.