Clinical Psychology is the application of psychology in a clinical setting, including researching and treating psychological distress, dysfunction or disorder. In many countries it is a regulated mental health profession. Central to the practice of clinical psychology is assessment of the issues and needs of clients, and provision of psycho-education or psychotherapy to improve subjective well-being, mental health, and life functioning.
The term Clinical Psychology was introduced in 1907 by Lightner Witmer. A recognised field and profession developed through the 20th century, drawing initially on various strands of experimental and psychotherapy (initially behavioral and psychoanalytic), and later from numerous branches of psychology as well from other fields such as neuroscience and sociology.
Different countries require various educational and professional qualifications to practice clinical psychology, traditionally at the doctoral level but increasingly at the masters level. The scope of the field has varied but has been said to include intellectual, emotional, biological, psychological, social, and behavioral aspects of human functioning across the life span, in varying cultures, at different socioeconomic levels. Clinical psychologists may not necessarily see an individual's distress or disorder as a problem within the client, even if the client experiences it in that way, but may see it as based within the wider familial, social or cultural environment. A common theme of those seeking assistance from clinical psychology is suffering, for example, from coping with chronic bodily pain from injury or illness.
Practitioners of clinical psychology can work with individuals, couples, children, adults, families and with small groups. They may work in psychiatric hospitals, general practice, psychological clinics, or academic centers. They may work individually in private practice or in multi-disciplinary teams involving other professions, commonly with licensed psychologists, social workers, psychiatric nurses and psychiatrists. They themselves may be a licensed psychologist, a social worker, a therapist, a counselor, a psychiatric nurse or a psychiatrist.
Training and licensing of clinical psychologists.
Clinical psychologists undergo many hours of graduate training in order to gain demonstrable competence and experience. At the doctoral level, usually 4 to 6 years post-Bachelors, and usually 3 to 5 years post-bachelors at the masters level. At the doctoral level, in USA and Australia there is an increasing move toward training clinical psychology graduate students in PhD programs. This is a model emphasizing research in universities. Others undertaking PsyD programs have more focus on practice (similar to professional degrees for medicine and law). Both models envision practicing Clinical Psychology in a research-based, scientifically valid manner, accredited by their national professional organizations. A increasing number of schools offer accredited programs in clinical psychology resulting in a Masters degree. At the masters level the emphasis is nearly always on professional practice rather than research.
In the U.K., clinical psychologists nearly always undertake a DClinPsy, which is a doctorate with both clinical and research components. This is a three-year full-time salaried program sponsored by the National Health Service (NHS) and based in universities and the NHS. Entry into these programs is highly competitive, and requires at least a three-year undergraduate degree in psychology approved by the British Psychological Society or an approved conversion course, plus some form of experience, usually in either the NHS as an Assistant Psychologist or in academia as a Research Assistant.
Clinical psychologists can offer a range of professional services, including:
Provide psychological treatment (psychotherapy)
Administer and interpret psychological assessment and testing
Conduct psychological research
Teaching
Development of prevention programs
Consultation (especially with schools and businesses)
Program administration
Provide expert testimony (forensics)
In 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.
The practice of clinical psychology requires a license in the United States, Canada, Australia and many other countries. In the UK, most qualified clinical psychologists apply to be 'chartered'. Most countries also require a certain number of continuing education credits per year in order to renew a license, which can be obtained though various means, such as taking audited classes and attending approved workshops. In the US there are several alternative licenses with which one can practice clinical psychology which are usually awarded in relation to one's educational degree. In the U.K., mental health titles such as "clinical psychologist" and "psychologist", are not yet protected by statutory registration, although there are plans. The title of "Assistant Psychologist" is used by a psychology graduate under the supervision of a qualified clinical psychologist, and the title "Trainee Clinical Psychologist" is used during the three-year doctoral program. There are also initiatives being taken at a Europe-wide level to develop standardized training and qualifications.
There are different theories and models of psychological processes used in clinical psychology. Clinical psychologists generally seek to base their work on research evidence and outcome studies as well as on clinical judgement and empathy. They help to research and develop evidence-based theories and models of the psychological causes and mediators of mental health problems, which can be applied to individual clients. Clinical psychologists often provide psychotherapy (also known as "talking therapy"), using various techniques to change thoughts, feelings or behaviors in order to enhance well-being, mental health, and life functioning. Clinical psychologists often also provide social skills training or other skills-based or psycho-educational interventions, either to clients themselves and/or to family members or others in sigificant relations with the client.
Generally speaking, psychotherapy involves a formal relationship between professional and client—usually an individual, couple, family, or small group—that employs a set of procedures intended to form a therapeutic alliance, explore the nature of psychological problems, and encourage new ways of thinking or behaving. Although there are literally dozens of recognized therapeutic orientations, their differences could be categorized on two dimensions: insight vs. action and in-session vs. out-session.
Insight—emphasis is on gaining greater understanding of the motivations underlying one's thoughts and feelings (e.g. Psychodynamic therapy)
Action—focus is on making changes in how one thinks and acts (e.g. Solution Focussed Therapy, Cognitive Behavioral Therapy)
In-session—interventions center on the here-and-now interactions between client and therapist (e.g. Humanistic therapy, Family Therapy)
Out-session—although the importance of the relationship is recognized, therapy is geared towards helping the client make changes outside of the session (e.g. Bibliotherapy, Rational Emotive Behavior Therapy)
The methods used are also different in regards to the population being served as well as the context and nature of the problem. Therapy will look very different between, say, a traumatized child, a depressed but high-functioning adult, a group of people recovering from substance dependence, and a ward of the state suffering from terrifying delusions. Other elements that play a critical role in the process of psychotherapy include the environment, culture, age, cognitive functioning, motivation, and duration (i.e. brief or long-term therapy).