Psychologist

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Not to be confused with Psychiatrist.
Psychologist David Lewis measures a subject’s responses to a TV commercial in the early 1980s using a specially modified EEG device.

A psychologist is a professional who evaluates and studies behavior and mental processes[1] (see also psychology). In order to become a psychologist, a person must complete either a master's degree or a doctorate degree, depending on the country in which they live. This definition of a psychologist is non-exclusive; in most jurisdictions, members of other professions (such as counselors and psychiatrists) can also evaluate, diagnose, treat, and study mental processes.[2] There are many types of psychologists, as is reflected by the 56 divisions of the American Psychological Association (APA).[3] Some of the major categories include clinical, counseling, and educational psychologists, who work with persons in a variety of therapeutic contexts; industrial, organizational and community psychologists, who apply psychological research, theories and techniques to "real-world" problems, questions and issues in business, industry, social benefit organizations, and government;[4][5][6] and also academics, who conduct psychological research or teach psychology in a college or university.

Psychologists are generally described as "applied" or "research-orientated." The common terms used to describe this central division in psychology are "scientists" or "scholars", those who conduct research, and "practitioners" or "professionals", those who apply psychological knowledge. The training models endorsed by the APA require that applied psychologists be trained as both researchers and practitioners,[7] and that they possess advanced degrees.

People often think of the discipline as involving clinical or counseling psychology. While counseling and psychotherapy are common activities for psychologists, these applied fields are just one branch in the larger domain of psychology.[8]

Licensing and Regulations

The University of Pennsylvania was the first to offer formal education in clinical psychology.

Australia

In Australia, the psychology profession and the use of the title 'psychologist' is regulated by an Act of Parliament, Health Practitioner Regulation (Administrative Arrangements) National Law Act 2008, following an agreement between the state and territory governments. Under the national law, registration of psychologists is administered by the Psychology Board of Australia (PsyBA).[9] Before July 2010, professional registration of psychologists was governed by various State and Territory Psychology Registration Board.[10] The Australian Psychology Accreditation Council (APAC) oversees education standards for the profession of psychology.

The minimum requirements for general registration in psychology, and to use the title 'psychologist', is an APAC approved four-year degree in psychology followed by either a two-year masters program or two years supervised by a registered psychologist.[11][12] Endorsement within a specific area of practice (e.g. clinical, counseling, educational, forensic, health, organizational or neuropsychological) requires additional qualifications.[13] These notations are not "specialist" titles (Western Australian psychologists could use "specialist" in their titles during a three-year transitional period from 17 October 2010 to 17 October 2013).[14][15][16]

Membership with Australian Psychological Society (APS) differs from registration as a psychologist. The standard route to full membership (MAPS) of the APS technically requires a masters or doctorate in psychology from an accredited course. An alternate route is available for academics and practitioners who have gained appropriate experience and made a substantial contribution to the field of psychology. Association membership requires four years of APAC-accredited undergraduate study.

Restrictions apply to all individuals using the title ''psychologist'' in all states and territories of Australia. However, the terms ''psychotherapist'', ''social worker'', and ''counselor'' are currently self-regulated with several organizations campaigning for government regulation.[17]

Belgium

Since 1933, the title "psychologist" has been protected by law in Belgium. It can only be used by people who are on the National Government Commission list. The minimum requirement is the completion of five years of university training in psychology (master's degree or equivalent). The title of "psychotherapist" is not legally protected.

Finland

In Finland, the title "psychologist" is protected by law. This restriction is governed by National Supervisory Authority for Welfare and Health (Finland). It takes 330 ECTS-credits (about six years) to accomplish the studies.

Germany

In Germany, the use of the title 'Diplom-Psychologe' ('Dipl.-Psych.') is restricted by law, and a practitioner is legally required to hold the corresponding academic title, which is comparable to a higher M.Sc. degree and requires at least five years of training at a university. Originally, a diploma degree in psychology awarded in Germany included the subject of clinical psychology. With the Bologna-reform, this degree was replaced by a master's degree. The academic degree of Diplom-Psychologe or M.Sc. (Psychologie) does not include a psychotherapeutic qualification, which requires three to five years of additional training. The psychotherapeutic training combines in-depth theoretical knowledge with supervised patient care and self-reflection units. After having completed the training requirements, psychologists take a state-run exam, which, upon successful completion (Approbation), confers the official title of "psychological psychotherapist" (Psychologischer Psychotherapeut).[18] After many years of inter-professional political controversy, non-physician psychotherapy was given an adequate legal foundation through the creation of two new academic healthcare professions.[19]

Greece

Since 1979, the title "psychologist" has been protected by law in Greece. It can only be used by people who hold a relevant license to practice as a psychologist. The minimum requirement is the completion of university training in psychology at a Greek university, or at a university recognized by the Greek authorities.[20]

The Netherlands

In the Netherlands, the title of "psychologist" is not restricted by law. The Dutch professional association of psychologists (NIP), using trademark law, posited its own title "Psychologist NIP" (Psycholoog NIP). This title is granted exclusively to holders of a master's degree in psychology after a year of postgraduate experience. The titles "psychotherapist" (psychotherapeut) and "healthcare psychologist" (gz-psycholoog / gezondheidszorgpsycholoog) are restricted through the Individual Healthcare Professions Act (wet BIG) to those who have followed further postgraduate (PsyD/DPsych or Licentiate level) training. The use of the titles "clinical psychologist" (klinisch psycholoog) and "clinical neuropsychologist" (klinisch neuropsycholoog) are reserved for those who have followed specialist post-licentiate training.

New Zealand

In New Zealand, the use of the title "psychologist" is restricted by law. Prior to 2004, only the title "registered psychologist" was restricted to people qualified and registered as such. However, with the proclamation of the Health Practitioners Competence Assurance Act in 2003, the use of the title "psychologist" was limited to practitioners registered with the New Zealand Psychologists Board. (The titles "clinical psychologist", "counseling psychologist", "educational psychologist", "intern psychologist", and "trainee psychologist" are similarly protected.) This is to protect the public by providing assurance that the title user is registered and therefore qualified, competent, and can be held accountable for their practice. The legislation does not include an exemption clause for any class of practitioner (e.g., academics, or government employees).

South Africa

In South Africa,[21] psychologists are qualified in either clinical, counseling, educational, organizational or research psychology. To attain the qualification, one must complete a recognized master's degree in psychology, an appropriate practicum at a recognized training institution,[22] and take an examination set by the Professional Board for Psychology.[23] Registration with the Health Professions Council of South Africa (HPCSA)[24] is required and includes a Continuing Professional Development component. The practicum usually involves a full year internship, and in some specializations, the HPCSA requires completion of an additional year of community service. The master's program consists of a seminar, coursework-based theoretical and practical training, a dissertation of limited scope, and is (in most cases) two years in duration. Prior to enrolling in the master’s program, the student will have studied psychology for three years as an undergraduate (B.A. or B.Sc., and, for organizational psychology, also B.Com.), followed by an additional postgraduate honours degree in psychology; see List of universities in South Africa. Qualification thus requires at least five years of study, and at least one internship. The undergraduate B.Psyc. is a four-year program integrating theory and practical training, and — with the required examination set by the Professional Board for Psychology — is sufficient for practice as a psychometrist or counselor.[25]

Sweden

In Sweden, the title "psychologist" is restricted in law. It can only be used after receiving a license from the government. The basic requirements are a completed five years specialized course in psychology (equivalent of a master's degree) and twelve months of practice under supervision. All other uses are banned, though often challenged. "Psychotherapist" follows similar rules but the basic educational demands are another one and a half years (spread out over three years) at a specialized course in psychotherapy (that vary concerning theoretical footing), in addition to an academical level degree within a field concerning the treatment of people (psychologist, social worker, psychiatrist a.s.o.).

United Kingdom

In the UK, the titles "registered psychologist" and "practitioner psychologist" are restricted by law. In addition, the following specialist titles are also restricted by law: "clinical psychologist", "counselling psychologist", "educational psychologist", "forensic psychologist", "health psychologist", "occupational psychologist" and "sport and exercise psychologist".[26] The Health Professions Council (HPC-UK) is the statutory regulator for practitioner psychologists in the UK. In the UK, the use of the title "chartered psychologist" is also protected by statutory regulation. The title "chartered psychologist" simply means that the psychologist is a chartered member of the British Psychological Society, but it does not necessarily signify the psychologist is registered with the HPC-UK. It is an offense for someone who is not in the appropriate section of the HPC-UK register to provide psychology services.[27] The requirements to register as a clinical, counseling and educational psychologists is a professional doctorate (and in the case of the latter two the British Psychological Society's Professional Qualification which meets the standards of a professional doctorate).[28] The title ‘psychologist’ is not protected on its own.[29] Also the title of "neuropsychologist" is not protected at present.[29] The British Psychological Society is working with the HPC-UK to ensure that the title of "neuropsychologist" is regulated as a specialist title for practitioner psychologists. One of the options could be the use of post-doctoral level registers.

In the UK, clinical psychologists undertake a Doctorate in Clinical Psychology (D.Clin.Psych., Clin.Psy.D. or similar), which is a doctorate with both clinical and research components. This is a three-year full-time salaried program, provided by thirty centers across the UK, sponsored by the National Health Service (NHS). These clinical psychology doctoral degrees are accredited by the British Psychological Society and the Health Professions Council (HPC). Entry into these programs is highly competitive and requires at least a three-year undergraduate degree in psychology, plus some form of experience, usually in either the NHS as an assistant psychologist or in academia as a Research Assistant.[30][31] More information about the path to training in the UK can be found at the central clearing house for clinical psychology training applications, and at www.ClinPsy.org.uk where questions can be answered on the forum ran by qualified UK clinical psychologists.

Employment

There are 19,000 practitioner psychologists registered[32] across seven categories: clinical psychologist, counseling psychologist, educational psychologist, forensic psychologist, health psychologist, occupational psychologist, sport and exercise psychologist in the United Kingdom since December 2012. At least 9,500 of these are clinical psychologists,[33] which is the largest psychology group within clinical settings such as the NHS. Around 2,000 are educational psychologists.[34]

United States and Canada

Regulation

A professional in the U.S. or Canada must hold a graduate degree in psychology (MA, Psy.D., Ed.D., or Ph.D.) or have a state license in order to use the title "psychologist".[35][36] The exception to this is the profession of a school psychologist who can be certified by boards of education to practice and use the title "psychologist" with an Education Specialist (Ed.S) degree. The most commonly recognized psychology professionals are clinical and counseling psychologists, who provide psychotherapy and/or administer and interpret psychological tests. There are state-by-state differences in requirements for academics in psychology and government employees.

Psychologists in the United States campaigned for legislation changes to enable specially trained psychologists to prescribe psychiatric medicine. New legislation in Louisiana, New Mexico, and Illinois has granted those who take an additional masters program in psychopharmacology permission to prescribe medications for mental and emotional disorders in coordination with the patient's physician. Louisiana was the second state to provide such legislation.[37] This legislation has not come without considerable controversy. As of 2009, Louisiana is the only state where the licensing and regulation of the practice of psychology by medical psychologists who prescribe medications is regulated by a medical board (i.e., the Louisiana State Board of Medical Examiners) rather than a board of psychologists.[38] While other states have pursued prescriptive privileges, they have yet to be successful. Similar legislation in the states of Hawaii and Oregon passed through the legislative House and Senate but it was vetoed by the Governor.[37]

In 1989 the U.S Department of Defense was directed to create the Psychopharmacology Demonstration Project. By 1997, ten psychologists were trained in psychopharmacology and granted the ability to prescribe psychiatric medications.[39]

Full membership with the American Psychological Association in the United States and Canada requires doctoral training (except in some provinces like Alberta where a master's degree is sufficient). Associate membership requires at least two years of postgraduate studies in psychology or an approved related discipline. The minimal requirement for full membership can be waived in circumstances where there is evidence that significant contribution or performance in the field of psychology has been made.[40]

Sample Curriculum for MA in Clinical Psychology in the U.S.
State Required School Required Electives

Chemical Dependency: 3
Human Sexuality: 2
Child Abuse: 2
Domestic Violence: 2
Aging: 2
Ethics & Law: 3
Psychological Testing: 3
Psychopharmacology: 3

Process and Psychotherapy: 4
Personality Theory: 6
Cross-Cultural: 3
Comparative Theories: 6
Psychology and Society: 2
Systems Theory & Family: 5
Assessing and Planning: 3
Brief Therapy: 2
Group and Couples Treatment: 6
Applied Therapeutic Techniques: 9
Developmental Psych and pathology: 9

Gay and Lesbian Issues: 2
ADHD: 1
Crisis Intervention: 2
Cognitive/Behavioral: 2
Existential Psychology: 2
Clinical Intervention with Adolescents: 2
Narratives of Women's Lives: 2

Where subject is required by both the state and the school, it is shown under the school's required column. Similar courses have been lumped together, for example, "Group Treatment Techniques" and "Couples Counseling" were combined, their units added together and called "Group and Couples Treatment"—just to keep the table of manageable size.

Schooling

There are a number of U.S. schools offering accredited programs in clinical psychology resulting in a master's degree. Such programs can range from forty-eight to eighty-four units, most often taking two to three years to complete after the undergraduate degree. Training usually emphasizes theory and treatment over research, quite often with a focus on school or couples and family counseling. Similar to doctoral programs, master's level students usually must fulfill time in a clinical practicum under supervision; some programs also require a minimum amount of personal psychotherapy.[41] While many graduates from master's level training go on to doctoral programs, a large number also go directly into practice—often as a licensed professional counselor (LPC), marriage and family therapist (MFT) or other similar licenses.[42]

There is stiff competition to gain acceptance into clinical psychology doctoral programs (acceptance rates of 2-5% are not uncommon). Clinical psychologists in the U.S. undergo many years of graduate training—usually five to seven years after the bachelor's degree—in order to gain demonstrable competence and experience. Licensure as a psychologist takes an additional one to two years post Ph.D./Psy.D. (licensure requires 3,000 hours of supervised training), depending on the state (see below under licensure). Today, in America, about half of all clinical psychology graduate students are being trained in Ph.D. programs—a model that emphasizes research and is usually housed in universities—with the other half in Psy.D. programs, which has more focus on practice (similar to professional degrees for medicine and law).[43] Both models envision practicing Clinical Psychology in a research-based, scientifically valid manner, and are accredited by the American Psychological Association[44] and many other English-speaking psychological societies. APA accreditation is very important for U.S. clinical psychology programs and may affect employment prospects and licensure after one graduates.[45]

Doctorate (Ph.D. and Psy.D.) programs usually involve some variation on the following 5 to 7 year, 90-120 unit curriculum:

  • Bases of behavior—biological, cognitive-affective, and cultural-social
  • Individual differences—personality, lifespan development, psychopathology
  • History and systems—development of psychological theories, practices, and scientific knowledge
  • Clinical practice—diagnostics, psychological assessment, psychotherapeutic interventions, psychopharmacology, ethical and legal issues
  • Coursework in statistics and research design
  • Clinical experience
    • Practicum—usually three or four years of working with clients under supervision in a clinical setting. Most practicum placements begin in either the first or second year of doctoral training
    • Doctoral internship—usually an intensive one or two-year placement in a clinical setting
  • Dissertation—Ph.D .programs usually require original quantitative empirical research, while Psy.D. dissertations involve original quantitative or qualitative research, theoretical scholarship, program evaluation or development, critical literature analysis, or clinical application and analysis. The dissertation typically takes 2-3 years to complete.
  • Specialized electives—many programs offer sets of elective courses for specializations, such as health, child, family, community, or neuropsychology
  • Personal psychotherapy—many programs require students to undertake a certain number of hours of personal psychotherapy (with a non-faculty therapist) although in recent years this requirement has become less frequent.
  • Comprehensive exams and/or master's thesis: A thesis can involve original data collection and is distinct from a dissertation

Licensure

Comparison of mental health professionals in the US
Occupation Degree Common licenses Prescription privilege Mean 2022
income (USD)
Clinical psychologist PhD/PsyD/EdD Psychologist Varies by state $90,130
Counseling psychologist (doctorate) PhD/PsyD/EdD Psychologist No $65,000
Counselor (master's) MA/MS/MEd MFT/LPC/LHMC/LPA No $49,710
School psychologist PhD/EdD/MS/EdS School psychologist No $81,500
Psychiatrist MD/DO Psychiatrist Yes $226,880
Clinical social worker PhD/DSW/MSW LCSW No $55,350
Psychiatric nurse MSN/BSN RN No $75,330
Psychiatric and mental health nurse practitioner DNP/PhD/MSN APRN/APN/PMHNP Yes (varies by state) $121,610
Expressive/Art therapist MA ATR No $55,900

The practice of clinical psychology requires a license in the United States, Canada, the United Kingdom, and many other countries. Although each of the U.S. states is different in terms of requirements and licenses (see [1] and [2] for examples), there are three common elements:[52]

  1. Graduation from an accredited school with the appropriate degree
  2. Completion of supervised clinical experience
  3. Passing a written examination and, in some states, an oral examination

All U.S. state and Canada province licensing boards are members of the Association of State and Provincial Psychology Boards (ASPPB) which created and maintains the Examination for Professional Practice in Psychology (EPPP). Many states require other examinations in addition to the EPPP, such as a jurisprudence (i.e. mental health law) examination and/or an oral examination.[52] Most states also require a certain number of continuing education credits per year in order to renew a license. This can be obtained through various means, such as taking audited classes and attending approved workshops.

There are professions whose scope of practice overlaps with the practice of psychology (particularly with respect to providing psychotherapy) and for which a license is required.

  • Psychologist. To practice with the title of "psychologist", in almost all cases a Doctorate degree is required (a PhD or PsyD in the U.S.). Normally, after the degree, the practitioner must fulfill a certain number of supervised postdoctoral hours ranging from 1,500-3,000 (usually taking one to two years), and passing the EPPP and any other provincial exams.[53]
  • Marriage and Family Therapist (MFT). An MFT license requires a Doctorate or master's degree. In addition, it usually involves two years of post-degree clinical experience under supervision, and licensure requires passing a written exam, commonly the National Examination for Marriage and Family Therapists which is maintained by the American Association for Marriage and Family Therapy. In addition, most states require an oral exam. MFTs, as the title implies, work mostly with families and couples, addressing a wide range of common psychological problems.[54] Some jurisdictions have exemptions that allow marriage and family therapy to be practiced without meeting the requirements for a license. That is, they offer a license but do not require that marriage and family therapists obtain one.[55]
  • Licensed Professional Counselor (LPC). Similar to the MFT, the LPC license requires a master's or doctorate degree, a minimum number of hours of supervised clinical experience in a pre-doc practicum, and the passing of the National Counselor Exam. Similar licenses are the Licensed Mental Health Counselor (LMHC), Licensed Clinical Professional Counselor (LCPC), and Clinical Counselor in Mental Health (CCMH). In some states, after passing the exam, a temporary LPC license is awarded and the clinician may begin the normal 3000-hour supervised internship leading to the full license allowing for the practice as a counselor or psychotherapist, usually under the supervision of a licensed psychologist.[56] Some jurisdictions have exemptions that allow counseling to be practiced without meeting the requirements for a license. That is, they offer a license but do not require that counselors obtain one.[55]
  • Licensed Psychological Associate (LPA) About twenty-six states offer a master's-only license, a common one being the LPA, which allows for the therapist to either practice independently or (more commonly) under the supervision of a licensed psychologist, depending on the state.[42] Common requirements are two to four years of post-master's supervised clinical experience and passing a Psychological Associates Examination. Other titles for this level of licensing include psychological technician (Alabama), psychological assistant (California), licensed clinical psychotherapist (Kansas), licensed psychological practitioner (Minnesota), licensed behavioral practitioner (Oklahoma), licensed psychological associate (North Carolina) or psychological examiner (Tennessee).
  • Licensed behavior analysts
Main article: Professional practice of behavior analysis
Licensed behavior analysts are licensed in five states to provide services for clients with substance abuse, developmental disabilities, and mental illness. This profession draws on the evidence base of applied behavior analysis and the philosophy of behaviorism. Behavior analysts have at least a master's degree in behavior analysis or in a mental health related discipline as well as at least five core courses in applied behavior analysis. Many behavior analysts have a doctorate. Most programs have a formalized internship program and several programs are offered online. Most practitioners have passed the examination offered by the behavior analysis certification board.[3] The model licensing act for behavior analysts can be found at the Association for Behavior Analysis International's website.

Employment

In the United States, of 170,200 psychologist jobs, 152,000 are employed in clinical, counseling, and school positions, 2,300 are employed in industrial-organizational, and 15,900 are in "all other" positions. Opportunities are limited for bachelor's degree and master's degrees holders, and they will face intense competition in the job market.[1]

The median salary in the U.S. in 2012 for clinical, counseling, and school psychologists was USD$69,280 and the median salary for organizational psychologists was USD$83,580.[1][57]

  • Offices of other health practitioners: $68,400
  • Elementary and secondary schools: $65,710
  • State government: $63,710
  • Outpatient care centers: $59,130
  • Individual and family services: $57,440

Professional Practice

Clinical psychologists can offer a range of professional services,[58] 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. Most clinical psychologists who engage in research and teaching do so within a college or university setting. Clinical psychologists may also choose to specialize in a particular field—common areas of specialization. Some of which can earn board certification,[59] include:

Contrast with Psychiatrists

Main article: Psychiatrist
See also: Clinical psychology

Although clinical psychologists and psychiatrists may share the same fundamental aim—the alleviation of mental distress—their training, outlook, and methodologies are often different. Perhaps the most significant difference is that psychiatrists are licensed physicians. As such, psychiatrists often use the medical model to assess mental health problems and rely on psychotropic medications as the chief method of addressing mental health problems.[60] Clinical psychologists receive extensive training in psychological test administration, scoring, interpretation, and reporting (psychiatrists are not trained in psychological testing and cannot administer Qualification Level C Tests). These tests help to inform diagnostic decisions and treatment planning. For example, in a medical center, a patient with a complicated clinical presentation who is being seen by a psychiatrist might be referred to a clinical psychologist for psychological testing to aid in diagnosis and treatment. In addition, psychologists (particularly those from Ph.D. programs) spend several years in graduate school being trained to conduct behavioral research, including research design and advanced statistical analysis. While this training is available for physicians via dual MD/Ph.D. programs, it is not typically included in medical education. Conversely, psychiatrists, as licensed physicians, have received training more broadly in other areas such as medicine and neurology and may bring this knowledge to bear in identifying and treating medical or neurological conditions that can present similarly to psychiatric diseases.

Psychologists generally do not prescribe medication. Although, in some jurisdictions, psychologists have limited prescribing privileges. Clinical and other psychologists are experts at psychotherapy (typically clinical psychologists are trained in a number of psychological therapies, including, behavioral, cognitive, humanistic, existential, psychodynamic, and systemic approaches), and psychological testing (e.g. including neuropsychological testing). In three US states (Illinois, Louisiana, and New Mexico), some psychologists with post-doctoral pharmacology training have been granted prescriptive authority for certain mental health disorders upon agreement with the patient's physician.[61][62]

See Also

References

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External Links

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