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Training and licensing of clinical psychologists

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Penn campus 2

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

Doctoral level trainingEdit

Clinical psychologists in the US undergo many hours of graduate training—usually 4 to 6 years post-Bachelors—in order to gain demonstrable competence and experience. Today, in America, about half of all clinical psychology graduate students are being trained in PhD programs—a model that emphasizes research and is usually housed in universities—with the other half in PsyD programs, which has more focus on practice (similar to professional degrees for medicine and law).[1] Both models envision practicing Clinical Psychology in a research-based, scientifically valid manner, and are accredited by the American Psychological Association[2] and many other English-speaking psychological societies.

Doctorate (PhD and PsyD) programs usually involve some variation on the following 4 to 6 year, 90-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
  • Clinical experience
    • Practicum—usually one or two years of working with clients under supervision in a clinical setting
    • Doctoral Internship—usually an intensive one or two year placement in a clinical setting
  • Dissertation—PhD programs usually require original quantitative empirical research, while PsyD dissertations often address qualitative research, theoretical scholarship, program evaluation or development, critical literature analysis, or clinical application and analysis
  • 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)

Masters level trainingEdit

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.

There are a number of U.S. schools offering accredited programs in clinical psychology resulting in a Masters degree. Such programs can range from 48 to 84 units, most often taking 2 to 3 years to complete post-Bachelors. Training usually emphasizes theory and treatment over research, quite often with a focus on school or couples and family counseling. Similar to doctoral programs, Masters-level students usually must fulfill time in a clinical practicum under supervision and undergo a minimum amount of personal psychotherapy.[3] While many graduates from Masters-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 license.[4]

Other related licenses open to Masters-level graduates in the US include: Marriage and Family Therapist (MFT), Licensed Professional Counselor (LPC), and Licensed Psychological Associate. (LPA).

Training in BritainEdit

In the U.K., clinical psychologists undertake a DClinPsy (or similar), 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). 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.[5]

In the UK there are currently no protected 'psychologist' titles. Indeed there are people using the title 'psychologist' who have no training in BPS accredited or unaccredited psychology courses at any level. The term clinical psychologist, counselling psychologist etc can be used perfectly legally by any member of the public for any purpose. There have been recent discoveries of clinical psychologists working in the NHS ( one for over 12 years!!!) with no psychology training at all! They were taken to court and convicted, not for use of the title, but for lying about their qualifications and misrepresentation.

Clinical psychologists are also not required to be licensed in the UK. There is no license that we apply for or maintain in order to continue practicing. In fact a large number of clinical psychologists are not a member of any professional body whatsoever. It is not a requirement that we are members of the British Psychological Society in order to enroll on our bachelors or doctoral training, but it is a requirement that we meet the BPS criteria for the Graduate Basis for Registration before being accepted on to doctoral training.

The current state of affairs rests with statutory regulation being a possible but distant future. The government are reluctant to create more regulatory authorities (such as the General Medical Council) and would prefer to encourage self-regulation by psychologists. The compromise was to contain psychologists under the Health Professions Council but this proved to be completely unsatisfactory and ineffectual. So clinical psychology remains completely unregulated, unlicensed and all titles are unprotected.

Professional practiceEdit

Clinical psychologists can offer a range of professional services, including:[6]

  • 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,[7] include:

LicensureEdit

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 somewhat different in terms of requirements and licenses (see [1] and [2] for examples), there are three common elements:[8]

  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
Clinical Psychologists and other mental health professionals
Occupation Degree Common Licenses Prescription Privilege Ave. 2004
Income
Clinical Psychologist PhD/PsyD Psychologist Mostly no $75,000
Counselor/Psychotherapist (Doctorate) PhD MFT/LPC No $65,000
School Psychologist EdD LEP No $78,000
Counselor/Psychotherapist (Masters) MA/MS/MC MFT/LPC/LPA No $49,000
Psychiatrist MD/DO Psychiatrist Yes $145,600
Clinical Social Worker PhD/MSW LCSW No $36,170
Psychiatric Nurse PhD/MSN/BSN APRN/PMHN No $53,450
Psychiatric and mental health Nurse Practitioner DNP/MSN MHNP Yes (Varies by state) $75,711
Expressive/Art Therapist MA ATR No $45,000

Sources:[9][10][11][12][13][14]

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.[8] Most states 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.

There are several licenses that allow one to practice clinical psychology, usually awarded in relation to one's educational degree.

  • 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 (usually taking 1 to 2 years), and passing the EPPP and any other provincial exams.[15]
  • Marriage and Family Therapist (MFT). An MFT license requires a Doctorate or Masters degree. In addition, it usually involves 2 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.[16]
  • Licensed Professional Counselor (LPC). Similar to the MFT, the LPC license requires a Masters 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.[17]
  • Licensed Psychological Associate. (LPA) About twenty-six states offer a Masters-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.[4] Common requirements are 2 to 4 years of post-Masters 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), or Psychological Examiner (Tennessee).

In the U.K., many mental health titles, including "psychologist", are not protected—although statutory registration of all the mental health professions is planned in the near future to help the public know who is qualified to practice. Currently, protected titles include "clinical psychologist", "counselling psychologist", and "educational psychologist". One can also become "Chartered" by the British Psychological Society. 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.

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