Education and training In the United States and Canada, full membership in each country's professional association—
American Psychological Association (APA) and
Canadian Psychological Association (CPA), respectively—requires doctoral training (except in some Canadian provinces, such as
Alberta, where a master's degree is sufficient). 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. Associate membership requires at least two years of postgraduate studies in psychology or an approved related discipline. was the first institution to offer formal education in clinical psychology in the U.S. Some U.S. schools offer 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 complete a clinical practicum under supervision; some programs also require a minimum amount of personal psychotherapy. While many graduates from master's level training go on to doctoral psychology programs, a large number also go directly into practice—often as a
licensed professional counselor (LPC), marriage and family therapist (MFT), or other similar licensed practice, which varies by state. 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—to gain demonstrable competence and experience. Licensure as a psychologist may take an additional one to two years post-PhD/PsyD. Some states require a 1-year postdoctoral residency, while others do not require postdoctoral supervised experience and allow psychology graduates to sit for the licensure exam immediately. Some psychology specialties, such as clinical
neuropsychology, require a 2-year postdoctoral experience regardless of the state, as set forth in the Houston Conference Guidelines. Today in America, about half of all clinical psychology graduate students are being trained in
PhD programs that emphasize melding research with practice and are conducted by universities—with the other half in
PsyD programs, which less focus on research (similar to professional degrees for medicine and law). Both types of doctoral programs (PhD and PsyD) envision practicing clinical psychology in a research-based, scientifically valid manner, and most are accredited by the APA. APA accreditation is very important for U.S. clinical, counseling, and school psychology programs because graduating from a non-accredited doctoral program may adversely affect employment prospects and present a hurdle for becoming licensed in some jurisdictions. Doctorate (PhD and PsyD) programs usually involve some variation on the following five to seven 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—PhD programs usually require original quantitative empirical research, while PsyD 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/adolescent, 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 or master's thesis: a thesis can involve original data collection and is distinct from a dissertation. Psychologists can be seen as practicing within two general categories of psychology: health service psychology, which includes "practitioners" or "professionals" and research-oriented psychology which includes "scientists" or "scholars". The training models (
Boulder and
Vail models) endorsed by the APA require that health service psychologists be trained as both researchers and practitioners, and that they possess advanced degrees. Psychologists typically have one of two degrees:
PsyD or
PhD. The PsyD program prepares the student primarily as a practitioner for clinical practice (e.g., testing, psychotherapy), but also as a scholar that consumes research. Depending on the specialty (industrial/organizational, social, clinical, school, etc.), a PhD may be trained in clinical practice as well as in scientific methodology, to prepare for a career in academia or research. Both the PsyD and PhD programs prepare students to take the national psychology licensing exam, the
Examination for Professional Practice in Psychology (EPPP). Within the two main categories are many further types of psychologists as reflected by APA's 54 Divisions, which are specialty or subspecialty or topical areas, including
clinical,
counseling, and
school psychologists. Such professionals work with persons in a variety of therapeutic contexts. People often think of the discipline as involving only such clinical or counseling psychologists. While counseling and
psychotherapy are common activities for psychologists, these health service psychology fields are just two branches in the larger domain of psychology. There are other classifications such as
industrial and organizational and
community psychologists, whose professionals mainly apply psychological research, theories, and techniques to "real-world" problems of business, industry,
social benefit organizations, government, and
academia.
APA-recognized specialties •
Clinical psychology •
Clinical neuropsychology •
Clinical child and adolescent psychology • School psychology • Behavioral and cognitive psychology •
Couple and family psychology •
Clinical health psychology • Geropsychology • Police and public safety psychology • Sleep psychology • Rehabilitation psychology • Group psychology and group psychotherapy •
Forensic psychology •
Industrial and organizational psychology •
Psychoanalysis •
Counseling psychology • Serious mental illness psychology • Clinical psychopharmacology Clinical psychologists receive training in a number of psychological therapies, including behavioral, cognitive, humanistic, existential, psychodynamic, and systemic approaches, as well as in-depth training in
psychological testing, and to some extent,
neuropsychological testing.
Services Clinical psychologists can offer a range of professional services, including: • Psychological treatment (psychotherapy) • Administering, scoring, and interpreting psychological tests • Prescribing medications (in six states) • Conducting psychological research • Teaching • Developing prevention programs • Consulting • Program administration • Expert testimony •
Supervision of students or other mental health professionals In practice, clinical psychologists might work with individuals, couples, families, or groups in a variety of settings, including private practices, hospitals, community mental health centers, 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.
Prescriptive Authority for Psychologists (RxP) Psychologists in the United States campaigned for legislative changes to enable specially-trained psychologists to
prescribe psychotropic medications. Legislation in
Idaho,
Iowa,
Louisiana,
New Mexico,
Illinois, and Colorado has granted those who complete an additional master's degree program in clinical
psychopharmacology authority to prescribe medications for mental and emotional disorders. , Louisiana is the only state where the licensing and regulation of the practice of medical psychology by medical psychologists (MPs) is regulated by a medical board (the Louisiana State Board of Medical Examiners) rather than a board of psychologists. While other states have pursued prescriptive authority, they have not succeeded. Similar legislation in the states of
Hawaii and
Oregon passed through their respective legislative bodies, but in each case the legislation was vetoed by the state's governor.
Licensure The practice of clinical psychology requires a license in the United States and Canada. Although each of the U.S. states is different in terms of requirements and licenses (see and for examples), there are three common requirements: • Graduation from an accredited school with the appropriate degree • Completion of supervised clinical experience • Passing a written and/or oral examination All U.S. state and Canada provincial 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 or an oral examination. By and large, a professional in the U.S. must hold a doctoral degree in psychology (PsyD, EdD, or PhD), and/or have a state license to use the title
psychologist. However, regulations vary from state to state. For example, in the states of Michigan, West Virginia, and Vermont, there are psychologists licensed at the master's level.
Differences with psychiatrists Although clinical psychologists and psychiatrists 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, and, as such, psychiatrists are apt to use the
medical model to assess mental health problems and to also employ
psychotropic medications as a method of addressing mental health problems. Psychologists generally do not prescribe medication, although in some jurisdictions they do have prescription privileges. In five U.S. states (New Mexico, Louisiana, Illinois, Iowa, Idaho, and Colorado), psychologists with clinical psychopharmacology training have been granted
prescriptive authority for mental health disorders. Psychologists receive extensive training in psychological test administration, scoring, interpretation, and reporting, while psychiatrists are not trained in psychological testing. In addition, psychologists (particularly those from PhD programs) spend several years in graduate school being trained to conduct behavioral research; their training includes research design and advanced statistical analysis. While this training is available for physicians via dual MD/PhD programs, it is not typically included in standard medical education, although psychiatrists may develop research skills during their residency or a psychiatry fellowship (post-residency). Psychiatrists, as licensed physicians, have been trained more intensively in other areas, such as internal medicine and neurology, and may bring this knowledge to bear in identifying and treating medical or neurological conditions that present with primarily psychological symptoms such as depression, anxiety, or paranoia (e.g.,
hypothyroidism presenting with depressive symptoms, or
pulmonary embolism with significant apprehension and anxiety).
Mental health professions •
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. Some jurisdictions have exemptions that let someone practice marriage and family therapy without meeting the requirements for a license. That is, they offer a license but do not require that marriage and family therapists obtain one. •
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 to practice as a counselor or psychotherapist, usually under the supervision of a licensed psychologist. Some jurisdictions have exemptions that allow counseling to practice without meeting the requirements for a license. That is, they offer a license but do not require that counselors obtain one. 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 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 having taken 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 Analyst Certification Board 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 181,600 jobs for psychologists in 2021, 123,300 are employed in clinical, counseling, and school positions; 2,900 are employed in industrial-organizational positions, and 55,400 are in "all other" positions. The median salary in the U.S. for clinical, counseling, and school psychologists in May 2021 was US$82,510 and the median salary for industrial-organizational psychologists was US$105,310. Psychologists can work in applied or academic settings. Academic psychologists educate higher education students, as well as conduct research, with graduate-level research being an important part of academic psychology. Academic positions can be tenured or non-tenured, with tenured positions being highly desirable. == See also ==