 OU
might ask the simple question,
“What is the difference between clinical
psychology and counseling psychology?” The answer, however, is not at
all simple because psychology can be applied in many different ways.
Some persons who study psychology end up practicing as counselors, some practice
as psychotherapists, and some practice as psychologists. To make it even
more complicated, some psychologists use techniques of psychotherapy and
some use techniques of counseling. So let’s try to disentangle some
of these elements.
Introduction:
General Psychology
We humans
are social creatures, and most of our behavior takes place in a social context.
Accordingly, the science of
Sociology
studies our social—or collective—behavior. But each of us, as an
individual, is motivated not just by social rituals but also by mind
and free will. Therefore, if you want to focus on community social
functioning as it is affected by medical care and mental health functioning,
you would study the field of Social
Work.
Now, if
you want to understand how the mind works biologically—that is, if you
want to understand the mechanics, so to speak, of the nervous system—you
would study the field of medicine called
Neurology
or the branch of psychology called
Biological
Psychology.
You could
also study the physiology of sensation and perception, and that could
take you into the associated field of
General
Psychology. Those who take this path usually
end up in academic psychology (also called
Experimental
Psychology), teaching or conducting research.
This research can be applied to everyday life in an almost infinite variety
of ways. On example would be the application of human factors research
to the design of machines to make them more “user
friendly.”
And then, of
course, all this knowledge can be applied clinically.
Clinical
Psychology—a (very) short history
Textbooks often
use the phrase “the science of behavior” as a definition of psychology.
Well, behavior is a very broad concept that can include all sorts
of influences, both rational and irrational. Systematically studied as a
rational science, the study of individual behavior began in the study
of human and animal perception under the influence of such men as Willhelm
Wundt, the “founder of modern scientific
psychology.”
 The
practical application of this psychological knowledge began when those
principles of animal and human perception were first applied in the field
of education by Lightner
Witmer [1]
when he inaugurated the first psychological clinic in 1896; as this
initial practical application of psychology grew, it expanded its clinical
applications to the treatment of various mental health disorders.
The word
clinic derives from the Latin clinicus, a bed-ridden person
or a physician who attends patients sick in bed. A clinic, therefore, is
a place where sick patients are treated. So, in the literal sense,
Clinical
Psychology is concerned with the work of
treating “sick” patients. In the broader, contemporary sense, however,
clinical psychology involves teaching about, research about, or treatment
of persons with any of the common mental health disorders. (Today, we understand
that someone with a phobia, for example, is not literally “sick in
bed.”)
As clinical
psychology grew, it became strongly influenced by the treatment principles
of
psychoanalysis
which place a large emphasis on unconscious functioning.
Although the whole story is quite complicated, the various forms of clinical
treatment that emerged in the mid-20th century through the associations with,
and reactions against, psychoanalysis resulted in what we now collectively
call
psychotherapy.
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If you’re
wondering, “What does a psychologist do?” see
Reasons
to Consult a Psychologist for a sampling of the many sorts of treatment
issues in clinical psychology. |
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Usually, the
degrees associated with clinical psychology are the traditional Ph.D. (Doctor
of Philosophy) —which involves training in both clinical treatment and
research—and the newer Psy.D. (Doctor of Psychology)—which emphasizes
clinical training and minimizes training in research.
Getting
a graduate degree in clinical psychology, however, is only part of the story.
If a person wants to provide clinical services (such as psychotherapy) to
the public as an independent practitioner (as opposed to teaching or conducting
research), the person must receive a license. Persons with doctorates
in clinical psychology usually become licensed as
Psychologists.
Persons with master’s degrees in clinical psychology usually become
licensed as Marriage and Family
Therapists. (See below, under
Licensure.)
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If you’re
wondering, “How does someone become a psychologist?” see
To
Become a Psychologist for a description of the process required to earn
a doctorate in clinical psychology and then become licensed as a
psychologist. |
|
Counseling—and
Counseling Psychology
The concept of
counseling (in British English it is spelled counselling) has
actually been around for ages, and it reflects the need for one person to
seek out help or advice from another person. Counseling as a professional
occupation, therefore, derives not from the clinic but from more social settings.
It focuses on helping persons resolve problems or role issues related to
work or school or family matters. In this setting, the counselor is a
“problem solver” who through direct advice or non-directive guidance
helps the client make rational decisions.
Here are some
general characteristics of counseling.
• |
It is concerned
with “normal” problems rather than mental health
problems. |
• |
It is concerned
with role functioning, with choices to be made, and with actions to be
taken. |
• |
It is more concerned
with present events than with past events. |
• |
It is more concerned
with conscious, rational thinking than with unconscious
functioning. |
|
Counseling has
traditionally been associated with the field of education (M.S. or M.S.E.
or Ed.D.), although some counselors may have bachelor’s or master’s
degrees in psychology. In addition, many psychology programs offer degrees,
most usually the Ph.D., in Counseling
Psychology, a branch of psychology specifically concerned with
the practice of counseling. Moreover, many counseling psychologists receive
training in vocational psychology, an aspect of psychology that, through
personal guidance and vocational testing, helps
individuals discover a fulfilling and productive work life.
Even though
counseling programs usually teach the various theories of psychotherapy,
training and supervision in the practice of psychotherapy usually
is not part of the education for counseling; accordingly,
personal
psychotherapy is usually not an academic requirement. In general,
whereas psychotherapy tends to involve a complex change in basic character
and often works with
unconscious
conflicts, counseling tends to be more limited and more concerned with the
immediate situation. Still, many counselors disagree among themselves
about the distinction between counseling and psychotherapy; some training
programs in counseling psychology, for example, may put a large emphasis
on psychotherapy.
A person with
a doctoral degree in counseling may become licensed as a Psychologist;
a person with a master’s degree in counseling may, in some states, become
licensed as a Licensed Professional Counselor. (See below, under
Licensure.)
Coaching
Since you might
find persons advertising themselves as providers of coaching, I will
give a brief description of this relatively new practice.
Coaching, like
counseling, is meant to help “healthy” clients, but instead of
helping them solve problems, coaching focuses on helping persons utilize
their abilities more effectively than they have previously. Advertising jargon
would call this “achieving your full potential.”
Here are some
general characteristics of coaching.
• |
Appointments
are usually conducted by telephone. |
• |
It can focus
on personal work, but it is usually used in business settings with
executives. |
• |
It tends to help
persons achieve personal and business goals. |
• |
Although specialized
training may be needed, no specific degree is required and no license is
needed to practice coaching. |
|
Licensure
In the U.S.,
all states have licensing laws as a way to guarantee to the consumer a minimal
standard of education and training that must be met by practitioners who
sell their services to the public in independent practice. These laws vary
from state to state, so see below in Additional
Resources for links (categorized by type of practice) to the various
regulating boards.
There are many settings,
however, in which a person with any of various degrees might work as a
“counselor” or “psychotherapist” without a
license:
• |
Drug and alcohol
counselors and residential treatment counselors who work for large agencies,
or in hospitals, are examples. Many of these persons have only bachelor’s
degrees. In these cases, “counselor” is a job title, not a license
to practice independently. |
• |
There are some
states in the U.S. in which a person with a master’s degree in education
or psychology may practice counseling or psychotherapy without a
license. |
• |
A validly ordained
Catholic priest who is actively serving his Ordinary (bishop or provincial)
can practice counseling as a part of his pastoral functions. Some Protestant
ministers and Rabbis can also provide counseling within the context of religious
duties. Also, any one of these persons who has received an advanced degree
in psychology or education and who has received supervised clinical training
in psychotherapy may ethically practice psychotherapy within the pastoral
role. |
Many states in the U.S.
allow individuals to practice counseling with a license.
Licensed
Professional Counselor (LPC). An
individual with a master’s or doctoral degree in counseling or a
counseling-related field from an accredited college or university, and who
has acquired the requisite hours of supervised practice, may become licensed
as an LPC in certain states.
Then, there are many different
licenses under which individuals may practice
psychotherapy.
Psychiatrist. A
psychiatrist
has an MD degree and is licensed (in California by the
Medical Board of California); by virtue of his or
her license to practice medicine, he or she can perform psychotherapy (or
psychoanalysis,
with the proper training from a psychoanalytic
institute).
Psychiatric
Nurse.
A psychiatric nurse (RPN), by virtue of his or her license to practice nursing,
can perform psychotherapy (with proper training) in some settings, but not
independently (except for an Advanced Psychiatric Nurse).
Psychiatric
Technician. These persons (licensed
in California by the
Board of Vocational Nursing & Psychiatric
Technicians) must practice under supervision in settings such as
hospitals, correctional facilities, and residential care facilities; they
cannot practice independently.
Social
Worker. A person who has a master’s
degree in social work (MSW), and who has acquired the requisite hours of
supervised practice, may become licensed as a Licensed Clinical Social
Worker (LCSW) and practice independently as a psychotherapist. In California,
LCSWs are licensed by the
Board of Behavioral Sciences. (Also, in California,
an Associate Clinical Social Worker (ASW) can perform psychotherapy
while working under the supervision of an LCSW in order to accrue supervised
experience before becoming licensed.)
|
According to
California
regulations, “LCSWs are authorized to employ
psychotherapeutic techniques, among other services, with individuals, couples,
families, and groups to improve the clients’ quality of life.”
(What does quality of life mean? In practice, it can be stretched
to mean anything. So be careful.) |
|
Marriage
and Family Therapist. There are states,
such as California, in which a person who has received a master’s degree
in clinical psychology, and who has acquired the requisite hours of supervised
practice, may become licensed as a Marriage and Family Therapist
(MFT)—and most MFTs usually call themselves psychotherapists as
well. In California, MFTs are licensed by the
Board of Behavioral Sciences. (Also, in California,
an MFT Intern can perform psychotherapy while working under the
supervision of an MFT in order to accrue supervised experience before becoming
licensed.)
|
According to
California
regulations, “MFTs are authorized to employ
psychotherapeutic techniques with individuals, couples, families, and groups
to improve the clients’ interpersonal functions.” The intent of
the law was to provide an alternative to psychologists, so that less educated,
and therefore less expensive, service providers might work with
non-psychiatric interpersonal issues. But when everyone—even
a person with a psychiaric disorder—has interpersonal functions, some
MFTs can stretch the laws to do anything they want. Consequently, because such
practitioners charge less for their services than psychologists, they are routinely
paid to treat psychiatric issues they are not qualitied to treat. And
managed care companies are quite happy to stretch
their profits thereby. So be careful. |
|
You might
occasionally find a psychotherapist who has a Ph.D. degree but only an MFT
license, as in Jane Doe, Ph.D., MFT. Such a case can be deceptive and calls
for caution, for two reasons.
1. |
This person might
have a Ph.D. in a field totally unrelated to psychology, such as anthropology,
while the degree allowing the MFT license is only an M.A. in
psychology. |
2. |
This person might
have the Ph.D. in psychology but was unwilling—or unable—to pass
the Psychologist licensing
examinations
and so took the easier MFT exam. |
|
|
Psychologist. The title Psychologist (in the U.S.) is usually
protected by state law; that is, a person with a degree in psychology can’t
be called a “psychologist” unless licensed as a psychologist by
a state. In California, psychologists are licensed by the
Board of
Psychology.
Yet when states
license psychologists they generally don’t care if the person has a
degree in clinical psychology or counseling psychology or
education. So in most states a person with a psychologist license
can legally do clinical work or counseling work, regardless of training or
type of degree. In California the degree must be a doctorate, but in some
states a person with a masters degree can be licensed as a
psychologist.
|
In California,
both a Registered Psychologist and a Psychological Assistant
are specific forms of registration by which an unlicensed person can perform
limited psychological functions to accrue hours of supervised professional
experience.
A registered psychologist can be registered only at a nonprofit community
agency and must possess (a) a doctoral degree which qualifies for psychology
licensure and (b) at least 1500 hours of qualifying supervised professional
experience.
A psychological assistant need not have any experience but must have at least
a qualifying master’s degree in psychology; a psychological assistant
can be employed and supervised by a licensed psychologist (or a board-certified
psychiatrist) in a private setting.
For more information about registered psychologists and psychological assistants,
see the website of the
California Board
of Psychology. |
|
Because
of all the confusion described above, it is not at all uncommon
for counselors, psychotherapists, and even psychologists to attempt
to treat problems for which they have not been specifically
or adequately trained.
|
As a
consumer,
therefore, you should know (a) what degree, (b) what license
(if
any!),
(c) what training, and (d) what sort of personal psychotherapy
your psychotherapist or counselor
(or
whatever)
has received.
You should also
understand that psychotherapy and counseling, because of their different
origins and purposes, have different
ethics.
What does
“ABD” mean?
In essence, it
means “A Big Deception.” Well, seriously, it really stands for
“All But (the) Dissertation,” and it refers to the fact that someone
who is trying to earn a Ph.D. has completed
“all” [2]
the coursework but has not yet written the doctoral
dissertation—a large piece of original research—that is required
to complete the degree.
Of course, many
persons have difficulty completing a dissertation, for a variety of reasons,
and it’s not necessarily a sign of academic failure to be struggling
to complete a degree. Still, an incomplete degree is no degree, and
there can be no respectable reason to pretend otherwise.
Nevertheless,
some psychotherapists-in-training feel so insecure about having an incomplete
degree that they will make business cards with ABD after their names, to
mislead their clients, as if the ABD were a title. But those three letters,
despite having the appearance of something official, are neither a degree
nor a license.
So, when someone
cannot just accept incompleteness honestly, but feels driven to hide it by
using “ABD,” then it’s all a big deception meant to
obscure academic failure.
And that leads
to a chilling thought. When a psychotherapist-in-training is caught up in
unconscious victimization and
entitlement, what chance do his or her clients have
to learn how to live honest lives?
Notes:
1.
McReynolds, P. (1987). Lightner Witmer: Little-known founder of clinical
psychology. American Psychologist, 42, 849–858.
2. Actually, the dissertation
is part of the coursework for a Ph.D., so unless the dissertation has been
completed, the student has not completed all the coursework.
No
advertising—no sponsor—just the simple truth . . .
 |
|
Additional
Resources
Biological Psychology:
Psychology
Jumping Stand: Biological Psychology
Coaching:
The Coaching & Mentoring Network
College of
Executive Coaching
Counseling:
American Counseling
Association
American Association of State
Counseling Boards
Canadian
Counselling Association
National Board of Certified
Counselors
Experimental
Psychology:
Experimental Psychology
Society
History of Clinical
Psychology:
Classics
in the History of Psychology
Classics
in the History of Psychology — Witmer (1907) —read one
of Witmer’s papers.
History of
Clinical Psychology
History
of Psychology Archives
Marriage and Family Therapy
(MFT):
American Association
for Marriage and Family Therapy provides information and resources
for marriage and family therapy.
California Board of Behavioral
Sciences oversees licensing of MFTs, LCSWs, and LPCs in
California.
Directory of State MFT Licensing Boards provides
the regulated titles and addresses of state boards regulating marriage and
family therapists.
Neurology:
American
Academy of Neurology
Pastoral
Counseling:
The American
Association of Pastoral Counseling provides information about pastoral
counseling.
Psychiatric
Nursing:
Board of Vocational
Nursing & Psychiatric Technicians oversees licensing of nurses
in California.
Psychiatric
Technicians:
Board of Vocational
Nursing & Psychiatric Technicians oversees licensing of psychiatric
technicians in California.
Psychiatry:
The
American Psychiatric Association represents all member psychiatrists,
and its site provides extensive information about psychiatry.
The Medical Board of
California oversees licensing of physicians in California.
Psychoanalysis:
Academy
for the Study of the Psychoanalytic Arts —“To advance
the study of psychoanalytic epistemology, theory, practice, ethics, and education
within a psychological framework consisting of philosophy, the arts, and
the anthropic sciences as opposed to biology, medicine, and the natural
sciences.”
The American Psychoanalytic
Association represents all member psychoanalysts.
The Lacanian School
of Psychoanalysis in the San Francisco Bay area, offers training
in Lacanian psychoanalysis.
Psychoanalysis
by Wolfgang Albrecht, in Berlin; provides links to pages with information
related to Psychoanalysis.
The San Francisco Psychoanalytic
Institute is a psychoanalytic training institute in San
Francisco.
The San Francisco Society
for Lacanian Studies provides information about training in Lacanian
psychoanalysis.
Lacan Related Papers provides links to numerous
Lacan-related papers.
Lacanian
Links provides links to Lacanian sites and is an extensive resource
for Lacanian articles and papers.
Psychology:
Association
of State and Provincial Psychology Boards —Roster for U.S.
and Canada. Find your state’s Board of Psychology to learn its requirements
for licensure as a psychologist.
The California Board
of Psychology
CALIFORNIA BUSINESS AND PROFESSIONS
CODE —Index
CALIFORNIA BUSINESS AND PROFESSIONS CODE
2900-2918 —the “Psychology Licensing Law”
The
California Psychological Association MCEP Accrediting Agency provides
information about continuing education for psychologists in California.
Divisions
of the American Psychological Association lists the various divisions
of the APA and will give you an idea of the many varied applications of
psychology.
Social Work:
California Board of
Behavioral Sciences oversees licensing of MFTs, LCSWs, and LPCs
in California.
Clinical Social Work Federation,
Inc. is maintained for clinical social workers and those with an
interest in their services.
Related pages within A Guide to Psychology
and its Practice:
Other Applications
of Psychology
Questions and Answers
about Psychotherapy
Reasons to Visit a
Psychologist
To Become a
Psychologist
Types of Psychological
Treatment
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