Careers in Clinical and Counseling Psychology

Quick Links to Subsections on this Page
Introduction	Education
Brief History	Employment
Important Terms	Learning More
Subfields	Outlook
A Typical Day	Summary
Pros and Cons	Acknowledgments

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Introduction

CLINICAL AND COUNSELING PSYCHOLOGY are two of the largest and most popular fields in psychology. Clinical and counseling psychologists deal with the causes, prevention, diagnosis, and treatment of individuals with psychological problems. These problems vary considerably as to their degree of severity. Although very similar, clinical and counseling psychologists differ with respect to the disorders of the patients they treat. Typically, clinical psychologists treat more severe disorders, such as phobias, bipolar disorder, and schizophrenia. On the other hand, counseling psychologists work with patients suffering from everyday stresses, including career planning, academic performance, and marriage and family difficulties.

Clinical and counseling psychologists can be found working in individual practices, schools, colleges and universities, hospitals, and other mental health facilities. The particular method of therapy utilized by each clinical and counseling psychologist is often influenced by the theoretical orientation they adhere to. There are a total of over 200 theoretical orientations, each providing a different explanation behind the causes of psychological disorders and their appropriate treatments. Some orientations are more popular than others; however, most psychologists integrate two or more into their therapy. Furthermore, some theoretical orientations are better at explaining and treating certain disorders more than others. Regardless of their orientation preference, clinical and counseling psychologists are trained to assist a variety of individuals and their emotional difficulties.

A Brief History

Clinical psychology began in 1896 as a result of a psychologist's work with a student who was chronic bad speller. At this point clinical psychology had not yet been associated with severe disorders and emotional difficulties. The psychologist's name was Lightner Witmer and he discovered that the student had a variety of learning disabilities. Afterwards he established a clinic where children with learning disorders and other difficulties could be assessed and treated. This clinic was also educational in nature because it offered advice to parents and teachers on dealing with their children's conditions.

Other psychologists, such as Sigmund Freud, began developing their own theories on the treatment of the general population and their accompanying psychological disturbances. Freud, also referred to as the father of psychology, introduced the world to the theory he called psychoanalysis. Carl Jung and Alfred Adler soon followed in Freud's footsteps; however, each had his own personal theory. Many other psychologists formulated their own theories throughout the years. Each theory was impacted by the theorist's family background, country and time period in which they lived, and their exposure to prominent people during their professional development. New theories of helping others continue to be developed today.

Important Terms and Definitions

*Some Important Terms in Clinical and Counseling Psychology*
	Assessment	Clinical assessment assists clinicians in choosing the best treatment methods for their clients via techniques such as interviews and testing.
	DSM-IV	The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) contains common diagnostic classifications of psychological disorders.
	Cognitive-Behavioral Therapy	Cognitive-behavioral therapists stress that our thoughts affect our emotions, our ability to relate to others, and our self-confidence. They believe that irrational and self-defeating thinking bring about psychological problems.
	Feminist Therapy	This therapy grew out of the need for women to cope with the demands of the family, discrimination, and working outside the home. It encourages clients to develop their own strengths and to focus on personal empowerment.
	Psychosocial Rehabilitation	Psychosocial rehabilitation may be used for people with severe mood disorders and schizophrenia. It helps them to cope with their disorder while living in a community setting.

Some Interesting Subfields

Within clinical and counseling psychology there are a variety of subfields. Often, psychologists choose a subfield they find particularly interesting and specialize in it. A subfield could be a particular theoretical orientation which guides the psychologist's therapeutic methods or it could be a particular disorder the psychologist is skilled at treating.

*Some Interesting Subfields Within Clinical and Counseling Psychology*
	Research	Psychologists are continuously doing research in order to test the effectiveness of therapies, drug treatments, and many other psychological questions.
	Counseling	Counseling involves working with a variety of individuals and their everyday problems in individual, family, or group settings.
	Psychotherapy	Psychotherapy is used for individuals with severe psychopathologies, such as schizophrenia and severe depression. Treatment strategies often include medication, and sometimes hospitalization.
	Psychiatry	Psychiatry is the field of medicine that specializes in prescribing medications for psychological disorders. This requires a medical degree and specialized training in the effects of certain medications.
	Child and Adolescent Psychology	Children and adolescents sometimes experience difficulties unique to their age group. Psychologists in this area give special attention to these issues and concerns.

A Typical Day Practicing Clinical and Counseling Psychology

A typical day as a clinical or counseling psychologist is difficult to describe because the work is so varied. For example, a psychologist in private practice may have some extra responsibilities than one working in a hospital or clinic setting. Regardless, each clinical and counseling psychologist encounters many of the same things throughout a typical day.

The beginning of the day starts with the psychologist getting the files ready of the clients being seen that day. Typically a psychologist will see no more than five clients per day. Psychologists see a variety of clients ranging from children to adults and couples to families. Each client brings along their own personal problems and individual needs. All this must be taken into account when deciding which therapy is best for each specific client.

Children and adolescents are the most difficult population to work with, typically because it may be difficult to gain the parents' cooperation with therapy. Disorders such as depression and anxiety are on the average relatively easy to treat. More difficult to treat are obsessive-compulsive disorder and bipolar disorder, depending on the severity of each. Schizophrenia is by far the hardest disorder to treat. If caught in its early stages, it can be maintained; however, people suffering from schizophrenia will never lead a normal life.

At the end of the day, which sometimes lasts up to 12 hours, psychologists must complete the appropriate paperwork for the clients seen that day. This can be a very tedious task because insurance companies require detailed paperwork on clients.

Pros and Cons of a Career in Clinical and Counseling Psychology

There are both positive and negative aspects to working in Clinical or Counseling Psychology. It is imperative to carefully think about each of these aspects before considering a career in this field. Here are some key points to consider:

*Some Potential Attractions of Careers in Clinical and Counseling Psychology*
	Personal Fulfillment	Working with and helping clients can bring a great deal of personal satisfaction.
	Making a Difference	Unique feelings come when you see a client make changes in their lives because you have helped them.
	Being Your Own Boss	In private practice, clinical and counseling psychologists are often their own bosses and set their own hours.
	Changing Environment	Each client provides different and interesting information about themselves; therefore, the psychologist is rarely bored from doing routine work.
	Learning Experience	Clients' diagnoses and therapeutic plans tend to be at least somewhat unique, providing ongoing learning opportunities.

*Some Potential Drawbacks of Careers in Clinical and Counseling Psychology*
	Long Hours	Clinical and counseling psychologists often put in up to 12 hours a day between working with clients and the accompanying paperwork.
	High Risk of Burnout	Therapy can be very intense and emotionally exhausting, especially if clients do not respond to treatment or who threaten to commit suicide.
	Paperwork	There is an enormous amount of paperwork associated with each client. Health insurance companies alone require a lot of paperwork about clients.
	Unchanging Clients	Some disorders are easier to treat than others. It can become very aggravating and frustrating to continuously work with a client who do not make life changes.
	Intensive	Therapy is very draining because a therapist's full attention must be given to each client. There is little room for daydreaming or allowing your thoughts to wander.

Education and Training for Careers in Clinical and Counseling Psychology

NEEDED SKILLS, ABILITIES, and KNOWLEDGE: It is important to be able to lead, inspire, and work effectively with people. Job opportunities are highly limited with a bachelor's degree in psychology. In order to work independently in a private practice, licensure is needed. Most states require a psychologist to complete a doctoral degree before becoming licensed; however, some states permit a license with just a master's degree. Without a license, a psychologist is required to work under the supervision of a doctoral-level psychologist. Licensing laws vary from state to state, however, all states require that applicants pass an examination prior to becoming licensed. In addition, some states require that their clinical and counseling psychologists continue their education for license renewal.

OPTIONS AND PAY RANGES WITH A BACHELOR'S DEGREE: Bachelor's degrees are very limiting in the field of psychology. According to the Occupational Outlook Handbook (Bureau of Labor Statistics) the starting salary for people with a bachelor's degree in psychology in 1997 was approximately $20,600. With this degree it is possible to work in a psychiatric hospital or residential home as a psychiatric assistant or technician. This work allows a large amount of interaction with patients, specifically, observing and recording their moods and behaviors. Unfortunately a psychiatric assistant does not have much influence with regards to the patient's treatment plan. Furthermore, licensure is not possible with a bachelor's degree alone.

OPTIONS AND PAY RANGES WITH A MASTER'S DEGREE: Most master's degrees require at least 2 years of full-time graduate study. Other requirements may include an internship in an applied setting and an original research project called a thesis. In 1997, the average salary with a master's degree was $40,000. Master's level jobs include working in group practices, hospitals, clinics, community health centers, and government offices. In most states master's degrees are not granted licensure. It is possible to practice therapy with a master's degree, but only under the supervision of a licensed psychologist. Master's degrees clearly offer better pay and responsibilities than a bachelor's degree.

*Some Terminal Master's Degree Programs for Pursuing a Career in Clinical and Counseling Psychology*
	Clinical Counseling Psychology Program at LaSalle University	This M.A. program has a concentration focus on psychological counseling, marriage and family therapy, and addictions counseling.
	Clinical Psychology Program at Shippensburg University	Offering a M.S. degree in clinical psychology, this program stresses close faculty/student interaction. The university has special laboratories for psychological research.
	Counseling Program at Loyola College	This program prepares students for positions in public or private settings as a mental health counselor.
	Clinical Psychology Program at West Chester University	This program prepares students for work in human service settings. It also offers research work, work on faculty projects, and the completion of a master's thesis.

OPTIONS AND PAY RANGES WITH A DOCTORAL DEGREE: Clinical and counseling psychology offers two doctoral degrees: the Ph.D. and the Psy.D. Both are equally challenging, require the same amount of educational training, qualify for licensure, and earn about the same salary (about $57,000 in 1997). Most doctoral educational programs are designed to last 5 years; however, they often take 7 or 8 to complete. Ph.D. programs are designed more for training in research, while Psy.D. programs emphasize the counseling aspect of psychology. Almost all of psychologists with a Psy.D. can be found practicing psychology in counseling settings. Although, psychologists possessing a Ph.D. can also practice, they are more likely to be involved in research or teaching within the higher education system. Doctoral level psychologists also have the ability to obtain licensure and go into private practice. This cannot be achieved with either a bachelor's or master's degree. Furthermore, doctoral degrees provide more job opportunities and job flexibility than the other degrees.

*Some Doctoral Degree Programs for Pursuing a Career in Clinical and Counseling Psychology*
	Doctoral Project/Clinical Dissertation at California School of Professional Psychology	This Psy.D. program gives students a choice between completing a project or dissertation, depending on the specific campus. Students are evaluated on their ability to apply literature research to practical life.
	Clinical Psychology at Widener University	This 5-year program combines the science of psychology with its clinical applications. The first three years are devoted to learning theoretical knowledge and clinical techniques.
	Clinical Psychology at University of Maine	This is a Ph.D. program, which offers specialization in experimental psychology, cognitive-behavioral psychology, psychopathology, and clinical research.
	Clinical Psychology at University of Pittsburgh	This Ph.D. program applies psychological and biological to the understanding of psychological disorders. Students also conduct their own research through externships.

Employment Resources for Clinical and Counseling Psychology

Employment resources in the field of clinical and counseling psychology are difficult to find for bachelor's degrees. Most of these jobs are advertised locally in a newspaper. Employment for master's and doctoral degrees can be found locally or on the internet. Other employment resources are job fairs which can often be found at colleges or universities. At times it is even possible to receive on-the-spot interviews at job fairs. Another possible option for finding employment information involves contacting local psychological agencies or businesses. They may be able to provide valuable information, resources, and employment opportunities.

*Some Resources for Exploring Careers and Career Prospects in Clinical and Counseling Psychology*
	American Psychological Association	This link is to a list of APA positions openings in counseling psychology.
	APA Monitor	This site has job listings categorized by state, including international countries.

Learning More About Clinical and Counseling Psychology

There are many possible ways to learn more about clinical and counseling psychology. The American Psychological Association (APA) has divisions to clinical and counseling psychology, as well as other interesting and related fields. Other possibilities include the large variety of psychological journals, which can be found in most libraries, specifically college and university libraries. Likewise, magazines like Newsweek and Psychology Today often publish recent articles about the current trends in the fields of clinical and counseling psychology. Finally, an extremely productive way of learning about clinical and counseling psychology involves interviewing someone working in the profession. For instance, psychologists in private practice or professors at college or universities can provide many insights about their profession.

*Some General Resources for Learning More about Clinical and Counseling Psychology*
	The Division of Independent Practice of the APA	This Division of APA explores the issues surrounding practitioners and their patients. It provides strategies meant to help improve private practices so as to ensure their continuing existence.
	Psychotherapy and Depression	This link discusses the general causes of depression, possible treatments, and the effectiveness of various treatments.

Outlook

Clinical and counseling psychology are expected to grow at an average rate in the coming years, according to the Occupational Outlook Handbook (Bureau of Labor Statistics). However, because of the recent trend of health maintenance organizations (HMO's) psychologists with doctoral degrees are suffering. HMO's are sending their member's to psychologists with master's degrees because they charge less money for therapy. If a psychologist with a doctoral degree wishes to do therapy with clients belonging to HMO's, they must take salary cuts.

Other psychologists have been pushing for prescription privileges. According to Robert J. Sternberg, editor of Career Paths in Psychology: Where your Degree Can Take You (1999), this privilege would allow psychologists to prescribe medications to their clients. The American Psychiatric Association strongly objects to this because it would eventually eliminate the need for psychiatrists. Presently however, psychiatrists are in high demand. Due to their low numbers, psychiatrists are often required to work with several different agencies at one time. Considering all these factors and more, Sternberg (1999) suggests that practitioners in private practice may be negatively affected by the possibility of future changes. Others remain optimistic and feel these changes will never take place.

Summary

Clinical and counseling psychology continues to be the largest area studied by psychology students. Within this career there are a number of different areas of specialization possible. This helps to make the career more interesting and exciting for students, as well as varying the typical day of a psychologist. Naturally, there are positive and negative aspects of clinical and counseling psychology. On the one hand, this field can be very personally rewarding; however, it often requires a great deal of education. Of the possible degrees earned by students, the doctoral degree offers the most career freedom, including the possibility to practice clinical or counseling psychology privately. Regardless, the future outlook on doctoral degrees predicts they will be in less demand on the job market than master's degrees. Perhaps more states will begin offering licensure to master's level graduates in the future. In conclusion, the field of clinical and counseling psychology is forever changing and will continue to grow so long as people require psychological assistance.

Acknowledgments

This page was created by Jill Rishel in the spring of 2000 as a project for a Senior Seminar in Psychology (PSY400) class taught by Dr. Arvid J. Bloom at West Chester University. The author would like to give special recognition to Delores Marra, M.S., Deanne Zotter Bonifazi, Ph.D., and Gretchen Gill for the valuable information they contributed.