Clinical Therapy

Professional psychological services

Clinical Concerns

Individuals, couples, and families go to a clinical psychologist because they have some kind of emotional distress or they believe that their actions and behaviors are causing them problems at home, at work, or in their personal relationships.

What is Clinical Psychology?

The American Psychological Association describes clinical psychology as the psychological specialty that provides comprehensive research-based mental and behavioral health care for individuals, couples, families, and groups; consultation to agencies and organizations on psychological matters; and clinical practice at the interface between psychological knowledge and the legal system. It is a broad specialty that addresses a wide range of mental and behavioral health problems and is distinguished by comprehensiveness and integration of knowledge and skill from an array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities, and varied systems.

The clinical psychologist must have relevant knowledge and understanding concerning:

psychological pathology and mental health across the lifespan;
the ability to assess cognitive, behavioral, emotional, and interpersonal functioning;
the ability to establish and maintain therapeutic relationships across a broad diversity of groups;
the ability to recognize and respond to ethical and legal issues pertaining to the practice of clinical psychology;
and understanding how different socialization and other experiences affect each person’s individual world view and identity.

The clinical psychologist performs assessment of individuals using clinical interviewing, behavioral assessment, and administration/interpretation of psychological tests; performs therapy and counseling using a range of evidence-based techniques; and provides consultation to organizations including consultation with lawyers and judges on a wide variety of matters.

The practice of clinical psychology differs from the practice of psychiatry. Clinical psychologists possess advanced university degrees at the Ph.D. or Psy.D. level. Clinical psychologist’s also benefit from post-doctoral residency, often within a medical school psychiatry program, that typically lasts one or two years after earning the Ph.D. or Psy.D. The clinical psychology residency involves assessment and treatment of serious mental disorders.

Psychiatrists earn a generalized MD degree and pursue several years of additional training in assessing and treating severe mental disorders. While psychiatrists also have a broad range of knowledge and expertise, their assessment and treatment approaches rely heavily on observation of patients, psychiatric interviewing, and the patient’s relevant personal history. Clinical psychologists use this same kind of data but also have expertise in use of formal tests and other procedures to assess patients. Their training is focused on psychotherapy and other forms of intervention besides medication.

Psychiatrists have the primary responsibility of administering medication to treat psychological problems. Clinical psychologists do not prescribe medication. However, a number of clinical psychologists pursue advanced training in the pharmacological characteristics of medications used to treat psychological problems. This specialized pharmacology training allows clinical psychologists to assess the patient’s response to medications and to consult with medical professionals about the uses and effects of medications used to treat anxiety, depression, ADHD, and severe mental health conditions.

The practice of clinical psychology also differs in many respects from the work of other mental health professionals such as social workers, licensed professional counselors, drug abuse treatment specialists, and marriage and family counselors. While these other groups of professionals typically have graduate school training and M.A. graduate degrees, relatively few are trained at the Ph.D. level. The clinical psychologist’s advanced training involves a broad range of behavioral and mental health issues. The clinical psychologist’s training also immerses the trainee in a detailed understanding of empirical research methods, and typically includes the trainee’s own conduct of independent research that is subject to intense scrutiny by a team of university professors.

While the clinical psychologist and other M.A. level mental health specialists are trained in evaluating and treating mental health issues, other mental health specialists tend to be more narrowly focused on relatively specialized treatment methods and types of mental health problems. That said, taking these differences into consideration, it is also true that therapeutic mental health care depends substantially on the quality of the patient’s relationship with the professional, and the LPC or clinical social worker may both be helpful in providing therapy or mental health counseling.

Why do people go to a clinical psychologist?

Sometimes people seek out a psychologist on their own and sometimes they are brought in (or urged to go) by their parents or spouses or relatives because their emotional disturbances and behaviors are affecting others. The problems that lead people to seek help are sometimes full-fledged psychological disorders such as anxiety, depression, or compulsive behavior, but more commonly the person’s problems are simply feelings that their life is not as satisfying as it might be and they suspect that their own attitudes and behaviors are partly responsible for this.

Individuals, couples, children, and adolescents who decide to get counseling or therapy usually realize, sometimes by intuition, that they have lost track of something in themselves that is causing them emotional distress, irrational behavior, or self defeating attitudes. They may feel worried, sad, nervous, or even depressed. They may think or know that their own behavior is working against them but they cannot, for some reason, make changes needed in their behavior by themselves or even with the help of spouses, friends, or relatives. In that sense, their desires, needs, motives, thoughts, and perceptions are happening outside of their conscious awareness or control.

How Does Counseling and Psychotherapy work?

Counseling and psychotherapy work by helping people become aware of patterns of thinking and behavior that exist more-or-less outside of their consciousness. A counselor does this by making suggestions and using educational efforts and specific learning experiences. A psychotherapist does this somewhat differently, primarily by helping a person with self-directed exploration, supported and guided by the therapist. Both approaches share a common goal of bringing increasing information about patterns and structures of behavior into the person’s awareness, where it can be examined, studied, and changed or dealt with more effectively. It has been said, with some measure of truth, that increasing the awareness of one’s of thoughts, feelings, and behaviors, decreases their power to influence life’s important decisions in ways that seem out of control.

Sometimes the self-defeating patterns that lead a person to a psychologist can be discerned in the memories of things that have affected the person in the past. Most often, however, the patterns show up over and over again in the events of the person’s present life, which the person understands only vaguely or incompletely. There are many reasons why self-defeating patterns manage to elude a person’s awareness. For most people, it is because the feelings are too painful or disruptive, so they are shoved aside for the sake of keeping life more pleasant. The mind does this naturally, and it is not unusual or abnormal. But it does mean that some hard work, and usually some trained and sensitive professional help, is needed to bring the information into focus and awareness.

Sometimes, people are concerned that counseling and therapy will get them bogged down in useless re-hashing of old memories that don’t seem to have much relevance. Old memories can help people understand why they think, feel, and behave in certain ways, but it is a misconception to believe that psychological treatment is focused mainly on memories. Rather, counseling and therapy are, and should be, relevant to the person’s life-experiences in the here-and-now – dealing with today’s self-defeating patterns, in which the individual is “stuck.” All forms of psychological treatment succeed by expanding awareness in the present moment, though they may differ in the methods of accomplishing this.

How Long Will Therapy Take?

People often ask whether therapy will take a long time, or whether results will happen quickly. There is no simple answer to this question, because each person is unique and has individual differences and problems.

Sometimes people do experience a very sudden sense of relief after starting psychotherapy. Often, however, the relief is temporary and problems remain and re-surface.

Typically, counseling and therapy require a commitment of from several weeks to several months before lasting results are seen.

How is Therapy Better Than Talking to a Friend?

People sometimes ask how counseling and therapy are better than just paying a “friend” to listen to them. The deeper question is whether counseling and therapy are any more successful than simply leaning on the people around us, and going ahead with life as best we can. There are a couple of answers to this question.

First, hundreds of reliable scientific studies, performed over many years, have shown that counseling and psychotherapy do produce beneficial results for the vast majority of people, even when the personal distress or difficulties do not amount to a diagnosable psychological condition.

Second, scientific studies have shown that when the psychological difficulties are serious enough to require medication or medical support, counseling and therapy significantly increase the benefits of the treatment. Beyond these general answers, it would not serve any useful purpose to talk about the relative merits of specific psychological interventions for specific conditions because the interactions between specific forms of counseling, therapy, and medical treatments involve a great deal of complexity. It is best to address questions about such matters in a consultation that is relevant to each person’s needs.