Psychology is the study of people, and their thoughts, feelings and behavior. As an academic science, the field of psychology tries to answer the question of ‘what it means to be human’ and why it is they do the things that they do.
Psychologists are dedicated professionals who make it their mission to help people who are in distress. They can diagnose mental conditions and offer talk therapy to help people deal with their problems. Debra Bailey Ph.D., a clinical psychologist, explains the difference between clinical and counseling psychology and offers some of the different conditions that each specialty may be able to treat.
Roots of Clinical and Counseling Psychology
While Clinical and Counseling psychology are two of the many different subspecialties in the field of Psychology, they have very different origins in the medical field. These differences can be seen in the theoretical orientation of their respective graduate programs. Historically, there was more of a bias toward behavioral and psychoanalytic perspectives in Clinical Psychology programs, whereas graduate programs in Counseling Psychology were more biased toward a client-centered, humanistic approach. They emphasized ‘wellness’ versus ‘psychopathology’ and did ‘counseling’ versus ‘psychotherapy’.
Clinical Psychologists specialize in the assessment, diagnosis, and treatment of people with serious mental illness. This includes people who are diagnosed with disorders like schizophrenia, bipolar disorder, major depression or psychosis. Also, they are trained in the administration and interpretation of projective personality assessment tests and historically, they often worked in inpatient psychiatric hospital settings.
Counseling Psychologists, on-the-other hand, worked with less pathological and otherwise healthier people who were suffering from milder symptoms. In this case, treatment was with people who experienced difficulties in functioning that arise from the stressors of daily life. Issues like grief, loss, relationship problems, vocational concerns, abuse and addiction, were most often the focus of ‘counseling’ or treatment.
Like Clinical Psychologists, Counseling Psychologists received training in the administration and interpretation of psychological assessment tests, but the focus here was on career and vocational counseling as opposed to projective personality tests. With regard to employment, Counseling Psychologists were more often employed in university counseling centers than inpatient psychiatric settings.
As the two specialties developed over time, meaningful differences between the two began to diminish. Both types of psychologists engage in talk therapy with their patients. And they have become more similar than different in the people they treat. What were once very different job descriptions, now frequently overlap, and doctoral level graduates from programs in Clinical and Counseling Psychology are increasingly employed in similar settings.
Doctoral level graduates from both specialties engage in teaching and research, as well as diagnose and treat people in settings that include hospitals and clinics, counseling centers in schools, colleges, and universities, community mental health centers, and independent practice settings. Both Clinical and Counseling Psychologists are required to be licensed in the state where they practice. They use the same CPT billing codes and they are reimbursed at the same rate from insurance companies.
Relationship to Psychiatry
Psychiatrists are medical doctors (M.D.’s) who diagnose and treat people who suffer from mental illness. They can prescribe medication and although they are also trained to do psychotherapy, its emphasis in training programs has declined. This is largely a product of economics because in practice, a psychiatrist can generate more income prescribing medication and seeing patient’s for 10 to 15 minute intervals for follow-up medication management sessions than seeing someone for a 45 to 50 minute psychotherapy session. Consequently, the role of psychiatry has become increasingly limited to the role of prescribing drugs and medication management.
Studies show that for some conditions, therapy and medication work better together than either one alone. Psychologists who treat patients in talk therapy often work with psychiatrists who can prescribe medications, which can be a crucial piece of the puzzle when it comes to treating mental conditions.
Choosing a Practitioner
Debra Bailey Ph. D. encourages every patient who has concerns about their mental health to visit their primary care doctor for a referral to a counseling or clinical psychologist. Working with patients through talk therapy, a Clinical or Counseling Psychologist can play an important role in the recovery from mental illness, situational stress, or a traumatic or adverse life event.