Frequently Asked Questions About Clinical Psychology

Jim Sturges

What’s the difference between a clinical psychologist and a psychiatrist?

A clinical psychologist has a doctor of philosophy (PhD) or doctor of psychology (PsyD) degree in clinical psychology. These degrees involve 4-6 years of study and practical experience in graduate school and a year or more of full-time supervised experience in a clinical internship. A doctorate in psychology prepares the psychologist to understand psychological research, and conduct psychological assessment and psychotherapy, which requires a license. Currently, psychologists do not prescribe medication except in the state of New Mexico or when trained for certain federal programs, and only then with extensive additional training in psychopharmacology. A psychiatrist has a doctor of medicine (MD) or sometimes doctor of osteopathic medicine (D.O.) degree, and four years of supervised experience in a psychiatric residency. Medical school primarily prepares the psychiatrist to conduct physical exams and prescribe medical treatments. The psychiatric residency provides training in treating psychiatric disorders.

What about other types of mental health providers?

There are marriage and family therapists, clinical social workers, educational and school psychologists, and others who may be licensed to provide therapy. For a description of each of these occupations, see the consumer brochure published by the California Board of Psychology.

Should I go to graduate school in psychology, and if so, where?

There are many areas of graduate study in psychology other than clinical, such as developmental, industrial-organizational, school, counseling, social, physiological, and experimental. Most have applied aspects as well as a research focus, and focus less on psychopathology than clinical psychology does. Psychologists work in many settings: Business and industry, institutions and care facilities, schools, universities, private research companies, hospitals, and in the community. As you learn about the different areas of psychology and related fields by talking with professionals (including your academic advisor), searching the web, and reading, you may discover that some areas are more interesting to you than others. There are lists of graduate programs available (e.g., in your university's psychology department office). The program lists include addresses to which you can write for more information. Once you have received materials from many different graduate programs you can decide on a smaller group of them to which you might want to apply.

I think a member of my family, one of my friends, or I have one of the disorders that we talked about in class. What should I do?

One thing to keep in mind is that sometimes hearing about symptoms makes people think they recognize a disorder, but often the problem is actually not severe enough to warrant diagnosis or treatment. This is so common it has a name: interns’ syndrome, because many medical interns experience it. However, many people experience a psychological disorder at some point in their lives. Rather than trying to make a diagnosis yourself, it is better to refer people to professionals when you have serious concerns (or see a professional if the concern is for yourself). Even psychologists should not diagnose people without having conducted a thorough evaluation.

What do the terms psychosis and neurosis mean?

Psychosis is a serious condition involving hallucinations or delusions. Hallucinations involve perceiving things that are not there, whereas delusions are firmly held false beliefs. An example of a hallucination is hearing voices (not just thinking your name is being called, a common misperception). An example of a delusion is believing that you are a messenger of God. However, beliefs shared by your social group are not considered delusions. Psychoses can occur in a variety of disorders and conditions, from the extreme forms of mood disorders to schizophrenia to substance intoxication. Neurosis is an outdated term for today’s anxiety, somatoform, and dissociative disorders. These psychologically based problems in functioning do not involve the seriously disturbed thought processes of the psychotic person, but are still disabling and distressing.

Does a person with schizophrenia have a split-personality?

No. Although "schizophrenic" is often used in English literature to mean "of two minds," the psychological term for split-personality is dissociative identity disorder, formerly multiple personality disorder. The misunderstanding arose when Bleuler (1908, 1911) coined the term schizophrenia, because he used the term “schiz” (similar to the word schism) to describe the splitting of mental functions, but did not mean splitting of the personality. Schizophrenia is a severe disorder causing problems in thinking, perceiving, behavior, and emotions.

What does it mean to be “insane”?

Insanity is actually a legal term rather than a psychological one, and its definition depends on the jurisdiction you are in. Typically it either means you did not have the capacity to tell right from wrong, or that your mental condition caused you to commit a crime. A related term is competence, which refers to your ability to understand and function in a particular situation.

What are the differences between different kinds of psychotherapy?

Some of the major approaches include client-centered therapy, which offers understanding and helps clients discover direction; psychodynamic therapy, which is focused on gaining insight into the unconscious underpinnings of problems; cognitive therapy, which focuses on restructuring thinking; and behavioral approaches that focus on changes in the environment and what we do, to improve functioning. Many psychotherapists are eclectic, meaning that they draw on a variety of approaches.

Aren’t most of people’s problems just normal? Why do you want to label them?

Some psychological problems are similar to what we all experience normally, such as some degree of anxiety. We consider the problems abnormal if they interfere with the ability to function vocationally, academically, socially, or at home, or if the problems are causing the individual a significant amount of distress. Whereas some people lean toward making diagnoses whenever possible, to facilitate communication and research or to clarify which treatments to use, other people worry that giving someone a label has too many detrimental effects to use except when absolutely necessary. What do you think?