View source for About clinical psychology

<div style="float:right;width:170px;">[[Image:Psi2.svg|thumb|150px|The [[Greek alphabet|Greek letter]] [[Psi (letter)|Psi]] is often used as a symbol of [[psychology]].]] 
{{Psychology sidebar}}</div>
'''Clinical psychology''' includes the scientific study and application of [[psychology]] for the purpose of understanding, preventing, and relieving psychologically-based distress or [[Mental illness|dysfunction]] and to promote subjective [[Mental health|well-being]] and personal development.<ref name="apa1">American Psychological Association, Division 12, [http://www.apa.org/divisions/div12/aboutcp.html About Clinical Psychology]</ref><ref name="plante">Plante, Thomas. (2005). ''Contemporary Clinical Psychology.'' New York : Wiley. ISBN 047147276X</ref> Central to its practice are [[Psychological testing|psychological assessment]] and [[psychotherapy]], although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration.<ref name="brain">Brain, Christine. (2002). ''Advanced psychology : applications, issues and perspectives.'' Cheltenham : Nelson Thornes. ISBN 0174900589</ref> In many countries clinical psychology is a regulated [[mental health professional|mental health profession]].

The field is often considered to have begun in 1896 with the opening of the first psychological [[clinic]] at the [[University of Pennsylvania]] by [[Lightner Witmer]]. In the first half of the 20th century, clinical psychology was focused on psychological assessment, with little attention given to treatment. This changed after the 1940s when World War II resulted in the need for a large increase in the number of trained clinicians. Since that time, two main educational models have developed—the [[Scientist-Practitioner Model of Clinical Psychology|Ph.D. science-practitioner model]] 
(focusing on research) and the [[Doctor of Psychology|Psy.D. practitioner-scholar model]] (focusing on clinical practice). Clinical psychologists are now considered experts in providing psychotherapy, and generally train within four primary theoretical orientations—[[Psychodynamic psychotherapy|Psychodynamic]], [[Humanistic psychology|Humanistic]], [[Cognitive Behavioral Therapy|Cognitive Behavioral]], and [[Family therapy|Systems or Family therapy]]. 

Clinical psychology may be confused with [[psychiatry]], which generally has similar goals (e.g. the alleviation of mental distress), but is unique in that psychiatrists are physicians with medical degrees. As such, they tend to focus on [[Psychoactive drug|medication]]-based solutions, although some also provide psychotherapeutic services as well. In practice, clinical psychologists often work in multidisciplinary teams with other professionals such as psychiatrists, [[occupational therapist]]s, and [[social work]]ers to bring a multimodal approach to complex patient problems.

==History==
{{main|History of psychology|History of psychotherapy}} {{see|Eastern philosophy and clinical psychology|Islamic psychology}}
[[Image:Phrenology1.jpg|thumb|left|Many 18th c. treatments for psychological distress were based on pseudo-scientific ideas, such as [[Phrenology]].]]
Although modern, scientific psychology is often dated at the 1879 opening of the first psychological laboratory by [[Wilhelm Wundt]], attempts to create methods for assessing and treating mental distress existed long before. The earliest recorded approaches were a combination of religious, magical and/or medical perspectives.<ref name="benjamin">Benjamin, Ludy. (2007). ''A Brief History of Modern Psychology.'' Malden, MA : Blackwell Publishing. ISBN 9781405132060</ref> Early examples of such physicians included [[Patañjali]], [[Padmasambhava]],<ref>T. Clifford and Samuel Wiser (1984), ''Tibetan buddhist medicine and psychiatry''</ref> [[Muhammad ibn Zakarīya Rāzi|Rhazes]], [[Avicenna]],<ref>Afzal Iqbal and A. J. Arberry, ''The Life and Work of Jalaluddin Rumi'', p. 94.</ref> and [[Jalal ad-Din Muhammad Balkhi-Rumi|Rumi]].<ref>Rumi (1995) cited in Zokav (2001), p. 47.</ref>

In the early 19th century, one could have his or her head examined, literally, using [[phrenology]], the study of personality by the shape of the skull. Other popular treatments included [[physiognomy]]—the study of the shape of the face—and [[mesmerism]], [[Franz Anton Mesmer|Mesmer's]] treatment by the use of [[magnet]]s. [[Spiritualism]] and [[Phineas Quimby]]'s "mental healing" were also popular.<ref name="benjamin2">Benjamin, Ludy. (2005). A history of clinical psychology as a profession in America (and a glimpse at its future). ''Annual Review of Clinical Psychology,'' 1, 1–30.</ref> 

While the scientific community eventually came to reject all of these methods, academic psychologists also were not concerned with serious forms of mental illness. That area was already being addressed by the developing fields of [[psychiatry]] and [[neurology]] within the [[Psychiatric hospital|asylum]] movement.<ref name="benjamin"/> It was not until the end of the 19th century, around the time when [[Sigmund Freud]] was first developing his "[[psychoanalysis|talking cure]]" in [[Vienna]], that the first scientifically clinical application of psychology began.

====Early clinical psychology====
[[Image:Witmer.jpg|thumb|175px|[[Lightner Witmer]], the father of modern clinical psychology.]]
By the second half of the 1800s, the scientific study of psychology was becoming well established in university laboratories. Although there were a few scattered voices calling for an applied psychology, the general field looked down upon this idea and insisted on "pure" science as the only respectable practice.<ref name="benjamin"/> This changed when [[Lightner Witmer]] (1867–1956), a past student of [[Wundt]] and head of the psychology department at the [[University of Pennsylvania]], agreed to treat a young boy who had trouble with spelling. His successful treatment was soon to lead to Witmer's opening of the first psychological clinic at Penn in 1896, dedicated to helping children with  [[learning disability|learning disabilities]].<ref name="heiden">Alessandri, M., Heiden, L., & Dunbar-Welter, M. (1995). "History and Overview" in Heiden, Lynda & Hersen, Michel (eds.), ''Introduction to Clinical Psychology''. New York : Plenum Press. ISBN 0306448777</ref> Ten years later in 1907, Witmer was to found the first journal of this new field, ''The Psychological Clinic'', where he coined the term "clinical psychology," defined as "the study of individuals, by observation or experimentation, with the intention of promoting change".<ref name="compass">Compas, Bruce & Gotlib, Ian. (2002). ''Introduction to Clinical Psychology.'' New York, NY : McGraw-Hill Higher Education. ISBN 0070124914</ref> The field was slow to follow Witmer's example, but by 1914 there were 26 similar clinics in the U.S.<ref name="evans">Evans, Rand. (1999). [http://www.apa.org/monitor/dec99/ss12.html Clinical psychology born and raised in controversy.] ''APA Monitor'', 30(11).</ref> 

Even as clinical psychology was growing, working with issues of serious mental distress remained the domain of [[psychiatry|psychiatrists]] and [[neurology|neurologists]].<ref name="routh">Routh, Donald. (1994). ''Clinical psychology since 1917 : Science, practice, and organization.'' New York : Plenum Press. ISBN 0306444526</ref> However, clinical psychologists continued to make inroads into this area due to their increasing skill at [[psychological assessment]]. Psychologists' reputation as assessment experts became solidified during [[World War I]] with the development of two intelligence tests, ''Army Alpha'' and ''Army Beta'' (testing verbal and nonverbal skills, respectively), which could be used with large groups of recruits.<ref name="benjamin2"/><ref name="heiden"/> Due in large part to the success of these tests, assessment was to become the core discipline of clinical psychology for the next quarter century, when another war would propel the field into treatment.

====Early professional organizations====
The field began to organize under the name "clinical psychology" in 1917 with the founding of the American Association of Clinical Psychology.  This only lasted until 1919, after which the [[American Psychological Association]] (founded by [[G. Stanley Hall]] in 1892) developed a section on Clinical Psychology, which offered certification until 1927.<ref name="evans"/> Growth in the field was slow for the next few years when various unconnected psychological organizations came together as the American Association of Applied Psychology in 1930, which would act as the primary forum for psychologists until after World War II when the APA reorganized.<ref name="apa100">American Psychological Association. (1999). [http://www.apa.org/monitor/dec99/ss13.html APA: Uniting psychologists for more than 100 years]. ''APA Monitor Online,'' 30(11).</ref> In 1945 APA created what is now called Division 12, its division of clinical psychology, which remains a leading organization in the field. Psychological societies and associations in other English-speaking countries developed similar divisions, including in Britain, Canada, Australia and New Zealand.

====World War II and the integration of treatment====
[[Image:Armypsytest.jpg|right|thumb|The [[United States Army|U.S. army]] conducts a psychological test developed by clinical psychologists for selection purposes.]]
When [[World War II]] broke out, the military once again called upon clinical psychologists. As soldiers began to return from combat, psychologists started to notice symptoms of psychological trauma labeled "shell shock" (eventually to be termed [[Posttraumatic stress disorder]]) that were best treated as soon as possible.<ref name="heiden"/> Because physicians (including psychiatrists) were over-extended in treating bodily injuries, psychologists were called to help treat this condition.<ref name="reisman">Reisman, John. (1991). ''A History of Clinical Psychology.'' UK : Taylor Francis. ISBN 1560321881</ref> At the same time, female psychologists (who were excluded from the war effort) formed the National Council of Women Psychologists with the purpose of helping communities deal with the stresses of war and giving young mothers advice on child rearing.<ref name="compass"/> After the war, the [[Veterans Administration]] in the U.S. made an enormous investment to set up programs to train doctoral-level clinical psychologists to help treat the thousands of veterans needing care. As a consequence, the U.S. went from having no formal university programs in clinical psychology in 1946 to over half of all PhDs in psychology in 1950 being awarded in clinical psychology.<ref name="compass"/>

WWII helped bring dramatic changes to clinical psychology, not just in America but internationally as well. Graduate education in psychology began adding psychotherapy to the science and research focus based on the 1947 [[Scientist-Practitioner Model of Clinical Psychology|scientist-practitioner model]], known today as the ''Boulder Model'', for PhD programs in clinical psychology.<ref>Routh, Donald. (2000). Clinical Psychology Training: A History of Ideas and Practices Prior to 1946. ''American Psychologist, 55(2),'' 236.</ref> Clinical psychology in [[United Kingdom|Britain]] developed much like in the U.S. after WWII, specifically within the context of the [[National Health Service]]<ref name="whatis">Hall, John & Llewelyn, Susan. (2006). ''What is Clinical Psychology?'' 4th Edition. UK: Oxford University Press. ISBN 0198566891</ref> with qualifications, standards, and salaries managed by the [[British Psychological Society]].<ref>Henry, David. (1959). Clinical psychology abroad. ''American Psychologist, 14(9),'' 601-604.</ref>

====Development of the Doctor of Psychology degree====
By the 1960s, psychotherapy had become imbedded within clinical psychology, but for many the PhD educational model did not offer the necessary training for those interested in practice rather than research. There was a growing argument that said the field of psychology in the U.S. had developed to a degree warranting explicit training in clinical practice. The concept of a practice-oriented degree was debated in 1965 and narrowly gained approval for a pilot program at the [[University of Illinois]] starting in 1968.<ref name="murray">Murray, Bridget. (2000). [http://www.apa.org/monitor/jan00/ed1.html The degree that almost wasn't: The PsyD comes of age]. ''Monitor on Psychology, 31(1).''</ref> Several other similar programs were instituted soon after, and in 1973, at the [[Vail Conference]] on Professional Training in Psychology, the [[Practitioner-Scholar Model]] of Clinical Psychology—or ''Vail Model''—resulting in the Doctor of Psychology ([[Psy.D.]]) degree was recognized.<ref name="norcrosspsyd">Norcross, J. & Castle, P. (2002). [http://www.psichi.org/pubs/articles/article_171.asp Appreciating the Psy.D: The Facts.] ''Eye on Psi Chim, 7(1),'' 22-26.</ref> Although training would continue to include research skills and a scientific understanding of psychology, the intent would be to produce highly trained professionals, similar to programs in medicine, dentistry, and law. The first program explicitly based on the Psy.D. model was instituted at [[Rutgers University]].<ref name="murray"/> Today, about half of all American graduate students in clinical psychology are enrolled in Psy.D. programs.<ref name="norcrosspsyd"/>

====A changing profession====
Since the 1970s, clinical psychology has continued growing into a robust profession and academic field of study. Although the exact number of practicing clinical psychologists is unknown, it is estimated that between 1974 and 1990, the number in the U.S. grew from 20,000 to 63,000.<ref>Menninger, Roy and Nemiah, John. (2000). ''American psychiatry after World War II: 1944-1994.'' Washington, D.C. : American Psychiatric Press. ISBN 0880488662</ref> Clinical psychologists continue to be experts in assessment and psychotherapy while expanding their focus to address issues of gerontology, sports, and the criminal justice system to name a few. One important field is health psychology, the fastest-growing employment setting for clinical psychologists in the past decade.<ref name="benjamin2"/> Other major changes include the impact of [[managed care]] on mental health care; an increasing realization of the importance of knowledge relating to multicultural and diverse populations; and emerging privileges to prescribe psychotropic medication.

==Professional practice==
[[Clinical psychologists]] can offer a range of professional services, including:<ref name="compass"/>

:*Administer and interpret psychological assessment and testing
:*Conduct psychological research
:*Consultation (especially with schools and businesses)
:*Development of prevention and treatment programs
:*Program administration
:*Provide expert testimony (forensic psychology)
:*Provide psychological treatment (psychotherapy)
:*Teach

In practice, clinical psychologists may work with individuals, couples, families, or groups in a variety of settings, including private practices, hospitals, mental health organizations, schools, businesses, and non-profit agencies. Most clinical psychologists who engage in research and teaching do so within a college or university setting. Clinical psychologists may also choose to specialize in a particular field—common areas of specialization, some of which can earn board certification,<ref>American Board of Professional Psychology, [http://www.abpp.org/abpp_certification_specialties.htm Specialty Certification in Professional Psychology]</ref> include:

:*[[Child psychopathology|Child and adolescent]]
:*[[Family therapy|Family]] and [[relationship counseling]]
:*[[Forensic psychology|Forensic]]
:*[[Health psychology|Health]]
:*[[Clinical neuropsychology|Neuropsychological disorders]]
:*[[Industrial and organizational psychology|Organization and business]]
:*[[Educational psychology|School]]
:*[[Mental illness|Specific disorders]] (e.g. [[Psychological trauma|trauma]], [[addiction]], [[Eating disorder|eating]], [[Sleep disorder|sleep]], [[Sexual dysfunction|sex]], [[clinical depression]], [[anxiety]], or [[phobia]]s)
:*[[Sport psychology|Sport]]

==Training and certification to practice==
[[Image:Penn campus 2.jpg|thumb|250px|The [[University of Pennsylvania]] was the first to offer formal education in clinical psychology.]]
{{main|Training and licensing of clinical psychologists}}

Clinical psychologists undergo many hours of graduate training—usually four to six years post-Bachelors—in order to gain demonstrable competence and experience. About half of all clinical psychology graduate students are being trained in [[Scientist-Practitioner Model of Clinical Psychology|Ph.D.]] programs—a model that emphasizes research—with the other half in [[Psy.D.]] programs, which has more focus on practice (similar to professional degrees for medicine and law).<ref name="norcrosspsyd"/> Both models are accredited by the [[American Psychological Association]]<ref>APA. (2005). [http://www.apa.org/ed/accreditation/qrg_doctoral.html Guidelines and Principles for Accreditation of Programs in Professional Psychology: Quick Reference Guide to Doctoral Programs].</ref> and many other English-speaking psychological societies. A smaller number of schools offer accredited programs in clinical psychology resulting in a [[Masters degree]], which usually take two to three years post-bachelors. 

In the U.K., clinical psychologists nearly always undertake a D.Clin.Psychol./Clin.Psy.D, which is a practitioner [[doctorate]] with both clinical and research components. This is a three-year full-time salaried program sponsored by the [[National Health Service]] (N.H.S.) and based in universities and the N.H.S. Entry into these programs is highly competitive, and requires at least a three-year undergraduate degree in psychology approved by the [[British Psychological Society]] or an approved conversion course, plus some form of experience, usually in either the NHS as an Assistant Psychologist or in academia as a Research Assistant. It is not unusual for applicants to apply several times before being accepted onto a training course as only about one-fifth of applicants are accepted each year.<ref>Cheshire, K. & Pilgrim, D. (2004). ''A short introduction to clinical psychology.'' London ; Thousand Oaks, CA : Sage Publications. ISBN 076194768X</ref> 

The practice of clinical psychology requires a license in the United States, Canada, the United Kingdom, and many other countries. Although each of the U.S. states is somewhat different in terms of requirements and licenses, there are three common elements:<ref name="ASPPB">{{cite web|url=http://www.asppb.org/|title=Association of State and Provincial Psychology Boards|accessdate=2007-02-17}}</ref>
:#Graduation from an accredited school with the appropriate degree
:#Completion of supervised clinical experience or internship
:#Passing a written examination and, in some states, an oral examination

All US states and Canada province licensing boards are members of the Association of State and Provincial Psychology Boards (ASPPB) which created and maintains the Examination for Professional Practice in Psychology (EPPP). Many states require other examinations in addition to the EPPP, such as a jurisprudence (i.e. mental health law) examination and/or an oral examination.<ref name="ASPPB"/> Most states also require a certain number of continuing education credits per year in order to renew a license, which can be obtained though various means, such as taking audited classes and attending approved workshops. Clinical psychologists require the Psychologist license to practice, although licenses can be obtained with a masters-level degree, such as Marriage and Family Therapist (MFT), [[Licensed Professional Counselor]] (LPC), and Licensed Psychological Associate (LPA).<ref>{{cite web|url=http://www.psychotherapyguild.com/disciplines.html|title=Professional Disciplines|accessdate=2008-12-01}}</ref>

In the UK, registration is due to become statutory in summer 2009 and will be administered by the [[Health professions council|HPC]]. Previously there has been a voluntary scheme through which the [[British Psychological Society|BPS]] award practicing certificates to qualified Clinical Psychologists who have completed sufficient continuing professional development activities and agree to abide by their professional Code of Conduct.{{Fact|date=July 2008}}

==Assessment==

An important area of expertise for many clinical psychologists is psychological assessment, and there are indications that as many as 91% of psychologists engage in this core clinical practice.<ref name="groth">Groth-Marnat, G. (2003). ''Handbook of Psychological Assessment,'' 4th ed. Hoboken, NJ : John Wiley & Sons. ISBN 0-471-41979-6</ref> Such evaluation is usually done in service to gaining insight into and forming hypotheses about psychological or behavioral problems. As such, the results of such assessments are usually used to create generalized impressions (rather than diagnoses) in service to informing treatment planning. Methods include formal testing measures, interviews, reviewing past records, clinical observation, and physical examination.<ref name="plante"/>  

There exist literally hundreds of various assessment tools, although only a few have been shown to have both high [[validity (psychometric)|validity]] (i.e., test actually measures what it claims to measure) and [[reliability (psychometric)|reliability]] (i.e., consistency). These measures generally fall within one of several categories, including the following:
*'''Intelligence & achievement tests.''' These tests are designed to measure certain specific kinds of cognitive functioning (often referred to as [[Intelligence quotient|IQ]]) in comparison to a norming-group. These tests, such as the [[Wechsler Intelligence Scale for Children|WISC-IV]], attempt to measure such traits as general knowledge, verbal skill, memory, attention span, logical reasoning, and visual/spatial perception. Several tests have been shown to predict accurately certain kinds of performance, especially scholastic.<ref name="groth"/>
*'''Personality tests.''' [[Personality test|Tests of personality]] aim to describe patterns of behavior, thoughts, and feelings. They generally fall within two categories: [[Objective test|objective]] and [[Projective test|projective]]. Objective measures, such as the [[Minnesota Multiphasic Personality Inventory|MMPI]], are based on restricted answers—such as yes/no, true/false, or a rating scale—which allow for computation of scores that can be compared to a normative group. Projective tests, such as the [[Rorschach inkblot test]], allow for open-ended answers, often based on ambiguous stimuli, presumably revealing non-conscious psychological dynamics.
*'''Neuropsychological tests.''' [[Neuropsychological tests]] consist of specifically designed tasks used to measure psychological functions known to be linked to a particular [[brain]] structure or pathway. They are typically used to assess impairment after an injury or illness known to affect [[neurocognitive]] functioning, or when used in research, to contrast neuropsychological abilities across experimental groups. 
*'''Clinical observation.''' Clinical psychologists are also trained to gather data by observing behavior. The clinical interview is a vital part of assessment, even when using other formalized tools, which can employ either a structured or unstructured format. Such assessment looks at certain areas, such as general appearance and behavior, mood and affect, perception, comprehension, orientation, insight, memory, and content of communication. One psychiatric example of a formal interview is the [[mental status examination]], which is often used in psychiatry as a screening tool for treatment or further testing.<ref name="groth"/>

====Diagnostic impressions====
{{Seealso|Mental disorder}}
<!-- Deleted image removed: [[Image:DSM-IV.jpg|thumb|175px|[[Diagnostic and Statistical Manual of Mental Disorders|The Diagnostic and Statistical Manual]] published by the [[American Psychiatric Association]].]] -->
After assessment, clinical psychologists often provide a [[medical diagnosis|diagnostic]] impression. Many countries use the ''[[International Statistical Classification of Diseases and Related Health Problems]]'' (ICD-10) while the U.S. most often uses the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' (the DSM version IV-TR). Both assume medical concepts and terms, and state that there are categorical disorders that can be diagnosed by set lists of descriptive criteria.<ref name="jablensky">Jablensky, Assen. (2005). Categories, dimensions and prototypes: Critical issues for psychiatric classification. ''Psychopathology, 38(4),'' 201</ref> 

Several new models are being discussed, including a "dimensional model" based on empirically validated models of human differences (such as the [[Big Five personality traits|five factor model]] of personality<ref name="widiger">Widiger, Thomas & Trull, Timothy. (2007). Plate tectonics in the classification of personality disorder: shifting to a dimensional model. ''American Psychologist, 62(2),'' 71-83.</ref><ref name="jablensky"/>) and a "psychosocial model", which would take changing, intersubjective states into greater account.<ref>Mundt, Christoph & Backenstrass, Matthias. (2005). Psychotherapy and classification: Psychological, psychodynamic, and cognitive aspects. ''Psychopathology, 38(4),'' 219</ref> The proponents of these models claim that they would offer greater diagnostic flexibility and clinical utility without depending on the medical concept of illness. However, they also admit that these models are not yet robust enough to gain widespread use, and should continue to be developed.

Some clinical psychologists do not tend to diagnose, but rather use ''[[clinical formulation|formulation]]''—an individualized map of the difficulties that the patient or client faces, encompassing predisposing, precipitating and perpetuating (maintaining) factors.<ref>Kinderman, P. and Lobban, F. (2000) Evolving formulations: Sharing complex information with clients. ''Behavioural and Cognitive Psychotherapy, 28(3),'' 307-310</ref>

==Clinical theories and interventions==
[[Image:Grouptherapy.jpg|right|frame|Clinical psychologists work with individuals, children, families, couples, or small groups.]]
{{main|Psychotherapy}}
Psychotherapy involves a formal relationship between professional and client—usually an individual, couple, family, or small group—that employs a set of procedures intended to form a therapeutic alliance, explore the nature of psychological problems, and encourage new ways of thinking, feeling, or behaving.<ref name="gabbard"/><ref name="plante"/>

Clinicians have a wide range of individual interventions to draw from, often guided by their training—for example, a cognitive behavioral therapy [[cognitive behavioral therapy|(CBT]]) clinician might use worksheets to record distressing cognitions, a [[psychoanalyst]] might encourage [[free association]], while a psychologist trained in [[Gestalt Psychology|Gestalt]] techniques might focus on immediate interactions between client and therapist. Clinical psychologists generally seek to base their work on research evidence and outcome studies as well as on trained clinical judgment. Although there are literally dozens of recognized therapeutic orientations, their differences can often be categorized on two dimensions: insight vs. action and in-session vs. out-session.<ref name="compass"/>
*Insight—emphasis is on gaining greater understanding of the motivations underlying one's thoughts and feelings (e.g. Psychodynamic therapy)
*Action—focus is on making changes in how one thinks and acts (e.g. [[Brief therapy|Solution Focused Therapy]], Cognitive Behavioral Therapy)
*In-session—interventions center on the here-and-now interaction between client and therapist (e.g. Humanistic therapy, Gestalt therapy)
*Out-session—a large portion of therapeutic work is intended to happen outside of session (e.g. Bibliotherapy, Rational Emotive Behavior Therapy)
 
The methods used are also different in regards to the population being served as well as the context and nature of the problem. Therapy will look very different between, say, a traumatized child, a depressed but high-functioning adult, a group of people recovering from substance dependence, and a ward of the state suffering from terrifying delusions. Other elements that play a critical role in the process of psychotherapy include the environment, culture, age, cognitive functioning, motivation, and duration (i.e. brief or long-term therapy).<ref name="gabbard"/><ref name="laroche">La Roche, Martin. (2005). The cultural context and the psychotherapeutic process: Toward a culturally sensitive psychotherapy. ''Journal of Psychotherapy Integration, 15(2),'' 169–185</ref>

===Four main perspectives===
The field is dominated in terms of training and practice by essentially four major perspectives: [[Psychodynamic psychotherapy|Psychodynamic]], [[Humanistic psychology|Humanistic]], [[Cognitive Behavioral Therapy|Cognitive Behavioral]], and [[Family therapy|Systems or Family therapy]].<ref name="plante"/>

====Psychodynamic====
{{main|Psychodynamic psychotherapy}}

The Psychodynamic perspective developed out of the [[psychoanalysis]] of [[Sigmund Freud]]. The core object of psychoanalysis is to make the unconscious conscious—to make the client aware of his or her own primal drives (namely those relating to sex and aggression) and the various [[Defense mechanisms|defenses]] used to keep them in check.<ref name="gabbard">Gabbard, Glen. (2005). ''Psychodynamic Psychiatry in Clinical Practice'', 4th Ed. Washington, DC : American Psychiatric Press. ISBN 1-58562-185-4</ref> The essential tools of the psychoanalytic process are the use of [[Free association (psychology)|free association]] and an examination of the client's [[transference]] towards the therapist, defined as the tendency to take unconscious thoughts or emotions about a significant person (e.g. a parent) and "transfer" them onto another person. Major variations on Freudian psychoanalysis practiced today include [[Self Psychology]], [[Ego psychology|Ego Psychology]], and [[Object relations theory|Object Relations Theory]]. These general orientations now fall under the umbrella term ''psychodynamic psychology'', with common themes including examination of transference and defenses, an appreciation of the power of the unconscious, and a focus on how early developments in childhood have shaped the client's current psychological state.<ref name="gabbard"/>

====Humanistic====
{{main|Humanistic psychology}}
Humanistic psychology was developed in the 1950s in reaction to both behaviorism and psychoanalysis, largely due to the [[Person-centered psychotherapy|person-centered therapy]] of [[Carl Rogers]] (often referred to as Rogerian Therapy) and [[existential psychology]] developed by [[Victor Frankl]] and [[Rollo May]].<ref name="plante"/> Rogers believed that a client needed only three things from a clinician to experience therapeutic improvement—congruence, unconditional positive regard, and empathetic understanding.<ref>McMillan, Michael. (2004). ''The Person-Centred Approach to Therapeutic Change.'' London, Thousand Oaks : SAGE Publications. ISBN 0761948686</ref> By using [[Phenomenology (psychology)|phenomenology]], [[intersubjective|intersubjectivity]] and first-person categories, the humanistic approach seeks to get a glimpse of the whole person and not just the fragmented parts of the personality.<ref>Rowan, John. (2001). ''Ordinary Ecstasy : The Dialectics of Humanistic Psychology.'' London, UK : Brunner-Routledge. ISBN 0415236339</ref> This aspect of holism links up with another common aim of humanistic practice in clinical psychology, which is to seek an integration of the whole person, also called ''self-actualization''. According to humanistic thinking,<ref name="Schneider">Schneider, K., Bugental, J., & Pierson, J. (2001). ''The handbook of humanistic psychology : leading edges in theory, research, and practice,'' 2nd ed. Thousand Oaks, CA : Sage Publications. ISBN 9780761921219</ref>  each individual person already has inbuilt potentials and resources that might help them to build a stronger personality and self-concept. The mission of the humanistic psychologist is to help the individual employ these resources via the therapeutic relationship.

====Cognitive Behavioral====
{{main|Cognitive behavioral therapy}}

Cognitive Behavioral Therapy (CBT) developed from the combination of [[Cognitive Therapy]] and [[Rational Emotive Behavior Therapy]], both of which grew out of [[Cognitive psychology]] and [[Behaviorism]]. CBT is based on the theory that how we think (cognition), how we feel (emotion), and how we act (behavior) are related and interact together in complex ways. In this perspective, certain dysfunctional ways of interpreting and appraising the world (often through ''schemas'' or ''beliefs'') can contribute to emotional distress or result in behavioral problems. The object of many cognitive behavioral therapies is to discover and identify the biased, dysfunctional ways of relating or reacting and through different methodologies help clients transcend these in ways that will lead to increased well-being.<ref>Beck, A., Davis, D., and Freeman, A. (2007). ''Cognitive Therapy of Personality Disorders,'' 2nd Ed. New York : Guilford Press. ISBN 978-1-59385-476-8</ref> There are many techniques used, such as [[systematic desensitization]], [[socratic questioning]], and keeping a cognition observation log. Modified approaches that fall into the category of CBT have also developed, including [[Dialectical behavior therapy|Dialectic Behavior Therapy]] and [[Mindfulness-based Cognitive Therapy]].<ref>Association for Behavioral and Cognitive Therapies. (2006). Albert Ellis is often referred as the "grandfather" of CBT for his influential work in this field. [http://www.aabt.org/What%20are/What%20Are%20Behavioral%20and%20Cognitive%20Therapies.html What is CBT?]. Retrieved 03-04-2007.</ref>

====Systems or Family Therapy====
{{main|Family therapy}}
Systems or [[Family therapy]] works with couples and families, and emphasizes family relationships as an important factor in psychological health. The central focus tends to be on interpersonal dynamics, especially in terms of how change in one person will affect the entire system.<ref>Bitter, J. & Corey, G. (2001). "Family Systems Therapy" in Gerald Corey (ed.), ''Theory and Practice of Counseling and Psychotherapy''. Belmost, CA : Brooks/Cole.''</ref> Therapy is therefore conducted with as many significant members of the "system" as possible.  Goals can include improving communication, establishing healthy roles, creating alternative narratives, and addressing problematic behaviors. Contributors include [[John Gottman]], [[Jay Haley]], [[Susan Johnson]], and [[Virginia Satir]].

===Other major therapeutic orientations===
{{seealso|List of psychotherapies}}
There exist dozens of recognized schools or orientations of psychotherapy—the list below represents a few influential orientations not given above. Although they all have some typical set of techniques practitioners employ, they are generally better known for providing a framework of theory and philosophy that guides a therapist in his or her working with a client.

*'''Existential.''' [[Existential therapy|Existential psychotherapy]] postulates that people are largely free to choose who we are and how we interpret and interact with the world. It intends to help the client find deeper meaning in life and to accept responsibility for living. As such, it addresses fundamental issues of life, such as death, aloneness, and freedom. The therapist emphasizes the client’s ability to be self-aware, freely make choices in the present, establish personal identity and social relationships, create meaning, and cope with the natural anxiety of living.<ref>Van Deurzen, Emmy. (2002). ''Existential Counseling & Psychotherapy in Practice.'' London; Thousand Oaks : Sage Publications. ISBN 0761962239</ref> Important writers in existential therapy include [[Rollo May]], [[Victor Frankl]], [[James Bugental]], and [[Irvin Yalom]].<p>One influential therapy that came out of Existential therapy is [[Gestalt Therapy]], primarily founded by [[Fritz Perls]] in the 1950s. It is well-known for techniques designed to increase various kinds of self-awareness—the best-known perhaps being the "empty chair technique"—which are generally intended to explore resistance to "authentic contact", resolve internal conflicts, and help the client complete "unfinished business".<ref name="woldt">Woldt, Ansel and Toman, Sarah. (2005). ''Gestalt Therapy: History, Theory, and Practice''. Thousand Oaks, CA. : Sage Publications. ISBN 0761927913</ref>

*'''Postmodern.''' Postmodern psychology says that the experience of reality is a subjective construction built upon language, social context, and history, with no essential truths.<ref>Slife, B., Barlow, S. and Williams, R. (2001). ''Critical issues in psychotherapy : translating new ideas into practice.'' London : SAGE. ISBN 0761920803</ref> Since "mental illness" and "mental health" are not recognized as objective, definable realities, the postmodern psychologist instead sees the goal of therapy strictly as something constructed by the client and therapist.<ref>Blatner, Adam. (1997). [http://www.blatner.com/adam/level2/pmodpsy198.htm The Implications of Postmodernism for Psychotherapy]. ''Individual Psychology, 53(4),'' 476-482.</ref> Forms of postmodern psychotherapy include [[Narrative Therapy]], [[Solution focused brief therapy|Solution-Focused Therapy]], and [[Coherence Therapy]].

*'''Transpersonal.''' The [[Transpersonal psychology|transpersonal perspective]] places a stronger focus on the [[spirituality|spiritual]] facet of human experience.<ref>Boorstein, Seymour. (1996). ''Transpersonal Psychotherapy.'' Albany : State University of New York Press. ISBN 0791428354</ref> It is not a set of techniques so much as a willingness to help a client explore spirituality and/or [[Transcendence (religion)|transcendent]] states of consciousness. It also is concerned with helping clients achieve their highest potential. Important writers in this area include [[Ken Wilber]], [[Abraham Maslow]], [[Stanislav Grof]], [[John Welwood]], [[David Brazier]] and [[Roberto Assagioli]].

===Other perspectives===
*'''Multiculturalism.''' Although the theoretical foundations of psychology are rooted in European culture, there is a growing recognition that there exist profound differences between various ethnic and social groups and that systems of psychotherapy need to take those differences into greater consideration.<ref name="laroche"/> Further, the generations following immigrant migration will have some combination of two or more cultures—with aspects coming from the parents and from the surrounding society—and this process of [[acculturation]] can play a strong role in therapy (and might itself be the presenting problem). Culture influences ideas about change, help-seeking, locus of control, authority, and the importance of the individual versus the group, all of which can potentially clash with certain givens in mainstream psychotherapeutic theory and practice.<ref>Young, Mark. (2005). ''Learning the Art of Helping,'' 3rd ed. Ch. 4, "Helping Someone Who is Different." Upper Saddle River, NJ : Pearson Education. ISBN 013111753X</ref> As such, there is a growing movement to integrate knowledge of various cultural groups in order to inform therapeutic practice in a more culturally sensitive and effective way.<ref name="price">Price, Michael. (2008). Culture matters: Accounting for clients' backgrounds and values makes for better treatment. ''Monitor on Psychology, 39(7),'' 52-53.</ref>

*'''Feminism.''' [[Feminist therapy]] is an orientation arising from the disparity between the origin of most psychological theories (which have male authors) and the majority of people seeking counseling being female. It focuses on societal, cultural, and political causes and solutions to issues faced in the counseling process. It openly encourages the client to participate in the world in a more social and political way.<ref>Hill, Marcia and Ballou, Mary. (2005). ''The foundation and future of feminist therapy.'' New York : Haworth Press. ISBN 0789002019</ref>

*'''Positive Psychology.''' [[Positive psychology]] is the scientific study of human happiness and well-being, which started to gain momentum in 1998 due to the call of [[Martin Seligman]],<ref>Seligman, Martin and Csikszentmihalyi, Mihaly. (2000). Positive psychology: An introduction. ''American Psychologist, 55(1),'' 5-14.</ref> then president of the APA. The [[history of psychology]] shows that the field has been primarily dedicated to addressing [[mental illness]] rather than mental wellness. Applied positive psychology's main focus, therefore, is to increase one's positive experience of life and ability to flourish by promoting such things as optimism about the future, a sense of flow in the present, and personal traits like courage, perseverance, and altruism.<ref>Snyder, C. and Lopez, S. (2001). ''Handbook of Positive Psychology.'' New York ; Oxford : Oxford University Press. ISBN 0195135334</ref><ref>Linley, Alex, et al. (2006). Positive psychology: Past, present, and (possible) future. ''The Journal of Positive Psychology, 1(1),'' 3-16.</ref> There is now preliminary empirical evidence to show that by promoting Seligman's three components of happiness—positive emotion (the pleasant life), engagement (the engaged life), and meaning (the meaningful life)—positive therapy can decrease clinical depression.<ref>Seligman, M., Rashid, T., & Parks, A. (2006). Positive Psychotherapy. ''American Psychologist, 61(8),'' 774-788.</ref>

===Integration===
{{main|Integrative Psychotherapy}}
In the last couple of decades, there has been a growing movement to integrate the various therapeutic approaches, especially with an increased understanding of cultural, gender, spiritual, and sexual-orientation issues. Clinical psychologists are beginning to look at the various strengths and weaknesses of each orientation while also working with related fields, such as [[neuroscience]], [[genetics]], [[evolutionary biology]], and [[psychopharmacology]]. The result is a growing practice of eclecticism, with psychologists learning various systems and the most efficacious methods of therapy with the intent to provide the best solution for any given problem.<ref>Norcross, John and Goldfried, Marvin. (2005). The Future of Psychotherapy Integration: A Roundtable. ''Journal of Psychotherapy Integration, 15(4),'' 392</ref>

==Professional ethics==
{{globalize/USA}}
The field of clinical psychology in most countries is strongly regulated by a code of ethics. In the U.S., professional ethics are largely defined by the APA ''Code of Conduct'', which is often used by states to define licensing requirements. The APA Code generally sets a higher standard than that which is required by law as it is designed to guide responsible behavior, the protection of clients, and the improvement of individuals, organizations, and society.<ref name="apa3">APA. (2003). ''[http://www.apa.org/ethics/code2002.html Ethical Principles of Psychologists and Code of Conduct].'' Retrieved [[July 28]], [[2007]].</ref> The Code is applicable to all psychologists in both research and applied fields. 

The APA Code is based on five principles: Beneficence and Nonmaleficence, Fidelity and Responsibility, Integrity, Justice, and Respect for People's Rights and Dignity.<ref name="apa3"/> Detailed elements address how to resolve ethical issues, competence, human relations, privacy and confidentiality, advertising, record keeping, fees, training, research, publication, assessment, and therapy.

==Comparison with other mental health professions==
:''See also: [[Mental health professional]]''

====Psychiatry====
[[File:Prozac.jpg|thumb|200px|[[Fluoxetine hydrochloride]], branded by [[Eli Lilly and Company|Lilly]] as Prozac, is a common [[antidepressant]] [[Psychoactive drug|drug]] prescribed by [[psychiatrist]]s. There is a small but growing movement to give prescription privileges to qualified psychologists.]]
Although clinical psychologists and [[psychiatrist]]s can be said to share a same fundamental aim—the alleviation of mental distress—their training, outlook, and methodologies are often quite different. Perhaps the most significant difference is that psychiatrists are licenced physicians. As such, psychiatrists often use the [[medical model]] to assess psychological problems (i.e. those they treat are seen as patients with an illness) and rely on [[Psychoactive drug|psychotropic medications]] as the chief method of addressing the illness<ref>Graybar, S. & Leonard, L. (2005), ''American Journal of Psychotherapy, 59(1),'' 1-19.</ref>—although many also employ [[psychotherapy]] as well. Psychiatrists and [[medical psychology|medical psychologists]] (who are clinical psychologists that are also trained to prescribe) are able to conduct physical examinations, order and interpret laboratory tests and [[EEG]]s, and may order brain imaging studies such as [[Computed tomography|CT]] or [[Computed tomography|CAT]], [[Magnetic resonance imaging|MRI]], and [[Positron emission tomography|PET]] scanning.

Clinical psychologists generally do not [[Medical prescription|prescribe]] medication, although there is a growing movement for psychologists to have limited [[Prescriptive authority for psychologists movement|prescribing privileges]].<ref>Klusman, Lawrence. (2001). Prescribing Psychologists and Patients' Medical Needs; Lessons From Clinical Psychiatry. ''Professional Psychology: Research and Practice, 32(5),'' 496.</ref> These medical privileges require additional training and education. To date, medical psychologists may prescribe psychotropic medications in [[Guam]], [[New Mexico]], and [[Louisiana]].<ref>Halloway, Jennifer. (2004). [http://www.apa.org/monitor/jun04/gaining.html Gaining prescriptive knowledge]. ''Monitor on Psychology, 35(6).'' p.22.</ref>

Unless a psychiatrist voluntarily chooses to obtain extra training he or she will have less knowledge of psychological assessment and psychotherapy than will a licensed clinical psychologist.

====Counseling psychology====
{{Mentalhealthprofessionals}}
[[Counseling psychology|Counseling psychologists]] study and use many of the same interventions and tools as clinical psychologists, including psychotherapy and assessment. Traditionally, counseling psychologists help people with what might be considered normal or moderate psychological problems—such as the feelings of anxiety or sadness resulting from major life changes or events.<ref name="brain"/><ref name="compass"/> Many counseling psychologists also receive specialized training in career assessment, group therapy, and relationship counseling, although some counseling psychologists also work with the more serious problems that clinical psychologists are primarily trained for, such as [[dementia]] or [[psychosis]]. 

There are fewer counseling psychology graduate programs than those for clinical psychology and they are more often housed in departments of education rather than psychology. The two professions can be found working in all the same settings but counseling psychologists are more frequently employed in university counseling centers compared to hospitals and private practice for clinical psychologists.<ref>Norcross, John. (2000). [http://www.psichi.org/pubs/articles/article_73.asp Clinical versus counseling psychology: What's the diff?] ''Eye on Psi Chi, 5(1),'' 20-22.</ref> There is considerable overlap between the two fields and distinctions between them continue to fade.

====School psychology====
[[School psychology|School psychologists]] are primarily concerned with the academic, social, and emotional well-being of children and adolescents within a scholastic environment. In the U.K., they are known as 'educational psychologists'. Like clinical (and counseling) psychologists, school psychologists with doctoral degrees are eligible for licensure as health service psychologists, and many work in private practice. Unlike clinical psychologists, they receive much more training in education, child development and behavior, and the psychology of learning. Common degrees include the [[Educational Specialist|Educational Specialist Degree]] (Ed.S.), [[Doctor of Philosophy]] (Ph.D.), and [[Doctor of Education]] (Ed.D.). 

Traditional job roles for school psychologists employed in school settings have focused mainly on assessment of students to determine their eligibility for special education services in schools, and on consultation with teachers and other school professionals to design and carry out interventions on behalf of students. Other major roles also include offering individual and group therapy with children and their families, designing prevention programs (e.g. for reducing dropout), evaluating school programs, and working with teachers and administrators to help maximize teaching efficacy, both in the classroom and systemically.<ref>Silva, Arlene. (2003). ''[http://www.nasponline.org/about_sp/whatis.aspx Who Are School Psychologists?]''. National Association of School Psychologists.</ref><ref>American Psychological Association (n.d.). ''[http://www.apa.org/crsppp/schpsych.html Archival Description of School Psychology]''. American Psychological Association.</ref>

====Clinical social work====
[[Social work]]ers provide a variety of services, generally concerned with social problems, their causes, and their solutions. With specific training, clinical social workers may also provide psychological counseling (in the US and Canada), in addition to more traditional social work. The Masters in Social Work in the U.S. is a two-year, sixty credit program that includes at least a one year practicum (two years for clinicians).<ref>http://www.cswe.org/NR/rdonlyres/111833A0-C4F5-475C-8FEB-EA740FF4D9F1/0/EPAS.pdf</ref> Unlike the PhD, which is a third level academic degree, the MSW is considered a professional degree (a second level university degree) and is sufficient for basic licensure in most states. <ref>http://www.aswb.org/lic_req.shtml</ref>

====Occupational therapy====
[[Occupational therapy]]—often abbreviated OT—is the "use of productive or creative activity in the treatment or rehabilitation of physically, cognitively, or emotionally disabled people."<ref>The American Heritage Dictionary of the English Language: Fourth Edition. (2000). [http://www.bartleby.com/61/19/O0021900.html "Occupational Therapy."]</ref> Most commonly, occupational therapists work with people with disabilities to enable them to maximize their skills and abilities. Occupational therapy practitioners are skilled professionals whose education includes the study of human growth and development with specific emphasis on the physical, emotional, psychological, sociocultural, [[cognitive]] and environmental components of illness and injury.

==Clinical psychology journals==
[[File:Psychologicalcliniccover.jpg|thumb|Cover of ''The Psychological Clinic,'' the first journal of clinical psychology, published in 1907 by [[Lightner Witmer]]]]
The following represents an (incomplete) listing of significant journals in or related to the field of clinical psychology.

{| border="0" cellspacing="0" cellpadding="0"
| valign="top" |
*''[[American Journal of Psychotherapy]]''
*''[[Annual Review of Clinical Psychology]]'' [http://arjournals.annualreviews.org/loi/clinpsy]
*''[[Annual Review of Psychology]]'' [http://arjournals.annualreviews.org/loi/psych]
*''[[British Journal of Psychotherapy]]''
*''[[British Journal of Clinical Psychology]]''
*''[[Clinical Psychology and Psychotherapy]]''
*''[[Clinical Psychology Review]]''
*''[[Clinical Psychology: Science and Practice]]''
*''[[In Session: Psychotherapy in Practice]]''
*''[[International Journal of Psychopathology, Psychopharmacology, and Psychotherapy|International Journal of Psychopathology,<br />Psychopharmacology, and Psychotherapy]]''
*''[[International Journal of Psychotherapy]]''
*''[[Journal of Abnormal Psychology]]''
*''[[Journal of Affective Disorders]]''
*''[[Journal of Anxiety Disorders]]''
| valign="top" style="padding-left:20px;" |
*''[[Journal of Child Psychotherapy]]''
*''[[Journal of Clinical Child Psychology]]''
*''[[Journal of Clinical Psychiatry]]''
*''[[Journal of Clinical Psychology]]''
*''[[Journal of Clinical Psychology in Medical Settings]]''
*''[[Journal of Clinical Psychopharmacology]]''
*''[[Journal of Consulting and Clinical Psychology]]''
*''[[Journal of Contemporary Psychotherapy]]''
*''[[Journal of Family Psychotherapy]]''
*''[[Journal of Psychotherapy Integration]]''
*''[[Journal of Psychotherapy Praxis & Research]]''
*''[[Journal of Rational-Emotive and Cognitive Behaviour Therapy]]''
*''[[Journal of Social and Clinical Psychology]]''
*''[[Psychopathology (journal)|Psychopathology]]''
*''[[Psychotherapy & Psychosomatics]]''
*''[[Psychotherapy Research]]''
|}

==Major influences==
{{Original research|date=July 2008}}
{{Unreferenced section|date=July 2008}}
{{not list}}
{| border="0" cellspacing="0" cellpadding="0"
| valign="top"|
*[[Aaron Beck]]
*[[Abraham Maslow]]
*[[Albert Bandura]]
*[[Albert Ellis]]
*[[Alfred Adler]]
*[[Anna Freud]]
*[[Carl Gustav Jung]]
*[[Carl Rogers]]
*[[David Shakow]]
*[[Donald Woods Winnicott]]
| style="padding-left:20px;" valign="top"|
*[[Erich Fromm]]
*[[Erik H. Erikson]]
*[[Fritz Perls]]
*[[George Kelly (psychologist)|George Kelly]]
*[[Gordon Allport]]
*[[Hans Eysenck]]
*[[Harry Stack Sullivan]]
*[[Heinz Kohut]]
*[[Irvin Yalom]]
*[[James Bugental]]
*[[John Bowlby]]
| style="padding-left:20px;" valign="top"|
*[[John Gottman]]
*[[Joseph Wolpe]]
*[[Karen Horney]]
*[[Lightner Witmer]]
*[[Milton H. Erickson]]
*[[Otto F. Kernberg]]
*[[Otto Rank]]
*[[Robert Yerkes]]
*[[Rollo May]]
*[[Ronald David Laing]]
| style="padding-left:20px;" valign="top"|
*[[Sigmund Freud]]
*[[Stanislav Grof]]
*[[Marsha M. Linehan]]
*[[Martin Seligman]]
*[[Mary Ainsworth]]
*[[Melanie Klein]]
*[[Morita Shoma]]
*[[Viktor Frankl]]
*[[Wilhelm Reich]]
| style="padding-left:20px;" valign="top"|
|}

==Criticisms and controversies==
*Clinical psychology is a diverse field and there have been recurring tensions over the degree to which clinical practice should be limited to treatments supported by empirical research.<ref name="observing">Pilgram, D. & Treacher, A. (1992) Clinical Psychology Observed. Routledge: London & USA/Canada. ISBN 0415046327</ref> It is also unclear as to what exactly constitutes adequate evidence to qualify as "support". Despite some evidence showing that all the major therapeutic orientations are about of equal effectiveness,<ref>Leichsenring, Falk & Leibing, Eric. (2003). The effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders: A meta-analysis. ''The American Journal of Psychiatry, 160(7),'' 1223-1233.</ref><ref>Reisner, Andrew. (2005). The common factors, empirically validated treatments, and recovery models of therapeutic change. ''The Psychological Record, 55(3),'' 377-400.</ref> there remains much debate about the efficacy of various forms treatment in use in clinical psychology.<ref>Lilienfeld, Scott et al. (2002). ''Science and Pseudoscience in Clinical Psychology.'' New York : Guilford Press. ISBN 1572308281</ref>
*Clinical Psychology can be subject to similar criticisms leveled at [[psychiatry]], for example by the [[anti-psychiatry]] movement, especially when more aligned with a biomedical model or using psychiatric diagnostic categories such as in the [[Diagnostic and Statistical Manual of Mental Disorders|DSM]]. Others may view this positively. It has been reported that clinical psychology has rarely allied itself with [[consumer/survivor movement|client groups]] and tends to individualize problems to the neglect of wider economic, political and social inequality issues that may not be the responsibility of the client.<ref name="observing"/> It has been argued that therapeutic practices are inevitably bound up with power inequalities, which can be used for good and bad.<ref>Kyuken, W. (1999) [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11657486 Power and clinical psychology: a model for resolving power-related ethical dilemmas.] ''Ethics Behav.'' 1999;9(1):21-37.</ref> A [[critical psychology]] movement has argued that clinical psychology, and other professions making up a "psy complex", often fail to consider or address inequalities and power differences and can play a part in the social and moral control of disadvantage, deviance and unrest.<ref>Smail, D. [http://www.davidsmail.freeuk.com/introfra.htm Power, Responsibility and Freedom.] Internet Publication.</ref><ref>{{cite web|url=http://www.ispn-psych.org/docs/11-01prescriptive-authority.pdf|title=International Society of Psychiatric-Mental Health Nurses. (2001). ''Response to Clinical Psychologists Prescribing Psychotropic Medications''|accessdate=2007-03-03}}</ref>

==See also==
* [[Anti-psychiatry]]
* [[Applied psychology]]
* [[Clinical Associate (Psychology)]]
* [[Clinical neuropsychology]]
* [[Clinical trial]]
* [[List of Clinical Psychologists]]
* [[List of credentials in psychology]]
* [[List of psychology topics]]
* [[List of psychotherapies]]
* [[Psychiatric and mental health nursing]]
* [[Psychoneuroimmunology]]

==References==
{{reflist|2}}

==External links==
{{wikiquotepar|Category:Psychology|Psychology}}
*[http://www.aacpsy.org/ American Academy of Clinical Psychology]
*[http://www.aamft.org/ American Association for Marriage and Family Therapy]
*[http://www.abpp.org/ American Board of Professional Psychology]
*[http://arjournals.annualreviews.org/loi/clinpsy/ Annual Review of Clinical Psychology]
*[http://www.apa.org/divisions/div12/homepage.html APA Society of Clinical Psychology (Division 12)]
*[http://www.asppb.org/ Association of State and Provincial Psychology Boards (ASPPB)]
*[http://www.bls.gov/oco/ocos056.htm Info on the field of psychology form the U.S. Department of Labor, Bureau of Labor Statistics]
*[http://www.iscp.org/ International Society of Clinical Psychology]
*[http://www.psychiatrist.com/ Journal of Clinical Psychiatry]
*[http://www.nami.org/ NAMI: National Alliance on Mental Illness]
*[http://www.nimh.nih.gov/ National Institute of Mental Health]
*[http://dictionary-psychology.com Psychology definitions]

[[Category:Applied psychology]]
[[Category:Clinical psychology]]
[[Category:Branches of psychology]]
[[Category:Behavioural sciences]]