impressions. The main purpose of this first chapter
is to clarify the nature of clinical psychology by
describing what clinical psychologists do and
where they do it, how they became clinicians,
and how they differ from other professionals who
also tend to people’s mental health needs. In the
process, we should gain a better understanding of
the field of clinical psychology.
Closely Related Mental Health Professions
Before we examine the nature of clinical psychol-
ogy, let us briefly review some of the other major
professions in the mental health field. Because most
confusion lies in contrasting clinical psychology
with psychiatry and with counseling psychology,
we focus most of our discussion on these fields.
Following this review, we can better present the
characteristics that give clinical psychology its
unique identity.
Psychiatrists
Apsychiatristis a physician. Psychiatry is rooted in
the medical tradition and exists within the frame-
work of organized medicine. Thus, psychiatrists are
often accorded the power and status of the medical
profession, even though their intellectual heritage
comes from the non-medical contributions of
Freud, Jung, Adler, and others. Although the latter
were physicians, they stepped out of the medical
tradition to develop a psychoanalytic system of
thought that had very little to do with medicine.
The psychiatric profession has vocally and effec-
tively pushed for a superior role in the mental
health professional hierarchy, and much of the pro-
fession’s argument has been based on its medical
background. Consistent with its roots in the medi-
cal tradition, psychiatry regards psychopathology as
a mental“illness”with discrete (often biologically
based) causes that can best be remedied with a med-
ical treatment, such as psychotropic medication.
Psychiatrists, like all medical doctors, complete
a general medical school curriculum early in their
training. Because of their medical training, psychia-
trists have the skills to function as physicians. They
may prescribe medication, treat physical ailments,
and give physical examinations. In addition to
some training in psychotherapy and psychiatric
diagnosis, psychiatrists make extensive use of a vari-
ety of medications in treating their patients’psycho-
logical difficulties. Furthermore, their medical
training makes them potentially better able to rec-
ognize medical problems that may be contributing
to the patient’s psychological distress. However, as
Box 1-1 suggests, even these traditional lines that
have served to distinguish psychiatrists from clinical
psychologists may become more blurred in the
future.
Following completion of the medical degree
and the general medical internship required of all
physicians, the typical psychiatrist-to-be receives
psychiatric training during a four-year residency.
This apprenticeship period involves supervised
work with patients in an outpatient or hospital set-
ting, accompanied by seminars, reading, discussion,
and related activities. The amount of formal psychiat-
ric coursework varies, but the core training experience
is the treatment of patients under the supervision of a
more experienced psychiatrist.
The following description of a psychiatrist
appears on the Web page HealthyMinds.org (www.
healthyminds.org/Main-Topic/What-is-a-Psychia-
trist.aspx), which is maintained by the American Psy-
chiatric Association:
A psychiatrist is a medical physician who
specializes in the diagnosis, treatment, and
prevention of mental illnesses, including
substance use disorders. Psychiatrists are
qualified to assess both the mental and
physical aspects of psychological distur-
bance. A psychiatrist has completed medi-
cal school (is an M.D. or D.O.) and an
additional four or more years of residency
training in psychiatry.... Because they are
physicians, psychiatrists can order or per-
form a full range of medical laboratory andCLINICAL PSYCHOLOGY: AN INTRODUCTION 5