residency programs in the United States, approxi-
mately 40% over the last 5 years, consists of interna-
tional medical school students (Moran, 2007, 2011).
Reasons offered for the decline in interest, especially
among medical students from the United States,
include psychiatry’s increased emphasis on biological
approaches (thus making the field more conventional
and similar to other medical specialties), the eco-
nomic impact of managed care on psychiatric prac-
tice, and the increased competition from other
mental health specialties, such as clinical psychology.
Consequently, many psychiatrists do not conduct
extensive psychotherapy with their patients, but
rather often schedule brief (i.e., quarter-hour)“med-
ication management” appointments with each
patient (e.g., see Harris, 2011). Opportunities to
work in depth with individuals experiencing psycho-
logical symptoms or to help teach behavioral skills
that may reduce and prevent symptoms are more lim-
ited in psychiatry than in clinical psychology.
As mentioned in Box 1-1, a major battle-
ground for the profession of psychiatry is that
of prescription privileges for non-medical health
care professionals, including clinical psychologists
(Katschnig, 2010; Rabinowitz, 2008). Some have
even pointed to the granting of prescription privi-
leges to psychologists in a handful of states to date
(e.g., New Mexico, Louisiana), as well as the fact
that many physicians do not rely on psychiatrists for
advice or guidance concerning the prescription of
psychiatric medications, as a signal of the“demise of
psychiatry”as a medical specialty (Koocher, 2007).
Whether this takes place remains to be seen. How-
ever, there is no doubt that the field of psychiatry is
suffering currently from a bit of an identity crisis
(Katschnig, 2010; Tasar, 2008).Counseling Psychologists
The activities ofcounseling psychologistsoverlap with
those of clinical psychologists. Traditionally,
counseling psychologists work with normal or
moderately maladjusted individuals. Their work
may involve group counseling or counseling with
individuals. Their principal method of assessment is
usually the interview, but counseling psychologists
also do testing (e.g., assessment of abilities,Psychiatrists are medical doctors that specialize in mental health.
killerb10/iStockphotoCLINICAL PSYCHOLOGY: AN INTRODUCTION 7