244 ❯ Step 4. Review the Knowledge You Need to Score High
- Clinical psychologists must earn a doctoral degree (PhD or a PsyD), which includes a
supervised internship and then a licensing exam. Their training does emphasize different
therapeutic approaches. Both psychiatrists and clinical psychologists see patients with
similar disorders. Since many problems respond best to a combination of medication and
supportive psychotherapy, clinical psychologists often work with psychiatrists. - Counseling psychologists typically have one of a number of different advanced degrees
(PhD, EdD, PsyD, or MA in counseling) and tend to deal with less severe mental health
problems in college settings, or in marital and family therapy practices. In the latter, they
try not to assign blame but provide a supportive ear to all parties and help clarify the
feelings of each individual to the others. - Psychoanalysts may or may not be psychiatrists, but all follow the teaching of Freud
and practice psychoanalysis or other psychodynamic therapies. They receive extensive
training and self-analysis with a more experienced psychoanalyst before they begin their
treatment of patients. - Clinical or psychiatric social workers typically have earned a master’s degree or doctoral
degree in social work (MSW or DSW), which includes a supervised internship, and have
passed a certification exam.
Other mental health care professionals include psychiatric nurse practitioners and
pastoral counselors, who combine spiritual guidance with practical counseling.
While many medical insurance plans will pay for the services of psychiatrists, clinical
psychologists, counseling psychologists, and clinical social workers, they will not pay for
the services of unlicensed therapists. In many places, anyone can call himself or herself a
therapist without having any training.Brief history of therapy
Archeological evidence and historical documents suggest that early humans believed people with
mental health problems were possessed by evil spirits. Trephining, also known as trepanning,
drilling holes in skulls, also indicates that early practitioners attempted to release these spirits.
Over 2,000 years ago, Greek physician Hippocrates proposed that psychological
problems have physical causes for which he prescribed rest, controlled diets, and abstinence
from sex and alcohol. More than 1,500 years ago, Greek physician Galen believed that
medicine was needed to treat abnormal behavior, which he thought was a result of an
imbalance in the four bodily humors, similar to today’s biomedical approach. Unfortuna-
tely, during the medieval period, most societies returned to the belief that demons or Satan
possessed people suffering from mental problems. Victims were punished with exorcisms
or tested by drowning and burning.
The Enlightenment brought reformers: in the 18th century, Philippe Pinel of France
and, in the 19th century, Dorothea Dix of the United States were champions of humane
treatment for those who were mentally ill. Instead of treating those with mental health
problems as sinners or criminals, they created separate institutions for them and pioneered
more individualized and kinder treatment strategies.Deinstitutionalization
Serious overcrowding of most mental institutions became a problem by the 1950s.
As a result, the needs of many patients were neglected. When better psychotropic drugs
were created, a movement, deinstitutionalization, began to remove patients who were not
considered a threat to themselves or the community from mental hospitals. Similar to the
more humane goals of Pinel and Dix, the intent was that patients would improve more