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- Clinical psychologistsmust earn a doctoral degree (Ph.D. or a Psy.D.), which includes a
supervised internship, then they must pass 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 psychologiststypically have one of a number of different advanced degrees
(Ph.D., Ed.D., Psy.D., or M.A. 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. - Psychoanalystsmay 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. - Clinicalorpsychiatric social workerstypically have earned a Master’s degree in social work
(M.S.W.), which includes a supervised internship, and have taken 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 most places, anyone can call himself/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Archeological evidence and historical documents suggest that early humans believed people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,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, Dorthea Dix of the United States were champions of humane
treatment for the 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
rapidly in familiar community settings. In the 1960s, Congress passed aid bills to establish
community mental health facilities in neighborhoods across the United States.Treatment of Psychological Disorders ❮ 229