Becoming a Clinical Psychologist

Overview

By Lilla Dale McManis, PhD

Clinical psychologists help people who are struggling with mental, emotional, social, and behavioral disorders by applying their extensive knowledge and expertise in assessment, diagnosis, treatment and prevention. Typically these psychologists focus on more severe issues than do counseling psychologists. Clinical psychology represents the largest subfield within psychology.

According to the National Institute of Mental Health, approximately 44 million (1 in 5) U.S. adults have a mental health disorder, with just half receiving treatment. This makes clinical psychology a robust and growing field that provides ample opportunity to work with and on behalf of individuals in your area of interest and preferred setting. Becoming a clinical psychologist involves many years devoted to the educational and training requirements. The career itself is on the demanding side, but there is a pressing need for these services and those who enter this profession derive a great deal of personal and professional satisfaction from their career choice.

In this article, you'll find information about:

What Clinical Psychologists Do

Clinical psychologists work directly with patients/clients, conduct research, and teach. They can work with individuals across the lifespan, but many choose to focus on a particular age group such as children, adolescents, adults, or the elderly. Clinical psychologists often specialize in one area such as depression, substance abuse, autism, post-traumatic stress, brain injury, or violence.

With a new client, clinical psychologists start by assessing using psychological tests, interviewing, and observing. Significant others may provide information particularly if the client is a child or an adult unable or unwilling to provide the needed information. Because clinical psychologists tend to work with individuals with disorders, this process allows them to learn whether the client meets the criteria for a diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and, if so, the degree of severity. Clinical psychologists use this information, along with a preferred approach, to determine a course of therapy. Therapy may be provided individually, in a group setting, or both. There are four main types of therapeutic approaches, although some clinical psychologists use a combination.

  • Psychoanalytic/psychodynamic is characterized by uncovering the unconscious meaning and motivation behind the client’s feelings, thoughts, and behaviors in a close and typically long-term relationship with the therapist.
  • Behavioral explores the role played by the learning of abnormal behaviors; therapy consists of the client learning more normal and appropriate behaviors, often using conditioning with positive and negative reinforcement.
  • Cognitive focuses on a client’s dysfunctional thinking that drives problematic behaviors and emotions; changing these subsequently transforms behaviors and emotions to be more normalized.
  • Humanistic revolves around the natural capability of human beings in general to make choices which are rational and to reach their maximum potential, with the therapist as guide rather than authority figure. 

Compared to those who solely provide direct client care, clinical psychologists who conduct basic or applied research often align similarly with regard to the population and/or type of disorder in which they specialize. With basic research, the clinical psychologist might study the systems of the body and brain such as genes or biochemical mechanisms as they influence behavior, thoughts, and emotions. Or they might investigate psychological theory. Applied researchers most often look at the application of science; examples would be determining which treatment approaches work most effectively for a particular disorder, or how to prevent a disorder in the first place.

Salary and Job Outlook

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The salary of a clinical psychologist is influenced by experience, specialty, and location. Salaries range from $40,080 to $113,640 for clinical psychologists, according to the U.S. Bureau of Labor Statistics. The current mean annual income for a clinical psychologist is $74,030. This is roughly $35.59 per hour. Those in hospitals, R&D and health practitioners' offices typically have higher salaries, as do those working in major urban areas. The degree of specialization is another factor that affects the level of compensation.

The job outlook for psychologists is promising. Clinical psychology is a growing field; the BLS expects the demand for clinical psychologists in the United States to increase by 20% from 2014 to 2024, which is much faster than average job growth overall.

The APA recommends specialization for those entering clinical psychology. Areas on the cusp of major growth include:

  • Geropsychology (elderly populations), as the number of Americans over 65 will double by 2050
  • Neuropsychology (brain and nervous system) due to major advances in imaging technology
  • Post-traumatic stress disorder (PTSD) as a viable area of specialization, due to the growing number of veterans suffering from it.

Work Environment

Clinical psychologists are able to work in a large number of settings including private practice, mental health hospitals, treatment centers, prisons, military bases, and higher education. Since their clients are generally experiencing more severe problems, practitioners are less likely to work in K-12 schools or community-based organizations. Those providing direct care in institutions such as hospitals, treatment centers, and prisons are usually part of a team that delivers a consistent and comprehensive support system. Many clinical psychologists are in private practice, either alone or in a practice group with other similar psychologists. Those more senior often supervise clinical psychology interns. There are also many opportunities for clinical psychologists who choose to teach at the post-secondary level or conduct research in universities, think tanks, and research facilities.

Due to their high education level and unique expertise, clinical psychologists have a substantial amount of independence when carrying out their specific duties. This autonomy comes with high expectations about job performance and responsibility for job-related decisions, particularly because of the high stakes of working with clients who have serious mental health issues and receive therapy or are research subjects. Clinical psychologists must cope with the stress of working with challenging clients, especially long-term. A positive aspect of being a psychologist is the support available through professional organizations. Being active in these allows the clinical psychologist to meet, learn from, and work with other like-minded professionals and this can be of great benefit both professionally and personally.

The setting in which clinical psychologists work will in part dictate the amount of flexibility in their schedule. When it comes to providing direct services, private practice will likely afford the most flexibility. However, to build and maintain a successful practice means being readily available; this can include weekends and evenings, as well as being accessible with little notice should a client go into crisis. Private practice also allows the clinical psychologist to take on clients in their area of specialization. Working in institutions likely means keeping a stricter schedule, as well as potentially heavy caseloads, but this is often where the greatest need for their services resides. With the exception of treatment centers that cater to specific issues, there can be less flexibility seeing patients with a particular type of disorder. Another thing to consider: a sole practitioner or one in a small practice group will have to keep extensive records and navigate the health insurance system themselves if they wish to be reimbursed for services rendered, while those in larger organizations will have administrative staff to help with this.

Teaching is the setting with fewer demands on the clinical psychologist’s time. However, you must be available of course for classes and office hours and it can be very time consuming to prepare lectures and grade assignments. Teaching can be very rewarding and, with clinical psychology being the most popular subfield, there is a high demand for qualified instructors. But keep in mind that many universities are going the route of hiring adjunct faculty (part-time instructors) to teach courses, making securing a full-time faculty position challenging. Those who conduct research in universities or think tanks will likely have the most flexibility, but only once they are more senior. Keep in mind though that a successful research career requires long hours for the research itself as well as for writing, wining grants and publishing your findings in academic journals. Nonetheless, it can be very satisfying to contribute research that improves the lives of individuals.

Requirements

Education and Training

States almost universally require a doctorate for licensing as a clinical psychologist. A master’s degree is generally expected before entering a doctoral program, but in some universities these degrees are combined. When students are accepted to a doctoral program without having a master’s degree, they typically must have an exemplary educational record. Majoring in clinical psychology – or, at a minimum, completing substantial coursework and having work or volunteer experience related to clinical psychology – is recommended to promote acceptance into the doctoral program of your choice. When selecting candidates, programs commonly make decisions based on coursework, experience, and standardized test scores (such as the GRE-Graduate Record Exam).

Clinical psychologists have an option of a PhD and or PsyD. Both require coursework and an internship, but a PhD in addition requires a dissertation of original research. A PhD prepares you for research and/or practice and to teach, whereas a PsyD is designed for those more interested in practice, although you can still participate in research in some settings as well as teach. Both require a supervised internship of at least 2,000 hours. Keep in mind that as clinical psychology is a popular choice, internships are competitive. The PsyD is a newer degree, but is gaining popularity with its focus on clinical practice, shorter time to complete, and higher acceptance rates into doctoral programs compared to a PhD.

The length of time to receive a doctorate depends on whether you already have a master’s, whether you take the PhD or PsyD route, and the various requirements of the individual university. But in general, the average length is 5 to 8 years. It’s important to be aware that earning a doctorate is expensive, with almost three-fourths of graduates having debt between $10,000 and $100,000.

Licensure

For clinical psychology, licensure at the state level is required to practice/provide direct therapeutic services in the U.S. The majority of states require the doctoral program to be regionally accredited or government-chartered and many require it to be APA (American Psychological Association) accredited. The APA does not accredit entirely online programs at this time. Supervised practicum training approved by the APA through the internship and post-doctoral level (another 2,000 hours on average) is expected.

A major component of the licensure process is to sit for the Examination for Professional Practice in Psychology (EPPP). To reduce obstacles around licensure, it is vital to choose a doctoral program carefully. Those who teach or conduct research and work in universities, state or federal agencies, research labs, or corporations may be exempt from licensure requirements, though this varies by state. Once licensed and practicing, psychologists can become board-certified in clinical psychology through the America Board of Professional Psychology (ABPP), which applies high standards for education, licensure, and experience.

Skills and Competencies

The particular competencies a clinical psychologist must possess depend to some extent on the area of specialization, but the following knowledge areas are what candidates are expected to know on the Examination for Professional Practice in Psychology:

  • Biological bases of behavior
  • Cognitive-affective bases of behavior
  • Social and cultural bases of behavior
  • Growth and lifespan development
  • Assessment and diagnosis
  • Treatment, intervention, prevention, and supervision
  • Research methods and statistics
  • Ethical, legal, and professional issues

Clinical psychology additionally calls on you to have outstanding observation and communication skills; aptitude for establishing and maintaining relationships; critical thinking and reasoning; the ability to apply scientific findings; strong problem-solving skills; trustworthiness, empathy, a non-judgmental character, and patience; and to have high tolerance to stress.

If you would like to gain the necessary education to become a clinical psychologist, we highly recommend that you check out our free School Finder Tool located HERE.

Exploring Further

To explore the clinical psychologist’s career further, here are some action steps:

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