community programs. specialties of psychiatrists as part of their evaluation of the patient, psychiatrists are one of only a few mental health professionals who may conduct physical examinations, order and interpret laboratory tests and eegs, and may order brain imaging studies such as ct or cat, mri, and pet scanning. a medical professional must evaluate the patient for any medical problems or diseases that may be the cause of the mental illness. historically psychiatrists have been the only mental health professional with the power to prescribe medication to treat specific types of mental illness. currently, physician assistants response to the psychiatrist (in lieu of and supervised) and advanced practice psychiatric nurses may prescribe medications, including psychiatric medications. clinical psychologists have gained the ability to prescribe psychiatric medications on a limited basis in a few u.s. states after completing additional training and passing an examination. educational requirements for psychiatrists typically the requirements to become a psychiatrist are substantial but differ from country to country. in general there is an initial period of several years of academic and clinical training and supervised work in different areas of medicine, in order to become a licensed medical doctor, followed by several years of supervised work and study in psychiatry, in order to become a licensed psychiatrist. in the united states and canada one must first complete a bachelor's degree. students may typically decide any major subject of their choice, however they must enroll in specific courses, usually outlined in a pre-medical program. one must then apply to and attend 4 years of medical school in order to earn his md or do and to complete his medical education. psychiatrists must then pass three successive rigorous national board exams (united states medical licensing exams "usmle", steps 1, 2, and 3), which draws questions from all fields of medicine and surgery, before gaining an unrestricted license to practice medicine. following this, the individual must complete a four-year residency in psychiatry as a psychiatric resident and sit for annual national in-service exams. psychiatry residents are required to complete at least four post-graduate months of internal medicine (pediatrics may be substituted for some or all of the internal medicine months for those planning to specialize in child and adolescent psychiatry) and two months of neurology, usually during the first year, but some programs require more. occasionally, some prospective psychiatry residents will choose to do a transitional year internship in medicine or general surgery, in which case they may complete the two months of neurology later in their residency. after completing their training, psychiatrists take written and then oral specialty board examinations. the total amount of time required to qualify in the field of psychiatry in the united states is typically 4 to 5 years after obtaining the md or do (or in total 8 to 9 years minimum). many psychiatrists pursue an additional 1–2 years in subspecialty fellowships on top of this such as child psychiatry, geriatric psychiatry, and psychosomatic medicine. in the united kingdom, the republic of ireland, and most commonwealth countries, the initial degree is the combined bachelor of medicine and bachelor of surgery, usually a single period of academic and clinical study lasting around five years. this degree is most often abbreviated 'mbchb', 'mb bs' or other variations, and is the equivalent of the american 'md'. following this the individual must complete a two-year foundation programmer that mainly consists of supervised paid work as a foundation house officer within different specialties of medicine. upon completion the individual can apply for "core specialist training" in psychiatry, which mainly involves supervised paid work as a specialty registrar in different subspecialties of psychiatry. after three years there is an examination for membership of the royal college of psychiatrists (abbreviated mrcpsych), with which an individual may then work as a "staff grade" or "associate specialist" psychiatrist, or pursue an academic psychiatry route via a phd. if, after the mrcpsych, an additional 3 years of specialization known as "advanced specialist training" are taken (again mainly paid work), and a certificate of completion of training is awarded, the individual can apply for a post taking independent clinical responsibility as a "consultant" psychiatrist. clinical psychologists main article: clinical psychology a clinical psychologist studies and applies psychology for the purpose of understanding, preventing and relieving psychologically based distress or dysfunction and to promote subjective well-being and personal development. in many countries it is a regulated profession that addresses moderate to more severe or chronic psychological problems, including diagnosable mental disorders. clinical psychology includes a wide range of practices, such as research, psychological assessment, teaching, consultation, forensic testimony, and program development and administration. central to clinical psychology is the practice of psychotherapy, which uses a wide range of techniques to change thoughts, feelings, or behaviors in service to enhancing subjective well-being, mental health, and life functioning. unlike other mental health professionals, psychologists are trained to conduct psychological assessment. clinical psychologists can work with individuals, couples, children, older adults, families, small groups, and communities. specialties of clinical psychologists clinical psychologists who focus on treating mental health specializes in evaluating patients and providing psychotherapy. they do not prescribe medication as this is a role of a psychiatrist (physician who specializes in psychiatry). there are a wide variety of therapeutic techniques and perspectives that guide practitioners, although most fall into the major categories of psychodynamic, cognitive behavioral, existential-humanistic, and systems therapy (e.g. family or couples therapy). in addition to therapy, clinical psychologists are also trained to administer and interpret psychological personality tests such as the mcmi, mmpi and the rorschach inkblot test, and various standardized tests of intelligence, memory, and neuropsychological functioning. common areas of specialization include: specific disorders (e.g. trauma), neuropsychological disorders, child and adolescent, family and relationship counseling. internationally, psychologists are generally not granted prescription privileges. in the us, prescriptive rights have been granted to appropriately trained psychologists only in the states of new mexico and louisiana, with some limited prescriptive rights in indiana and the us territory of guam. educational requirements for clinical psychologists main article: training and licensing of clinical psychologists clinical psychologists, having completed an undergraduate degree usually in psychology or other social science, generally undergo specialist postgraduate training lasting at least two years (e.g. australia), three years (e.g. uk), or four to six years depending how much research activity is included in the course (e.g. us). in countries where the course is of shorter duration, there may be an informal requirement for applicants to have undertaken prior work experience supervised by a clinical psychologist, and a proportion of applicants may also undertake a separate phd research degree. today, in the u.s., about half of licensed psychologists are trained in the scientist-practitioner model of clinical psychology (phd)—a model that emphasizes both research and clinical practice and is usually housed in universities. the other half are being trained within a practitioner-scholar model of clinical psychology (psyd), which focuses on practice. a third training model called the clinical scientist model emphasizes training in clinical psychology research. outside of coursework, graduates of both programs generally are required to have had 2 to 3 years of supervised clinical experience, a certain amount of personal psychotherapy, and the completion of a dissertation (phd programs usually require original quantitative empirical research, whereas the psyd equivalent of dissertation research often consists of literature review and qualitative research, theoretical scholarship, program evaluation or development, critical literature analysis, or clinical application and analysis). continuing education requirements for clinical psychologists most states in the us require clinical psychologists to obtain a certain number of continuing education credits in order to renew their license. this was established to ensure that psychologists stay current with information and practices in their fields. the license renewal cycle varies, but renewal is generally required every two years. the number of continuing education credits required for clinical psychologists varies between states. in nebraska, psychologists are required to obtain 24 hours of approved continuing education credits in the 24 months before their license renewal. in california, the requirement is for 36 hours of credits. new york state does not have any continuing education requirements for license renewal at this time (2014). activities that count towards continuing education credits generally include completing courses, publishing research papers, teaching classes, home study, and attending workshops. some states require that a certain number of the education credits be in ethics. most states allow psychologists to self-report their credits but randomly audit individual psychologists to ensure compliance. counseling psychologist or psychotherapist further information: psychotherapy and clinical psychology § comparison with other mental health professions counseling generally involves helping people with what might be considered "normal" or "moderate" psychological problems, such as the feelings of anxiety or sadness resulting from major life changes or events. as such, counseling psychologists often help people adjust to or cope with their environment or major events, although many also work with more serious problems as well. one may practice as a counseling psychologist with a phd or edd, and as a counseling psychotherapist with a master's degree. compared with clinical psychology, there are fewer counseling psychology graduate programs (which are commonly housed in departments of education), counselors tend to conduct more vocational assessment and less projective or objective assessment, and they are more likely to work in public service or university clinics (rather than hospitals or private practice). despite these differences, there is considerable overlap between the two fields and distinctions between them continue to fade. mental health counselors and residential counselors are also the name for another class of counselors or mental health professionals who may work with long-term services and supports (ltss) clients in the community. such counselors may be advanced or senior staff members in a community program, and may be involved in developing skill teaching, active listening (and similar psychological and educational methods), and community participation programs. they also are often skilled in on-site intervention, redirection and emergency techniques. supervisory personnel often advance from this class of workers in community programs. behavior analysts and community/institutional roles behavior analysts are licensed in five states to provide services for clients with substance abuse, developmental disabilities, and mental illness. this profession draws on the evidence base of applied behavior analysis, behavior therapy, and the philosophy of radical behaviorism. behavior analysts have at least a master's degree in behavior analysis or in a mental health related discipline as well as at least five core courses in applied behavior analysis (narrow focus in psychological education). many behavior analysts have a doctorate. most programs have a formalized internship program and several programs are offered online. most practitioners have passed the examination offered by the behavior analysis certification board or the examination in clinical behavior therapy by the world association for behavior analysis. the model licensing act for behavior analysts can be found at the association for behavior analysis international's website. behavior analysts (who grew from the definition of mental health as a behavioral problem) often use community situational activities, life events, functional teaching, community "reinforcers", family and community staff as intervenors, and structured interventions as the base in which they may be called upon to provide skilled professional assistance. approaches that are based upon person-centered approaches have been used to update the stricter, hospital based interventions used by behavior analysts for applicability to community environments behavioral approaches have often been infused with efforts at client self-determination, have been aligned with community lifestyle planning, and have been criticized as "aversive technology" which was "outlawed" in the field of severe disabilities in the 1990s. school psychologist and inclusion educators school psychologists' primary concern is with the academic, social, and emotional well-being of children within a scholastic environment. unlike clinical psychologists, they receive much more training in education, child development and behavior, and the psychology of learning, often graduating with a post-master's educational specialist degree (eds), edd or doctor of philosophy (phd) degree. besides offering individual and group therapy with children and their families, school psychologists also evaluate school programs, provide cognitive assessment, help design prevention programs (e.g. reducing drops outs), and work with teachers and administrators to help maximize teaching efficacy, both in the classroom and systemically. in today's world, the school psychologist remains the responsible party in "mental health" regarding children with emotional and behavioral needs, and have not always met these needs in the regular school environment. inclusion (special)