clinical psychology clinical psychology clinical psychology is an integration of human science, behavioral science, theory, and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development. central to its practice are psychological assessment, clinical formulation, and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration. in many countries, clinical psychology is a regulated mental health profession. part of a series onpsychology outline history subfields basic types abnormal behavioral behavioral genetics biological cognitive/cognitivism comparative cross-cultural cultural developmental differential evolutionary experimental mathematical neuropsychology personality positive psychodynamic psychometrics quantitative social applied psychology applied behavior analysis clinical community consumer counseling critical educational environmental ergonomics food forensic health humanistic industrial and organizational legal medical military music occupational health political psychometrics religion school sport traffic lists disciplines organizations psychologists psychotherapies research methods theories timeline topics psychology portal not to be confused with psychiatry. the field is generally considered to have begun in 1896 with the opening of the first psychological clinic at the university of pennsylvania by lightner witmer. in the first half of the 20th century, clinical psychology was focused on psychological assessment, with little attention given to treatment. this changed after the 1940s when world war ii resulted in the need for a large increase in the number of trained clinicians. since that time, three main educational models have developed in the us—the phd clinical science model (heavily focused on research), the phd science-practitioner model (integrating scientific research and practice), and the psyd practitioner-scholar model (focusing on clinical theory and practice). in the uk and the republic of ireland, the clinical psychology doctorate falls between the latter two of these models, whilst in much of mainland europe, the training is at the masters level and predominantly psychotherapeutic. clinical psychologists are expert in providing psychotherapy, and generally train within four primary theoretical orientations—psychodynamic, humanistic, cognitive behavioral therapy (cbt), and systems or family therapy. clinical psychology is different from psychiatry. although practitioners in both fields are experts in mental health, clinical psychologists treat mental disorders primarily through psychotherapy. currently, only six us states, louisiana, new mexico, illinois, iowa, idaho, and colorado (being the most recent state) allow clinical psychologists with advanced specialty training to prescribe psychotropic medications. psychiatrists are medical doctors who specialize in the treatment of mental disorders via a variety of methods, e.g., diagnostic assessment, brief psychotherapy, psychoactive medications, and medical procedures such as electroconvulsive therapy (ect) or transcranial magnetic stimulation (tms). additionally, psychiatrists are legally authorized to prescribe psychotropic medications in all states of the u.s. and in all provinces of canada. in education, clinical psychologists attend a graduate institution and have a doctor of philosophy (ph.d.) or a doctor of psychology (psy.d.) degree, while psychiatrists completed their studies at a medical school and hold a medical degree (m.d.) or an osteopathic degree (d.o.), with the latter only available in the united states. history main articles: history of psychology and history of psychotherapy many 18th c. treatments for psychological distress were based on pseudo-scientific ideas, such as phrenology. the earliest recorded approaches to assess and treat mental distress were a combination of religious, magical, and/or medical perspectives. in the early 19th century, one approach to study mental conditions and behavior was using phrenology, the study of personality by examining the shape of the skull. other popular treatments at that time included the study of the shape of the face (physiognomy) and mesmer's treatment for mental conditions using magnets (mesmerism). spiritualism and phineas quimby's "mental healing" were also popular. while the scientific community eventually came to reject all of these methods for treating mental illness, academic psychologists also were not concerned with serious forms of mental illness. the study of mental illness was already being done in the developing fields of psychiatry and neurology within the asylum movement. it was not until the end of the 19th century, around the time when sigmund freud was first developing his "talking cure" in vienna, that the first scientific application of clinical psychology began. early clinical psychology cover of the psychological clinic, the first journal of clinical psychology, published in 1907 by lightner witmer the university of pennsylvania was the first to offer formal education in clinical psychology. by the second half of the 1800s, the scientific study of psychology was becoming well established in university laboratories. although there were a few scattered voices calling for applied psychology, the general field looked down upon this idea and insisted on "pure" science as the only respectable practice. this changed when lightner witmer (1867–1956), a past student of wundt and head of the psychology department at the university of pennsylvania, agreed to treat a young boy who had trouble with spelling. his successful treatment was soon to lead to witmer's opening of the first psychological clinic at penn in 1896, dedicated to helping children with learning disabilities. ten years later in 1907, witmer was to found the first journal of this new field, the psychological clinic, where he coined the term "clinical psychology", defined as "the study of individuals, by observation or experimentation, with the intention of promoting change". the field was slow to follow witmer's example, but by 1914, there were 26 similar clinics in the us. even as clinical psychology was growing, working with issues of serious mental distress remained the domain of psychiatrists and neurologists. however, clinical psychologists continued to make inroads into this area due to their increasing skill at psychological assessment. psychologists' reputation as assessment experts became solidified during world war i with the development of two intelligence tests, army alpha and army beta (testing verbal and nonverbal skills, respectively), which could be used with large groups of recruits. due in large part to the success of these tests, assessment was to become the core discipline of clinical psychology for the next quarter-century, when another war would propel the field into treatment. early professional organizations the field began to organize under the name "clinical psychology" in 1917 with the founding of the american association of clinical psychology. this only lasted until 1919, after which the american psychological association (founded by g. stanley hall in 1892) developed a section on clinical psychology, which offered certification until 1927. growth in the field was slow for the next few years when various unconnected psychological organizations came together as the american association of applied psychology in 1930, which would act as the primary forum for psychologists until after world war ii when the apa reorganized. in 1945, the apa created what is now called division 12, the society for clinical psychology, which remains a leading organization in the field. psychological societies and associations in other english-speaking countries developed similar divisions, including in britain, canada, australia, and new zealand. world war ii and the integration of treatment when world war ii broke out, the military once again called upon clinical psychologists. as soldiers began to return from combat, psychologists started to notice symptoms of psychological trauma labeled "shell shock" (eventually to be termed post-traumatic stress disorder) that were best treated as soon as possible. because physicians (including psychiatrists) were over-extended in treating bodily injuries, psychologists were called to help treat this condition. at the same time, female psychologists (who were excluded from the war effort) formed the national council of women psychologists with the purpose of helping communities deal with the stresses of war and giving young mothers advice on child rearing. after the war, the veterans administration in the us made an enormous investment to set up programs to train doctoral-level clinical psychologists to help treat the thousands of veterans needing care. as a consequence, the us went from having no formal university programs in clinical psychology in 1946 to over half of all phds in psychology in 1950 being awarded in clinical psychology. wwii helped bring dramatic changes to clinical psychology, not just in america but internationally as well. graduate education in psychology began adding psychotherapy to the science and research focus based on the 1947 scientist-practitioner model, known today as the boulder model, for phd programs in clinical psychology. clinical psychology in britain developed much like in the us after wwii, specifically within the context of the national health service with qualifications, standards, and salaries managed by the british psychological society. development of the doctor of psychology degree by the 1960s, psychotherapy had become embedded within clinical psychology, but for many, the phd educational model did not offer the necessary training for those interested in practice rather than research. there was a growing argument that said the field of psychology in the us had developed to a degree warranting explicit training in clinical practice. the concept of a practice-oriented degree was debated in 1965 and narrowly gained approval for a pilot program at the university of illinois starting in 1968. several other similar programs were instituted soon after, and in 1973, at the vail conference on professional training in psychology, the practitioner–scholar model of clinical psychology—or vail model—resulting in the doctor of psychology (psyd) degree was recognized. although training would continue to include research skills and a scientific understanding of psychology, the intent would be to produce highly trained professionals, similar to programs in medicine, dentistry, and law. the first program explicitly based on the psyd model was instituted at rutgers university. today, about half of all american graduate students in clinical psychology are enrolled in psyd programs. a changing profession since the 1970s, clinical psychology has continued growing into a robust profession and academic field of study. although the exact number of practicing clinical psychologists is unknown, it is estimated that between 1974 and 1990, the number in the us grew from 20,000 to 63,000. clinical psychologists continue to be experts in assessment and psychotherapy while expanding their focus to address issues of gerontology, sports, and the criminal justice system to name a few. one important field is health psychology, the fastest-growing employment setting for clinical psychologists in the past decade. other major changes include the impact of managed care on mental health care; an increasing realization of the importance of knowledge relating to multicultural and diverse populations; and emerging privileges to prescribe psychotropic medication. professional practice clinical psychologistoccupationnamesclinical psychologistoccupation typepsychologist, mental health professionalactivity sectorspsychology, health care, forensic science, psychological research, psychological assessmentdescriptioncompetenciesassessment and treatment of psychopathologyeducation required doctor of psychology (psyd) or doctor of philosophy (phd) fields ofemploymenthospitals, clinicsrelated jobs psychiatrist psychotherapist clinical psychologists engage in a wide range of activities. some focus solely on research into the assessment, treatment, or cause of mental illness and related conditions. some teach, whether in a medical school or hospital setting, or in an academic department (e.g., psychology department) at an institution of higher education. the majority of clinical psychologists engage in some form of clinical practice, with professional services including psychological assessment, provision of psychotherapy, development and administration of clinical programs, and forensics (e.g., providing expert testimony in a legal proceeding). in clinical practice, clinical psychologists may work with individuals, couples, families, or groups in a variety of settings, including private practices, hospitals, mental health organizations, schools, businesses, and non-profit agencies. clinical psychologists who provide clinical services may also choose to specialize. some specializations are codified and credentialed by regulatory agencies within the country of practice. in the united states, such specializations are credentialed by the american board of professional psychology (abpp). training and certification to practice clinical psychologists study a generalist program in psychology plus postgraduate training and/or clinical placement and supervision. the length of training differs across the world, ranging from four years plus post-bachelors supervised practice to a doctorate of three to six years which combines clinical placement. in the us, about half of all clinical psychology graduate students are being trained in phd programs—a model that emphasizes research—with the other half in psyd programs, which has more focus on practice (similar to professional degrees for medicine and law). both models are accredited by the american psychological association and many other english-speaking psychological societies. a smaller number of schools offer accredited programs in clinical psychology resulting in a master's degree, which usually takes two to three years post-bachelors. in the uk, clinical psychologists undertake a doctor of clinical psychology (dclinpsych), which is a practitioner doctorate with both clinical and research components.