Counseling vs Clinical

What is the difference between a clinical psychologist and a counseling psychologist?

Many people are puzzled by the fact that some professional psychologists identify themselves as “counseling” psychologists, while others describe themselves as “clinical” psychologists. Counseling and clinical psychologists often perform similar work as researchers and/or practitioners and may work side by side in any number of settings, including academic institutions, hospitals, community mental health centers, independent practice, and college counseling centers, where they may have overlapping roles and functions. To add to the confusion, the term “clinical” psychology is sometimes used in a generic sense by legislators to refer to psychologists authorized to provide direct services in health care settings, regardless of their training.

The differences between counseling and clinical psychologists are rooted in the history of each specialty, which has influenced the focus and emphasis of the training they receive. Both counseling and clinical psychologists are trained to provide counseling and psychotherapy. In order to understand the traditions and orientation of each specialty, it may be helpful to consider the etymology of each of the descriptive terms. Clinical derives from the Greek, “kline,” which means bed, (and is also found in the root of the word “recline”). Clinical practice has traditionally referred to care provided at the bedside of an ill patient. Counsel is from the Latin, “consulere,” which means to consult, advise, or deliberate. These differences, broadly speaking, reflect the earliest focus of each field. Clinical psychologists have traditionally studied disturbances in mental health, while counseling psychologists’ earliest role was to provide vocational guidance and advice. Today, though, the differences between psychologists from each specialty are more nuanced, and there are perhaps more similarities than differences among individual psychologists from each field.

The specialties of counseling and clinical psychology evolved concurrently, and at times, their paths of development intertwined. At the end of the 19th century and the beginning of the 20th, psychologists began to seek ways to apply the findings of psychological science to the problems people experience in the world, in areas such as learning disabilities or mental illness. These first psychological clinics offered assessment and treatment services. Later, “clinical psychologists” began to provide psychotherapy, which previously had been the exclusive domain of psychiatrists. At the same time, as society became increasingly industrialized, the vocational guidance movement began to offer assistance to those seeking careers in which they would be most successful (and to provide employers with the most productive employees). Over time, this field relied increasingly on scientific psychology, as psychologists researched the personality traits, interests, and aptitudes that affected job performance and satisfaction, and developed instruments to measure candidates’ qualities and evaluate the work environment. In 1945, the American Psychological Association established a Division of Personnel and Guidance Psychologists.

The roles of both groups of psychologists changed significantly in the aftermath of World War II. Returning veterans frequently suffered from poor mental health, and required assistance to enable them to reintegrate successfully into society. In order to meet this unprecedented demand for mental health services, the Veterans Administration hospital system employed large numbers of both clinical and vocational psychologists, and established training programs for them. Large numbers of clinical psychologists began to treat veterans’ psychiatric problems, while the VA also contracted with colleges and universities to provide vocational and educational advisement services. Because work is an integral part of the fabric of life, vocational psychologists often found that the personal readjustment counseling they offered took into account other factors in clients’ experiences.

In 1951, the Division of Personnel and Guidance Psychologists changed its name to the Division of Counseling Psychology. In this way, the specialty formalized the expansion of its focus from solely career issues, to an emphasis on overall well being throughout the life span. Counseling psychologists have frequently stressed the field’s historical focus on a normal client population; that is, the research conducted and published in the professional literature is oriented toward people without serious or persistent mental illnesses. The Georgia conference (1987) reaffirmed counseling psychology’s reliance on a developmental perspective to focus on the strengths and adaptive strategies of an individual across the life span.

Thus, the approach a counseling psychologist takes may reflect this perspective. However, both counseling and clinical psychologists are licensed in all 50 states as ‘licensed psychologists’, and as such are all able to practice independently as health care providers. Counseling psychologists are employed in a wide range of settings including college and university counseling centers, university research and teaching positions, independent practice, health care settings, hospitals, organizational consulting groups, and many others. If you are seeking psychotherapy with a psychologist, or are looking to employ one, it is NOT ONLY worthwhile BUT ESSENTIAL to ask the individual psychologist, whether counseling or clinical, to describe his or her training, orientation and current style of practice.

–Patricia R. Roger and Gerald Stone