What is Clinical Psychology?

The two important processes that inform the practice of clinical psychology include psychotherapy and psychological assessments (psychometric assessments and clinical assessments). However, clinical psychologists are also trained and equipped to do forensic testimony, clinical programme development, research, tutoring, supervising, neuropsychological assessments and much more...

Clinical psychologists are considered to be experts in providing a clinical diagnosis of mental illness or disorder, doing psychotherapy as a methodology to address psychological problems and/or psychological testing. They are often trained and are competent in different theoretical orientations, which include: Behavior therapy, Cognitive behavioral therapy (CBT), psychodynamic, humanistic and systems or family therapy to mention only a few.

An Overview of the Therapies Mentioned and Often Used by Clinical Psychologists

Psychodynamic psychotherapy focuses on revealing the unconscious content of an individual’s psyche in order to understand and lessen psychic tension. The interpersonal relationship between the therapist and patient plays an important role in the process. Due to it’s in depth nature, this type of therapy could require a longer process, however, some patients prefer this “gentle process” to a more goal orientated and solution focused process. Especially if they have the need to delve deeply into their pasts to gain understanding of how it informed current behavior or emotional distress.

Behaviour therapy or behavior therapy uses certain methods developed for strengthening desired behavior or to reduce or eliminate undesired behaviors. This method does not focus on the psychodynamic state of the patients. The focus is mainly on the behavior of the patient and not on the emotions or thoughts that may contribute to the existence of those behaviors.

Humanistic psychology focuses more on the positive aspects of a patient for example a person’s right of autonomy (free will), their potential and that they are inherently good. It stresses the importance of personal development, growth and self actualization.

Cognitive behavioral therapy (CBT) is a psychotherapeutic approach that is more goal orientate and uses systematic procedures to change emotional difficulties, problematic behaviors and distorted thinking patterns. It has proven itself as a highly effective methodology to address many disorders for example, OCD, depression, anxiety, substance use and so forth. It focuses on the relationship between thoughts, feelings and behaviors. The therapist and the patient both play an active role in the therapeutic process. This is an active intervention and patients are often give “home work” or tasks to do or practice between sessions.

Family therapy or systems therapy is a type of therapy that sees the system or the dynamics in which relationships function as an important force. It suggests that people cannot be understood in isolation from the systems they function in. Each person plays an important part in that system. People are interconnected and interdependent. It often draws on the strength, support and wisdom of the wider system or to correct dysfunctional systems in order to enhance personal development and emotional health.

Eclectic Approach – some psychologists see the value of utilizing more than one theoretical underpinning or approach and prefer to use the different approaches in a combined way to understand and address their patient’s distress.

Qualifications and Registration as a Clinical Psychologist

In order to qualify as a psychologist in South Africa, a person has to have a Masters degree in psychology. A Clinical Psychologist has to choose their category of specialty for example “clinical psychology” before they start their masters degree. To be selected into a masters programme is often very difficult and very strict criteria is followed by the different universities. The selection process is a 2-5 day process, depending on the university. Selectors take academic performance, past experiences and personality into consideration when choosing candidates for any of the psychology masters programmes. Due to the intensity of the programmes, universities only choose a few candidates which could be as few as 5 psychology master students per university per category per year. After a candidate completed their master’s degree, they have to do an internship year at a hospital under supervision of a psychologist registered in the same category. Thereafter they have to do a community year at a state hospital, which is determined by the Department of Health. Writing and passing a national board exam is the last phase before they are able to register as an independent practitioner with the HPCSA (Health Professions Council of South Africa). All medical practitioners have to register with the HPCSA. The process of qualifying as a clinical psychologist takes a minimum of seven years, however some practitioners prefer to further their studies and complete their doctorate degree (PhD). This process could take a further 2-6 years of academic and practical studies.

Scope of Practice of Clinical Psychologists As Prescribed By The HPCSA (Health Professions Council of South Africa)

“In addition to the scope of the profession of psychologists as prescribed in the regulations, the following acts falls within the scope of practice of clinical psychologists:

(a) assessing, diagnosing, and intervening in clients dealing with life challenges, particularly those with developmental and forms of psychological distress and/or psychopathology; identifying psychopathology in psychiatric disorders, and psychological conditions; identifying, and diagnosing psychiatric disorders and psychological conditions; applying evidenced-based psychological interventions to people with psychological, and psychiatric conditions; referring clients to appropriate professionals for further assessment or intervention;

(b) advising on the development of policies, based on various aspects of psychological theory and research; designing, managing, and evaluating programmes dealing with psychological, and psychiatric problems;

(c) training and supervising other registered clinical psychologists in clinical psychology;

(d) conducting psychological practice, and research in accordance with the Ethical Rules of Conduct for Practitioners registered under the Health Professions Act, 1974; adhering to the scope of practice of clinical psychologists” (HPCSA).