Do You Need a Doctorate to Be a Clinical Psychologist?

Contrary to popular opinion, Clinical Psychologists do much more than therapy

Source: Photographeeeu/Shutterstock

Written by: Jackson A. Smith, MA & Dillon T. Browne, Ph.D.

Licensing standards for psychologists across Canada are inconsistent. Due to provincial/territorial jurisdiction over licensure for psychologists, some provinces and territories enable a person with master’s level training to become a licensed psychologist while others, including Ontario (from where we write), only grant the title "Psychologist" to those with doctoral degrees.[i] In Ontario, masters-level clinicians are given the title "Psychological Associate," which helps the public differentiate between levels of training.

In the U.S., the word "psychologist" is legally reserved for individuals who have successfully completed a doctorate from an American Psychological Association (APA) accredited program.[ii] The First Street Accord, an agreement between the APA and Canadian Psychological Association (CPA) originally signed in 2012 and re-signed in 2017, asserts that the "accreditation standards, policies and principles, and processes for each organization are seen as equivalent".[iii]

Accordingly, it would make sense for the title psychologist to require a doctoral degree. More training is better for the public, right? It's not quite that simple.

In this article, we sought to describe what makes a clinical psychologist unique. And specifically, why doctoral training should be required to hold the title psychologist.

What Is a Clinical Psychologist? Hint: Think Beyond the Clinician

When most people hear the term psychologist, their immediate impression is that of a mental health professional who provides psychotherapy. Of course, this impression is not incorrect; rather, it is incomplete.

The APA provides the following definition of clinical psychology: “The field of Clinical Psychology involves research, teaching, and services relevant to the applications of principles, methods, and procedures for understanding, predicting, and alleviating intellectual, emotional, biological, psychological, social and behavioral maladjustment, disability and discomfort, applied to a wide range of client populations.”[iv]

From this definition, it becomes clear that a psychologist is more than a psychotherapist. Clinical psychologists, especially those who have completed a doctoral degree, are:

• Scientists conducting research
• Clinicians providing therapeutic supports
• Health-care consultants working to improve complex systems
• Teachers of interdisciplinary colleagues and new generations of psychologists

The focus on research is the most important piece of the puzzle, as it relates to the origins of the field.

Origins Based in Scientific Inquiry of Difficult Behavior and Mental Illness

The foundation of clinical psychology was not the provision of applied, therapeutic interventions that people think about today; it was established as the scientific study of mental illness.

Treatment for psychopathology was originally the domain of physicians (psychiatrists and neurologists) and it wasn't until after Lightner Witmer opened the first psychological clinic at the University of Pennsylvania in 1896 and the first clinical hospital school in 1907 that the field became more applied. In 1907, Witmer also produced the field's first journal and coined the term clinical psychology to mean "the study of individuals, by observation or experimentation, with the intention of promoting change."[v] [vi] By the 1960s, psychotherapy, along with assessment, had become some of the primary offerings of clinical psychology; however, the scientific investigation of psychological phenomena remained central.

Scientist-Practitioner (Boulder) Model of Doctoral Training

In 1949, an ideal training system for clinical psychologists, known as the scientist-practitioner model, was established at a conference in Boulder, Colorado. This is the training model utilized by Ph.D. programs.

Practitioner-Scholar (Vail) Model of Doctoral Training
In 1973, an alternative training model was established. The practitioner-scholar model, established at a conference in Vail, created the PsyD degree for students primarily interested in practice (as opposed to research). Although the practitioner-scholar degree is intended for those more interested in practice than research, PsyD programs still require students to complete original research and produce a dissertation.

Master’s level preparation falls well short of the training provided by Ph.D. and PsyD programs. Thus, for the field to remain true to the original dedication to scientific inquiry, doctoral training is necessary.

Is It Just a Matter of Research Training? No, There’s Still More

Clinical psychologists perform many roles. In addition to conducting research, clinical psychologists work as clinicians, supporting individuals and groups, and as consultants, supporting organizations and governments.

Psychology Essential Reads

What Is a Scientific Model?

Inviting Psychology to the Cocktail Party

Clinical Practice

In clinical settings, clinical psychologists work with individuals with the greatest degrees of complexity. This increased complexity necessitates a high degree of training and experience, including knowledge of diagnostic criteria and treatments for a wide array of psychopathologies and behavioral presentations. Clinical psychologists also create and evaluate the efficacy of specialized and targeted treatments.

Consulting

In addition to providing clinical supports for individuals and groups (i.e., family therapy), clinical psychologists can act as internal or external consultants for organizations and governments, supporting the design, implementation, and evaluation of interventions for general or targeted populations as well as the development of policies and intentional systems of care involving multiple organizations. This type of work requires sophisticated research skills and extensive domain expertise.

The two-year training at a master’s level, while offering important training and some clinical experience in assessment and treatment, is limited in research training and does not provide the same level of proficiency and expertise required for treating highly complex cases, conducting rigorous research in clinical and community settings, and developing evidence-based treatments and valid assessments.

On the other hand, doctoral training, spanning five to seven years in Canada, includes psychological research, assessment, and therapeutic intervention design, implementation, and evaluation. This depth of training adds significant value in terms of the theoretical and applied knowledge, expertise, and experience, which uniquely positions clinical psychologists to contribute to the field of mental health research and practice at numerous levels.[vii]

Conclusion

Bringing the discussion back to the definition of clinical psychology put forth by the APA, which highlights the importance of research, teaching, and “services relevant to the applications of principles, methods, and procedures for understanding, predicting, and alleviating intellectual, emotional, biological, psychological, social and behavioral maladjustment, disability and discomfort, applied to a wide range of client populations” it is evident that such a professional would require the advanced training only offered by a terminal degree such as a Ph.D. or PsyD.

In sum, we believe that the skills nurtured in a doctoral degree are those that are required for the continued development of the field of clinical psychology, including the advancement of the methodological validity of psychological and behavioral research and treatments for individuals and communities.