Counseling Psychology Misinformation

[foreverbull]

About to teach an intro class, and I'm starting to discover why so many folks are misinformed about counseling psychology.

The Myers Exploring Psychology text (2016) says the following:
–"Counseling psychologists help people to cope with challenges and crises (including academic, vocational, and marital issues)."
–"Clinical psychologists assess and treat people with mental, emotional, and behavior disorders."

Myers doesn't ever mention that counseling psychologists can also assess and treat mental, emotional, and behavior disorders, although he states that both can provide therapy.

It's 2017 and we still have scholars asserting that counseling psychologists focus on "issues of living" rather than diagnosable mental illness, although every single job/practica I've had has focused on diagnosing and treating mental illness as a counseling psychologist. It's a bit disheartening, and I have to say, insulting to see that counseling psychology is still seen by some scholars as focusing on folks who have "challenges" despite the fact that we are trained to assess, diagnose, and treat mental illness. My graduate program blended with clinical psychology and we took the same classes for diagnosis, cognitive assessment, and did similar practica, so I'm not sure why the divergent descriptions of whom we treat (both APA-accredited programs, so APA oversight for both programs to diagnose/assess). I also know several clinical psychologists who see clients with career concerns, life transition/adjustment issues, cultural issues, and see couples for therapy. My clinical colleagues and I are so similar in our professions that I often forget that we came from different types of programs. There are still some differences here and there in some course requirements and career choices: it may be that more clinical psychologists are involved in working in hospitals and/or psych hospitals more frequently than counseling folks, but I've seen both programs graduate folks who went into primary care roles and/or VAs.

Both clinical and counseling folks go on to become licensed psychologists free to diagnose & treat mental illness, and Medicare considers us all to be "clinical psychologists" for billing purposes regardless of the degree due to the training that we all get in assessing/diagnosing/treating mental illness.

However, a colleague of mine who sought an internship site with her population of speciality (many years of experience under her belt) was turned down from even applying to the site because she was from a counseling program (they only wanted clinical applicants, she contacted them, they said no, they wouldn't consider her application despite her experience). I hope practices like this aren't widespread in the APPIC system. Either way, I feel like misinformation like the above by scholars certainly doesn't help clarify the equivalency of the training between programs to the new generation of students. I'm just surprised that my field's foundation/history is still driving how people see counseling psychologists rather than looking at more relevant information such as our training, how we are licensed, and looking at the current practice of counseling psychologists today.

Whew, I needed to vent!

Anyone else confused by the way counseling vs. clinical psychologists have been compared?

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[rerope]

To be honest this was a definite concern of mine last cycle. The counseling program and lab I'm in are comprised of only clinical (or clinical-community) psychologists and the curriculum is very well balanced compared to clinical programs I interviewed at but ultimately this was the best fit. Thank goodness the internship sites I'm interested in have taken students from my program recently so I know its not an impassable barrier but I am annoyed by the stigma and the notion that my program is 'less competitive' or 'easier' than clinical programs

 

[G Costanza]

It’s hard to imagine the training is easier when 67% of counseling PhD students come in with a masters degree vs 21% of a clinical PhD. I know in my program, if you came in with a masters, it took you five years. If you came in with a bachelors, it’s seven.

I’ve never experienced any stigma from my degree but I’ve only worked in counseling centers. When I look at postings for jobs in my area (VA, hospitals, PP, etc), I consistently see both counseling and clinical degrees preferred.

If someone if going to market a book as a textbook, I’d like to see the author(s) cite factual claims just like a journal article. It’s a shame we teach undergrad students through texts that are often unscrutinized.

 

[PsyDr]

Clinical vs counseling; PhD vs psyd; etc.

I think at one point those distinctions made a difference. If one uses the MD vs DO vs MBBS, as a proxy, it would seem that the differences disappear in practice.

I do think that there has been an attempt to over diagnose/pathologize, which has pushed counseling psychology and the rest of the field to act like a normal human reaction is a mental illness. Looking at you bereavement.

 

[deleted106747]

Counseling psych here working in the VA... that frustrates me a good deal. Not only because it's incorrect, but it's lazy.

 

[foreverbull]

Thanks for the feedback.

"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."
- APA Division 17 (Society for Counseling Psychology)

For any folks who are seeking a strongly multiculturally-focused graduate program and interested in multicultural research, that is part of the foundation of Counseling Psychology, one that I consider as part of my Counseling Psychology identity, but it's certainly not limited to those seeking that kind of research.

I see APA-accredited Counseling & Clinical doctoral programs as offering similar training but with some differences in foundation & perspective. Both are rigorous in their training and the more reputable programs in both require APA oversight.

If I can sway one student who knew nothing about Counseling Psychology to apply to a Counseling Psychology program, I've done my job. 😉

 

[Feelings Doctor]

I'm not a counseling psych but the stigma and misconception I've seen around this "distinction" has been confusing at best and damaging at worst. It's also been recommended to me on more than one occasion by certain faculty that I switch to a counseling psych emphasis due to my commitment to a social justice lens and serving and studying diverse and marginalized populations. I have always found the idea that somehow only counseling psych folks "own" multiculturalism to be shameful for the clinical and school psych fields. Supposedly ALL APA-trained and licensed psychs are operating from APA standards and ethical code, and serving and respecting diverse individuals is one of our main principles, so I don't see how it's excusable for only ONE branch of psychology to be invested in multicultural work. That being said, the reality is, as @foreverbull has noted, if you are a multiculturally-minded person and are interested in being trained in research and practice that is grounded in this lens, then you may be interested in seeking counseling psych programs, because this emphasis may be more guaranteed than in other fields of applied psychology.

As for how to explain the difference between counseling and clinical psychology, I am at a loss aside from the historical roots of each and the current occasional difference in emphasis on multiculturalism. @foreverbull, do you have any other suggestions for distinctions? I guess counseling psychology suffers from a similar nomenclature issue to school psychology, since there is tons of variation from state to state in what people consider school psychologists and there is stigma attached to school psychologists as even less equipped to do clinical work than counseling psychologists, sometimes confusing school psychologists with school counselors or academic counselors or even speech therapists.

 

[Justanothergrad]

Despite the historical roots making a clear distinction I'm not sure there is enough of one to reasonably argue they are distinct fields anymore. Training, licensure, and outcomes are pretty much the same with differences more due to the program/advisor than anything else. Perhaps the only areas with distinctive differences are counseling centers and behavioral med, but that doesn't account for a majority of either field. Neither does the cursory vocational training. The issue of how clinical/counseling is defined is two fold in my mind for why this is a problem and inconsistent with today: 1972 was the last time counseling psychology had a conference to define itself as a field and a ton has changed in the realms of psychology professional identity AND medical billing. We aren't the same field we were then (and shouldn't be); that identity doesn't serve us competitively in the market because it isn't the same either. That all said, there are some political forces to keep us separate, from each area independetntly out of tradition and because I suspect APA doesnt want to see the largest division ever if they were to merge.


Other myth: Counseling psychologists aren't good at assessment. I really love knocking this one down.

 

[foreverbull]

I have always found the idea that somehow only counseling psych folks "own" multiculturalism to be shameful for the clinical and school psych fields. Supposedly ALL APA-trained and licensed psychs are operating from APA standards and ethical code, and serving and respecting diverse individuals is one of our main principles, so I don't see how it's excusable for only ONE branch of psychology to be invested in multicultural work. That being said, the reality is, as @foreverbull has noted, if you are a multiculturally-minded person and are interested in being trained in research and practice that is grounded in this lens, then you may be interested in seeking counseling psych programs, because this emphasis may be more guaranteed than in other fields of applied psychology.

As for how to explain the difference between counseling and clinical psychology, I am at a loss aside from the historical roots of each and the current occasional difference in emphasis on multiculturalism. @foreverbull, do you have any other suggestions for distinctions? I guess counseling psychology suffers from a similar nomenclature issue to school psychology, since there is tons of variation from state to state in what people consider school psychologists and there is stigma attached to school psychologists as even less equipped to do clinical work than counseling psychologists, sometimes confusing school psychologists with school counselors or academic counselors or even speech therapists.

Nomenclature-wise, I think people just aren't exposed to it as often as "Clinical Psychologist" so it's confusing. Couple that with the fact that the "counseling" part drops out when you become licensed at the state level, and it's easy to see why no one knows what it is unless there is more overall exposure. In media/articles, instead of authors defaulting to "Clinical Psychology" when discussing practice/treatment, including the "Counseling/Clinical Psychology" combo would at least give some representation and would be more accurate given the large degree of overlap.

The biggest difference in my opinion IS the multiculturalism & social advocacy philosophy/lens. The foundation is integral to my training in Counseling Psychology and was woven throughout my graduate program. We had a multicultural counseling course (APA didn't require Clinical Psych students to take this course at the time I attended grad school), we discussed diversity in depth in almost every course, and multicultural topics were explored via panels, lectures, discussions, outreach, etc. that we were required to participate in or attend throughout our entire program. In every course we read research articles/reviews that addressed cultural issues and we examined how diverse populations responded to treatments or were excluded in research, etc. and/or the results of such studies. We were trained to recognize and identify the cultural limitations of research studies, cognitive & personality assessments, etc. and identify possible cultural considerations in presenting problems that folks of different backgrounds come to therapy with. Many colleagues pursued research with racial/ethnic minorities or sexual/gender minorities in our program.
I took it for granted that this was commonplace across all doctoral psychology programs until internship and beyond, when I worked alongside Clinical colleagues from different programs around the country who did not have the same training.

Because Counseling Psychology folks are so few and far between, I don't know if this was unique within Counseling Psychology programs, either (weigh in here, Counseling folks!), but I am strongly aligned with the multicultural/social advocacy foundation of my subfield, as are the vast majority of my program's graduates.

In an increasingly multicultural landscape for all subfields of psychology, I'm wondering if some individual Clinical programs also strongly emphasize multiculturalism (within-program variability?). I don't think Counseling Psychology should have a "monopoly" on multiculturalism research/practice either; it would be great if it was included as part of the current foundation of all psychology branches in greater breadth and depth.

 

[WisNeuro]

In an increasingly multicultural landscape for all subfields of psychology, I'm wondering if some individual Clinical programs also strongly emphasize multiculturalism (within-program variability?). I don't think Counseling Psychology should have a "monopoly" on multiculturalism research/practice either; it would be great if it was included as part of the current foundation of all psychology branches in greater breadth and depth.

This is common in clinical programs since changes were made to accreditation years ago. Between my own training and affiliations with programs since that time (n of 3) all had portions of almost every class dedicated to multicultural issues, as well as at least one standalone class.

 

[DynamicDidactic]

Perhaps the biggest distinction I can make between these programs is that Counseling Psychology tends to be housed in Schools of Education while Clinical Psychology tends to be housed in Liberal Arts and Sciences. Not all programs but most.

 

[smalltownpsych]

As a clinical psychologist, I am sure that we are so much better than they are or maybe that is just ingroup/outgroup dynamics at play. Seriously though, I used Myers text for a few years and there were quite a few flaws, as I recall and that was definitely one of them. He is a social psychologist, what the heck does he know about clinical practice? He probably could point out that I was inaccurate in some way with my flippant social psych comment, but he probably wouldn’t know how to find his way out of a psych hospital. 😉

 

[foreverbull]

I'm definitely going to consider a different text next time around!

@WisNeuro I'm thinking someday there'll be no differences between the two at all and they'll merge. That is, if folks from both subfields in APA supported it.

 

[WisNeuro]

I'm definitely going to consider a different text next time around!

@WisNeuro I'm thinking someday there'll be no differences between the two at all and they'll merge. That is, if folks from both subfields in APA supported it.

Still gonna depend on individual programs and adherence to a certain standard in areas of training. In the area that I did my fellowship, the counseling psych people had good neuro assessment training and access to a lot of pracs, in my grad program, the counseling psych people got almost zero neuro training and were essentially locked out of the two places in town that offered pracs. There'd have to be some agreement that will take a lot to iron out. Additionally, people like some of their different distinctions. Like the PsyD issue. The handful or so of reputable PsyDs are indistinguishable from PhDs, aside from tuition, but still keep that label for some reason.

 

[DynamicDidactic]

I'm definitely going to consider a different text next time around!

May I recommend the Lillenfeld text, its really the best intro text I have seen.

 

[foreverbull]

May I recommend the Lillenfeld text, its really the best intro text I have seen.

Thanks, I'll check it out!

 

[Sharewithme]

[QUOTE="I do think that there has been an attempt to over diagnose/pathologize, which has pushed counseling psychology and the rest of the field to act like a normal human reaction is a mental illness. Looking at you bereavement.[/QUOTE]

Bereavement itself is not a mental illness.

 

[G Costanza]

[QUOTE="I do think that there has been an attempt to over diagnose/pathologize, which has pushed counseling psychology and the rest of the field to act like a normal human reaction is a mental illness. Looking at you bereavement.

Bereavement itself is not a mental illness.[/QUOTE]

My initial reaction to that quote was that if you’re looking for the group guilty of overpatholgizing, counseling psychologists would be near the bottom of the list.