The Clinical Psychology Megapost, Or: What Is A Clinical Psychologist And How Do I Become One?
What’s a clinical psychologist?
A clinical psychologist* is a person with a clinical psychology PhD or PsyD. Typically clinical psychologists focus on topics associated with mental health or psychopathology in any group, including children, people with chronic health conditions, older adults, forensic populations, families, people living in poverty, students, and people with developmental disabilities, among others. Often clinical psychologists work within mental health systems to improve care or other outcomes among people with mental health issues.
(*Although many of these things will apply internationally, this post is geared towards psychologists in the United States and Canada. If you are in another country, your mileage may vary.)
Clinical psychologists can work:
• In medical hospitals
• In psychiatric hospitals
• In research hospitals
• In forensic hospitals
• In state and federal institutions
• In private institutions
• In prisons and other forensic settings
• At Veteran’s Affairs
• At the Department of Defense
• In community mental health settings
• In outpatient clinics
• In private practices
• In universities
• In rehabilitation centers
• In halfway houses
• In residential settings
• In research settings
• In advocacy settings
• In policy settings
• In administrative settings
Clinical psychologists work with:
• People diagnosed with mental illnesses
• People diagnosed with physical illnesses
• People currently experiencing distress or dysfunction
• The families, loved ones, or other people associated with the people mentioned above
• Other people for lots of reasons. Typically clinical psychologists work with a more severe population (people experiencing more significant problems) compared to counseling psychologists (who often focus on things like wellbeing), but not always.
Clinical psychologists can work with:
• All ages
• All genders
• All sexual orientations
• All cultural and ethnic backgrounds
• All abilities
• All educational levels
• All socioeconomic backgrounds
• All religions
• All people in general, as long as the particular clinical psychologist is competent to treat that particular person and their particular presenting problem(s)
Clinical psychologists have extremely varied responsibilities and day-to-day tasks, including:
- Clinical work
- Individual therapy
- Group therapy
- Couples’ therapy
- Family therapy
- Diagnostic assessments
- Neuropsychology assessments
- Disability assessments
- Functional assessments
- Legal assessments
- Aptitude assessments
- Intellectual assessments
- Needs assessments
- Creating treatment plans
- Monitoring treatment progress
- Coordinating care
- Creating research ideas and questions
- Conducting literature reviews
- Applying for grants
- Conducting research
- Conducting clinical work within research projects
- Analyzing data
- Writing journal articles, books, and chapters
- Presenting findings at conferences and other events
- Disseminating research to non-academics, including mental health clinicians
- Applying research in real world settings (for example, implementing a new treatment found to be helpful)
- Mentoring undergraduate students, graduate students, interns, postdoctoral fellows, early career psychologists, research assistants
- Supervising clinical work
- Supervising research
- Training other clinicians
- Leading a mental health team
- Leading a mental health treatment program
- Leading a research lab
- Leading a psychology department
- Developing new treatments
- Developing new treatment programs
- Developing new policies
- Evaluating treatments
- Evaluating treatment programs
- Evaluating policies
13 not-easy steps to becoming a clinical psychologist
1. Complete a bachelor’s degree
You will need a bachelor’s degree to get into graduate school. The easiest route to a PhD/PsyD in clinical psychology is a psychology BA or BS, possibly with another major or minor in something like biology or sociology (meaning, something connected to your interests in psychology). However, a degree in psychology is not required to get into a PhD/PsyD program in clinical psychology. If you do not major in psychology, you may need to take post-baccalaureate classes later as most PhD/PsyD programs require specific psychology classes, usually including intro, abnormal, and research & statistics.
2. Get research experience
You will need research experience to get into a PhD/PsyD program in clinical psychology. I recommend at least two years and at least two presentations. You can do this while in undergrad or afterwards. You don’t need to do research full-time (5-10 hours/week is okay) but you do need to learn about research while doing it. Don’t accept a position where all you do is data entry or mundane tasks like that. Be a part of the action- developing research ideas, conducting research, analyzing data, presenting findings. Learn all that you can from your supervisor and other people involved. Use this time to develop research skills and become better at understanding other peoples’ research and developing your own.
3. Get clinical experience (optional)
You do not need clinical experience to get into a PhD/PsyD program, but it might help. I tend to recommend it so that you can get experience in a clinical setting and/or with a clinical population so you understand better what you’re getting into.
4. Get teaching experience (optional)
You do not need teaching experience to get into a PhD/PsyD program, but it might help.
5. Get a master’s degree (optional)
Some people choose to get a master’s degree in clinical psychology, counseling, or experimental psychology before applying to PhD/PsyD programs. I only recommend this if you need to show you have an improved GPA and/or you want to use a master’s program to get research experience. In either case I recommend a experimental psychology program first, and then clinical psychology.
7. Complete a PhD or PsyD program in clinical psychology
This is the key thing. While you are in your program, get varied experience in different clinical settings with different clinical populations. Get involved with research. Say yes to many opportunities but say no to things you’re not interested in or don’t have time for. Don’t stick only to your number 1 interest- try different things, explore the possibilities. Listen to feedback and use it to get better but don’t take criticism as a comment on you as a person. Publish. Get involved with leadership and/or administrative roles. Essentially, build an impressive CV that shows that you have well-rounded skills and experience, but also are creating a niche of your own expertise. See this ask for more.
8. Complete a dissertation
The major research milestone in a PhD/PsyD program (of any type) is the dissertation. This is your major research project, where you start to carve out your area of expertise in your field. You use the dissertation to show what you’ve learned, to learn new things, and to add something important to your field. It is an enormous and difficult undertaking, but so worth it. I recommend you pick something that is achievable in the amount of time you have left (don’t make your goal “discover all genes that cause depression,” make it “determine whether cortisol is higher among people with chronic depression compared to acute depression”) and something that you will enjoy enough to keep you motivated during the years you will be working on that project.
9. Apply for a predoctoral internship program
The last clinical milestone is a pre-doctoral internship. A match process is how it’s determined where each student applying for an internship goes (similar to medical school residency programs). Students apply for internships around the United States and Canada in the fall, and interview in December and January. Students each rank the places they interviewed at in the order of their preference, and put that ranking into an online system. Each internship does the same- ranks each student in order of their preference. The system “matches” each student with an internship, attempting to match each student with the highest ranked internship possible. However, there are more students applying each year than internships, so every year students go unmatched. This year about 82% of students matched, and of those, 80% matched to an accredited internship. Accreditation is very important for future licensure and employment. This gap in matching is one reason to go to a really really good graduate program- better programs have better match rates, and many internship programs won’t review applications from students who go to unaccredited or low quality schools. See this ask for more.
10. Complete a pre-doctoral internship program in clinical psychology
This is your last big chance to get clinical experience. So my advice is to look for programs that will help you fill important gaps in your training (for example, are you interested in PTSD but don’t have experience in Cognitive Processing Therapy? Find a program that trains in CPT) and helps you fill out your area of expertise. So, both broaden and deepen your experience. Find programs that are really interested in training you and not just getting a cheap therapist for a year. Look for places that often hire their interns as postdocs or staff psychologists, and for places that send interns to the sorts of postdocs or jobs you will want.
11. Receive your PhD or PsyD
You’re done! Congratulations! (Remember to do your exit counseling!)
12. Apply for and complete a postdoctoral fellowship (optional)
Many (maybe most) psychologists do a postdoctoral fellowship. A postdoctoral fellowship or residency is additional training after you finish your doctoral degree. Typical clinical postdocs are 1 year, research postdocs are 2 years, and speciality training postdocs like neuropsychology are 2 years. However some postdocs might be longer or shorter. You might do one so you can gain specific training you want or need- for example, clinical psychologists specializing in neuropsychology nearly always do a postdoc in neuropsychology (and have to in order to be boarded as a neuropsychologist), or you might want training in a particular area of research you don’t have. You might do one so you can get licensed because many jobs require applicants to already be licensed or license-eligible (and many states require supervised hours post-degree and/or other requirements). You might do one because you want a research job and it’s difficult to get one without a postdoc, particularly in academia or academia-adjacent positions. You might do one because you want to get in with a specific institution and they don’t have a job for you that year (many places hire from within, particularly from their intern and postdoc pool).
13. Get licensed
Clinical psychologists generally get licensed within a 2-3 years of graduating (but it’s possible to do it sooner). State requirements vary a lot, so do your research so you can a) get licensed in the state you want to right now, and b) make it possible to get licensed in other states you might want to in the future. Licensure in the US always requires passing the EPPP, the national licensing exam and graduation from an APA-accredited or equivalent graduate program and internship. Many states have additional requirements like 1500 post-degree supervised clinical hours, a state exam, or additional coursework. The process is long and expensive (like everything else in this process).
14. Get a job
This is when you finally get to be a full-fledged clinical psychologist! There are many jobs available for psychologists, but the biggest areas of need are rural and other poorly served areas. Think about what’s most important to you- type of position, type of institution, money, location, etc. –and find something that’ll work for you.
So how long will this take?
A typical path to being a clinical psychologist looks like this:
- Bachelor’s degree: 4 years
- Postgraduate research experience (optional): 2 years
- PhD/PsyD: 4-6 years
- Predoctoral internship: 1 year
- Postdoctoral fellowship (optional): 1-2 years (get licensed during this)
So an average range is 9 to 15 years from beginning your undergraduate degree to starting your first job as a licensed clinical psychologist. Some people will need more time but it’s very unlikely to do it faster than this.
You keep mentioning “APA” and “accreditation.” What’s that?
APA is the American Psychological Association, and it is the main body that accredits (recognizes as quality and meeting minimum standards) graduate programs, Predoctoral internships, and postdoctoral fellowships in psychology. The Canadian Psychological Association (CPA), California Psychology Internship Council (CAPIC), and Psychological Clinical Science Accreditation System (PCSAS) are also reputable and professionally recognized accrediting bodies.
It is essential to go to an APA-, CPA- and/or PCSAS-accredited graduate program and a APA-, CPA-, CAPIC- and/or PCSAS-accredited internship. It will be difficult to get licensed and get a job if you don’t. Accreditation also protects students. (Also, unaccredited schools are unaccredited because they are not good schools. The accrediting standards are not very high). You don’t need an accredited postdoc, but you might choose to get one because it’s likely to make it easier to get licensed and boarded, and it may make you more marketable.