Erika Martinez, PsyD is a clinical neuropsychologist in Miami, Florida, who specializes in psychological assessment for learning disorders, ADHD, dementia and other cognitive impairments.
Clinical psychologists work in a variety of environments, including schools, prisons, research institutions, colleges and universities, businesses and organizations, and private practice. In addition to working directly with patients, they may also assume roles as researchers or educators.
A career as a clinical psychologist usually requires a doctoral degree, although in some cases a master’s degree is sufficient, especially for those who intend to work solely in counseling. Those who do earn a doctorate, however, often have more choices of where and how they would like to work in the field. Read on for more information about how to become a clinical psychologist, the various paths a graduate can take in the process of building a career, and what it is like to actually work in the field.
Becoming a clinical psychologist usually begins with a bachelor’s degree in psychology or a related field; some choose to earn their bachelor’s degree in a field such as marketing or business, and add psychology as their minor. Some schools offer an associate degree in clinical psychology, but keep in mind this is typically a stepping stone to a bachelor’s degree. After obtaining the bachelor’s degree, students generally go on to get a master’s or doctoral degree. Students may choose from a variety of on-campus or online degree programs in each of the levels of education:
Psychology is an expansive professional scientific field focusing on the study of human behavior. Psychologists and mental health professionals work in a number of specialty areas, including the following:
Clinical psychologists work closely with their patients to diagnose and address a gamut of mental, emotional and psychological problems. In some cases they work one-on-one with individuals; in others, their skills are applied to groups or families with common needs. Interviewing and testing patients are often first steps; they then design and implement appropriate treatment plans for both acute and chronic conditions. Clinical psychologists can choose to specialize in a certain area, such as school psychology, health psychology, neuropsychology and more. Although hands-on work is the norm in this field, some clinical psychologists minimize direct interaction with patients by focusing on research or education.
The exact job duties of a clinical psychologist vary, but the five primary responsibilities of clinical psychologists are:
In order to accomplish these tasks, clinical psychologists:
Conduct and administer tests to diagnose patients and identify disorders.
Analyze and interpret test results in order to assess patient psychological disorders.
Interview patients, friends and family members to obtain additional information germane to diagnosis and treatment.
Investigate causes of and contributing factors to mental health problems.
Consult with other healthcare professionals, such as psychiatrists, as necessary in order to coordinate and administer treatment. (Most states do not allow psychologists to prescribe medications to patients).
Counsel patients on identifying problems and treating them.
Prepare written assessments and reports for patient records.
Conduct and present research or medical findings to colleagues.
One size does not fit all in clinical psychology. Every person is unique, with different problems, personalities and priorities. It’s the job of a clinical psychologist to take these factors into account and develop a customized treatment plan. There are, however, some underlying philosophies and standard methodologies that are commonly employed.
Identifying problems and their causes is the first hurdle. To do so, clinical psychologists use a variety of methods:
These are typically done with the patients themselves, and may also include friends, family members, colleagues or anyone else (with the patient’s permission) who might have information or insights pertinent to the patient’s mental problems. Even if other methods of assessment are used, such as observation or testing, at least one personal interview (usually called a clinical interview) will likely take place to get background information.
In some cases, the clinical psychologist can observe the patient’s behavior to get another perspective that is separate from the patient’s direct report.
Questionnaires or surveys completed by the patient can provide a quantitative method of assessment. Ideally, a test will be standardized, objective, and reliable; measure what is intended to be measured; and provide results that can be compared to a benchmark. Many psychological tests do not meet all five criteria by themselves, but are useful when used as part of a greater whole. Common tests include those that assess aptitude, achievement, intelligence (IQ), attitude, personality and behavior.
Based on the results from assessment, the clinical psychologist may identify a specific problem or condition, and inform the patient of the diagnosis. Clinical psychologists often refer to The Diagnostic and Statistical Manual of Mental Disorders (DSM) to accurately diagnose problems, keeping in mind that a single patient may have multiple diagnoses, and taking that into account when choosing the proper treatments.
Most of the treatments offered by clinical psychologists involve a form of therapy. Patients may benefit from individual therapy, group therapy, hypnotherapy or some combination thereof. Therapies are usually grounded in one of four main schools of practice: psychodynamic, cognitive, behavioral and humanistic. Most clinical psychologist do not limit themselves to just one school when administering therapy, but instead pull from multiple approaches when developing treatment plans.
This is the type of therapy many people think of when picturing psychological treatment: a patient lying on a couch, talking about their problems and answering questions that probe into their subconscious. Specifically, psychodynamic therapy examines a patient’s conscious and unconscious drives and motivations as a way of shedding light on their underlying issues.
Mind over matter is the key to cognitive therapy, which is based on the idea that negative mental processes cause negative psychological problems. By changing how they think, patients should be able to change how they act and feel.
Often combined with cognitive therapy, behavioral therapy examines learning processes and their relation to behavior. Ivan Pavlov made great strides in behavioral therapy with his famous experiments with dogs and his work in classical conditioning. Today, a type of behavioral therapy called “systematic desensitization” is used to cure phobias and overcome anxiety.
This type of therapy focuses on self-awareness and the idea that the patient is inherently good. The patient is treated in a holistic manner in order to reach her or his full potential.
Many mental illnesses can also be effectively treated with proper medication; however, in most states clinical psychologists cannot prescribe medications. If medication is needed, a clinical psychologist may refer the patient to a psychiatrist licensed to dispense medication.
We asked clinical neuropsychologist Erika Martinez her about her motivation in choosing this career, her day-to-day responsibilities, and her advice for aspiring students.
I came across a DSM (diagnostic manual) in the back seat of my father’s car when I was 11 or so, and leafed through it as we sat in Miami traffic. After reading through the criteria for a particular severe disorder, I asked my father if a particular person we knew had that condition. After that, I came across books like John Douglas’ Mindhunter and Robert Hare’s Without Conscience, and series like Profiler, and I was hooked on the field.
It changes daily. Some days start with an evaluation and finish with therapy sessions; other days it’s the opposite. Some days, I spend time working on my business. On Fridays, I spend the day interpreting test results and writing reports. Along the way I’ve learned that I can’t just do testing or therapy; I need the variety.
It varies with the work. With testing, it’s usually telling a parent their child has a serious diagnosis. For me, it can be very discouraging when a client isn’t making progress in therapy.
Helping people figure out what’s going on inside, and then helping them learn about and live life in healthier ways.
In no particular order:
Don’t study psychology to avoid math classes. There’s A LOT of statistics classes in psychology, especially in doctoral programs.
Go to therapy yourself, for two reasons: it makes you more empathetic with the people who sit on your couch, and it helps you to continue your personal growth. The more you grow as a person, the more you’ll be able to help others do the same.
If you’re only interested in providing therapy, consider getting an applied master’s degree in mental health counseling, marriage and family therapy, or clinical social work. It is significantly less expensive and requires less time in school, and you can do the same work.
Doctoral programs are best for people interested in pursuing careers in research and academia, and who want to conduct psychological testing and evaluations.
Although there are several educational paths to become a clinical psychologist, most begin with a bachelor’s degree. This may be in psychology, but it’s common to choose a different major, possibly with a minor in psychology. A graduate degree comes next, with some students choosing to stop at the master’s level, and others continuing to a terminal degree (either a PhD or PsyD). Some schools have programs that bypass the master’s degree, instead setting students on a course where they proceed directly from a bachelor’s degree into a doctoral program.
After completing schooling, licensing and/or certification are required for practice. Each state has its own requirements for clinical psychologists to practice. Generally speaking, licensure requires a doctoral degree, completion of an internship, and one to two years of clinical psychology experience. At that point, candidates should be qualified to pass the Examination for Professional Practice in Psychology (EPPP).
Board certification is an important milestone for those who want to advance in the field, typically with commensurately higher pay. Individuals who earn board certification have proved that they meet specific requirements that qualify them to competently provide clinical care in a particular specialty.
Board certification is recommended as a way to establish credibility and qualifications. It increases marketability for competitive jobs, and assures patients that the clinical psychologist possesses the specialized skills needed in a particular area of practice. While board certification is not a legal state requirement for practice, many individual employers, such as hospitals and clinics, do require it.
The leading provider of board certifications is the American Board of Professional Psychology (ABPP). In order to receive certifications from the ABPP, applicants must hold a doctoral degree from a program accredited by the American Psychological Association, a license to practice, and sufficient years of experience that qualify them in a particular specialty.
The process for board certification begins after the clinical psychologist has amassed enough experience to specialize for certification. At that point, applicants submit professional credentials and practice samples for peer review, and then take an oral exam. Some board certifications, such as neuropsychology and forensic psychology, also require a written examination.
Candidates can accelerate the specialization process in graduate school by taking appropriate electives or completing an internship in their desired specialty. A mentor can help students choose a specialty, and guide them through obtaining the necessary education and experience. Graduate students may also consider registering with the ABPP. Students pay less expensive entrance fees, and they can upload required information and documentation about their schooling and experiences on an ongoing basis. A potential drawback of planning for certification while still in school is that career paths and plans change over time, and graduates may end up in an entirely different specialty than planned.
From infancy through the teen years, children have specific psychological needs. Child psychologists focus on applying scientific methods designed to understand the cognitive functions and emotional needs of children, especially how they learn and develop. Board certification in clinical child psychology requires a minimum of three to five years of postdoctoral experience, depending on the doctorate degree held.
Health psychologists examine how the overall health of individuals is related their psychological characteristics. They apply psychological knowledge to promote healthy lifestyles that discourage unhealthy behavior and reduce illness. These professionals must complete a one-year internship, an approved postdoctoral fellowship, or three years of postdoctoral experience.
Neuropsychologists apply the principles of psychology to the functions of the brain and central nervous system. Much of their work relates to studying and treating brain injuries as well as developmental disorders. A two-year residency in neuropsychology or a related discipline, as well as didactics in eight core areas, are required for board certification, in addition to a doctorate degree and license.
Not only do clinical psychologists work with people, they work for them, and their skills should be developed to navigate the human mind and offer solutions to those in need. Building these skills takes work, but it’s essential to being a successful clinical psychologist. At a basic level, clinical psychologists should show facility in the following areas:
Probably one of the most important skills to have as a clinical psychologist, the ability to communicate information and ideas to others is vital when dealing directly with patients and in research settings.
Many disorders and problems are complex and not easily communicated—especially when patients themselves often do not understand what is going on. The ability to pay attention, listen, and read between the lines is imperative in order to properly diagnose patients.
Patients’ internal “data,” such as their feelings and emotions, may be attained through careful observation of non-verbal cues. Patients cannot always accurately or clearly express what is wrong, or the factors that are affecting them, but may provide clues through their behavior.
Well-reasoned and logical thinking is necessary across the board, from direct patient care to research. Diagnosing patients, developing treatment plans, designing experiments, and interpreting results all rely on the ability to examine problems from different perspectives and consider alternatives.
Facts and information sometimes hide their true meanings, appearing unrelated or random. Good clinical psychologists are skilled at sorting through data to detect possible patterns and relevance.
Explaining not only the “what,” but also the “how” and “why” is important when introducing new or complex concepts to patients or colleagues.
Clinical psychologists must put their patients’ best interests first. Sometimes this translates into convincing them of ideas that patients initially disagree with, or making efforts to find creative solutions when traditional approaches fail.
Not all solutions will be simple, straightforward or dichotomous. There will also likely be ethical dilemmas when practicing as a clinical psychologist. Managing these complex situations requires making considered decisions informed by clinical knowledge and compassion.
Even outside of the research realm, clinical psychologists’ work is firmly rooted in scientific principles and concepts. They need a mastery of these ideas, and the skills to apply them to patient treatment or other areas of focus.
The above skills are universally helpful for clinical psychologists, and the ability to use them effectively may well lead to positions that require more responsibility and command higher salaries or fees. In many cases, however, these skills have a more indirect influence on a career; for example, a clinical psychologist who communicates and listens to patients exceptionally well is more likely to achieve success in treatment.
Other skills can have a more direct impact on salary. The field of clinical psychology is no different from any other in that additional skills qualify individuals to assume more extensive and difficult job duties. Such abilities increase marketability and can lead to higher pay. Pain management is a relatively new specialty for clinical psychologists, involving the use of psychological concepts to help manage or reduce pain. It takes specialized training and experience to learn to apply mental thought processes and behaviors to control the physical sensations of pain, resulting in a desirable skill that employers will pay for. Another skill that may bring financial compensation is the ability to perform and interpret in-depth research. Clinical research requires advanced science and math skills to interpret statistical and scientific data. Certain jobs in clinical psychology tap into these analytical skills, and pay more to reflect the expertise required.
Experience factors heavily into salary. Clinical psychologists with fewer than five years of experience draw a median pay of$64,598.
Five to ten years of experience increases that number dramatically, to $74,184. Ten to 20 years of experience will provide a median salary increase to $83,530, while more than 20 years of experience raises the figure to $87,809.
The median salary for clinical psychologists in 2014 was$72,568,
more than twice the national average of about $35,000 for all jobs, as reported by the Bureau of Labor Statistics.
Specializing in clinical research can also produce similar results, raising the median salary to more than$77,000.
Depending on the geographical location of practice, the level of experience, and the particular specialty, median pay may be significantly higher or lower. For example, working in pain management bumps the median salary almost 10 percent, to about$79,000.
In general, those working for private businesses or in upper management positions make the most money, while those in education tend to make less.
Here is the average annual base salary for a few specific jobs in the field:
The tool below provides further details into clinical psychologist salaries:
Some people find the skills and experiences of clinical psychology appealing, but want to follow a slightly different path that still involves working with people. Following is a partial listing of related careers and their salaries; job growth statistics are for the period of 2012 to 2022.
Those seeking a job in clinical psychology can benefit from numerous job search sites that focus on clinical psychology positions or related jobs. The following links provide more information on the career and the field at large, and may help lead graduates to potential job opportunities: