Are Clinical Psychologists Simply Expensive Therapists?

Are Clinical Psychologists simply expensive therapists? Discuss. Clinical Psychology is a combination of science, knowledge and theories which together formulate a scientific approach which enables a clinical psychologist to ask questions about the human experience and life and how these experiences affect people in order to treat them (Plante, 2010). The services of clinical psychologists and therapists are required when individuals are suffering with anxiety, depression, trauma, relationship and marital issues and deeper mental health issues which alter and have a negative effect on psychological well-being (Hunsley & Lee, 2010). Mental health statistics show that one in four people will experience a mental health problem at some course in a year with anxiety and depression being the most common in the UK so it is therefore no wonder that waiting lists for therapists and clinical psychologists are very long (Foundation, 2011). There are many debates as to whether clinical psychologists are simply expensive therapists because it has been argued that therapists and clinical psychologists offer very similar treatments, both of which are successful but with the only different being the price. This essay will investigate and aim to answer the question as to whether clinical psychologists are simply expensive therapists. This essay will look at what clinical psychologists do and who they work with and also what therapists do. It will focus on key differences between the two and the reasons why clinical psychology is more expensive and whether this cost is justified.

What do Clinical Psychologists do? Clinical psychologists as with many psychologists aim to reduce, prevent and alleviate psychological distress and dysfunction in order to promote psychological well-being and to improve people’s lives. Clinical psychologists can work with a number of people across the lifespan including those suffering from anxiety problems, depression learning disabilities and also deeper routed mental illnesses. They can work with very young children suffering with emotional or physical trauma or the elderly coming to terms with a terminal illness. They diagnose these illnesses or disorders that people are suffering with and decide on the best course of treatment. They then work alongside a medical team of Doctors so that the Doctors can then prescribe the treatment and medication that a clinical psychologist recommends (BPS, 2011). Due to the vast amount of knowledge that Clinical Psychologists have from years and years of training, they are able to carry out research which can be very important to science and change the way we view and treat certain illnesses or disorders (Allpsychologyschools, 2011).

What do therapists do? Therapists also aim to reduce psychological distress and increase wellbeing. The term therapist is a very broad term for trained people to offer treatment in order to help people feel better. As with clinical psychologists they help people to make decisions and problem solve by offering support, guidance and clarification (Allpsychologyschools, 2011). There are many different types of therapists and they tend to work with adults with those suffering with marital and relationships problems and life problems in general (recomparison, 2011). Examples of different therapies available are; behavioural therapies which look at thought processes and behaviours, Psychodynamic therapies which investigate the unconscious and link current behaviour to traumas and events during childhood and humanistic therapies which look at the person in the current situation and how they can develop (Counsellingdirectory, 2011).

Similarities and differences between clinical psychologists and therapists. From the above examples of what clinical psychologists and therapists do it is clear to see that they are very similar. In fact many people believe the terms clinical psychologist and therapist are interchangeable and therefore this essay will now look at how they are different and answer the question of whether clinical psychologists are simply expensive therapists (Tarren, 2010). One difference between clinical psychologists and therapists is the academic qualifications and training they have undergone. Clinical psychologists have a very advanced degree, usually having studied at undergraduate level, master’s level and then PhD or Doctorate level. This therefore means they have a very deep knowledge and understand of the human mind and ways to help treat people. The training they undergo enables them to function as scientist practitioners in the NHS focusing on evidence based practises unlike therapists which focus on theory based practices. Also, Therapists only have only a general degree or in some disciples no degree at all (Allpsychologyschools, 2011). It could therefore be said that clinical psychologists ought to be more expensive as they are more advanced than the typical therapist, they are able to contribute their knowledge and understanding at a number of different levels within the healthcare system such as schools and organizations and they also contribute to a variety of roles within the healthcare system such as assessments, consultancy, intervention and treatment. However it has been suggested that clinical psychologist are vastly over priced to the point that people cannot afford to pay for their services and now many services within the NHS are looking for opportunities to create therapy posts which will employ people from other professions who have the correct post-graduate training therefore causing implications for clinical psychologist places within the NHS. The fact that many people cannot afford clinical psychologists and see them as too expensive in the current climate gives people a reason to seek therapy and help from elsewhere and therefore using therapists. Even when the economic climate returns to the way it was, people may still avoid using expensive clinical psychologists because using therapists and alternate therapies would have been a norm for quite a while and clinical psychologists may no longer seem a necessity. To avoid this there needs to be an increase global emphasis on the importance of clinical psychologists and the unique skills and advantages that clinical psychologists supposedly have over other therapists to make them more expensive (Smith, 2006). Clinical psychologists are able to diagnose problems and why people feel certain ways, they are trained on how the mind works and therefore work very closely with doctors and psychiatrists in order to say what medications should be prescribed to help the person. They can then refer the individual for treatment or therapy with a different person (multidisciplinary). Therapists on the other hand don’t tell the individual what the problem is but rather they listen and help the individual themselves discover why they feel the way they do. They are not as advanced on how the mind works but they are trained on the techniques involved in providing therapy. These are usually called ‘talking therapies’ and are promoted in the NHS (Talking Therapies, 2011). Due to the popularity of ‘talking therapies’ within the NHS, NICE believe that 10,000 more therapists are needed, 5,000 of which should be clinical psychologists but their training should become more based on therapy, more specifically cognitive behavioural therapy (CBT). CBT is a treatment which looks at the thought processes and aims to change negative, irrational thinking into more positive, realistic though processes, therefore resulting in positive personality changes and outlook on life. CBT has been proven very successful with a success rate of over 50% for anxiety sufferers and just one course of CBT can lead to 12 months free of depression (Economics, 2006). Practitioners of CBT can claim they are therefore offering NICE approved treatments and charge a lot more fees because of this whereas other general therapists and counsellors cannot despite the fact that there has been no sufficient evidence that CBT is more effective than other therapies even though some therapies are much more effective than others (Mollon, 2010).

Clinical psychologists and therapy. Clinical psychologists seem to dislike being referred to as ‘therapists’ or those who provide therapy. Eysenck (1940) was the first clinical psychologist in Britain and he attacked one form of therapy – psychotherapy;
“It is our belief that training in therapy is not, and should not be, an essential part of the clinical psychologist’s training, that clinical psychology demands competence in the fields of diagnosis and/or research, but that therapy is something essentially alien to clinical psychology, and that if it is considered desirable on practical grounds that psychologists perform therapy, a separate discipline of Psychotherapist should be built up to take its place alongside that of Clinical Psychologist.” Despite Eysenck’s view of this form of therapy, Smith (1977) carried out a study of clinical psychology looking at psychotherapy and found that it is effective, “someone chosen at random from the experimental group after therapy had a two-to-one chance of being better off on the measure examined than someone chosen at random from the control group”. However the study also brought about results that slightly devalue clinical psychologists by finding that the therapy was effective regardless of the therapists academic and previous experience (PhD, no degree etc) and also the type of therapy did not affect the effectiveness either. Eysenck later developed behaviour therapy based on Pavlov’s Dog and from this cognitive behavioural therapy was formed to which clinical psychologists attacked. One clinical psychologist defined CBT as “virtually anything to anyone” therefore it is not individual specific and anyone can use it therefore devaluing clinical psychologists and also devalue the context of the patient’s experience. It has been stated that people need to be cared for and respected for and valued and not just pushed into compliant with models of ‘normality’ which are handed down by psychologists and cognitive behavioural therapists (Hussain, 2006).

Why clinical psychologists are expensive. If a person goes to a therapist for help then they will talk a lot more and actually help themselves through self discovery rather than the therapist helping them directly. A clinical psychologist however, you pay for help that is specific to your needs, you gain an accurate diagnosis which can help you understand your problems and also you can be prescribed medications because clinical psychologists work in tandem with doctors and psychiatrists (Allpsychologyschools, 2011). Clinical psychologists are indeed very expensive and they are also paid a significant amount more than therapists, sometimes up to £100,000 they are paid if they are for example a consultant clinical psychologist. This different in salary has caused a vast amount of rivalry amongst the profession especially with those who offer psychological therapies whom believe that the pay difference is unjustified especially since a lot of the treatment and service is very similar (NIMHE, 2007). Despite some people believing the two terms are interchangeable and therapists believing they offer a very similar service, it is not necessarily true. Indeed clinical psychologists aim to reduce psychological distress as with therapists, however clinical psychologists have been through a rigorous education system to gain a much deeper understanding and knowledge which gives them the ability to work in a multidisciplinary team and also the ability to operate across a variety of therapeutic models so that a patient receives individual specific treatment tailored to them. Therapists however are trained in their specific therapy and will usually only offer this one therapy to patients. Turpin (2009) said that clinical psychologist service is dependent on a much high level of knowledge, skills and competences rather than the provision of good quality evidence based therapies and this is why they are more expensive because these skills and competences are part of the clinical psychology curriculum and training with other therapists will not come into contact with. Overall there is great controversy as to whether clinical psychologists are simply expensive therapists. Nick Serieys, a CBT therapist argued against the NICE decision to employ 10,000 new therapists, 50% of which should be clinical psychologists. He argues that there is no sufficient evidence that clinical psychologists are more effective than CBT therapists who are counsellors, occupational therapists and so on and the only different being is that they are very expensive in comparison (Hussain, 2006). In contrary, Jeremy Halstead, a lead consultant clinical Psychologist believes that clinical psychologists are rightly more expensive than other therapists, arguing that clinical psychologists offer a much better deal as therapists due to their ability to formulate problems from a variety of perspectives and theories therefore they are more flexible in their approach and can tailor more individual specific treatment (Hussain, 2006). I believe that clinical psychologists are simply just expensive therapists, but rightly so. Clinical Psychologists go through years of extensive training as previously mentioned and have a significantly greater depth of knowledge in order to work in multidisciplinary teams and to link their knowledge for diagnosis and treatment across many topics, whereas therapists are trained in how to provide an individual therapist and do now have a greater knowledge of the underlying reasons why a person may need therapy. Clinical psychologists however do have this knowledge and work with doctors in order to ensure they are prescribed the right medicines. Therefore although clinical psychologists and therapists may appear to do very similar work, clinical psychologists have a greater depth of knowledge in order to treat, diagnose and also the skills to carry out research and are very flexible compared to therapists who do have a vast amount of knowledge but in the area of just therapy.

References
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