Therapy

Psychology and Religion

It never ceases to surprise me how there are so often unspoken boundaries between psychology and religion. Understandably, mental health is a messy business, and church staff are rarely trained to deal well with mental health issues. At the same time, may psychologists shy away from in-depth discussion of religion because it is also not something we're particularly trained in. We are instead trained to know our fastball and stick to it. 

Except that our fastball really is the same. We both work tirelessly to help people to love, to love themselves well, and to love others well. Therefore, I ask for you to take a second to be open to considering the richness that might lie in the space where the two overlap, the space where we can help heal, challenge, and grow people into the best of what they can become, one step at a time. 

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The church and the therapy room are places for reaching people in their suffering, and it takes acknowledging that suffering in order for that connection and healing to take place.

If the pain goes unacknowledged then they may persist with self-blame and frustration or go away from the therapy session or the church feeling unseen, often not to return.

They can come away thinking that they don't belong, aren't worthy of love, or are too broken to be helped. Obviously the opposite is true. 

These processes are the same. 

I read an article recently where someone wrote that millennials don't go to church, they go to therapy. As a therapist, I'm not okay with that. Nor is the opposite side of the continuum helpful, where people of faith do not understand or appreciate the value of professional psychological services. It can be both, and too often individuals don't have the experience of how the church and mental health professionals interact, of how they are complimentary. Similarly when people go to therapy seeking to fill that sense of what is greater, they too often fill it with themselves or remain empty. Connection between the two spheres is a rich space for people to heal and grow, fully connecting with who they are meant to be.

Psychology is unique in that it is a science. It emphasizes use of the scientific method to address questions related to mood, behavior, thoughts, and interactions. We use these tools to help people in the most effective way possible, weaving techniques and approaches supported by research with our understanding of the core conditions that help a person feel loved and accepted. As clinical scientists and scientist practitioners do what we can with what we have here on earth. But Dr. Ken Pargament says it best in his excellent books on psychology and religion, that those who fear science debunking spirituality are vastly underestimating God and vastly overestimating science. Religion has nothing to fear from psychology and vice versa.

But we have so much to gain from each other. There can be shared information and learning; there can be greater appreciation and knowledge about mental health issues, resources, and providers within the church, and within psychology there is so much we can learn about the depth of the existential human experience from the people who have been the original counselors for thousands of years. 

This will the the first of many posts addressing the intersection of psychology and religion. There is so much healing possible at that intersection, and I am hopeful. 

What does someone have to do to be a clinical psychologist?

Unless you know someone who has been through the gauntlet-like process of becoming a clinical psychologist, chances are you only have a general idea of what it means. It can be helpful for potential clients to know what goes into it and how "clinical psychologist" is different from counselor or social worker. Knowing these differences is an important part of being an informed consumer when it comes to therapy. Today I'll get us started then focus in on the Clinical Psychologist category. 

Categories of "therapists" or "counselors"-- master's level (Licensed Professional Counselor, Marriage and Family Therapist, Licensed Clinical Social Worker, etc) and doctoral level (Clinical Psychologist). "What about psychiatrists?" you say. They're MD's; they prescribed medication and get significantly less therapy training. 

Master's level clinicians have received a set amount of training and, once licensed, have completed a set number of hours of clinical training. Generally their therapy services cost a smidge less and are easier to find. Doctoral level clinicians have a bit more schooling and have better odds of being either informed about or engaged in research.  Being "up on the research" can make a difference in the same way you would want a surgeon up to date on the latest and most effective techniques rather than the same one he's been doing for thirty years. 

I'll talk more about master's level clinicians and how to find the right therapist for you in future posts, but for now I want to focus on that doctorate level side and what goes into that. 

Step 1: Getting into grad school.

There are two types of programs people (or cats) can do: PhD (doctorate of philosophy in clinical or counseling psychology) and PsyD (doctorate of psychology). Generally the difference is the level of time spent learning about or doing research. PhD's generally have a greater emphasis on learning how to do research and learning how to interpret other's research. PsyD's generally have a greater emphasis on training in clinical skills. So the balance of time between learning research and clinical skills is general even in a PhD and more heavy on the clinical side in a PsyD. Having a therapist who understands research can indicate that they are more likely to know which treatments have shown through repeated testing to be effective at helping people. 

Clinical psychology PhD programs are harder to get into than med school. The quality of programs varies. There are for-profit and online programs that are not accredited by the American Psychological Association (APA); these don't generally provide good training-- run away from these. Be sure to look for someone who went through an accredited program because this means their training met high standards of training and education. These programs are not big money makers for universities generally, so they aren't everywhere and programs generally take only 3-9 students per year. Many people end up moving far and wide to get into these PhD programs and make great sacrifices over the course of their 4-7 year training. 

2. Surviving grad school.

In addition to classes, every program has a qualifying exam of some kind. It is typically some demonstration of knowing a lot of information generally and/or some info on an area of specialty. That's in addition to classes, doing research in a lab (usually), and doing clinical practicum (learning how to do therapy - usually a couple years of this in different contexts).

You might happen upon one of these trainees when looking for affordable counseling. Many departments offer therapy through training clinics. They'll having basic skills and will be supervised by a licensed psychologist. For clients with relatively straight forward, short-term issues this is a great option.

Oh yeah, and they do a dissertation. It's terrible, but I don't want to talk about it. It's terrible.

3. Predoctoral internship.

The final year of grad school is an internship. Currently it is absurd and very competitive. Most people again pick up and move at least out of state, if not halfway across the country. It's a computer match system where students and sites (again, hopefully APA-accredited programs-- places like medical schools, hospitals, community mental health centers, prisons, etc), interview and rank each other. By now if the student isn't completely broke or deep in dept, that happens with traveling all over for interviews. The internship is almost always a year of working as a therapist full-time. Again, another chance to get cheap therapy!

4. Postdoctoral residency and licensure hoops.

Here things start varying widely from state to state. Every state has a Board of Psychology that can provide specific guidance for your state. Currently a postdoc residency (another full-time year of mostly clinical work) is necessary either for licensure as a psychologist in most states or to be competitive for professor-y jobs. Postdocs are less competitive than internships, but it's another hoop often involving moving across state lines. Then there is the big monster test, the EPPP (no, I don't know what it stands for, don't ask). It covers ALL of psychology. All of it. In Texas, there's also the jurisprudence exam (law and ethics) and an oral exam, where you have to go to Austin and sit in front of and handful of intimating experts and talk about what you would do with some hypothetical clients. And you pay, lots and lots of money actually, to take these tests. 

5. Licensed. Finally.

And then when school, internship, postdoc, and licensure tests are passed, then you have a clinical psychologist! Ta da! It's a uniquely harrowing combination of education and training that people only do if they're just crazy enough...

Nobody becomes a psychologist by accident.