Discussions are going on about whether New Zealand psychologists should have limited prescription rights – be able to prescribe medication for people experiencing the kinds of psychological distress that might be helped by drugs. Some of you reading this may be surprised – “but haven’t they always done this?”, you might think. The answer is no, and this might be a reflection of the common confusion between psychology and psychiatry.
Psychiatry is a medical specialisation, and that means psychiatrists are medical doctors. This also means psychiatrists come from a background that puts strong emphasis on medical explanations for psychological distress. It’s a big oversimplification, but think of it this way: just as medical doctors treat green snot and sore throat as a product of something biomedical (germs that can be killed with antibiotics), they also approach psychological problems in the same way, as if something biomedical has broken down and needs to be fixed with medication.
Of course, nobody would ever suggest a psychological disorder is 100% medical, so psychiatrists will also complement medication (where necessary) with talk therapies to assist people towards recovery.
Psychologists are not trained in a medical model, however, and that means two things. First, psychological disorder does not necessarily mean someone is physically broken, and second, medication isn’t therefore the only way to treat someone. Clinical psychologists’ primary tool for helping clients is talk therapy, and they are very good at it. Here’s why.
If you are someone who sits in the corner at parties, watching other people get their groove on, then you’re already a student of psychology. If you decide to make a career out of it (psychology, that is, not parties), then all you need do is join thousands of others enrolling each year for a psychology degree.
I am not lying when I say that the course I teach had more than 1200 applications this year, and I’m not alone – psychology is one of the most popular courses at most universities in the Western world. Many more females than males study psychology – about two-thirds of the first-year class are women, and the numbers get bigger as you move through. This is partly because women tend to do better, but also because psychology is not seen as an obviously masculine career course. This is really unfortunate, because not all psychology is about therapy.
So, if you want to be a clinical psychologist, you need to finish your three-year psychology degree first. Then you can apply for entry to a clinical psychology programme. It’s a hugely resource-intensive course because it involves hundreds of hours of supervised “real” work. That means supply can’t meet demand – some universities will accept fewer than a 10th of those who apply.
Acceptance is followed by a minimum of three more years of study that includes working as an intern psychologist with real clients, and a master’s thesis (equivalent to a full year of independent research that you write up as a book of up to 40,000 words) or PhD (three years and up to 100,000 words). Most people take seven or eight years to finish.
Clinical psychology (and psychiatry) is identified by the Government as a “long-term skills shortage” – there aren’t enough produced locally to meet demand, so New Zealand actively tries to recruit psychologists and psychiatrists from overseas. Even though GPs and clinical psychologists both train for a long time, GPs earn quite a bit more, which is of concern because you can get a student allowance to study to be a GP but not if you want to be a clinical psychologist.
In the meantime, remember what I said about more girls than guys? Psychology needs men.