Psychologist

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Not to be confused with Psychiatrist.

Psychologist David Lewis measures a subject’s responses to a TV commercial in the early 1980s using a specially modified EEG device.

A psychologist studies normal and abnormal mental states from cognitive, emotional, and social processes and behavior by observing, interpreting, and recording how individuals relate to one another and to their environments.[1] To become a psychologist, a person often completes a graduate university degree in psychology, but in most jurisdictions, members of other behavioral professions (such as counselors and psychiatrists) can also evaluate, diagnose, treat, and study mental processes.[2]

Professional practice[edit]

Psychologists can be seen as practicing within two general categories of psychology: applied psychology which includes "practitioners" or "professionals", and research-orientated psychology which includes "scientists", or "scholars". The training models endorsed by the American Psychological Association (APA) require that applied psychologists be trained as both researchers and practitioners,[3] and that they possess advanced degrees.

Psychologists typically have one of two degrees (PsyD or PhD). The PhD prepares a psychologist to conduct scientific research for a career in academia; whereas, the PsyD prepares for clinical practice (e.g. testing, psychotherapy). Both PsyD and PhD programs can prepare students to be licensed psychologists, and training in these types of programs prepares graduates to take state licensing exams.

Within the two main categories are many further types of psychologists as reflected by the 56 professional classifications recognized by the APA,[4] including clinical, counseling, and educational psychologists. Such professionals work with persons in a variety of therapeutic contexts. People often think of the discipline as involving only such clinical or counseling psychologists. While counseling and psychotherapy are common activities for psychologists, these applied fields are just two branches in the larger domain of psychology.[5] There are other classifications such as industrial, organizational and community psychologists, whose professionals mainly apply psychological research, theories, and techniques to "real-world" problems of business, industry, social benefit organizations, government,[6][7][8] and academia.

Clinical and counseling psychologists[edit]

Clinical and counseling psychologists can offer a range of professional services, including:[9]

  • Providing psychological treatment (psychotherapy)
  • Administering and interpreting psychological assessment and testing
  • Conducting psychological research
  • Teaching
  • Developing prevention programs
  • Consulting (especially with schools and businesses)
  • Program administration
  • Providing expert testimony (forensics)

In practice, clinical and counseling psychologists might work with individuals, couples, families, or groups in a variety of settings, including private practices, hospitals, mental health organizations, schools, businesses, and non-profit agencies.

Most clinical and counseling who engage in research and teaching do so within a college or university setting. Clinical and counseling psychologists may also choose to specialize in a particular field. Common areas of specialization, some of which can earn board certification, include:[10]

Contrasted with psychiatrists[edit]

Main article: Psychiatrist
See also: Clinical psychology

Although clinical and counseling psychologists and psychiatrists share the same fundamental aim—the alleviation of mental distress—their training, outlook, and methodologies are often different. Perhaps the most significant difference is that psychiatrists are licensed physicians, and, as such, psychiatrists are apt to use the medical model to assess mental health problems and to also employ psychotropic medications as a method of addressing mental health problems.[11]

Psychologists generally do not prescribe medication, although in some jurisdictions they do have limited prescription privileges. In three US states (Illinois, Louisiana, and New Mexico), some psychologists with post-doctoral pharmacology training have been granted prescriptive authority for certain mental health disorders upon agreement with the patient's physician.[12][13]

Clinical and counseling psychologists receive extensive training in psychological test administration, scoring, interpretation, and reporting, while psychiatrists are not trained in psychological testing. Such tests help to inform diagnostic decisions and treatment planning. For example, in a medical center, a patient with a complicated clinical presentation who is being seen by a psychiatrist might be referred to a clinical psychologist for psychological testing to help the psychiatrist determine the diagnosis and treatment. In addition, psychologists (particularly those from Ph.D. programs) spend several years in graduate school being trained to conduct behavioral research; their training includes research design and advanced statistical analysis. While this training is available for physicians via dual MD/Ph.D. programs, it is not typically included in standard medical education, although psychiatrists may develop research skills during their residency or a psychiatry fellowship (post-residency). Psychologists from Psy.D. programs tend to have more training and experience in clinical practice (e.g. psychotherapy, testing) than those from Ph.D. programs.

Psychiatrists, as licensed physicians, have been trained more intensively in other areas, such as internal medicine and neurology, and may bring this knowledge to bear in identifying and treating medical or neurological conditions that present with primarily psychological symptoms such as depression, anxiety, or paranoia, e.g., hypothyroidism presenting with depressive symptoms, or pulmonary embolism with significant apprehension and anxiety.[14]

Clinical and counseling psychologists receive training in a number of psychological therapies, including behavioral, cognitive, humanistic, existential, psychodynamic, and systemic approaches, as well as in-depth training in psychological testing, and to some extent, neuropsychological testing.

Licensing and regulations[edit]

Australia[edit]

In Australia, the psychology profession, and the use of the title "psychologist", is regulated by an Act of Parliament, the Health Practitioner Regulation (Administrative Arrangements) National Law Act 2008, following an agreement between state and territorial governments. Under this national law, registration of psychologists is administered by the Psychology Board of Australia (PsyBA).[15] Before July 2010, the professional registration of psychologists was governed by various state and territorial Psychology Registration Boards.[16] The Australian Psychology Accreditation Council (APAC) oversees education standards for the profession.

The minimum requirements for general registration in psychology, including the right to use the title "psychologist", are an APAC approved four-year degree in psychology followed by either a two-year master's program or two years of practice supervised by a registered psychologist.[17][18] There is also a '5 + 1' registration pathway, including a four-year APAC approved degree followed by one year of postgraduate study and one year of supervised practice[19][20]. Endorsement within a specific area of practice (e.g. clinical, counseling, educational, forensic, health, organizational or neuropsychological) requires additional qualifications.[21] These notations are not "specialist" titles (Western Australian psychologists could use "specialist" in their titles during a three-year transitional period from 17 October 2010 to 17 October 2013).[22][23][24]

Membership with Australian Psychological Society (APS) differs from registration as a psychologist. The standard route to full membership (MAPS) of the APS ususually requires four years of APAC-accredited undergraduate study, plus a master's or doctorate in psychology from an accredited institution. An alternate route is available for academics and practitioners who have gained appropriate experience and made a substantial contribution to the field of psychology.

Restrictions apply to all individuals using the title "psychologist" in all states and territories of Australia. However, the terms "psychotherapist", "social worker", and "counselor" are currently self-regulated, with several organizations campaigning for government regulation.[25]

Belgium[edit]

Since 1933, the title "psychologist" has been protected by law in Belgium. It can only be used by people who are on the National Government Commission list. The minimum requirement is the completion of five years of university training in psychology (master's degree or equivalent). The title of "psychotherapist" is not legally protected. As of 2016, Belgian law recognizes the clinical psychologist as an autonomous health profession. It reserves the practice of psychotherapy to medical doctors, clinical psychologists and clinical orthopedagogists.[26]

Finland[edit]

In Finland, the title "psychologist" is protected by law. The restriction for psychologists (licensed professionals) is governed by National Supervisory Authority for Welfare and Health (Finland) (Valvira).[27] It takes 330 ECTS-credits (about six years) to complete the university studies (master's degree). There are about 6,200 licensed psychologists in Finland.[28]

Germany[edit]

In Germany, the use of the title Diplom-Psychologe (Dipl.-Psych.) is restricted by law, and a practitioner is legally required to hold the corresponding academic title, which is comparable to a higher M.Sc. degree and requires at least five years of training at a university. Originally, a diploma degree in psychology awarded in Germany included the subject of clinical psychology. With the Bologna-reform, this degree was replaced by a master's degree. The academic degree of Diplom-Psychologe or M.Sc. (Psychologie) does not include a psychotherapeutic qualification, which requires three to five years of additional training. The psychotherapeutic training combines in-depth theoretical knowledge with supervised patient care and self-reflection units. After having completed the training requirements, psychologists take a state-run exam, which, upon successful completion (Approbation), confers the official title of "psychological psychotherapist" (Psychologischer Psychotherapeut).[29] After many years of inter-professional political controversy, non-physician psychotherapy was given an adequate legal foundation through the creation of two new academic healthcare professions.[30]

Greece[edit]

Since 1979, the title "psychologist" has been protected by law in Greece. It can only be used by people who hold a relevant license to practice as a psychologist. The minimum requirement is the completion of university training in psychology at a Greek university, or at a university recognized by the Greek authorities.[31]

The Netherlands[edit]

In the Netherlands, the title of "psychologist"[32] is not restricted by law. The Dutch professional association of psychologists (NIP), using trademark law, posited its own title "Psychologist NIP" (Psycholoog NIP). This title is granted exclusively to holders of a master's degree in psychology after a year of postgraduate experience. The titles "psychotherapist" (psychotherapeut) and "healthcare psychologist" (gz-psycholoog for gezondheidszorgpsycholoog) are restricted through the Individual Healthcare Professions Act (wet BIG) to those who have followed further postgraduate (PsyD/DPsych or licentiate level) training. The use of the titles "clinical psychologist" (klinisch psycholoog) and "clinical neuropsychologist" (klinisch neuropsycholoog) are reserved for those who have followed specialist post-licentiate training.

New Zealand[edit]

In New Zealand, the use of the title "psychologist" is restricted by law. Prior to 2004, only the title "registered psychologist" was restricted to people qualified and registered as such. However, with the proclamation of the Health Practitioners Competence Assurance Act, in 2003, the use of the title "psychologist" was limited to practitioners registered with the New Zealand Psychologists Board. The titles "clinical psychologist", "counseling psychologist", "educational psychologist", "intern psychologist", and "trainee psychologist" are similarly protected.[33] This is to protect the public by providing assurance that the title-holder is registered and therefore qualified and competent to practice, and can be held accountable. The legislation does not include an exemption clause for any class of practitioner (e.g., academics, or government employees).

South Africa[edit]

South African psychologist Pumla Gobodo-Madikizela.

In South Africa,[34] psychologists are qualified in either clinical, counseling, educational, organizational, or research psychology. To become qualified, one must complete a recognized master's degree in Psychology, an appropriate practicum at a recognized training institution,[35] and take an examination set by the Professional Board for Psychology.[36] Registration with the Health Professions Council of South Africa (HPCSA)[37] is required and includes a Continuing Professional Development component. The practicum usually involves a full year internship, and in some specializations, the HPCSA requires completion of an additional year of community service. The master's program consists of a seminar, coursework-based theoretical and practical training, a dissertation of limited scope, and is (in most cases) two years in duration. Prior to enrolling in the master’s program, the student studies psychology for three years as an undergraduate (B.A. or B.Sc., and, for organizational psychology, also B.Com.), followed by an additional postgraduate honours degree in psychology; see List of universities in South Africa. Qualification thus requires at least five years of study and at least one internship. The undergraduate B.Psyc. is a four-year program integrating theory and practical training, and—with the required examination set by the Professional Board for Psychology—is sufficient for practice as a psychometrist or counselor.[38]

Sweden[edit]

In Sweden, the title "psychologist" is restricted by law. It can only be used after receiving a license from the government. The basic requirements are a completed five-year specialized course in psychology (the equivalent of a master's degree) and twelve months of practice under supervision. All other uses are banned, though often challenged.

The title "Psychotherapist" is governed by similar rules, but the basic educational demands require another one-and-a-half years (spread out over three years) in a specialized course in psychotherapy (courses vary regarding theory), in addition to an academic-level degree within a field concerning the treatment of people (psychologist, social worker, psychiatrist).

United Kingdom[edit]

In the UK, "registered psychologist" and "practitioner psychologist" are protected titles.[39] The title of "neuropsychologist" is not protected.[39] In addition, the following specialist titles are also protected by law: "clinical psychologist", "counselling psychologist", "educational psychologist", "forensic psychologist", "health psychologist", "occupational psychologist" and "sport and exercise psychologist".[40] The Health and Care Professions Council (HCPC) is the statutory regulator for practitioner psychologists in the UK. In the UK, the use of the title "chartered psychologist" is also protected by statutory regulation, but that title simply means that the psychologist is a chartered member of the British Psychological Society, but is not necessarily registered with the HCPC. However, it is an offense for someone who is not in the appropriate section of the HCPC register to provide psychological services.[41] The requirement to register as a clinical, counseling, or educational psychologist is a professional doctorate (and in the case of the latter two the British Psychological Society's Professional Qualification, which meets the standards of a professional doctorate).[42] The title of "psychologist", by itself, is not protected.[39] The British Psychological Society is working with the HCPC to ensure that the title of "neuropsychologist" is regulated as a specialist title for practitioner psychologists.[citation needed]

In the UK, clinical psychologists undertake a doctorate in Clinical Psychology (D.Clin.Psych., Clin.Psy.D., or similar), which has both clinical and research components. This is a three-year full-time salaried program provided by thirty centers across the UK, sponsored by the National Health Service (NHS). These clinical-psychology doctoral degrees are accredited by the British Psychological Society and the HCPC. Entry into these programs is highly competitive and requires at least a three-year undergraduate degree in psychology, plus some form of experience, usually in either the NHS, as an assistant psychologist, or in academia, as a Research Assistant.[43][44] More information about the path to training in the UK can be found at the central clearing house for clinical psychology training applications, and at www.ClinPsy.org.uk, where questions can be answered on the forum run by qualified UK clinical psychologists.

Employment[edit]

As of December 2012, in the United Kingdom, there are 19,000 practitioner psychologists registered[45] across seven categories: clinical psychologist, counseling psychologist, educational psychologist, forensic psychologist, health psychologist, occupational psychologist, sport and exercise psychologist. At least 9,500 of these are clinical psychologists,[46] which is the largest group of psychologists in clinical settings such as the NHS. Around 2,000 are educational psychologists.[47]

United States and Canada[edit]

Regulation[edit]

A professional in the U.S. or Canada must hold a graduate degree in psychology (MA, Psy.D., Ed.D., or Ph.D.), or have a state license to use the title psychologist.[48][49] The exception to this is the profession of school psychology, which most states certify or license separately or under different requirements than healthcare provider psychologists. The most commonly recognized psychology professionals are clinical and counseling psychologists, who provide psychotherapy, or administer and interpret psychological tests. Requirements vary state-by-state for academics in psychology, as well as for government employees.

Psychologists in the United States campaigned for legislative changes to enable specially trained psychologists to prescribe psychiatric medicine. New legislation in Idaho, Iowa, Louisiana, New Mexico, and Illinois has granted those who take an additional masters program in psychopharmacology permission to prescribe medications for mental and emotional disorders, in coordination with the patient's physician.[50] As of 2009, Louisiana is the only state where the licensing and regulation of the practice of psychology by medical psychologists who prescribe medications is regulated by a medical board (the Louisiana State Board of Medical Examiners) rather than a board of psychologists.[51] While other states have pursued prescriptive privileges, they have not succeeded. Similar legislation in the states of Hawaii and Oregon passed through their respective legislative bodies, but in each case the legislation was vetoed by the state's governor.[50]

In 1989, the U.S Department of Defense was directed to create the Psychopharmacology Demonstration Project. By 1997, ten psychologists were trained in psychopharmacology and granted the ability to prescribe psychiatric medications.[52]

In the United States and Canada, full membership in the American Psychological Association requires doctoral training (except in some Canadian provinces, such as Alberta, where a master's degree is sufficient).[a] The minimal requirement for full membership can be waived in circumstances where there is evidence that significant contribution or performance in the field of psychology has been made. Associate membership requires at least two years of postgraduate studies in psychology or an approved related discipline.[53]

Sample Curriculum for MA in Clinical Psychology in the U.S.
State Required School Required Electives

Chemical Dependency: 3
Human Sexuality: 2
Child Abuse: 2
Domestic Violence: 2
Aging: 2
Ethics & Law: 3
Psychological Testing: 3
Psychopharmacology: 3

Process and Psychotherapy: 4
Personality Theory: 6
Cross-Cultural: 3
Comparative Theories: 6
Psychology and Society: 2
Systems Theory & Family: 5
Assessing and Planning: 3
Brief Therapy: 2
Group and Couples Treatment: 6
Applied Therapeutic Techniques: 9
Developmental Psych and pathology: 9

Gay and Lesbian Issues: 2
ADHD: 1
Crisis Intervention: 2
Cognitive/Behavioral: 2
Existential Psychology: 2
Clinical Intervention with Adolescents: 2
Narratives of Women's Lives: 2

Where subject is required by both the state and the school, it is shown under the school's required column. Similar courses have been lumped together, for example, "Group Treatment Techniques" and "Couples Counseling" were combined, their units added together and called "Group and Couples Treatment"—just to keep the table of manageable size.

Schooling[edit]

The University of Pennsylvania was the first institution to offer formal education in clinical psychology. in U.S.

There are a number of U.S. schools offering accredited programs in clinical psychology resulting in a master's degree. Such programs can range from forty-eight to eighty-four units, most often taking two to three years to complete after the undergraduate degree. Training usually emphasizes theory and treatment over research, quite often with a focus on school, or couples and family counseling. Similar to doctoral programs, master's level students usually must fulfill time in a clinical practicum under supervision; some programs also require a minimum amount of personal psychotherapy.[54] While many graduates from master's level training go on to doctoral psychology programs, a large number also go directly into practice—often as a licensed professional counselor (LPC), marriage and family therapist (MFT), or other similar licensed practice.[citation needed]

There is stiff competition to gain acceptance into clinical psychology doctoral programs (acceptance rates of 2-5% are not uncommon). Clinical psychologists in the U.S. undergo many years of graduate training—usually five to seven years after the bachelor's degree—to gain demonstrable competence and experience. Licensure as a psychologist takes an additional one to two years post Ph.D./Psy.D. (licensure requires 3,000 hours of supervised training), depending on the state. Today in America, about half of all clinical psychology graduate students are being trained in Ph.D. programs that emphasize research and are conducted by universities—with the other half in Psy.D. programs, which have more focus on practice (similar to professional degrees for medicine and law).[55] Both types of doctoral programs (Ph.D. and Psy.D.) envision practicing clinical psychology in a research-based, scientifically valid manner, and most are accredited by the American Psychological Association.[56]

APA accreditation[57] is very important for U.S. clinical, counseling, and school psychology programs because graduating from a non-accredited doctoral program may adversely affect employment prospects and present a hurdle for becoming licensed in some jurisdictions.[58][59][60][61]

Doctorate (Ph.D. and Psy.D.) programs usually involve some variation on the following 5 to 7 year, 90-120 unit curriculum:

  • Bases of behavior—biological, cognitive-affective and cultural-social
  • Individual differences—personality, lifespan development, psychopathology
  • History and systems—development of psychological theories, practices and scientific knowledge
  • Clinical practice—diagnostics, psychological assessment, psychotherapeutic interventions, psychopharmacology, ethical and legal issues
  • Coursework in statistics and research design
  • Clinical experience
    • Practicum—usually three or four years of working with clients under supervision in a clinical setting. Most practicum placements begin in either the first or second year of doctoral training
    • Doctoral internship—usually an intensive one or two-year placement in a clinical setting
  • Dissertation—Ph.D. programs usually require original quantitative empirical research, while Psy.D. dissertations involve original quantitative or qualitative research, theoretical scholarship, program evaluation or development, critical literature analysis or clinical application and analysis. The dissertation typically takes 2-3 years to complete.
  • Specialized electives—many programs offer sets of elective courses for specializations, such as health, child, family, community or neuropsychology
  • Personal psychotherapy—many programs require students to undertake a certain number of hours of personal psychotherapy (with a non-faculty therapist) although in recent years this requirement has become less frequent.
  • Comprehensive exams or master's thesis: A thesis can involve original data collection and is distinct from a dissertation

Licensure[edit]

The practice of clinical psychology requires a license in the United States, Canada, the United Kingdom, and many other countries. Although each of the U.S. states is different in terms of requirements and licenses (see [1] and [2] for examples), there are three common requirements:[62]

  1. Graduation from an accredited school with the appropriate degree
  2. Completion of supervised clinical experience
  3. Passing a written examination and, in some states, an oral examination

All U.S. state, and Canada provincial, licensing boards are members of the Association of State and Provincial Psychology Boards (ASPPB) which created and maintains the Examination for Professional Practice in Psychology (EPPP). Many states require other examinations in addition to the EPPP, such as a jurisprudence (i.e. mental health law) examination or an oral examination.[62] Most states also require a certain number of continuing education credits per year in order to renew a license. Licencees can obtain this through various means, such as taking audited classes and attending approved workshops.

There are professions whose scope of practice overlaps with the practice of psychology (particularly with respect to providing psychotherapy) and for which a license is required.

  • Psychologist. To practice with the title of "psychologist", in almost all cases a doctorate degree is required (a PhD or PsyD in the U.S.). Normally, after the degree, the practitioner must fulfill a certain number of supervised postdoctoral hours ranging from 1,500-3,000 (usually taking one to two years), and passing the EPPP and any other state or provincial exams.[63]
  • Marriage and Family Therapist (MFT). An MFT license requires a doctorate or master's degree. In addition, it usually involves two years of post-degree clinical experience under supervision, and licensure requires passing a written exam, commonly the National Examination for Marriage and Family Therapists, which is maintained by the American Association for Marriage and Family Therapy. In addition, most states require an oral exam. MFTs, as the title implies, work mostly with families and couples, addressing a wide range of common psychological problems.[64] Some jurisdictions have exemptions that let someone practice marriage and family therapy without meeting the requirements for a license. That is, they offer a license but do not require that marriage and family therapists obtain one.[65]
  • Licensed Professional Counselor (LPC). Similar to the MFT, the LPC license requires a master's or doctorate degree, a minimum number of hours of supervised clinical experience in a pre-doc practicum, and the passing of the National Counselor Exam. Similar licenses are the Licensed Mental Health Counselor (LMHC), Licensed Clinical Professional Counselor (LCPC), and Clinical Counselor in Mental Health (CCMH). In some states, after passing the exam, a temporary LPC license is awarded and the clinician may begin the normal 3000-hour supervised internship leading to the full license allowing to practice as a counselor or psychotherapist, usually under the supervision of a licensed psychologist.[66] Some jurisdictions have exemptions that allow counseling to practice without meeting the requirements for a license. That is, they offer a license but do not require that counselors obtain one.[65]
  • Licensed Psychological Associate (LPA) Twenty-six states offer a master's-only license, a common one being the LPA, which allows for the therapist to either practice independently, or, more commonly, under the supervision of a licensed psychologist, depending on the state.[67] Common requirements are two to four years of post-master's supervised clinical experience and passing a Psychological Associates Examination. Other titles for this level of licensing include psychological technician (Alabama), psychological assistant (California), licensed clinical psychotherapist (Kansas), licensed psychological practitioner (Minnesota), licensed behavioral practitioner (Oklahoma), licensed psychological associate (North Carolina) or psychological examiner (Tennessee).
  • Licensed behavior analysts
Main article: Professional practice of behavior analysis
Licensed behavior analysts are licensed in five states to provide services for clients with substance abuse, developmental disabilities, and mental illness. This profession draws on the evidence base of applied behavior analysis and the philosophy of behaviorism. Behavior analysts have at least a master's degree in behavior analysis or in a mental health related discipline, as well as having taken at least five core courses in applied behavior analysis. Many behavior analysts have a doctorate. Most programs have a formalized internship program, and several programs are offered online. Most practitioners have passed the examination offered by the Behavior Analysis Certification Board.[3] The model licensing act for behavior analysts can be found at the Association for Behavior Analysis International's website.

Employment[edit]

Comparison of mental health professionals in USA
Occupation Degree Common Licenses Prescription Privilege Ave. 2004
Income (USD)
Clinical Psychologist PhD/PsyD Psychologist Mostly no $75,000
Counseling Psychologist (Doctorate) PhD/PsyD Psychologist No $65,000
Counseling Psychologist (Master's) MA/MS/MC MFT/LPC/LPA No $49,000
School Psychologist PhD, EdD Psychologist No $78,000
Psychiatrist MD/DO Psychiatrist Yes $145,600
Clinical Social Worker PhD/MSW LCSW No $36,170
Psychiatric Nurse PhD/MSN/BSN APRN/PMHN No $53,450
Psychiatric and mental health Nurse Practitioner DNP/MSN MHNP Yes (Varies by state) $75,711
Expressive/Art Therapist MA ATR No $45,000

In the United States, of 170,200 jobs for psychologists, 152,000 are employed in clinical, counseling, and school positions; 2,300 are employed in industrial-organizational positions, and 15,900 are in "all other" positions.

The median salary in the U.S., in 2012, for clinical, counseling, and school psychologists was USD$69,280 and the median salary for organizational psychologists was USD$83,580.[1][74]

See also[edit]

Notes[edit]

  1. ^ APA membership is not a requirement for licensure in any of the 50 states. This fact should not be confused with APA accreditation of graduate psychology programs and clinical internships.

References[edit]

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  2. ^ "What's the Difference Between a Counselor and a Psychologist?" Oregon Unlicensed Practitioners, 27 January 2015
  3. ^ See: Scientist–practitioner model and Practitioner-scholar model
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  25. ^ e.g. Australian Counseling Association and Psychotherapy and Counseling Federation of Australia
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  27. ^ Professional practice rights 12 December 2008 by valvira.fi
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