Counseling Psychology vs. Clinical Psychology

Many times I've spoken with people in the psychology field or interested in the psychology field who have no idea what "counseling psychology" is and often have misperceptions about it, although they've heard of clinical psychology. I'd like to break down the differences and similarities in the current field of psychological practice. Note that I say "current" because each field has different foundations and philosophies, but seemingly fewer differences in terms of how they are actually practiced in job settings today. First, let's dispel the most common myths about counseling psychology:

  • MYTH #1: Counseling psychology practice is "therapy-lite." Some people in the field of psychology still believe that counseling psychology is therapy for people struggling with life challenges like adjustment, career, and life transitions only. Not so. Both counseling and clinical programs train students to assess, diagnose, and treat mental illness AND more general life challenges. Both can work in hospital settings, VAs, college counseling, private practice, prisons, non-profits, community mental health, universities as professors, etc. Both can provide individual therapy, couples therapy, group therapy, family therapy, supervision, cognitive assessments, consultation, etc. Both are licensed as "licensed psychologists" by state boards; there is usually no distinction by state boards after licensure (however, it should be noted that this varies by state).

  • MYTH #2: Counseling psychology isn't as scientifically rigorous as clinical psychology. This is determined by the graduate program's training philosophy (scientist-practitioner vs. practitioner-scholar) rather than counseling vs. clinical tracks. The vast majority of counseling psychology doctoral programs are science-based. For example, my counseling psychology alma mater was 50% science/research, 50% practice-related, which is the standard in scientist-practitioner programs within both counseling and clinical psychology. My program’s research requirements to complete the program were actually higher than some clinical folks I spoke with (I had to complete a predissertation and a dissertation to graduate; others just complete a dissertation).

  • MYTH #3: Counseling psychology is "easier" to get into, not as competitive, etc. According to APA's website search feature (in 2017), there were 75 APA-accredited counseling psychology programs, while there were 242 APA-accredited clinical psychology doctoral programs in the U.S. By sheer numbers alone, there are fewer counseling psychology doctoral programs to apply to. Per APA data from 2016, counseling psychology doctoral programs offer fewer acceptances overall, and their admissions rate averages 11% compared to clinical psychology's 12% acceptance rate average. The admissions rates to both programs are comparable. That said, there are nuances. Some psychologists argue that for-profit PsyD clinical psychology programs* inflate the acceptance rate, creating a much wider range of acceptance rates across clinical psychology programs. Fair point; counseling psychology appears to have a more restricted range of acceptance rates overall, but ultimately, the rates average out to be comparable. The more recent APA study in 2019 reported similar acceptance rates: 12.8% acceptance for clinical, 10.8% acceptance rates for counseling (a 2% difference). These percentages have been fairly steady over the past decade, with only slight changes.

    *Of note, APA does not separate acceptances by clinical PsyD vs. PhD at this time, and debating the quality of training of a PsyD vs. a PhD is beyond the scope of this post.

Now that we've dispelled the common myths, let's discuss the true differences. Those differences are history and foundation (per APA Div. 17 Website): "Clinical psychologists have traditionally studied disturbances in mental health, while counseling psychologists’ earliest role was to provide vocational guidance and advice. Today, though, the differences between psychologists from each specialty are more nuanced, and there are perhaps more similarities than differences among individual psychologists from each field."

Counseling psychology arose from vocational/career counseling and guidance and helping people adjust to life challenges, whereas clinical psychology arose from treating mental illness, a legacy of the field of psychiatry (starting with Freud and his contemporaries). However, both fields began to overlap significantly in the late-1900s, and both fields promote and advance psychological science and the practice of psychology today.

According to Division 17 of APA (Society of Counseling Psychology), "The practice of counseling psychology encompasses a broad range of culturally-sensitive practices that help people improve their well-being, alleviate distress and maladjustment, resolve crises, and increase their ability to function better in their lives. With its  attention to both to normal developmental issues and problems associated with physical, emotional, and mental disorders, the specialization holds a unique perspective in the broader practice-based areas of psychology." In a nutshell, counseling psychology seeks culturally-sensitive practices when providing therapy, and counseling psychologists treat a wide range of concerns, including but not limited to mental illness.

As a counseling psychologist, the biggest difference I've been aware of between clinical and counseling psychology is my identity as a counseling psychologist: I came from a foundation that celebrates diversity and infused diversity/social justice training throughout my education. Several colleagues of mine in counseling psychology conducted research in multicultural perspectives and issues. Viewing mental illness and life challenges through a cultural lens is what I consider to be a unique influence of my counseling psychology training, and part of my professional identity. This is not to say that clinical psychology programs do not have multicultural training at all, but a multicultural course was not required for clinical programs by APA at the time of my graduate training (although APA required counseling programs to include it as part of the curriculum), and historically, there has been less emphasis on multicultural research & practice in clinical psychology programs.

In sum, in practice today, clinical and counseling psychologists are both trained to provide psychotherapy and assess, treat, and diagnose mental illness, but also treat a myriad of issues that may or may not be considered "mental illness." You may see more clinical psychologists employed in certain settings and more counseling psychologists employed in others, but there is such a high degree of overlap that these differences seem to be more a legacy of history than differences in training. However, finding a counseling psychologist is a rarity because there are so few counseling psychology doctoral programs in the United States compared to clinical psychology programs. We are a little like unicorns in the field in the states that lack counseling psychology doctoral programs!

I’ve had the opportunity to work alongside clinical psychology folks—performing the exact same roles. In my experiences, there is no difference between the two in practice. The real differences lie in perspective and history/foundation rather than scientific involvement or populations that we work with.