What is the National Alliance on Mental Illness?


The National Alliance on Mental Illness (NAMI) is a United States-based advocacy group originally founded as a grassroots group by family members of people diagnosed with mental illness.

NAMI identifies its mission as “providing advocacy, education, support and public awareness so that all individuals and families affected by mental illness can build better lives” and its vision as “a world where all people affected by mental illness live healthy, fulfilling lives supported by a community that cares”. NAMI offers classes and trainings for people living with mental illnesses, their families, community members, and professionals, including what is termed psychoeducation, or education about mental illness. NAMI holds regular events which combine fundraising for the organization and education, including Mental Illness Awareness Week and NAMIWalks.

Headquartered in Arlington, Virginia, NAMI has around 1,000 state and local affiliates and is represented in all 50 US states, Washington, D.C., and Puerto Rico. NAMI is funded primarily through pharmaceutical company donations. Additional funding comes from individual donors, as well as sponsorships and grants. NAMI publishes a magazine around twice a year called The Advocate. NAMI also runs a HelpLine five days a week, which is funded in part by pharmaceutical companies Janssen and Lundbeck.

Brief History

NAMI was founded in Madison, Wisconsin, by Harriet Shetler and Beverly Young. The two women both had sons diagnosed with schizophrenia, and “were tired of being blamed for their sons’ mental illness”. Unhappy with the lack of services available and the treatment of those living with mental illness, the women sought out others with similar concerns. The first meeting held to address these issues in mental health led to the formation of the National Alliance for the Mentally Ill in 1979. In 1997, the legal name was changed to the acronym NAMI by a vote of the membership due to concerns that the name National Alliance for the Mentally Ill did not use person-first language. In 2005, the meaning of NAMI was changed to the backronym National Alliance on Mental Illness.


NAMI identifies its mission as to promote recovery by preserving and strengthening family relationships “affected by mental illness”. NAMI’s programmes and services include education, support groups, informational publications, and presentations. Although originally focused primarily on family members, in more recent years NAMI has moved toward trying to include people diagnosed with mental illness as well (although activists have criticised these efforts). In addition, NAMI has a strong focus on discriminatory attitudes and behaviours about mental illness (what they term stigma); another identified goal is “to increase public and professional understanding”, and “to improve the mental health system”.


The National Alliance on Mental Illness is a 501(c)(3) non-profit run by a board of directors who are elected by membership. NAMI National is the umbrella organisation; state and local affiliates operate semi-independently, in an attempt to more accurately represent those in the surrounding communities. Since 2015, NAMI has been using a four-year strategic plan which expires in 2019.

The national chief executive officer from 2014-2019 was Mary Giliberti, who resigned on 24 April 2019. She was immediately preceded by Michael Fitzpatrick. Gilberti, who has a law degree from Yale University and clerked for Judge Phyllis A. Kravitch. Before coming to NAMI, Giliberti worked as a senior attorney at Bazelon Centre for Mental Health Law for almost ten years and the Senate Health, Education, Labour, and Pensions Committee from 2008 to 2014. She worked for NAMI National during this time as the director of public policy and advocacy for federal and state issues. In 2017, she was “appointed by the Secretary of the U.S. Department of Health and Human Service (HHS) to serve as one of 14 non-federal members of HHS’ Interdepartmental Serious Mental Illness Coordinating Committee.”

National and state NAMI organisations function to provide Governance, Public Education, Political Advocacy, and management of NAMI’s Educational Programmes. At the local level, the local NAMI chapters also provide assistance in obtaining mental health resources, scheduling and administration of NAMI’s programmes, and hosting local meetings and events for NAMI members.

In February 2020, NAMI Sioux Falls has merged with the South Dakota Office. The move was a result of a decision by the national NAMI office.


In 2017, NAMI partnered with Alpha Kappa Alpha (since 2015), Instagram, tumblr, Women’s Health, Fox Sports, Stanley Centre for Psychiatric Research at Broad Institute, Jack and Jill of America, The Jed Foundation, and Lokai. Celebrity partnerships included Utkarsh Ambudkar, Maria Bamford, Andrea Barber, AJ Brooks, Sterling K. Brown, Corinne Foxx, Naomi Judd, Dawn McCoy, Stefania Owen, Alessandra Torresani, Wil Wheaton, DeWanda Wise, and Chris Wood.

Philosophy and Positions

NAMI generally endorses a medical model approach to mental illnesses, and previously was a major proponent of terming them “serious brain disorders” during the “decade of the brain”. NAMI endorses the term anosognosia, or “that someone is unaware of their own mental health condition or that they can’t perceive their condition accurately”. While NAMI previously referred to mental illnesses as “serious brain disorders”, current advice on their “How we talk about NAMI” page recommends against this language.


NAMI programmes are generally in the area of support and education for individuals and families, often for no cost. The programmes are set up through local NAMI Affiliate organisations, with different programmes varying in their targeted audience.

NAMI Family-to-Family

The NAMI Family-to-Family Education Programme is a free eight-week course targeted toward family and friends of individuals with mental illness, providing education from a medical model perspective of mental illness. Originally offered as a twelve-week programme, but updated to a shorter model in 2020, the courses are taught by a NAMI-trained family member of a person diagnosed with a psychiatric disorder. Family-to-Family is taught in 44 states, and two provinces in Canada. The programme was developed by clinical psychologist Joyce Burland. Facilitators are required to teach material from the curriculum without alteration.


The Family-to-Family programme provides general information about mental illness and how it is currently treated from a medical model perspective. The programmes cover mental illnesses including schizophrenia, depression, bipolar disorder, etc., as well as the indications and side effects of medications. Family-to-Family takes a biologically-based approach to explaining mental illness and its treatments.

According to the NAMI website, Family-to-Family programme states its goals as teaching coping and advocacy skills, providing mutual support, how to “handle a crisis”, “information on mental health conditions and how they affect the brain”, and locating resources in the community

Evidence Base

The NAMI Family-to-Family programme has initial research evidence; one randomised clinical trial showed gains in empowerment, increases in problem solving and reductions in participant anxiety scores following the class; these changes persisted at 6 month follow up. These studies confirm an earlier finding that Family-to-Family graduates describe a permanent transformation in the understanding and engagement with mental illness in themselves and their family. Because a randomized controlled trial is at risk of poor external validity by mechanism of self-selection, Dixon and colleges sought out to strengthen the evidence base by confirming the benefits attributed to Family-to-Family with a subset of individuals who declined participation during initial studies.

The NAMI Family-to-Family programme was found to increase self efficacy in family members involved in caring for a family member with schizophrenia while reducing subjective burden and need for information. In light of recent research, Family-to-Family was added to the SAMHSA National Registry of Evidence-Based Programmes and Practices (NREPP), although as of January 2018 this database and designation has been eliminated by SAMHSA.

NAMI Peer-to-Peer

The NAMI Peer-to-Peer is an eight-week educational programme aimed at adults diagnosed with a mental illness. The NAMI Peer-to-Peer programme describes the course as a holistic approach to recovery through lectures, discussions, interactive exercises, and teaching stress management techniques. The programme provides information about biological explanations of mental illness, symptoms, and personal experiences. The programme also includes information about interacting with healthcare providers as well as decision making and stress reducing skills. The Peer-to-Peer philosophy is advertised as being centred around certain values such as individuality, autonomy, and unconditional positive regard. The programme is also available in Spanish.

Preliminary studies have suggested Peer-to-Peer provided many of its purported benefits (e.g. self-empowerment, disorder management, confidence). Peer interventions in general have been studied more extensively, having been found to increase social adjustment.

NAMI In Our Own Voice

The NAMI In Our Own Voice (IOOV) programme started as a mental health consumer education program for people living with schizophrenia in 1996, and was further developed to IOOV with grant funding from Eli Lily & Co. in 2002. The programme was based on the idea that those successfully living with mental illness were experts in a sense, and sharing their stories would benefit those with similar struggles. The programme approached this by relaying the idea that recovery is possible, attempting to build confidence and self-esteem. Because of the initial success of the programme and positive reception, IOOV also took on the role of public advocacy.

NAMI In Our Own Voice involves two trained speakers presenting personal experiences related to mental illness, in front of an audience. Unlike the majority of NAMI’s programmes, IOOV consists of a single presentation educating groups of individuals with the acknowledgement many are likely unfamiliar with mental illness. The programme’s aims include raising awareness regarding NAMI and mental illness in general, addressing stigma, and empowering those affected by mental illness. Other than those directly affected by mental illness, In Our Own Voice often educates groups of individuals like law enforcement, politicians, and students.

In Our Own Voice has been shown to be superior at reducing self stigmatisation of families when compared to clinician led education. Research into the effectiveness of the NAMI In Our Own Voice programme has shown the programme also can be of benefit to Graduate level therapists and adolescents. A 2016 study evaluating IOOV in California found significant reductions in desire for social distancing after attending an IOOV presentation, although no validated measures were used in the evaluation.

NAMI Basics

The NAMI Basics Programme is a six-session course for parents or other primary caregivers of children and adolescents living with mental illness. NAMI Basics is conceptually similar to NAMI Family-to-Family in that it aims to educate families, but recognises providing care for a child living with mental illness presents unique challenges in parenting, and that mental illness in children typically manifest differently than in adults. Because of the development of the brain and nervous system throughout childhood and adolescence, information regarding mental illness biology and its presentation is fundamentally different from with adults. The NAMI Basics programme has a relatively short time course to accommodate parents’ difficulty in attending because of their caregiver status.

NAMI Connection

The NAMI Connection Recovery Support Group Programme is a weekly support group for adults living with mental illness. The programme is for adults 18+ diagnosed with mental illness and groups are usually weekly for 90 minutes. The support groups are led by trained facilitators who identify as having experienced mental illness themselves.

NAMI On Campus

NAMI On Campus is an initiative for university students to start NAMI On Campus organisations within their respective universities. NAMI On Campus was started to address the mental health issues of college-aged students. Adolescence and early adulthood are periods where the onset of mental illness is common, with 75% of mental illnesses beginning by age 24. When asked what barriers, if any, prevented them from gaining support and treatment, surveys found stigma to be the number one barrier.

Ending the Silence

This 50-minute or one hour programme is available for students, school staff, and family members. It involves two presenters: one who shares educational information and one who is a young adult living well in recovery who shares their personal story. This programme has been shown to improve the mental health knowledge of middle- and high school students.

In 2017, Former Second Lady of the United States Tipper Gore gave a $1 million donation to the Ending the Silence programme.


NAMI receives funding from both private and public sources, including corporations, federal agencies, foundations and individuals. NAMI maintains that it is committed to avoiding conflicts of interest and does not endorse nor support any specific service or treatment. Records of NAMI’s quarterly grants and contributions since 2009 are freely available on its website.

In 2017, NAMI had a 16% increase in overall revenue.


The 2017 annual report noted “$11.3 million raised across the country by 68,000 participants.”


The funding of NAMI by multiple pharmaceutical companies was reported by the investigative magazine Mother Jones in 1999, including that an Eli Lilly & Company executive was then “on loan” to NAMI working out of NAMI headquarters.

During a 2009 investigation into the drug industry’s influence on the practice of medicine, US Senator Chuck Grassley (R-IA) sent letters to NAMI and about a dozen other influential disease and patient advocacy organisations asking about their ties to drug and device makers. The investigation confirmed pharmaceutical companies provided a majority of NAMI’s funding, a finding which led to NAMI releasing documents listing donations over $5,000.

Dr. Peter Breggin refers to NAMI as an “AstroTurf lobbying organisation” of the “psychopharmaceutical complex”.

What is the International Society for Bipolar Disorders?


The International Society for Bipolar Disorders (ISBD) is a non-profit organisation based in Pittsburgh, Pennsylvania, where it was founded 17 June 1999. The society focuses on research and education in bipolar disorders.

The society has a membership consisting of mental health professionals and patients and their family members representing 50 countries. The mission of the society is to advance the treatment of all aspects of bipolar disorder, thereby improving patient outcomes and quality of life, through fostering international collaboration in education and research. The society hosts biennial professional meetings and offers educational programmes. The official journal of the society is Bipolar Disorders and a subscription is included with membership.

Brief History

The ISBD was founded at the 3rd International Conference on Bipolar Disorder, in Pittsburgh, Pennsylvania, in June 1999 by David J. Kupfer and Thomas Detre (University of Pittsburgh Medical Centre). In September 1999, the official peer-reviewed society journal, Bipolar Disorders, published its first issue.

The ISBD held its first meeting in Sydney, Australia, in February 2004 with over 400 participants in attendance. The society held its second meeting in August 2006 in Edinburgh, Scotland, with over 600 attendees. As of 2013, the society has over 800 members in 50 countries with an elected board representing 15 countries.

Educational Programmes

The society supports the following educational initiatives:

  • The Psychiatric Trainee Support programme:
    • Offers psychiatric trainees a free two-year membership in the society in order to enhance knowledge of bipolar disorder among this group, narrow the gap between bipolar research and clinical practice, and ultimately to improve diagnosis, treatment and outcomes for patients with bipolar disorder.
    • These supported memberships are open to psychiatric residents, postgraduate students and junior faculty up to the Assistant Professor or equivalent level with less than five years as faculty in their career trajectory.
    • The programmes seek to support 70% of trainees from developing countries.
  • The Samuel Gershon Awards for Junior Investigators:
    • Named in honour of Samuel Gershon, past ISBD President and pioneer of early lithium research, offer four awards for original research submissions.
    • Awards are based on the originality of the content, as well as the significance of the findings reported, and are evaluated by an international scientific panel under the auspices of the ISBD.
    • These awards are open to psychiatric trainees, postgraduate students and junior faculty up to the assistant professor rank from around the world.
    • The awards are presented in conjunction with the society’s biennial meeting where the winners present their research in a special session showcasing the work of junior people in the field.
  • The ISBD Research Fellowship for Junior Investigators:
    • Provides an opportunity for the recipient to travel to another facility to get training in a particular type of research methodology (i.e. brain imaging, genetics, clinical trials, etc.).
    • The fellowship is intended to cover up to six months support for salary, travel, or some combination of these costs as they are incurred in pursuit of additional training.
    • This could take the form of summer programs, participation in smaller prospective studies, or through some other opportunity.


The society organises biennial meetings that provides updates on topics such as epidemiology, pharmacotherapy, psychotherapies, genetics, neurobiology, imaging research, and bipolar disorder in special populations.

What is World Mental Health Day (2021)?


World Mental Health Day (10 October) is an international day for global mental health education, awareness and advocacy against social stigma.


It was first celebrated in 1992 at the initiative of the World Federation for Mental Health, a global mental health organisation with members and contacts in more than 150 countries.

This day, each October, thousands of supporters come to celebrate this annual awareness programme to bring attention to mental illness and its major effects on peoples’ lives worldwide.

In some countries this day is part of an awareness week, such as Mental Health Week in Australia.

Brief History

World Mental Health Day was celebrated for the first time on 10 October 1992, at the initiative of Deputy Secretary General Richard Hunter. Up until 1994, the day had no specific theme other than general promoting mental health advocacy and educating the public.

In 1994 World Mental Health Day was celebrated with a theme for the first time at the suggestion of then Secretary General Eugene Brody. The theme was “Improving the Quality of Mental Health Services throughout the World”.

World Mental Health Day is supported by WHO through raising awareness on mental health issues using its strong relationships with the Ministries of health and civil society organizations across the globe. WHO also supports with developing technical and communication material.

On World Mental Health Day 2018, Prime Minister Theresa May appointed Jackie Doyle-Price as the UK’s first suicide prevention minister. This occurred while as the government hosted the first ever global mental health summit.

World Mental Health Day Themes

  • 1994 – Improving the Quality of Mental Health Services throughout the World.
  • 1996 – Women and Mental Health.
  • 1997 – Children and Mental Health.
  • 1998 – Mental Health and Human Rights.
  • 1999 – Mental Health and Aging.
  • 2000-2001 – Mental Health and Work.
  • 2002 – The Effects of Trauma and Violence on Children & Adolescents.
  • 2003 – Emotional and Behavioural Disorders of Children & Adolescents.
  • 2004 – The Relationship Between Physical & Mental Health: co-occurring disorders.
  • 2005 – Mental and Physical Health Across the Life Span.
  • 2006 – Building Awareness – Reducing Risk: Mental Illness & Suicide.
  • 2007 – Mental Health in A Changing World: The Impact of Culture and Diversity.
  • 2008 – Making Mental Health a Global Priority: Scaling up Services through Citizen Advocacy and Action.
  • 2009 – Mental Health in Primary Care: Enhancing Treatment and Promoting Mental Health.
  • 2010 – Mental Health and Chronic Physical Illnesses.
  • 2011 – The Great Push: Investing in Mental Health.
  • 2012 – Depression: A Global Crisis.
  • 2013 – Mental health and older adults.
  • 2014 – Living with Schizophrenia.
  • 2015 – Dignity in Mental Health.
  • 2016 – Psychological First Aid.
  • 2017 – Mental health in the workplace.
  • 2018 – Young people and mental health in a changing world.
  • 2019 – Mental Health Promotion and Suicide Prevention.
  • 2020 – Move for mental health: Increased investment in mental health.
  • 2021 – Mental Health in an Unequal World.

Are Mindfulness-Based Interventions Useful for Nursing Students?

Research Paper Title

The effects of mindfulness-based interventions on nursing students: A meta-analysis.


Recently, mindfulness interventions have been extensively applied in the field of nursing education. However, no consensus has been reached on whether these interventions can reduce anxiety and depression in nursing students.

This meta-analysis was designed to determine the effect of mindfulness interventions on levels of depression, anxiety, stress and mindfulness for nursing students. It was a meta-analysis of randomised controlled trials.


The following Chinese and English databases were searched for relevant articles: Pubmed, Embase, Cochrane library, Web of Science, CNKI (China National Knowledge Infrastructure) and Wanfang. The search encompassed the establishment of these databases up until January 2020. Two reviewers separately entered the data into Review Manager Software 5.3.


A total of 10 randomised controlled trials (RCTs) were reviewed. It was found that mindfulness interventions significantly lowered levels of depression (SMD = -0.42, 95% CI:-0.56 to -0.28, P < 0.001), anxiety (SMD = -0.32, 95% CI:-0.47 to -0.17, P < 0.001) and stress (SMD = -0.50, 95% CI:-0.65 to -0.35, P < 0.001) in nursing students. Furthermore, the interventions raised levels of mindfulness in this group (SMD = 0.54, 95% CI:0.33-0.75, P < 0.001).


Mindfulness interventions can significantly reduce nursing students’ negative emotions, helping them to manage their stress and anxiety. College nursing educators should consider adopting mindfulness interventions in nursing education to promote the mental health of students.


Chen, X., Zhang, B., Jin, S-X., Quan, Y-X., Zhang, X-W. & Cui, X-S. (2021) The effects of mindfulness-based interventions on nursing students: A meta-analysis. Nurse Education Today. doi: 10.1016/j.nedt.2020.104718. Online ahead of print.

What is a Psychologist?


A psychologist is a person who studies normal and abnormal mental states, perceptual, cognitive, emotional, and social processes and behaviour by experimenting with, and observing, interpreting, and recording how individuals relate to one another and to their environments.

Applied Psychology in the United States

Applied psychology applies theory to solve problems in human and animal behaviour. Clinical psychology is a field of applied psychology that focus on therapeutic methods. Other applied fields include counselling psychology and school psychology. Licensing and regulations can vary by country, state, and profession.

Clinical Psychology

Education and Training

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). 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.

Some US schools offer accredited programmes in clinical psychology resulting in a master’s degree. Such programmes 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 counselling. Similar to doctoral programs, master’s level students usually must fulfil time in a clinical practicum under supervision; some programmes also require a minimum amount of personal psychotherapy. While many graduates from master’s level training go on to doctoral psychology programmes, a large number also go directly into practice – often as a licensed professional counsellor (LPC), marriage and family therapist (MFT), or other similar licensed practice (see below).

There is stiff competition to gain acceptance into clinical psychology doctoral programs (acceptance rates of 2-5% are not uncommon). Clinical psychologists in the US 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. programmes that emphasize research and are conducted by universities – with the other half in Psy.D. programmes, which have more focus on practice (similar to professional degrees for medicine and law). Both types of doctoral programmes (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 (APA).

APA accreditation is very important for US clinical, counselling, and school psychology programmes because graduating from a non-accredited doctoral programme may adversely affect employment prospects and present a hurdle for becoming licensed in some jurisdictions.

It should be noted that 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 programmes and clinical internships.

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

  • Bases of behaviour: 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. programmes 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 programmes offer sets of elective courses for specialisations, such as health, child, family, community or neuropsychology.
  • Personal psychotherapy: many programmes 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.

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, and that they possess advanced degrees.

Psychologists typically have one of two degrees: PsyD or PhD. The PsyD programme prepares the student only for clinical practice (e.g., testing, psychotherapy). Depending on the specialty (industrial/organisational, social, clinical, school, etc.), a PhD may be trained in clinical practice as well as in scientific methodology, to prepare for a career in academia or research. Both the PsyD and PhD programmes prepare students to take state licensing exams.

Within the two main categories are many further types of psychologists as reflected by the 56 professional classifications recognised by the APA, including clinical, counselling, and school psychologists. Such professionals work with persons in a variety of therapeutic contexts. People often think of the discipline as involving only such clinical or counselling psychologists. While counselling and psychotherapy are common activities for psychologists, these applied fields are just two branches in the larger domain of psychology. There are other classifications such as industrial, organisational and community psychologists, whose professionals mainly apply psychological research, theories, and techniques to “real-world” problems of business, industry, social benefit organisations, government, and academia.


  • Specific disorders (e.g. trauma, addiction, eating and sleep disorders, sexual dysfunction, depression, anxiety, or phobias).
  • Neuropsychological disorders.
  • Child and adolescent psychology.
  • Family and relationship counselling.
  • Health psychology.
  • Medical Psychology.
  • Sport psychology.
  • Forensic psychology.
  • Industrial and organisational psychology.
  • Educational psychology.

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


Clinical psychologists can offer a range of professional services, including:

  • Psychological treatment (therapy).
  • Administering and interpreting psychological assessment and testing.
  • Conducting psychological research.
  • Teaching.
  • Developing prevention programmes.
  • Consulting.
  • Programme administration.
  • Expert testimony.

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

Most clinical who engage in research and teaching do so within a college or university setting. Clinical psychologists may also choose to specialise in a particular field.

Prescription Privileges

Psychologists in the United States campaigned for legislative changes to enable specially trained psychologists to prescribe psychotropic medications. Legislation in Idaho, Iowa, Louisiana, New Mexico, and Illinois has granted those who complete an additional master’s degree program in psychopharmacology permission to prescribe medications for mental and emotional disorders. As of 2019, Louisiana is the only state where the licensing and regulation of the practice of psychology by medical psychologists (MPs) is regulated by a medical board (the Louisiana State Board of Medical Examiners) rather than a board of psychologists. 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.

In 1989, the US Department of Defence was directed to create the Psychopharmacology Demonstration Project (PDP). By 1997, ten psychologists were trained in psychopharmacology and granted the ability to prescribe psychiatric medications.


The practice of clinical psychology requires a license in the United States and Canada. Although each of the US states is different in terms of requirements and licenses, there are three common requirements:

  • Graduation from an accredited school with the appropriate degree.
  • Completion of supervised clinical experience.
  • Passing a written and/or oral examination.

All US 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. Most states also require a certain number of continuing education credits per year in order to renew a license. Licensees 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.

It should be noted that 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 programmes and clinical internships.

Ambiguity of Title

To practice with the title of “psychologist”, in almost all cases a doctorate degree is required (a PhD or PsyD in the US). Normally, after the degree, the practitioner must fulfil 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. A professional in the US 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. Additional regulations vary from state to state.

Differences with Psychiatrists

Although clinical 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.

Psychologists generally do not prescribe medication, although in some jurisdictions they do have prescription privileges. In five US states (New Mexico, Louisiana, Illinois, Iowa, and Idaho), psychologists with post-doctoral clinical psychopharmacology training have been granted prescriptive authority for mental health disorders.

Clinical psychologists receive extensive training in psychological test administration, scoring, interpretation, and reporting, while psychiatrists are not trained in psychological testing. In addition, psychologists (particularly those from Ph.D. programmes) spend several years in graduate school being trained to conduct behavioural research; their training includes research design and advanced statistical analysis. While this training is available for physicians via dual MD/Ph.D. programmes, 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. programmes.

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.

Mental Health Professions (US)

OccupationDegreeCommon LicensesPrescription Privilege
Clinical PsychologistPhD/PsyDPsychologistMostly No
Counselling Psychologist (Doctorate)PhD/PsyDPsychologistNo
Counselling Psychologist (Master’s)Ma/MS/MCMFT/LPC/LPANo
School PsychologistPhD/EdDPsychologistNo
Clinical Social WorkerPhd/MSWLCSWNo
Psychiatric NursePhD/MSN/BSNAPRN/PMHNNo
Psychiatric and Mental Health Nurse PractitionerDNP/MSNMHNPYes (Varies by State)
Expressive/Art TherapistMAATRNo
  • 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.
    • Further, 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.
    • 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.
  • Licensed Professional Counse;lor (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 Counsellor Exam.
    • Similar licenses are the Licensed Mental Health Counsellor (LMHC), Licensed Clinical Professional Counsellor (LCPC), and Clinical Counsellor 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 counsellor or psychotherapist, usually under the supervision of a licensed psychologist.
    • Some jurisdictions have exemptions that allow counselling to practice without meeting the requirements for a license – That is, they offer a license but do not require that counsellors obtain one.
  • 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.
    • 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 behavioural practitioner (Oklahoma), licensed psychological associate (North Carolina) or psychological examiner (Tennessee).
  • Licensed Behaviour Analysts:
    • Licensed behaviour 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 behaviour analysis and the philosophy of behaviourism.
    • Behaviour analysts have at least a master’s degree in behaviour analysis or in a mental health related discipline, as well as having taken at least five core courses in applied behaviour analysis.
    • Many behaviour analysts have a doctorate.
    • Most programmes have a formalised internship programme, and several programmes are offered online.
    • Most practitioners have passed the examination offered by the Behaviour Analysis Certification Board.
    • The model licensing act for behaviour analysts can be found at the Association for Behaviour Analysis International’s website.


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

The median salary in the US, in 2012, for clinical, counseling, and school psychologists was US$69,280 and the median salary for organisational psychologists was US$83,580.

Psychologists can work in applied or academic settings. Academic psychologists educate higher education students as well as conduct research, with graduate-level research being an important part of academic psychology. Academic positions can be tenured or non-tenured, with tenured positions being highly desirable.


To become a psychologist, a person often completes a degree in psychology, but in other jurisdictions the course of study may be different and the activities performed may be similar to those of other professionals.


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). Before July 2010, the professional registration of psychologists was governed by various state and territorial Psychology Registration Boards. 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. However, AHPRA (Australian Health Practitioner Regulation Agency) is currently in the process of phasing out the 4 + 2 internship pathway. Once the 4 + 2 pathway is phased out, a master’s degree or PhD will be required to become a psychologist in Australia. This is because of concerns about public safety, and to reduce the burden of training on employers. 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. Endorsement within a specific area of practice (e.g. clinical neuropsychology, clinical, community, counselling, educational and developmental, forensic, health, organisational or sport and exercise) requires additional qualifications. 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).

Membership with Australian Psychological Society (APS) differs from registration as a psychologist. The standard route to full membership (MAPS) of the APS usually 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 “counsellor” are currently self-regulated, with several organisations campaigning for government regulation.


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 recognises the clinical psychologist as an autonomous health profession. It reserves the practice of psychotherapy to medical doctors, clinical psychologists and clinical orthopedagogists.


A professional in the US 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.


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). 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.


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 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). 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.


Since 1979, the title “psychologist” has been protected by law in Greece. It can only be used by people who hold a relevant license or certificate, which is issued by the Greek authorities, to practice as a psychologist. The minimum requirement is the completion of university training in psychology at a Greek university, or at a university recognised by the Greek authorities. Psychologists in Greece are legally required to abide by the Code of Conduct of Psychologists (2019). Psychologists in Greece are not required to register with any psychology body in the country in order to legally practice the profession.


In India, “clinical psychologist” is specifically defined in the Mental Health Act, 2017. An MPhil degree of two years duration recognized by the Rehabilitation Council of India is required to apply for registration as a clinical psychologist. This procedure has been criticised by some stakeholders since clinical psychology is not limited to the area of rehabilitation. Titles such as “counsellor” or “psychotherapist” are not protected at present. In other words, an individual may call themselves a “psychotherapist” or “counsellor” without having earned a graduate degree in clinical psychology or another mental health field, and without having to register with the Rehabilitation Council of India.

New Zealand

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”, “counselling psychologist”, “educational psychologist”, “intern psychologist”, and “trainee psychologist” are similarly protected. 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).


In Norway, the title “psychologist” is restricted by law and can only be obtained by completing a 6 year integrated programme, leading to the Candidate of Psychology degree. Psychologists are considered health personnel, and their work is regulated through the “health personnel act”.

South Africa

In South Africa, psychologists are qualified in either clinical, counselling, educational, organisational, or research psychology. To become qualified, one must complete a recognised master’s degree in Psychology, an appropriate practicum at a recognised training institution, and take an examination set by the Professional Board for Psychology. Registration with the Health Professions Council of South Africa (HPCSA) is required and includes a Continuing Professional Development component. The practicum usually involves a full year internship, and in some specialisations, the HPCSA requires completion of an additional year of community service. The master’s programme 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 programme, the student studies psychology for three years as an undergraduate (B.A. or B.Sc., and, for organisational psychology, also B.Com.), followed by an additional postgraduate honours degree in psychology. Qualification thus requires at least five years of study and at least one internship. The undergraduate B.Psyc. is a four-year programme 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 counsellor.

United Kingdom

In the UK, “registered psychologist” and “practitioner psychologist” are protected titles. The title of “neuropsychologist” is not protected. 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”. 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. The requirement to register as a clinical, counselling, 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). The title of “psychologist”, by itself, is not protected. 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.

Employment (UK)

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

Book: An Introduction to Child and Adolescent Mental Health

Book Title:

An Introduction to Child and Adolescent Mental Health.

Author(s): Maddie Burton, Erica Pavord, and Briony Williams.

Year: 2014.

Edition: First (1st).

Publisher: SAGE Publications.

Type(s): Hardcover, Paperback, and Kindle.


Anyone who works within children and adolescent mental health services will tell you what a challenging and complex world it is. To help prepare you, the authors have produced a clear introduction to child and adolescent mental health that takes you step-by-step on a journey through the subject. Beginning with the foundations, the book explores the common mental health concepts and influences that you can expect to encounter examining topics like the difference between emotional and mental health issues and how mental health problems develop.

Book: Never Let Go: How to Parent Your Child Through Mental Illness

Book Title:

Never Let Go: How to Parent Your Child Through Mental Illness.

Author(s): Suzanne Alderson.

Year: 2020.

Edition: First (1st).

Publisher: Vermilion.

Type(s): Paperback, Audiobook, and Kindle.


How to help your child with mental illness through partnering, not parenting.

Never Let Go is a supportive and practical guide for parents looking after a child with a mental illness. Suzanne Alderson understands the agonising struggle of bringing a child back from the brink of suicide, having spent three years supporting her own daughter through recovery. Her method of ‘partnering, not parenting’ has now helped thousands of other parents through her charity, Parenting Mental Health.

Combining Suzanne’s honest personal experience with expert input from psychologists, this book provides parents with the methods and knowledge they need to support, shield and strengthen their child as they progress towards recovery. Chapters include a background to the mental health epidemic, why a new method of parenting is crucial, how to change your thinking about mental health and practical advice on solutions to daily problems including accepting the new normal, dealing with others, and looking after yourself as well as your child.

Book: Understanding Mental Illness 6th edition: Mental Health Awareness For Self Teaching

Book Title:

Understanding Mental Illness 6th edition: Mental Health Awareness For Self Teaching.

Author(s): Marianne Richards.

Year: 2015.

Edition: Sixth (6th).

Publisher: CreateSpace Independent Publishing Platform.

Type(s): Paperback and Kindle.


Understanding Mental Illness is the 6th edition of this professionally acclaimed book. This is a comprehensive, jargon-free guide aimed at volunteers, patients, carers, new professionals and students of mental health, as well as the keen general reader.

The book contains a wealth of information, including a history of mental illness from primitive times to the 20th century, with the often-bizarre treatments meted out in earlier times.

There is a selection of case histories on common disorders, together with ‘pen portraits’ illustrating ‘a day in the life of’ medical and non-medical therapists. Illustrated throughout with a glossary, suggested reading and index. The keen student is sure to find topics of interest for further study in this fascinating field.

Book: An Educator’s Guide to Mental Health and Wellbeing in Schools

Book Title:

An Educator’s Guide to Mental Health and Wellbeing in Schools.

Author(s): James Hollinsley.

Year: 2018.

Edition: First (1st).

Publisher: John Catt Educational Ltd.

Type(s): Paperback and Kindle.


A brilliant and practical collection of essays by educators, psychologists and counsellors, highlighting the critical importance of mental health and wellbeing of students in our schools.

The book has been collated and edited by James Hollinsley, Head of the Longwood Primary Academy in Essex, highly respected and awarded for their proactive approach to child mental health. An absolutely critical read for all those involved in the education of young people, the book offers: a range of best-practice case studies; searingly honest anonymous stories from survivors of poor mental health who have also been (or are) practitioners in schools; and advice from experts and specialists, including psychologists, counsellors and SEN specialists.

Book: Positive Mental Health: A Whole School Approach

Book Title:

Positive Mental Health: A Whole School Approach.

Author(s): Jonathan Glazzard and Rachel Bostwick.

Year: 2018.

Edition: First (1st).

Publisher: Critical Publishing Ltd.

Type(s): Paperback and Kindle.


Is mental health provision a concern in your school? Are you looking to develop a whole school approach to mental health issues? Do you need targeted, evidence-informed strategies? This book emphasises the importance of creating a whole school culture which promotes a positive attitude towards mental health. Suitable for both primary and secondary school teachers and leaders, it provides you with concise, practical guidance to help improve your existing mental health provision, all backed by the latest research.