Clinical Psychology means the independent evaluation, classification, treatment and rehabilitation of mental, cognitive, perceptual, emotional, behavioural or nervous disorders or conditions, development disabilities, psychoactive substance abuse disorders of habit or conduct, the psychological aspects of physical illness. In the strict sense of the word, a "Clinical Psychologist" means a person having a professional qualification in clinical psychology recognized by the Rehabilitation Council of India (RCI), obtained from an RCI approved institution and granted by a university recognized by the University Grant Commission as per Section 11 and 12 of RCI Act (1992). We can also say that a clinical psychologist is one who has been trained in psychiatric hospital and has interacted with those who have suffered. Therefore, a clinical psychologist is a professional, who can contribute to society using knowledge which is given to him/her which includes psycho-educational, evaluation therapy, remediation and consultation, the use of psychological and neuropsychological testing, assessment, psychotherapy. Clinical psychology also represents the single largest subfield of psychologists. Most of the clinical psychologists are interested in mental health and some of their speciality areas include child mental health, adult mental health, learning disabilities, emotional disturbances, substance abuse, geriatrics and health psychology.
As per the mandate given in RCI Act (1992), the Rehabilitation Council of India is developing; monitoring and regulating skill-based clinical psychology training courses on the similar lines as many other professional courses are regulated by national level monitoring bodies. Until now only 20 institutes have been recognized across the country which include NIMHANS, CIP, IHBAS, RINPAS, PGIBAMS and the recognition of four other centres funded by the Health Ministry under Human Resource Development in Mental Health Programme is in process for the conduct of 2 yr M. Phil Degree Course in Clinical Psychology. According to 13.2 of RCI Act, 1992, no person other than one who possesses a recognized clinical psychology qualification (M.Phil, or PhD) and is "enrolled on the Register of CRR" shall hold office as Clinical Psychologist or any such office (by whatever designation called) in Government or in any institution maintained by a local or other authority; and shall practice as clinical psychologist anywhere in India. Therefore, in terms of legal and professional ethics, any person having obtained a mere Masters degree in psychology is not eligible to practice as clinical psychologist, in whatsoever manner and capacity, in any government, semi-government or private institution, which is deemed as violation of the 13.2 of RCI Act, 1992 by the practitioner and the employer as well..
Many psychiatric illnesses were clinical psychologist can be useful include obsessive–compulsive disorder (OCD), post traumatic stress disorders (PTSD), generalized anxiety disorders (GAD), panic disorders, phobia, sleep disorders, substances use and addictive disorder, mood disorders and neuro-cognitive disorders. In case of such disorders simple counselling does a not show good result but proper technique like Cognitive Behavioural Therapy (CBT), Rational Emotive Behavioural Therapy (REBT), Systematic Desensitization (SD) and Cognitive Therapy (CT) can yield better results given by expert in these specialities. OCD which is a commonly observed behavioural problem and some famous people like Lady Macbeth, John Bunyan and Charles Darwin are reported to have suffered from this disorder. Obsessions are unwanted and intrusive thoughts, images and impulses and are usually regarded by the individual experiencing these as senseless, unacceptable and difficult to ignore. Once an obsession occurs, it is accompanied by feelings of discomfort or anxiety and the urge to neutralize the obsession. Neutralizing often takes the form of compulsive behaviour (such as washing, checking, looking at one point etc). People suffering from Obsessive compulsive disorders always believe that without compulsive acts they cannot live properly and when they realise that it is affecting much of their life, they come to psychiatrist. However, it is important to note that such disorders cannot be overcome alone with the help of medicines but need interactive sessions with a trained psychologist who can help such patients overcome these problems with specialized therapies.
Generalized Anxiety Disorder (GAD) is a disorder where our client always report excessive worry, an unrealistic view of problems, irritability, restlessness, muscle tension, decreased or difficulty in concentration, tension, palpitation, trembling etc. This illness is also treatable with the help of clinical psychologist who can rate their anxiety level and plan management for them. Cognitive approaches and behavioural approaches used by clinical psychologist address clients having hypothesized cognitive distortions somatic symptoms respectively. The major techniques used in behavioural approaches are relaxation and biofeedback. Clinically collected data indicate that a combination of cognitive and behavioural approaches is more effective in treating a vast number of patients. Post traumatic stress disorder (PTSD) is a type of disorder which can develop after a person is exposed to one or more traumatic events and develops symptoms such as intrusion, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity. The lifetime incidence of PTSD is estimated to be 9 to 15 percent and studies done in Kashmir valley also have reported similar results. Although PTSD can appear at any age, it is most prevalent in young age because they tend to be more exposed to precipitating situations. Psychotherapy and Exposure therapy are used by clinical psychologist is treatment of such cases In exposure therapy the patient re-experiences the traumatic events through imaging techniques or in vivo exposure. Therapist also helps clients by using method of stress management, including relaxation techniques and cognitive approaches to cope with stress. Another technique that is used to treat PTSD is eye movement desensitization and reprocessing (EMDR) and studies have reported that it is an effective treatment.
One of the important areas where clinical psychologist is very much needed is child psychiatry, which includes various psychiatric disorders seen in childhood which includes disorders of psychological development, behavioral & emotional disorders with onset usually occurring in childhood and adolescence like mental retardation, specific development disorders, pervasive development disorders, hyperkinetic disorders, conduct disorder etc. Clinical psychologist play very important role in assessing and managing childhood disorders. It is he who can assess intelligence quotient, personality assessment, attitude assessment etc and by doing this clinical psychologist helps psychiatrist and the field of psychiatry. Clinical psychologists also perform neuropsychological assessment, wherein they examine the relationship between behavior and brain functioning in the realms of cognitive, motor, sensory, and emotional functioning.
The author is Lecturer and clinical Psychologist in Government Medical Collage, Srinagar, and executive member of Indian Association of Clinical Psychology (IACP).