The most obvious difference between clinical psychology and marriage and family therapy is the context of work. Where clinical psychologists treat a variety of mental health issues in many different contexts, marriage and family therapists mostly work in the context of couples and family relationships.
There is certainly some overlap between these two professions, though. Both clinical psychologists and marriage and family therapists are mental health professionals with advanced training in diagnosing and treating mental disorders. But as you will explore in this guide, there are far more features that make these fields distinct than the common threads that bind them.
Whether you are interested in a career in one of these fields, unsure of the type of mental health care you need, or perhaps both, this guideline will help you differentiate between the two.
Clinical Psychology Vs Marriage and Family Therapy
Clinical psychology focuses on diagnosing and treating mental, emotional, and behavioral disorders. In contrast, marriage and family therapy specifically addresses issues within relationships and families, offering solutions for interpersonal dynamics. Both are vital, but they cater to different aspects of mental health and relationships.
Differences in Duties
Let’s begin by expounding on the primary difference between clinical psychology and marriage and family therapy – the context of practice.
On a basic level, clinical psychology is practiced in a wide range of contexts. Clinical psychologists might work with someone who has schizophrenia, depression, or a body-focused disorder. What’s more, they might work with clients who are children, teenagers, or adults, usually in an individual setting.
Though these and other issues might also be explored in marriage and family therapy, the context is more focused. Clientele includes couples and families that engage in therapy together (though individual sessions for each person are common).
The scope of treatment is often different, too. Suppose you have an anxiety disorder, and you are seeing a clinical psychologist for help. In the context of therapy, you and your psychologist might explore the history of your anxiety and your triggers and work on psychoeducational activities that help you develop strategies for dealing with your anxiety in a healthy and effective manner.
In other words, the point of individual therapy for your anxiety disorder is to understand why you have anxiety and how to best address it. This is often done through talk therapy, cognitive-behavioral therapy, and targeted interventions that help you develop specific skills.
Now, suppose you are in a troubled marriage with two teenage kids. You and your spouse go to marriage and family therapy to try to save your marriage. Your therapist might take a broad approach to uncovering the source of your marriage difficulties by interviewing you and your spouse together, observing how you interact with one another, and examining how you communicate, too.
From there, the therapist might have you and your spouse take part in active interventions like role-playing to facilitate working through feelings of distrust, lack of communication, anger, and so forth. In this case, these activities might not focus as much on past issues as they often do in individual therapy and might instead zero in on the current problems and devising strategies for addressing them.
The context of marriage and family therapy broadens even further when children are involved. In this example, there are four people in the family unit, necessitating a group therapy approach to treatment rather than the individual focus when seeing a clinical psychologist.
It should be noted, though, that clinical psychologists often work with groups of clients – their practice is not limited to individual therapy. However, it’s safe to say that clinical psychologists treat individuals more often than groups, whereas marriage and family therapists treat couples and families more often than individuals.
Another important difference between these professions is the types of mental health issues they address. Typically, clinical psychologists work with clients with a serious mental illness or perhaps comorbid conditions. A good example of this is someone with a psychotic disorder like schizophrenia. Due to the nature and severity of this disorder, individual therapy with a clinical psychologist is warranted.
Marriage and family therapists usually work with clients who have less severe mental health issues, if they have mental health issues at all. For example, many people who seek marriage and family therapy do so because of issues like an inability to communicate, differing parenting approaches, or financial difficulties. These issues can cause significant distress in a marriage or family relationship, but they are a different type of issue than something like schizophrenia.
The length of the working relationship varies between clinical psychologists and marriage and family therapists as well. Clinical psychologists might work with the same client for many months or even years. Marriage and family therapy tends to be much shorter, typically ending in a handful of weeks or a couple of months.
For example, someone with a personality disorder might seek treatment from a clinical psychologist who provides dialectical behavioral therapy or DBT. This type of therapy involves weekly talk therapy sessions and usually lasts about one year. The focus of DBT is usually on factors like the following:
- Working through stress in a healthy manner
- Learning to control one’s emotions
- Learning to practice mindfulness
- Strengthening one’s ability to relate effectively to other people
Contrast this with a typical marriage and family course of treatment. Parents might seek help in managing their child’s outbursts of negative behaviors. Treatment might include Emotion-Focused Family Therapy or EFFT, which involves training parents to help their child manage their emotions and behaviors, thereby reducing the likelihood of angry outbursts and other negative behaviors. This type of therapy might only take a few sessions to generate results.
Differences in Work Environment
Clinical psychologists can work in many different settings, from private practice to community mental health. Because of their training in diagnosing and treating mental disorders, clinical psychologists also often work in healthcare settings, such as hospitals and inpatient mental healthcare facilities, where patients might be more likely to have a severe mental illness.
Some clinical psychologists work in educational settings, too. Public and private school districts might employ clinical psychologists to provide services to seriously mentally disturbed students. Colleges and universities might employ clinical psychologists to provide treatment for faculty, staff, and students, or they might work as classroom instructors.
In some cases, clinical psychologists work in correctional facilities, psychology research centers, or government agencies like the Department of Health and Human Services.
Marriage and family therapists, on the other hand, most commonly work in private practice and mental health centers. It’s common for marriage and family therapists to work in healthcare settings, too, where their expertise in family dynamics can be valuable in helping families work through the illness or death of a loved one.
Unlike clinical psychologists, marriage and family therapists are much less common in inpatient and research settings. For example, a state mental hospital might have multiple clinical psychologists on staff to address the significant mental health needs of its patients, whereas they might not have any marriage or family therapists on staff.
Ultimately, though, clinical psychologists and marriage and family therapists share the commonality of working with clients in a professional care setting in the context of a therapeutic relationship, even if the specific settings might be different.
Differences in Education
The educational requirements are one of the most significant differences between clinical psychology and marriage and family therapy. Where both options require you to first complete a four-year undergraduate degree program in psychology, counseling, or a related field, the progress of education diverges after that.
Because of the nature of clinical psychology and its focus on severe mental illnesses, it’s most common for workers in this field to have a doctorate. Most clinical psychology doctoral programs require about five years of study, which includes the coursework and field experience needed to complete a master’s degree and the advanced coursework, field experience, and research needed to complete a doctorate. Usually, the master’s degree is earned as part of the doctorate, though some programs might split these degrees in two.
As a clinical psychology graduate student, you are likely to take courses in the following:
- Foundations of Psychotherapy
- Psychometrics
- Psychological Assessment
- Clinical Research Methods
- Developmental Psychopathology
Multiple field experiences are required as well. These usually take the form of several practicum experiences throughout the doctoral program, various clinical placements throughout the program, and a post-doctoral internship that lasts a year.
While some marriage and family therapists complete a doctoral program, completing one’s studies at the graduate level is more common. A master of science or master of arts in marriage and family therapy typically requires about three years of full-time study, though some programs can be completed in as little as two years.
Some of the coursework in a marriage and family therapy program is the same as that in a clinical psychology degree. For example, both programs include studies in psychological theory, therapeutic treatments, psychological assessment, and professional ethics. However, marriage and family therapy programs focus much more on developing skills specific to working with couples and families. This includes courses such as:
- Systemic Family Therapy Theories
- Substance Abuse and Addiction Treatment in Family Therapy
- Marriage Counseling
- Family Development Across the Lifespan
- Psychoeducational Family Therapy
As with clinical psychology programs, marriage and family therapy degrees include practicum and internship experiences that allow you to gain hands-on experience while being supervised by a licensed therapist. Though many marriage and family graduate programs include a research component (e.g., a thesis or capstone project), the breadth and depth of research are not the same as what’s expected in a doctoral dissertation for a clinical psychology Ph.D.
Of course, whether someone pursues a graduate degree in marriage and family therapy or a doctorate in clinical psychology, the appropriate licensure must be earned after graduation. The specific requirements for licensure in these fields slightly vary in each state, but some combination of post-degree supervised work experience, professional development, and examinations is likely to be required.
Which is Better? Clinical Psychology or Marriage and Family Therapy?
The nature of the mental health issue is what determines whether clinical psychology or marriage and family therapy is most appropriate.
As noted earlier, people with a serious psychological problem are better served by a clinical psychologist because of their training and expertise in treating psychological disorders. However, people who are struggling in their relationship with a significant other, children, or other family members, are best served by working with a marriage and family therapist who can facilitate improved communication and family functioning.
There are, of course, situations in which a clinical psychologist and marriage and family therapist might work together with the same client. For example, assume a husband has a dissociative disorder and that his mental health is causing significant distress for his wife and children. In this case, he might work individually with a clinical psychologist to address his dissociative disorder while the entire family works with a marriage and family therapist to address the disorder’s effects on the family unit and learn skills to support him in his pursuit of better mental health.
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