The Future of Clinical Psychology

What neuroscience promises and the implications for clinicians & patients today.

Posted Jan 23, 2016

Dennis Hill, CC 2.0
Source: Dennis Hill, CC 2.0

Sure, clinical psychology has made progress in the last century. There's now cognitive-behavioral therapySSRIs, and such but they're no, pardon the pun, magic pill.

Clinical psychology's progress is dwarfed by other fields' advances. For example, a century ago, a person might be institutionalized for predicting that today, people would carry a device in their pocket that can video-call anyone wirelessly for free (Skype,) watch thousands of techno-marvel movies (NetFlix,) and instantly search much of the world's information (Google.)

Fortunately, recent progress in neuropsychology is laying the foundation for equally dramatic changes in clinical psychology.

Of course, talk therapy, counseling, and coaching will remain part of clinical psychology's future. After all, people will continue to want a professionally trained confidant who is a good listener, questioner, educator, and perhaps advice-offerer  Plus, some mental health issues, even if rooted in a person's biology, are triggered and exacerbated by external events and by his or her reactions to them. Only talk therapy can address those.

But here are some of the changes in clinical psychology that neuroscience and molecular biology research portend:

Toward discovering the core causes of mental illness. Substantial progress has been made in understanding mental illnesses' root cause. For example, two genes that regulate glutamate transmission appear to cause major depression. Glutamate transportation may also be key to repetitive disorders such as OCD, autism and Tourette's Syndrome. Poor coordination among synapses may cause schizophrenia and other psychoses. Intelligence may have roots in a newly-found gene cluster.

Ever better instrumentation will accelerate progress. For example, it is now possible to measure neural activity in moving animals at the single-cell level. Scanning electron microscopes can detect sub-atomic particles. 

So what? A disease that we label today as  "depression, 'anxiety," "schizophrenia," or "autism" will likely come to be understood as mere umbrella terms, with molecular and environmental causes specific to the individual. Molecular advances like those above pave the way for individualized medicine, whether for mental illness or bodily disease, for example, heart disease, cancer, and diabetes.

Ethical frontiers. Ethics debates will continue to parallel the science research. For example, bioethicists are already debating whether augmentation should be allowed, encouraged, or prohibited. For example, if it becomes possible for gene therapy to raise the likely intelligence of a fertilized egg, should parents have the right to elect that? Do the benefits to the child, parents, and society outweigh the liabilities? Could adequate safeguards be provided? To ensure broad access, should Medicaid, which provides health care for the poor, cover the treatment? No doubt, as science progresses, new ethical issues will be explored.

In the meantime. While full cures may be only under development, remember that even today's standard treatments--for example, cognitive-behavioral therapy, SSRI's, electro-convulsive therapy, and deep brain stimulation have greatly improved many people's lives. Clinical psychology's being only in its adolescence offers us another silver lining: It can temper our hubris. We can only do so much...as of 2016.

Here are links to the other articles in this series:

The Future of Relationships

The Future of Work

The Future of Education

The Best of Marty Nemko is now in its 2nd edition. Career coach Dr. Marty Nemko can be reached at mnemko@comcast.net..