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Catapres (clonidine) is a medication that was initially approved to treat high blood pressure. However, because of its calming effects, clonidine is often prescribed to people with attention deficit hyperactivity disorder (ADHD). It can help with symptoms such as hyperactivity, impulsivity, aggression, overarousal, and sleep difficulties.

The Food and Drug Administration (FDA) has approved Kapvay, the extended-release version of clonidine, as a medication for children with ADHD ages six and up. It can be taken alone or along with stimulant medication.

How Clonidine Works

Clonidine prompts your brain to send signals to your blood vessels to relax them, lowering blood pressure. Its exact mechanisms in treating ADHD are not fully understood.

Stimulant vs. Non-Stimulant ADHD Medications

ADHD medications are generally categorized as either stimulants or non-stimulants. Clonidine, which is part of the class of drugs known as centrally acting alpha-agonist hypotensive agents, is considered a non-stimulant treatment for ADHD.

Non-stimulant medications are usually prescribed if a person with ADHD can’t tolerate stimulant medication because of severe side effects. Some health conditions also prevent using stimulants, such as certain psychiatric disorders, sleep disorders, cardiovascular disease, or a history of stimulant misuse.

Strattera (atomoxetine), the antidepressant medication Wellbutrin (bupropion), and Qelbree (viloxazine) are examples of other non-stimulant medications. The antihypertensive drug Intuniv (guanfacine) is another.

Pros and Cons of Clonidine for ADHD

Pros

Clonidine offers these benefits, especially for children:

• Can boost the effects of stimulants: Clonidine can be prescribed in addition to a stimulant medication, and it often enhances the effectiveness of the stimulant.
• No appetite effect: Clonidine doesn’t increase or decrease appetite. Some other stimulants suppress appetite, which can be a problem for people who are already underweight.
• Effective for kids: A meta-analysis of 73 studies looked at the efficacy of six ADHD medications for kids 6 to 18 years old. Among the three non-stimulants included, clonidine was found to be the most effective and tolerable compared with atomoxetine and extended-release guanfacine. (Wellbutrin was left out because evidence was lacking.)
• Reduces anxiety: People who have ADHD often experience anxiety. Medication from the benzodiazepine family, such as Xanax (alprazolam) or Valium (diazepam), is often prescribed for anxiety. However, these can be habit-forming and negatively affect cognitive functions such as attention. For this reason, clonidine is often prescribed to help people with ADHD who have anxiety.
• Helps with sleep difficulties: Sleep problems are another issue many people with ADHD face. A potentially positive effect of taking clonidine is that it can help improve sleep. In fact, some doctors prescribe a low dose of clonidine off-label (this means using an FDA-approved drug for an unapproved use) to help with sleep.
• Not addictive: While traditional stimulant medications might be avoided because they can be habit-forming, clonidine is not considered to be addictive.
• Reduces blood pressure: If you have ADHD and high blood pressure, clonidine may be a good choice for you because it will also help reduce your blood pressure.
• Can treat tic disorders: If you have both Tourette syndrome or another tic disorder and ADHD, clonidine can help the symptoms of both.

Cons

Clonidine is not suitable for everyone. It has some disadvantages that you should know about if you are considering taking clonidine.

• Doesn’t help all ADHD presentations: Clonidine helps with hyperactivity, impulsivity, aggression, overarousal, and sleep difficulties. However, it hasn’t been found to be as helpful for inattentive symptoms of ADHD.
• Little research on adults with ADHD: Studies have shown that clonidine can help ADHD symptoms in children and adolescents, but clonidine is not typically prescribed for adult ADHD. This could be because the symptoms that clonidine helps the most, such as aggression, hyperactivity, and impulsivity, often diminish in adulthood.
• Less effective than stimulants: Clonidine isn’t as effective as stimulant medications for treating ADHD symptoms. However, its effects are significant enough for the FDA to approve its use for ADHD.
• May cause brain fog: Rather than increasing the ability to focus, some people find clonidine reduces their focus or causes brain fog. Problems with the ability to focus can be temporary as your body adjusts to the clonidine. However, some people find this problem continues.
• May cause drowsiness: While clonidine can help with nighttime sleep problems, some people who take clonidine also feel fatigued or sedated during the daytime. This can have negative effects on school or work performance. Sometimes, the sleepiness decreases with time. This is an important side effect to discuss with your doctor, as it has the potential to be dangerous if you drive a vehicle or operate machinery.
• May cause erectile dysfunction (ED): A drawback for men taking clonidine is ED. Even though you might feel embarrassed to talk to your doctor about ED, they will be aware that this is a possible side effect and will want to help you resolve the issue.

Forms and Dosage

When clonidine is first prescribed, it’s usually at the lowest dose. This may be 0.05 to 0.1 milligrams (mg) to start. Your doctor gradually increases the dose until the effective (therapeutic) dose is found. Catapres tablets come in 0.1mg, 0.2mg, and 0.3mg. Kapvay is the extended-release version, and it’s available in 0.1mg.

Once the therapeutic dose has been found using tablets, using a clonidine patch is an option. It may take a few weeks to see the full effects of clonidine on ADHD symptoms, but you may see some improvement sooner.

Side Effects of Clonidine

These side effects often go away after you’ve taken the medication for a while, but if they don’t or they’re bothersome, talk to your doctor:

• Behavior problems
• Constipation
• Dizziness
• Dry mouth
• Erectile dysfunction
• Fatigue
• Headache
• Irritability
• Low blood pressure
• Nausea
• Upper abdominal pain
• Vomiting

Rare But Serious Side Effects

If you experience these or any other unusual or persistent side effects, contact your doctor as soon as possible:

• Difficulty breathing
• Hallucinations
• Hives
• Hoarseness
• Irregular heartbeat
• Rash
• Slow heart rate
• Swelling anywhere in the body

Precautions When Taking Clonidine

If you have a history of low blood pressure, you may be more likely to feel dizzy, lightheaded, and nauseous while taking clonidine.

Many people forget to take their medication. If you miss a dose of clonidine, don’t take a double dose as it could lower your blood pressure too much.

It’s important that you don’t stop taking clonidine abruptly, as this may cause rebound high blood pressure. Instead, your dose should be decreased gradually. Your doctor can give you advice on the best tapering schedule.

Compassion involves feeling another person’s pain and wanting to take steps to help relieve their suffering. The word compassion itself derives from Latin and means “to suffer together.”

It is related to other emotions, such as sympathy, empathy, and altruism, although the concepts have some key differences. Empathy refers more to the general ability to take another person’s perspective and feel the emotions of others. Compassion, on the other hand, is what happens when those feelings of empathy are accompanied by the desire to help.

Think of compassion as a revved-up, more active form of empathy. It’s why you might send your friend a “just checking in” text when you know they’ve had a rough day. When you notice your co-worker is extra quiet, compassion is why you offer a quick, “Hey, you seem a little off today. Is everything OK?”

The Value of Compassion

Compassion allows you to acknowledge someone’s struggles and respond with kindness, care, and support. It’s empathy in action. Showing compassion to yourself and others can strengthen relationships, increase happiness, and lower stress.

Sometimes, it just comes naturally, but there are also things you can do to strengthen it. Start by listening without judgment, offering to help, and practicing gratitude. Focus on being patient and showing forgiveness (for others *and* yourself) for mistakes. Think of compassion like a muscle: The more you practice, the stronger it will become.

Signs That You’re Feeling Compassion

How can you tell when what you are feeling is compassion (or empathy or sympathy or something else)? Some signs that what you are experiencing is compassion include:

• Feeling like you have a great deal in common with other people, even if you are very different in many ways.
• Being able to understand what other people are going through and feeling their pain.
• Being mindful of other people’s emotions, thoughts, and experiences.
• Taking action when you see that someone else is suffering.
• Having a high level of emotional intelligence so that you can understand, manage, and act on your own emotions as well as the emotions of others.
• Feeling gratitude when other people express compassion for your own hardships.

The Two Main Types of Compassion

Experts often distinguish between the two main forms of compassion, which vary depending on where these feelings are directed.

Compassion for Others

It really does hurt to know that others are hurting, and sometimes, that hurt makes us want to help. When you experience compassion for other people, you not only feel their pain—you also want to find a way to relieve their suffering. These feelings compel you to take action to do what you can to make the situation better.

Self-Compassion

Self-compassion is all about giving yourself grace instead criticism. It involves being able to acknowledge your weaknesses or failures without being judgmental or critical.

Rather than beating yourself up over past mistakes, you feel understanding, mindful, and accepting of yourself and your imperfections.

How to Flex Those Compassion Muscles

Even when you feel compassion, knowing how to best help or show your support is not always easy. You might feel awkward or uncomfortable or worry about making the situation worse. When emotions feel *heavy* and you aren’t quite sure how to help, there are several different steps you can take to show compassion to others. 

• Speak with kindness
• Apologize when you’ve made a mistake
• Listen carefully and without judgment
• Be encouraging
• Offer to help someone with a task
• Be happy for someone else’s success
• Accept people for who they are
• Forgive people for making mistakes
• Be respectful
• Express gratitude and appreciation
• Be patient

Compassion and empathy share common elements, but compassion goes a step beyond. Rather than just imagining yourself in their shoes, compassion drives you to take action to help that person. Because you are able to feel those emotions so keenly—almost as if it is happening to you—there is a strong motivation to find a way to change the situation or ease the other person’s pain.

Why Compassion Can Make a Real Difference

Compassion can have a positive impact on your life, ranging from improving your relationships to boosting your overall happiness. Some of the positive effects of compassion:

Giving Feels Good

One of the reasons why compassion can be so effective is that both giving and receiving can improve your psychological well-being. Being the recipient of compassion can help you get the support you need to carry you through a difficult time. But giving compassion to others can be just as rewarding.

For example, researchers have found that giving money to others who need it actually produces greater happiness rewards than spending it on ourselves.

It Helps People Live Longer

Helping others doesn’t just feel good—it can also help you live longer. Engaging in activities such as volunteering to help those you feel compassion for can improve your longevity. Research has found that people who volunteer out of concern for others tend to live longer, healthier lives than those who do not.

Showing Compassion Leads to a Life of Purpose

Evidence indicates that the happiness that comes from living a life of purpose and meaning—one that is fueled by kindness and compassion—can contribute to better health. Researchers have found that people who experience what is known as eudaimonic happiness—or the kind of happiness that comes from living a meaningful life that involves helping others—experience lower levels of depression, stronger immunity, and less inflammation.

Compassion Improves Relationships

Compassion can also help you build the social support and connections that are important for mental well-being. It can also protect your interpersonal relationships. Research suggests that compassion is a key predictor of the success and satisfaction of relationships.

Interestingly, the study found that while people tend to gain the greatest benefits when their partner notices their acts of kindness, they actually experience benefits whether their partner notices or not. What does that mean, exactly? It suggests that compassion is its own reward.

Simple Ways You Can Be More Compassionate

While some people tend to be more compassionate by nature, experts also suggest that there are steps you can take to cultivate a greater sense of compassion for both yourself and others:

Bring Your Attention to the Situation

The first component of compassion is to become more aware of what other people are experiencing. Imagine yourself in their shoes. Being able to see things from another person’s perspective can help you gain a sense of compassion for their situation. Practice putting yourself in someone else’s place and imagine how you might feel. Focus on feeling how they might be feeling.

Let Go of Judgment

Accepting people as they are and avoiding judgment is important. Focus on accepting people for who they are without criticizing or blaming the victim.

Practice Mindfulness

Mindfulness is a practice of focusing on the present, becoming more aware of your own thoughts, and observing these thoughts without judging them. Research suggests that mindfulness-based interventions can be effective for improving self-compassion.

Show a Little Love and Kindness (Through Meditation)

Loving-kindness meditation is a form of meditation, also known as compassion meditation, that involves meditating while directing kind, compassionate thoughts toward yourself or others. Research suggests that this form of meditation can help people improve their connection to others and boost well-being.

Potential Pitfalls of Compassion

One potential pitfall of compassion is that constant exposure to the distress of others may contribute to what is known as compassion fatigue.

People who work in helping or caregiving roles (such as nurses, doctors, or emergency care workers) often experience an extreme state of tension as well as a preoccupation with those they are helping. Because of this, helpers can experience symptoms of trauma themselves. The result? It can potentially dampen their feelings of compassion.

Combating compassion fatigue is particularly important in healthcare and other helping professions. Research suggests that interventions that involve mindfulness meditation and other mindfulness-based practices can help people in these roles experience greater compassion for others, improve positive feelings, and reduce distress.

When we fall in love, we often believe the relationship will last forever. We always hope that this one is the one, that it will be different this time, and that there’s no way anything can ever happen to break you up.

Except, sometimes those things can happen, and you do break up. If we only look at the divorce rate, research shows it is around 50% (although measuring divorce rates is more complex than comparing marriages to divorces in a single year). Because they are not as closely monitored, it is much more difficult to obtain rates on casual and common law partnerships that break up.

Relationships end for a wide variety of reasons. Conflict is one common reason, but sometimes it involves other reasons that mean ending a relationship with someone you still care about. When this happens, you must learn to break up with someone you love. To do this, you should:

1. Acknowledge that it will cause pain on both sides
2. Have a face-to-face conversation
3. Be honest but not overly detailed
4. Avoid responding to arguments
5. Make a clean break in order to create distance
6. Be sympathetic
7. Don’t shame or blame the other person
8. Allow yourself to grieve the relationship

Why and How Do Breakups Happen?

Most of us enter relationships with the hope that we will never have to end them. Marriage, especially, is built on the premise that it will remain “until death do us part.”

Common causes for breakups include personality differences, lack of time spent together, infidelity, lack of positive interactions between the couple, low sexual satisfaction, and low overall relationship satisfaction.

How to Break up the Right Way

We say “right” way, but in reality, there is no right or “best” way to break up. Every relationship is different, and every person in a relationship is different. It is up to you to consider the personality, needs, and feelings of your partner as you read through this article and figure out how to end things.

Recognize That It’s Never Easy

Understand that there is no pain-free way to break up. We all wish that we could end relationships without any hurt or pain. But no matter how broken the relationship is, officially ending it will cause pain on both sides. Once you acknowledge that there will be pain, you can be prepared for the aftermath.

Do It Face-to-Face

If you’ve ever been dumped by text or email (or if you’ve been ghosted altogether), you know how it feels to be given so little consideration that the other person didn’t even bother to tell you in person. Why do the same to another person?

Your partner deserves the dignity of a face-to-face conversation. An intimate setting is arguably better, but if you are worried about your partner having a violent reaction, a public place is safer.

Be Honest But Don’t Give Too Much Detail

In general, people want to know why they’re being dumped. While “you’re terrible in bed” or “you lack ambition” might seem like an honest answer, it doesn’t really preserve your partner’s self-esteem or dignity.

Using a reflexive sentence like “I don’t feel we’re compatible sexually” or “I don’t think our long-term goals align anymore” are nicer ways to express your feelings. Don’t do a play-by-play of the things the other person did wrong or use clichés like “it’s not you, it’s me.”

Do Not Give In to Arguments or Protests

If the breakup is a surprise for the other person, they might try to argue, protest, or give reasons why you should remain together and try again one more time. If you are at the point of breaking up, nothing can restore or revive the relationship now. Giving in will only delay the inevitable.

Show Empathy

Express your sadness at the breakup and share some good things about your time together. Being dumped feels really bad. You can soften the blow a little by talking about some of the good times you shared together.

Say something like, “You taught me so much about cooking and I am a better cook now, thanks to you”. You want to make the other person feel like they had a positive impact on your life despite the relationship ending.

Avoid Blaming or Shaming

Avoid turning the other person into “the bad guy.” Nobody’s perfect. You have faults too, and turning your ex-partner into an evil figure is not helpful (aside from obvious instances of violence, but that’s not the kind of relationship we’re talking about here).

They may have done some bad things, like cheating, but they are human too. It’s better to resolve your feelings around what they did (if they did anything wrong) rather than who they are.

Give Yourself Time to Grieve

Even if you are the one ending the relationship, there will be a period of heartbreak, sadness, and pain. This is one of the most difficult parts of figuring out how to break up with someone you love. You still care about them, but you need to remind yourself of the reasons why the relationship isn’t working.

Most of us have had those fluttering feelings we commonly call “butterflies in the stomach”—the feeling we get when we’re nervous or excited about something. It’s a common phenomenon for people everywhere.

This article will discuss what it is, the science behind what is happening, if butterflies are truly a sign of love, the negative aspects of this feeling, and how to manage that butterflies in the stomach feeling.

What Is This Butterflies in the Stomach Sensation?

If you notice, butterflies usually occur when we are nervous, anxious, or excited. For example, maybe you had the jitters and got that “butterflies” in your stomach feeling before you were scheduled to give a big presentation to your team.

Or if you’re dating, maybe you experienced butterflies in your stomach when someone attractive approached you or when they knocked on your door before you went out on your first date. In those cases, you were likely excited.

How Science Explains the Butterfly Feeling

Scientists trace this sensation to a few things. The first is a chemical that is released called dopamine, the “feel-good” chemical. Dopamine helps us feel happy during pleasurable activities, like when you’re flirting or having sex.

The surge of norepinephrine in your central nervous system also contributes to feeling butterflies. Norepinephrine is both a hormone and neurotransmitter. As a neurotransmitter, it works as a chemical messenger between your nerve cells. Norepinephrine is released during times of stress or fear when the “fight or flight” response kicks in.

Similarly, it’s released during those romantic moments of attraction or arousal. While nervousness and arousal might seem like entirely different things, in both cases our bodies are in an excited, almost primitive state. Research has in fact shown that romantic love shares many characteristics with mammalian attraction.

The third way science explains the phenomenon we call butterflies in the stomach has to do with the gut-brain axis. If you have a gut feeling, butterflies in your stomach or gastrointestinal nervousness or stress, you’re receiving intelligence, but it’s coming from your gut area.

In effect, you’re experiencing the gut and brain’s remarkable connection. According to Johns Hopkins Medicine, what is nicknamed our second brain or gut brain, is located in our digestive system. The digestive system even has its own nervous system called our enteric nervous system (ENS).

Do Butterflies in the Stomach Mean Love?

When people describe the signs of love at first sight, they sometimes describe an instant attraction or knowing. They may also talk about experiencing butterflies in their stomach, stomach distress or a euphoric feeling.

Research from a study showed that hormonal changes happen when people fall in love, but those changes were transient. The cortisol levels rose significantly amongst those who had recently fallen in love compared with those who had not. Women in love showed higher testosterone levels while men in love showed lower levels of FSH and testosterone. But when tested 12 and 24 months later, their hormones reverted to normal levels.

If you’re confused about your romantic feelings for someone, take this quiz. It may help you see that you may very well be experiencing signs of attraction, infatuation or lust rather than love.

Can Butterflies in the Stomach Be a Bad Thing?

Having butterflies or gut-level signals can be a good thing. For example, it’s nice to be excited about a romantic prospect and feel that gentle flip-flop in our tummies. If our gut warns us to avoid a certain person, we should trust what it’s saying. Our gut has valuable information that it’s communicating to help us avoid danger.

Sometimes gut sensations and what people may erroneously call butterflies in the stomach signal a gastrointestinal disorder.  Nausea, persistent abdominal pain and extreme discomfort in the gut area can occur after an upsetting emotional situation or be traced to a physical cause. Whatever the source, it’s wise to seek medical attention about this.

According to one study, stresses from our thoughts and emotions after upsetting situations do indeed affect us. The bidirectional interaction between the brain and gut affects functional gut diseases like IBS. Dysregulation of the system is implicated in the origination and continuation of several stress-sensitive disorders.

Managing Butterflies in the Stomach

Based on the mind-gut intimate relationship, it’s understandable that people diagnosed with anxiety disorders and/or mood disorders have a high rate of IBS symptoms. In research, cognitive behavioral therapy, and other psychological interactions were effective for those suffering from IBS.

Let’s say it’s the first time you’re doing public speaking or going on a date after many years of not dating. Maybe your pulse has quickened, you’re hyperventilating a bit, you’re weak in the knees and the butterflies in the pit of your stomach are doing somersaults. No need to worry as that’s a pretty normal reaction to have.

Here are ways to manage the stress and respond before it gets the better of you. Some things you can do in the moment to calm yourself and some suggestions you might want to develop a practice around:

Having butterflies in your stomach lets you know you’re excited or stressed about something. Most of the time it’s nothing to worry about. Often temporary, it will likely pass. But if you constantly have this sensation, you’re advised to get treatment. You might be experiencing some kind of panic, stress or anxiety disorder.

An aptitude test is designed to assess what a person is capable of doing or to predict what a person is able to learn or do given the right education and instruction. The goal of an aptitude test is to predict the ability to learn new skills. It represents a person’s level of competency to perform a certain type of task.

What Does an Aptitude Test Do?

Aptitude tests are often used to assess academic potential or career suitability and may be used to assess mental or physical talent in a variety of domains. They are based on the idea that people have innate abilities and inclinations that predispose them to succeeding (or struggling) in specific areas.

So, is an intelligence test an example of an aptitude test? Not exactly. The two tests are similar but distinct in what they measure. An intelligence test measures your current cognitive skills; on the other hand, an aptitude test measures whether you have the potential to develop skills in specific areas in the future.

Aptitude Test Examples

People encounter a variety of aptitude tests throughout their personal and professional lives, often starting while they are children going to school.

Here are a few examples of common aptitude tests:

• An aptitude test assessing an individual’s potential for becoming a fighter pilot
• A career test evaluating a person’s capability to work as an air traffic controller
• An aptitude test given to high school students to determine which type of careers they might be good at
• A computer programming test to determine how a job candidate might solve different hypothetical problems 
• An aptitude test designed to assess a person’s physical abilities needed for a particular job, such as a police officer or firefighter

When You Might Take an Aptitude Test

Some situations where you might encounter aptitude tests include those given in school or work settings. Some examples of how these might be used include:

Aptitude Tests in School

Students encounter a variety of aptitude tests throughout school as they think about what they might like to study in college or do as a career.

For example, a student might take an aptitude test suggesting they are good with numbers and data. Such results might imply that a career as an accountant, banker, or stockbroker would be a good choice for that student.

Another student might find that they have strong language and verbal skills, suggesting that a career as an English teacher, writer, or journalist might be a good choice.

Special Aptitude Tests

Special aptitude tests are designed to look at an individual’s capacity in a particular area. For example, a business that is looking to hire a computer programmer will consider a candidate’s work history and interview performance, but they might also want to administer an aptitude test to determine if a person possesses the necessary skill to perform the job.

In this case, the special aptitude test is designed to look at a very narrow range of ability: how skilled and knowledgeable the candidate is at computer programming.

Multiple Aptitude Tests

Multiple aptitude tests are designed to measure two or more different abilities. In some cases, such tests may even resemble intelligence tests in terms of their focus and scope. The Scholastic Assessment Test (SAT) that high school students take during their senior year is a good example of a multiple aptitude test.

The Graduate Requisite Exam (GRE), as well as the specialized tests required in order to get into medical (MCAT), law (LSAT), and business graduate programs, are also examples of multiple aptitude tests.

Types of Aptitude Tests

Aptitude tests fall into different categories or types. Different types are given in settings such as schools or workplaces.

Some of the common types of aptitude tests include those focused on specific skills, such as:

• Verbal reasoning: The capacity for language skills and reading comprehension
• Inductive reasoning: The ability to infer general ideas and principles based on specific observations
• Logical reasoning: The ability to use logic to solve problems, spot patterns, and identify relationships
• Numerical reasoning: Assesses overall numerical aptitude and ability to reason with and manipulate numerical data
• Abstract reasoning: The capacity for taking general, abstract information and using that information to solve problems and identify patterns
• Creative and artistic aptitude: The ability to come up with novel ideas and exhibit artistic potential
• Spatial reasoning: The ability to understand relationships between two- and three-dimensional objects, patterns, and shapes
• Situational judgment: The capacity for solving problems and making decisions quickly and accurately
• Mechanical aptitude: The ability to understand mechanical concepts and technical information
• Error checking: Looks at how well you are able to spot mistakes and errors

Intelligence Tests vs. Aptitude Tests

So what exactly makes an aptitude test different from an intelligence test? Below, we compare the differences.

Intelligence encompasses many different abilities including problem-solving, reasoning, memory, knowledge, and the ability to adapt to a changing environment.

Similar to intelligence and aptitude tests are achievement tests, which measure a person’s knowledge and skill level in a particular area. Achievement tests tend to focus on what a person has learned as a result of formal learning or training.

So, what are the differences among intelligence, achievement, and aptitude tests? Viewing the three types of tests in terms of a timeline may help you differentiate them:

• Past: Achievement tests measure what you’ve already learned or accomplished.
• Present: Intelligence tests measure the innate cognitive ability you have right now.
• Future: Aptitude tests aim to uncover where you can potentially apply your skills in the future.

Aptitude tests can help you get an idea of what you are good at or what you might be good at given the right training. However, these tests cannot tell you everything. Consider your results carefully and evaluate other factors, such as your interests and experiences. Then, use this information to explore career options.

A poor score on an aptitude test doesn’t mean that you don’t have the potential to eventually succeed or even excel in that area, just as a high score on an aptitude test isn’t a guarantee of success. Instead, think of this information as a guide for where you might need extra work. With the right support, training, and effort, you can play to your strengths and overcome potential weaknesses.

Clinical psychology specialty integrates the science of psychology with treating complex human problems. In addition to directing treating people for mental health concerns, the field of clinical psychology also supports communities, conducts research, and offers training to promote mental health for people of all ages and backgrounds.

This article discusses what clinical psychologists do, the history of the discipline, and the different approaches used today in treating mental health conditions.

What Is Clinical Psychology?

Clinical psychology is the branch of psychology concerned with assessing and treating mental illness, abnormal behavior, and psychiatric problems. This psychology specialty area provides comprehensive care and treatment for complex mental health problems. In addition to treating individuals, clinical psychology also focuses on couples, families, and groups.

History of Clinical Psychology

Early influences on the field of clinical psychology include the work of the Austrian psychoanalyst Sigmund Freud. He was one of the first to focus on the idea that mental illness was something that could be treated by talking with the patient, and it was the development of his talk therapy approach that is often cited as the earliest scientific use of clinical psychology.

American psychologist Lightner Witmer opened the first psychological clinic in 1896 with a specific focus on helping children who had learning disabilities. It was also Witmer who first introduced the term “clinical psychology” in a 1907 paper.

Witmer, a former student of Wilhelm Wundt, defined clinical psychology as “the study of individuals, by observation or experimentation, with the intention of promoting change.”

By 1914, 26 other clinics devoted to clinical psychology had been established in the United States. Today, clinical psychology is one of the most popular subfields and the single largest employment area within psychology.

Evolution During the World Wars

Clinical psychology became more established during the period of World War I as practitioners demonstrated the usefulness of psychological assessments. In 1917, the American Association of Clinical Psychology was established, although it was replaced just two years later with the establishment of the American Psychological Association (APA).

During World War II, clinical psychologists were called upon to help treat what was then known as shell shock, now referred to as post-traumatic stress disorder (PTSD).

During the 1940s, the United States had no programs offering a formal clinical psychology degree. The U.S. Veterans Administration set up several doctoral-level training programs and by 1950 more than half of all the Doctor of Philosophy (PhD)-level degrees in psychology were awarded in the area of clinical psychology.

Changes in Focus

While the early focus in clinical psychology had mainly been on science and research, graduate programs began adding additional emphasis on psychotherapy. In clinical psychology PhD programs, this approach is today referred to as the scientist-practitioner or Boulder Model.

Later, the Doctor of Psychology (PsyD) degree option emerged, which emphasized professional practice more than research. This practice-oriented doctorate degree in clinical psychology is known as the practitioner-scholar or Vail model.

Treatment Approaches in Clinical Psychology

Clinical psychologists who work as psychotherapists often utilize different treatment approaches when working with clients. While some clinicians focus on a very specific treatment outlook, many use what is referred to as an eclectic approach. This involves drawing on different theoretical methods to develop the best treatment plan for each individual client.

Some of the major theoretical perspectives within clinical psychology include:

Psychodynamic Approach

This perspective grew from Sigmund Freud’s work; he believed that the unconscious mind plays a vital role in our behavior. Psychologists who utilize psychoanalytic therapy may use techniques such as free association to investigate a client’s underlying unconscious motivations.

Modern psychodynamic therapy utilizes talk therapy to help people gain insight, solve problems, and improve relationships. Research has found that this approach to treatment can be as effective as other therapy approaches.

Cognitive Behavioral Approaches

This approach to clinical psychology developed from the behavioral and cognitive schools of thought. Clinical psychologists using this perspective will look at how a client’s feelings, behaviors, and thoughts interact. 

Cognitive-behavioral therapy (CBT) often focuses on changing thoughts and behaviors contributing to psychological distress. Specific types of therapy that are rooted in CBT include:

Humanistic Approaches

This approach to clinical psychology grew from the work of humanist thinkers such as Abraham Maslow and Carl Rogers. This perspective looks at the client more holistically and is focused on such things as self-actualization.

Some types of humanistic therapy that a clinical psychologist might practice include client-centered therapy, existential therapy, Gestalt therapy, narrative therapy, or logotherapy.

How to Become a Clinical Psychologist

In the United States, clinical psychologists usually have a doctorate in psychology and receive training in clinical settings. The educational requirements to work in clinical psychology are quite rigorous, and most clinical psychologists spend between four to six years in graduate school after earning a bachelor’s degree.

Before choosing a clinical psychology program, you should always check to be sure that the program is accredited by the APA. After completing an accredited graduate training program, prospective clinical psychologists must also complete a period of supervised training and an examination.

Students in the United Kingdom can pursue a doctorate-level degree in clinical psychology (DClinPsychol or ClinPsyD) through programs sponsored by the National Health Service.

These programs are generally very competitive and are focused on both research and practice. Students interested in enrolling in one of these programs must have an undergraduate degree in a psychology program approved by the British Psychological Society in addition to experience requirements.

Careers In Clinical Psychology

Clinical psychologists work in a variety of settings (hospitals, clinics, private practice, universities, schools, etc.) and in many capacities. All of them require these professionals to draw on their expertise in special ways and for different purposes.

Some of the job roles performed by those working in clinical psychology can include:

• Assessment and diagnosis of psychological disorders, such as in a medical setting
• Treatment of psychological disorders, including drug and alcohol addiction
• Offering testimony in legal settings
• Teaching, often at the university level
• Conducting research
• Creating and administering programs to treat and prevent social problems

Some clinical psychologists may focus on one of these or provide several of these services. For example, someone may work directly with clients who are admitted to a hospital for psychological disorders, while also running a private therapeutic office that offers short-term and long-term outpatient services to those who need help coping with psychological distress.

The Conners 4 is a reporting measure used for evaluating children and adolescents for attention-deficit/hyperactivity disorder (ADHD).

The Conners 4 has forms for parents and teachers that show how a child presents in the home and the classroom.

Children ages eight and up can also complete a self-report form that provides information about their experience of their symptoms.

What Is the Conners 4 Used For?

The Conners rating scales for ADHD were introduced by Multi-Health Systems, Inc (MHS) in 1970. It undergoes regular updates to ensure accuracy and validity. The Conners 4 is the most recent update and was released in 2022 and replaced the Conners 3.

The Conners 4 Test Measures

• When scored, the Conners 4 will measure:
• Attention issues
• Impulsivity
• Executive dysfunction
• Hyperactivity
• Anxiety
• Depression

Since it is not unusual for children and teens to have some difficulty with things like focusing throughout the school day, arguing with authority figures, or occasionally forgetting assignments, these scales help providers determine when a child’s difficulties go beyond what is developmentally appropriate.

Determining If an ADHD Diagnosis May Be Appropriate

In addition to these scales, the Conners 4 measures how closely the client’s presentation matches the diagnostic criteria for ADHD, oppositional defiant disorder (ODD), and conduct disorder. The Conners 4–ADHD Index then indicates how likely a client has ADHD based on these scores. This helps the evaluator determine whether a diagnosis of ADHD can explain symptoms the client is experiencing or if another diagnosis is a better fit.

Validity Scales

Finally, the Conners 4 has validity scales that screen for consistency (making sure that the person completing the form did not answer randomly) as well as for possible over or under-reporting of symptoms.

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, states that:

• A child or adolescent must have six symptoms of either inattentive or hyperactive-type ADHD in order to meet criteria and be diagnosed
• Older adolescents must have five or more symptoms.
• If a client meets criteria based on both the inattentive and hyperactive/impulsive symptoms, they can be diagnosed with ADHD Combined Type.

How Is the Conners 4 Different From Other Conners Tests?

According to MHS, the Conners 4 provides several useful updates from the previous edition:

• Improved Cultural Competency: First, developers incorporated new research about ADHD presentation across cultures and ethnicities to improve cultural competency and diagnostic accuracy for BIPOC children who, historically, have been misdiagnosed.
• Allowed for greater gender expression: Clients have the option to choose “other” as a gender instead of just “male” and “female” as well.
• Better rating scales: Instead of just screening for possible anxiety and depression, the Conners 4 has norm-referenced rating scales for these symptoms to provide more information about a child’s symptoms. Similarly, instead of simply asking if a child has difficulty in different areas, it calculates how severely a child is impaired at home, school, and in social settings. It provides additional questions about safety concerns and sleep issues as well.
• Updated Language: The Conners 4 uses updated language to be more inclusive and easier for respondents to understand.

Potential Limitations of the Conners 4

The Conners 4 does not independently determine whether or not someone has ADHD. An evaluator may administer a cognitive assessment to get more information about learning, functioning, and abilities.

They may use a test of sustained attention to observe a child or teen’s ability to focus in real-time. Depending on the child’s age, the evaluator may use a personality test to see if they meet criteria for another diagnosis in addition to or instead of ADHD.

As with previous versions of this measure, the Conners 4 measures observable behaviors. Since ADHD is a neurodevelopmental difference, it can impact behavior. However, some people with ADHD may mask or hide their symptoms and may get a false negative (test results might not be consistent with ADHD). In other words, someone who has ADHD might not be diagnosed with ADHD, and test results might not accurately reflect their diagnosis.

For those whose symptoms do not present in a way that is easily measured by the Conners 4, they may still identify with symptoms of ADHD. This is valid, and if they find that resources by and for the ADHD community benefit them, they can still use these resources.

Additionally, many do not have access to formal assessment for ADHD, particularly those with low income. If you notice symptoms but cannot get evaluated, the ADHD community and resources can still help you manage your or your child’s symptoms.

How to Complete the Conners 4

The Conners 4 can be completed on paper or online. Evaluators may send an encrypted link via email, allow you to complete the Conners 4 on a computer in their office, or provide a printed form.

Like the Conners 3, the Conners 4 utilizes a series of Likert scale questions with the options:

• Not true at all/Never
• Just a little true/Occasionally
• Pretty much true/Often
• Very much true/Very often

The Conners 4 Parent Form

If you complete the Conners 4 parent form (answering questions about your child), answer the questions honestly regarding your child’s behavior and what they shared with you.

The Conners 4 Self-Report Form

If you are completing the self-report form (if you are the child or teen being evaluated), answer honestly and know that there are no right or wrong responses about your own experience.

How Is the Conners 4 Scored?

The Conners 4 uses online scoring and yields T-scores, a type of norm-referenced rating. If you complete the Conners 4 online, the software scores your completed test and sends scores to the evaluator automatically. If you complete a paper form, the evaluator will input your responses into the scoring program.

“Over-reporting” means that an individual reported more symptoms than are actually present, and “under-reporting” means that they held back and did not disclose symptoms that might be present. The intent of validity scales is to determine when someone’s answers might not be honest, though sometimes validity scales might elevate even if the individual is trying to be honest in their report.

For instance, a child with low self-esteem might elevate for over-reporting, or a child who is worried about pleasing adults may elevate for under-reporting. A parent or teacher who is overwhelmed by a child’s behaviors might unintentionally over-report symptoms as well.

An evaluator must consider validity scales in interpreting the test data. If validity scales indicate that the scores cannot accurately determine whether or not an individual meets criteria for ADHD, the evaluator might use other self-report measures, tests of sustained attention, and information from the intake interview to determine whether or not criteria are present.

Understanding Your Child’s Conners 4 Scores

After completing an evaluation, a provider should meet with the parent and child to go over the scores and answer any questions you have about the results. 

Remember that inattention, restlessness, executive dysfunction, and other symptoms that occur with ADHD are not unique to one diagnosis. Even if a client does not meet the diagnostic criteria for ADHD, this does not mean they do not have these symptoms.

For more information on how to support your ADHD child, Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) is an organization run by and for the ADHD community. Additionally, Neurodivergent Practitioners and ND Therapists are both online directories that can connect you with mental health providers who offer neurodiversity-affirming care and support.