You can be a clinical psychologist without holding the title of Dr.
There is a psychotherapy institute near me that offers doctoral level classes, but you get a certificate instead of a degree.

To hold the title of Dr. you have to do the dissertation process. PhDs (and presumably PsyDs who also do a dissertation) are very possessive of the title. I'm a PhD candidate in the social sciences (not psych) doing dissertation research now. There are people who are ABD (all but dissertation) and other people who have terminal professional degrees (a J.D. for example, or C.P.A.) Typically those disciplines are not research oriented and don't require a dissertation. But they do require another test to gain the certification needed to actually practice.The MD (a regular medical doctor) in the US is a professional degree. In the UK it is an academic degree similar to a PhD. So in the US, you can hold the title of doctor with only the MD (first professional degree.) Its a rare exception to the rule I guess. The other exception is the PsyD which is clinical oriented but doesn't always require a dissertation. Most respected programs do require one though I think.

I think it pretty much holds true that in any nation, the dissertation process is the important threshold. If your program is geared to working with patients, you probably won't get a real "doctorate's" because you will probably finish without writing a dissertation.

If you ever go through the dissertation and peer review process, you'll know why people who achieve those titles become professionally possessive of them. UGH.