clinical psychology

1. History of ClinicalHistory of Clinical
PsychologyPsychology
Roots ofRoots of TreatmentTreatment && PreventionPrevention
in Clinical Psychologyin Clinical Psychology
Lecture 6Lecture 6

2. How Clinical PsychologistsHow Clinical Psychologists
Became Involved inBecame Involved in TreatmentTreatment

3.  During the period of 1850-1890s, psychologists such asDuring the period of 1850-1890s, psychologists such as
Kraeplin focused on the classification of psychoses. But byKraeplin focused on the classification of psychoses. But by
the late 1800s, this focus shifted from psychoses tothe late 1800s, this focus shifted from psychoses to
investigating new treatments for neurotic patients, such asinvestigating new treatments for neurotic patients, such as
suggestion and hypnosis.suggestion and hypnosis.
 Specifically, Jean Charcot gained a widespread reputationSpecifically, Jean Charcot gained a widespread reputation
for his investigations of hysterical patients. Although trainedfor his investigations of hysterical patients. Although trained
as a neurologist, Charcot employed a psychosocialas a neurologist, Charcot employed a psychosocial
approach in explaining hysteria.approach in explaining hysteria.
 At about the same time, the momentous collaboration ofAt about the same time, the momentous collaboration of
Josef Breuer and Sigmund Freud began.Josef Breuer and Sigmund Freud began.

4. The beginning of PsychoanalysisThe beginning of Psychoanalysis
 In the early 1880s, Breuer was treating a young patientIn the early 1880s, Breuer was treating a young patient
named "Anna O", who was diagnosed with hysteria.named "Anna O", who was diagnosed with hysteria.
Anna O's treatment presented many challenges but alsoAnna O's treatment presented many challenges but also
led to the theoretical breakthroughs that greatlyled to the theoretical breakthroughs that greatly
influenced the psychotherapy practice later. Based oninfluenced the psychotherapy practice later. Based on
Freud's work with Charcot and Breuer's experiences withFreud's work with Charcot and Breuer's experiences with
hysterics, Breuer and Freud published Studies onhysterics, Breuer and Freud published Studies on
Hysteria in 1895.Hysteria in 1895.
 This collaboration served as the launching pad forThis collaboration served as the launching pad for
Psychoanalysis, the single most influential theoreticalPsychoanalysis, the single most influential theoretical
and treatment development in the history of psychiatryand treatment development in the history of psychiatry
and clinical psychology.and clinical psychology.

5.  In 1900, Freud publishedIn 1900, Freud published The Interpretation of DreamsThe Interpretation of Dreams thatthat
resulted in mainstream acceptance of the psychoanalyticresulted in mainstream acceptance of the psychoanalytic
perspective .perspective .
 The psychological conference at Clark university in 1906,The psychological conference at Clark university in 1906,
where Freud delivered his famous lectures to Americanwhere Freud delivered his famous lectures to American
professionals and general public, stimulated the acceptance ofprofessionals and general public, stimulated the acceptance of
Freud's psychoanalytic theories in United States .Freud's psychoanalytic theories in United States .
 For many coming years, the treatment of psychopathologyFor many coming years, the treatment of psychopathology
was dominated by the field of psychiatry, largely because ofwas dominated by the field of psychiatry, largely because of
the influence of Freud and the development of psychoanalysisthe influence of Freud and the development of psychoanalysis
as the primary method for treating psychopathology.as the primary method for treating psychopathology.

6.  As Freud was basically a physician, it would have beenAs Freud was basically a physician, it would have been
natural to assume that the treatment of psychopathologynatural to assume that the treatment of psychopathology
was an extension of the treatment of other disorders of thewas an extension of the treatment of other disorders of the
nervous system and, therefore, a task best left to trainednervous system and, therefore, a task best left to trained
physicians.physicians.
 Surprisingly, it was not Freud but his followers who arguedSurprisingly, it was not Freud but his followers who argued
that the practice of psychotherapy should be limited to thosethat the practice of psychotherapy should be limited to those
with medical training.with medical training.
 Consequently, the entry of psychologists into the therapyConsequently, the entry of psychologists into the therapy
enterprise became quite difficult.enterprise became quite difficult.

7.  One of the earliest ways in which psychologists becameOne of the earliest ways in which psychologists became
involved in the treatment of psychological problems wasinvolved in the treatment of psychological problems was
through the child guidance movement in the early 1900s.through the child guidance movement in the early 1900s.
 In 1909 William Healy established a child guidance clinic inIn 1909 William Healy established a child guidance clinic in
Chicago to provide services for children with psychologicalChicago to provide services for children with psychological
problems.problems.
 The clinic was staffed by psychiatrists, social workers, andThe clinic was staffed by psychiatrists, social workers, and
psychologists who treated children and adolescents,psychologists who treated children and adolescents,
primarily for problems that are now labeled Conduct Disorderprimarily for problems that are now labeled Conduct Disorder
and Oppositional Defiant Disorder in the DSM-IV.and Oppositional Defiant Disorder in the DSM-IV.

8.  A second trend that influenced early work in interventionsA second trend that influenced early work in interventions
with children was Play therapy. Based mostly on Freud'swith children was Play therapy. Based mostly on Freud's
psychoanalytic theory, psychologists conducted therapy inpsychoanalytic theory, psychologists conducted therapy in
which children were encouraged to engage in play and thewhich children were encouraged to engage in play and the
therapist would offer psychoanalytic interpretations of theirtherapist would offer psychoanalytic interpretations of their
play.play.
 Group therapy also began to attract attention. By the earlyGroup therapy also began to attract attention. By the early
1930s, the works of both J. L. Moreno and S. R. Slavson1930s, the works of both J. L. Moreno and S. R. Slavson
were having an impact.were having an impact.
 Another precursor of things to come was the technique ofAnother precursor of things to come was the technique of
"passive therapy" described by Frederick Allen (1934)."passive therapy" described by Frederick Allen (1934).

9.  With the exception of the early work of clinical psychologistsWith the exception of the early work of clinical psychologists
in child guidance clinics, the involvement of clinicalin child guidance clinics, the involvement of clinical
psychologists in the treatment of psychopathology has beenpsychologists in the treatment of psychopathology has been
primarily fueled by forces from outside psychology.primarily fueled by forces from outside psychology.
 In much the same way that the First World War was criticalIn much the same way that the First World War was critical
in increasing the role of psychologists in assessment, thein increasing the role of psychologists in assessment, the
Second World War played an integral role in the emergenceSecond World War played an integral role in the emergence
of clinical psychologists as providers of treatment forof clinical psychologists as providers of treatment for
psychopathology.psychopathology.

10. World War II: Clinical Psychology and theWorld War II: Clinical Psychology and the
Treatment of PsychopathologyTreatment of Psychopathology

11.  The Second World War renewed the need for psychologists toThe Second World War renewed the need for psychologists to
evaluate the competencies of thousands of men and womenevaluate the competencies of thousands of men and women
who were being enlisted in the armed services.who were being enlisted in the armed services.
 Psychologists were once again asked to administerPsychologists were once again asked to administer
psychological tests to draftees. World War II and the periodpsychological tests to draftees. World War II and the period
that followed it are most noteworthy, however, for thethat followed it are most noteworthy, however, for the
emergence of a new set of skills for psychologists.emergence of a new set of skills for psychologists.
 Clinical observations of soldiers who had experienced theClinical observations of soldiers who had experienced the
stress of combat led to the identification of a syndrome ofstress of combat led to the identification of a syndrome of
symptoms of psychological trauma that were displayed bysymptoms of psychological trauma that were displayed by
many soldiers. This syndrome was labeled "shell shock" ormany soldiers. This syndrome was labeled "shell shock" or
"battle fatigue" at the time, but is now known as Post"battle fatigue" at the time, but is now known as Post
Traumatic Stress Disorder (PTSD).Traumatic Stress Disorder (PTSD).

12.  The primary symptoms of PTSD are high levels of anxiousThe primary symptoms of PTSD are high levels of anxious
arousal, recurrent and persistent intrusive thoughts andarousal, recurrent and persistent intrusive thoughts and
emotions pertaining to the trauma, and persistent efforts toemotions pertaining to the trauma, and persistent efforts to
avoid all reminders and thoughts about the traumatic event.avoid all reminders and thoughts about the traumatic event.
 Physicians and others involved in providing medicalPhysicians and others involved in providing medical
assistance to combat soldiers noted that the symptoms couldassistance to combat soldiers noted that the symptoms could
be managed most effectively if the victims were treated asbe managed most effectively if the victims were treated as
quickly as possible and in the context of battle.quickly as possible and in the context of battle.
 Those soldiers for whom treatment was delayed andThose soldiers for whom treatment was delayed and
administered in a hospital removed from the battlefield wereadministered in a hospital removed from the battlefield were
more likely to suffer extended and more severe reactions thanmore likely to suffer extended and more severe reactions than
those who received immediate psychological attention.those who received immediate psychological attention.

13.  The dilemma faced by the armed services in addressingThe dilemma faced by the armed services in addressing
the needs of these thousands of "psychologicalthe needs of these thousands of "psychological
casualties" was the insufficient number of trainedcasualties" was the insufficient number of trained
individuals available to provide treatment.individuals available to provide treatment.
 Medical personnel, including those physicians trained inMedical personnel, including those physicians trained in
the relatively young field of psychiatry, were needed tothe relatively young field of psychiatry, were needed to
treat physical casualties.treat physical casualties.
 Psychologists were called on once again to fill a needPsychologists were called on once again to fill a need
because they were perceived as having the mostbecause they were perceived as having the most
representative set of skills needed for the taskrepresentative set of skills needed for the task

14. The National Council of Women PsychologistsThe National Council of Women Psychologists
 During World War ll, the majority of people who pursuedDuring World War ll, the majority of people who pursued
college and graduate degrees were male, and as a result,college and graduate degrees were male, and as a result,
most clinical psychologists were men. However, women inmost clinical psychologists were men. However, women in
psychology emerged as an important force during this time.psychology emerged as an important force during this time.
 Interestingly, women psychologists were excluded from APA'sInterestingly, women psychologists were excluded from APA's
war mobilization effort.war mobilization effort.
 Women within psychology founded theWomen within psychology founded the National Council ofNational Council of
Women PsychologistsWomen Psychologists and worked to help with communityand worked to help with community
problems, such us reducing the stress of war on civilians andproblems, such us reducing the stress of war on civilians and
giving advice about child care to women who worked outsidegiving advice about child care to women who worked outside
their homes during the war, many for the first time. Thistheir homes during the war, many for the first time. This
organization was just one example of the struggles of womenorganization was just one example of the struggles of women
to achieve equal status with men in clinical psychology.to achieve equal status with men in clinical psychology.

15. The Veterans' AdministrationThe Veterans' Administration
 The end of World War II brought rapid and dramaticThe end of World War II brought rapid and dramatic
changes in the field of clinical psychology.changes in the field of clinical psychology.
 At the conclusion of the war, the armed services and theAt the conclusion of the war, the armed services and the
Veterans' Administration (VA) were faced with the task ofVeterans' Administration (VA) were faced with the task of
providing care for more than 40,000 psychologicallyproviding care for more than 40,000 psychologically
wounded veterans who had returned home.wounded veterans who had returned home.
 Too few psychiatrists were available to manage this task;Too few psychiatrists were available to manage this task;
consequently, the VA chose to draw on psychology as aconsequently, the VA chose to draw on psychology as a
new source of professionally trained mental healthnew source of professionally trained mental health
personnel.personnel.

16.  At this time, the membership of APA, including psychologistsAt this time, the membership of APA, including psychologists
in all specializations, was barely 4,000.in all specializations, was barely 4,000.
 The VA system estimated that 4,700 clinical psychologistsThe VA system estimated that 4,700 clinical psychologists
were needed to provide treatment for psychological casualtieswere needed to provide treatment for psychological casualties
from World War II. To meet this need, the VA investedfrom World War II. To meet this need, the VA invested
enormous amounts of money to pay for the training ofenormous amounts of money to pay for the training of
doctoral-level clinical psychologists.doctoral-level clinical psychologists.
 Consequently, whereas in 1946 there were no formalConsequently, whereas in 1946 there were no formal
university programs to train clinical psychologists, by 1950university programs to train clinical psychologists, by 1950
half of all PhDs in psychology were being awarded in clinicalhalf of all PhDs in psychology were being awarded in clinical
psychology.psychology.

17. Alternative Approaches to PsychotherapyAlternative Approaches to Psychotherapy
 The role of psychologists in conducting psychotherapy wasThe role of psychologists in conducting psychotherapy was
expanded by more than just the military and VA hospitals.expanded by more than just the military and VA hospitals.
 Carl Rogers, one of the founders ofCarl Rogers, one of the founders of humanistic psychologyhumanistic psychology,,
was also influential in involving psychologists inwas also influential in involving psychologists in
psychotherapy during this period.psychotherapy during this period.
 While he was director of the Rochester Child GuidanceWhile he was director of the Rochester Child Guidance
Center, Rogers spearheaded an effort to loosen the hold ofCenter, Rogers spearheaded an effort to loosen the hold of
psychiatrists on the practice of psychotherapy, arguing thatpsychiatrists on the practice of psychotherapy, arguing that
trained and qualified clinical psychologists could perform astrained and qualified clinical psychologists could perform as
well as medically trained analysts.well as medically trained analysts.

18.  Rogers provided a strong impetus to move psychotherapyRogers provided a strong impetus to move psychotherapy
out of the exclusive realm of medicine, psychiatry, andout of the exclusive realm of medicine, psychiatry, and
psychoanalysis.psychoanalysis.
 With the publication in 1942 of his book Counseling andWith the publication in 1942 of his book Counseling and
Psychotherapy, Rogers not only identified psychotherapy asPsychotherapy, Rogers not only identified psychotherapy as
a legitimate activity for clinical psychologists but also offereda legitimate activity for clinical psychologists but also offered
the first model of psychotherapy that was not based onthe first model of psychotherapy that was not based on
psychoanalytic theory.psychoanalytic theory.

19. The Behavioral Approach:The Behavioral Approach:
 Finally, the role of psychologists in providing treatment forFinally, the role of psychologists in providing treatment for
psychological disorders was also fueled by advances inpsychological disorders was also fueled by advances in
theory and research on learning and conditioning processestheory and research on learning and conditioning processes
that led to behaviorally oriented treatments.that led to behaviorally oriented treatments.
 As models of classical conditioning and operant conditioningAs models of classical conditioning and operant conditioning
of behavior emerged over the course of the early and midof behavior emerged over the course of the early and mid
1900s, psychologists began to see the potential value of1900s, psychologists began to see the potential value of
these models for explaining and treating maladaptivethese models for explaining and treating maladaptive
behavior.behavior.
 For example, the early work of Watson, Raynor, and JonesFor example, the early work of Watson, Raynor, and Jones
showed the role that conditioning and learning play in theshowed the role that conditioning and learning play in the
development of fears (e.g., Jones, 1924a, 1924b).development of fears (e.g., Jones, 1924a, 1924b).

20.  Among the first to apply behavioral models to treatment wasAmong the first to apply behavioral models to treatment was
psychiatrist Joseph Wolpe (1958), who suggested thatpsychiatrist Joseph Wolpe (1958), who suggested that
"neurotic" behaviors (anxiety disorders) were learned through"neurotic" behaviors (anxiety disorders) were learned through
a process of conditioning and could be unlearned by a similara process of conditioning and could be unlearned by a similar
process, which he called "reciprocal inhibition".process, which he called "reciprocal inhibition".
 The principles of conditioning and learning theory wereThe principles of conditioning and learning theory were
applied to treat variety of clinical problems including phobiaapplied to treat variety of clinical problems including phobia
,obsessive compulsive ,anxiety and disruptive behavior in,obsessive compulsive ,anxiety and disruptive behavior in
children.children.
 In 1967,Association for Advancement of Behavioral TherapyIn 1967,Association for Advancement of Behavioral Therapy
(AABT) was founded and remains one of the major(AABT) was founded and remains one of the major
professional organizations for clinical psychologists.professional organizations for clinical psychologists.

21. The Cognitive – Behavioral Approach:The Cognitive – Behavioral Approach:
 The treatment focus in 1970s was on changingThe treatment focus in 1970s was on changing
thinking ,feelings and expectations becamethinking ,feelings and expectations became
important as the goal of changing overt behavior.important as the goal of changing overt behavior.
 The works of Albert Ellis using Rational EmotiveThe works of Albert Ellis using Rational Emotive
Behavior Therapy, Aron Beck using CognitiveBehavior Therapy, Aron Beck using Cognitive
treatments for depression; and the self efficacy worktreatments for depression; and the self efficacy work
of Bandura, led to the changes in the integrativeof Bandura, led to the changes in the integrative
cognitive approaches with behavioral approaches.cognitive approaches with behavioral approaches.

22. Present ApproachesPresent Approaches
 During the late 1970s and early 1980s professionals soughtDuring the late 1970s and early 1980s professionals sought
to integrate the best methods of the various approaches onto integrate the best methods of the various approaches on
case-by-case basis. An emphasis was placed on thecase-by-case basis. An emphasis was placed on the
common factors leading to an Eclectic Approach.common factors leading to an Eclectic Approach.
 Emerged in late 1900s, the Bio-psycho-social approachEmerged in late 1900s, the Bio-psycho-social approach
suggested that the biological ,psychological and socialsuggested that the biological ,psychological and social
aspects of health and illness intimately influence each other.aspects of health and illness intimately influence each other.
Thus psychologists must understand the multidimensionalThus psychologists must understand the multidimensional
bio-psycho-social influences in order to treat and understandbio-psycho-social influences in order to treat and understand
others.others.

23. How Clinical Psychologists BecameHow Clinical Psychologists Became
Involved inInvolved in PreventionPrevention ofof
PsychopathologyPsychopathology

24.  The treatment of psychopathology, like the treatment of anyThe treatment of psychopathology, like the treatment of any
problem or disorder, can reduce the prevalence or numberproblem or disorder, can reduce the prevalence or number
of existing cases of disorder. Treatment cannot, however,of existing cases of disorder. Treatment cannot, however,
reduce the incidence of new cases of a disorder.reduce the incidence of new cases of a disorder.
 That is, no matter how effective psychologists become inThat is, no matter how effective psychologists become in
treating problems related to anxiety, depression, eatingtreating problems related to anxiety, depression, eating
disorders, or substance abuse, to name but a few, thedisorders, or substance abuse, to name but a few, the
treatment of existing problems will not reduce the number oftreatment of existing problems will not reduce the number of
new individuals who develop these problems.new individuals who develop these problems.
 Recognition of this simple fact provided the impetus for theRecognition of this simple fact provided the impetus for the
development of prevention efforts in public health in generaldevelopment of prevention efforts in public health in general
and for the prevention of psychopathology in particular.and for the prevention of psychopathology in particular.

25.  Prevention of psychological problems was not an integral partPrevention of psychological problems was not an integral part
of the goals of clinical psychology as the science andof the goals of clinical psychology as the science and
profession developed during the first half of the twentiethprofession developed during the first half of the twentieth
century.century.
 Beginning in the 1950s, however, a number of factorsBeginning in the 1950s, however, a number of factors
increased psychologists' awareness of the importance ofincreased psychologists' awareness of the importance of
prevention in dealing with mental health concerns in Americanprevention in dealing with mental health concerns in American
society.society.
 The report of theThe report of the United States Joint Commission on MentalUnited States Joint Commission on Mental
Illness and HealthIllness and Health in the latein the late 1950s1950s, President Kennedy's, President Kennedy's
initiative for new programs to combat mental retardation andinitiative for new programs to combat mental retardation and
psychological disorders inpsychological disorders in 19631963, and the development of, and the development of
comprehensive community mental health centers in thecomprehensive community mental health centers in the 1960s1960s
were all landmark events in moving prevention into mentalwere all landmark events in moving prevention into mental
health programs and policies in the United States.health programs and policies in the United States.

26.  All these initiatives highlighted the need to reduce theAll these initiatives highlighted the need to reduce the
incidence of new cases of psychopathology.incidence of new cases of psychopathology.
 In addition, they emphasized the unequal access ofIn addition, they emphasized the unequal access of
Americans to mental health treatment. Individuals of lowerAmericans to mental health treatment. Individuals of lower
socioeconomic status have less access to mental healthsocioeconomic status have less access to mental health
professionals and are less able to pay for such servicesprofessionals and are less able to pay for such services
because of lack of income and lack of health insurance tobecause of lack of income and lack of health insurance to
cover the costs of such services.cover the costs of such services.
 Prevention programs that can eliminate some of the socialPrevention programs that can eliminate some of the social
factors that contribute to the development of psychologicalfactors that contribute to the development of psychological
problems may be able to eliminate some of these inequities.problems may be able to eliminate some of these inequities.

27.  Clinical psychologists have played a central role in theClinical psychologists have played a central role in the
development of prevention programs to reduce the incidencedevelopment of prevention programs to reduce the incidence
of new cases of a wide range of psychological problems andof new cases of a wide range of psychological problems and
disorders.disorders.
 Prevention programs focus primarily on children asPrevention programs focus primarily on children as
psychologists attempt to prevent the onset of disorders earlypsychologists attempt to prevent the onset of disorders early
in children's lives.in children's lives.
 Prevention includes programs to prevent aggressivePrevention includes programs to prevent aggressive
behavior and conduct disorder, depression, and substancebehavior and conduct disorder, depression, and substance
use & abuse, and so on.use & abuse, and so on.

28. The Development of ClinicalThe Development of Clinical
Psychology as a ProfessionPsychology as a Profession

29.  As clinical psychologists have acquired new skills and roles,As clinical psychologists have acquired new skills and roles,
particularly in the areas of assessment, and treatment,particularly in the areas of assessment, and treatment,
psychology has needed to organize itself as a profession topsychology has needed to organize itself as a profession to
monitor and regulate the activities of those who presentmonitor and regulate the activities of those who present
themselves to the public as clinical psychologists.themselves to the public as clinical psychologists.
 For example, what does it mean to say that you are a clinicalFor example, what does it mean to say that you are a clinical
psychologist?psychologist?
 What skills, competencies, and credentials must you have inWhat skills, competencies, and credentials must you have in
order to use this label for yourself?order to use this label for yourself?
 What are the ethical and professional standards that governWhat are the ethical and professional standards that govern
psychologists' interactions with their clients?psychologists' interactions with their clients?
 What assurances are provided to the public that the methodsWhat assurances are provided to the public that the methods
used by clinical psychologists have been proven to be effective?used by clinical psychologists have been proven to be effective?

30.  All such issues had to be addressed as clinicalAll such issues had to be addressed as clinical
psychology has worked to define and regulate itself as apsychology has worked to define and regulate itself as a
profession.profession.
 TheThe APAAPA has played a leading role in the developmenthas played a leading role in the development
and regulation of the profession of psychology,and regulation of the profession of psychology,
including establishing ethical principles for the practiceincluding establishing ethical principles for the practice
of psychology, accrediting training programs in clinicalof psychology, accrediting training programs in clinical
psychology, and working with state legislatures and thepsychology, and working with state legislatures and the
U.S. Congress to support legislation to monitor andU.S. Congress to support legislation to monitor and
regulate the practice of psychology.regulate the practice of psychology.

31. Clinical psychology’sClinical psychology’s
Interactions with APAInteractions with APA

32.  During the early part of the twentieth century, clinical and otherDuring the early part of the twentieth century, clinical and other
applied psychologists complained that their interests were notapplied psychologists complained that their interests were not
being met within the APA. As a result, in 1917 fifteen of the 375being met within the APA. As a result, in 1917 fifteen of the 375
members of APA broke off to form the American Association ofmembers of APA broke off to form the American Association of
Clinical Psychology (AACP).Clinical Psychology (AACP).
 With the threat of losing more members, APA reluctantly agreed toWith the threat of losing more members, APA reluctantly agreed to
consider certifying some members as "consulting psychologists"consider certifying some members as "consulting psychologists"
and two years later in 1919, established a special Clinical Sectionand two years later in 1919, established a special Clinical Section
to handle professional issues.to handle professional issues.
 In the early 1930s, the New York State Psychological Association,In the early 1930s, the New York State Psychological Association,
in an attempt to deal with issues of ethics, licensing, andin an attempt to deal with issues of ethics, licensing, and
standardization of training, became the Association of Counselingstandardization of training, became the Association of Counseling
Psychologists (ACP). In 1937, the clinical section of the APAPsychologists (ACP). In 1937, the clinical section of the APA
disbanded, left the APA again, and joined ACP, which wasdisbanded, left the APA again, and joined ACP, which was
renamed the American Association for Applied Psychologyrenamed the American Association for Applied Psychology
(AAAP).(AAAP).

33.  The formation of American Association for AppliedThe formation of American Association for Applied
Psychology represented a significant split between thePsychology represented a significant split between the
scientific and applied aspects of psychology.scientific and applied aspects of psychology.
 In a reflection of this split, in 1939 Carl Rogers discussed theIn a reflection of this split, in 1939 Carl Rogers discussed the
possibility of awarding professional psychologists a doctor ofpossibility of awarding professional psychologists a doctor of
psychology degree (similar to the current PsyD degree)psychology degree (similar to the current PsyD degree)
rather than a PhD.rather than a PhD.
 The split between scientific and applied psychology wasThe split between scientific and applied psychology was
addressed in the 1940s when APA changed its membershipaddressed in the 1940s when APA changed its membership
standards.standards.
 The APA previously had required that its members mustThe APA previously had required that its members must
have at least two research publications beyond thehave at least two research publications beyond the
dissertation. In 1945 APA was restructured in ways that weredissertation. In 1945 APA was restructured in ways that were
particularly supportive of practitioners, including anparticularly supportive of practitioners, including an
elimination of the requirement of publications forelimination of the requirement of publications for
membership.membership.

34.  The impetus for this change came from the need to unifyThe impetus for this change came from the need to unify
psychologists for the purpose of responding to the country'spsychologists for the purpose of responding to the country's
wartime needs.wartime needs.
 The APA by laws were expanded to include the advancementThe APA by laws were expanded to include the advancement
of psychology not only as a science but also as a professionof psychology not only as a science but also as a profession
and as a means of promoting human welfare.and as a means of promoting human welfare.
 An arm of the APA, the Practice Directorate, is devotedAn arm of the APA, the Practice Directorate, is devoted
specifically to issues that pertain to psychology as aspecifically to issues that pertain to psychology as a
profession. The Practice Directorate supports legislation that isprofession. The Practice Directorate supports legislation that is
important to psychology, conducts public educationimportant to psychology, conducts public education
campaigns, and engages in efforts to support practicingcampaigns, and engages in efforts to support practicing
psychologists.psychologists.

35. Formation of a new organization: TheFormation of a new organization: The
American Psychological SocietyAmerican Psychological Society

36.  The tension between research and appliedThe tension between research and applied
interests of psychology arose again in the 1980sinterests of psychology arose again in the 1980s
when academic psychologists raised concernswhen academic psychologists raised concerns
that APA had become too involved with thethat APA had become too involved with the
practice of psychology and was ignoringpractice of psychology and was ignoring
psychological research.psychological research.
 These concerns led to the formation of a newThese concerns led to the formation of a new
organization, the American Psychologicalorganization, the American Psychological
Society (APS), in 1988.Society (APS), in 1988.

37.  The APS is strongly committed to the promotion ofThe APS is strongly committed to the promotion of
scientific research in basic and applied psychology andscientific research in basic and applied psychology and
provides an alternative for psychologists who worry thatprovides an alternative for psychologists who worry that
APA has become more of a guild to protect the practice ofAPA has become more of a guild to protect the practice of
psychology in ways that are not tied to the scientific basispsychology in ways that are not tied to the scientific basis
of the field.of the field.
 The two groups function independently of one another withThe two groups function independently of one another with
separate governing bodies, separate annual conventions,separate governing bodies, separate annual conventions,
and separate scientific journals. However, manyand separate scientific journals. However, many
psychologists, and many scientifically oriented clinicalpsychologists, and many scientifically oriented clinical
psychologists in particular, are members of bothpsychologists in particular, are members of both
organizations.organizations.

38. ConclusionConclusion

39.  The history of clinical psychology can be tracedThe history of clinical psychology can be traced
through advances and landmark events in research,through advances and landmark events in research,
assessment, treatment, and prevention and throughassessment, treatment, and prevention and through
the development of the profession of clinicalthe development of the profession of clinical
psychology.psychology.
 Contemporary clinical psychology is ever evolvingContemporary clinical psychology is ever evolving
,currently adapting to numerous changes and,currently adapting to numerous changes and
challenges.challenges.
 Clinical psychology has now found its way intoClinical psychology has now found its way into
general health care with applications to numerousgeneral health care with applications to numerous
medical problems and issues.medical problems and issues.

40.  Although the changes in clinicalAlthough the changes in clinical
psychology have been radical, the goalpsychology have been radical, the goal
that binds clinical psychologists togetherthat binds clinical psychologists together
remains the same: to apply theirremains the same: to apply their
knowledge and skill to the mental healthknowledge and skill to the mental health
needs of people everywhere.needs of people everywhere.

41. THE ENDTHE END