Professional Developments

It should be evident at this point that psychology has had more than its share of challenging problems in trying to maintain a scientific posture in academia while facing the growing demands of a service profession in the larger society. Before World War II the American Psychological Association (APA) was slow to grant unqualified membership to applied disciplines like clinical psychology. In reaction to this, many of its members broke away in 1938 to form the American Association of Applied Psychology (AAAP). It was not until 1944 that a reconciliation was achieved and the applied psychologists returned to the fold.

At the end of World War II about 44,000 servicemen and women were hospitalized with service-connected problems. A large proportion of them suffered from psychological maladjustments of one sort or another. Other veterans who were not hospitalized also experienced chronic emotional disorders from their wartime experience. To meet the need for counseling and psychotherapy, in 1946 the U.S. Veterans Administration introduced a program to train clinical psychologists that was to have tremendous influence on the growth of this profession. The subsequent Korean and Vietnam wars also helped further the use and acceptance among the broader public of such psycholog-ical treatments.

The rapid growth of clinical psychology generated concern over the exact nature of this profession. In 1947 the APA appointed a committee chaired by David Shakow (1901-1981) which, in 1949, sponsored a conference at Boulder, Colorado. The aim of this conference was to establish guidelines for training in clinical psychology. Its official report concluded that clinical psychologists should be trained first and foremost as scientists, and second as practicing clinicians. The resultant “Boulder model” of clinical psychology, which called for research expertise leading to the doctoral degree, is known as the scientist-practitioner model (Raimy, 1950).

By the 1960s there were more openings in clinical psychology than doctoral graduates to ill these positions (Schofield, 1966). Other areas of psychological application including social, developmental, forensic, and industrial-organizational, grew at three times the rate of academic areas like experimental psychology (Tryon, 1963). With the advancing longevity of the citizenry, geriatric psychology was to become a major aspect of caregiving. The applied trend can be seen in the founding of various divisions in the APA, many of which seem unrelated to scientific pursuits, as, for example, Psychologists in Public Service, Rehabilitation Psychology, Community Psychology, Exercise and Sport Psychology, and Media Psychology. A growing number of psychologists with traditional scientific interests complained that the APA had become a guild, interested primarily in furthering the financial goals of its members rather than seeking the basic principles of psychology. Applied psychologists answered by pointing out how their so-called basic science colleagues were influenced by granting agencies, which used project funding to direct what would or would not be empirically investigated. Economic factors were apparently at play on both sides of the coin.

By the mid-1960s mounting evidence accrued that strongly suggested that few clinical psychologists opted for a career in basic science. Undoubtedly, the social upheavals of the 1960s involving struggles over civil rights, rising crime rates, increasing use of drugs, and mounting opposition to the Vietnam War contributed to the motivation among applied psychologists to put their energies into rectifying these social and personal problems in living. A huge majority of clinical psychologists chose to work in the private sector, many times opening their own practices of diagnosis and treatment (Shakow, 1965). In the face of such developments another conference was held in 1973 at Vail, Colorado. The resultant “Vail model” recognized the importance of professional clinical training per se. In effect, the “scientist” emphasis of the Boulder model was dropped. The Vail model called for training in professional graduate schools that awarded a Doctor of Psychology (Psy.D.) instead of the Ph.D. This meant that a graduate student in a Psy.D. program did not have to present a research dissertation in order to be granted the degree. Graduates from Psy.D. programs have since made great contributions to the professional aspects of psychology and have been duly recognized in winning awards and achieving the distinction of being elected president of the APA. However, the predominant aspiration among graduate clinical programs in the United States remains the Boulder model.

There was an unresolved problem for those research psychologists (now in the minority!) who felt they were not being properly represented by the increasingly applied orientation of APA. In the 1980s several attempts to satisfy such dissidents were made, but no reorganization of APA seemed to work. The final plan designed to correct things was put before the APA membership in 1988, but it was rejected by two thirds of those voting. That fall a separate organization called the American Psychological Society (APS) was founded by the dissidents. The APS promised to “give psychology away” rather than sell it—a phrase taken from George Miller’s (1969) earlier presidential address to the APA in which he cautioned against the heavy trend toward applied psychology, with its attendant economic motives. History had therefore repeated itself, except now it was the basic scientists (APS) and not the applied professionals (AAAP) who walked out to found a separate organization from APA. Whether there will be another reconciliation only time will tell. Dynamic tensions within the APA have been an integral part of its history. Clinical and theoretical dialogue between divergent viewpoints will surely continue into the future. In 1977, the APA was composed of 50 divisions, and it celebrated the fiftieth anniversary of its divisional structure. APA division membership has grown by 17% over the last 10 years. Divisions within the APA continue to proliferate, and their relationship to APA continues to change and clarify over the years. With well over 110.000 members, the APA also recognizes the American Psychological Association for Graduate Students (APAGS) with over 40.000 members in 1997. The APA is the world’s largest organization for psychologists.

Although there were clinicians who had a consistent theoretical outlook in their work, such as the nondirective therapists who followed Carl Rogers, the theoretical rationale employed by most applied psychologists is best typified as eclectic. That is, surveys consistently revealed that a psychologist working in the field adapted her or his theory to the problem at hand, rather than adjusting the problem to fit only one preconceived theory. In psychotherapy, for example, we might find the same clinician who uses a neo-Freudian insight approach when working with adults relying on Skinnerian operant conditioning in working with children. In fact, a therapist might proffer an analytical insight to the same client with whom he is using some kind of behavior modification technique to reduce symptoms.

Whereas in the 1930s one would not be likely to hear of something called “cognitive behaviorism,” it became increasingly common to do so in the closing decades of the twentieth century. In all likelihood, this is just another manifestation of the effort we saw Bandura making to bring comprehensive explanations to psychology. Psychologists in the applied field were just as prone to introduce complexity into their views, or to combine theoretical formulations, as were psychologists in academia. The older schools of thought are gradually melding together. At the same time, however, there are new approaches to psychotherapy springing up almost monthly. Some of these, such as George A. Kelly’s (1905-1967) constructive alternativism, are welcome additions. But most of the others seem to be mere variations on established themes.

Psychology’s growth of popularity in American society has been phenomenal. It is consistently among the top selections as a major course of undergraduate study in colleges across the country. Businesses, church groups, the military complex—everywhere one looks in the post-World War II period there are signs of psychological involvement. Practicing clinicians have established certification and licensing requirements to further strengthen their professional identity. Due to rising costs, there has been a growing influence on the practice of psychology from third-party sources like insurance companies, who try to set standard fees, and the use of specific therapeutic techniques for the treatment of specific disorders. There are expectations that to keep costs down in the future, many clients will have therapy with practitioners holding a master’s degree, under the supervision of a Ph.D. psychologist. Terminal master’s degree programs in clinical psychology date back to the late 1940s and early 1950s. In the late 1990s there were over three hundred master’s programs related to psychology, graduating over 8,000 psychologists each year. In 1983, it was estimated that 28,000 master’s level professionals were working in the field of psychology. The Council of Applied Master’s Programs in Psychology (CAMPP) and The North American Association of Master’s in Psychology (NAMP) are relatively new organizations created to support master’s programs in psychology and master’s practitioners. There is an ongoing debate as to whether to admit master’s psychologists to full membership in the APA. An interesting aspect of the growth of psychology as a discipline and profession is the fact that more women are selecting psychology for both undergraduate and graduate study. Indeed, it is common to hear that a “feminization” of psychology took place over the final third of the twentieth century.

A continuing debate in clinical work has to do with just how successful psychotherapy is, and whether or not we really can train people to be effective therapists. The evidence suggests that psychotherapy per se does help people to adjust (Lambert & Bergin, 1992). But there is little proof that having advanced training in clinical work makes a great difference. Therapists with master’s degrees do as well as those with Ph.D. degrees (Dawes, 1994). Some Ph.D. clinicans seem therefore to want their clinical practice to be raised a notch. That is, they believe they should have the right to prescribe certain medications. Others think this should remain the responsibility of a physician. It was mentioned in the section on academic developments that biopsychology has been making great strides. Despite serious questions concerning the ultimate value of drug treatment (Fisher & Greenberg, 1997, pp. 115-172), emotional disorders such as depression are increasingly treated with pharmacological agents. But if psychology is being engulfed by biology (“socio-” or otherwise) in the academic realm and by medicine in the professional realm, what does that leave for it to do on its own?