A Preliminary Report
The Psychological Clinic Copyright, 1929, by Lightner Witmer, Editor VOL. XVIII, NOS. 3-4 May-June, 1929 validating the clinical method in vocational GUIDANCE
- Author:
Morris S. Viteles, Ph.D.
Assistant Professor of Psychology, University of Pennsylvania In 1921 there was organized, as a part of the Psychological Clinic of the University of Pennsylvania, a Vocational Guidance Clinic1 the purpose of which is to apply psychological principles and techniques?primarily those of clinical psychology?in helping the individual to ‘’ prepare for, enter upon, and make progress ln an occupation.”
Since 1921 there have been annually examined in the Clinic approximately 150 individuals, ranging in age from 14 to maturity, presenting problems of vocational adjustment. In this Clinic is employed a method of individualized treatment which has come to be known as the clinical method in guidance. The method has been described in detail elsewhere,2 but a brief reference to it seems necessary as an introduction to this sketchy description of a study designed to determine objectively the validity of this method as an approach in vocational guidance.
The chief feature of the clinical method is the shifting away from the consideration of the group as a unit of guidance, and an insistence upon the complete study of the individual as essential to adequate vocational guidance. This complete study of the individual for purposes of guidance is what is meant by the “clinical approach” in guidance. The aim of the clinical approach, or the 1 Viteles, Morris S., A Psychological Clinic for Vocational Guidance, Voc. Quid. Mag., Vol. IV, No. 2, November, 1925.
2 Viteles, Morris S., The Clinical Approach in Vocational Guidance, Voc. Guid. Mag., Vol. VII, No. 1, October, 1928.
purpose of the clinical examination is that of fitting together into a complete whole the various data bearing upon the life,?or more specifically in this case,?the vocational adjustment of the individual. In preparing such complete study of the individual for the purpose of guidance, at least eight factors must be considered.
These include:
The vocational interests of the individual.
2. His competency, or ability to profit from training in the occupation or occupations entered, and to attain success therein. 3. Temperament. 4. The individual’s health. 5. His appearance. 6. His education. 7. His vocational experience. 8. The social and economic factors affecting his life and of importance in guidance.
In connection with certain of these, such as interest and competency, it is possible for objective tests to be employed in completing the analysis. In the case of others, the interview and the social investigation of family life and individual history must be depended upon to secure the necessary information. Each of these factors must be weighted, and only as the result of a consideration of each of them can a definite decision of value to the individual be reached. In the Vocational Guidance Clinic referred to above, it has been the aim to make the decision, or counsel as definite as possible, that is, to send each individual away with as definite a program as it has been possible to formulate following a review and weighting of each of these factors.
The purpose of the study to be described here was to determine just how satisfactory this advice has been; to determine the extent to which the individual has been helped through the application of the clinical method in “preparing for, entering upon, and progressing in a vocation.” Briefly stated, the objective of the study has been to investigate the validity of this clinical method in vocational adjustment. The study has taken the form of follow-up in connection with which each individual who has received advice has been personally visited, and information concerning his progress obtained on a schedule designed to reveal facts of significance in gauging the Progress of the individual towards vocational adjustment. The nature of the items upon which information was sought and the import of the items can readily he discerned from an examination ?f the sample schedules presented in this report. The character ?f the data obtained in this way can perhaps be best illustrated by presenting in detail a few of the completed schedules. There is, for example, the case of I.R., presented in Schedule I below.
Schedule I PSYCHOLOGICAL CLINIC University of Pennsylvania Case No. Name: I. R. Date of Exam.: 1-12-24 Address: Date of Follow-up: 2-15-26 Referred by: J. W. S. Source of Information: J. W. S.
Diagnosis: Normal Mentality
^commendation: Complete 8tli grade academic work, after which he should learn watch repairing trade. This would not appear harmful to one suffering from his physical defect. Return to this clinic in one year. (Health condition consists of chronic pulmonary T.B., potentially active, with cardiac hypertrophy.)
PRESENT STATUS
I. If Attending School: A. School Record 1. Name of school 2. Grade Completed 8th grade. 3. Course 4. Conditions 5. Repetitions 6. Changes in Course 7. Reasons for course changes 8. Remarks B. Jobs Held During Summer and After School Ho’itrs Prnrr, T -r, ? . Separation vm-io Position Firm Urs. Earnings Cause 4-6-24? Stock boy Dept. Store Sat. $2.00 5”6’24 All Day 1. Remarks II. If Working A. 1. Date of leaving school: 6-1924 2. Reasons for leaving school: Graduated grammar school 72 THE PSYCHOLOGICAL CLINIC 3. School History between examination date and date of separation from school: a. Grades covered: 8 A & 8 B c. Repetitions: None b. Character of work: None d. Conditions: None B. Occupational Experience
From-To Position Firm Earnings
Separation Cause 7-10-24? Office Boy Dr Goods $10.00 a wk. Discharged 9-21-24 ?lack of initiative 2-16-25 To learn Jewelry Still Workto present trade shop $ 8.50 a wk. ing C. Supplementary School Training (School Attended, Courses taken, etc.) III. To What Extent Was Recommendation Followed: Boy working at jewelry shop. IV. If Not Followed, Why Not? Agency which referred the boy disapproved of work because of boy’s physical condition. Jeweler who was consulted felt the same way. V. Supplementary Data (Use reverse side of sheet if necessary). However, as seen above, after boy was unsatisfactorily placed in other jobs, he was placed with a jewelry concern where he is still working and getting along very well. I.R. did not work from October, 1924 until February, 1925, when he was sent to his present position. He never made an attempt to secure a job on his own initiative.
This represents a case in which after a few unsatisfactory trials in other fields, the recommendation was followed and resulted in a satisfactory adjustment. In contrast with this is the case of H.H. in which the recommendation has not been followed (Schedule II).
Schedule II PSYCHOLOGICAL CLINIC University of Pennsylvania Date of Exam.: 2-2-24 Case No.: 5526 Date of Follow-up: Name: H. H. February, 1926 Address: Referred by: White Williams Foundation Source of Information: Mother Diagnosis: Normal Mentality Recommendations That he be apprenticed to learn a trade, preferably that of machinist or tool maker, and that particular care be taken to choose that VALIDATING THE CLINICAL METHOD 73 type of organization which gives thorough training to its apprentices, and undertakes to develop with care boys accepted as apprentices. Present Status
If Attending School :
A. School Record 1. Name of school 2. Grade 3. Course 4. Conditions 5. Repetitions 6. Changes in Course 7. Reasons for course changes 8. Remarks B. Jobs Held During Summer and After School Hours
Separation
From-To Position Firm Hrs. Earnings Cause
1. Remarks II. If Working A. 1. Date of leaving school 2. Reasons for leaving school 3. School History between examination date and date of separation from school: a. Grades covered c. Repetitions b. Character of work d. Conditions B. Occupational Experience
Separation
Frorn-To Position Firm Earnings Cause Shortly Pasting Hat $12.00 a wk. after ex- leather Factory aaination bands in till hats Present date
C. Supplementary School Training (School Attended, Courses taken, etc) ?til. To What Extent Was Recommendation Followed: Recommendation was not followed.
IV. if Followed, Why Not? The idea didn’t especially appeal to the boy, and besides, he wanted to work at S’s hat factory to be with another boy, a friend of his.
V. Supplementary Data (Use reverse side of sheet if necesary). There is no chance of any advancement in that hat factory, so H.H. would like to change his position now. If he does, his mother says she will write to the Psychological Clinic about it.
However, such a citation of cases is unsatisfactory as the sole method of evaluating clinical techniques, although this has often been practically the only type of evidence offered in favor of accomplishments on the part of psychiatrists, social workers, clinical psychologists and others in presenting the advantages of the particular approach of each in individual adjustment. The citation of case studies must be supplemented by the study of the accomplishments of the group by means of the statistical method. A preliminary statistical analysis of this type has been undertaken in the case of those who have sought advice in the Vocational Guidance Clinic as a means of validating the clinical method. A brief survey of results obtained in such a preliminary statistical study of one group is presented below.
The group consists of 91 individuals seen in the Vocational Guidance Clinic during the academic year (1923-1924). They were followed up approximately two and one-half years after the visit to the Clinic. No follow-up could be made in the case of 16 of these, either because they had left the city or for other reasons, so that there remain 75 concerning whom information is available.
As a first step in this statistical study the proportion following the advice given in the Clinic was determined. This represents one measure of the value of the clinical method as well as of other methods in guidance. If a large proportion fail to follow the advice, it is evident that there is no excuse for continuing to give advice. In the case of this group of 75 it was found that 43, or 58 per cent, followed the recommendation completely. In addition, 16, or 21 per cent, partially followed the recommendation. The recommendation was considered as partially followed if the individual accepted part of the advice,?if, for example, he was placed in the job which was recommended but failed to take the evening course recommended. Similarly, if he was placed in a job similar to the one recommended, such as an apprentice in carpentry instead of cabinet making, it was considered that the advice had been partially followed. Applying such a standard it was found that a total of 59, or 79 per cent, had accepted and acted upon the advice given in the Vocational Guidance Clinic. In the case of 16, or 21 per cent, the advice was not followed.
It seemed interesting to examine the reasons given for failing to follow the advice.3 In 8 of the cases, the subject lost interest in the vocation recommended partly on the basis of his interests at the time of the examination. Home conditions and family dissuasions affected 3 of these cases. Economic reasons forced 4 to turn to more lucrative vocations. Other factors, such as illness, played a part in some cases. Thus illness, combined with a physical abnormality, caused one girl to lose every job secured after working a very shoit time. One subject did not want to be more than a mile or two from home when at work; in one case the examination was taken out of curiosity, etc. In practically every case in which the advice was not followed there are involved conditions arising after the examination. The fact that so large a percentage actually followed the advice, and that conditions not under the control of the Examiner influenced to so large an extent those who failed to follow the advice, are themselves evidence in favor of the value of this approach in guidance. That the advice is followed is probably in itself an evidence of satisfactory adjustment. Moreover, in going over the individual case records there is aroused the general impression that those who followed the advice are more satisfactorily adjusted than those who failed to do so. However, this impression may very readily be biased.
An attempt has been made to check this impression by means ?f a necessarily sketchy comparison of progress in school and at work of those who acted upon the advice with those who failed to act upon the clinical recommendation.
Of those who were examined, 35 were still attending school at the time of the follow-up. (It must be recalled that advice in many instances takes the form of a recommendation of a particular course in. school.)
Of 23 who followed the recommendation, 2, or 4.3 per cent, have failed or repeated one or more grades between the date of the examination and the date of the follow-up.
Of the 4 who ‘partially followed the recommendation, 1, or 25 per cent, has failed in school.
Of the 8 who failed to follow the recommendation, 3, or 35.7 per eent, have failed in school during this time. In the case of conditions, 2, or 8.7 per cent, of those who followed 3 In some cases more than one reason is given for the failure to follow the Clinic’s recommendation.
the recommendation have been conditioned in individual subjects; 1, or 25 per cent, of those who partially followed the recommendation, and 1, or 12 per cent, of those who failed to follow the recommendation. The low figure for conditions in the case of those who failed to follow the recommendation may be associated with the greater number of repetitions.
An interesting fact has appeared in the case of wages. Information on wages was available in the case of 24 who have left school. Of these, the 10 who followed the recommendation are making an average weekly wage of $13.35. Those who partially followed the recommendation are averaging $17.00 per week. Eight who failed to follow the recommendation are averaging $20.25 weekly. At first glance, it would therefore seem profitable not to follow the recommendations made in the Clinic. However, it must be kept in mind that blind alley jobs often pay a higher initial wage than those offering an opportunity for advancement, and that, in many instances, the recommendation was for an apprenticeship or placement in a job with low initial wages offering opportunities for training.
An attempt was made to analyze the changes in jobs during the period covered by the follow-up, but the length of time is too short to make these figures significant. Of those who have left school and are employed there are only 7 individuals who held more than two jobs. Of these, 3 are in the group of those who did not follow the recommendations. Of those who followed the recommendations none failed to obtain employment. Twenty per cent of those who partially followed the recommendations and ten per cent who did not follow the recommendations have had no jobs during this time. The facts given about this single group of 75 can only be considered as illustrative of the data which is being obtained in validating the clinical method, and not in any sense as conclusive. During the current year approximately 150 additional cases have been followed up. The addition of the figures from this follow-up will add to the reliability of those cited. It is planned, in addition, to resume the follow-up in every case at intervals of 2 or 3 years. In considering the facts presented in this report it must be pointed out that the writer does not consider this follow-up as fulfilling all the requirements of a complete evaluation of the clinical method. It is felt, for example, that it is necessary to cover a longer period of time before the exact value of guidance through this method can be determined. Much more information about changes in wages through a long period of time, about changes in jobs, etc., must be obtained. The influence of such factors as changes in the economic circumstances of the family, in health, in interest, must be submitted to more detailed analysis. Moreover, in a final evaluation it is necessary to compare the progress of a control group, consisting those to whom no advice has been given with an experimental Si’oup, consisting of those to whom advice has been given. The facts reported above are, however, suggestive of the value of the clinical method and of the importance of future follow-up studies of this type iu the evaluation of guidance activities employing the clinical as well as other methods.
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