The Definition of Clinical Psychology and Standards of Training for Clinical Psychologists
PART I
In undertaking to clarify the terms “clinical psychology” and “clinical psychologist” and to define desirable standards of training of clinical psychologists, the committee sought the opinions of outstanding psychologists for the purpose of basing its report upon their combined judgments, and addressed the following questions to about twenty five clinical psychologists:
1. What is clinical psychology? There has been some question as to the meaning of the term “clinical” and some doubt about its use. If you think the term should not be used as a description of the work that is usually done, state what your concept of the term is.
Clinical psychology is sometimes referred to as a field of work and sometimes as a method of approach. In your opinion how should it be used? What types of problems should be studied by the “clinical” psychologist and what should not? Be as specific as you can. 2. What should be the minimum requirements for qualification as a clinical psychologist in terms of (a) academic courses, (Z>) academic degrees, and (c) experience?
Upon the basis of the replies to these questions the committee formulated the following report concerning the definition of clinical psychology and standards of training for clinical psychologists. I. Definition of Clinical Psychology A. Use of the Term There is some dissatisfaction with the use of the term “clinical.” One psychologist refuses to use the word as descriptive of the type of work done or of the service given. Others, while not refusing to use the term, express a preference for such terms as “psychological counselling,” “personal development service,” “psychological service,” or “individual psychology.” The dissatisfaction seems to be due largely to the fact that in its derivation, as well as in its original use, the term implies bedside care and that it has been definitely borrowed from the field of medicine. Some object to the term on the ground that other terms such as “psychological service” or “personal development service” give a better description of the type of work done and are more inviting to clients. A large majority of the psychologists, however, are of the opinion that although the term “clinical” is not entirely a fortunate one, nevertheless it has become so sanctioned by usage for the last twenty-five years that it should be retained; indeed many agree that it would be difficult to abolish the term even if it were desirable to do so.
Although the term is borrowed from medicine and was originally used to connote bedside care of a patient it is no longer used by any profession in this restricted sense. There are eye clinics, dental clinics, mental hygiene clinics, and out-patient clinics. These applications of the term seem entirely appropriate and do not involve any distortion of the use of the term. The committee therefore recommends that the use of the terms “clinical psychology,” “clinical psychologists,” and “psychological clinic” be continued, and that clinical psychology be used to denote that art and technology which deals with the adjustment problems of human beings.
Scope and Meaning and Methods of Approach
Clinical psychology is defined both as a field of work and as a method of approach. It is a field of work in the sense that it is the application of certain psychological principles, knowledge, and procedures to the individual problems of human adjustment. This body of psychological principles and knowledge which is available for application to particular human problems is the field of clinical psychology. It is a method of approach in that certain techniques and methods are used in the application of these principles to the problems of a particular individual.
These problems include vocational guidance, industrial selection and placement, differential mental diagnosis, educational classification, mental hygiene, child guidance, special education, delinquency, and so on. In short, clinical psychology is a form of applied psychology which aims to define the behavior capacities and behavior characteristics of an individual through methods of measurement, analysis, and observation; and which, on the basis of an integration of these findings with data secured from the physical examinations and social histories, gives suggestions and recommendations for the proper adjustment of that individual. So formulated, clinical psychology may concern itself with the behavior problems of normal, superior, inferior, and abnormal individuals of all ages. In all medically complicated cases, however, it should have a cooperative relationship with clinical medicine. The clinical psychologist should not undertake responsibilities which in the long run can be safeguarded only through the profession of medicine. Thus defined, it becomes apparent that the field of clinical psychology is extremely broad. It includes that body of psychological knowledge and those psychological techniques which are necessary to the understanding of the psychological aspects of human behavior. Where physical or medical problems are involved, diagnosis and treatment should be carried on in cooperatioin with the physician. This implies that if a case involving both psychological and medical problems is first referred to a psychologist, the physician should work as an auxiliary to the psychologist; and that, on the other hand, when such a case is referred to a physician, the psychologist should serve as the auxiliary.
While clinical psychology is a form of applied psychology that does not mean that the field is without academic and research possibilities. On the contrary, some of the fundamental problems of general psychology can be approached best through the clinical method. The contributions of the study of the feeble-minded to general psychology have long been recognized as important. The studies of the abnormal and the delinquent have contributed heavily to our knowledge of the factors influencing the development of personality. Moreover, sound clinical procedure can be based only upon the results of sound research. The committee believes the growth of clinical psychology to be dependent upon continued research, and recommends strongly that the research method be an integral part of clinical procedure.
II. Standards of Training for Clinical Psychologists If the above statement of the field and methods of clinical psychology is correct, it becomes apparent that the clinical psychologist must be exceptionally well trained. The problems of human adjustment have such wide ramifications that even in the present formative state of our knowledge no one person can master the entire field. If the clinical psychologist specializes in speech defects, he can scarcely be equally conversant with juvenile delinquency; if he specializes in the educational guidance of school children, he will probably not attain equal authority in work with adults; the problems of the pre-school child are not those of the adolescent; and, moreover, when he deals with the abnormal and subnormal, he must reckon in many ways with other branches of science such as neurology, endocrinology, and anatomy.
It is obvious, therefore, that if the clinical psychologist is to be competent he must specialize in some particular branch of clinical psychology. It is equally obvious that it is impossible to specify, except in a general way, courses of study for his training. For example, the course of study which is of particular value to the personnel officer in industry may be of little value to the specialist in mental retardation; and the courses which are necessary for work in the pre-school field may not be those prescribed for work with adults or delinquents. However, if clinical psychology is conceived as the art and technology which deals with the adjustment problems of human beings, then certain broad general courses become clearly evident. It is clear that if one is to deal with the problems of human adjustments, he must have well in hand that large body of theoretical knowledge about human behavior known as psychology. He can secure this only by assiduously applying himself in a systematic way to the usual academic courses in psychology, such as general, experimental, comparative, systematic, abnormal, child, and educational psychology, as well as to statistics and to mental and educational tests. In fact, it should be assumed that if one is to be a clinical psychologist he should first be a psychologist.
But the art of dealing with human adjustment requires more than a knowledge of human behavior. Adjustment depends as freREPORT OF COMMITTEE OF CLINICAL SECTION 7 quently upon a manipulation of the factors without the individual as it does upon the analysis of those within. Therefore, the clinical psychologist should be thoroughly acquainted with the schools, both private and public, and with the institutions and other community resources for placement and training. He should have a grasp of the philosophy of education and of modern educational methods, and should be particularly familiar with the various types of special education, such as the education of the retarded and of the physically and socially handicapped.
He should have an appreciation of the influence of community and family life upon the behavior of the individual. It is therefore necessary that he pursue courses in sociology and in social pathology. He should be able to recognize some of the more common physical disorders in order to refer them to the proper authorities. He should therefore have courses in physiology, neurology, and anatomy and heredity; and should have one or more years of clinical experience in the observation and examination of different types of clinical cases, as well as experience in the systematic observation of the behavior of normal children.
While the committee recommends that nothing less than the training outlined above be accepted as sufficient for the practice or the registration for the practice of clinical psychology, nevertheless, in order to bring theoretical standards into accord with actual practice, it believes it necessary to recognize two levels of clinical work, namely that of the clinical psychologist and that of the assistant clinical psychologist, with respective qualifications1 stipulated as follows.
Psychologist
The clinical psychologist shall possess the degree of Doctor of Philosophy or equivalent degree in Psychology from an accredited university.
He shall have mastered the general technique of experimental and research methods, and shall be qualified to conduct and direct research independently.
He shall be familiar with modern educational philosophy and methods, and shall have general knowledge in the fields of the biological and social sciences. i Based in part upon ‘’ Training and Standards for the Clinical Psychologist” contained in the 1933 and 1934 Year Books of The Association of Consulting Psychologists.
He shall have gained at least one year’s experience2 under clinical conditions where he shall have had adequate supervision, and shall be acquainted with a variety of clinical cases. He shall have knowledge of cotirt procedure in the commitment of cases.
Assistant Psychologist The assistant psychologist shall possess the degree of Master of Arts or equivalent degree in Psychology from an accredited university. He shall have gained one year’s experience 3 under clinical conditions where he shall have had adequate supervision, and shall be acquainted with a variety of clinical cases.
2 One year shall be designated as fifteen hours per week covering a period of forty weeks.
Experience shall include practice in: (a) the use of various tests and scales, (ft) the interpretation of test results, (c) remedial procedures in dealing with educational disabilities, behavior disorders, and personality difficulties, and (d) vocational and educational guidance. 3 To be defined as above.
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