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Many 18th-century treatments for psychological distress were based on pseudo-scientific ideas, such as phrenology.

Although research in psychology is often dated to the opening of the first psychological laboratory by Wilhelm Wundt in 1879, attempts to create methods for assessing and treating mental distress existed long before. The earliest recorded approaches were a combination of religious, magical, and/or medical perspectives.[1] Early examples of such physicians included Patañjali, Padmasambhava,[2] Rhazes, Avicenna,[3] and Rumi.[4]

In the early 19th century, one could have his or her head examined, literally, using phrenology, the study of personality by the shape of the skull. Other popular treatments included physiognomy—the study of the shape of the face—and mesmerism, Mesmer's treatment by the use of magnets. Spiritualism and Phineas Quimby's "mental healing" were also popular.[5]

While the scientific community eventually rejected these methods, academic psychologists also were not concerned with serious forms of mental illness. That area was already being addressed by the then-developing fields of psychiatry and neurology within the asylum movement.[1] It was not until the end of the 19th century, around the time when Sigmund Freud was first developing the recent idea of a "talking cure" in Vienna, that the first clinical applications of psychology began.[citation needed]

Early clinical psychology

Lightner Witmer, the father of modern clinical psychology

By the second half of the 1800s, the scientific study of psychology was becoming well-established in university laboratories. Although there were a few scattered voices calling for an applied psychology, the general field looked down upon this idea and insisted on "pure" science as the only respectable practice.[1] This changed when Lightner Witmer (1867–1956), a past student of Wundt and head of the psychology department at the University of Pennsylvania, agreed to treat a young boy who had trouble with spelling. His successful treatment was soon to lead to Witmer's opening of the first psychological clinic at Penn in 1896, dedicated to helping children with learning disabilities.[6] Ten years later in 1907, Witmer was to found the first journal of this new field, The Psychological Clinic, where he coined the term "clinical psychology," which he defined as "the study of individuals, by observation or experimentation, with the intention of promoting change."[7] The field was slow to follow Witmer's example, but by 1914, there were 26 similar clinics in the US.[8]

Even as clinical psychology was growing, working with issues of serious mental distress remained the domain of psychiatrists and neurologists.[9] However, clinical psychologists continued to make inroads into this area due to their increasing skill at psychological assessment. Psychologists' reputation as assessment experts grew during World War I with the development of two intelligence tests, Army Alpha and Army Beta (testing verbal and nonverbal skills, respectively), which could be used to screen large groups of military recruits.[5][6] Due in large part to the success of these tests, assessment became the core function of clinical psychology for the next quarter century, when another war would propel the field into treatment.[citation needed]

Early professional organizations

The field began to organize under the name "clinical psychology" in 1917, when J. E. Wallace Wallin led the founding of the American Association of Clinical Psychology. This only lasted until 1919, after which the American Psychological Association (founded by G. Stanley Hall in 1892) developed a section on Clinical Psychology, which offered certification until 1927.[8] Growth in the field was slow for the next few years when various unconnected psychological organizations came together as the American Association of Applied Psychology in 1930, which would act as the primary forum for psychologists until after World War II when the APA reorganized.[10] In 1945, the APA created what is now called The Society of Clinical Psychology (Division 12), which remains a leading organization in the field. Psychological societies and associations in other English-speaking countries developed similar divisions, including in Britain, Canada, Australia and New Zealand.[citation needed]

World War II and the integration of treatment


The US army conducts a psychological test developed by clinical psychologists for selection purposes. The image is card IV of the Rorschach inkblot test.

When World War II broke out, the military once again called upon clinical psychologists. As soldiers began to return from combat, psychologists started to notice symptoms of psychological trauma labeled "shell shock" (eventually to be termed posttraumatic stress disorder) that were best treated as soon as possible.[6] Because physicians (including psychiatrists) were over-extended in treating bodily injuries, psychologists were called to help treat this condition.[11] At the same time, female psychologists (who were excluded from the war effort) formed the National Council of Women Psychologists with the purpose of helping communities deal with the stresses of war and giving young mothers advice on child rearing.[7] After the war, the Veterans Administration in the US made an enormous investment to set up programs to train doctoral-level clinical psychologists to help treat the thousands of veterans needing care. As a consequence, the US went from having no formal university programs in clinical psychology in 1946 to over half of all Ph.D.s in psychology in 1950 being awarded in clinical psychology.[7]

WWII helped bring dramatic changes to clinical psychology, not just in America but internationally as well. Graduate education in psychology began adding psychotherapy to the science and research focus based on the 1947 scientist–practitioner model, known today as the Boulder Model, for Ph.D. programs in clinical psychology.[12] Clinical psychology in Britain developed much like in the U.S. after WWII, specifically within the context of the National Health Service[13] with qualifications, standards, and salaries managed by the British Psychological Society.[14]

Development of the Doctor of Psychology degree

By the 1960s, psychotherapy had become imbedded within clinical psychology, but for many the Ph.D. educational model did not offer the necessary training for those interested in practice rather than research. There was a growing argument that said the field of psychology in the US had developed to a degree warranting explicit training in clinical practice. The concept of a practice-oriented degree was debated in 1965 and narrowly gained approval for a pilot program at the University of Illinois starting in 1968.[15] Several other similar programs were instituted soon after, and in 1973, at the Vail Conference on Professional Training in Psychology, the Practitioner–Scholar Model of Clinical Psychology—or Vail Model—resulting in the Doctor of Psychology (Psy.D.) degree was recognized.[16] Although training would continue to include research skills and a scientific understanding of psychology, the intent would be to produce highly trained professionals, similar to programs in medicine, dentistry, and law. The first program explicitly based on the Psy.D. model was instituted at Rutgers University.[15] Today, about half of all American graduate students in clinical psychology are enrolled in Psy.D. programs.[16]

A changing profession

Since the 1970s, clinical psychology has continued growing into a robust profession and academic field of study. Although the exact number of practicing clinical psychologists is unknown, it is estimated that between 1974 and 1990, the number in the US grew from 20,000 to 63,000.[17] Clinical psychologists continue to be experts in assessment and psychotherapy while expanding their focus to address issues of gerontology, sports, and the criminal justice system to name a few. One important field is health psychology, the fastest-growing employment setting for clinical psychologists in the past decade.[5] Other major changes include the impact of managed care on mental health care; an increasing realization of the importance of knowledge relating to multicultural and diverse populations; and emerging privileges to prescribe psychotropic medication. Approximately 20% of clinical health psychologists identify themselves as counseling psychologists as well.[18]

In the UK psychology is now one of the most popular degree subjects, and over 15,000 people graduate in psychology each year, many with the hope of developing this into a career, although only around 600 places for doctoral training in clinical psychology means there is intense competition for these places.[19][20] There is also fierce competition to get into US Ph.D. programs in clinical psychology, with an average acceptance rate of 8%.[21]

See also


  1. 1.0 1.1 1.2 Benjamin, Jr., Ludy (2007). A brief history of modern psychology, Malden, MA: Blackwell Publishing.
  2. Clifford, Terry (1984). Tibetan buddhist medicine and psychiatry: The diamond healing, York Beach, Maine: Weiser.
  3. Iqbal, Afzal (1991). The life and work of Jalaluddin Rumi, New York, NY: Oxford University Press.
  4. Rumi (1995) cited in Zokav (2001), p. 47.
  5. 5.0 5.1 5.2 Benjamin, Ludy (2005). A history of clinical psychology as a profession in America (and a glimpse at its future). Annual Review of Clinical Psychology 1: 1–30.
  6. 6.0 6.1 6.2 (1995) "History and overview" Introduction to clinical psychology, New York, NY: Plenum Press.
  7. 7.0 7.1 7.2 (2002) Introduction to clinical psychology, New York, NY: McGraw-Hill Higher Education.
  8. 8.0 8.1 Evans, Rand (1999). Clinical psychology born and raised in controversy. APA Monitor 30 (11).
  9. Routh, Donald (1994). Clinical psychology since 1917: Science, practice, and organization, New York, NY: Plenum Press.
  10. Uniting psychologists for more than 100 years 30 (11).[dead link]
  11. Reisman, John (1991). A history of clinical psychology, United Kingdom: Taylor Francis.
  12. Routh, Donald (2000). Clinical psychology training: A history of ideas and practices prior to 1946. American Psychologist 55 (2).
  13. (2006) What is clinical psychology, 4th, United Kingdom: Oxford University Press.
  14. Henry, David (1959). Clinical psychology abroad. American Psychologist 14 (9): 601–04.
  15. 15.0 15.1 Murray, Bridget. (2000). The degree that almost wasn't: The PsyD comes of age. Monitor on Psychology, 31(1).
  16. 16.0 16.1 Norcross, J. & Castle, P. (2002). Appreciating the Psy.D: The Facts.[dead link] Eye on Psi Chim, 7(1), 22–26.
  17. Menninger, Roy and Nemiah, John. (2000). American psychiatry after World War II: 1944–1994. Washington, D.C.: American Psychiatric Press. ISBN 0-88048-866-2
  18. Nicholas, D. R., & Stern, M. (2011). Counseling psychology in clinical health psychology: The impact of specialty perspective. Professional Psychology: Research and Practice, 42(4), 331-337. DOI:10.1037/a0024197
  19. (2011 [last update]). Information for aspiring clinical psychologists. URL accessed on August 26, 2011.
  20. (2010 [last update]). Clearing House for Postgraduate Courses in Clinical Psychology. URL accessed on August 26, 2011.
  21. (2011 [last update]). Relative Weighting of Admission Variables in Developmental Psychology Doctoral Programs. URL accessed on August 26, 2011.
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