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Clinical Psychology As Science and Profession / David Shakow Clinical Psychology as Science a Profession Clinical Psychology as Science a Profession Davide Shakow I~ ~o~!!~n~~:up LONDON AND NEW YORK First published 1969 by Transaction Publishers Published 2017 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN 711 Third Avenue, New York, NY 10017, USA Routledge is an imprint of the Taylor & Francis Group, an informa business Copyright © 1969 by David Shakow. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Catalog Number: 2006045687 Library of Congress Cataloging-in-Publication Data Shakow, David, 1901- Clinical psychology as science and profession / David Shakow. p. cm. Originally published: Chicago : Aldine Pub. Co., c!969. Includes bibliographical references and index. ISBN 0-202-30890-1 (pbk. : alk. paper) 1. Clinical psychology. 2. Clinical psychology—Study and teaching. I. Title. RC467.S48 2006 616.89—dc22 2006045687 ISBN 13: 978-0-202-30890-6 (pbk) To the memories of Frederick Lyman Wells, William McDougall, and Edwin Garrigues Boring, and to Grace Helen Kent, teachers of both psychology and psychology called clinical Preface For more than four-and-a-half decades (from early in my college days) I have lived on the exhilarating but "perilous" professional borders surrounding clinical psy­ chology. At different periods in this career I have inevitably become involved in teaching, field training, research, and administration related not only to clinical psychology, but also to other "helping" professions such as psychiatry, social work, nursing, and medicine. These endeavors were associated either directly with the institutions in which I was employed, or indirectly as a member of committees or as a participant in conferences devoted to one or another of these topics. So much preoccupation with this area naturally afforded many opportunities for formulating principles of conduct, testing out techniques, and expressing opinions on the issues involved. The essays which resulted have been published in a wide range of journals and books. Considering the marked growth of clinical psychology during this period and the continuing demand for many of these articles, there appears to be some justification for making them more accessible. The articles were, of course, written for different occasions over the course of many years. They cannot therefore have the systematic organization or felicitous flow of a volume that is more respectful of the unities. I apologize for the more than occasional overlappings and the actual repetitions-in many instances I have had to crib from myself. (In some instances where the overlapping was too gross I have abridged a few of the papers.) Perhaps in the process of overlooking these, the reader may even be gracious enough to interpret them as merely the reasonable efforts of an author to emphasize important points. I hope that the consistency of much of the philosophy (bias! for some) which resides in these articles will be manifest. This philosophy derives fundamentally from William James and to some extent from Sigmund Freud, but more directly from a number of my teachers-particularly Fred Wells, William McDougall, Grace Kent, and Edwin Boring. The papers in this volume are organized into five categories. The introductory series provides both historical background about clinical psychology and discussion of the roles and functions of the clinical psychologist. This is followed by the most extensive section, that dealing with the training of clinical psychologists. The third group is concerned with psychology's professional relations with psychiatry, with psychotherapy as a speciality, and with medicine. The fourth section deals with various aspects of psychology's relationships with psychoanalysis. The volume vii viii PREFACE concludes with the treatment of a broader and more general issue, that of public service. I am grateful both to the students and colleagues who have taught me so much in the daily round of direct activities, and to the colleagues I have been associated with in committees and in conferences from whom I have learned equally if somewhat differently. To Ruth Ann Van Dyke I am indebted for so efficiently handling the multitudinous problems connected with assembling a volume of this kind. Contents Preface Part I History and Functions I 1. Clinical Psychology: An Evaluation [I948] I 2. Clinical Psychology [1952] I4 3· Clinical Psychology [I968] 38 4· The Functions of the Psychologist in the State Hospital [I939] 43 5· Administration of Psychological Services in Institutions for the Mentally Disordered and Mentally Retarded [I950] 47 6. The Psychologist in the Clinic Setting [I948] 55 7· The Role of the Psychologist [I965] 58 Part II Training Objectives and Programs 71 8. An Internship Year for Psychologists [I938] 7I 9· The Training of the Clinical Psychologist [I942] 75 IO. The Worcester Internship Program [I946] 87 I I. Recommended Graduate Training Program in Clinical Psychology [I 94 7] 98 I2. Problems in the Clinical Training of the Clinical Psychologist [I950] I26 I3. The Improvement of Practicum Training and Facilities [I957] I29 I4. Seventeen Years Later: Clinical Psychology in the Light of the I947 CTCP Report [I965] I45 I5. Thoughts Second and Sober on Education in Clinical Psychology [I969] I57 I6. Homo Scientius et Homo Professionalis-Sempervirens? [I968] I76 ix X CONTENTS Part III Liaison with Other Professions 185 17. Psychology and Psychiatry: A Dialogue [1949] 185 18. One Hundred Years of American Psychiatry, A Special Review [1945] 213 19. Some Aspects of Mid-Century Psychiatry: Experimental Psychology [1953] 224 20. Ideal Program of Training for Psychotherapists: Patterns of Institutional Sponsorship [1969] 240 21. Comments on Behavioral Science in Medicine [1968] 249 22. Psychology for the General Practitioner [1948] 256 Part IV Relationship with Psychoanalysis 269 23. One Psychologist as Analysand [1940] 269 24. Training in Clinical Psychology-A Note on Trends [1945] 278 25. Psychoanalytic Education of Behavioral and Social Scientists for Research [1962] 281 26. Ethics for a Scientific Age-Some Moral Aspects of Psychoanalysis [1965] 296 Part V Commitment to Public Service 307 27. On the Rewards (and, Alas, Frustrations) of Public Service [1968] 307 Epilogue 321 Bibliography 323 Index 337 Clinical Psychology as Science and Profession PART I History and Functions The first three papers in Part I tend to emphasize in different ways the historical aspects of clinical psychology. No attempt has been made to be exhaustive. Rather, the effort has been to point up areas relevant to the context for which the article was prepared. The next group of papers in this section emphasizes particularly the roles and functions of the clinical psychologist, especially as reflected in his work in the hospital and the clinic. I. Clinical Psychology: An Evaluation For its twenty-fifth anniversary, the American Orthopsychiatric Associa­ tion decided to put out a volume Orthopsychiatry 1923-1948: Retrospect and Prospect, of which Lawson G. Lowrey was editor. I was asked to write the following article on clinical psychology, in which I tried to meet the spirit of the volume. Clinical psychology, having celebrated its fiftieth birthday (Brotemarkle, 1947), is now entering adolescence. Puberty seems to have arrived with a vigor and animation, not untouched with brashness, in marked contrast to the extended, rather asthenic, childhood. Its zeal is in fact creating problems for its parent and more remotely related disciplines. These fields themselves are in a state of postwar reorganization and find it necessary to reorient to this additional pressure. I shall attempt in this essay to follow through the high points of the child's development, evaluate the features of his adolescence, and consider the promise of his maturity. Reprinted with permission from L. G. Lowrey and V. Sloane (Eds.), Orthopsychiatry, I923-1948: Retrospect and Prospect, 1948 (American Orthopsychiatric Association) Copy­ right, the American Orthopsychiatric Association, Inc. I 2 PART I HISTORY AND FUNCTIONS ORIGINS We can agree with Louttit (1939, p. 362) that clinical psychology in any organized fashion dates from the time that Lightner Witmer in 1896 (Fernberger, 1931, p. rr) first established the psychological clinic at the University of Pennsylvania. Despite the tendency for historians (Stevenson & Smith, 1934; Witmer, 1940) of the move­ ment to minimize or neglect almost entirely the role Witmer played, child guidance in this country may with good justification be said to have started with his establish­ ment of the Clinic. It was Witmer, too, who coined the terms "clinical psychology," "psychological clinic," and "orthogenics," terms which have become part of the language. From the beginning he called for the qualitative study of the individual patient, not only for diagnostic purposes, but especially for therapeutic ones. The need for detailed consideration of a case was recognized even to the extent of establishing a hospital school (Fernberger, 1931, p. 14) in order to be able to observe children over an extended
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