Historical Manifestation of Clinical Psychology

For the years prior to 1890, there is really very little in the history of clinical psychology to separate it
from the history of abnormal psychology or, as and Henry (1941) termed it, “medical psychology.”
Reisman (1976) finds useful search for the roots of modern clinical psychology resulted in improved
care for the mentally ill.

 Philippe Pinel, a French physician. Shocked by the senseless brutality that was the custom in
19th-century “mental hospitals,” he get appointed head of the asylum at Bicêtre and, later,
Salpêtrière. Through kindness and humanity, he accomplished much in a very difficult field.
 At about the same time, an Englishman, William Tuke, was devoting himself to the
establishment of what might be called a model hospital for the humane treatment of the
sick and troubled.
 In America, Eli Todd developed a retreat in Hartford for the mentally ill. Todd emphasized
the role of civilized care, respect, and morality. Through his efforts, it became less
fashionable to regard mental patients as incurable and treatment had begun to replace the
routine harshness of custody.
 Dorothea Dix travelled from state to state for 40 years campaigning for more humane
treatment and better facilities for the insane and the mentally retarded. Using the force of
logic, facts, public sentiment, and good old-fashioned lobbying, she wrought her will. In
1848, New Jersey responded by building a hospital for the “insane”—the first in a procession
of more than 30 states to do so.

The Beginnings (1850–1899)

DIAGNOSIS AND ASSESSMENT
clinical psychology has always been emphasize on assessing differences, rather than
commonalities, among people.

 Francis Galton, an Englishman devoted effort to the application of quantitative methods

to understanding differences among people. Pursuing his interests in sensory acuity,
motor skills, and reaction time, he established an anthropometric laboratory in 1882.
 Cattell gave his attention to reaction time differences among people while Witmer
became interested in variation in psychological skills among children. Cattell believed, as
did Galton, that the study of reaction time differences was a way of approaching the
study of intelligence. In fact, Cattell coined the term mental tests to describe his
measures (Thorndike, 1997). Through the use of a battery of 10 tests, Cattell hoped to
discover the constancy of mental processes, even predicting that such tests could be
used in the selection and training of people as well as in the detection of disease. This
early work was first halting steps of the testing movement.
 Witmer began the current model of treatment in clinical psychology by opening the first
psychological clinic in 1896 and starting the first psychological journal, called The
Psychological Clinic. Through his groundbreaking work identifying and treating children
who experienced educational difficulties (due to cognitive deficits and/or psychological
symptoms), the field of clinical psychology arose as a profession dedicated towards
scientific examination and treatment of individuals who were unable to function
adaptively in their society. Interestingly, an initial major emphasis in clinical psychology
 assessment and treatment involved a focus on youth. This emphasis continued until the
end of the Second World War.
 The diagnostic work of Kraepelin in 1913. When Emil Kraepelin divided mental illness
into those types determined by exogenous factors (curable) and those caused by
endogenous factors (incurable), he initiated a romance with classification schemes that
persists even today.

INTERVENTIONS
 Emil Kraepelin’s focus was on the classification of psychoses. However, others were
investigating new treatments for “neurotic” patients, such as suggestion and hypnosis.
 Jean Charcot investigated patients with hysteria—patients with “physical symptoms”
(e.g., blindness, paralysis) that did not seem to have an identifiable physical cause . He
was a master of the dramatic clinical demonstration with hypnotized patients. As a
matter of fact, he believed that only patients with hysteria could be hypnotized.
However, he was probably investigating hypnosis rather than hysteria.

Others, such as Hippolyte Bernheim and Pierre Janet, were critical of Charcot’s work. Bernheim
felt that the symptoms of hysteria reflected nothing more than suggestibility. Janet, on the other
hand, came to regard hysteria as a manifestation of a “split personality” and also as a kind of
hereditary degeneration.

 In the early 1880s, Breuer was treating a young patient named “Anna O,” who was
diagnosed with hysteria. Anna O’s treatment presented many challenges but also led to
theoretical breakthroughs that would influence psychotherapy practice for years to
come. In 1895, Breuer and Freud published Studies on Hysteria. Their collaboration
served as the launching pad for psychoanalysis, the single most influential theoretical
and treatment development in the history of psychiatry and clinical psychology.

RESEARCH
 Wilhelm Wundt, a German, is usually credited with establishing the first formal
psychological laboratory, in Leipzig in 1879.
 An American, William James, also established a laboratory, and in 1890, he published his
classic text Principles of Psychology.

Their influence is also clearly discernible in the scientist-practitioner model that has served
the field of clinical psychology for so many years.

THE PROFESSION
Two events of great significance in the development of clinical psychology as a profession occurred
just as the 19th century was winding down.

 The first was the founding of the American Psychological Association (APA) in 1892, with G.
Stanley Hall as its first president.
 In 1896, Lightner Witmer established the first psychological clinic at the University of
Pennsylvania.
Many would date the real beginning of clinical psychology from this time. It was he who named the
field “clinical psychology,” and he was the first to teach a specific course in clinical psychology.
Further, it was Witmer who in 1907 founded the first journal in clinical psychology,
The Psychological Clinic—a journal that he edited and contributed articles to until it ceased
publication in 1935.

The Advent of the Modern Era (1900–1919)

DIAGNOSIS AND ASSESSMENT
 In 1904, Binet and his colleague Theodore Simon were asked to develop an instrument
to differentiate degrees of mental “subnormality” among French schoolchildren for
placement purposes. The result was the 1908 Binet-Simon Scale. Later, psychologist
Henry Goddard brought Binet tests to the US, where psychologist Lewis Terman
produced the first American revision in 1916.
 Personality testing was progressing . Carl Jung began using word association methods
around 1905 to attempt to uncover unconscious material in patients. In 1910, the Kent-
Rosanoff Free Association Test was published.
 In 1904, Charles Spearman offered the concept of a general intelligence that he termed
g. Edward Thorndike countered with a conceptualization that emphasized the
importance of separate abilities.
 Meanwhile, early in World War I, to screening and classifying the thousands of new
recruits to the U.S. Army ,a group of five members of the American Psychological
Association (APA), chaired by Robert Yerkes, was asked by the Medical Department of
the Army to create an instrument to classify men for assignment according to their
mental abilities. The result was the Army Alpha, a scale of verbal ability, published in
1917. The Army Beta, a non-verbal scale, followed shortly thereafter. For further
classification, psychologist Robert Woodworth developed the Psychoneurotic Inventory
during the same period; it was the first questionnaire specifically designed to explore
for the presence of psychopathology.

INTERVENTIONS
 Clifford Beers wrote A Mind That Found Itself, a chronicle of his experiences while
hospitalized as a mental patient. His efforts were instrumental in launching the mental
hygiene movement.
 In 1900, Freud published The Interpretation of Dreams. Concepts such as the unconscious,
the Oedipus complex, the ego, and sexuality became a focus within the psychological realm.

RESEARCH
 Ivan Pavlov's work on classical conditioning has become a central part of theory and
research while also playing a significant role in a variety of therapeutic methods.
 In 1905, Binet and Simon offered some evidence for the validity of their new test, and in
1916, Terman’s research on the Binet-Simon test appeared.

THE PROFESSION
 In 1906, Morton Prince began publishing the Journal of Abnormal Psychology, and in 1907,
Witmer began publication of The Psychological Clinic.
  In 1909, Healy established the juvenile Psychopathic Institute in Chicago.
 The Iowa Psychological Clinic had been started in 1908, the same year that Goddard began
offering psychological internships at the Vineland Training School in New Jersey.
 By 1910, there were 222 APA members, paying annual dues of $1. However, the focus of
APA was on psychology as a science, not as a profession.
 Finally, in 1919, the first Section of Clinical Psychology was created within the APA.
Meanwhile, an ever-increasing number of psychological clinics were being established. However,
World War I and the growth of the group testing movement did as much as anything to spur the
development of the new profession.

Between the Wars (1920–1939)

DIAGNOSIS AND ASSESSMENT
 During the late 1920s and early 1930s, the Pintner-Patterson Nonverbal Intelligence Scale,
the Arthur Point Scale, the Cornell-Coxe Test, and the Goodenough Draw-a-Man measure
of intelligence were developed, thereby creating both individual and group tests as well as
verbal and nonverbal tests.
 A bit later, Gesell’s Developmental Scales of Intelligence and Doll’s Vineland Social Maturity
Scale appeared.
 In 1939, the initial Wechsler-Bellevue test of intelligence, the first individual (non-group)
instrument for the measurement of adult intelligence, was created by psychologist David
Wechsler.
 Aptitude and vocational test like ,Seashore tests of musical ability, the Strong Vocational
Interest Blank, and the Kuder Preference Record were formed.
 Clinical psychologists developed personality tests, including Woodworth’s Personal Data
Sheet, the Pressey X-O Test for Emotions, the Downey Will-Temperament Test, and the
Allport Vernon Study of Values.
 Development of projective tests ,when Swiss psychiatrist Hermann Rorschach published
psychodiagnostik ,his pioneering inkblot test. The text stemmed from psychoanalytic theory,
which posited that when presented with ambiguous stimuli like inkblots patients would
impose their own order on the stimuli and, in so doing, reveal unconscious determinants of
behavior.
 In 1937, clinical psychologists Beck and Klopfer published separate manuals proposing
scoring systems for the Rorschach Test, thereby enhancing its clinical utility.
 In 1935, Morgan and Murray published the Thematic Apperception Test (TAT), a projective
instrument requiring subjects to look at pictures portraying ambiguous scenes and provide
their own interpretations of the scenes; in doing so, they were thought to reveal
unconscious, hidden motives and desires.

INTERVENTIONS
 The entry of psychologists into therapeutic activities in various child guidance clinics. In 1909
,Healy founds a child guidance clinic in Chicago.
 Freud’s emphasis seemed to lie with adults and with the sexual antecedents of their
problems.
 Adler’s de-emphasis of the role of sexuality, and his concomitant emphasis on the structure
of family relationships. Adler’s (1930) ideas were firmly ensconced in those American clinics
that dealt with children’s problems.
  In 1928, Anna Freud, the distinguished daughter of Sigmund Freud, described play therapy(a
technique that relies on the curative powers of the release of anxiety or hostility through
expressive play. ) derived from psychoanalytic principles.
 “Passive therapy” described by Frederick Allen (1934).
 In 1920, John Watson described case of Albert and white rat, in which a young boy was
conditioned to develop a neurotic-like fear of white, furry objects .
 Mary Cover Jones (1924) showed how such fears could be removed through conditioning.
 J. Levy (1938) described “relationship therapy.” These latter three events marked the
beginnings of behavior therapy.

RESEARCH
Clinical research was still in its infancy.

 Behaviourism taught clinicians the power of conditioning in the development and treatment
of behaviour disorders.
 Gestalt psychology emphasized the importance of understanding that patients’ unique
perceptions contribute to their problems.
 1939 ,Wechsler publishes his research on the Wechsler-Bellevue.

THE PROFESSION
 In 1931, the Clinical Section of the APA appointed a committee on training standards.
 In 1935, the APA Committee on Standards of Training defined clinical psychology as “that art
and technology which deals with the adjustment problems of human beings”.
 In 1936, Louttit published the first clinical psychology text, and in 1937, the Journal of
Consulting Psychology was founded.
Such events signaled real growth for clinical psychology as a profession. Psychological tests were
beginning to become financial winners. James McKeen Cattell founded the Psychological
Corporation in 1921 to develop and market psychological tests. The proceeds were used to stimulate
psychological research. Thus, money began to invade the ivory tower.

World War II and Beyond (1940–Present)

DIAGNOSIS AND ASSESSMENT
 In 1943, the Minnesota Multiphasic Personality Inventory (MMPI) appeared (Hathaway,
1943). The MMPI was an objective self-report test whose major function, initially, seemed to
be attaching psychiatric labels to patients. Although other tests such as the Rorschach were
often put to similar uses, the MMPI was unique in that no theoretical interpretation of
scores or responses was necessary.
 In 1949, Wechsler published another individual test. This one, the Wechsler Intelligence
Scale for Children .In 1955, the Wechsler Adult Intelligence Scale (a revision of the Wechsler-
Bellevue Scale) appeared.
 Objective measures, such as the MMPI and its revision, MMPI-2 are based on a nomothetic
approach to assessment in which test scores are interpreted using empirically based rules
involving the contrast between an obtained score and the average score obtained from a
 large representative sample. Responses from projective measures, in contrast, are often
interpreted using an idiographic approach.
 Beginning in the late 1950s, a movement termed radical behaviorism began to assert its
influence. personality traits, according to the radical behaviorists, cannot be measured
directly. Personality assessment came under attack, and clinical psychology programs in the
1960s took on much more of a behavioral bent. In 1968, Walter Mischel made a strong case
that traits exist more in the minds of observers than in the behavior of the observed. the
1970s would witness the rise of behavioral assessment. Behaviors were understood within
the context of the stimuli or situations that either preceded or followed them.
 psychometrically sound personality inventories (e.g., the Millon Clinical Multiaxial Inventory
and the NEO-Personality Inventory), and several empirical demonstrations that personality
traits do appear to be fairly stable across time and across situations.
 The first edition of the American Psychiatric Association’s Diagnostic and Statistical Manual
of Mental Disorders (DSM-I) appeared in 1952.
 In 1947, Halstead introduced an entire test battery to aid in the diagnosis of
neuropsychological problems.
 In 1968 DSM-II was published.
 In 1970s ,Rise of behavioral assessment.
 In 1980, DSM-III was published.
 In 1980s, Interest rises in personality assessment and computer-based test interpretations.
 In 1987, DSM-III-R was published.
 In 1990s, Managed health care impacts psychological assessment.
 In 1994 ,DSM-IV was published.
 In 2013, DSM-V was published.

INTERVENTIONS
 In 1946, Alexander and French published an influential book on briefer psychoanalytic
interventions.
 In 1950, John Dollard and Neal Miller published Personality and Psychotherapy.
 Carl Rogers published Client-Centered Therapy in 1951, his was the first major alternative to
psychoanalytic therapy up to that point.
 Perls introduced Gestalt therapy (Perls, Hefferline, & Goodman, 1951).
 Frankl (1953) talked about logotherapy and its relationship to existential ttheory.
 In 1958, Ackerman described family therapy.
 In 1962 Ellis explained his rational-emotive therapy (RET), an important forerunner of
cognitive-behavioral therapy.
 Berne’s (1961)develop transactional analysis, or TA. Therapy .
 Andrew Salter (1949) wrote Conditioned Reflex Therapy.
 In 1952 ,Eysenck publishes his critique of psychotherapy.
 In 1953 ,Skinner outlines application of operant principles.
 In 1958, Joseph Wolpe introduced systematic desensitization, a technique based on
conditioning principles.
 In 1965 ,Conference in Swampscott, MA, gives birth to community psychology.
 In 1967, Beck introduces cognitive therapy. He outlined his approach in the book
Depression: Causes and Treatment.
 Brief or time-effective therapy (Budman & Gurman, 1988) is becoming a preferred mode of
psychotherapeutic intervention.
  “Manualized” forms of treatment have been introduced into clinical work (e.g., Beck, Rush,
Shaw, & Emery, 1979; Strupp & Binder, 1984). The treatment “package” can be
implemented and completed in 10 to 15 sessions or less.
 Bythe 1950s, some clinicians had begun to be disenchanted with therapy methods.They
sought a more “preventive” approach. Their search culminated in the rise of community
psychology in the 1960s and health psychology in the 1980s ,increasing focus on brief
psychotherapy, increase in psychotherapy research.
 In 1990s ,Managed health care has tremendous impact on psychological services.
 in 1995, lists of “empirically supported treatments” for adults and youth established. (e.g.,
Task Force on Promotion and Dissemination of Psychological Procedures, 1995).
 In 2002 ,New Mexico becomes first state to allow prescription privileges for psychologists.

RESEARCH
 In 1943 ,Hathaway and McKinley publish MMPI data.
 B. F. Skinner, Ogden Lindsley, and Harry Solomon described a behavior therapy research
project in 1953.
 Joseph Wolpe’s research in South Africa on animal and human emotional problems led him
to develop the method of systematic desensitization.
 In 1954 ,Rogers and Dymond report their research on the counseling process. And Rotter
publishes his social learning theory.
 Hans Eysenck, introduced many clinicians to behavior therapy through his important book
on the topic in 1960.
 In 1977, Mary Smith and Gene Glass published a survey that supported the efficacy of
psychotherapy, research continues to grow to this day.
 In 1980s, Psychopathology research grows following publication of DSM-III.
 clinical psychologists began identifying the etiological (causal) factors of various mental
disorders. Symptomatic growth of this research area is the “splitting” of a major clinical
psychology journal, the Journal of Consulting and Clinical Psychology (JCCP), into two. Now,
in addition to JCCP, we have the journal Psychological Assessment.
 In 1990s ,Interest in behavioral genetics increases( investigation on behaviors and individual
differences, including intelligence, personality, and psychopathology.)
 In 2000s, Brain imaging allows a view of both the structure and function of the brain and is
becoming an important component in research on psychopathology.

THE PROFESSION
 1945 (Connecticut passes first certification law)
 1946 (VA and NIMH begin support of psychology)
 1947 (ABEPP/ABPP is established to certify the competence of clinicians)
 1949 (Boulder Conference promulgates the scientist-practitioner model)
 1953 (APA publishes Ethical Standards)
 1968 (First Psy.D. program established)
 1981 (Revised Ethical Standards published)
 1988 (Schism within APA leads to the foundation of the American Psychological Society)
 1992 (Another revision of Ethical Principles published)
 1995 (APA endorses pursuit of prescription privileges for psychologists)
 2002 (Another revision of Ethical Principles published)
  2006 (APS changes its name to Association for Psychological Science)
 2010 (Most recent, amended version of Ethical Principles published)

However, although training and practice are in a state of flux, certain constants remain. Clinical
psychologists are still involved in assessment and treatment. They still have research contributions
to make, and they are still concerned with their professional development. The goal that binds
clinical psychologists together remains the same: to apply their knowledge and skill to the mental
health needs of people everywhere.