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Key Words assessment, managed care, professional organizations, psychiatry, psychotherapy
Abstract Clinical psychology emerged as a profession in the United States in the 1890s with studies conducted by psychologists with patients in the mental asylums of that time, and with the founding of Witmer's psychological clinic, where he treated children with learning and behavioral problems. This chapter traces the history of clinical psychology as a profession, from the focus on assessment at the turn of the twentieth century to the provision of psychotherapy that would come to dominate the field after World War II. It concludes with a discussion of some of the contemporary concerns in the profession and how those might impact the future practice of clinical psychologists.
INTRODUCTION
Since the popularization of psychoanalysis in America, shortly after Sigmund Freud's only visit to the United States in 1909, the American public's stereotype of a psychologist was a practitioner listening to the woes of a patient reclining on a couch. It would require another 50 years and the development of clinical psychology as a profession before that stereotype would become prototype (with or without the couch). Now, early in the twenty-first century, roughly a century after Freud's visit, the profession of clinical psychology is once again undergoing considerable change. This chapter provides a selective historical account of the development of this profession over the past century and offers some speculations about what may lie in the future for those individuals who choose to practice as clinical psychologists.
The Commission for the Recognition of Specialties and Proficiencies (2004) defined the professional clinical psychologist as follows:
Clinical psychology is a general practice and health service provider specialty in professional psychology. Clinical psychologists assess, diagnose, predict, prevent, and treat psychopathology, mental disorders, and other individual or group problems to improve behavior, adjustment, adaptation, personal effectiveness, and satisfaction. What distinguishes clinical psychology as a general practice specialty is the breadth of problems addressed and of populations served, (p. 1)
The multiple roles listed in this definition-assessment, diagnosis, prevention, treatment-were not all indigenous to the pioneering clinical psychologists. The assessment role is arguably the beginning of clinical psychology. It emerged from the research of the new science of psychology at the turn of the twentieth century and has been...