Training in clinical psychology; an English point of view.

DEVELOPMENTS during and immediately following the war have emphasized the great importance which the rather ill-defined field of "clinical psychology" has, both in the theoretical and in the practical sphere. Much discussion has centered on the definition of the subject matter, and on the best methods of training appropriate for practitioners; the report of the Committee on Training in Clinical Psychology of the American Psychological Association (/), the papers of the Josiah Macy Jr. Foundation Conference on Training in Clinical Psychology (5), and the minutes of the National Association for Mental Health Committee on the Training of Psycho-Therapists (7) are evidence of the wide interest taken in this matter by respectable bodies both in this country and overseas. The great importance of the subject, the hope that our experience in training clinical psychologists in the only British University Centre which undertakes such training might be of interest to American readers, and the belief that the direction along which both the A PA and the Josiah Macy Jr. reports point lies counter to the best interests of psychology as a whole, and of clinical psychology in particular, have led us in this paper to discuss what, in our view, the nature and function of clinical psychology should be. The main conclusion of the APA report, which is also supported by the majority of other recommendations, transactions, conferences, and memoranda which we have seen, lies in the stress "of the need for preparing the clinical psychologists with a combination of applied and theoretical knowledge in three major areas: diagnosis, therapy and research" (1). Equally briefly, it is our belief that training in therapy is not, and should not be, an essential part of the clinical psychologist's training; that clinical psychology demands competence in the fields of diagnosis and/or research, but that therapy is something essentially alien to clinical psychology, and that, if it be considered desirable on practical grounds that psychologists perform therapy, a separate discipline of Psycho-therapist should be built up, to take its place beside that of Clinical Psychologist. Let us examine in detail the arguments put forward in favour of their belief by the writers of the APA report. Unfortunately, these arguments are given throughout in terms of unproven assumptions, lacking in any kind of factual support. We have been able to discover only two reasons for the belief "that no clinical psychologists can be considered adequately trained unless he has had sound training in psychotherapy" (7). One is in terms of social need: "The social need for the increase of available therapists is great. Clinical psychologists are being called upon to help this need . " (7). This argument has been widely criticized on the grounds that we must be careful not to let social need interfere with scientific requirements; that ultimately psychology cannot simply go where social need requires, unless it wishes to be led into a cul-de-sac. A science must follow its course according to more germane arguments than the possibly erroneous conceptions of "social need. " That other pressures than that of social need may be more important is indeed recognised by the writers of the report. They say: "If a social need for therapy exists, then the need for research is even greater" (/). "The fact that there is not equal pressure for the latter is mainly due to the excusable but still short-sighted outlook of the public. The universities, with their more far-sighted orientation, have a serious responsibility to develop research interests and abilities in the clinical psychologists they train. The interest should be in research on the laws of human behavior primarily and on technical devices and therapy secondarily" (1). Thus the first argument leads inevitably to the second, which is based on therapeutic experience as an indispensable qualification for research. "Our strong conviction about the need for therapeutic experience grows out of the recognition that therapeutic contact with patients provides an experience which cannot be duplicated by any other type of relationship for the intensity and the detail. with which it reveals motivational complexities. A person who is called upon to do diagnostic or general research work in the field of clinical psy-