CHAPTER 2: Evolution of Clinical Psychology

Question 1

In recent decades, the clinical specialization has enjoyed great popularity and notoriety among psychology professionals and the general public; in fact, today, when many people hear of a “psychologist,” they immediately think of a “clinical psychologist” practicing psychotherapy or assessment.

Answer 1

This assumption regarding psychology was inaccurate until at least the early 1900s. The discipline of clinical psychology simply didn’t exist until around the turn of the 20th century, and it didn’t rise to prominence for decades after that.

Question 2

Early Pioneers of Clinical Psychology

Answer 2

William Tuke (1732-1822)
Philippe Pinel (1745-1826)
Eli Todd (1769-1833)
Dorothea Dix (1802-1887)

Question 3

In his homeland of England, _________ heard about the deplorable conditions in which the mentally ill lived. He visited asylums to get a firsthand look, and he was appalled by what he saw.

Answer 3

William Tuke (1732-1822)

Question 4

A residential treatment center where the mentally ill would always be cared for with kindness, dignity, and decency.

Answer 4

York Retreat

Question 5

What William Tuke was to England, _____________ was to France—a liberator of the mentally ill.

Answer 5

Philippe Pinel (1745-1826)

Question 6

He advocated for the staff to include in their treatment of each patient a case history, ongoing treatment notes, and an illness classification of some kind—components of care that suggested he was genuinely interested in improving these individuals rather than locking them away.

Answer 6

Philippe Pinel (1745-1826)

Question 7

“To rule [the mentally ill] with a rod of iron, as if to shorten the term of an existence considered miserable, is a system of superintendence, more distinguished for its convenience than for its humanity or success”

Answer 7

From Pinel’s Treatise on Insanity in 1806, we get a sense of his goal of empathy rather than cruelty for the mentally ill:

Question 8

As Frances (2013a) describes Pinel, “our field couldn’t possibly have a better father and role model. . . . Pinel liked his patients as people and treated them as if they were simply human. When given the choice of joining Napoleon as a personal physician or staying with his patients, he turned down Napoleon’s”

Answer 8

In Europe in the late 18th and early 19th centuries, society’s views toward the mentally ill were undergoing significant change and “the voices of Pinel and Tuke were part of a growing chorus that sang of individual rights and social responsibility”.

Question 9

He made sure that the chorus of voices for humane treatment of the mentally ill was also heard on the other side of the Atlantic Ocean. He was a physician in Connecticut in 1800, a time when only three states had hospitals for the mentally ill.

Answer 9

Eli Todd (1769-1833)

Question 10

Todd had learned about Pinel’s efforts in France, and he spread the word among his own medical colleagues in the United States. They supported Todd’s ideals both ideologically and financially, such that Todd was able to raise funds to open

Answer 10

The Retreat in Hartford, Connecticut, in 1824.

Question 11

Todd ensured that patients at The Retreat were always treated in a humane and dignified way.

Answer 11

He and his staff emphasized patients’ strengths rather than weaknesses, and they allowed patients to have significant input in their own treatment decisions.

Question 12

In 1841, ________ was working as a Sunday school teacher in a jail in Boston, where she saw firsthand that many of the inmates were there as a result of mental illness or retardation rather than a crime. She devoted the rest of her life to improving the lives and treatment of the mentally ill.

Answer 12

Dorothea Dix (1802-1887)

Question 13

Typically, Dix would travel to a city, collect data on its treatment of the mentally ill, present her data to local community leaders, and persuade them to treat the mentally ill more humanely and adequately.

Answer 13

Her efforts resulted in the establishment of more than 30 state institutions for the mentally ill throughout the United States (and even more in Europe and Asia), providing more decent, compassionate treatment for the mentally ill than they might have otherwise received.

Question 14

Their efforts do, however, represent a movement prevalent through much of the Western world in the 1700s and 1800s that promoted the fundamental message that people with mental illness deserve respect, understanding, and help rather than contempt, fear, and punishment.

Answer 14

Tuke, Pinel, Todd, and Dix did not create clinical psychology.
As this message gained power and acceptance, it created fertile ground in which someone— Lightner Witmer, most would argue—could plant the seed that would grow into clinical psychology.

Question 15

He was born in Philadelphia and earned an undergraduate degree in business at the University of Pennsylvania. He eventually received his doctorate in psychology in 1892 in Germany under Wilhelm Wundt, who many views as the founder of experimental psychology. He also studied under James McKeen Cattell, another pioneer of experimental psychology.

Answer 15

Lightner Witmer (1867-1956)

Question 16

At the time Witmer received his doctorate, psychology was essentially an academic discipline, a field of research. It had almost none of the applied functions that characterize the field today.

Answer 16

In the late 1800s, psychologists didn’t practice psychology, they studied it.

Question 17

A major historical shift took place 4 years after Witmer received his doctoral degree when, in 1896, he founded the first psychological clinic at the University of Pennsylvania, where he had returned as a professor.

Answer 17

At the 1896 convention of the American Psychological Association, Witmer (1897) spoke to his colleagues and fellow members about his clinic and encouraged them to open their own—to “throw light upon the problems that confront humanity” (p. 116)—but they were largely unenthusiastic.

Question 18

By 1914, there were about 20 psychological clinics in the United States, most of which were modeled on Witmer’s.

Answer 18

By 1935, the number had soared to more than 150, and an issue of Witmer’s journal from that year was dedicated to a survey of activities taking place in these clinics, as well as some specific suggestions for the training of clinical psychologists.

Question 19

In his clinic, Witmer and his associates worked with children whose problems arose in school settings and were related to learning or behavior.

Answer 19

They were referred by their schools, parents, physicians, or community authorities.

Question 20

Witmer (1907) emphasized that clinical psychology could be applied to adults as well as children, or to problems that had nothing to do with school:

Answer 20

“Indeed, the clinical method is applicable even to the so-called normal child. . . . Whether the subject be a child or an adult, the examination and treatment may be conducted and their results expressed in the terms of the clinical method”

Question 21

Witmer also founded the first scholarly journal in the field
Witmer authored the first article, titled “Clinical Psychology,” in the first issue.

Answer 21

The Psychological Clinic in 1907.

Question 22

This article included the first known publication of the term clinical psychology, as well as a definition of the term and an explanation of the need for its existence and growth.

Answer 22

The article began with a description of Witmer’s (1907) innovation: “During the last ten years the laboratory of psychology at the University of Pennsylvania has conducted, under my direction, what I have called a ‘psychological clinic’”.