Subsequent Professional Developments 347training in clinical psychology to about 2,800 clinical majors.
The profession was growing at a rapid and exhilarating pace.
SUBSEQUENT PROFESSIONAL DEVELOPMENTS
In 1918, Leta Hollingworth suggested the creation of a new
doctoral degree, the PsyD, which could be awarded to psy-
chologists who sought not to be scientists but practitioners of
psychology (Hollingworth, 1918). A similar suggestion was
made by Crane (1925–1926) with a similar imperceptible
response. In 1947, a commission appointed by Harvard Uni-
versity published a report recommending that Harvard estab-
lish a PsyD program for clinical psychologists (University
Commission to Advise on the Future of Psychology at
Harvard, 1947). The report included the following statement,
which proved to be somewhat prophetic and a bit comical: “If
the best universities deliberately dodge the responsibility for
training applied psychologists, the training will be attempted
in proprietary schools but under conditions so deplorable that
the universities will either be begged to assume responsibility
or blamed for not doing so” (p. 33). However, by the time this
report was published, the Harvard psychology department
had already acted by spinning off a new Department of Social
Relations, which included the psychology clinic and its staff
and which continued to offer the PhD.
The first institution to offer a PsyD degree was the Uni-
versity of Illinois (Peterson, 1992). It began its PsyD program
in 1968 as an alternative for clinical graduate students who
might find it more appealing than its PhD program. The PsyD
program had a greater focus on training for practice and did
not require experimental research; instead, the student could
present a detailed case history or a documented attempt at
clinical intervention and be prepared to discuss its theoretical,
practical, and research implications. Eventually this program
was dropped at Illinois and its leading proponent, Donald Pe-
terson, went to Rutgers University to become dean of its
Graduate School of Applied and Professional Psychology.
(One of the illustrious PsyD graduates of the Rutgers pro-
gram was Dorothy W. Cantor, president of the APA in 1996.)
In the meantime, the California School of Professional
Psychology opened its doors in 1969, offering a 6-year PhD
program. Other universities, such as Baylor and Yeshiva,
began to offer PsyD programs, and a number of proprietary
schools of professional psychology were established, most of
which offered the PsyD.
What seemed to spur the growth of PsyD programs was the
Vail Conference held in Colorado in 1973 (Korman, 1974).
That conference endorsed the practitioner-training model as
an alternative to the scientist-practitioner one. But of course
there was more to it than that. After the first burst of post-
war growth had waned, some universities (e.g., Chicago and
Northwestern) had dropped their clinical programs and almost
all colleges had far more applicants than they could accept; this
alarmed some clinicians into thinking their profession would
not be viable until there were independent schools for the train-
ing of clinical psychologists. The alarm proved unjustified, as
the number of graduate training programs in clinical psychol-
ogy at universities has continued to increase. As of June 2001,
some 50 years after APA approval began, 202 programs were
approved or regularly monitored for approval. (Courtesy of
Tia Scales at the Education Directorate of the American Psy-
chological Association.) In addition, 53 free-standing schools
were producing clinicians (two were counseling programs). In
August 1976, these schools banded together into an organiza-
tion of their own, the National Council of Schools of Profes-
sional Psychology, in order to ensure that their interests were
pursued and protected (Stricker & Cummings, 1992).
The trend toward state certification and licensure of psy-
chologists reached something like a conclusion when
Missouri in 1977 became the last state to enact licensing
legislation—though concerns remained about the revocation
of laws and legal challenges to them. Clinicians themselves
used legal suits to gain admission privileges in hospitals and
to be counted as part of medical staffs. Their goals were to
compel medical insurance companies to reimburse them for
their services and (in 1988 in Welch et al. v. American Psy-
choanalytic Association et al.) to force an end to the restric-
tions imposed on lay analysts and their training and practice.
Often the APA was involved in this litigation, attesting to a
growing involvement in professional issues both within that
organization and among clinical psychologists.
In the days of NIMH training grants to PhD programs in
clinical psychology, it was considered a policy failure for
graduates to enter into independent private practice. Indeed,
most of those PhDs took public-sector jobs, whether in teach-
ing, at the VA, or in community mental health centers. That is
no longer the case. More and more clinical psychologists are
in private practice, and they have promoted the passage of
freedom-of-choice legislation, mandating that if insurance
companies pay psychiatrists for psychotherapy, they must do
the same for clinical psychologists. In a world of managed
care, clinical psychologists find themselves competing vigor-
ously for their share of the market. To aid third-party payers
in determining which psychologists merit reimbursement, a
National Register of Health Service Providers was developed
by Carl Zimet and others. To be listed in the register, a psy-
chologist must hold a state license or certification, have suc-
cessfully completed at least 1 year of internship, and must
have 2 years of supervised experience in a health setting.