Professional Training in Clinical and School Psychology: Evolution of the American Model

In the United States, professional education in psychology developed in response to pressing individual human problems such as marital distress, depression, anxiety, childhood behavior problems, etc. These are «behaviors,» defined within the culture as «problems» to be fixed by «specialists.» Practitioners were initially unlicensed, with little or no training, and more than 250 different forms of psychotherapy were practiced. Some people were surely helped but the therapies were not empirically tested. Eventually, individual states began to protect the title «psychologist.» A doctoral degree was required, typically the PhD, along with passing a written examination. However, the examination mostly covered the scientific facts of psychology and provided little evidence that the practitioner was qualified to help persons in distress. Nevertheless, evidence mounted that well trained psychologists could be helpful to the public. The PsyD (Doctor of Psychology) degree was developed to train practitioners, as opposed to scientists or scientist-practitioners. Eventually, practitioners were able to attain other advanced credentials, such as Board Certification. Licensed psychologists were able to take a practical examination which requires working with a patient while being observed by senior practitioners. The newest development in the evolution of practitioner skills is medication privileges. In the state of New Mexico psychologists may now prescribe psychotropic medications. Unfortunately, these practitioner oriented developments are only loosely linked to scientific psychology. In countries with market economies the future of psychological practice is more likely to be driven by economic issues than by empirical findings.