Tag: Psychologist

On This Day … 01 April

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People (Births)

  • 1908 – Abraham Maslow, American psychologist and academic (d. 1970).

People (Deaths)

  • 1922 – Hermann Rorschach, Swiss psychologist and author (b. 1884).

Abraham Maslow

Abraham Harold Maslow (01 April 1908 to 08 June 1970) was an American psychologist who was best known for creating Maslow’s hierarchy of needs, a theory of psychological health predicated on fulfilling innate human needs in priority, culminating in self-actualisation.

Maslow was a psychology professor at Brandeis University, Brooklyn College, New School for Social Research, and Columbia University.

He stressed the importance of focusing on the positive qualities in people, as opposed to treating them as a “bag of symptoms”.

A Review of General Psychology survey, published in 2002, ranked Maslow as the tenth most cited psychologist of the 20th century.

Hermann Rorschach

Hermann Rorschach (08 November 1884 to 02 April 1922) was a Swiss psychiatrist and psychoanalyst.

His education in art helped to spur the development of a set of inkblots that were used experimentally to measure various unconscious parts of the subject’s personality. His method has come to be referred to as the Rorschach test, iterations of which have continued to be used over the years to help identify personality, psychotic, and neurological disorders.

Rorschach continued to refine the test until his premature death at age 37.

On This Day … 30 March

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People (Births)

  • 1882 – Melanie Klein, Jewish Austrian-English psychologist and author (d. 1960).

People (Deaths)

  • 1873 – Bénédict Morel, Austrian-French psychiatrist and physician (b. 1809).

Melanie Klein

Melanie Klein (née Reizes; 30 March 1882 to 22 September 1960) was an Austrian-British author and psychoanalyst known for her work in child analysis. She was the primary figure in the development of object relations theory. Klein suggested that pre-verbal existential anxiety in infancy catalysed the formation of the unconscious, resulting in the unconscious splitting of the world into good and bad idealisations. In her theory, how the child resolves that split depends on the constitution of the child and the character of nurturing the child experiences; the quality of resolution can inform the presence, absence, and/or type of distresses a person experiences later in life.

Contributions to Psychoanalysis

Klein was one of the first to use traditional psychoanalysis with young children. She was innovative in both her techniques (such as working with children using toys) and her theories on infant development. Gaining the respect of those in the academic community, Klein established a highly influential training program in psychoanalysis.

By observing and analysing the play and interactions of children, Klein built onto the work of Freud’s unconscious mind. Her dive into the unconscious mind of the infant yielded the findings of the early Oedipus complex, as well as the developmental roots of the superego.

Klein’s theoretical work incorporates Freud’s belief in the existence of the death pulsation, reflecting the notion that all living organisms are inherently drawn toward an “inorganic” state, and therefore, somehow, towards death. In psychological terms, Eros (properly, the life pulsation), the postulated sustaining and uniting principle of life, is thereby presumed to have a companion force, Thanatos (death pulsation), which seeks to terminate and disintegrate life. Both Freud and Klein regarded these “biomental” forces as the foundations of the psyche. These primary unconscious forces, whose mental matrix is the id, spark the ego – the experiencing self – into activity. Id, ego and superego, to be sure, were merely shorthand terms (similar to the instincts) referring to highly complex and mostly uncharted psychodynamic operations.

Benedict Morel

Bénédict Augustin Morel (22 November 1809 to 30 March 1873) was a French psychiatrist born in Vienna, Austria. He was an influential figure in the field of degeneration theory during the mid-19th century.

Morel received his education in Paris, and while a student, supplemented his income by teaching English and German classes. In 1839 he earned his medical doctorate, and two years later became an assistant to psychiatrist Jean-Pierre Falret (1794-1870) at the Salpêtrière in Paris.

Morel’s interest in psychiatry was further enhanced in the mid-1840s when he visited several mental institutions throughout Europe. In 1848 he was appointed director of the Asile d’Aliénés de Maréville at Nancy. Here he introduced reforms towards the welfare of the mentally ill, in particular liberalisation of restraining practices. At the Maréville asylum he studied the mentally handicapped, researching their family histories and investigating aspects such as poverty and childhood physical illnesses. In 1856 he was appointed director of the mental asylum at Saint-Yon in Rouen.

Morel, influenced by various pre-Darwinian theories of evolution, particularly those that attributed a powerful role to acclimation, saw mental deficiency as the end stage of a process of mental deterioration. In the 1850s, he developed a theory of “degeneration” in regards to mental problems that take place from early life to adulthood. In 1857 he published Traité des dégénérescences physiques, intellectuelles et morales de l’espèce humaine et des causes qui produisent ces variétés maladives, a treatise in which he explains the nature, causes, and indications of human degeneration. Morel looked for answers to mental illness in heredity, although later on he believed that alcohol and drug usage could also be important factors in the course of mental decline.

On This Day … 27 March

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People (Deaths)

  • 1938 – William Stern, German-American psychologist and philosopher (b. 1871).
  • 1946 – Karl Groos, German psychologist and philosopher (b. 1861).
  • 1998 – David McClelland, American psychologist and academic (b. 1917).

William Stern

William Stern (April 29, 1871 to March 27, 1938), born Louis William Stern, was a German psychologist and philosopher. He is known for the development of personalistic psychology, which placed emphasis on the individual by examining measurable personality traits as well as the interaction of those traits within each person to create the self.

Stern also coined the term intelligence quotient, or IQ, and invented the tone variator as a new way to study human perception of sound. Stern studied psychology and philosophy under Hermann Ebbinghaus at the University of Berlin, and quickly moved on to teach at the University of Breslau. Later he was appointed to the position of professor at the University of Hamburg.

Over the course of his career, Stern wrote many books pioneering new fields in psychology such as differential psychology, critical personalism, forensic psychology, and intelligence testing. Stern was also a pioneer in the field of child psychology. Working with his wife, Clara Joeesephy Stern, the couple kept meticulous diaries detailing the lives of their 3 children for 18 years. He used these journals to write several books that offered an unprecedented look into the psychological development of children over time.

Karl Groos

Karl Groos (10 December 1861 to 27 March 1946, in Tübingen) was a philosopher and psychologist who proposed an evolutionary instrumentalist theory of play. His 1898 book on The Play of Animals suggested that play is a preparation for later life.

Groos was full Professor of philosophy in Gießen, Basel and 1911-1929 in Tübingen.

His main idea was that play is basically useful, and so it can be explained by the normal process of evolution by natural selection. When animals ‘play’ they are practising basic instincts, such as fighting, for survival. This is translated from the original as “pre-tuning”. Despite this insight, Groos’ work is seldom read today, and his connection of play with aesthetics has been termed “misguided”. Another area of study was the psychology of literature, including statistical analysis.

Among his scholars is the German philosopher Willy Moog (1888-1935) (doctorate on Goethe supervised by Karl Groos in Gießen 1909).

David McClelland

David Clarence McClelland (20 May 1917 to 27 March 1998) was an American psychologist, noted for his work on motivation Need Theory. He published a number of works between the 1950s and the 1990s and developed new scoring systems for the Thematic Apperception Test (TAT) and its descendants.

McClelland is credited with developing Achievement Motivation Theory, commonly referred to as “need for achievement” or n-achievement theory. A Review of General Psychology survey published in 2002, ranked McClelland as the 15th most cited psychologist of the 20th century.

On This Day … 25 March

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People (Deaths)

Milton H. Erickson

Milton Hyland Erickson (05 December 1901 to 25 March 1980) was an American psychiatrist and psychologist specialising in medical hypnosis and family therapy.

He was founding president of the American Society for Clinical Hypnosis and a fellow of the American Psychiatric Association, the American Psychological Association, and the American Psychopathological Association.

He is noted for his approach to the unconscious mind as creative and solution-generating. He is also noted for influencing brief therapy, strategic family therapy, family systems therapy, solution focused brief therapy, and neuro-linguistic programming.

On This Day … 23 March

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People (Births)

  • 1900 – Erich Fromm, German psychologist and sociologist (d. 1980).
  • 1933 – Philip Zimbardo, American psychologist and academic.

People (Deaths)

  • 2008 – Vaino Vahing, Estonian psychiatrist, author, and playwright (b. 1940).

Erich Fromm

Erich Seligmann Fromm (23 March 1900 to 18 March 1980) was a German social psychologist, psychoanalyst, sociologist, humanistic philosopher, and democratic socialist. He was a German Jew who fled the Nazi regime and settled in the US. He was one of the founders of The William Alanson White Institute of Psychiatry, Psychoanalysis and Psychology in New York City and was associated with the Frankfurt School of critical theory.

Philip Zimbardo

Philip George Zimbardo (/zɪmˈbɑːrdoʊ/; born 23 March 1933) is an American psychologist and a professor emeritus at Stanford University. He became known for his 1971 Stanford prison experiment, which was later severely criticised for both ethical and scientific reasons. He has authored various introductory psychology textbooks for college students, and other notable works, including The Lucifer Effect, The Time Paradox, and The Time Cure. He is also the founder and president of the Heroic Imagination Project.

Stanford Prison Experiment

The Stanford prison experiment (SPE) was a social psychology experiment that attempted to investigate the psychological effects of perceived power, focusing on the struggle between prisoners and prison officers. It was conducted at Stanford University on the days of 15-21 August 1971, by a research group led by psychology professor Philip Zimbardo using college students. In the study, volunteers were assigned to be either “guards” or “prisoners” by the flip of a coin, in a mock prison, with Zimbardo himself serving as the superintendent. Several “prisoners” left mid-experiment, and the whole experiment was abandoned after six days. Early reports on experimental results claimed that students quickly embraced their assigned roles, with some guards enforcing authoritarian measures and ultimately subjecting some prisoners to psychological torture, while many prisoners passively accepted psychological abuse and, by the officers’ request, actively harassed other prisoners who tried to stop it. The experiment has been described in many introductory social psychology textbooks, although some have chosen to exclude it because its methodology is sometimes questioned.

The US Office of Naval Research funded the experiment as an investigation into the causes of difficulties between guards and prisoners in the United States Navy and United States Marine Corps. Certain portions of it were filmed, and excerpts of footage are publicly available.

The experiment’s findings have been called into question, and the experiment has been criticized for unscientific methodology. Although Zimbardo interpreted the experiment as having shown that the “prison guards” instinctively embraced sadistic and authoritarian behaviours, Zimbardo actually instructed the “guards” to exert psychological control over the “prisoners”. Critics also noted that some of the participants behaved in a way that would help the study, so that, as one “guard” later put it, “the researchers would have something to work with,” which is known as demand characteristics. Variants of the experiment have been performed by other researchers, but none of these attempts have replicated the results of the SPE.

Vaino Vahling

Vaino Vahing (15 February 1940 to 23 March 2008), was an Estonian writer, prosaist, psychiatrist and playwright. Starting from 1973, he was a member of Estonian Writers Union.

Vaino Vahing has written many articles about psychiatry, but also literature – novels, books and plays with psychiatric and autobiographical influence. He has played in several Estonian films.

On This Day … 20 March

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People (Births)

  • 1895 – Fredric Wertham, German-American psychologist and author (d. 1981).
  • 1904 – B. F. Skinner, American psychologist and author (d. 1990).

Frederic Wertham

Fredric Wertham (born Friedrich Ignatz Wertheimer, 20 March 1895 to 18 November 1981) was a German-American psychiatrist and author. Wertham had an early reputation as a progressive psychiatrist who treated poor black patients at his Lafargue Clinic at a time of heightened discrimination in urban mental health practice. Wertham also authored a definitive textbook on the brain, and his institutional stressor findings were cited when courts overturned multiple segregation statutes, most notably in Brown v. Board of Education.

Despite this, Wertham remains best known for his concerns about the effects of violent imagery in mass media and the effects of comic books on the development of children. His best-known book is Seduction of the Innocent (1954), which asserted that comic books caused youth to become delinquents. Besides Seduction of the Innocent, Wertham also wrote articles and testified before government inquiries into comic books, most notably as part of a US Congressional inquiry into the comic book industry. Wertham’s work, in addition to the 1954 comic book hearings led to creation of the Comics Code, although later scholars cast doubt on his observations.

B.F. Skinner

Burrhus Frederic Skinner (20 March 1904 to 18 August 1990) was an American psychologist, behaviourist, author, inventor, and social philosopher. He was a professor of psychology at Harvard University from 1958 until his retirement in 1974.

Considering free will to be an illusion, Skinner saw human action as dependent on consequences of previous actions, a theory he would articulate as the principle of reinforcement: If the consequences to an action are bad, there is a high chance the action will not be repeated; if the consequences are good, the probability of the action being repeated becomes stronger.

Skinner developed behaviour analysis, especially the philosophy of radical behaviourism, and founded the experimental analysis of behaviour, a school of experimental research psychology. He also used operant conditioning to strengthen behaviour, considering the rate of response to be the most effective measure of response strength. To study operant conditioning, he invented the operant conditioning chamber (aka the Skinner Box), and to measure rate he invented the cumulative recorder. Using these tools, he and Charles Ferster produced Skinner’s most influential experimental work, outlined in their book Schedules of Reinforcement (1957).

Skinner was a prolific author, having published 21 books and 180 articles. He imagined the application of his ideas to the design of a human community in his utopian novel, Walden Two (1948), while his analysis of human behaviour culminated in his work, Verbal Behaviour.

Contemporary academia considers Skinner, along with John B. Watson and Ivan Pavlov, a pioneer of modern behaviourism. Accordingly, a June 2002 survey listed Skinner as the most influential psychologist of the 20th century.

What is Health Psychology?

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Introduction

Health psychology is the study of psychological and behavioral processes in health, illness, and healthcare.

It is concerned with understanding how psychological, behavioural, and cultural factors contribute to physical health and illness. Psychological factors can affect health directly. For example, chronically occurring environmental stressors affecting the hypothalamic-pituitary-adrenal axis, cumulatively, can harm health. Behavioural factors can also affect a person’s health. For example, certain behaviours can, over time, harm (smoking or consuming excessive amounts of alcohol) or enhance health (engaging in exercise). Health psychologists take a biopsychosocial approach. In other words, health psychologists understand health to be the product not only of biological processes (e.g. a virus, tumour, etc.) but also of psychological (e.g. thoughts and beliefs), behavioural (e.g. habits), and social processes (e.g. socioeconomic status and ethnicity).

By understanding psychological factors that influence health, and constructively applying that knowledge, health psychologists can improve health by working directly with individual patients or indirectly in large-scale public health programs. In addition, health psychologists can help train other healthcare professionals (e.g. physicians and nurses) to apply the knowledge the discipline has generated, when treating patients. Health psychologists work in a variety of settings: alongside other medical professionals in hospitals and clinics, in public health departments working on large-scale behaviour change and health promotion programs, and in universities and medical schools where they teach and conduct research.

Although its early beginnings can be traced to the field of clinical psychology, four different divisions within health psychology and one related field, occupational health psychology (OHP), have developed over time. The four divisions include clinical health psychology, public health psychology, community health psychology, and critical health psychology Professional organisations for the field of health psychology include Division 38 of the American Psychological Association (APA), the Division of Health Psychology of the British Psychological Society (BPS), the European Health Psychology Society, and the College of Health Psychologists of the Australian Psychological Society (APS). Advanced credentialing in the US as a clinical health psychologist is provided through the American Board of Professional Psychology.

Overview

Recent advances in psychological, medical, and physiological research have led to a new way of thinking about health and illness. This conceptualisation, which has been labelled the biopsychosocial model, views health and illness as the product of a combination of factors including biological characteristics (e.g. genetic predisposition), behavioural factors (e.g. lifestyle, stress, health beliefs), and social conditions (e.g. cultural influences, family relationships, social support).

Psychologists who strive to understand how biological, behavioural, and social factors influence health and illness are called health psychologists. Health psychologists use their knowledge of psychology and health to promote general well-being and understand physical illness. They are specially trained to help people deal with the psychological and emotional aspects of health and illness. Health psychologists work with many different health care professionals (e.g. physicians, dentists, nurses, physician’s assistants, dietitians, social workers, pharmacists, physical and occupational therapists, and chaplains) to conduct research and provide clinical assessments and treatment services. Many health psychologists focus on prevention research and interventions designed to promote healthier lifestyles and try to find ways to encourage people to improve their health. For example, they may help people to lose weight or stop smoking. Health psychologists also use their skills to try to improve the healthcare system. For example, they may advise doctors about better ways to communicate with their patients. Health psychologists work in many different settings including the UK’s National Health Service (NHS), private practice, universities, communities, schools and organisations. While many health psychologists provide clinical services as part of their duties, others function in non-clinical roles, primarily involving teaching and research. Leading journals include Health Psychology, the Journal of Health Psychology, the British Journal of Health Psychology, and Applied Psychology: Health and Well-Being. Health psychologists can work with people on a one-to-one basis, in groups, as a family, or at a larger population level.

Clinical Health Psychology (ClHP)

ClHP is the application of scientific knowledge, derived from the field of health psychology, to clinical questions that may arise across the spectrum of health care. ClHP is one of the specialty practice areas for clinical psychologists. It is also a major contributor to the prevention-focused field of behavioural health and the treatment-oriented field of behavioural medicine. Clinical practice includes education, the techniques of behaviour change, and psychotherapy. In some countries, a clinical health psychologist, with additional training, can become a medical psychologist and, thereby, obtain prescription privileges.

Public Health Psychology (PHP)

PHP is population oriented. A major aim of PHP is to investigate potential causal links between psychosocial factors and health at the population level. Public health psychologists present research results to educators, policy makers, and health care providers in order to promote better public health. PHP is allied to other public health disciplines including epidemiology, nutrition, genetics and biostatistics. Some PHP interventions are targeted toward at-risk population groups (e.g., undereducated, single pregnant women who smoke) and not the population as a whole (e.g. all pregnant women).

Community Health Psychology (CoHP)

CoHP investigates community factors that contribute to the health and well-being of individuals who live in communities. CoHP also develops community-level interventions that are designed to combat disease and promote physical and mental health. The community often serves as the level of analysis, and is frequently sought as a partner in health-related interventions.

Critical Health Psychology (CrHP)

CrHP is concerned with the distribution of power and the impact of power differentials on health experience and behaviour, health care systems, and health policy. CrHP prioritises social justice and the universal right to health for people of all races, genders, ages, and socioeconomic positions. A major concern is health inequalities. The critical health psychologist is an agent of change, not simply an analyst or cataloguer. A leading organisation in this area is the International Society of Critical Health Psychology.

Health psychology, like other areas of applied psychology, is both a theoretical and applied field. Health psychologists employ diverse research methods. These methods include controlled randomised experiments, quasi-experiments, longitudinal studies, time-series designs, cross-sectional studies, case-control studies, qualitative research as well as action research. Health psychologists study a broad range of health phenomena including cardiovascular disease, (cardiac psychology), smoking habits, the relation of religious beliefs to health, alcohol use, social support, living conditions, emotional state, social class, and more. Some health psychologists treat individuals with sleep problems, headaches, alcohol problems, etc. Other health psychologists work to empower community members by helping community members gain control over their health and improve quality of life of entire communities.

Occupational Health Psychology

Pickren and Degni and Sanderson observed that in Europe and North America occupational health psychology (OHP) emerged as a specialty with its own organisations. The authors noted that OHP owes some of that emergence to health psychology as well as other disciplines (e.g. industrial/organisational psychology, occupational medicine). Sanderson underlined examples in which OHP aligns with health psychology, including Adkins’s research. Adkins documented the application of behavioural principles to improve working conditions, mitigate job stress, and improve worker health in a complex organisation.

Origins and Development

Health psychology developed in different forms in different societies. Psychological factors in health had been studied since the early 20th century by disciplines such as psychosomatic medicine and later behavioural medicine, but these were primarily branches of medicine, not psychology.

United States In 1969, William Schofield prepared a report for the APA entitled The Role of Psychology in the Delivery of Health Services. While there were exceptions, he found that the psychological research of the time frequently regarded mental health and physical health as separate, and devoted very little attention to psychology’s impact upon physical health. One of the few psychologists working in this area at the time, Schofield proposed new forms of education and training for future psychologists. The APA, responding to his proposal, in 1973 established a task force to consider how psychologists could:

  • Help people to manage their health-related behaviours;
  • Help patients manage their physical health problems; and
  • Train healthcare staff to work more effectively with patients.

Health psychology began to emerge as a distinct discipline of psychology in the United States in the 1970s. In the mid-20th century there was a growing understanding in medicine of the effect of behaviour on health. For example, the Alameda County Study, which began in the 1960s, showed that people who ate regular meals (e.g. breakfast), maintained a healthy weight, received adequate sleep, did not smoke, drank little alcohol, and exercised regularly were in better health and lived longer. In addition, psychologists and other scientists were discovering relationships between psychological processes and physiological ones. These discoveries include a better understanding of the impact of psychosocial stress on the cardiovascular and immune systems, and the early finding that the functioning of the immune system could be altered by learning.

Led by Joseph Matarazzo, in 1977, APA added a division devoted to health psychology. At the first divisional conference, Matarazzo delivered a speech that played an important role in defining health psychology. He defined the new field in this way, “Health psychology is the aggregate of the specific educational, scientific and professional contributions of the discipline of psychology to the promotion and maintenance of health, the prevention and treatment of illness, the identification of diagnostic and etiologic correlates of health, illness and related dysfunction, and the analysis and improvement of the healthcare system and health policy formation.” In the 1980s, similar organizations were established elsewhere. In 1986, the BPS established a Division of Health Psychology. The European Health Psychology Society was also established in 1986. Similar organisations were established in other countries, including Australia and Japan. Universities began to develop doctoral level training programmes in health psychology. In the US, post-doctoral level health psychology training programmes were established for individuals who completed a doctoral degree in clinical psychology.

United Kingdom Psychologists have been working in medical settings for many years (in the UK sometimes the field was termed medical psychology). Medical psychology, however, was a relatively small field, primarily aimed at helping patients adjust to illness. The BPS’s reconsideration of the role of the Medical Section prompted the emergence of health psychology as a distinct field. Marie Johnston and John Weinman argued in a letter to the BPS Bulletin that there was a great need for a Health Psychology Section. In December 1986 the section was established at the BPS London Conference, with Marie Johnston as chair. At the Annual BPS Conference in 1993 a review of “Current Trends in Health Psychology” was organized, and a definition of health psychology as “the study of psychological and behavioural processes in health, illness and healthcare” was proposed.

The Health Psychology Section became a Special Group in 1993 and was awarded divisional status within the UK in 1997. The awarding of divisional status meant that the individual training needs and professional practice of health psychologists were recognised, and members were able to obtain chartered status with the BPS. The BPS went on to regulate training and practice in health psychology until the regulation of professional standards and qualifications was taken over by statutory registration with the Health Professions Council in 2010.

A number of relevant trends coincided with the emergence of health psychology, including:

  • Epidemiological evidence linking behaviour and health.
  • The addition of behavioural science to medical school curricula, with courses often taught by psychologists.
  • The training of health professionals in communication skills, with the aim of improving patient satisfaction and adherence to medical treatment.
  • Increasing numbers of interventions based on psychological theory (e.g. behaviour modification).
  • An increased understanding of the interaction between psychological and physiological factors leading to the emergence of psychophysiology and psychoneuroimmunology (PNI).
  • The health domain having become a target of research by social psychologists interested in testing theoretical models linking beliefs, attitudes, and behaviour.

The emergence of AIDS/HIV, and the increase in funding for behavioural research the epidemic provoked.
The emergence of academic /professional bodies to promote research and practice in health psychology was followed by the publication of a series of textbooks which began to lay out the interests of the discipline.

Objectives

Understanding Behavioural and Contextual Factors

Health psychologists conduct research to identify behaviours and experiences that promote health, give rise to illness, and influence the effectiveness of health care. They also recommend ways to improve health care policy. Health psychologists have worked on developing ways to reduce smoking and improve daily nutrition in order to promote health and prevent illness. They have also studied the association between illness and individual characteristics. For example, health psychology has found a relation between the personality characteristics of thrill seeking, impulsiveness, hostility/anger, emotional instability, and depression, on one hand, and high-risk driving, on the other.

Health psychology is also concerned with contextual factors, including economic, cultural, community, social, and lifestyle factors that influence health. Physical addiction impedes smoking cessation. Some research suggests that seductive advertising also contributes to psychological dependency on tobacco, although other research has found no relationship between media exposure and smoking in youth. OHP research indicates that people in jobs that combine little decision latitude with a high psychological workload are at increased risk for cardiovascular disease. Other research reveals a relation between unemployment and elevations in blood pressure. Epidemiologic research documents a relation between social class and cardiovascular disease.

Health psychologists also aim to change health behaviours for the dual purpose of helping people stay healthy and helping patients adhere to disease treatment regimens (also see health action process approach). Health psychologists employ cognitive behavioural therapy and applied behaviour analysis (also see behaviour modification) for that purpose.

Preventing Illness

Health psychologists promote health through behavioural change, as mentioned above; however, they attempt to prevent illness in other ways as well. Health psychologists try to help people to lead a healthy life by developing and running programmes which can help people to make changes in their lives such as stopping smoking, reducing the amount of alcohol they consume, eating more healthily, and exercising regularly. Campaigns informed by health psychology have targeted tobacco use. Those least able to afford tobacco products consume them most. Tobacco provides individuals with a way of controlling aversive emotional states accompanying daily experiences of stress that characterize the lives of deprived and vulnerable individuals. Practitioners emphasize education and effective communication as a part of illness prevention because many people do not recognise, or minimise, the risk of illness present in their lives. Moreover, many individuals are often unable to apply their knowledge of health practices owing to everyday pressures and stresses. A common example of population-based attempts to motivate the smoking public to reduce its dependence on cigarettes is anti-smoking campaigns.

Health psychologists help to promote health and well-being by preventing illness. Some illnesses can be more effectively treated if caught early. Health psychologists have worked to understand why some people do not seek early screenings or immunisations, and have used that knowledge to develop ways to encourage people to have early health checks for illnesses such as cancer and heart disease. Health psychologists are also finding ways to help people to avoid risky behaviours (e.g. engaging in unprotected sex) and encourage health-enhancing behaviours (e.g. regular tooth brushing or hand washing).

Health psychologists also aim at educating health professionals, including physicians and nurses, in communicating effectively with patients in ways that overcome barriers to understanding, remembering, and implementing effective strategies for reducing exposures to risk factors and making health-enhancing behaviour changes.

There is also evidence from OHP that stress-reduction interventions at the workplace can be effective. For example, Kompier and his colleagues have shown that a number of interventions aimed at reducing stress in bus drivers has had beneficial effects for employees and bus companies.

The Effects of Disease

Health psychologists investigate how disease affects individuals’ psychological well-being. An individual who becomes seriously ill or injured faces many different practical stressors. These stressors include problems meeting medical and other bills, problems obtaining proper care when home from the hospital, obstacles to caring for dependents, the experience of having one’s sense of self-reliance compromised, gaining a new, unwanted identity as that of a sick person, and so on. These stressors can lead to depression, reduced self-esteem, etc.

Health psychology also concerns itself with bettering the lives of individuals with terminal illness. When there is little hope of recovery, health psychologist therapists can improve the quality of life of the patient by helping the patient recover at least some of his or her psychological well-being. Health psychologists are also concerned with providing therapeutic services for the bereaved.

Critical Analysis of Health Policy

Critical health psychologists explore how health policy can influence inequities, inequalities and social injustice. These avenues of research expand the scope of health psychology beyond the level of individual health to an examination of the social and economic determinants of health both within and between regions and nations. The individualism of mainstream health psychology has been critiqued and deconstructed by critical health psychologists using qualitative methods that zero in on the health experience.

Conducting Research

Like psychologists in the other main psychology disciplines, health psychologists have advanced knowledge of research methods. Health psychologists apply this knowledge to conduct research on a variety of questions. For example, health psychologists carry out research to answer questions such as:

  • What influences healthy eating?
  • How is stress linked to heart disease?
  • What are the emotional effects of genetic testing?
  • How can we change people’s health behaviour to improve their health?

Teaching and Communication

Health psychologists can also be responsible for training other health professionals on how to deliver interventions to help promote healthy eating, stopping smoking, weight loss, etc. Health psychologists also train other health professionals in communication skills such as how to break bad news or support behaviour change for the purpose of improving adherence to treatment.

Applications

Improving Doctor-Patient Communication

Health psychologists aid the process of communication between physicians and patients during medical consultations. There are many problems in this process, with patients showing a considerable lack of understanding of many medical terms, particularly anatomical terms (e.g. intestines). One area of research on this topic involves “doctor-centred” or “patient-centred” consultations. Doctor-centred consultations are generally directive, with the patient answering questions and playing less of a role in decision-making. Although this style is preferred by elderly people and others, many people dislike the sense of hierarchy or ignorance that it inspires. They prefer patient-centred consultations, which focus on the patient’s needs, involve the doctor listening to the patient completely before making a decision, and involving the patient in the process of choosing treatment and finding a diagnosis.

Improving Adherence to Medical Advice

Health psychologists engage in research and practice aimed at getting people to follow medical advice and adhere to their treatment regimens. Patients often forget to take their pills or consciously opt not to take their prescribed medications because of side effects. Failing to take prescribed medication is costly and wastes millions of usable medicines that could otherwise help other people. Estimated adherence rates are difficult to measure (see below); there is, however, evidence that adherence could be improved by tailoring treatment programs to individuals’ daily lives. Additionally, traditional cognitive-behavioural therapies have been adapted for people suffering from chronic illnesses and comorbid psychological distress to include modules that encourage, support and reinforce adherence to medical advice as part of the larger treatment approach.

Ways of Measuring Adherence

Health psychologists have identified a number of ways of measuring patients’ adherence to medical regimens:

  • Counting the number of pills in the medicine bottle.
  • Using self-reports.
  • Using “Trackcap” bottles, which track the number of times the bottle is opened.

Managing Pain

Health psychology attempts to find treatments to reduce or eliminate pain, as well as understand pain anomalies such as episodic analgesia, causalgia, neuralgia, and phantom limb pain. Although the task of measuring and describing pain has been problematic, the development of the McGill Pain Questionnaire has helped make progress in this area. Treatments for pain involve patient-administered analgesia, acupuncture (found to be effective in reducing pain for osteoarthritis of the knee), biofeedback, and cognitive behaviour therapy.

Health Psychologist Roles

Below are some examples of the types of positions held by health psychologists within applied settings such as the UK’s NHS and private practice.

  • Consultant health psychologist:
    • A consultant health psychologist will take a lead for health psychology within public health, including managing tobacco control and smoking cessation services and providing professional leadership in the management of health trainers.
  • Principal health psychologist:
    • A principal health psychologist could, for example lead the health psychology service within one of the UK’s leading heart and lung hospitals, providing a clinical service to patients and advising all members of the multidisciplinary team.
  • Health psychologist:
    • An example of a health psychologist’s role would be to provide health psychology input to a centre for weight management.
    • Psychological assessment of treatment, development and delivery of a tailored weight management programme, and advising on approaches to improve adherence to health advice and medical treatment.
  • Research psychologist:
    • Research health psychologists carry out health psychology research, for example, exploring the psychological impact of receiving a diagnosis of dementia, or evaluating ways of providing psychological support for people with burn injuries.
    • Research can also be in the area of health promotion, for example investigating the determinants of healthy eating or physical activity or understanding why people misuse substances.
  • Health psychologist in training/assistant health psychologist:
    • As an assistant/in training, a health psychologist will gain experience assessing patients, delivering psychological interventions to change health behaviours, and conducting research, whilst being supervised by a qualified health psychologist.

Training

In the UK, health psychologists are registered by the Health Professions Council (HPC) and have trained to a level to be eligible for full membership of the Division of Health Psychology within the BPS. Registered health psychologists who are chartered with the BPS will have undertaken a minimum of six years of training and will have specialised in health psychology for a minimum of three years. Health psychologists in training must have completed BPS stage 1 training and be registered with the BPS Stage 2 training route or with a BPS-accredited university doctoral health psychology program. Once qualified, health psychologists can work in a range of settings, for example the NHS, universities, schools, private healthcare, and research and charitable organisations. A health psychologist in training might be working within applied settings while working towards registration and chartered status. A health psychologist will have demonstrated competencies in all of the following areas:

  • Professional skills (including implementing ethical and legal standards, communication, and teamwork).
  • Research skills (including designing, conducting, and analysing psychological research in numerous areas).
  • Consultancy skills (including planning and evaluation).
  • Teaching and training skills (including knowledge of designing, delivering, and evaluating large and small scale training programme).
  • Intervention skills (including delivery and evaluation of behaviour change interventions).

All qualified health psychologists must also engage in and record their continuing professional development (CPD) for psychology each year throughout their career.

In Australia, health psychologists are registered by the Psychology Board of Australia. The standard pathway to becoming an endorsed health psychologists involves a minimum of six years training and a two-year registrar programme. Health psychologists must also undertake continuing professional development (CPD) each year.

On This Day … 19 March

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People (Deaths)

  • 1996 – Lise Østergaard, Danish psychologist and politician (b. 1924).

Lise Ostergaard

Anna Elisabeth “Lise” Østergaard (18 November 1924 to 19 March 1996) was a Danish psychologist and a politician in the social-democratic party. Under Anker Jørgensen’s leadership, she was Minister without Portfolio (1977-1980) and Minister of Culture (February 1980 to September 1982). As a psychologist, she was head of psychology in Copenhagen’s Rigshospitalet (1958) as well as the first woman to become professor of clinical psychology at Copenhagen University (1963), a position she resumed after her political career ended in the mid-1980s.

Psychology

After graduating in 1947, Østergaard worked as a psychologist in Norrtulls sjukhus, a children’s hospital in Stockholm. In 1949, she returned to Denmark, first spending a year in Dronning Louises Børnehospital (Queen Louise’s Children’s Hospital) before moving to the newly established children’s psychology clinic at Copenhagen University where she remained until 1954. She then entered the Rigshospitalet’s psychology department where she was appointed head psychologist in 1958, expanding her experience in clinical psychology. As a result, from 1955 to 1960 she headed a course in clinical psychology for the Dansk Psychologforening (Danish Psychologists Association) while teaching as the first woman psychologist at the university. She also took up assignments as a guest lecturer in Lund, Sweden, and Bergen, Norway.

Published in 1961, her Den psykologiske testmetode og dens relation til klinisk psykiatri (The Psychological Test Method and its Relationship to Clinical Psychiatry) raised considerable interest among psychiatrists. While working at Rigshospitalet, Østergaard treated a number of schizophrenic patients. In 1962, this led to her En psykologisk analyse af de formelle schizofrene tankeforstyrrelser (A Psychological Analysis of Formal Schizophrenic Thought Disorders), paving the way for research on the borderline between psychology and psychiatry in collaboration with the National Institute of Mental Health in the United States.

In 1963, Østergaard became the first female professor of psychology at Copenhagen University. After heading the Studenterrådgivningsklinikken (Student Advisory Clinic, 1964-1968), she established the Institut for Klinisk Psykologi (Clinical Psychology Institute) in 1968. From 1970 to 1973, she was a member of Denmark’s Unesco committee and from 1973 a member of Akademiet for de Tekniske Videnskaber (The Danish Academy of Technical Sciences).

What is Medical Psychology?

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Introduction

Medical psychology, or Medicopsychology, is the application of psychological principles to the practice of medicine, primarily drug-oriented, for both physical and mental disorders.

The American Society for the Advancement of Pharmacotherapy defines medical psychology as “that branch of psychology integrating somatic and psychotherapeutic modalities into the management of mental illness and emotional, cognitive, behavioral and substance use disorders”.

A medical psychologist who holds prescriptive authority for specific psychiatric medications and other pharmaceutical drugs must first obtain specific qualifications in Psychopharmacology. A trained medical psychologist, or psychopharmacologist who has prescriptive authority is equated with a mid-level provider who has the authority to prescribe psychotropic medication such as antidepressants for neurotic disorders. However, a medical psychologist does not automatically equate with a psychologist who has the authority to prescribe medication. In fact, most medical psychologists do not prescribe medication and do not have the authority to do so.

Medical psychologists apply psychological theories, scientific psychological findings, and techniques of psychotherapy, behaviour modification, cognitive, interpersonal, family, and life-style therapy to improve the psychological and physical health of the patient. Psychologists with post doctoral specialty training as medical psychologists are the practitioners with refined skills in clinical psychology, health psychology, behavioural medicine, psychopharmacology, and medical science. Highly qualified and post graduate specialised doctors are trained for service in primary care centres, hospitals, residential care centres, and long-term care facilities and in multidisciplinary collaboration and team treatment.

Medical Psychology Specialty

The field of medical psychology may include pre-doctoral training in the disciplines of health psychology, rehabilitation psychology, pediatric psychology, neuropsychology, and clinical psychopharmacology, as well as sub-specialties in pain management, primary care psychology, and hospital-based (or medical school-based) psychology as the foundation psychological training to qualify for proceeding to required post-doctoral specialty training to qualify to become a Diplomate/Specialist in Medical Psychology. To be a Specialist in Medical Psychology a psychologist must hold Board Certification from the American Board of Medical Psychology which requires a doctorate degree in psychology, a license to practice psychology, a post doctorate graduate degree or acceptable post doctoral didactic training, a residency in medical psychology, submission of a work product for examination, a written and oral examination by the American Board of Medical Psychology. The American Board of Medical Psychology maintains a distinction between specialists and psychopharmacological psychologists or those interested in practicing one of the related psychological disciplines in primary care centres. The term Medical Psychologists is not an umbrella term, and many other specialties in psychology such as healthcare psychology, embracing the biopsychosocial paradigm of mental/physical health and extending that paradigm to clinical practice through research and the application of evidenced-based diagnostic and treatment procedures are akin to the specialty and are prepared to practice in Integrated and Primary Care Settings.

Adopting the biopsychosocial paradigm, the field of medical psychology has recognised the Cartesian assumption that the body and mind are separate entities is inadequate, representing as it does an arbitrary dichotomy that works to the detriment of healthcare. The biopsychosocial approach reflects the concept that the psychology of an individual cannot be understood without reference to that individual’s social environment. For the medical psychologist, the medical model of disease cannot in itself explain complex health concerns any more than a strict psychosocial explanation of mental and physical health can in itself be comprehensive.

Duties

Medical psychologists and some psychopharmacologists are trained and equipped to modify physical disease states and the actual cytoarchitecture and functioning of the central nervous and related systems using psychological and pharmacological techniques (when allowed by statute), and to provide prevention for the progression of disease having to do with poor personal and life-style choices and conceptualisation, behavioural patterns, and chronic exposure to the effects of negative thinking, choosing, attitudes, and negative contexts. The specialty of medical psychology includes training in psychopharmacology and in states providing statutory authority may prescribe psychoactive substances as one technique in a larger treatment plan which includes psychological interventions. The medical psychologists and psychopharmacologists who serve in states that have not yet modernised their psychology prescribing laws may evaluate patients and recommend appropriate psychopharmacological techniques in collaboration with a state authorised prescriber. Medical psychologists and psychopharmacologists who are not Board Certified strive to integrate the major components of an individual’s psychological, biological, and social functioning and are designed to contribute to that person’s well-being in a way that respects the natural interface among these components. The whole is greater than the sum of its parts when it comes to providing comprehensive and sensible behavioural healthcare and the medical psychologist is uniquely qualified to collaborate with physicians that are treating the patients physical illnesses.

Certifications

The Academy of Medical Psychology defines medical psychology as a specialty trained at the post doctoral level and designed to deliver advanced diagnostic and clinical interventions in Medical and Healthcare Facilities utilising the knowledge and skills of clinical psychology, health psychology, behavioural medicine, psychopharmacology and basic medical science. The Academy of Medical Psychology makes a distinction between the Psychopharmacologist who is a psychologist with advanced training in psychopharmacology and may prescribe medicine or consult with physician or nurse practitioner prescribers to diagnose mental illness and select and recommend appropriate psychoactive medicines, and the Medical Psychologists who are prepared to do the psychopharmacology consulting or prescribing, but also must have training which prepares them for functioning with Behavioural and Lifestyle components of physical disease and functioning in or in consultation with multidisciplinary healthcare teams in Primary Care Centres or Community Hospitals in addition to traditional roles in the treatment of mental illness and substance abuse disorders. The specialty of Medical Psychology and this distinction from Psychopharmacologist is recognised by the National Alliance of Professional Psychology Providers (the psychology national practitioner association; see http://www.nappp.org).

A specialty of medical psychology has established a specialty board certification, American Board of Medical Psychology and an Academy of Medical Psychology (www.amphome.org) requiring a doctorate degree in psychology and extensive post doctoral training in the specialty and the passage of an oral or written examination.

Although the Academy of Medical Psychology defines medical psychology as a “specialty” and has established a “specialty board certification,” and is recognised by the national psychology practitioner association (www.nappp.org) there is a split in national psychology associations between NAPPP and APA and the American Psychological Association and the National Alliance of Professional Psychology Providers do not currently recognise the same specialties with the APA being a group that represents scientists, academics, and practitioners (as a minority) and NAPPP being an organization that represents only practitioners. However, Louisiana, having a unique to that state definition of medical psychology does recognise the national distinction between Medical Psychology as a Specialty and a psychopharmacology proficiency (See APA proficiency in psychopharmacology) and restricts the term and practice of medical psychology by statute (the Medical Psychology Practice Act) as a “profession of the health sciences” with prescriptive authority. It is equally important to note than the American Psychological Association does not recognise that the term medical psychology has, as a prerequisite, nor should the term be equated with having, prescriptive authority and has established psychology post doctoral prescribing medicines as “a proficiency in psychopharmacology”.

In 2006, the American Psychological Association (APA) recommended that the education and training of psychologists, who are specifically pursuing one of several prerequisites for prescribing medication, integrate instruction in the biological sciences, clinical medicine and pharmacology into a formalised programme of postdoctoral education. In 2009, the National Alliance of Professional Providers in Psychology recognised the education and training specified by the American Board of Medical Psychology (www.amphome.org; ABMP) and the Academy of Medical Psychology as the approved standards for post graduate training and examination and qualifications in the nationally recognised specialty in Medical Psychology. Since then numerous hospitals, primary care centres, and other health facilities have recognised the ABMP standards and qualifications for privileges in healthcare facilities and verification of specialty status.

The following Clinical Competencies are identified as essential in the education and training of psychologists, wishing to pursue prescriptive authority. These recommended prerequisites are not required or specifically recommended by APA for the training and education of medical psychologists not pursuing prerequisites for prescribing medication:

  • Basic Science: anatomy, & physiology, biochemistry.
  • Neurosciences: neuroanatomy, neurophysiology, neurochemistry.
  • Physical Assessment and Laboratory Exams: physical assessment, laboratory and radiological assessment, medical terminology.
  • Clinical Medicine and Pathophysiology: pathophysiology with emphasis on the principal physiological systems, clinical medicine, differential diagnosis, clinical correlation and case studies, chemical dependency, chronic pain management.
  • Clinical and Research Pharmacology and Psychopharmacology: pharmacology, clinical pharmacology, pharmacogenetics, psychopharmacology, developmental psychopharmacology.
  • Clinical Pharmacotherapeutics: professional, ethical and legal issues, combined therapies and their interactions, computer-based aids to practice, pharmacoepidemiology.
  • Research: methodology and design of psychopharmacology research, interpretation and evaluation, FDA drug development and other regulatory processes.

The 2006 APA recommendations also include supervised clinical experience intended to integrate the above seven knowledge domains and assess competencies in skills and applied knowledge.

The national psychology practitioner association (NAPPP; http://www.nappp.org) and top national certifying body (Academy of Medical Psychology; http://www.amphome.org) have established the national training, examination, and specialty practice criterion and guidelines in the specialty of Medical Psychology and have established a national journal in the specialty. Such certifying bodies, view psychopharmacology training (either to prescribe or consult) as one component of the training of a specialist in Medical Psychology, but recognise that training and specialised skills in other aspects of the treatment of behavioural aspects of medical illness, and mental illness affecting physical illness is essential to practice at the specialty level in Medical Psychology. The Louisiana Academy of Medical Psychology (LAMP), currently the largest organisation of psychologists with prescriptive authority in the world and the only organization representing practitioners of medical psychology in Louisiana as defined by Louisiana statute within any jurisdiction in the United States, no longer recognises the Academy of Medical Psychology as an adequate certifying body for its practitioners, and its members have resigned from the Academy of Medical Psychology en masse. Similarly, virtually all members of LAMP have also resigned from the Louisiana Psychological Association (LPA) after many LPA members uncovered that the LAMP’s prescriptive authority movement covertly came to an agreement with Louisiana’s medical board to transfer the entire practice of psychology for psychologists with prescriptive authority to the medical board. Louisiana is the only state in which the practice of psychology, including psychological testing, psychotherapy, diagnosis, and treatment for some psychologists (i.e. medical psychologists) is regulated by a medical board.

What is the Scientist-Practitioner Model?

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Introduction

The scientist-practitioner model, also called the Boulder Model, is a training model for graduate programmes that provide applied psychologists with a foundation in research and scientific practice. It was initially developed to guide clinical psychology graduate programmes accredited by the American Psychological Association (APA).

David Shakow created the first version of the model and introduced it to the academic community. From the years of 1941 until 1949, Shakow presented the model to a series of committees where the core tenets developed further. The model changed minimally from its original version because it was received extremely well at all of the conferences. At the Boulder Conference of 1949, this model of training for clinical graduate programmes was purposed. Here, it received accreditation by the psychological community and the American Psychological Association.

The goal of the scientist-practitioner model is to increase scientific growth within clinical psychology in the United States. It calls for graduate programmes to engage and develop psychologists’ background in psychological theory, field work, and research methodology. The scientist-practitioner model urges clinicians to allow empirical research to influence their applied practice; while simultaneously, allowing their experiences during applied practice to shape their future research questions. Therefore, continuously advancing, refining and perfecting the scientific paradigms of the field.

Refer to Practitioner-Scholar Model.

Brief History

After World War I, returning veterans reported decreased life satisfaction after serving. This was primarily due to the lack of clinical psychologists available to treat victims of “shell-shock” (now known as post traumatic stress disorder). At this time, psychology was primarily an academic discipline, with just a few thousand practicing clinicians. The Second World War also influenced the development of the Boulder Model by fuelling the growth of clinical psychology. Psychiatrists in the US military requested help from psychologists in efforts to treat “psychological and psychiatric casualties the war was producing”.

In order to increase life satisfaction for World War II veterans the federal government increased funding to clinical psychology graduate programmes and created the GI Bill. As a result, after the war Psychology graduate programmes flourished with applicants and resources. The field’s increasing popularity called for action, by the academic community, to establish universal standards for educating graduate psychologists. Although the model has not been as prominent in industrial/organisational (I/O) psychology, Campbell acknowledged that the model later influenced I/O psychology.

Development

David Shakow is largely responsible for the ideas and developments of the Boulder Model. On 03 May 1941, while he was chief psychologist at Worcester State Hospital, Shakow drafted his first training plan to educate clinical psychology graduate students during a Conference at The New York Psychiatric Institute, now referred to as Shakow’s 1941 American Association for Applied Psychology Report. In the report, Shakow outlined a 4-year education track:

  • Year 1: establish a strong foundation in psychology and other applied sciences.
  • Year 2: learn therapeutic principles and practices needed to treat patients.
  • Year 3: internship, gain supervised field experience.
  • Year 4: complete research dissertation.

Overall, the report aimed to help clinical graduate students perfect their abilities to complete diagnoses, therapy, and scientific research. The report was endorsed and recommended its review to the American Association for Applied Psychology (AAAP). Later in the year, the AAAP accepted the recommendation and planned a conference to address training guidelines for graduate programmes. The following year the Penn State Conference was held with 3 subcommittees containing representatives from educational institutions, health establishments, and business/industry. These measures were taken to ensure that the final model was not biased towards Shakow’s profession, although only minute changes were made to his original model.

In 1944, a conference was held at the Vineland training school to reexamine Shakow’s report. The American Association for Applied Psychology integrated into the American Psychological Association. Meanwhile, increased demand for professional psychologists prompted the United States Public Health Service (USPHS) and the Veteran Administrative (VA) to increase funding for clinical psychology graduate programs. With more resources at hand, APA president, Carl Rogers asked David Shakow to chair The Committee on Training in Clinical Psychology (CTCP). This committee’s primarily responsibility was to decide upon an effective model for education at the graduate level.

Shakow’s revised report was published in the Journal of Consulting Psychology in 1945 titled Graduate Internship Training in Psychology. Shakow presented his published report to the CTCP and received minimal critique. So, the committee submitted his report to the APA for approval. The APA endorsed Shakow’s training model and published it in the American Psychologist declared as the set agenda for an upcoming conference discussing training methods in clinical graduate programs. By December, the report was known as “The Shakow Report”.

The CTCP members made site visits and evaluations of universities who had clinical graduate programmes. At a joint meeting of the USPHS and the CTCP, a six-week conference was suggested to discuss reported inconsistencies in current clinical training programmes. The conference would be sponsored by the APA and would be granted $40,000 in financial backing by the USPHS.

In January 1949, a planning meeting for the upcoming conference was held in Chicago by members of the CTCP and representatives from the APA board of directors. Here, details including the conference’s name, attendants, and location were decided upon. The planning committee of 1949, agreed to name the conference, The Boulder Conference on Graduate Education in Clinical Psychology, and invited participants from a variety of disciplines. The conference would be held at the University of Colorado at Boulder, thereby allowing participants to attend the proceeding annual meeting of the APA scheduled in Denver.

Boulder Conference

The Boulder Conference met from 20 August to 03 September 1949. A total of 73 committee members attended the conference representing fields of academic and applied psychology, medicine, and educational disciplines. This conference’s goal was to agree upon a standard training plan for clinical psychologists. The Shakow Report was on the agenda, and was received with unanimous support. Due to this consensus, the Shakow report is now referred to as the Boulder Model.

This model aims to teach clinical graduate students to adhere to the scientific method when executing their applied practices. The model states that in order to master these techniques, graduate students need to attend seminars and lectures that strengthen their background in psychology, complete monitored field work, and receive research training. Ultimately, most psychologists specialise in either research academia or applied practice, but this model argues that having sufficient knowledge in the entire field will enhance a psychologist’s ability to perform their specialty.

Criticisms

Despite the Boulder Model’s widespread adoption by graduate psychology programmes, it was met with mounting criticism after its instalment in 1949. The debate over the Boulder Model’s value centres around an array of criticisms:

  • That the Boulder Model lacks validity, meaning that the Boulder Model does not actually help graduate students become better scientists and practitioners.
  • That the Boulder Model monopolises the energies of students, demanding that they spend a large portion of their graduate careers studying research methods that they will not use in professional practice, and depriving them of intensive and extensive formal training and apprenticeship in the art and craft of psychotherapy.
  • That the Boulder Model promotes a view of humans and their suffering that has been simplified to the point at which it does not yield significantly clinically useful guidance to determine practice. Further, the tendency to focus on symptoms and discrete patient characteristics promotes an instrumentalising view of people in distress that filters into the clinical work of students.
  • That diversity of clinical approaches is restricted as programs emphasize those methods that can be easily measured.
  • That the version of the scientific method taught in Boulder Model programmes stresses data gathering techniques over critical thinking skills and theory-building, setting it apart from the so-called hard sciences in its uncritical approach to empiricism.
  • That publication history tends to eclipse clinical sensitivity and depth in the evaluation and promotion of students.
  • That the Boulder Model promotes short-cycle research over longitudinal and more intricate studies that cannot be completed within the timeframe of a training cycle. Thus, that minority of students who do follow a more research-oriented career path are not trained in, or trained to respect, qualitative, longer-term or more complex studies of human psychology.
  • In short, that the skills needed for practice in clinical psychology versus those needed for research are not compatible.

Criticisms continued to accumulate until 1965 at the Chicago Conference. Here, it was recommended that clinical graduate programmes restructured their training methods for students who wanted to focus their careers on applied practices. This idea was reinforced by the Clark Committee of 1967. The committee developed the practitioner-oriented model for clinical graduate programmes, and presented it at the Vail Conference in 1973. This model was accepted readily to coexist with the Boulder Model, which is still used by many psychology graduate programmes today.

Core Tenets

Core tenets of the today’s model included in the current Boulder Model:

  • Giving psychological assessment, testing, and intervention in accordance with scientifically based protocols.
  • Accessing and integrating scientific findings to make informed healthcare decisions for patients.
  • Questioning and testing hypotheses that are relevant to current healthcare.
  • Building and maintaining effective cross-disciplinary relationships with professionals in other fields.
  • Research-based training and support to other health professions in the process of providing psychological care.
  • Contribute to practice-based research and development to improve the quality of health care.