Psychology: A science with many applications and a profession with multiple specialties
From the earliest days of scientific psychology in the late 19th century, and well into the 20th century, psychologists in the United States pioneered many different applications of this nascent discipline in various forms of public service. Most of the psychologists responsible for these early innovative practices were professors in distinguished academic institutions, and most had earned their doctoral degrees based on a common body of knowledge. Indeed, many of them had studied under that same lead professor, namely Wilhelm Wundt, in his laboratory at the University of Leipzig in Germany. A lucid portrayal of these early years, including tensions that arose from the applications of psychology, is provided in Donald S. Napoli’s book “Architects of Adjustment: The History of the Psychological Profession in the United States” (1981, Kennikat Press).
By mid-20th century, following two world wars, recognition of psychology’s applications to society, including its national defense, increased significantly. An excellent account of these developments is provided by James H. Capshew’s book “Psychologists on the March: Science, Practice, and Professional Identity in America, 1929 –1969” (1999, Cambridge University Press). Public demand for various psychological services grew commensurately, especially, but not exclusively, in the area of clinical psychological services after World War II, with many returning military personnel in need of such services through the Veterans Administration (VA). By this time also there were many more universities with psychology departments, including those qualified to offer graduate work to the doctoral degree.
To ensure that there was some form of quality control in the doctoral education of more psychologists to render clinical services, the VA and the Public Health Service (PHS) requested that the American Psychological Association (APA) develop criteria for these government agencies to use in deciding which university programs in clinical psychology to fund. This development led to the accreditation of doctoral programs in certain professional practice areas of psychology, beginning with clinical psychology and a few years thereafter to counseling psychology and school psychology as well. These three areas, in addition to industrial-organizational psychology which did not participate in the accreditation process, became known within the APA as de facto specialties of professional psychology and remained such through most of the last century. Together they accounted for the largest number of practicing psychologists, with clinical psychology being by far the largest of the four specialties.
As the applications of psychology increased over the past century, there were from the earliest years concerns about differentiating one form of practitioner from another through some kind of certification process for purposes of informing the public, if not also in some measure to protect guild interests. Although various efforts were undertaken to certify the credentials of practicing psychologists in different areas of application during the early years, none became policy. By the mid-1940s, with increased recognition of psychologists and their contributions to society during the war years, psychology became for the first time a licensed profession. By that time, in addition, the APA helped form the American Board of Examiners in Professional Psychology (today known as the American Board of Professional Psychology) as a certification body external to the APA membership organization. Its purpose was to examine and certify psychologists in different areas of professional practice, in as much as the early licensure laws and regulations were of a generic nature. That is, they did not differentiate one area of practice from another. They simply governed the practice of psychology in general terms and protected the title “psychologist.” This is true for other licensed professions as well, e.g., medicine and law. Now, of course, all states have licensing laws and regulations pertaining to the practice of psychology, though most of them remain generic in nature. If the reader wishes to learn more about the licensing of psychologists in various states, Canadian provinces, and territories, the website of the Association of State and Provincial Psychology Boards is an excellent source of information.
The generic nature of licensure that exists in most jurisdictions is consistent with a value orientation that remained throughout the past century, namely that those receiving a doctoral degree in psychology (the entry level of education for the profession) have a common grounding in the scientific foundations of psychology regardless of the specialized scientific or practice interests they may pursue. It is a value orientation expressed in the accreditation standards for doctoral education in the profession, referred to as “broad and general” foundations. It is also a theme aptly discussed by former APA President Joseph Matarazzo in his 1987 American Psychologist® journal article: “There is only one psychology: No specialties, but many applications.” By the time this article was published, opinion among psychologists was divided, not only on the issue of whether there are “specialties” in psychology, as that term is known in other licensed professions such as medicine, but whether in fact psychology was even any longer a single scientific discipline in contrast to a group of diverse interest groups as represented by the APA’s many membership divisions and a growing number of specialized scientific organizations of psychologists external to the APA. These and other related perspectives on the evolving science and profession of psychology were debated in a national conference on graduate education sponsored by the APA in 1987. The conference was summarized in the publication, edited by Leonard Bickman and Henry Ellis, “Preparing Psychologists for the 21st Century” (1990, Lawrence Erlbaum Associates).
Although there are some fundamental principles and procedures common to all practices of psychology, including a common body of ethics requiring continued competence, the growth in the scientific and practice bodies of knowledge related to various areas of application makes it very difficult, if even possible, for one person to remain competent as a practitioner in all such areas. This fact, and the possibility that without some form of standard guidelines various self-declared specialties of practice might emerge, led the APA in 1996 to establish a “de jure” process by which to formally recognize practice specialties in psychology. The body established to carry out this function for the APA was the Commission for Recognition of Specialties and Proficiencies in Professional Psychology (CRSPPP). From the onset, the work of CRSPPP was aided substantially by the work a decade earlier of the APA Board of Professional Affairs Subcommittee on Specialization. That subcommittee set forth four parameters as critical in recognizing one distinctive area of practice from another: (1) populations served, (2) problems addressed, (3) theoretical orientations or procedures used, and (4) settings of practice.
The notion advanced was that some distinctive combination of these four parameters would be associated with a particular specialty. The subcommittee also considered it possible that a psychologist, in one or more specialties, might want or need to become certified in a narrower scope of service than is characteristic of a specialty. It suggested that the name “proficiency” be given to such an aspect of practice. Both concepts of specialty and proficiency were thus adopted by CRSPPP in the implementation of a process by which to formally recognize distinctive areas of psychological practice.
Now, more than 15 years following the creation of CRSPPP, APA has recognized the following 12 specialty areas of practice: behavioral and cognitive psychology, clinical psychology, clinical child psychology, clinical health psychology, clinical neuropsychology, counseling psychology, family psychology, forensic psychology, industrial-organizational psychology, professional geropsychology, psychoanalytic psychology, and school psychology. Taken together, all but the specialty of Industrial-Organizational Psychology are often referred to as “health service psychology” specialties.
The principles or criteria that govern specialty recognition are clear demonstration of the following:
An administrative organization that is responsible for the specialty.
Evidence of a public need for the specialty.
Recognition of the importance of cultural and individual diversity in practice of the specialty.
Distinctiveness of the specialty’s body of knowledge and professional applications.
Advanced scientific and theoretical preparation through education and training.
Advanced preparation in the parameters of practice (populations, problems and procedures/techniques) within a range of settings.
Formally structured education and training programs.
Structures or opportunities for continuing professional development.
Evidence of the specialty’s effectiveness.
Procedures for quality improvement in the specialty.
Guidelines for specialty practice.
Specialist identification and evaluation procedures for benefit of the public.
Somewhat similar criteria have been applied to the recognition of proficiencies, seven of which have been identified to date.
From the practitioner’s perspective, certification in one or more proficiencies generally occurs after a person has completed the education and training required in a specialty. For example, a psychologist trained in the specialty of clinical psychology may want to become certified in such recognized proficiencies as psychopharmacology, the treatment of alcohol or other psychoactive substance use disorders or the assessment and treatment of serious mental disorders. In turn, there is a structure to professional education in the specialty areas themselves. The education and training required for some specialties can be completed at the doctoral level, while for others the specialty education and training must be completed at the postdoctoral level. For more detailed information related to the recognition of specialties and proficiencies, as well as for information about each of the recognized specialties and proficiencies and their education requirements, the reader is referred to the CRSPPP website.
This same website likewise will lead the reader to information about two important organizations external to the APA, both of which were begun for the purpose of clarifying for the public the nature of professional practice in psychology and its specialties, including education, training and credentialing structures. The Council of Specialties (COS) is composed of organizations responsible for oversight of the specialties. The Council of Credentialing Organizations in Professional Psychology (CCOPP) is responsible for coordination of policies related to education, training and credentialing across the profession of psychology. It includes, among other important organizations, the American Board of Professional Psychology (ABPP), begun some 50 years ago to coordinate credentialing of psychologists in specialties through board certification following an examination. To date, however, such board certification is voluntary, not required, for professional practice in a specialty, unless the institution or setting in which one practices requires such evidence of competence. An example of the latter is in certain medical centers or other health care settings in which such certification is required of all professional service providers. Historically, only a small percentage of psychologists practicing in specialty areas have been ABPP-certified, a percentage that is likely to increase as the professional practice of psychology increases in various aspects of health care in which collaboration with other health professionals is the norm.
If students at the high school level express an interest in psychology, a career that may require graduate education, their first and foremost attention is best guided to the type of undergraduate education institution for which they are best suited, academically, personally and financially. They should not be preoccupied at that stage of their education with specialties of professional practice or scientific research in psychology. In fact, at the undergraduate level of education, they need not necessarily even declare a major field of study in psychology, though that is certainly an option for them to choose. If they do not elect psychology as a major or minor field of study at the undergraduate level, however, they should be sure to take courses in science and mathematics that will prepare them well for scientific foundations of psychology to which they will be exposed in their graduate education; for it is upon that scientific foundation that careers in research or professional practice are grounded. In addition, perhaps most important for their undergraduate education, students need to learn to think critically across different types of disciplines, for such habits of thought are essential to the pursuit of the science and professional practice of psychology.
For students at the undergraduate level of education who are considering a career in psychology, in addition to discussing options for such with their college or university faculty, there is an excellent resource for them in the APA publication “Graduate Study in Psychology,” updated annually. This volume provides information about master’s and doctoral degree programs of all types in psychology and has information about the costs and employment outcomes of program graduates in addition to requirements for admission and academic degree. For students who think they are interested in the licensed practice of psychology in one of the health service psychology specialties, selecting a doctoral program that is accredited by the Commission on Accreditation that functions through the APA is very important (more information about accreditation of psychology programs can be found through the APA Accreditation Office website. Whether they choose to do their doctoral work in an academic department of a university (usually leading to the PhD degree) or in a professional school of psychology (more likely leading to a PsyD degree) is also a choice for them to make. “Graduate Study in Psychology” offers information related to these degrees.
To summarize, while the science of psychology and some of its public service applications are a century old, the development of psychology as a profession with formally recognized specialties of practice is much younger. Organized medicine, by contrast, has a longer history of professional development and consequently is probably better known by the public, though not necessarily better understood in terms of specialties than is psychology. Two strategic goals of APA are increasing the public’s understanding of psychology as a scientific discipline and increasing the public’s understanding of psychology as a licensed health profession. That understanding can begin with the large population of high school and undergraduate students who take one or more courses in psychology each year. Thus, the role of their teachers at these levels of education is of vital importance to the APA in achieving its goals.
About the Author
Paul D. Nelson, PhD, now retired, served on the American Psychological Association staff from 1982-2006, initially as director, Program Consultation and Accreditation and subsequently as associate executive director and director of Graduate Education Programs in the Education Directorate.