On the PsyD
IN THE JANUARY MONITOR, Bridget Murray notes that the first PsyD program, launched in 1968 at the University of Illinois in Urbana-Champaign, lasted only 12 years because "training practitioners turned out to be a poor fit with the values of a research-oriented psychology department," according to founder Don Peterson.
The implication that there is an inherent conflict between the values of a department such as ours and the training of practitioners is troubling. In fact, the history of clinical psychology training in our department affirms that training in both clinical service and clinical research are thoroughly compatible and mutually reinforcing. As the department head that presided over the demise of the PsyD program, I can attest that the program's termination did not signal an intent to cease training practitioners. What we did decide in 1980, on the advice of our clinical colleagues, is that all clinical admissions would be offered to students whose commitment to research matched their commitment to clinical service.
This decision, for all practical purposes, terminated our PsyD program. In 1980, we were admitting each year about 10 of the 300 or so applicants for admission to our clinical division. There were by then many PsyD programs, training hundreds and ultimately thousands of practitioners. The number of programs whose students were fully qualified to practice and had a concurrent commitment to the career of a creative scholar was quite small. It seemed in keeping with our mission as a research university that we focus our training on these students. The preparation for practice has not, however, been slighted by the concurrent emphasis on research and, indeed, most of our clinical graduates are licensed clinical psychologists.
EMANUEL DONCHIN, PHD Champaign, Ill.
New hope for schizophrenia
IN REFERENCE TO "NEW HOPE for people with schizophrenia" (February Monitor) you did not do your homework or literature review. The "new hope" has been there for over 60 years. For example, Frieda Fromm-Reichmann (the psychoanalyst in "I Never Promised You a Rose Garden") and Bertram Karon ("Psychotherapy of Schizophrenia") describe very well what schizophrenia is all about and the process of recovery. In the words of one of my psychology students, "That book will really help me" (referring to "Rose Garden"). At age 17, she is already working with schizophrenics in foster-care settings.
ELIZABETH A. WAIESS, PSYD East Lansing, Mich.
I GREATLY APPRECIATED YOUR article on recovery from schizophrenia. I'm writing to inform you and your readers of other resources on this topic of which you may not be aware. What you are calling "psychosocial rehabilitation" has been practiced for many years now as part of the "Windhorse" treatment model at Friendship House in Boulder, Colo. Friendship House was founded by faculty in the Contemplative Psychotherapy Department at The Naropa Institute (now Naropa University), and continues to operate today as part of the Boulder County Mental Health Center. Another therapeutic community based on the same model exists in Northhampton, Mass.
An essential book in the consideration of these issues is "The Seduction of Madness" by Edward M. Podvoll, MD (HarperCollins, 1990). Dr. Podvoll did exactly what the advocates quoted in your article say psychologists don't do--listened to the voices of patients and worked to create a healing environment and relationships that could facilitate recovery. His book provides a thorough, thoughtful, grounded and compassionate examination of the processes of mind in psychosis, and of his view of the means for recovery. I hope you will add this book to your list of further reading, and let the people interviewed for your article know of its existence.
MARNI RACHMIEL Boulder, Colo.
The Surgeon General's message
THE OVERARCHING MESSAGE in the Surgeon General's mental health report and in his interview with the Monitor (February) is well-received: Mental illness necessitates a level of public attention that is commensurate with its societal impact. Federal and state efforts designed to reduce restrictions on mental health services and to increase public awareness of the nature of mental disorders have the potential to go a long way in promoting mental health in the United States.
At the same time, I am concerned about the specific content of Dr. Satcher's recommended public educational approach. He suggests the conveyance that mental illnesses are "real" because they have a clear "physical/chemical basis," thus making them no different from other physical illnesses such as diabetes. However, mental illness is not unique in this regard--what life process doesn't have a physical basis? The advocated view critically misses the element of mental illness. Instead of operating steadfastly through an anti-Cartesian lens, it is important to recognize that what makes mental illness (and all illness for that matter) "real" and relevant is the profound and disabling impact it has on the individual and on society.
Furthermore, it is important that the Surgeon General refrain from overstating current knowledge of the pathophysiology underlying psychopathology. While neuroscience and related fields have considerable potential to improve our understanding, assessment and treatment of mental dysfunction in the future, any current claims aimed at the public must be based in fact, not fiction.
MATTHEW R. MAJESKIE Madison, Wis.
Students and peer-review
AS A STUDENT MEMBER OF APA, I was very interested to read the Monitor's January article regarding students' participation in psychology journals' peer-review process. While I was pleased to read that a handful of journals are incorporating students, I was more than disheartened to learn that many in the field are adamantly opposed to this inclusion. From the perspective of someone currently in training with the hopes of entering academia, I see students' involvement in the review of manuscripts as an incredible training tool. This type of experience would teach those in doctoral programs how to review, what makes a strong piece of research, and how to write stellar manuscripts. Ultimately, everyone benefits--students receive better training, and journals receive stronger manuscripts (from those students) and better reviewers (students who graduate and go on to join editorial boards).
The fears outlined in the January article seem unfounded. The issue of confidentiality of the submitted manuscripts seems like a non-issue for students at this point in their training. Doctoral level students understand the nature of confidential information and are confronted by that type of material every day. Secondly, student reviews would not replace the professional reviews ordinarily done; rather, student reviews would complement the others, as David Rosenbaum, PhD, stated. Not allowing students to be mentored in the review process seems to be quite a missed opportunity for us all.
M. MEGHAN DAVIDSON Columbia, Mo.