Clinical Psychologists as Psychotherapists: History, Future, and Alternatives.

Abstract

As managed care and other cost-containment strategies become central features of the American health care system, doctoral-level clinical psychologists will be increasingly supplanted in the role of psychotherapist by lower cost providers such as social workers, marriage and family counselors, and masters-level psychologists. To provide one basis for clinical psychologists to make judgments about their role in psychotherapy; this article describes what the field was like before psychotherapy became a core activity and then compares the present transition with its historical counterpart: the opening up of the psychotherapy profession to doctoral-level clinical psychologists after World War II. History suggests that efforts to resist the current changes will be unsuccessful and that the most adaptive coping strategy for clinical psychologists is to take advantage of the transition by reenvisioning training and practice of clinical psychologists.

National Trends in the Use of Outpatient Psychotherapy

“…It is widely believed that managed care has shifted the provision of psychotherapy from psychologists, psychiatrists, and other physicians to other lower cost professionals (38,39). The current findings belie this belief.…”

Training the scientist–practitioner for the 21st century: Putting the bloom back on the rose

“…Our role as clinical psychologists now is to find our places in this prefabricated world. Along with Humphreys (1996), we agree that it is essential for the field to reexamine its universe of alternatives. In doing so, we suggest that one way of adapting to our current circumstances is through the reaffirmation of the scientist-practitioner model.…”

“…Third, the American Psychological Association developed a Committee on Training, which furnished the Veterans Administration with the names of clinical psychology training programs eligible to participate in the Veterans Administration programs (Humphreys, 1996). This recognition and the concomitant benefits provided the impetus for the unprecedented development of professional programs throughout the country.…”

“…Three pivotal developments were instituted to meet this demand. First, in response to the multitude of returning military personnel in need of psychiatric treatment or vocational and personal adjustment counseling, the Veterans Administration initiated a training program for clinical psychologists (Humphreys, 1996). The individuals responsible for developing this training model resisted tying the program framework too closely to medicine, even though the impetus came from a shortage of psychiatrists (Kubie, 1949;Luchins, 1949).…”

Character Motivations in the Representation of Mental Health Professionals in Popular Film

“…Of course, mental health practice is indeed a profession-a difficult one that requires a great deal of training and commitment, leading most practitioners to want to be well compensated. The diversification of clinical psychological service away from a reliance on psychotherapy (Humphreys, 1996) is an instance of how professionals sometimes find it necessary to alter the services they provide to remain financially secure. Although it is tempting to simply dismiss cinematic portrayals of money-hungry mental health professionals as inaccurate, such a dismissal is parallel to the tendency of some professionals to avoid overt discussions of financial issues, possibly damaging the treatment process itself (Herron, 1992).…”