Clinical Psychology at Harvard:

AT the mention of the word psychology the layman usually conjures up an image of a psychoanalyst listening to a patient. In fact, most psychologists seldom see patients at all. At Harvard, the frequency is approaching zero.

After a decade of turmoil, the Social Relations Department ended its graduate program in clinical psychology in Fall 1967. This February, President Bok placed a moratorium on admissions to the program which replaced it, Clinical Psychology and Public Practice. Despite a well recognized need for clinical experience for abnormal psychologists, the death of these two programs ends most of the clinical psychology at Harvard. What killed it?

Research and teaching in abnormal personality began at Harvard in 1927 when the late Morton Prince, professor of Social Ethics, and Henry Murray '15, professor emeritus of Psychology, then a young physician, set up the Harvard Student Clinic on Plympton Street. The Plympton Clinic was at first primarily a center for personality research. However, in 1946 the Veterans' Administration, faced with thousands of returning shell-shocked G.I.s began to fund graduate programs in university psychology departments to train non-medical psychotherapists to cope with the needs of these veterans. The National Institute of Mental Health (NIMH) added more money for these clinical training programs beginning in the 1950s. These Federal grants allowed Harvard to expand the Plympton Clinic into a full-fledged program in research and clinical training in abnormal psychology.

As increasing emphasis was placed on practical training in psychology in the fifties, a model of the ideal abnormal personality psychologist evolved. Named after the psychology convention where it won acceptance, the Boulder model places equal value on ability in scholarly research and in clinical work. An abnormal personality psychologist must have a command of both personality theory and methods of therapy evaluation in order not only to be an effective therapist but also to develop and test new treatments. He must be a skilled clinician to be a good researcher.

Actual involvement with people who have personality problems gives a researcher a vital sensitivity to the nature of those problems, since the real significance of abstract character traits only comes alive in direct encounters between people. As David McClelland, professor of Psychology, says, "Clinical psychology helps keep personality psychology honest. It keeps psychologists' noses buried in real, live people instead of abstractions, pigeons and tests."

The Boulder model is unique within the academic world. Bucking the current trend toward separating academic from professional work, it stresses the importance of integrating research in abnormal personality with the practical applications of that research. A good abnormal psychologist, then, is both a good researcher and a good clinician.

The Boulder model was widely accepted as the goal of training in clinical psychology in the 1950s. Ironically its conceptual strengths have proven to be its administrative weaknesses. The problems and subsequent death of clinical psychology at Harvard and other universities have resulted from the reluctance of academic, research-oriented departments to follow the Boulder model.

According to Norman Watt, professor of Psychology at the University of Massachusetts at Amherst and a former lecturer in the clinical psychology program at Harvard, the Social Relations Department with its strong research emphasis opposed the Boulder ideal. Despite the addition of practical training, Harvard's graduate program continued the Plympton Street Clinic's stress on research. Students did supervised fieldwork in therapy centers such as the Massachusetts Mental Health Center and the Fernald State School, but they were trained mainly as scientists.

Criteria for hiring and promoting faculty placed higher value on research expertise and publication than on clinical and teaching skills. Watt says, "The clinical interests of untenured faculty were inhibited in order to get academic stature for tenure." Furthermore, instructors did not get teaching credit for the great amount of supervision they did in order to train students in their fieldwork. As a result Watt maintains, "Students were not intensively trained in their good practica experiences. The faculty were not rewarded for good practica training."

ANOTHER sign of the rockiness of the marriage between research and practical work in Harvard's clinical program was the unsuccessful ten-year search for a person with top clinical and research credentials to lead the program. McClelland, then a teacher in the program, conducted the frustrating search. Two of his choices were turned down by President Pusey's ad hoc committee on the appointment. Although both men were fine clinicians and good scholars, their research credentials did not satisfy the President's committee. Finally in 1966 McClelland and the committee agreed on Professor Norman Garmizey of the University of Minnesota. Garmizey accepted but then turned down the offer because the Social Relations Department would not hire a second tenured professor to share clinical and field training duties with him.

Garmizey's rejection marked the end of the futile hunt for the mythical leader who would be both a topflight clinician and, in Harvard tradition, the best scholar available. McClelland gave up his attempt to find a person who would satisfy the professional requirements of the American Psychologyical Association (APA) and the NIMH and also the academic requirements of the Social Relations Department and the President's ad hoc committee.

The failure to find a leader for the program, as well as general hostility toward applied personality psychology within the research-oriented Social Relations Department, led directly to the demise of the program. In Fall 1967, the department's faculty voted to end the graduate training program in clinical psychology.

Although several faculty members in Social Relations still do both clinical work and research, clinical work has been de-emphasized. Furthermore, present graduate students in abnormal personality can in fact do supervised fieldwork in clinical settings, but this work is not as common, structured or intensive as it was in the old program. Although clinical work has not been totally banished by the Social Relations Department, the 1967 decision to stop the training program ended the full financial, administrative and intellectual commitment necessary to do good clinical work.

The program's attempt to follow the Boulder model fell victim to conflicting external demands. Although it was moderately successful in integrating research and practice, it still failed to satisfy either camp. The Social Relations Department wanted more research. The APA and the NIMH, which accredited and partially funded the program, wanted more clinical work.

GARDNER Lindzey, professor of Psychology and chairman of the Department of Psychology and Social Relations, comments about this identity crisis: "Clinical psychology inevitably involves some substantial degree of professional training. In an arts and sciences faculty, professional training always seems out of place. There is a sort of built-in conflict between the basic values of arts and sciences faculties and the basic training needs of a professional program."

Lindzey correctly identifies the conflict at Harvard between pure research and practical application, but this does not invalidate the Boulder model. Despite the problems of combining research and practice at Harvard, it is still vital for a good abnormal personality psychologist to have a solid command of both. Consequently, it is important for an abnormal personality program to offer training in both theory and practice. The clinical psychology program was the victim of a squeeze between research and professional training. The conflicting and arbitrary bureaucratic demands of the University on one side and of the APA and the NIMH on the other ignored the basic good sense of the Boulder ideal.

However, the end of the Social Relations Department's formal involvement in clinical psychology did not end the need for such a program. In 1967, President Pusey appointed a committee to find a way to salvage clinical psychology in some form in the University. The report of the President's Committee on Training in Clinical Psychology at Harvard University, written mainly by Robert W. White '25, professor of Psychology, proposed the creation of a new graduate program in Clinical Psychology and Public Practice (CPPP, or CP3).

CP3 was planned as a cooperative venture among four faculties: the Social Relations departments of the faculties of Education, Medicine, Divinity, and Arts and Sciences. The interfaculty arrangement had two purposes. First, it was hoped it would offset the arts and sciences emphasis on research, and second, it was supposed to make clinical psychology more responsive to the needs of so many people for psychological help.

The second purpose distinguished CP3 from traditional clinical training programs, including Harvard's old program. White wanted CP3 to train people to provide mental health care to the majority of Americans who cannot afford the time and expense of one-to-one psychotherapy. He saw CP3 graduates as workers and administrators in public clinical settings, such as community mental health centers, mental hospitals, schools, and churches. He wrote in his report, "Our proposals contain a radical change of emphasis in training, with the aim of preparing men and women to provide for previously neglected populations, to meet new expectations, to assume new responsibilities, and, above all, to initiate new ways of serving mental health needs."

CP3 got under way in Fall 1969. The program was beset with serious problems from the very beginning. First, teachers and students soon developed two, very different definitions of public clinical psychology. Some stuck to White's goal of learning to provide mental health care in traditional clinical settings. Others felt that this sort of work just patched up the more seriously damaged psychological victims of institutions throughout society which failed to meet human needs. The concerns of this wing of CP3 went beyond just schools and hospitals to include the effects of all kinds of institutions on individuals: police departments, families, neighborhoods, the media. This group wanted to study, propose, and apply preventive methods to the problem of making all types of social institutions more responsive to the people they serve.

Unavoidably, these conceptual differences created some tension in CP3. It was, however, a fruitful tension. Edwin N. Barker, associate professor in the School of Education and a teacher in CP3, said, "The lack of intellectual coherence causes anxiety, ambiguity and confusion. This is a good learning environment, but it creates problems. These problems are inevitable in trying to create a new field."

Ultimately, the more serious problems were bureaucratic. Once again it took a long time to find a person to lead the program; and unfortunately, the man chosen, Dr. Richard R. Rowe, then associate dean for Administration of the School of Education, had neither the academic stature nor the political clout necessary to build a new program at Harvard. Lacking an initial financial commitment to CP3 from any of the four faculties, Rowe was forced to play the role of a beggar. Although he did get the money, the fact that he had to go hat in hand to each of the four faculties meant that the power remained with the deans. CP3 also lacked a spokesman to argue for greater support in each of the participating faculties.

Furthermore, teachers and faculty administrations disagreed on the title of the degree to be awarded to CP3 graduates. The dispute over whether to grant a Ph.D. or an Ed.D. revived the old conflict between the relative importance of research and practical applications.

In general, the four participating schools did not make a strong and shared commitment to CP3. As Paul N. Ylvisaker, dean of the School of Education says, "Ironically, as CP3 achieved four-school status, it became isolated from all four schools." The crowning blow was a bitter dispute between students and teachers over the amount of power students should have in making policy.

In order to resolve the host of problems plaguing CP3, Rowe finally requested that the review by an ad hoc committee which was scheduled for 1974 be held instead in Fall 1972. After an intensive study of CP3 the committee recommended in its report to President Bok that the University either increase its commitment to the program and restructure it by placing it in one school with interdisciplinary ties, or drop the program altogether. Unexpectedly, Bok chose to drop it. Unwilling to increase University support for an historically unstable program, Bok placed a moratorium on admissions to CP3, effectively killing it.

Regardless of the merits and flaws of the conflicting visions and administrative structure of CP3, the fact remains that its passing ends clinical psychology at Harvard, whether it be the traditional kind taught in the old program in the Social Relations Department, White's brand of clinical psychology in public settings, or the more recent "preventive" approach of changing institutions.

The essential truth of the Boulder model, that research and clinical experience in abnormal psychology go hand in hand, is still valid. But administrative failure, combined with a powerful research bias, has sabotaged every effort to integrate theory and practice in abnormal personality study at Harvard. Once again clinical psychology at Harvard is dead. Yet the need so clearly identified by the Boulder model remains.