field of clinical psychology: arriving at a definition, The

Canadian Psychology, May 1996 by Vallis, T Michael, Howes, Janice L

Abstract

The Executive and members of the Section on Clinical Psychology of the Canadian Psychological Association (CPA) have developed a definition of the field of clinical psychology. This definition was approved by the Board of Directors as a CPA document in May 1993. In this article the development of the definition is summarized. The need for a definition, as well as the process of drafting the definition, are highlighted. Strategies for the use of the definition in advancing the field of clinical psychology are also addressed. The definition itself is included in an appendix.

BACKGROUND

Clinical psychologists make a unique and valuable contribution to the service of individuals, groups, and society. By combining scientific and applied skills, clinical psychologists are able to practice, to evaluate their practice, and to develop new methods and standards of practice. In the current social climate of economic restraint, as well as demand for cost - effectiveness and health care reform, our clinical skills may well become more valued by society than they are at present.

In order to effectively represent ourselves to others, as well as to ourselves, we should be able to define what it is that we do, how we are trained to do it, and how we are credentialed. Yet there exists no official, accepted definition of clinical psychology. The Section on Clinical Psychology of the Canadian Psychological Association (CPA) accepted the task of developing a definition of clinical psychology to be used for educational and advocacy purposes. In this article, the process, outcome, and implications of these efforts are summarized.

The idea of developing a definition of clinical psychology was generated at the second Annual Business Meeting of the Section on Clinical Psychology, which was held in Calgary, 1991. The intent was to develop a document that would provide a framework from which to guide advocacy efforts and education. The definition was targeted for use within the field to help promote competency and professional autonomy, as well as to help differentiate clinical psychology from other nonpsychology professions (e.g., psychiatry, social work). The Executive of the Section on Clinical Psychology believed that it was in a unique position to advocate on behalf of clinical psychology. The Section represents clinical psychologists from across Canada, it can limit its concerns to clinical psychology exclusively, and it can make recommendations and represent positions independently from provincial and territorial psychological associations and regulatory bodies. Provincial and territorial associations and regulatory bodies, by definition, have a much broader constituency to represent than clinical psychology.

The Executive of the Section on Clinical Psychology believed that developing a definition of the field was a major undertaking and were aware of difficulties that Division 12 of the American Psychological Association (APA) had encountered in their efforts to arrive at a definition (Resnick, 1991). APA Division 12 began working on a definition in 1982, when its first task force was constituted. Despite significant effort, the task force was unable to reach a consensus. The task force did, however, make important strides in determining the scope of clinical psychology. In 1984 it became clear that there was a need to decide whether clinical psychology was best considered a broad field of endeavour or a specialty. To help make this determination a second task force was constituted in 1985. While no consensus on a definition was reached by 1990, the task force decided that clinical psychology should be considered a broad field, not a specialty. Also in 1990, the Board of Directors of APA Division 12 approved a definition (cited in Resnick, 1991). Unfortunately, APA Division 12 has been unable, as yet, to have the APA governance structure adopt this definition, owing to concerns from nonclinical practice constituencies (Barlow, June, 1994, personal communication). However, APA Division 12 has published the definition in their journal, The Clinical Psychologist (Resnick, 1991), and this definition has been adopted by the Council of University Directors of Clinical Training. Although aware of the difficulties encountered by the APA Division 12, the Executive of the CPA Section on Clinical Psychology believed that the attempt to develop an acceptable "made in Canada" definition of clinical psychology was worthwhile.

Why a Definition is Needed

One might legitimately ask whether clinical psychology requires a formal definition at all. Since the training, areas of competency, and activities within clinical psychology are diverse, perhaps a clear, acceptable definition is not possible. It could also be argued that since clinical psychologists have been functioning for some time without a formal definition none is required. Further, the experience of the APA Division 12 could be viewed as evidence that a definition acceptable to nonclinical psychologists is not possible to achieve, and therefore not worth the effort. Despite these concerns, the Executive of the Section on Clinical Psychology believed there were important reasons to develop a definition of our field. First, there is a lack of public awareness of the training, competency, and areas of practice of clinical psychologists. For instance, many individuals in the general population, possibly the majority, do not know the distinction between a clinical psychologist and a psychiatrist. Even if this distinction was known, the diversity in areas of competence and scope of practice between different clinical psychologists is a source of confusion. A definition would be helpful in educating the public and making them better informed about what services clinical psychologists can and can not offer.