Ingrid Lunt. The International Handbook of Psychology. Editor: Kurt Pawlik & Mark R Rosenzweig. Sage Publications. 2000.
The Emergence of Psychology as a Profession
Over the past fifty years there has been an extremely rapid and substantial development and expansion of psychology as a profession. Emerging from a predominantly academic discipline in the early part of the twentieth century, psychology has rapidly become an applied profession, to the point where at the end of the century a significant majority of psychologists work as practitioners in professional contexts. Indeed, for the first half of the century, until about 1950, most psychologists held posts teaching and doing research in universities or colleges; however, today, in the United States, for example, only about 33% of the 100,000 psychologists with doctoral degrees work in academic settings, while the remaining 67% are deployed in a wide variety of practitioner work settings and contexts. The proportion of psychologists now working in academic settings may be even lower in many countries of the Western world, while in developing countries there may be an even stronger emphasis on practitioner and professional psychology (Rosenzweig, 1992; Wilpert & Lunt, 1998), where social needs and economic circumstances demand a concentration on practical problems.
Professional psychologists work in settings which include private clinical or consulting practice, the state or local government service in the health, social welfare and education services, universities, industry, private organizations and companies, and a growing range of contexts in which psychology has been applied by practitioners. This growing number of different contexts has led to a growth in specialization of psychologists (see below). In turn, the growth in specialization has led to an increase in the number of specialist qualifications, and in the demand for specialist post-graduate education and training.
In most countries, psychology became rapidly ‘professionalized’ following World War II, a period when psychologists increasingly became involved in various social service domains, in attempts to solve individual and social problems (Louw, 1997a). Thus, from the 1950s on, we see a growth in the health-service-provider areas and a relative decline in the traditional academic/research areas (Rosenzweig, 1992). Clinical, educational and organizational psychologists constituted the earliest groups of professional psychologists. More recently, professional psychology has become increasingly diversified and specialized with professional groups of counseling, environmental, forensic, health, sports and traffic psychologists, and a growing trend of specialization with a growth in specialist education and training and profession-alization within specialties.
For the present purposes we define professionalization as the development of the use of skills based on a unique body of theoretical knowledge, education and training in those skills, competence ensured by examination, a code of professional conduct, orientation toward the public good, a professional organization (Millerson, 1964). We see that over the recent decades and across the world, psychologists increasingly aspire to full professional status. There are a number of trends which demonstrate this growing professionalization. These include: pressures in most countries for legal recognition and regulation of psychologists, an increase in level of qualification and length of education and training required for professional practice, a growing concern with ethical issues, pressures to develop systems to facilitate psychologists’ mobility between different countries and therefore for mutual recognition of the equivalence of qualifications, and a growing specialization and differentiation within professional psychology.
Most countries have aspired to increased professionalization through legal regulation and ethical codes, higher qualifications, and the institutionalization of psychology in universities and professional associations. Many countries now have laws which regulate psychologists, most countries have developed codes of ethics through their national psychologist association, and in most countries, the education and qualifications for psychologists have progressively increased in scope and status to a high level; indeed, many countries and psychological specialties require doctoral level qualification for professional practice. For example, doctoral level education is required for practice as a clinical psychologist in the USA and the UK, increasingly in Canada, and will be required in South Africa within the next four years; this trend appears likely to spread to other countries. In Australia, six years’ university education plus two years’ supervised experience is usually the requirement for membership of any specialist professional college of the Australian Psychological Society (APS), while from January 2000 six years’ university education is required for basic membership of APS. In European countries, there is considerable variation in the pattern of education and training for professional psychologists (e.g., Lunt, 1997; Newstead & Makkinen, 1997), though there are moves for more common standards, while many of the former colonial countries have until recently followed the pattern of education of the colonizing countries (Leung & Zhang, 1995).
It is well known that psychology first emerged as a discipline in Europe which dominated its development until the middle of the twentieth century; following World War II the USA succeeded Europe as the leader and has dominated the field up to the present. Traditional psychology as a discipline and a profession is permeated with Euro-American cultural values that champion rational, liberal, and individualistic ideals (Kim, 1995) and thus was basically non-existent in its traditional form in non-Western countries before World War II. However, it is only relatively recently that the implications of fundamental differences between individualistic and collectivistic cultures for psychology have been emphasized, and the potential links between folk and scientific epistemology allowed expression, and the importance of indigenous psychologies brought to the fore. Thus, in many non-Western countries, psychology as a profession has emerged only recently, and it is only now becoming apparent that Western modes of professionalization may not be the most appropriate or culturally relevant for all countries.
Definition and Scope of Professional Psychology
Robert M. Yerkes frequently referred to the work of academic psychologists as the ‘profession of psychologists’ (Yerkes, 1918), and the term is frequently used to cover both scientist and practitioner psychologists. This chapter will mainly refer to ‘professional psychologists’ as the group of psychologists who apply the findings of the science of psychology, and who work directly or indirectly with clients in a predominantly practitioner, though including teaching, role. As stated above, this has been the direction of the major expansion of psychology, and its professionalization has led to a strong focus in all countries on this practitioner or professional role. However it has been stated that the scope of professional psychology has become restricted over the years to the ‘practice’ of psychology (Evans, Staudt Sexton, & Cadwallader, 1992), and in some countries restricted to or dominated by clinical psychology.
This definition fits in with definitions of ‘professional’ provided by the wider literature which suggests the distinguishing features of a ‘profession’ to be a unique body of knowledge and set of skills (for gate-keeping and standard-setting), a code of conduct, self-regulation and disciplinary procedures for its members (Freid-son, 1994; Millerson, 1964). The first occupations to be considered professions were theology, medicine, and law, which early on gained the status of ‘learned professions’ these were followed in the nineteenth century by architecture and engineering, and in this century by a proliferation of other occupations claiming or aspiring to professional status. Psychologists have become increasingly professionalized in all countries; this professionalization has manifested itself through an increase in the length of the education and training period (for example, see Cumming, Siddler, & Hyslop, 1997; EFPPA, 1990; Martin, 1989), pressures for regulation of the practice and the profession (EFPPA, 1997b; Lindsay, 1995; Pulverich, 1998), the development of codes of ethics (e.g., Lindsay, 1996; Sinclair, 1993), and an increase in political activity in relation to other professionals.
The Relationship between Scientists and Practitioners
Although there are those who would suggest that there is a fundamental separation between basic research and applied practice (e.g., Schönpflug, 1993), the majority of professional psychologists consider that science forms an integral foundation and base for the practice of psychology. This model, which originated in part with Witmer’ clinic in the USA in the 1890s and was articulated much later at a conference in Boulder, Colorado, in 1949, led to a widespread commitment to a ‘scientist-practitioner’ model of professional psychology. This model dominates major countries in the world and their practice of psychology (e.g., Cumming et al., 1997; Lunt, 1998a). The Boulder conference of 1949 clearly marked a further stage in the professionalization of American clinical psychology, and led to an exclusive definition of ‘clinical psychologist’ in the USA; this was claimed to be in order to ‘safeguard the public as well as the profession against the still greater evils that are bound to arise if the profession cannot define what the title “clinical psychologist” stands for’ (Raimy, 1950, p. 38). Protection of the title of ‘psychologist’ is an aspiration of a growing number of psychology associations which seek legal regulation for their members.
The ‘scientist-professional’ or ‘scientist-practitioner’ model dominated clinical psychology in the USA, United Kingdom, and Australia, and later many other countries in Europe and across the world. Thus, for example, there was a presumed relationship between the development of new psychological knowledge such as attachment theory, locus of control, anxiety, learning theories, and the application of this knowledge, together with theories of change such as behaviorism and psychoanalysis, which supported the early development of clinical psychology; the scientific basis of mental testing led to the early development of educational psychology; while understanding of the science of selection and the science of human factors and later of organizations led to the field of work and organizational psychology. Not only was scientific knowledge assumed to be the source of new applications, but it was also claimed to be necessary to the practice of professional psychology, hence in part the lengthy education and training requirements for professional psychologists. The model has been subjected to criticism (e.g., Dawes, 1994; Pilgrim & Treacher, 1992) and, as Schönpflug (1993) has pointed out, the relationship between science and application is not straightforward. This relationship is embodied in the nature of national psychology associations (see below), some of which combine scientific and practitioner interests in one body, while others have separate associations for science and practice aspects of the discipline.
Professional Identity of Professional Psychologists
Within the health sector, clinical psychologists developed their role alongside medical professionals, in particular psychiatrists. In many countries there has been a struggle for psychologists to develop and maintain their autonomy as a separate profession. This has taken different forms according to the different social, economic, and employment contexts. Historically, psychologists have in some countries had to defer to their medical colleagues, either in their role as administrators of test and assessment procedures, or in their struggle to gain reimbursement privileges for psychological treatment through health insurance. However, in the majority of countries, professional psychologists assert their professional identity as a science-based profession, and have gained status through their lengthy education and training and through their professional organizations.
Different Groups of Professional Psychologists
Although clinical psychology dominates the practitioner domain in all countries (Wilpert & Lunt, 1998), in many countries professional psychologists have become increasingly differentiated and specialized, with specialist patterns of education and training for the different branches. This section provides very brief information on the major specializations within professional psychology, within a context of rapid growth in specialist subfields. Again, it is necessary to be clear as to the definition of ‘professional psychologist’ as one who provides a psychological service directly or indirectly to a client. In the UK, for example, these professional groups are defined by the British Psychological Society (BPS) through its professional Divisions which differ in structure from its scientific ‘Sections’ the professional Divisions are defined through the possession of a separate route of education and training leading to a specialist qualification and title; there are currently Divisions for clinical, counseling, educational, forensic, health, occupational, teaching psychology, with sports psychology developing its own route (BPS, 1995). This provides one definition of ‘professional psychology’ which is used by Shim-min and Wallis in their account of the development of professional status for occupational psychology (Shimmin & Wallis, 1994).
Clinical psychologists (for many the ‘prototype’ professional psychologists) constitute the earliest group of professional psychologists seeking to apply the findings of the science of psychology in a practitioner or client context. The founder of clinical psychology (and school psychology) is widely held to be Lightmer Witmer, a professor at the University of Pennsylvania, who founded a psychological clinic in 1896, and proposed to a meeting of the American Psychological Association (APA) that year that ‘the principles of psychology should be used to help people individually’ (Routh, 1994). In the UK, Hans Eysenck is generally considered to have founded clinical psychology at the Maudsley Hospital in London in the late 1940s and early 1950s, where a strong tradition of behavior therapy dominated the profession for several decades, although the earlier psychoanalytic tradition was maintained at the Tavistock Clinic also in London. As noted above, clinical psychologists emerged as a major group in the 1950s, in the United Kingdom as part of the post-war development of the Welfare State, and in other countries also as a response to some of the problems resulting from the war. This was a period when professional associations of psychologists were founded in many countries (see below).
Clinical psychology has evolved in many countries over its fifty years into a professionalized and specialized activity, with growing sub-specialisms in clinical neuropsychology, drug and addiction rehabilitation, gerontological psychology, and community psychology (see below). As mentioned, in most countries, it is a science-based profession, relying on thoroughly verified research findings, careful evaluation of models and procedures, and the use of hypothesis testing in assessment and intervention. This is not necessarily the model in all countries, and there are a number of countries where a more hermeneutic tradition prevails, and a long tradition of clinical psychologists using often highly sophisticated psychoanalytic models continues. There is furthermore debate within the profession itself as to the appropriateness of the ‘pure’ scientific approach to the alleviation of human problems and distress (see for example Pilgrim & Treacher, 1992).
Although a substantial part of clinical psychologists’ work in most countries is as psychotherapists for children, adults, couples, and families, they also play an important role in work with people with learning difficulties, work with offenders, work in organizational change and training, work with older clients in the field of gerontology, and in the field of disaster and crisis. Clinical psychologists have themselves specialized and developed specialisms in further subfields such as clinical neuropsychology, forensic psychology, learning disability, child mental health, adult mental health, and gerontology, with the development of post-qualification training and specialist titles.
Clinical psychologists have become professionalized through the growth of specialist organizations, usually within a wider psychologist association. Clinical psychology was established by 1945 as Division 12 of the American Psychological Association (APA), and as an early Division of the International Association of Applied Psychology (IAAP); in the UK, the British Psychological Society’ Division of Clinical Psychology was formed in 1970, though clinical psychologists had long belonged to the Medical Section of BPS and later the Division of Educational and Child Psychology. 1998 saw the formation of the International Society for Clinical Psychology.
Work and Organizational Psychologists
The group of psychologists concerned with human behavior and experience in organized work settings started with the name ‘industrial psychologists’, or its equivalent in other languages. The name later became ‘industrial and organizational psychologists’ in the USA, and ‘work and organizational psychologists’ in Europe, while in the UK the name ‘occupational psychologists’, is still held today by many professionals and by the relevant Division of the British Psychological Society. However, the more widely used name ‘work and organizational psychologists’ is perhaps a more accurate reflection of their field of activity, and is in more common use internationally (and see Drenth and Wang, Chapter 25). This is the second largest category of psychologists after clinical psychologists and is a fast-growing sector in psychology across the world.
Work and organizational psychologists are concerned with human behavior at work, and may specialize in human factors and the interaction of humans with machines, in understanding and working with groups and organizations, in appraisal, assessment and selection, personnel issues, and in training and development, and human resources management. This field of professional work developed early this century, both in the USA and in Europe. The first President of the British Psychological Society was the occupational psychologist C. S. Myers in 1920, the founder and first director of the National Institute of Industrial Psychology (NIIP) in 1921 in London, UK. The expansion of this field in the UK was based in the 1920s mainly on two institutions in London, the NIIP, and the industrial Health Research Board of the Medical Research Council, both founded at about the same time. These developments were paralleled in other countries.
The APA’ Division 14, Industrial and Organizational Psychology, was an early Division of the Association (and the Society of Industrial and Organizational Psychology (SIOP) is a major organization in the field). In the UK the BPS has both a Division of Occupational Psychology and an Occupational Psychology Section, while in Europe the European Association of Work and Organizational Psychology (EAWOP) provides further manifestation of the institutionalization of the subfield, and internationally, Division 1 of the IAAP is the Division of Work and Organizational Psychology.
Educational (School) Psychologists
Educational psychology has also been claimed to originate with Lightmer Witmer’ clinic in the 1890s, though substantively it may be said to originate with the work of early pioneers in the field of psychometrics such as Sully in the US, Binet in France, and Burt who was appointed as the first school psychologist in the UK in 1913. Early school psychology was influenced by ‘particular paradigmatic approaches to learning, most notably a cognitive perspective relating success or failure on school learning tasks to the individual’ level of intelligence as measured by standardized tests’ (Burden, 1994, p. 303). This paradigm dominated the profession of school psychology for many decades; the survey undertaken by the United Nations Educational Scientific and Cultural Organization (UNESCO) and the International Bureau of Education (IBE) in 1948 indicated that the main function of school psychologists across the world at that time was the assessment and diagnosis of exceptional children for the purpose of classifying and treating various educationally related difficulties, often through placement in special provision (UNESCO/IBE, 1948). The survey was followed by a specially convened UNESCO conference in Hamburg (Wall, 1956) which attempted to establish concrete goals for guiding the provision of school psychological services.
A major survey carried out in the early 1990s (Oakland & Cunningham, 1992) of 54 developed and developing countries suggested that school psychologists ‘appear to value the traditional roles accorded them, particularly those relating to assessment and intervention’ (p. 122), and that psychometric tests provided a major tool in their work. They estimated that the 87,000 school psychologists working throughout the world represented a 100% increase in a period of just over ten years (Catterall, 1977-79), and that this increase was predicted to continue. The school psychologist respondents in this survey generally emphasized their commitment to a scientist-practitioner model in which scientific knowledge forms the basis for practice (Oakland, 1992), a commitment reiterated in the major handbook in the field: ‘school psychology must first and foremost be built on the foundations of scientific psychology’ (Reynolds & Gutkin, 1999).
Although assessment continues to be a central function of school psychologists, over the past twenty years there has been some dissatisfaction with traditional psychometric approaches to assessment, with the development of curriculum-related approaches (e.g., Shapiro & Elliott, 1999) and more recently dynamic assessment (Campione & Brown, 1987) in order to emphasize the context of learning and the interactive nature of pupils’ learning. Simultaneously, many school psychologists have developed consultation as an approach to their work with schools (e.g., Gutkin and Curtis, 1999) and have developed approaches to working with schools as organizations based on systems theories (e.g., Apter, 1982; Burden, 1981).
As early Divisions of the APA, both Educational Psychology as Division 15 and School Psychology as Division 16 existed by 1945, while the International School Psychology Association (ISPA) is a flourishing international organization with its own journal and conferences; the Division of Educational and Child Psychology of the British Psychological Society (DECP of BPS) was formed in the 1940s, and an early Division of IAAP, the oldest international organization of psychologists is the Division of Educational, School and Instructional Psychology.
Counseling psychology has been a rapidly growing field of psychology in many countries over the past ten years. In Australia, the membership of the Australian Board of Counseling Psychology has grown rapidly, while in both the USA and the UK, numbers belonging to this professional subgroup have doubled during the 1990s (Pickard & Carroll, 1994; Tyler, 1972). Counseling psychology may probably be said to have originated with the work of Carl Rogers and his holistic approach to the person, which led to the development of client-centered work (e.g., Rogers, 1980). This is one of the fast-growing fields of professional psychology across all countries.
Again, APA Division 17 of Counseling Psychology existed as early as 1945, though the UK Division of Counseling Psychology was not formed until 1982.
With the growing emphasis on health and on prevention rather than therapy, the sub-specialism of health psychology has grown rapidly in the past decade. It emerged in the 1970s as a response to the changes in patterns of health and illness and awareness of the psychological aspects of major diseases and causes of death. Health psychologists are defined variously in different countries, with some countries defining health psychology as a subfield of clinical psychology, others as a separate group, and still other countries effectively replacing the term ‘clinical psychology’ by ‘health psychology’. In all countries this is a rapidly growing field. Health psychology is the study of psychological and behavioral processes in health, illness, and health care. With the increasing awareness of the contribution of psychological factors to health, and the power of health promotion and attention to life style in mental and physical well-being, health psychologists contribute with research and intervention strategies in a range of areas. These include the following: health risk behaviors, health protective enhancing behaviors, health-related cognitions, processes influencing health care delivery, psychological aspects of illness, and stress factors (Johnston, 1994).
There are Divisions of Health Psychology in both APA and in BPS, the IAAP has a Division of Health Psychology, and the European Health Psychology Society (EHPS) and the International Health Psychology Society (IHPS) bring together health psychologists at the European and international level.
Teaching and Research Psychologists
The majority of psychologists for the first half of the twentieth century were engaged in teaching and research, and this remains a significant source of employment for psychologists who normally require a PhD to enter university teaching. In most countries teaching psychology is restricted to university level, though in both the USA and the UK there are some programs at high school level. Psychologists are engaged in research in universities, in research units funded by government, private industry or funding councils or bodies, in hospitals and clinics, and in a range of settings. A significant amount of applied psychology research has direct practical application and may be used to improve drug safety, transport safety, accident prevention, and so on. In most countries the number of universities and therefore university and college programs in psychology have increased significantly over the past twenty years, and psychology continues to be one of the most popular subjects for university study.
As mentioned above, professional psychology is being differentiated into further subfields, such as traffic psychology which exists as a field in a number of European countries where traffic psychologists are involved in driver diagnostics and selection, driver improvement and rehabilitation, traffic safety work, and research work on safety and evaluation of human—machine interfaces (EFPPA, 1997a; Risser, 1998). In a number of European countries, there are attempts to develop this area as a full professional field with its own post-graduate education, and its own definition of the field and those entitled to practice in this field. Indeed the Traffic Psychology Section of one European country states its explicit objectives as: safeguarding the existing areas of activity of traffic psychologists, opening up of new areas of activity, and asserting and securing the legal recognition of the profession. Other fields such as environmental psychology, sports psychology, consumer psychology, and disaster psychology are developing in the same way, becoming increasingly professionalized with a claim to a specific area of work and specific qualifications. It is not simply a matter of applying psychology in different contexts and settings, but rather the professionalization of the subfield, with the development of specialist training and specialist titles which aim to protect the field of activity.
Regulations and Laws for Psychologists
Certification and Licensing
With increased professionalization of psychologists’ work there have been increasing pressures in all countries to develop laws and regulations which at minimum restrict the title of psychologist to those with certain qualifications, which may restrict the field of work to those holding the title, and which aim to protect the public from unqualified practitioners. Professional regulation sets out the terms and conditions by which members of the profession are recognized and may practice, and has two purposes: to identify those with the levels of education and training deemed necessary to practice, and to enforce minimum standards of behavior through a code of conduct and a disciplinary procedure. Thus in most countries there have been attempts to define a certain level of education and qualification, to use this as the basis for a license, and to make the possession of such qualification and license mandatory for practice as a professional psychologist.
The first psychology law was introduced in 1945 in the state of Connecticut in the USA. Credentialling and licensing procedures are now well developed across the USA, where licensing is arranged at the state level by the State Registration Boards; these form an alliance of state, territorial, and provincial agencies responsible for the licensure and certification of psychologists throughout the US and Canada, the Association of State and Provincial Psychology Boards (ASPPB), formerly the American Association of State Psychology. Although its original purpose was to produce the Examination for Professional Practice in Psychology (EPPP), which is used by most boards in assessing candidates for licensure and certification, it is now a world leader in the regulation of psychologists, and serves to obtain, interpret, and disseminate information on legal and regulatory matters.
In the USA, the National Register of Health Service Providers in Psychology which is a private credentialling organization, offers a national credential which determines whether psychologists have met certain educational, training, and state/provincial licensing standards and have no evidence of having violated ethical or professional conduct codes. Following a ‘grandparenting’ period between 1974-1978, the current criteria for listing are:
- Be currently, actively licensed, certified, or registered by a state/provincial board of examiners of psychology at the independent practice level of psychology; and
- Have completed a doctoral degree in psychology from a regionally accredited educational institution that meets the Guidelines for Defining a Doctoral degree in Psychology; and
- Have completed two years (3,000 hours) of supervised experience in health services in psychology, of which one year (1,500 hours) is in an organized health service training program or internship and one year (1,500 hours) is at the postdoctoral level.
A similar organization exists in Canada, the Canadian Register of Health Service Providers in Psychology, with similar requirements. Between the 1960s and the 1990s, legislation was enacted to regulate the practice of psychology in each of Canada’ ten provinces and in the Northwest territories.
In many countries of Africa, psychological practice has adopted the model provided by the UK (in Anglophone countries) or France (Francophone countries) with university education following a similar pattern. Most African countries do not yet have regulation for psychologists. However, the profession of psychology has been regulated for over twenty years in both Zimbabwe and South Africa. In Zimbabwe psychology has been controlled since 1971 by the Psychological Practices Act, which is administered by full-time staff of the Health Professions Council, and all psychologists are required to have an Honours degree in psychology plus post-graduate training which includes supervised practice to be registered. In South Africa, statutory recognition was granted to psychology as a profession in 1975, with two forms of registration, a voluntary Register through the South African Psychological Association (SAPA), a body formed in 1948, the other a statutory register kept by the South African Medical and Dental Council (SAMDC), now the Health Professions Council (Louw, 1990, 1997a, 1997b; Richter et al., 1998). The Council’ Professional Board for Psychology is charged by statute to register those wishing to use the title ‘psychologist’ and to restrict specified diagnostic and therapeutic activities to registered psychologists, and therefore exercises statutory control over the profession of psychology. The qualification for registration is a Master’ degree plus twelve months internship at an accredited institution, thus requiring a minimum of six years, though this is likely to change to doctoral level requirement in the future. Recent developments in that country and the formation of a new society, the Psychological Society of South Africa (PsySSA) have led to renewed negotiations concerning regulation of the profession of psychology, which could provide a model for other African countries in their aspirations to develop the profession.
The situation is different in Europe where each country works with a different system and where there is a range of regulatory and licensing practice (see for example, McPherson, 1998; Pulverich, 1995, 1998). A survey of regulations for psychologists in European countries (EFPPA, 1997b) demonstrated the wide range of legal recognition and regulation in the sample of European psychological associations, while highlighting the common direction of state regulation of this professional group. The first European state to regulate psychology was the German Democratic Republic in 1967; individual countries enacted individual regulation over the following decades, and have reached different stages in the development of statutory regulation. At the present time, there is some form of regulation of psychology either in place or proposed in every European state where there is a well-developed profession of psychology, usually clinical psychology (McPherson, 1998). However, there is no European system of regulation, nor is there likely to be so, since the orientation of the European Union is counter to pan-European regulation and in favor of the principle of subsidiarity (devolving to member states the responsibility for regulation), and procedures to promote cross-border recognition (see below).
In the United Kingdom, the British Psychological Society is the professional body for all psychologists; in 1987 it amended its Charter to permit it to provide a Register for all those recognized as Chartered Psychologists. In the absence of a law protecting the title of ‘psychologist’, Chartered Psychologist status fulfils a similar role, and forms the basis of the legal status which is currently being sought in the UK. This means that the public is protected through the existence of a Register of Chartered Psychologists, albeit voluntary, which guarantees the qualifications and the disciplinary procedures under which psychologists practice in the United Kingdom. The concept of a ‘chartered’ profession is widely used in the United Kingdom, and refers to the role of professional bodies in defining the education and qualifications required to practice in a particular field, and the regulation of this practice through an ethical code and disciplinary procedures with which members undertake to comply. Professional self-regulation of this kind is widespread in the United Kingdom, though the late 1990s have seen pressures for greater accountability and external control in the wake of a number of well-publicized cases of malpractice.
This is not the place to discuss the relative merits of regulation by government ministry, and self-regulation through a national professional association, though there is a substantial and growing literature on this topic, and there are growing pressures within governments to question the principle of self-governing professions and the balance between economic self-interest and protection of the public.
Qualifications and Mobility
Although the qualifications of psychologists in all countries have increased over the past fifty years, with doctoral qualifications required for practice as a clinical psychologist in both the USA and the UK, and about to be required in South Africa, requirements vary across the world. An increasing proportion of new Doctorates in psychology in the USA come from Professional Schools which are set up outside universities specifically for professional training of psychologists (Peterson, 1991). At the present time, although countries such as Australia, Norway, and the UK, for example, have developed professional doctorates for clinical psychology training, these continue to be organized through universities. The USA and the UK have well-developed systems of accreditation which aim to ensure the quality and standards of postgraduate programs across the country. The variation in patterns of qualification across the world makes mobility and evaluation of equivalence of qualifications difficult (see Hall, Lunt, & Ritchie, 1999). Nevertheless increased globalization and regional directives to promote free movement of goods and services provide the impetus for the development of systems for the recognition of qualifications, and the political direction is towards greater mobility across international boundaries.
Systems for facilitating mobility across borders are well worked out in the USA and Canada. As mentioned above, the private credentialling organization in the USA, the National Register of Health Service Providers in Psychology, and similarly the Canadian Register of Health Service Providers in Canada offers a national credential that determines whether psychologists have met certain minimum standards, and therefore promotes mobility for individual psychologists across the USA, or across Canada, at least in the health field, and at least for doctoral programs. The standards have been adopted by the APA and the Association of State and Provincial Psychology Boards (ASPPB). More recently, the North American Free Trade Agreement (NAFTA) seeks to promote mobility between the USA, Canada, and Mexico, thus covering a large area of the world’ psychologists. Similarly, in Canada, the Agreement on Internal Trade (AIT) aims to remove barriers to free movement among the provinces and territories of Canada; the Psychology Sectoral Work Group on AIT is attempting to implement the Agreement by achieving bilateral or multilateral agreements among already similar jurisdictions, and by producing a framework aimed to cover all jurisdictions.
In Europe, the Treaty of Rome which established the European Community in 1957 aspired to a situation of freedom to work anywhere in the European Community; this has been realized through Directive 89/48/EEC which requires European member states to provide mechanisms for the recognition of qualifications, and aims to remove barriers to movement between states. Although there was initially a hope that professional qualifications could be harmonized across Europe, experience demonstrated otherwise, and the Directive now operates on the basis of ‘mutual recognition’. Thus each member state of the European Union (15) and increasingly other countries in Europe, for example those in the European Free Trade Agreement (EFTA) are required to provide systems for recognition of qualifications; in practice language provides a major barrier to mobility of psychologists across European borders. There are some moves currently to develop a common framework of qualification for psychologists across Europe, which could in the future lead to a common qualification and certification as a psychologist, though these are at a very early stage (Lunt, 1998b, 1999).
At the present time, regional groupings are developing their own systems for recognizing equivalence of qualifications; the assumption is that as large regional groupings develop their own procedures for mobility and recognition, this will lead to increased internationalization, and enhanced professional standards for all countries.
Ethics, Ethical Codes, and Disciplinary Procedures
With growing professionalization of psychology, national psychology associations have increasingly developed codes of ethics to govern the conduct of their members (e.g., Francis, 1999; Leach & Harbin, 1997). This is a feature of professionalization adopted by all aspiring professional groups, claiming that this places the welfare of the public before the interests of the profession itself. The development of psychology from an academic discipline to a more professional activity has led to the growth of a number of different professional subgroups as already mentioned, with an increasing range and complexity of potential ethical concerns. Sinclair (1993) reviewed articles listed in Psychological Abstracts from 1927 to draw a picture of the evolution of interest in ethical issues and codes of ethics. She states that ‘very few articles on ethical responsibilities or ethics codes (appeared) prior to the end of World War II’ (p. 175), a period when, as we have seen, professional psychology began to develop rapidly. Since that time there has been a growing concern with ethics, and a growing literature on the subject.
It is widely recognized that there are two different purposes for ethical codes: first, the regulation of inappropriate behavior through defining minimal expectations and rules of conduct; second, the promotion of high standards or optimal behavior. The first has a regulatory and discipline function, the second is aspirational.
The earliest Code of Ethics in psychology was that developed by the APA, following the creation of a new Committee on Ethical Standards for Psychology in 1948. This Committee set out criteria that the Code should meet which included the following:
- That it should be an expression of the best ethical practice in the field of psychology as judged by a large representative sample of members of the APA;
- That it should be empirically developed;
- That it should involve wide participation by APA members in its formulation.
The empirical approach taken by the APA in 1948 was unusual and different from other professions which had tended to begin with a committee of experts and the development of a set of rules. 7,500 members of the APA were asked ‘to describe a situation that they know of first-hand in which a psychologist made a decision having ethical implications, and to indicate what the correspondent perceived as being the ethical issue involved’ (Crawford, 1992). This exercise led to the adoption of the Ethical Standards of Psychology published in 1953 (APA, 1953); since then, a number of revisions have led to the present code (APA, 1992) which consists of the following six General Principles: (i) Competence, (ii) Integrity, (iii) Professional and Scientific Responsibility, (iv) Respect for People’ Rights and Dignity, (v) Concern for others’ Welfare, (vi) Social Responsibility, and eight categorical Standards: (i) General Standards, (ii) Evaluation, Assessment or Intervention, (iii) Advertising and other Public Statements, (iv) Therapy, (v) Privacy and Confidentiality, (vi) Teaching, Training, Research and Publishing, (vii) Forensic Activities, (viii) Resolving Ethical Issues.
Through the 1970s and 1980s national psychological associations developed their own codes; comparisons have indicated that they have much in common (Leach & Harbin, 1997; Lindsay, 1996; Sinclair, 1993). However, in their comparison of the psychology ethics codes of 24 countries, Leach and Harbin (1997) found that, although there were major similarities between the codes of different psychology associations, the Canadian code was most similar to that of the USA, while the Code of the Chinese Psychological Society was the most dissimilar. For example, all of the US principles were found in Australia, Canada, Israel, and South Africa, while none were found in China. These authors assumed a universalist position, ‘positing that some ethical principles and standards will overlap with one another regardless of country and culture, whereas other ethical principles and standards will be unique to a particular culture’ (p. 182).
Within Europe, the European Federation of Professional Psychologists’ Associations (EFPPA), a federation of thirty national psychology associations (see below) decided to attempt the development of a common ethical code for the member associations of the Federation. This work culminated in the European MetaCode of Ethics (EFPPA, 1995) which was accepted by EFPPA Member Associations in 1995, and which all member associations agreed to adopt, modifying their own codes where necessary. The European MetaCode articulates the common ethical principles of respect for a person’ rights and dignity, competence, responsibility, integrity, and specifies the content of national ethical codes (Lindsay, 1996), thus providing a consistent foundation of ethical guidelines at least in this region.
Although the Code of the Canadian Psychological Association (CPA) is similar to that of the USA, the CPA having used the Code of the APA for many years until their own Code was adopted in 1986 (revised in 1991), it has excited interest in the international community for nine features which appear to be unique (Sinclair, 1998). These are:
- Setting objectives based on a critical analysis of the international and interdisciplinary literature on codes of ethics;
- Inclusion of an overriding ethic of a social contract;
- Use of an empirical methodology in developing the Code;
- Organization of the Code round four ethical principles;
- Differential weighting of the four ethical principles;
- Inclusion of a model for ethical decision-making;
- Inclusion of a role for personal conscience;
- Inclusion of both minimum and idealized standards;
- Presentation of the Code as an umbrella document.
However, the mere existence of codes of ethics does not necessarily guarantee good conduct; as mentioned Codes may provide ‘bottom-line’ rules or proscriptions for behavior or aspirational guidelines. The increasing complexities of professional practice, the growing criticism of professionals by clients and consumers, and the political distrust of professionals has led to the publication of manuals such as that by Keith-Spiegel and Koocher (1985) who suggest that ethics codes tend to be fairly blunt instruments and may create conceptual confusion in their attempt to be all things to all people (p. 2). Manuals such as this provide case examples and examples of ethical dilemmas in order to sensitize psychologists to the complexity of the issues involved in professional practice.
Countries vary in their implementation of disciplinary procedures; for some countries these are administered by a government department, others have a Professional Board, while still others administer the investigatory and disciplinary procedures within the psychological association. In South Africa, for example, registration of psychologists has been through the Medical and Dental Council (now the Health Professions Council) which has its own Professional Board, separate from the Psychological Association. On the other hand, in the UK the BPS is seeking legal registration of psychologists and aspires to retain the disciplinary function within its own society, as do some other professions in this country, and to maintain the functions which are carried out by the BPS for the voluntary Register.
Institutionalization of Psychology
From early beginnings of groups of psychologists (mainly academic) forming associations or societies which provided a forum to meet and to give papers and discuss scientific research, the profession of psychology has become gradually more institutionalized through this century. This institutionalization was demonstrated early on by the foundation of Chairs and departments of psychology in universities, and by the formation of societies and associations to bring together psychologists and more recently to represent their interest and their professional identity. This section will focus mainly on the growth of professional associations which emerged particularly in the 1940s and 1950s in response to the enormous increase in the numbers of professional psychologists.
National Professional Associations in Psychology
As with other professional groups, the role of national professional associations of psychologists is becoming increasingly important in the professionalization of the field. The psychology associations of most countries started with scientific or ‘learned’ societies formed as early as the APA (1892) (Benjafield, 1996; Evans et al., 1992) when ‘a small gathering of academicians met on July 8, 1892, in the study of G. Stanley Hall and formed the American Psychological Association’ at a time ‘when the new, experimental psychology was still in its infancy in America’ (Evans et al., 1992). The APA had a membership of 31 when it was founded in 1892; in its first fifty years 3,000 members joined, whereas in its second fifty years over 130,000 members have joined. A similar increase in the second half of this century is demonstrated in the BPS. This was founded in the UK in 1901, and its membership has increased exponentially in recent years. Other European countries formed scientific societies of psychology early in the twentieth century, for example in Germany the Deutsche Gesellschaft für Psychologie, in Italy the Societa de Psicologia Italiana, and in France the Societè Francaise de Psychologie. Learned societies exist primarily to ‘advance scientific psychological research and to further the co-operation of investigators in the different branches of psychology’ (BPS objects as stated in Knight, 1954) or ‘the advancement of psychology as a science’ (APA objects) and do not act to set professional standards for practitioners.
In many countries the emergence of psychology as a profession led to a split or the emergence of a separate association which was intended to meet the needs of professional psychologists. Thus in the USA the perception was that “private practitioners” had come to dominate the APA by 1975 (and t)he Council and the APA found themselves engaged in major conflicts in the period 1970 to 1975 as the ‘practitioner’ segment moved their agenda regarding professional autonomy to the fore (Evans et al., 1992, p. 241). The APS formed in 1988 in reaction to the perceived focus of the APA on the needs and interests of professional psychologists, especially clinical psychologists (Evans et al., 1992). In Australia, the Australian Psychological Society formed out of the Australian Branch of the BPS in the 1970s, and now has a comprehensive structure and service provision, uniting scientists and practitioners, with separate science and profession Directorates. In South Africa, although the first sub-department of psychology was established in the University of Stellenbosch in 1917, the first society of psychologists, the South African Psychological Association, was formed in 1948, and this country has had a number of different psychology associations in part reflecting its own political situation until the formation of the Psychological Society of South Africa in 1994, a body which aimed to bring together a number of earlier associations. In other African countries, there have been loose associations formed during the 1970s and 1980s, many using the British model, for example the Zimbabwe Psychological Association which was formed in 1971.
Different and separate organizations, more like guilds or unions, formed in many European countries in the 1940s and 1950s; these organizations developed an explicit concern to enforce professional standards by restricting membership to those with appropriate training. Thus in the 1940s and 1950s associations formed in Germany, in Norway (in 1938), Sweden, Denmark, and Finland reflecting the growing professionalization of psychology. In countries of southern Europe, there has been a tendency to form professional ‘colleges’ (e.g., the ‘colegio’ in Spain), or ‘orders’ (the ‘ordine’ in Italy) which also demonstrate the professionalization of the field. In the UK, the BPS has remained an organization providing for both scientists and practitioner or professional psychologists, with a Scientific Board and a Professional Board to meet the specific and separate interests of these groups within one organization.
In the past fifty years, most national associations of psychologists have played an active role in seeking legislation and regulation for psychologists, frequently engaging in political and lobby activity, contributing to the drafting of legislation, and in some cases determining the level of qualifications. Many national associations now have relatively large offices, and carry out a wide range of professional and sometimes political activity.
Regional and International Associations
The recent decades have seen a growing interest in regional and international activity in psychology. The organization of this occurs both at the scientific level, and more recently at the professional level. It is worth mentioning that there are a number of different international and regional organizations representing different interests and aspects of psychology and psychologists.
There are two major ‘federal’ organizations, providing federations of national psychology societies/associations: IUPsyS (the International Union of Psychological Science) and EFPPA (the European Federation of Professional Psychologists Associations). The oldest international association of psychology is the International Association of Applied Psychology (IAAP) which was founded in 1920 and which is an individual membership association with 14 Divisions of different specialist interest in applied psychology; there is a growing number of international ‘specialist topic’ organizations, such as the International Society for the Study of Behavioral Development (ISSPD) and regional specialist topic organizations, particularly in Europe, such as the European Association of Work and Organizational Psychology (EAWOP) or the European Health Psychology Society (EHPS). There are also other regional associations such as the InterAmerican Society of Psychology (SIP) which bring together individual psychologists from the region. The majority of these organizations hold congresses and publish newsletters or journals thus contributing to the dissemination of the discipline, and providing a forum to bring together psychologists in professional gatherings.
The International Union of Psychological Science is a federation of national scientific societies, which aims to represent psychology in its full breadth as a science and as a profession. It grew out of the International Congress Committee which had been responsible for organizing the International Congress of Psychology starting in Paris in 1889. After World War II, at the ICP in Edinburgh in 1948, participants decided to organize an International Union of Psychological Science, similar to other scientific unions. The IUPsyS was founded by 11 Charter members at the International Congress of Psychology in Stockholm in 1951, and now has members from 64 countries (1999) and carries out a wide range of activities to promote and develop the discipline at an international level. The aims of the IUPsyS are:
- To develop the exchange of ideas and scientific information between psychologists of different countries, and in particular, to organize International Congresses, and other meetings, on subjects of general or special interest in psychology;
- To contribute to psychological documentation in different countries by fostering exchange of publications of all kinds, including reviews, films, and biographies;
- To aid scholars of different countries to go abroad to universities, laboratories, libraries and other institutions;
- To foster the exchange of students and of young research workers;
- To collaborate with other international and national organizations in matters of mutual interest;
- To engage in such other activities as will further the development of the science of psychology.
The Union demonstrates the increasing institutionalization and thus professionalization of psychology as a discipline through its scientific activity.
The other federal organization is EFPPA which has considerable overlap in membership with the IUPsyS within Europe, in part because of the integrated focus of several national psychology associations (see above).
The European Federation of Professional Psychologists’ Associations (EFPPA) is a major regional federation involved in professional psychology. This is a federation of psychology associations, founded in 1981, and which now covers all the countries of Western Europe, increasing numbers of countries from former East Europe, and of course plays a growing role within the European Union. There are 30 member associations of EFPPA (1999) representing over 100,000 psychologists across Europe. The member associations of EFPPA are various in nature and focus; as mentioned above, in some countries there are separate organizations for the science and the practice or ‘profession’ of psychology, while in others these different groups belong to the same organization. The aims of EFPPA are:
- To promote communication and cooperation between member associations in Europe, and to contribute to their development;
- To further the establishment of ethical codes of practice for psychologists, and to promote the application of psychology as a means of improving the well-being of those to whom psychologists offer services;
- To promote the furtherance of psychology and its application, with particular reference to professional training and the professional status of psychologists;
- To support the interests of psychology and its application in relation to any European or international organizations concerned with specifying requirements for the professional practice of psychology;
- To support member associations in promoting the interests of psychology within their own countries;
- To facilitate contacts with international bodies of psychology;
- To promote the development of professional psychology in all its different areas and subject matters and, as appropriate, to assist in the coordination of this activity.
The development of EFPPA and its evolving activities and focus reflect the growing professionalisation of psychology in Europe, particularly though not only on the professional practitioner aspect, and EFPPA itself represents both the profession and the science of psychology (EFPPA Statutes article 3), (see EFPPA, 1999).
Another major regional grouping is the Inter-American Society of Psychology/Sociedad Interamericana de Psicologia (SIP), founded almost fifty years ago, which brings together psychologists in North, Central, and South America, and which holds conferences every two years. However, unlike EFPPA, SIP does not have a political professional focus, since it provides a forum for individual psychologists to meet rather than for national psychology associations to cooperate. The implementation of the NAFTA agreement mentioned above may give this regional organization a sharper focus and a greater involvement in professional activities of this kind.
With greater professionalization and globalization there are other regional groups of psychologists, for example in the Asia-Pacific region. These institutional trends highlight the need for a balance between national, regional, and international concerns and activities.
The past fifty years have seen the establishment of psychology as a profession, and its development to full professional status, and an enormous growth in the numbers of psychologists working in professional contexts across the world. This period has also seen the growth of professional organizations both at a national level, and more recently at a regional and international level. In the majority of countries there are provisions or proposals for the regulation of professional psychologists usually through governmental ministries, particularly in the health field. Protection and regulation of the title is more common than regulation of the field of activities, a trend in line with current political and consumer pressures to promote competition and to increase the rights of consumers to choose providers. Regulation of the profession has been accompanied by the development of codes of ethics, and guidelines and manuals which promote the development of ethical practice and are used in the discipline and education of psychologists in this field. While the status of psychologists has been enhanced through an increase in the length of their education and training, and the demands required prior to recognition as competent to practice, a growing specialization within the field leads to demands for further specialist training, and in some cases further specialist titles, usually given at the present time by national professional associations such as those in Germany (BDP), the Netherlands (NIP), Norway (NPF), and the UK (BPS), all of whom grant specialist titles following recognized post-graduate education.
These trends seem likely to continue. What is also likely to increase in the next century is the internationalization of professional psychology with growing opportunities for movement between countries, and cooperation across national borders. It is also likely that psychologists will expand their activity into further fields of practice, partly as a result of new scientific knowledge, partly as a result of the political professional process of job expansion.