A dictionary definition of clinical psychology would be something like “the use of expert knowledge and clinical skills firstly to assess and then to prevent or relieve mental distress or disorder”. As such, it can be said to be as old as the human race. All old wives and witchdoctors operate by finding out the mental state of the sufferers, for example “assessment”, and then finding the words to guide them into recovery, for example “psychotherapy”. Providing they start with sufficient empathy and understanding, the more training and the more practical experience they have, the better at it the healers will get. Until very recently in human history, the pharmacopeia was so weak and so variable that this sort of treatment provided a large proportion of all the effective healing available – midwifery, bone-setting and what amounted to clinical psychology was what there was. With the development of more effective pharmacological preparations, the healing professions began to separate out. The barbers and bone-setters took control of surgical treatments. At the same time, the doctors, though still very reliant on an effective bedside manner to relieve psychological distress, had their monopoly of drug treatments enshrined in law. Considering the ineffectiveness of the eighteenth-century pharmacopeia, it is quite astonishing how strict the law was on preserving the doctors’ professional monopoly of it. Healing treatments outside these two branches fell into comparative disuse and low repute, especially when practiced by women.
As psychology gradually crystallised out from other disciplines during the nineteenth century, it was initially regarded as a pure science, devoted to studying the processes of the mind, rather than as an applied science which could be used to alter these processes – the popularity of pseudo-scientific treatments like mesmerism, spiritual healing and bizarre uses of electricity had brought such ideas into disrepute. This very soon changed however. Scientific psychology is generally said to date from the establishment of Wundt’s first psychology laboratory in 1879. A pupil of Wundt’s, Lightner Witmer, started the first psychology clinic in Pennsylvania only a few years later, in 1896. This clinic dealt primarily with school assessment and behavioural problems in young children. (It is quite noticeable that the general public is still much more willing to accept the idea of psychological interventions with children than with adults.)
The main skill which psychologists brought to bear at that stage was assessment. This received an enormous boost in the First World War, when psychological tests were used by every army as a quick way of assessing soldiers to find their suitability for different tasks. Therapy came slightly later, as the doctors found that they were unable to cope with the mental stresses caused by the war. Since then, psychologists have infiltrated into almost every aspect of human society, and clinical psychologists in particular have forged themselves a firm professional identity. Anyone can call themselves a therapist or a counsellor, but just as the doctors were centuries ago, clinical psychologists are legally defined and have to have professionally registered qualifications.
This book therefore is not aimed at a wide range of readers with some broad general interests in common; it is designed for a specific group of people who have to acquire a lot of quite clearly defined expertise. The exact amount of training and the qualification awarded vary slightly from country to country. This book is, however, entirely concerned with America. I must admit that I find this slightly irritating. I would have preferred an encyclopedia which at least paid lip service to the training, qualifications and likely professional challenges to be found in other countries. In practice, this does not matter too much however, as the American model is increasingly being followed elsewhere in the world. This involves at least three years of postgraduate training leading either to a PhD (more research-based) or a PsyD (more practice-based) doctorate, plus a period of practical experience.
This encyclopedia consists of just over 500-signed entries, averaging about six pages or so in length, by about 800 contributors, most of them American associate professors. The entries are sensibly arranged in a single alphabetical sequence, but cover seven broad themes, and so there are seven subject editors in addition to the two editors-in-chief. How, given this enormous array of people, they managed to get the work completed I cannot imagine. My own experience of trying to get the laggard’s belated entry in before the early bird’s contribution has become too out of date gives me the impression that steering 800 psychologists must have been closely akin to herding cats. The editors have succeeded however. All the contributions seem to be reasonably up-to-date: I noticed regular references up to 2013 publications.
The seven broad themes covered in this book are:
Classification/Diagnosis & Assessment;
Historical, Philosophical & Conceptual Issues (including a rather random selection of biographical entries);
Legal & Ethical Issues (American law of course, readers in other countries need to treat these with caution);
Methodological Issues;
Professional Issues (again, all American with work of the American Psychological Association and other bodies well described, but their equivalents in Britain, for example, hardly touched on);
Psychological Disorders, Including Culture-Bound Syndromes; and
Treatment & Prevention.
A thematic index at the front of the first volume provides a guide to entries on related topics, so that, even with the printed version I have been working through, it is reasonably easy to pick up on inter-related topics. All the entries have a see also section as well to provide further guidance.
All the entries are referenced, mainly to scholarly journal papers, and also have separate short lists of suggested further reading: just two or three suggestions of useful book chapters and papers from widely available journals per entry. I have only given the references a cursory glance, but the further readings I have checked up on have all been accurate, helpful and reasonably accessible.
Up until half a century ago, or even less, the study of mental disorder, especially in America, was completely dominated by psychodynamic ideas. It was practically impossible to get a job in the field without at least paying lip service to Freud. Textbooks from that era seem quite astonishingly unbalanced to us now. I do occasionally worry that Cognitive Behaviour Therapy is reaching towards an unhealthy dominance in some quarters, but this book seems to me just at the moment to present a far more balanced picture. It would be interesting to see whether a reader in 2065 would feel the same about it. There are a few minor weaknesses: there is a short four-page entry on computerised therapy, but it is already clear to me that it is not enough on the provision of remote services: virtually all of the entries on diagnosis and assessment seem to be based on the idea of person-to-person contact. I strongly suspect that long before 2065, this concept will seem remarkably quaint and dated. Doctors have had to accept the concept of informed patient. Psychologists will have to get even more used to the self-assessed client than they already are, whether they like it or not. I would have welcomed an entry discussing ways of guiding clients through to the more reliable self-assessment sites and away from the charlatans that infest the Web. The mono-culturalisation of the world is proceeding at such a pace that the sections on the trivial differences between Americans that can lead to culture-bound syndromes will probably have disappeared before 2065 too. By and large, however, this book currently seems to me to be comprehensive and well-balanced. It would be interesting to see how the young people who form its target readership will look back on it as they near retirement.
This target readership is clearly American students undertaking postgraduate studies leading to registration by the American Psychological Association (APA) as clinical psychologists. There are, at the last count, about 250 American and Canadian institutions offering such training. All their libraries should, unquestioningly, try to acquire this encyclopedia: it is obviously going to be a major reference source in their field. Psychology, and especially clinical psychology, is such an American-dominated discipline that libraries catering for similar training programmes in other countries will find most of the content relevant and useful, and so they should also consider it for acquisition. Large portions of it would be relevant and useful for trainees in the more general fields of health psychology, child psychology, counselling, psychiatric nursing and, obviously, psychiatry. Academic libraries catering for courses on those subjects will need other core reference tools in their particular fields but would find this book to be a useful source of supporting reading. I don’t know how many individual practitioners the publishers are expecting to acquire it as a desk reference. There are other books equally suited to their needs – I did recommend the Psychologists’ Desk Reference (Koocher et al., 2013), for example, as an excellent collection of handy practical check-lists specifically aimed at American clinical psychological practitioners (RR 2014/126). Although most of the material here should be within the comprehension of a reasonably well-educated general reader, the book is probably less suited for public library use – there are numerous other textbooks, handbooks, encyclopedias of psychology, etc., on the market already. Reference libraries that can afford it may, however, wish to bear this in mind as a back-up source.
