I believe that we must make a greater effort to differentiate between scientific and pseudoscientific clinical psychology and to hasten the day when the former replaces the latter....
ON CLINICAL PRACTICE
Scientific clinical psychology is the only legitimate and acceptable form of clinical psychology. This first principle seems clear and straightforward to me - at least as an ideal to be pursued without compromise. After all, what is the alternative? Unscientific clinical psychology? Would anyone openly argue that unscientific clinical psychology is a desirable goal that should be considered seriously as an alternative to scientific clinical psychology?...
Where there are lots of unknowns - and clinical psychology certainly has more than its share - it is all the more imperative to adhere as strictly as possible to the scientific approach. Does anyone seriously believe that a reliance on intuition and other unscientific methods is going to hasten advances in knowledge?...
Understandably, the prospect of publicly exposing the questionable practices of fellow psychologists makes most of us feel uncomfortable. Controversy never is pleasant. Public challenges to colleagues' activities certainly will anger those members of the clinical psychology guild who are more concerned with image, profit, and power than with scientific validity. However, if clinical psychology ever is to establish itself as a legitimate science, then the highest standards must be set and adhered to without compromise. We simply cannot afford to purchase superficial tranquillity at the expense of integrity....
Most of us have become accustomed to giving dispassionate, objective, critical evaluations of the scientific merits of journal manuscripts and grant applications; now we must apply the same kind of critical evaluation to the full spectrum of activities in clinical psychology....
Clinical psychologists cannot justify marketing unproven or invalid services simply by pointing to the obvious need and demand for such services, any more than they could justify selling snake oil remedies by pointing to the prevalence of diseases and consumer demand for cures.
...(S)cientific training must be the sine qua non of graduate education in clinical psychology....
Everyone seems to have opinions about what makes for effective scientific training, but such views seldom are backed by sound empirical evidence. Even where evidence exists, it may exert little influence on the design of clinical training programs. It ought to be otherwise, of course; those who train scientists should be reflexive, taking a scientific approach themselves toward the design and evaluation of their training programs. Unfortunately, the structure and goals of graduate training in clinical psychology tend to be highly resistant to change. Institutional, departmental, and personal traditions, alliances, and empires are at stake, and these tend to make the system unresponsive to logical, empirical, or ethical appeals.
Training program faculty members need ... to stop worrying about the particular jobs their students will take and focus instead on training all students to think and function as scientists in every aspect and setting of their professional lives....
Too much emphasis has been placed on the acquisition of facts and the demonstration of competency in specific professional techniques, and too little emphasis has been placed on the mastery of scientific principles; the demonstration of critical thinking; and the flexible and independent application of knowledge, principles, and methods to the solution of new problems. There is too much concern with structure and form, too little with function and results....
ON PROGRAM EVALUATION
The ultimate criterion for evaluating a program's effectiveness is how well its graduates actually perform as independent clinical scientists. Thus, program evaluations should focus on the quality of a program's products - the graduates - rather than on whether the program conforms to lists of courses, methods, or training experiences.
...(F)or clinical psychology to have integrity, scientific training must be integrated across settings and tasks. Currently, many graduate students are taught to think rigorously in the laboratory and classroom, while being encouraged - implicitly or explicitly - to check their critical skills at the door when entering the practicum or internship setting....
ON 'BREAKING AWAY'
In my more cynical moments, I sometimes suspect that many psychologists view serious proposals for scientific standards in practice and training as a betrayal, rate busting, or breaking away from the pack. ... Inevitably, a breakaway will come. Some groups of clinical psychologists will become obsessed with quality, dedicated to achieving it. These psychologists will adopt as their manifesto something similar to the one I have outlined here. When this happens, the rest of clinical psychology - all those who said that it couldn't be done, that it was not the right time - will be left behind in the dust.
Excerpted from "Manifesto for a Science of Clinical Psychology," by Richard M. McFall, The Clinical Psychologist, 1991, Volume 44, Number 6, 75-88.
For full text: http://pantheon.yale.edu/~tat22//manifest.htm
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