Two different but related developments played an important role in the history of psychologists in the fields of mental health care in Germany during the 20th century. The first development took place in the field of applied psychology, which saw psychological professionals perform mental testing, engage in counseling and increasingly, in psychotherapy in practical contexts. This process slowly began in the first decades of the 20th century and included approaches from different schools of psychotherapy. The second relevant development was the emergence of clinical psychology as an academic sub-discipline of psychology. Having become institutionalized in psychology departments at German universities during the 1960s and 1970s, clinical psychology often defines itself as a natural science and almost exclusively focuses on cognitive-behavioral approaches. There are four phases of the growing relationship between psychology and psychotherapy in Germany in which the two developments were increasingly linked: first, the entry of psychology into psychiatric and psychotherapeutic fields from approximately 1900 until 1945; second, the rise of psychological psychotherapy and the emergence of clinical psychology after World War II until 1972, when the diploma-regulations in West Germany were revised; third, a phase of consolidation and diversification from 1973 until the pivotal psychotherapy law of 1999; and fourth, the shifting equilibrium as established profession and discipline up to the reform of the psychotherapy law in 2019. Overall, the emergence of psychological psychotherapy has not one single trajectory but rather multiple origins in the different and competing academic and professional fields of mental health care.
Kathleen Someah, Christopher Edwards, and Larry E. Beutler
There are many approaches to psychotherapy, commonly called “schools” or “theories.” These schools range from psychoanalytic, to variations of insight- and conflict-based approaches, through behavioral and cognitive behavioral approaches, to humanistic/existential approaches, and finally to integrative and eclectic approaches. Different and seemingly new approaches typically have been informed by older and more established ones. For instance, cognitive behavioral therapy (CBT), one of the more widely used approaches, evolved from traditional behavior therapy but has become sufficiently distinct by adding its own complex variations so as functionally to represent an approach of its own. New approaches abound both in number and in complexity. Modern clinicians have had to become increasingly widely read and creative in trying to understand the ways in which patients may be helped. The sheer number of approaches, which has climbed into the hundreds, has challenged the field to find ways of ensuring that the treatments presented are effective. The advent of Evidence Based Practices (EBP) throughout the healthcare fields has placed the responsibility on those who advocate for particular types of treatment scientifically to demonstrate their efficacy and effectiveness. While this movement has brought standards to the field and has offered some assurance that psychotherapy is usually helpful, there remains much debate about whether the many different schools produce different results from one another. The debate about how best to optimize positive effects of psychotherapy continues, and there remain many questions to be asked of psychotherapy theories and of research on these approaches.
Wade E. Pickren and Ingrid G. Farreras
In a relatively brief period of time, the discipline of psychology in the United States changed from being mostly concerned with its status as a legitimate science, qua physics or biology, to a rapidly growing field caught up in the tensions between academic science and the practice of psychology as a mental health profession. The numerical growth of the field’s members was heavily concentrated in the professional areas of mental health application. This was due primarily to the changed conditions of postwar life and the concerns of policymakers about the mental health of citizens in a dynamic, fast-changing, and fast-paced society. Government funding for psychology dramatically increased, especially funds for training clinical psychologists and for conducting research on mental health problems. It was not long before many of the clinical psychologists moved away from solely academic work and into the private practice of providing psychotherapy to clients. The discipline’s main organizational body of the time was the American Psychological Association, which came under pressure to allocate intellectual, organizational, and financial resources to the support of its practitioner members. One of the most intense battles of this period was that of creating different training models for clinical psychology. The early postwar model placed priority on training clinical psychology students to be scientists first, but by the 1960s, the demand for greater emphasis on training for practice had to be addressed for the field to remain coherent. Along with the internal tensions, psychology had to come to terms with external pressures as well. Among its challenges were those from competing professions, such as medicine, to its legal and cultural authority to provide professional services. Psychology eventually won those battles, but only after a state-by-state fight. Psychology was also presented with the challenges of a society wrestling with social problems, such as the demands for equal civil rights and opportunities. By the late 1960s, there were increasing demands for inclusion of students and faculty of color in graduate training and while there were some successes, there remained challenges that endured into the 21st century.
Mind cure, or mental healing, was a late 19th-century American healing movement that extolled a metaphysical mind-over-matter approach to the treatment of illness. Emerging in New England in the mid-19th century out of a mix of mesmerism and metaphysical philosophies, due to its effectiveness, by the 1880s it achieved national recognition. Three individuals are credited with creating and popularizing mental (or metaphysical) healing: Phineas Parkhurst Quimby, Warren Felt Evans, and Mary Baker Eddy. Mind cure was appealing because it helped treat ailments for which the medicines of the day were ineffective, especially problems with the “nerves.” Mental healers employed non-invasive mental and spiritual methods to treat ailing people, called mental therapeutics. As a practice and therapeutic philosophy, mind cure is historically noteworthy because it shaped the earliest forms of psychotherapy in the United States, advanced therapeutic work within the realm of mind-body medicine, birthed the influential New Thought movement, and helped set the stage for the beginnings of religious pluralism and the positive reception of Asian meditation teachers in the West.