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Clinical Science Model should be guided by a systematic, critical,

evidence-based analysis of their relative merits.


Richard M. McFall,1 Teresa A. Treat,2 A comparative evaluation of the field’s com-
and Robert F. Simons3 peting models should prove beneficial, with
1 Indiana University & Psychological Clinical Science
far-reaching implications. However, a prereq-
Accreditation System, U.S.A., 2 University of Iowa, uisite to any such analysis is a clear grasp of
U.S.A., and 3 University of Delaware, U.S.A.
the models to be compared. Thus, the aim here
is neither to compare nor to choose among
The field of clinical psychology today is models. It is to focus narrowly on explicating
characterized by a remarkable degree of the tenets, rationale, and implications of one
heterogeneity—in its theories, methods, model, the CS model, referring to other models
applications, educational approaches, and only in passing where this helps illuminate the
underlying conceptual models. Conceptual CS model’s distinctive features. The CS model
models are like mental blueprints: they are is presented here from the perspective of its
invented constructions designed to organize, advocates, not only to explain the model’s
connect, channel, and give meaning and pur- content, logic and rationale, but also to convey
pose to thought and action within their target a sense of its advocates’ investment in the
domains. The clinical science (CS) model is one model.
of the competing conceptual models within Proponents of the CS model believe that it
the field of clinical psychology. It was created offers clinical psychology the advantage of an
to guide all aspects of clinical psychology, from objective, empirical, proven framework for
the search for basic and applied knowledge, making genuine and steady progress toward
to the translation of such knowledge into the field’s twin goals. These proponents believe
optimal standards for professional service, to that the field’s unified adoption of this model
the structuring of education and training in would transform clinical psychology into a
the specialty (Baker, McFall, & Shoham, 2008; more rigorous and integrative applied science
McFall, 1991, 2006). capable of rapidly expanding psychological
Most clinical psychologists probably would knowledge and improving public health. They
agree that the field’s overarching twin goals also expect that a unified adoption of this
are (a) to increase knowledge about mental model would have a positive ripple effect,
and behavioral health problems, and (b) to promoting science-centered education and
provide services that enhance the public’s practice across the broad spectrum of mental
health and well being. There would be much and behavioral health disciplines, institutions,
less agreement, however, about the specifics and educational levels. They believe, in turn,
of how best to define, measure, and achieve that this would pay significant dividends over
these abstract goals. Disagreements about such time to the public’s health and welfare.
fundamental issues are at the heart of the field’s
heterogeneity, and the failure to resolve such
Epistemic Foundations
differences impedes the field’s progress. It is
unlikely that competing conceptual models are The CS model is founded on the basic premise
equally plausible, reasonable, and productive. that a rigorous and uncompromising adher-
From a clinical science perspective, choosing ence to a scientific epistemology (i.e., to one’s
among these conceptual models is not simply way of knowing, or deciding “truth”) is
a matter of personal taste. Rather, the choice the most productive and powerful way to

The Encyclopedia of Clinical Psychology, First Edition. Edited by Robin L. Cautin and Scott O. Lilienfeld.
© 2015 John Wiley & Sons, Inc. Published 2015 by John Wiley & Sons, Inc.
DOI: 10.1002/9781118625392.wbecp458
2 CLINICAL SCIENCE MODEL

advance knowledge about the origins, nature, Finally, if the model’s advocates are correct
assessment, amelioration, and prevention of in their belief that the scientific epistemology
mental and behavioral health problems. This offers the surest path to advancing knowledge
epistemology also offers the best framework and to improving clinical services, then it
for developing, evaluating, delivering, and dis- follows logically that this epistemology should
seminating the safest and most cost-effective be the centerpiece of all education and training
clinical services. Moreover, it provides the for future generations of clinical psychologists.
essential foundation for rigorous, high-quality, The goal should be to produce a cadre of
education and training in clinical psychology. integrative clinical scientists, all of whom have
The CS model’s advocates believe that a the knowledge and skills to function both as
scientific epistemology offers a systematic, basic and applied researchers, on the one hand,
disciplined, rational, quantitative, and self- and as independent providers and overseers
correcting method of seeking valid answers of clinical services, on the other hand. This
to some of life’s most difficult questions. This ability to bridge and integrate across domains
discovery process is central to the CS model. and roles allows them to contribute to the
Science is not a set of facts or answers. It is advancement of knowledge regarding mental
a framework by which to expand knowledge and behavioral health even as they are able to
incrementally, an unfolding pathway that yields deliver, disseminate, supervise, and administer
successive approximations to “truth.” Thus, the most cost-effective, empirically supported
a science-centered search for knowledge is a mental and behavioral health-care services.
means to an end, and should not be confused The CS model’s advocates justify their com-
with the end itself. It is a mistake, therefore, mitment to the scientific epistemology by
to equate the scientific epistemology with pointing to the promise they see in the his-
specific answers to specific questions, or to torical record of scientific achievements. They
criticize it for having failed thus far to solve believe science has proven itself—across a wide
specific problems or for reporting findings that range of problem areas and disciplines—to
subsequently are overturned by later findings. be the most productive and reliable of all
The model’s advocates also believe that a sci- approaches to seeking “truth.” It repeatedly
entific epistemology offers the best framework has yielded fruitful, often unexpected, and
for comparing, evaluating, and improving the amazingly effective and enduring solutions to
validity and utility of clinical assessments, as previously intractable theoretical and practical
well as the efficacy and effectiveness of clin- problems. The CS model’s advocates believe
ical interventions. Science has no monopoly that an uncompromising commitment to a
on good ideas, so the creative ideas behind scientific epistemology will be as fruitful and
beneficial for the field of clinical psychology as
clinical procedures can come from anywhere,
it has been for so many other fields of inquiry.
including research evidence, clinical expe-
Of course, the full payoff remains to be seen,
rience, intuition, and inspiration. However,
but proponents believe that no alternative
proponents of the CS model believe that the
epistemology can match science’s record; that
scientific method, with its strong inference
there is no better epistemic choice; and that
approach to choosing among plausible rival
science’s contributions to clinical psychology
ideas and claims, offers the most rigorously
have been very encouraging thus far.
systematic, valid, and productive way to sep-
arate the wheat from the chaff. Through its
Evolution of the CS Model
well-established quantitative and qualitative
methods of hypothesis testing and refinement, For the first 30 years following clinical psy-
it represents a programmatic, incremental way chology’s official birth, in the late 1940s, the
to pursue “truth.” field’s only recognized conceptual model was
CLINICAL SCIENCE MODEL 3

the scientist–practitioner model (Bootzin, Consequently, at least in the beginning, the


2007). This model proclaimed that all clin- Boulder model’s professed ideal of integrating
ical psychologists must be trained both as science and practice was more an aspiration
scientists and as practitioners. The model’s than a reality. The hyphen at the center of
ideal of an integrated discipline, symbolized scientist–practitioner actually signified the
by the model’s hyphenated name, actually field’s divisions more than its envisioned
was the by-product of a hard-won compromise integration. True, the scientist–practitioner
between two conflicting factions of clinical psy- model required every doctoral student to
chologists, each with a very different vision for learn statistics and research methods, and
the emerging field. The scientist faction wanted to produce an independent research product
clinical psychology to continue to develop as it for the doctoral dissertation. It also required
had been (i.e., as a research specialty focused that each student learn psychological testing
on investigating the origins, assessment, and and psychotherapeutic methods. But these
treatment of psychopathology, but otherwise research and practical training components
not much different than the other specialty were like two separate worlds. To deal with the
areas within psychology). These scientists were inherent tensions between these two worlds,
concerned that the connections between the some students chose to specialize in one world
science and practice of clinical psychology or the other. Other students adopted a com-
were tenuous, at best; that the theories, assess- partmentalized solution, specializing in both,
ments, and interventions of practicing clinical but keeping these worlds separate as they
psychologists had little empirical support; and moved back and forth between the laboratory
thus that practitioners’ push to launch clini- and the clinic. True integration awaited the
cal psychology as an applied profession was development of a translational bridge between
premature, overreaching, and likely to have research and application activities.
negative long-term repercussions. In the 1970s, the latent tension between
Those in the practitioner faction, in contrast, research and practice became public with
wanted the field to develop as an applied profes- the emergence of a new, competing model that
sion, like medicine. They were eager to respond emphasized practice—the scholar–practitioner
to their country’s urgent call for psychological model. It was based on the rationale that doc-
services in the aftermath of World War II, toral students in clinical psychology who were
even if their current services were backed by committed to pursuing careers solely as prac-
little more than good intentions. Their vision titioners did not need to spend time learning
of building an applied specialty was receiving research methods that they never would use;
financial support and encouragement from the they would be better served if they used this
Veterans Administration and the United States time, instead, to hone their clinical skills, which
Public Health Service, so they saw this moment presumably would make them better practi-
as a rare opportunity that must be seized. They tioners. Advocates for this new model thought
were confident that as psychologists became it should be sufficient for these students, like
more actively involved in clinical practice, medical students, to receive just enough science
the scientific evidence and knowledge would training to prepare them to read and interpret
follow, that clinical practice would stimulate the clinical research literature, allowing them
more applied research, and that this, in turn, to use such information to guide their clinical
would advance both psychological science and practice. Graduates from scholar–practitioner
practice. Many in the scientist faction were not programs received a PsyD degree instead of a
persuaded, however; nor were they eager to PhD. This scholar–practitioner model initially
shift their research focus from the basic ques- met with resistance from traditionalists; how-
tions that interested them to the applied ever, by 2012 the number of clinical training
questions that interested clinical practitioners. programs subscribing to this model, as well as
4 CLINICAL SCIENCE MODEL

the number of students enrolled in such pro- evidence-based practitioners had formed a
grams, had grown to the point that over half society devoted to promoting clinical psy-
of all doctoral students in clinical psychology chology as a scientific discipline. Initially this
were being trained in scholar–practitioner society was called “Section III of Division
programs. Moreover, some of these programs 12 of the American Psychological Associa-
had started offering a PhD, even though tion: Section for the Development of Clinical
their research training differed substantially Psychology as an Experimental/Behavioral
from that offered by scientist–practitioner Science.” The society reorganized in 1990 with
programs. Clearly, the field had undergone a new name, “Society for a Science of Clinical
a significant change: research training, with Psychology” (Oltmanns & Krasner, 1993).
its scientific epistemology, no longer was the By 1994, many researchers, practitioners, and
common core of all clinical psychology. Many academics felt the need for a more substan-
in the scientist–practitioner camp viewed this tial reform effort on behalf of psychological
change as an alarming sign of the erosion of clinical science. They were distressed, in par-
clinical psychology’s scientific foundations. ticular, by what they perceived to be growing
Largely in response to this change, a third tensions between good scientific training,
model emerged in the 1990s—the clinical on one hand, and the requirements doctoral
science model. In many respects, the CS model programs must satisfy to receive professional
is not really new; it essentially represents accreditation. With support from NIMH and
a reaffirmation of the idealized, integra- the Association for Psychological Science, a
tive, science-centered version of the original representative group of 24 educators from
scientist–practitioner model. Proponents leading science-centered doctoral programs
of the CS model are not opposed to the met to discuss the future of clinical psychology
scientist–practitioner model, but encourage in the twenty-first century. This conference
like-minded clinical scientists to join them, led to the founding in 1995 of the Academy
under the CS banner, in calling for a renewed of Psychological Clinical Science (APCS),
commitment to a scientific epistemology, which now has over 60 members, comprising
along with the requirements that all clinical doctoral programs as well as clinical internship
psychologists must be trained both as scientists programs. All APCS members had subscribed
and as practitioners; that this training must to the scientist–practitioner model, but were
be integrated and reciprocally reinforcing, attracted to the emerging CS model, seeing
with clinical problems shaping the research it as a contemporary interpretation of the
questions, and with research evidence being scientist–practitioner model initially envi-
translated into improved clinical procedures; sioned by the scientist faction at the birth
and that clinical practitioners bear an ethical of clinical psychology in the 1940s. Within
responsibility to be held accountable for the APCS, the CS model is viewed as a way
validity of their claims and promises, and for of identifying and promoting the strongest
ensuring the cost-effectiveness of their services. possible science-centered approach to clin-
Essentially, the proponents of the emergent ical psychology—in research, service, and
CS model insist that science be restored to education.
what they believe is its rightful place as the The CS model’s advocates believe that the
centerpiece for all of clinical psychology—in 1940s vision of building a science-centered dis-
research, service, and education. cipline is a realistic possibility today, thanks to
From the field’s beginning, scientific clin- decades of basic and applied research into the
ical psychologists had argued for a stronger causes, assessment, treatment, and prevention
science-centered and unified interpretation of mental and behavioral problems. They argue
of the scientist–practitioner model. In the that psychological science has built a solid
1960s, for example, academic researchers and foundation that can unite science and practice,
CLINICAL SCIENCE MODEL 5

and can provide sound empirical guidance Implications of the CS Model


to clinical practitioners. Unfortunately, these
advances in psychological clinical science In the CS model, clinical psychology is viewed
so far have not had the influence on clinical as an integrated applied science. Thus, the
practice that one might have expected. When hyphen in the scientist–practitioner model
making clinical decisions, many clinicians, always must be translated as “and,” never as
especially those from programs that minimize “or.” This implies that all of the field’s applied
research training, give more weight to their service activities must be science-centered, that
personal clinical experiences and intuitions they be grounded in, governed by, and compat-
than to the research evidence. Some even ible with the best available scientific evidence.
have declared that the research findings from Likewise, this conception also requires that
randomized clinical trials and other controlled a common goal of all of the field’s scientific
studies are irrelevant to clinical practice in research activities should be to generate new
the “real world.” The limited translation of knowledge that potentially can be translated
research findings into everyday practice has into practical contributions aimed at solving
highlighted the increasingly critical role that “real world” clinical problems. As applied
clinical scientists can play in the implemen- scientists, clinical researchers are obligated
tation and dissemination of prevention and to pursue problems with implications for
intervention science in applied settings. Thus, improving public health.
even though clinical psychologists increas- The CS model also considers clinical psychol-
ingly are less likely to function as front-line ogy to be a transdisciplinary and hub science.
service providers, they remain critical to the This means that clinical scientists must leave
development, evaluation, implementation, their silos, drain their moats, and build bridges.
and dissemination of scientifically grounded Clinical scientists need to draw upon the best
clinical services. theories, methods, and evidence from within
In 2007, APCS launched the Psychological their own specialty, of course, but also from
Clinical Science Accreditation System (PCSAS; throughout all of psychological science and
www.pcsas.org). PCSAS is an independent, beyond. They need to establish collaborative
nonprofit corporation created for the pur-
connections with such allied scientific fields
pose of using the leverage of accreditation
as cognitive science; neuroscience; sociology
to promote superior science-centered PhD
and anthropology; molecular and behavioral
education and training in clinical psychology,
genetics; behavioral economics; immunology;
to enhance the scientific knowledge base for
endocrinology; pharmacology; and many oth-
mental and behavioral health care, and to
ers. Because no individual psychologist can
increase the quality and quantity of clinical
scientists contributing to the advancement become an expert in all fields, collaboration
of public health. The primary objective of across traditional disciplinary boundaries is
PCSAS is to provide rigorous, objective, and essential. Clinical psychologists should be
empirically based accreditation of U.S. and prepared to do whatever it takes—to go wher-
Canadian PhD programs in psychological ever the evidence leads them—to solve the
clinical science. Its longer term objective pressing problems in mental and behavioral
is to transform the field by encouraging health. They must search out and adopt the
psychologists—researchers, practitioners, and very best scientific ideas and knowledge, no
educators alike—to unite in establishing the matter what the source, no matter how that
scientific epistemology as the bedrock of clini- reshapes the field. And because psychological
cal psychology. Proponents of the CS model see science stands at the intersection of so many
PCSAS as yet another significant evolutionary interrelated fields, this hub position gives it
step toward achieving the field’s twin goals. both an opportunity and a responsibility to
6 CLINICAL SCIENCE MODEL

reciprocate by making scientific contributions Another implication of the CS model is that


that help advance these related fields. the sine qua non of a successful CS training
Thus, to realize clinical psychology’s twin program is a clear track record of consistently
goals, CS advocates assert that the field must producing graduates who pursue successful
adopt a rigorously science-centered, inte- careers as clinical scientists. A program’s out-
grative, and transdisciplinary approach—in comes are what count most: a CS training
every facet of its activities, without excep- program is successful only when a majority
tion. Compartmentalized clinical psychology of its graduates function as clinical scientists.
(i.e., rigorous science in the laboratory, but If a program builds such a record of success,
intuitive art in the clinic) is not acceptable in it is difficult to say that it is doing things
the CS model. Clinical practitioners must think wrong. This focus on outcomes does not mean
and act as scientists in all they do, including: that CS programs must produce clones of
when deciding whether to offer a service; when their faculties. In fact, clinical science is not
choosing, administering, and interpreting a narrow domain. There are multiple career
assessments; when diagnosing and analyzing paths that require science training, many of
complaints and symptoms; when weighing which involve applied clinical activities, such
the costs, benefits, and risks of interven- as developing and testing new assessments and
tions (vs. no intervention); when measuring interventions; program development, admin-
treatment outcomes and cost-effectiveness; istration, and evaluation; treatment outcome
when training and supervising other providers; research; refining and elaborating current
when designing and administering health-care treatments; evaluating the contributions of
systems; and when informing the public of specific factors to treatment outcomes; assess-
the field’s (or a specific clinician’s) capabilities, ing population-specific or culture-specific
achievements, and limitations. treatment effects; training, supervising, and
The CS model also imposes stringent require- evaluating service providers; and conducting
ments on the faculty members and supervisors programmatic etiological research with clin-
charged with educating tomorrow’s clinical ical populations. As the health-care system
psychologists. It requires that they design, of North America continues to evolve, and as
implement, evaluate, and refine their pro- services that traditionally have been performed
grams with an eye to ensuring that they are by clinical psychologists continue to migrate
science-centered, coherent, and up-to-date; to other disciplines, advocates of CS training
that the students are selected to match their contend that graduates from CS programs are
programs’ requirements and goals; that their best prepared to assume a leading role within
programs’ content is selected and communi- this changing system.
cated in ways that foster scientific skepticism, The CS model does not require training pro-
intellectual curiosity, creativity, and method- grams to conform to a uniform list of courses,
ological rigor; that their programs’ pedagogical cover a fixed body of content, or employ a
methods are optimally efficient and effective; specific pedagogy or method. No single system
that students’ progress and achievements are of CS training has proven itself superior to
assessed sensitively and constructively with all others thus far, so there is no empirical
valid measures; that their students acquire basis for being highly prescriptive. Moreover,
the requisite skills to conduct independent, courses, content, and methods are moving
cutting-edge research, to evaluate scientific targets; they must change over time with
evidence, and to test and evaluate theories advances in knowledge. A highly prescriptive
and claims; and that their programs’ grad- approach to content and methods does not
uates have the competence to function as encourage innovation and progress—two hall-
independent providers of clinical services and marks of the scientific enterprise. Of course,
procedures. the model expects programs to ensure that
CLINICAL SCIENCE MODEL 7

students acquire the core knowledge and skills an expert at everything; to be ethical, clini-
that define the domain of clinical psychol- cians must practice within the bounds of their
ogy (i.e., psychopathology and adaptation; expertise. And because the CS model obligates
assessment, measurement, and evaluation; clinicians to choose the most cost-effective
intervention and prevention; research meth- services, this also means that if research shows
ods, design, and quantitative methods). But that masters- or bachelor-level providers are
the model does not specify how these must be as effective as doctoral-level psychologists at
taught. Nor does it require that all graduates delivering a particular service, and can do
fit the same mold, or that they must be experts this at a lower cost, and then doctoral-level
at everything. The CS model simply promotes psychologists should defer to these more
a set of abstract principles, values, goals, and cost-effective providers. The CS model is not
standards for CS training. Within these broad intended to protect guild interests or to pro-
constraints, it offers flexibility, encouraging mote clinical psychologists into privileged
individual programs to experiment, to develop positions within the health-care system. The
the best educational program possible, taking CS model’s mission is to promote psycho-
into account the local circumstances, available logical science in the interest of advancing
resources, scientific expertise of the faculty, knowledge, improving health care, and serving
and research interests and aptitudes of the the public.
individual students.
The CS model takes a similar approach Criticisms of the CS Model
toward clinical practice, promoting abstract
principles, values, goals, and standards for The CS model’s lofty aspirations impose high
optimal clinical practice, but within these standards on clinical psychologists in all they
constraints, not requiring adherence to any do—in research, in application, and in edu-
list of specific assessment methods, diagnostic cation. These requirements, with their call for
systems, or intervention techniques. Again, accountability and their challenging implica-
as with course content or training techniques, tions, are a distinguishing feature of the CS
these are expected to change over time as our model, and are part of the model’s appeal to
scientific knowledge advances. Rather than many psychologists. Not surprisingly, however,
prescribing specific procedures, the CS model the model also has stirred criticisms among
simply requires that practitioners choose their some clinical psychologists (e.g., Wampold,
procedures based on the best available research 2001; Westen, Novotny, & Thompson-Brenner,
evidence. This evidence should lead practi- 2004). Space does not permit the coverage of all
tioners to reach a general consensus regarding such criticisms, but some prominent examples
the most promising procedures, at any given will give a flavor of the objections to the CS
point in time, and this naturally would lead model:
them to converge on a limited set of proce- Most clinical psychologists agree that the
dures. But the model would not be dictating scientific method—with its skeptical hypoth-
the use of these specific procedures per se; esis testing, reliance on controlled research,
rather, it would be dictating the process and and insistence on a critical and dispassionate
standards by which the procedures are chosen. quantitative analysis of evidence—is the best
This is consistent with the model’s scientific way to advance basic knowledge. At the same
epistemology. time, however, a number of clinical psycholo-
The model also requires practitioners to offer gists are skeptical about the contributions that
and deliver empirically supported procedures the scientific method and the results from con-
themselves only if they personally are qualified trolled scientific research can make to applied
and competent to use them. No one can be questions and to clinical practice. They worry
8 CLINICAL SCIENCE MODEL

that the model’s extensive research focus must The CS model has also been criticized for
be to the detriment of more applied activities. requiring that pedagogic content and methods
Some critics have claimed that the model’s be based on scientific evidence, rather than on
uncompromising commitment to the sci- personal preferences or commonly accepted
entific epistemology imposes unreasonable, traditions; that educators stay abreast of the
unrealistic, and counterproductive constraints literature and modify their practices as the
on clinical psychologists. For example, CS evidence changes; that faculty mentors model
advocates have been criticized for granting the integration of research and clinical practice
unwarranted preferential status to certain for their students; and that programs accept
“empirically supported” treatments, although a major share of the responsibility for the
numerous studies using randomized control achievements, competencies, and career out-
designs, with large and carefully selected sam- comes of their students and graduates. These
ples and with meticulous measurement of critics argue that such requirements impinge
outcomes, have shown clear treatment dif- on academic freedom. Proponents of the CS
ferences for a wide variety of specific clinical model not only believe that such account-
problems. These critics also have argued that ability to empirical methods and evidence is
limiting clinicians’ choices of intervention pro- reasonable; they also believe it is essential to
cedures to those with solid empirical support the integrity and future of the field.
from scientific research precludes consider- Perhaps the most common criticism to con-
ation of other factors believed to be critical front advocates of the CS model involves its
to clinical success, such as personal clinical approach to doctoral training. Specifically,
experience and judgment, commonly accepted critics argue that doctoral training in CS
standards of practice, client culture, training focuses too narrowly on preparing students
history, and nonspecific factors. This view has for careers as research scientists, and thus
received support from the American Psycho- does not prepare them adequately to accept
logical Association Presidential Task Force on independent responsibility for the delivery
Evidence-Based Practice (APA Presidential of clinical services. Clinical scientists see
Task Force on Evidence-Based Practice, 2006), this criticism as a misguided reflection of
which recommended that clinical psycholo- the outdated notion that clinical psycholo-
gists base their practice equally on research gists must make a dichotomous career choice
evidence, clinical experience, and considera- between research science and clinical prac-
tion of client culture. Clinical scientists have tice. Clinical scientists believe that first-rate
responded by noting that the CS model does science training and first-rate application
not rule out consideration of any factors a training are essential to the kinds of roles
priori; it simply asserts that empirical evidence that clinical psychologists will be expected
from controlled research must be the gold to fill in the future. In fact, the goal of doc-
standard for evaluating all claims about the toral training in CS programs is to integrate
value and relevance of any particular factor, the research and applied training so thor-
such as clinical experience or client culture. oughly that all graduates are highly competent
If the research evidence supports the claimed and qualified not only to engage in scien-
value of a given factor, then this factor should tific research but also to deliver the most
be considered when making clinical decisions; cost-effective psychological services. These
otherwise, it should not. In the absence of training goals are articulated explicitly in
such an empirically based criterion for judg- the accreditation criteria of the Psycholog-
ing the legitimacy of claims, all claims would ical Clinical Science Accreditation System
have an equal standing, no claims could be (www.pcsas.org).
discounted, and there could be no progress In sum, proponents of the CS model encour-
toward “truth.” age all clinical psychologists to adopt the CS
CLINICAL SCIENCE MODEL 9

model’s scientific epistemology and commit- psychology: Toward a scientifically principled


ment to accountability for the validity of claims approach to mental and behavioral health care.
and the effectiveness of practices. Indeed, the Psychological Science in the Public Interest, 9,
model’s proponents believe that the future 67–103.
Bootzin, R. R. (2007). Psychological clinical science:
of clinical psychology demands that the field
Why and how we got to where we are. In T. A.
transform itself into a psychological clinical
Treat, R. R. Bootzin, & T. B. Baker (Eds.),
science, thoroughly integrating the elements Psychological clinical science: Papers in honor of
of scientific research, empirically supported Richard M. McFall (pp. 3–28). Mahwah, NJ:
clinical practice, and science-centered educa- Lawrence Erlbaum.
tion. The model’s proponents are convinced McFall, R. M. (1991). Manifesto for a science of
that this transformation is essential to clinical clinical psychology. The Clinical Psychologist, 44,
psychology’s continuing role in the emerging 75–88.
mental and behavioral health-care system of McFall, R. M. (2006). Doctoral training in clinical
the future. Health care in the United States psychology. Annual Review of Clinical
is undergoing a dramatic change. With the Psychology, 2, 21–49.
Oltmanns, T. F., & Krasner, L. (1993). A voice for
advent of managed care, decisions about the
science in clinical psychology: The history of
structure and content of mental and behav-
Section III of Division 12. The Clinical
ioral health care increasingly are driven by Psychologist, 46, 25–32.
evidence regarding cost-effectiveness, rather Wampold, B. F. (2001). The great psychotherapy
than by professional prerogatives and interests. debate: Models, methods, and findings. Mahwah,
Thus, if doctoral-level clinical psychologists NJ: Lawrence Erlbaum.
hope to play a meaningful role in the future Westen, D., Novotny, C. M., & Thompson-Brenner,
health-care system, they must bring something H. (2004). The empirical status of empirically
special. Advocates of the CS model believe clin- supported psychotherapies: Assumptions,
ical psychology’s commitment to a scientific findings, and reporting in controlled clinical
epistemology provides that special quality. trials. Psychological Bulletin, 130, 631–663.

SEE ALSO: Academy of Psychological Clinical Sci- Further Reading


ence (APCS); American Psychological Association
Benjamin, L.T., Jr. (2005). A history of clinical
(APA); Association for Psychological Science (APS);
psychology as a profession in America (and a
Evidence-Based Practice in Psychology; Psychologi-
glimpse at its future), Annual Review of Clinical
cal Clinical Science Accreditation System (PCSAS);
Psychology, 1, 1–30.
Scholar–Practitioner Model; Scientist–Practitioner
Capshew, J. H. (1999). Psychologists on the march:
Gap
Science, practice, and professional identity in
America, 1929–1969. New York: Cambridge
References University Press.
APA Presidential Task Force on Evidence-Based McFall, R.M. (2007). On psychological clinical
Practice (2006). Evidence-based practice in science. In T. A. Treat, R. R. Bootzin, & T. B.
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