By Ben Welter
In a front-page story more than 50 years ago, the Minneapolis Tribune’s Victor Cohn introduced readers to the new field of clinical psychology. The story’s single source, an associate professor of psychology at the University of Minnesota named William Schofield, enjoyed a distinguished academic career spanning 40 years. The reporter went on to enjoy a similarly distinguished career as a writer and editor at the Washington Post. Schofield, who retired in 1988, leads an active life in Minneapolis. An update follows the article.
‘NEW KIND OF DOCTOR’
He Works for Order
In Confused Minds
By VICTOR COHN
Minneapolis Tribune Staff Writer
|Dr. William Schofield in 1952.|
“A man comes in and says, ‘I’m miserable. I’m fed up. I want help.’
“We try valiantly for months to make the least change in him, the least dent. And we realize how hard it is.
“When it comes to understanding and controlling human behavior, the amount of ignorance is appalling.”
THE SPEAKER was a new kind of doctor of the mind – a clinical psychologist.
His job is to help bring relief to the depressed and troubled. But it is also to learn, to measure, to gradually bring some order where ignorance prevails.
Let’s meet a clinical psychologist. Let’s ask, “What’s the difference between a psychologist and a psychiatrist?”
Let’s meet Dr. William Schofield, 33, associate professor of psychology at the University of Minnesota, sixth floor, Mayo Memorial medical center.
“A PSYCHIATRIST is an M.D. with special training to diagnose and treat abnormal behavior,” he says.
“A clinical psychologist is not a doctor of medicine at all, but a specialist in the science of behavior applied in the same setting – the psychiatric clinic or hospital.
“He’s part of the psychiatric team – social worker, psychologist, psychiatrist.
“You go to the psychiatric clinic. A social worker talks to you, takes a history and looks into your family and work situations.
“Then a clinical psychologists sees your file before he gives you some psychological tests and uses some other diagnostic tools.
“Intelligence tests. The Minnesota multiphasic personality inventory, the most widely used test of its kind in the country.
|Hermann Rorschach, a Swiss psychiatrist, developed the inkblot test in the early 20th century. Is this a clown mask, or a jowly man — or a copyrighted image I shouldn’t have messed with?|
“A Rorschach sometimes, asking you to analyze a set of ink blots.
“THEN YOU SEE a psychiatrist. And the team confers. Should you be hospitalized? It asks. Or come in for weekly treatment – therapeutic interviews with psychiatrist, clinical psychologist or psychiatric social worker.
“We cannot cure everyone, but we can help many people adjust to the life they must lead.”
There are many kinds of psychologists – experimental, industrial, social, animal, educational, counseling and guidance. Most have been well established for years, but the clinical psychologist was a rare bird before World War II:
Then mental casualties flooded army hospitals, and psychiatrists screamed for help. Quick, intensive training was given psychologists of many backgrounds.
AFTER THE WAR the clinical psychologist rapidly multiplied. Today there is no good mental hospital or clinic that does not include him.
In many state mental hospitals, including some of Minnesota’s, he is almost solely responsible for mental treatment – psychotherapy, group and individual. In these hospitals psychiatrists are few or completely absent.
Like any young science, psychology is trailed by fringe followers and quacks – self-styled “advice counselors,” bump feelers, handwriting analysts and assorted healers.
|This one’s easy: A small dog diving into a mud puddle.|
In 1951 the Minnesota legislature passed a certification law entitling working psychologists with at least a master’s degree and respectable university training to display a certificate saying, “Certified Psychologist.” A display of such a certificate is the public’s protection.
Some 300 were certified right off the bat. New psychologists must now take a state exam.
PSYCHOLOGISTS with a Ph.D. degree and at least five years’ experience, who can get by three days of written and practical exams, also are certified now by an American Board of Examiners in Professional Psychology. It is frankly patterned after the boards that now certify medical specialists.
Older, qualified psychologists were blanketed in here too. A few months ago the university’s Schofield became the first clinical psychologist in Minnesota to be so certified by examination.
We are going to be increasingly dependent on this type of man to put mental treatment on a scientific basis.
Finding out why some methods – say electric-shock – work on some patients and not others is among Schofield’s research fields. The clinical psychologist is trained to construct tests and evaluate treatment.
We are going to be increasingly dependent on [t]his type of psychologist when members of our society break down.
A simple-spoken, serious Dr. Schofield has been on the witness stand at Minnesota murderers’ trials, testifying whether their test-behavior seemed normal or not.
We are going to be increasingly dependent on all the members of the psychiatric team to help us all with our everyday troubles.
March 2006 update: I sat down for an interview with Bill Schofield, now 84, at the teak dining table in his neatly appointed apartment in Minneapolis last week. Eighteen years into retirement, the former University of Minnesota psychology professor had reviewed the questions I’d sent him and was well prepared to discuss how his field had changed over the past half-century. He had exchanged e-mails with former colleagues still in the field and pored over recent literature to address such topics as:
Dr. William Schofield in 2006.
How has the certification and licensing process changed? Slowly, it turns out. “One of the reasons it took so long to develop licensing programs was fear from the medical community that psychologists would be practicing medicine,” Schofield said. Psychiatrists and physicians worried that patients under the care of a psychologist would avoid seeking medical treatment for underlying medical problems, and that state laws would not be uniform and stringent.
For a brief period, Minnesota had only a certification process, but eventually the Legislature approved a licensing standard. Not until 1977, when Missouri took the plunge, did all states require licensing for psychologists. A national register of licensed psychologists was first published in 1975. It was developed partly in response to the health insurance industry’s reluctance to cover psychological services, he said.
Treatment costs: Schofield was unable to recall how much a typical psychologist would have charged in the mid-1950s. He said he never charged more than $75 an hour for the part-time clinical work he performed throughout his career, seeing about three to five patients a week over a 40-year period.
The Minnesota Multiphasic Personality Inventory, in use since 1942, has been translated into more than 30 languages, including … what is this, Danish?
But he had plenty of current data to share. For example, the Medicare reimbursement rate for testing by a psychologist in 2006 is about $92 an hour; the rate for such testing by a technician ranges from $24.60 to $42.33 an hour; the rate for testing by computer runs about $25 an hour, including time for the psychologist’s interpretation and reporting. Insurance rates are in line with those set by Medicare. Private psychologists, of course, can and do charge more; patients pay the difference.
Diagnostic tools: The 1955 article noted the use of the Minnesota Multiphasic Personality Inventory, Rorschach inkblots, intelligence tests and interviews. What tools are different now? “I don’t know of anything that’s new in the field of clinical psychology that pertains to testing,” he said. One major change is the widespread use of paraprofessionals and computers.
We chatted at length on such dry topics before moving on to personal matters. What’s Dr. Schofield up to now? “A little bit of everything,” he said. He and his wife, Gerri, have been married 60 years; they have two children and five grandchildren. A granddaughter studying at the University of Minnesota meets him for dinner regularly. His wife lives in a nursing home a few miles away; he visits her every other day.
He manages the bird sanctuary at his apartment complex, directing the work of volunteers and making sure there’s enough birdseed and suet on hand. He also helps out with the pantry at the complex, and he’s on the board of directors. He teaches a couple of adult-education courses a year; he just finished a class on “the principles of mental hygiene.” And he plays table tennis regularly at the complex: “There are two gals that beat me regularly, so I’m the third best here. It’s fun.”
What does he miss most since retiring? “Not a thing,” he said, but quickly added: “I do miss seeing patients.” He specialized in “short-term, intensive psychotherapy,” treating most clients weekly for up to 10 weeks.
A few patients required treatment lasting months or even years, but he resolved one case in a little over an hour. Without giving away too much detail, he described treating a local radio announcer who woke up one morning unable to speak “and of course he was hysterical.” The man’s boss referred him to Dr. Schofield, who diagnosed the problem as “hysterical aphonia” and was able to treat him successfully in a single session.
The 1955 article mentioned quacks on the fringes of clinical psychology: “self-styled ‘advice counselors,’ bump feelers, handwriting analysts and assorted healers.” One last question for the retired professor: Who’s on the fringes of psychology today?
“Dr. Phil,” he said, without hesitation, his eyes wrinkling into a smile. “You know Dr. Phil? And Oprah. And Judge Judy. They all mean well – and do well within limits, but …” His voice trailed off, and the smile faded as he moved on to a related concern. “Pastoral counseling is extremely important,” he said, “but frequently the training is not meaningfully integrated with a pastoral context.”