Here is my thesis, my text for today if you will: the world needs a profession of psychology, but the version that is currently available is sadly lacking in meeting that need. The hope for a strong, relevant, and robust profession of psychology simply has not yet been met. In my opinion, that is one of the tragedies of our times.

The real tragedy of psychology’s failed promise as a profession is not that it is guided so little by science, for what is truth? Nor that the effectiveness of our treatments is open to question, for what profession does not constantly confront such questions? Nor that charlatans and sham psychologists abound unrepudiated, for when has society ever been free of such? No, our tragedy and great failure is that we know so little about how to help our fellow man and are poorly positioned to apply what we do know. We should be more concerned with how to prevent war, how to deal with poverty, how to cope with racism, and the reduction of human misery than with the truly petty questions that clog the channels of too much of our scholarly discourse. Wrestling with big issues and large-scale solutions gives professions their significance and purpose.

Instead of focusing on the great unknowns of the human condition and how to improve it, we argue over the nature of evidence. Instead of attacking the important human issues with what we have, we first want to convert everyone to the same methods and get rid of anyone who does not think the same way. Instead of conducting ourselves as confident and competent professionals, we obsesses over whether our practitioners have the right attitudes. In need of lightning bolts to illuminate the storm clouds of human misery, we have only lightning bugs! Others may not agree with my conclusions or fault my flowery rhetoric but I am sincere in believing that we psychologists have miserably failed in our social responsibility to build the psychological profession that is so desperately needed. Even if you do not agree with that statement, perhaps we can at least agree that we could do much better. In the time I have available, my hope is to stimulate thinking that is, if not out of the box, at least out of the ruts in which we have been trapped for far too long.

As an insider observer and participant in the development of the profession for the past four decades, it has often seemed to me that we disagree less over what the important human problems are than we do over how we should resolve them. And we disagree about the “how” to such an extent that we never get around to addressing the what --- much like a dysfunctional family that never takes a vacation trip because its members cannot agree on which airline to use!

Today, I plan to point out some of the problems I have with our profession and provide some general ideas of what needs to be done about them. Let me start with some of the ways we keep tripping over our own feet.

A Misguided Emphasis on Science at the Expense of Social Relevance

Let me be clear at the outset that I am not opposed to research or to science. But I am critical of what I believe to be a misplaced emphasis on the nature of truth and on the “correct” methods of investigation. We lack an outward focus on the great issues and the great needs which psychology could and should address. Instead, our focus is inward on the quality of our science and how we know what we know. Our focus on science is sometimes too self-conscious, too self-righteous, and too strident, for our own good. We have a penchant for worrying so much about our scientific legitimacy that we draw overly narrow definitions of science and scientific methods and reach silly conclusions about how to discover truth.

This is not a new habit for psychology. In his presidential address over 60 years ago, Gordon Allport (1940) noted that our discipline’s survival depended on its ability to address society’s needs; which was not happening because of an overemphasis on fidelity to method which, in turn, prevented investigators from adapting research methods to the demand characteristics of the problems:

Methodism as the sole requirement of science means that all the faithful crowd onto a carpet of prayer, . . . Psychology as a science … can be justified only by giving mankind practical control of its destinies, not by squatting happily on a carpet of prayer. (Allport, 1940, p22-23)

A modern version of Allport’s “methodism” may be found in the controversy regarding so-called evidence supported treatments (EST). APA’s Society of Clinical Psychology (Division 12) compiled a list of manualized psychological interventions for specific disorders based on randomized controlled studies [Norcross, p 345 for citations]. Publication of the list brought quick objections from several other APA divisions and individuals, worried about possible misinterpretations or misapplications of such a list.

Understandably dismayed by the shoddy practices and extravagant claims of some clinicians and the perceived failure of organized psychology to forcefully address such unscientific and unprofessional behavior, some scientists inappropriately advocated for the incorporation of EST therapies into accreditation standards and their acceptance as the standard, ethical practices for clinical interventions (cite CPA task force, Lillienfield and Section 3 Presidential address). Some even went so far as to call for professional organizations to impose stiff sanctions, including expulsion if necessary, on clinicians who routinely used interventions and assessment instruments that were deemed devoid of what those scientists deemed a lack of supporting data (Lohr, Fowler, and Lillienfield, 2002).

Not surprisingly, many clinicians objected to what they viewed as an overly narrow definition of research and the assumptions underlying the decision rules, as well as misguided attempt to gain favor with an increasingly discredited managed-care industry by convincing them that psychology was scientifically legitimate. The discussion quickly moved to arguments over definitions of science, what qualifies as research, and the nature of evidence; a debate that continues unabated 10 years after the first list was published and which led to vitriolic attacks of colleagues by their opponents on both sides of the issue.

Division 12, or any other group, has a perfect right to use whatever decision rules it likes with respect to categorizing evidence or acceptable research designs, but suggestions and/or intimations by some that the list be used to evaluate clinical practice, reveals fundamental differences between the views of EST proponents and many other scientists and practitioners. Because I previously discussed the problems I see with such attempts in my presidential address (Fox, 1996), I will only summarize the major points here.
First, the EST list that some would impose on practice is based on an overly narrow definition of science that most practitioners and many scientists would not accept. Restricting evidence to what is demonstrated in randomized, controlled studies ties practice to a definition of science that mimics the physical sciences and leads to a rejection of the very idiographic approaches that clinicians are forced to pursue by the very nature of their work.

Second, if practitioners actually restricted themselves to only those therapeutic approaches that have been scientifically validated, they would be limiting their role to that of a technician (Peterson,). Clinicians rarely face clearly defined problems for which they can prescribe predesigned solutions. Rather, the most common need is for flexible, problem solving solutions for complaints that are not precisely definable and that change with time.

Third, the fact of the matter is that if clinicians restrict themselves to applying only narrowly validated or known techniques; they will never be of much value to society. Lest you think that statement is an invitation to charlatanism, remember that clinicians do not have the luxury to start from what is known. They must start with the needs of the people who come to them and then apply all the knowledge, information and skill they have to help resolve those problems. Of course, professionals must exercise great care not to promise more than they can deliver, but at the same time, they simply cannot settle for doing only those things that we know for sure. Clinicians live in a world of ambiguity and uncertainly. It is their job to use their experience, knowledge and skill to help resolve the problem with which they are confronted, nothing more or less.

The goal of clinicians is to improve the behavioral effectiveness or well being of their clients and the plain fact of the matter is that they now have at their disposal a number of treatments (such as psychotherapy) which lead to behavioral improvement for more than two thirds of their patients. Many widely accepted medical and surgical interventions do not even approach such a success rate.

Fourth, many psychological therapies concerned with transforming the person with the problem are aimed at building on the client’s strengths in order to help them cope more adequately or grow in the face of life’s vicissitudes; goals which are antithetical to one of the stated goals of EST advocates i.e. determining which treatment in what dosage is best for which specific problem. Seligman (2002) neatly stated the dilemma in the following manner:

(The) idea of building buffering strengths, as a curative move in therapy simply does not fit into a framework that believes each patient has a specific disorder; with a specific underlying pathology that will then be relieved by a specific healing technique that remedies deficits (p 23).

All such differences aside, the point is that our primary failure as a profession is not our lack of a solid research base for our interventions. Nor is it our failure to agree on the appropriate research paradigm for assessing treatment effectiveness. No, our true failure is our tendency to argue endlessly over such things without ever addressing the larger social ills that so plague our world today.

We are the science and profession that should be at the center of the action in a society in which at least 7 of the leading causes of death could be substantially reduced if people at risk improved just 5 habits (such as stopping smoking, losing weight, and so on); and in which approximately half of all causes of mortality are linked to social and behavioral factors. To take but one example, the Surgeon General recently announced that obesity has become our nation’s fastest rising public health threat affecting nearly one-third of the adult American population and is more detrimental to health than smoking and alcohol abuse. More than any science and profession on the scene, changing habits and life styles is the essence of our purpose. This is our “stuff!”

Why is psychology not front and center in the minds of our countrymen when the need is so great? Why have we not made addressing these matters our top priority and why are we not on the ramparts in Congress and in the media every day leading the discussion about how to address these pressing matters? Why do we spend our time and energy debating about how best to do science when the world starves for help? How long will it be before we realize that in terms of the survival of a profession, it is our social relevance that is the critical variable?

We still know so very little about the human animal and what makes him tick and some of our scientific colleagues are right about some of our practitioners being an embarrassment to any profession. However, the fact of the matter is that the major social and behavioral problems of people in our age do not include which brand of psychotherapy rests on the most solid scientific base; nor which kind of psychological outcome research has the greatest claim to scientific veracity; nor even whether the managed care industry can be convinced that psychological treatments are effective enough to warrant coverage in health insurance plans. Questions such as these are important to scientists and have great relevance to how the profession develops; but they miss the main point of what makes a profession valuable to any society: addressing the critical issues of importance to that society, whatever they may be. My personal favorite big issues are racism, poverty, hate, and the healing power of human love, but the list will vary from one society to another and from one time to another.

If we hope to flourish and fulfill our own promise, we cannot expect the world to wait indefinitely for what it needs from us while we indulge our fascination with our disciplinary navel lint. We need to be about the larger issues and the big questions befitting the great profession we profess to be: What is the best way to help people develop habits that they know they should practice but have trouble maintaining (sticking to a healthy diet, quitting smoking, exercising regularly, refraining from alcohol and substance abuse, and taking medication appropriately). How do we use our professional relationships and the increasing connectivity of our society to enhance learning, develop more responsible adults, and improve personal relationships? How can we tap the power of the Internet to expand and extend the use of psychological interventions for the 70-100 million Americans who now use the Internet to retrieve health-related information or the 90 % of US families who will have Internet access in less than 10 years (IOM, 2001, p. 31-32)? How do we help people optimize such attributes as trust, love, empathy and responsibility? How do we prevent school and family violence, or prevent war or make marriages last a lifetime or enhance sexual enjoyment? How do we prevent terrorism? The list is endless, and exciting. But this list is not where our profession is currently focused. Your list may differ somewhat from mine, but I am guessing you get the idea. We need to focus on what is important to the world in which we live that falls within our purview and we need to do so in a public, visible manner.

If we want to truly change our focus and become the profession society needs, then I believe we will need to do several things: define ourselves to the world in a more comprehensive and positive manner; develop and use an alternative nomenclature for assessing and altering behavior; and develop a more uniform and appropriate culture for educating the kind of professionals society needs. In the balance of our time, I will address each of these matters.

Failure to Define Ourselves More Comprehensively and Positively

We need to free ourselves from the assumption that the science and profession of psychology are co-extensive. The science of psychology is very broad encompassing both human and animal behavior as well as many other areas of scant relevance to professional practice. Contrarily, the profession must deal with practical problems in living that are of only marginal interest or relevance to large segments of psychological science. The area of need defines professions, not their underlying science or sciences (which they never the less most assuredly must have). Medicine meets society’s need for a profession that is concerned with society’s needs to deal with illness, disease and injury. The profession of psychology should be identified as dealing with the area of human need that our science attempts to understand: the problems of human experience and behavior, especially purposive, motivated behavior and how to enhance it. The profession is concerned with those human problems arising out of or associated with purposive behavior which is at least potentially understandable and solvable through adequate knowledge in psychology. I have proposed the following definition which is almost identical with those adopted by several schools of professional psychology:

Professional psychology is that profession which is concerned with enhancing well-being and the effectiveness of human functioning. A professional psychologist is one who has expertise in the development and application of quality services to the public in a controlled, organized, effective manner, based upon psychological knowledge, attitudes and skills in order to enhance the human experience.

This definition is for the professional field of practitioner psychology --- for the kinds of activities that require public regulation in the same sense that such professions as medicine and dentistry are regulated. It is not intended to apply to other activities such as teaching or research, which from certain perspectives could also be called “professional psychology.”

To repeat: practitioner professions are identified by the field of need they serve, not by the technology or defined knowledge base in terms of which they function. Medicine, for example, is concerned with all human problems of illness, whether or not there is an adequate knowledge base to understand, or the technology to effectively treat, such illnesses. Cancer was considered a problem for medical practitioners long before physicians knew what caused it or anything about how to cure it. Similarly, professional psychology should be defined as the profession dealing with the problems of coping effectiveness and the full range of human experience, even though we do not understand the disruptions of many patterns of behavior or the effective change processes that would correct such suffering. It is the area of need we fill that makes us of value to society; and while that is closely tied to the understanding generated by our underlying science, the science and the profession are not the same things and the differences are critical, not casual.

The failures to understand the differences have led to some unfortunate comparisons and inappropriate criticisms of practice. McFall (2002), for example, uses the following quote from Rotter (1971) to bolster his criticism:

Most clinical psychologists I know would be outraged to discover that the Food and Drug Administration allowed a new drug on the market without sufficient testing, not only of its efficacy to cure or relieve symptoms, but also of its short term side effects and the long term effects of continued use. Many of these same psychologists, however, do not see anything unethical about offering services to the public—whether billed as a growth experience or as a therapeutic one—which could not conceivably meet these same criteria. (See McFall in Div 42 file for reference)

The comparison works well with respect to the prescribing of medicines in many, but no means all, instances but it is not an appropriate model for governing our profession -- or even medicine, for that matter. The argument, as Mark Twain said of Wagner’s music, is not as good as it sounds. Rotter’s comparison fails to account for physicians who do their best to relieve pain and suffering for conditions they do not yet understand and which they cannot alleviate or cure. How does the his idealized view of medicine rationalize the prescribing of aspirin for pain for many years before physicians understood the mechanisms by which it worked, or even for their sometimes using older, less effective treatments because their experience showed that the old ones were just as effective with certain patients? Some of the arguments used to bolster the case for regulating and governing psychological practice are overly simplistic and reveal a lack of understanding of the different realities in which scientists and professionals, of perforce, operate and they sometimes draw on comparisons with an overly idealistic view of medicine.

The same lack of understanding often comes up in debates regarding expansions in the boundaries of our practice. As an active participant in APA governance debates and discussions for the past 40 years, I have heard colleagues oppose psychologists practicing psychotherapy because it would be practicing medicine. Some opposed the passage of freedom of choice legislation giving us access to insurance reimbursement and changing hospital regulations to allow psychologists to practice as independent providers because it would medicalize the profession. Recently, such arguments have re-surfaced with respect to efforts to secure prescription privileges for appropriately trained and credentialed psychologists (e.g. Beutler, 2002).

A group of psychologists co-signed a full-page ad in the Albuquerque Journal (Friday, March 1, 2002, pA6) with several medical/psychiatric groups opposing a pending bill to grant psychologist prescriptive privileges arguing that psychologists are not physicians and that there is no substitute for a medical education. The supreme irony is that such critics have themselves bought into medicine’s arguments with respect to the how our profession should be defined while criticizing clinicians for embracing a medical model! They might take note of the recent US Supreme Court Case decision accepting psychology’s word, over that of psychiatry, regarding the appropriate use of psychotropic medication in the Sell case.

Psychologists who favor prescription privileges, and I am one of them, have no desire to practice medicine without going to medical school. However, they do insist that they be allowed to practice psychology without going to medical school! Prescribing has not been the sole province of medicine for many years. Nurses, pharmacists, optometrists, physician assistants, and podiatrists all prescribe in some, if not all, states. Medicine has opposed all of these incursions as posing great risks to the public health, though they have never demonstrated that the predicted declines in public health were ever realized with the success of other professions.

Sometimes I think that my colleagues are not aware of how much of what we do as both a science and a profession overlaps with medicine even though we are a very different profession. The content areas and themes of psychology listed by the Encyclopedia of Psychology (Vol I, pp xii-xiii) include not only the traditional clinical areas of assessment, adjustment and dysfunction, and intervention, but also such areas as:

• Biological and cognitive processes (including biological systems, sensory processes, perception, learning, memory, cognition, language, communication, emotions)
• Personal, interpersonal and social processes (including personality, self, identity, social cognition, interpersonal perception, intelligence, sex and gender, attitudes and attitude change, attraction and close relationships, group and intergroup processes)
• Interactive systems and contacts (including the family, school, work and employment, community and neighborhood, and person-machine and person-environment interactions)
• Development across the life span (including key biological and psychosocial processes and development from infancy through late adulthood)
• Cultural and cross-cultural psychology (including key theories and issues and areas of research and ethno cultural groups and traditions)

Each of these areas of our discipline has both scientific and applied implications for a comprehensive view of health. Arguments that we should not pursue any one of these areas because they impinge on the practice of medicine or because doing so “medicalizes” our profession, fail to understand the comprehensive nature of the profession. Psychology is much broader than “health” but it certainly encompasses health. Similarly, we are not simply health providers when we attempt to alleviate suffering and dysfunctional habits, but what we do often overlaps or even duplicates some of what other health providers might do to address the same situation. More importantly, we have the capacity to effect such fundamental changes in the troubled persons and systems that we often enhance their health and well-being along the way.

Failure to Develop A Better, More Relevant Classification System

In my opinion, we would take a giant step toward becoming the profession that I believe society needs if we would create a viable alternative to the current medical systems for the classification of illnesses and diseases. I am not opposed to the currently available nomenclatures. They provide a valuable function, as far as they go. But that is the exact point, isn’t it? The popular DSM, for example, does not go far enough, and is based on medical, not psychological, science. The fact that consumers want something different is clearly shown in the establishment of the NIH National Center for Complementary and Alternative Medicine whose budget request for next year tops $116 million.

What is needed is an alternative way of viewing bodily conditions, one that focuses less on the illness and more on the person who has the illness. We need a nomenclature that addresses the positive, adaptive personal and emotional characteristics that influence the predicted course and consequences of an illness or disability.

In one sense, our critics are correct when they chastise us clinicians for embracing a medical model and giving up our uniqueness with claims that we can provide many of the same services as psychiatrists but with less fuss and expense. Truth be told, we clinicians have often used such arguments with legislators, administrators and insurance executives when seeking parity with psychiatrists. I have made these and similar arguments many times myself, with some success I might add. But in terms of the bigger picture and what we really need to be about as a profession, such arguments are wrong. We are psychologists. We need to promote a different, psychological approach that is grounded in our discipline and science and the verities of the human experience. We must provide a different approach that offers added value to society. We can do better than aspire to be the racket that imitates the racket that is called psychiatry (Szasz).

Let’s look at just one of hundreds of examples of the “extra” that a psychological perspective could bring to the table. Heart attack victims, as I know from personal experience, are counseled by their physicians to make certain life styles changes in their diet and exercise routines while also getting regular check-ups and taking various medications. Taken together, these changes can substantially reduce the risk of future attacks. These matters are well known and psychology has a role to play in helping patients with changing their habits and life styles, or their treatment compliance if you will. The treatment works to help prevent future attacks. It is one of the advances for which modern medicine justifiably takes pride. We are a part of that system and can even get reimbursed for such services nowadays. Everything that is done is based on an illness driven approach and it works pretty well. The problem is that it does not go far enough because it doe not address the psychosocial aspects of the problem and they may be critical.

Such factors as the ability to manage stress, or reduce hostility, or enhance the healing effects of marital and familial support, or maintain a positive attitude, or capitalize on the mediating influence of religion all play a major role in the prevention and recovery from heart attacks, but they are not incorporated into the disease model. I have had a heart attack and I was treated in one of the leading hospitals in the country by a world-renowned cardiologist. None of the factors mentioned was included in the assessment and rehabilitation program that I was given. I am not complaining. From what I understand, I received state of the art medical treatment and I have had no recurrences. But none of the mediating factors mentioned above were included in my rehabilitation, although they should be included routinely. In my opinion, this is unlikely to happen without the leadership of psychology. If we are to get serious about building a real, significant and socially needed profession, then we should make it happen.

An alternative classification system of the sort I believe is needed would focus on key “functional” behaviors that are missing or disrupted and on the methods for restoring those “functions” for optimal performance. In such an approach, psychological interventions would be oriented more toward the strengths and positive emotions that lend substance to life and act as critical buffers against various illnesses and diseases and or help mediate and reverse their effects than on curing or correcting illnesses or disease processes. Psychology has the goods, so to speak, to offer society a positive, classification system that focuses on human strengths and emotional assets and aims to help unleash the real stuff of human potential. Seligman (2001) has already framed the challenge for science and, by implication, for our profession:

Can there be a psychological science that is about the best things in life: Can there be a classification of the strengths and virtues that make life worth living? Can parents and teachers use this science to raise strong, resilient children ready to take their place in a world in which more opportunities for fulfillment are available? Can adults teach themselves better ways to happiness and fulfillment? (p 29)

Our answer has to be yes. The world is waiting to get started but it needs the roadmap that we could provide about how to get there. The world actually needs an alternative way to classify, understand, enhance, and sometimes change, behavior.

Failure to Provide the Right Educational Home for Professional Education and Training

In addition to focusing out attention outward on the larger social problems, defining ourselves more comprehensively and relevantly, and developing a psychological approach to classifying human problems, we need to address some basic issues with our current methods of educating and socializing our students into the profession.

I do not think that we will be truly accepted as an important, major profession until we can produce graduates who are readily identifiable by their degree, which are seen as having mastered particular knowledge, attitudes and skills, and who are trained in publicly visible institutions dedicated to serving important human needs. Although there is much to admire about the current system, the quality and productivity of the faculty, and intellectual potential of the students, I believe that we are far from meeting those requirements because we do not uniformly train our students in professional school environments granting a professional degree.

Differing degrees. Most of our practitioners are not readily identifiable as psychologists by virtue of the degree they hold. Less than 15% of our training programs award a degree that is unique to psychology: the PsyD. The vast majority award PhD or EdD degrees that are shared with many other disciplines and have no unique relationship to the profession of psychology. Our practitioners are not visible to the public eye as psychologists when they are listed by name and degree. To put it simply, this means we miss a lot opportunities to register our profession in the public conscious. Such public visibility and public awareness may not be of great import to professors and scientists, but professions need to be noticed and known to the community in which they practice. Having people recognize who they are and what they do immediately on reading the degree is a decided plus in the public market place.

Predictable knowledge base. We do not produce graduates whose mastery of the same knowledge base and clinical skills can be considered as similar as what one might generally expect for a profession. Although all of our practitioners graduate from accredited programs, the accreditation standards allow very wide latitude with respect to academic content and clinical skill instruction. Far more latitude, I believe, than what is the case with, for example, medicine. I base my conclusion on my experience as faculty member in three medical schools and four psychology programs that were accredited, as a veteran accreditation site visitor, and as one who has participated in the recruiting and hiring of many dozens of new graduates in both professions.

The greater variability in knowledge and clinical skill sets among psychology graduates is in large part the result of the different cultures of the programs in which they were trained. Some are trained in graduate school environments; others are trained in professional school environments. The cultural differences between the two are important. For example, graduate faculties eschew facile applications of knowledge and are likely to proceed cautiously when exploring new issues or new situation. A major concern in this culture is the avoidance of claims that something is true when, in fact, it is not true. Professional faculties, on the other hand, constantly look for newer, better, more cost effective practices to address the problems presented by patients or clients. Their approach to new of different treatments tends to be pragmatic and heavily dependent on clinical experience. The needs of clients rather than the dictates of science shape their behavior. Both orientations are important and one is not inherently superior to the other. Each of them had its advantages and disadvantages.

Our attempt to train individuals who are comfortable in both cultures has not been very successful, in my opinion. And that is predictable. Our own vocational interest research has consistently shown that the two cultural interests converge only very, very rarely in the real world. Persons of these two orientations have interest patterns and ways of being that are quite different from each other. Can anyone seriously question that the effects of training in an environment dominated by one of these attitudes versus the other will produce very different kinds of students?

Another important difference in training cultures is that graduate faculties are fierce guardians of their absolute right to determine what is taught and to certify the competence of graduates. They rightly resist all efforts by external bodies (be they licensing boards or accreditation organizations) to dictate what must be taught or which interfere in any way, shape or form with matters that should be the exclusive purview of faculty. Professional faculty, on the other hand, tend to favor such ideas as “core” or required curricula because they: help insure the eligibility of their graduates for licensure in all state jurisdictions, provide a public record of the knowledge which members of the profession have mastered, and assure their students that their education is sanctioned by both the profession and state licensing agencies and that are essential to good practice.

Visible Training Centers. Finally, we do not train our students in visible institutions dedicated to addressing the important human needs served by our profession. Unlike Schools of Medicine, or Dentistry, or Law, or Nursing, or even Veterinary Medicine, our students are trained in settings that are virtually invisible to the public (i.e. departments, divisions or centers) because they are embedded in larger organizational entities. Nor are our programs affiliated with large, comprehensive treatment and research institutions through which the profession serves the public and in which students gain hands on experience. Psychology needs to develop a system of comprehensive service centers that are affiliated with our training programs and dedicated to helping people cope more effectively with life, develop more of their potential, and recover functions that were lost or never developed. We need centers that are funded generously, partly by public funds. Although it is not their most important attribute, it is not irrelevant that our centers also should be large and visible --- not the sort of thing that can be located in the basement, or a back wing, or a few rooms of something else as envisioned by George Albee 40 years ago. That vision, or something very much like it, still is very much needed. Our profession needs it, and society needs it.

Conclusion

In summary, I believe that the current version of professional psychology in the U.S. is woefully deficient in its ability to meet the needs of society and achieve the status to which it should rightly aspire. I believe that psychology itself has contributed to this state of affairs by both deliberate and inadvertent actions that together have created a professional culture that serves the needs neither of the profession nor of society.
If we want to be serious about building a real profession psychology, we will need to do several things, including the following:

1. We must focus our energy, resources and training on the resolution of those human problems that are of primary concern to society.
2. We need to forge a professional identity that is tied in the public mind to the field of human need we serve.
3. We must develop a classification system of human behavior (and their attendant psychological interventions) that is not tied to illness or disease.
4. We must train ourselves in visible educational systems that are focused on the resolutions of human problems in living and which grant a professional degree that is unique to our profession.

Bits and pieces of this agenda have been accomplished already. Now we need to put those pieces together into a coherent whole and make ourselves into the profession that society needs. The need is apparent and our ability to meet it is manifest. All that remains is the will to get started.