Some ruminations on the validation of clinical procedures.

It is becoming almost a cliché to say that “clinical psychology is in a state of ferment,” a remark which is ambiguous as to whether the “ferment” is a healthy or pathological condition. Dr. E. Lowell Kelly finds upon follow-up that about 40 per cent of the young clinicians who were studied in the early days of the Veterans’ Administration training programme now state that they would not go into clinical psychology if they had it to do over again (personal communication). In recent textbooks, such as Garfield’s, one can detect a note of apology or defensiveness which was not apparent even a decade ago (13, pp. vi, 28, 88, 97, 101, 109, 116, 152, 168, 451, and passim). No doubt economic and sociological factors, having little to do with the substance of clinical psychology, contribute in some measure to this state of mind within the profession. But I believe that there are also deeper reasons, involving the perception by many clinicians of the sad state of the science and art which we are trying to practise (17). The main function of the clinical psychologist is psychodiagnosis; and the statistics indicate that, while the proportion of his time spent in this activity has tended to decrease in favour of therapy, it nevertheless continues to occupy the largest part of his working day. Psychodiagnosis was the original basis upon which the profession became accepted as ancillary to psychiatry, and it is still thought of in most quarters as our distinctive contribution to the handling of a patient. One is therefore disturbed to note the alacrity with which many psychologists move out of psychodiagnosis when it becomes feasible for them to do so. I want to suggest that this is only partly because of the even higher valence of competing activities, and that it springs also from an awareness, often vague and warded off, that our diagnostic instruments are not very powerful. In this paper I want to devote myself entirely to this problem, and specifically to problems of validity in the area broadly labeled “personality assessment.” I have chosen the word “ruminations” in my title. It helps from time to time for us to go back to the beginning and to formulate just what we are