A look at the profession: then and now

Psychology has been around since the time of ancient Greek, Egyptian, Chinese and Indian civilizations. In the ensuing years, the profession has evolved into a field with numerous notable figures, significant discoveries, various subspecialties and an array of treatment interventions. In the last 50 years, the discipline has continued to progress and grow thanks to curriculum changes, more opportunities for hands-on practice and publication and the prevalence of technology.

When Ethan Pollack, Ph.D., faculty member at the Massachusetts School of Professional Psychology and partner and founder of private, group practice Needham Psychotherapy Associates, received his doctorate in 1968, he deviated from the expected career path at that time. In the ‘60s, students were expected to land teaching jobs following graduation, Pollack reports. “My training was primarily, almost exclusively, in the department of psychology in a traditional setting. We were expected to be scientists first and practitioners second,” he says, noting that most faculty when he was in school did not actively practice, while today at MSPP where Pollack teaches, all faculty are practitioners.

Although the scientific aspect of his education “scared the living hell out of me,” Pollack appreciates learning the historical context of the profession. “Students today don’t have that. But they are far better prepared to engage in clinical psychology. We got clinical training late in our schooling,” he says. “My cohort was on the cusp of rapid explosion of clinical practice in the ‘70s.”

Private practices were also rare when Pollack and a colleague opened their group practice in Needham in late 1974. “The city had a population of about 20,000 and seven or eight practitioners in the community. We were the only full time practice. Now, Needham must have 50 or 60 minimum,” he says.

Martin J. Fino, Ph.D., 67-year old clinical psychologist in Ludlow, Vermont, gained early experience in the military after graduating as a 2nd Lieutenant in the Air Force through the ROTC program at Notre Dame University. During his deferment, he earned his doctorate from Kent State University in Ohio in 1973 and then served as a staff psychologist at Chanute Air Force Base in Illinois and as chief of the mental health clinic at Royal Air Force Base Bentwaters in England. “I was working with 10 physicians, five dentists and optometrists. It was very collegial,” he says.

Upon discharge, Fino worked in the outpatient department at Bay State Medical Center in Springfield for three years before opening a private practice in the same city and then moving the practice to Rutland, Vermont in 2000. His experiences in the military as well as the stint at the medical center steered him toward psychophysiological issues.

Now semi-retired, he keeps his hand in the profession by doing Social Security evaluations and also helped process the backlog of veterans’ disability claims for the Veterans Administration in Prescott, Arizona.

Some recently graduated psychologists are quickly achieving leadership positions in the field. In the short span since he graduated from MSPP in 2008, David S. Stein, Psy.D, attending psychologist and faculty member at the Development Medicine Center at Children’s Hospital in Boston, has realized his goal of becoming a pediatric psychologist. He has been doing neuropsychological testing and behavioral therapy with special populations, including children with Down syndrome, learning disabilities, attention deficit hyperactive disorder, and autism.

Stein is also co-director for the Down Syndrome Project at Children’s and oversees research efforts with the help of a senior neurologist. “I’m also the director of Quality Improvement for pediatric psychology,” he says.

Stein will have an opportunity to engage in research on applied behavioral analysis and neurodevelopment in preschoolers, thanks to a four-year grant that the Down Syndrome Program’s research team was recently awarded. “We will see if we can boost development in children with Down syndrome,” he says. The study is currently preparing for recruitment and will begin in the next few months.

Technology has changed the way Stein and his classmates practice. “Everything is done on the computer now. I have many apps for scoring neuropsychological tests. I dictate all reports using Dragon (a speech-recognition program) and use Excel spreadsheets for scoring test results. We do online billing and get quality metrics online,” he says. “In school, technology made a big difference. I could get access to journals and literature online. During my fourth and fifth years when I was writing my dissertation, I had access to the Harvard library through internships at Cambridge Hospital. I did not have to go to a physical library.”

This trend reflects a major difference, says 72-year old Pollack, an admitted “digital immigrant,” whose early practice was totally devoid of technology. “Everything was done with paper and pencil,” he says.

Like Stein, Michele A. Fouts, MA, has worked mainly with children, particularly those who have autism or developmental disabilities as a result of trauma and neglect, after earning her master’s degree in psychology from St. Michael’s College in Colchester, Vermont and becoming licensed in 2006. Her experiences with what she calls “a fragmented system” prompted her to found and direct the Dynamic Engagement Institute at the Sapphire Center in New Haven, Vermont. “I wanted to create one system outside all the bureaucracies. So I provide one set of staff that is highly trained in a number of disciplines. This reduces the number of transitions for the child and family,” she says.

In addition to serving as program administrator, Fouts counsels children and their parents, trains and supervises doctoral students, works part-time for Head Start and has a small private practice.

Fouts joined the Vermont Psychological Association and the Vermont Association of Psychoanalytic Studies. “Once you’re on your own, carrying the precious gift of the well-being and health of clients on your shoulders, isolation becomes a big part of the work. You have community when you belong to VPA or some other organization. It’s a great source of connection and inspiration,” she says.

Pollack encourages new psychologists to join professional associations. “Without the efforts of these organizations and those who support them, we’d be in a more difficult position. They advocate for the profession,” he says.

Fino suggests newly licensed psychologists in private practice find opportunities to socialize. “I would encourage anyone in private practice to have an informal way of collaborating,” he says.

Fouts adds that those entering the field should “put intense energy into continuing to learn.” She says, “In graduate school, you are saturated in knowledge and feel you’ve got it, but then you’re in the real world and not in that ivory tower.”