TOWARDS AN INTERNATIONAL PROFESSION OF CLINICAL PSYCHOLOGY: AN ANGLO-SWEDISH PERSPECTIVE

Previous reviews of the international trends in the development of clinical psychology as a profession have identified the United Kingdom and the Nordic States as countries where the role of the psychologist is approximating that in North America. The article presents a review of the historical and current influences on the development of clinical psychology in the United Kingdom and in Sweden. In Europe, where clinical psychology is mainly a Health Service profession rather than a private practice, independence of the management and medical responsibility of the psychiatrist has become more of a key issue. Of the two major ‘schools’ of clinical psychology, identified in Britain with the behavioral approach of the Maudsley Institute of Psychiatry and the psychodynamic approach of the Tavistock Clinic, the behavioral school tended to dominate in Britain until the 1970s. In Sweden, the psychodynamic approach importing many of the aspects of British Object Relations Theory, gained ascendence. This resulted in a split between the more academic form of clinical psychology in Sweden, which had produced research of international importance (e.g. the role of psychological factors in stress-related illness), and professional education in psychology with its emphasis on psychotherapeutic training. Whereas in Britain, during the 1970s, clinical psychology broke away from psychiatry, became more eclectic, and entered the general medical and health areas, these changes failed to take place in Sweden. On the other hand, private practice amongst psychologists in Sweden has shown a dramatic increase during recent years and there are now some clear trends towards eclecticism in the education of psychologists. The issue of medical responsibility remains unresolved in Sweden. That British clinical psychology has reached more progressive and cordial professional relationships in this respect may be, in part, due to the status of the scientist-practitioner role that the initial behavioral emphasis achieved. The major contributions of and trends in British and Swedish clinical psychology are discussed with a view to identifying international trends.