The Deeds of the Dirty Dozen
Review of The Practice of Psychology: The Battle for Professionalism edited by R. H. Wright and N. A. Cummings
Great revolutions have great leaders who attempt to steer the process of social transformation. Their names are known to all history buffs. America had Jefferson, Hancock, and Adams; France had Danton, Robespierre, and Saint-Just; Russia had Lenin, Trotsky, and Stalin.
Clinical psychology has undergone its own revolution, but its leaders are far from household names-at least outside certain professional circles. Their relative anonymity notwithstanding, 14 men, who call themselves "The Dirty Dozen," have managed to transform clinical psychology. The reference to dirt in their name underscores their willingness to engage in political activism and "all sorts of 'psychologically unseemly acts'" (Wright, p. 2) to advance the professional and financial interests of practicing clinical psychologists. A recent citation honoring these men highlights their achievement: "Once scorned and confronted by seemingly insurmountable odds, the following fourteen professional psychologists, affectionately called The Dirty Dozen, changed for all time the face of the American Psychological Association" (quoted in Wright & Cummings, 2001, p. 270). 
The Practice of Psychology: The Battle for Professionalism tells the story of the Dirty Dozen. The purpose of the book is to provide a frank, unvarnished account of how they acquired control of the American Psychological Association (APA) in their efforts to "professionalize" clinical psychology over the past 30 years. Coedited by two members of the group, it comprises eight chapters: Rogers Wright on the history of the Dirty Dozen; Nicholas Cummings on the rise of free-standing professional schools of clinical psychology; Ronald Fox on the impact of the Dirty Dozen on the APA; Mathilda Canter on the history of APA's Division of Psychotherapy; Jack Wiggins on the history of reimbursement for psychological services; Stanley Moldawsky on heirs to the Dirty Dozen; plus two short personal memoirs written by two members of the group (Theodore Blau and Melvin Gravitz). The volume concludes with appendices that reprint citations honoring the Dirty Dozen, plus a gallery of their photographic portraits.
As the contributors to this volume tell it, the story of the Dirty Dozen's triumph over adversity goes something like this: The APA had long been dominated by ivory-tower academic psychologists whose attitudes toward professional psychology ranged from benign neglect to outright contempt. Accordingly, graduate training in APA-approved clinical psychology programs was biased toward scientific research, thereby failing to prepare students for careers in psychotherapy. Oblivious to the politics of the healthcare marketplace, the APA's academic leaders also failed to lobby Congress in defense of private practitioners who were struggling to compete against psychiatrists and social workers for healthcare dollars.
In response to these crises, the Dirty Dozen organized to defend the economic and professional interests of clinical psychologists. Rejecting the scientist/practitioner model of training as wholly inadequate to meet the needs of aspiring psychotherapists, several members launched free-standing proprietary schools of clinical psychology. The Dirty Dozen acquired control of state associations and eventually the APA itself. Politically astute, its members tirelessly lobbied Congress and other governmental agencies in their efforts to advance the interests of private practitioners. A longstanding goal of the Dirty Dozen has been to acquire prescription privileges for clinical psychologists.
Ironically, the Dirty Dozen's attempt to professionalize clinical psychology differs in two important ways from how physicians professionalized medicine during the early decades of the 20th century (Starr, 1982, pp. 112-127). Medicine established itself as a legitimate profession by strengthening the connection between basic science and clinical practice, whereas the Dirty Dozen repudiate the scientist/practitioner model. Unfortunately, their gambit may ultimately undermine the professional status of clinical psychology. A profession requires epistemic authority for its survival (Freidson, 2001, pp. 152-176). Societal recognition of a profession rests on the claim that its practitioners possess expertise unavailable to those outside the profession. If the self-described leaders of clinical psychology sever its connection with science, they will destroy the field by cutting it off from its source of epistemic authority. A professional psychology divorced from basic science will cease to command the allegiance of consumers, Congress, or the public at large.
Also, as medicine became more professionalized, many free-standing medical schools disappeared (Starr, 1982, p. 118). Unlike university-based programs, such as those at Harvard and Johns Hopkins, many proprietary schools lacked funds for establishing laboratories, libraries, and other essentials of modern medical education. As the training of physicians became upgraded, scientifically weak proprietary schools disappeared. Ironically, members of the Dirty Dozen have been among the most enthusiastic proponents of proprietary schools for training clinical psychologists.
Perhaps because the Dirty Dozen have been so successful, the tone of this book is often smug and self-congratulatory. Clinical psychologists who do not celebrate the liberation of practice from science will find it very depressing to read. Nevertheless, The Practice of Psychology is informative, eye-opening, and essential reading for anyone interested in what has happened to our field.
- The members of the Dirty Dozen are Theodore F. Blau (deceased), Nicholas A. Cummings, Raymond D. Fowler, Melvin A. Gravitz, Ernest Lawrence, Marvin Metsky, C. J. Rosencrans Jr. (deceased), S. Don Schultz (deceased), A. Eugene Shapiro, Max Siegel (deceased), Robert Weitz, Jack G. Wiggins, Rogers H. Wright, and Francis A. Young.
Freidson, E. (2001). Professionalism: The third logic. Chicago: University of Chicago Press.
Starr, P. (1982). The social transformation of medicine. New York: Basic Books.
Wright, R. H. (2001). The rise of professionalism within American psychology and how it came to be: A brief history of the Dirty Dozen. In R. H. Wright & N. A. Cummings (Eds.), The practice of psychology: The battle for professionalism (pp. 1-69). Phoenix, AZ: Tucker and Theisen.
Wright, R. H. & Cummings, N. A. (2002). The practice of psychology: The battle for professionalism. Phoenix, AZ: Tucker and Theisen.
J. McNally, Ph.D.
Department of Psychology