Again, after much time, consideration, and struggle, the controversy concerning whether to proceed towards opening clinical training to nonmedical candidates appears irresolvable, at least for now. The conclusion at the San Diego meetings was that we have studied and debated as much as we reasonably can, and that no action for change is now possible. No single proposal appeared to have enough support to gain the necessary majority of votes, and a Board proposal to further study the issue was defeated in Council.
At Board and Council, it was argued that we risked letting this stormy, intensely debated matter seem to die with a whimper—that it might appear that the issue was not allowed to come to a vote. But others felt strongly that we had debated honestly, openly, and for long enough, and there was no course but to accept that opinions were too diverse and polarized, and no consensus possible. Apparently, the time is not ripe for change.
One Councilor put it this way: “The discussion has been long, thorough, fair, and complete—an experience in consciousness raising and cooperation. We are witnessing a revolution in psychiatry, medicine, and therapy. But it is clear that we are not ready to decide. Why not let it rest until the times are different?”
The issue which actually came to a vote was whether to take a nonbinding straw poll of the members asking the general question, “Do you favor mandating a procedure to offer clinical training to selected, qualified psychologists with a Ph.D. degree?”
This proposal originated in the final report of the Spruiell Committee, which had been charged to develop and draft a proposal to introduce clinical training for nonmedical candidates upon which the membership could vote.
In his report to both Board and Council, Dr. Spruiell gave the results of an informal survey he had conducted of directors of institutes and chairpersons of education committees. All twenty-six institutes responded, and while the results were informal and the data based in some cases on estimates, the results were very similar to the polls of societies reported last December, lending, in Dr. Spruiell's view, validity to the findings.
Eleven institutes opposed any form of change whatsoever, eleven were for some form of change, and three could not fill out the questionnaire, as the spread of opinion was too wide. Among those who opposed change, the least opposition was to Model C: the model imposing the most stringent monitoring of individuals by the Board, including a waiver system. Among those favoring nonmedical training, there was about an even split pro and con regarding Model C (and Model A also) and a moderate majority favoring Model B.
Dr. Spruiell's committee concluded that an adequate majority of opinion does not exist within or among institutes
or within the Board (a change in the Bylaws of the Association requires a two-thirds majority). They were therefore unable to provide a specific option to vote upon. The committee's recommendation to conduct a straw poll of individual members was, in effect, a hope and a plea for guidance. If enough members in general favor some sort of nonmedical training, it might signal us to pursue the matter further. But the committee, in effect, conceded that it found it impossible to carry out its charge.
One argument for doing such a poll was that there might be more consensus revealed in a secret vote than would be anticipated from public debate. Additionally, several expressed the view that if a single, specific moderate proposal, such as Model B, were voted upon, more consensus might be found. The major argument for conducting such a straw poll, however, was that after so much discussion, the members deserved a chance to express themselves directly, even if it were no more than a gesture.
The discussion at the Board had a different tone than that at Council. Members of the Board were concerned that if they took no action they might be seen as blocking the free exercise of the will of the membership. However, many felt the results of such a poll would be meaningless at best, and possibly misleading and harmful. The wording of the proposal was made purposely general, even vague—to determine how widespread the wish to go further might be if the details did not have to be worked out before a vote.
What good, many asked, would a 60:40 or even 70:30 vote showing that the members in general or in principle favored nonmedical training, when we have already learned that when we finally formulate a specific, concrete way to implement it, ideological, ethical, and organizational beliefs and loyalties reveal so many constituencies at odds with each other, that no wide consensus on any particular proposal is possible. Those that favor nonmedical training have conditions, and the conditions vary. The confusion would simply be perpetuated, many thought.
The Board, however, accepted the recommendation of the Spruiell Committee, and voted to recommend to the Council that they conduct the straw poll. The Council, however, appeared swayed by the arguments that such a poll was an attempt to demonstrate our good intentions and betrayed an unwillingness to accept what our deliberations have shown—that the necessary consensus does not exist. Apparently most agreed that because the proposal was so general, the results would be not useful, possibly inaccurate, would merely perpetuate confusion, and possibly be taken by others outside our organization to be more binding or significant than was actually the case. The vote in Council regarding conducting the poll was 31 against, 7 for.