Correspondence Clinical Psychology Forum 1998; 117: 2

I was thankful to see John Marzillier (1998) defend clinical psychology against Alan Jones’ (1998) nihilism. There is a general problem of morale in mental health services, not least in other professions besides clinical psychology. Clinical psychology needs to take more of a lead in the development of services and has resources unavailable to other disciplines.

Professional rivalry with psychiatry has commonly been blamed for lack of influence (Pilgrim and Treacher 1992). Biological psychiatry may regard clinical psychology as peripheral and the dominance of this approach in psychiatry understandably affects the identity of clinical psychology. However, clinical psychology too often accepts the split between biological psychiatry and psychotherapy encouraged by psychiatry itself and retreats into psychotherapy. The current fashion is for cognitive behavior therapy or cognitive analytic therapy.

There is a tradition of social psychiatry, even if it has to be represented as "antipsychiatry" (Double 1992). Social psychiatry may not always have been thoroughgoing enough, and should amount to more than the recognition of environmental factors in an aetiological eclecticism, which is still essentially biological in approach. Clinical psychologists are probably better placed than any other profession to appreciate this situation and to contribute to the assessment and management of mental health problems in the community.

Yours Faithfully

DB Double

Consultant Psychiatrist

Norfolk Mental Health Care NHS Trust


Double DB. (1992) Training in "anti-psychiatry". Clinical Psychology Forum , 46, 12-4

Jones, A. (1998) ‘What’s the bloody point?": more thoughts on fraudulent identity. Clinical Psychology Forum, 112, 3-9

Marzillier, J. (1998) "Whats the bloody point?" (letter). Clinical Psychology Forum, 115, 2

Pilgrim, D. and Treacher, A. (1992) Clinical Psychology Observed. London: Routledge