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Clinical Sociology

Clinical sociology is a humanistic, multidisciplinary specialization that seeks to improve the quality of people’s lives. Clinical sociologists assess situations and reduce problems through analysis and intervention. Clinical analysis is the critical assessment of beliefs, policies, and/or practices with an interest in improving a situation. Intervention, the creation of new systems as well as the change of existing systems, is based on continuing analysis.

Clinical sociologists have different areas of expertise—such as health promotion, sustainable communities, social conflict, or cultural competence— and work in many capacities. They are, for example, community organizers, sociotherapists, mediators, focus group facilitators, social policy implementers, action researchers, and administrators. Many clinical sociologists are full-time or part-time university professors, and these clinical sociologists undertake intervention work in addition to their teaching and research.

The role of the clinical sociologist can be at one or more levels of focus from the individual to the intersocietal. Even though the clinical sociologist specializes in one or two levels of intervention (e.g., marriage counseling, community consulting), the practitioner will move among a number of levels (e.g., individual, organization, community) in order to analyze or intervene or both.

The History of American Clinical Sociology

When sociology emerged as a discipline in the 1890s, the nation was struggling with issues of democracy and social justice. There was rural and urban poverty, women were still without the vote, and there were lynchings. Farmers and workers in the late 1800s were frustrated because they could see the centralization of economic and political power in the hands of limited groups of people. This kind of frustration led to public protests and the development of reform organizations. In this climate, it is not surprising that many of the early sociologists were scholar-practitioners interested in reducing or solving the pressing social problems that confronted their communities.

The First University Courses

While many of the early sociologists were interested in practice, the earliest known proposal using the words ‘‘clinical sociology’’ was by Milton C. Winternitz (1885– 1959), a physician who was dean of the Yale School of Medicine from 1920 through 1935. At least as early as 1929, Winternitz began developing a plan to establish a department of clinical sociology within Yale’s medical school. Winternitz wanted each medical student to have a chance to analyze cases based on a medical specialty as well as a specialty in clinical sociology.

Winternitz vigorously sought financial support for his proposal from the Rosenwald Fund, but he was unable to obtain the necessary funds for a department of clinical sociology. He did note, however, the success of a course in the medical school’s section on public health that was based on the clinical sociology plan.

The first course using the words ‘‘clinical sociology’’ in the title was taught by Ernest W. Burgess (1886–1966) at the University of Chicago. Burgess taught the course in 1928 and then offered it twice in 1929. During these years, the course was considered to be a ‘‘special’’ course and did not appear in the university’s catalog. Burgess offered the clinical sociology course, as a regular course, five times from 1931 through 1933. The course continued to be listed in the catalog for the next several years but was not taught after 1933.

The University of Chicago catalogs did not include a description of the clincal sociology course, but the course always was listed under the social pathology grouping. All courses in this section dealt with topics such as criminality, punishment, criminal law, organized crime, and personal disorganization. Several of the students enrolled in these first clinical sociology courses were placed in child guidance clinics. Clarence E. Glick, for instance, was the staff sociologist at Chicago’s Lower North Side Child Guidance Clinic and Leonard Cottrell was the clinical sociologist at the South Side Child Guidance Clinic.

Two other universities offered clinical courses in the l930s—Tulane University in Louisiana and New York University. The Tulane University course was designed to give students the opportunity to learn about behavior problems and social therapy by conferences and fieldwork in a child guidance clinic. Louis Wirth (1897–1952), a full-time faculty member and director of the New Orleans Child Guidance Clinic, was scheduled to teach the course in the spring of 1930. Wirth was unable to teach the course because he accepted a one-year Social Science Research Council Fellowship to work in Europe. The course was taught in his absence, but the university’s course information does not identify the professor who took Wirth’s place.

When Wirth returned to the United States in 1931, he joined the faculty of the University of Chicago. In the spring of 1932 he taught a ‘‘minor’’ course in clinical sociology but by then he no longer was working with child guidance clinics.

New York University also offered clinical sociology courses in the early 1930s. Harvey Warren Zorbaugh (1896–1965) was a faculty member there in the School of Education which provided undergraduate and graduate preparation for visiting teachers, educational counselors, clinicians, social workers, and school guidance administrators. The major focus of the program was the solution of educational problems and other social dilemmas.

Zorbaugh, along with Agnes Conklin, offered ‘‘Seminar in Clinical Practice’’ in 1930. The course was intended to qualify students as counselors or advisers to deal with behavioral difficulties in schools. From 1931 through 1933 the clinical practice course was called ‘‘Seminar in Clinical Sociology.’’ The course was one of the highest numbered courses in educational sociology and was offered both terms of each year. The course was open to graduate students who were writing theses or engaged in research projects in the fields of educational guidance and social work.

Zorbaugh, author of The Gold Coast and the Slum: A Sociological Study of Chicago’s Near North Side, had been involved with clinics at least since 1924. That was the year Zorbaugh and Clifford Shaw organized two sociological clinics in Chicago— the Lower North and South Side Child Guidance Clinics. Zorbaugh was associate director of the Lower North Side Child Guidance Clinic in 1925.

Zorbaugh was a founder, in 1928, of the Clinic for the Social Adjustment of the Gifted at New York University. He was director of this clinic at its inception and was actively involved in its work for over fifteen years. The clinic was for intellectually gifted and talented preadolescents. The clinic gave graduate students the opportunity to have supervised experiences in teaching, clinical diagnosing and treating of children with behavioral problems.

During the 1953–54 academic year, Alvin W. Gouldner (1920–1980) was teaching in the Department of Sociology and Anthropology at Antioch College in Ohio. Before joining the faculty, Gouldner had been a university teacher for four years and then worked, for one year, as a consultant to Standard Oil of New Jersey.

Gouldner offered ‘‘Foundations of Clinical Sociology’’ at Antioch. The course was taught at the highest undergraduate level, and students who enrolled in the course were expected to have completed the department’s course in social pathology. The college bulletin provided the following description of the course:

A sociological counterpart to clinical psychology with the group as the unit of diagnosis and therapy. Emphasis on developing skills useful in the diagnosis and therapy of group tenstions. Principles of functional analysis, group dynamics, and organizational and small group analysis examined and applied to case histories. Representative research in the area assessed.

The term ‘‘clinical sociology’’ first appears in print

The first known published linking of the words clinical and sociology was in 1930 when Milton C. Winternitz, a pathologist and dean of the Yale Medical School, wanted to establish a department of clinical sociology. After working on the idea at least as early as 1929, he wrote about it in a report to the president of the Yale Medical School and the report was published in the 1930 Yale University Bulletin. That same year saw the publication of a speech Winternitz had given at the dedication of the University of Chicago’s new social science building. The speech also mentioned clinical sociology.

Abraham Flexner, a prominent critic of medical education and director of the Institute for Advanced Study at Princeton, mentioned clinical sociology in 1930 in his Universities: American, English, German. Flexner did not approve of the Institute of Human Relations that Winternitz was establishing at Yale. In the pages of criticism devoted to the institute, Flexner briefly mentioned clinical sociology: ‘‘Only one apparent novelty is proposed: a professor of clinical sociology’’ (Flexner 1930).

Winternitz continued to write about the value of clinical sociology until 1936 when his last report as dean was filed. One of Winternitz’s (1932) most forceful statements in support of the field was the contemporary-sounding statement that appeared in his 1930–1931 annual report:

The field for clinical sociology does not seem by any means to be confined to medicine. Within the year it has become more and more evident that a similar development may well be the means of bringing about aid so sorely needed to change the basis of court action in relation to crime. . .

Not only in medicine and in law, but probably in many other fields of activity, the broad preparation of the clinical sociologist is essential. . .

The first discussion of clinical sociology by a sociologist was Louis Wirth’s 1931 article, ‘‘Clinical Sociology,’’ in The American Journal of Sociology. Wirth wrote at length about the possibility of sociologists working in child development clinics, though he did not specifically mention his own clinical work in New Orleans. Wirth wrote ‘‘it may not be an exaggeration of the facts to speak of the genesis of a new division of sociology in the form of clinical sociology’’ (Wirth 1930).

In 1931, Wirth also wrote a career development pamphlet, which stated:

The various activities that have grown up around child-guidance clinics, penal and correctional institutions, the courts, police systems, and similar facilities designed to deal with problems of misconduct have increasingly turned to sociologists to become members of their professional staffs (Wirth 1931).

Wirth ‘‘urged (sociology students) to become specialists in one of the major divisions of sociology, such as social psychology, urban sociology. . . or clinical sociology’’ (Wirth 1931).

In 1931, Saul Alinsky was a University of Chicago student who was enrolled in Burgess’s clinical sociology course. Three years later, Alinsky’s article, ‘‘A Sociological Technique in Clinical Criminology,’’ appeared in the Proceedings of the Sixty- Fourth Annual Congress of the American Prison Association. Alinsky, best known now for his work in community organizing, was, in 1934, a staff sociologist and member of the classification board of the Illinois State Penitentiary.

In 1944 the first formal definition of clinical sociology appeared in H.P. Fairchild’s Dictionary of Sociology. Alfred McClung Lee, the author of that definition, was known as one of the founders of the Society for the Study of Social Problems, the Association for Humanist Sociology, and the Sociological Practice Association. Lee later used the word ‘‘clinical’’ in the title of two articles—his 1945 ‘‘Analysis of Propaganda: A Clinical Summary’’ and the 1955 article ‘‘The Clinical Study of Society.’’

Also appearing in 1944 was Edward McDonagh’s ‘‘An Approach to Clinical Sociology.’’ McDonagh had read Lee’s definition of clinical sociology but had not seen Wirth’s 1931 article. McDonagh, in his Sociology and Social Research article, proposed establishing social research clinics that had ‘‘a group way of studying and solving problems’’ (McDonagh 1944).

In 1946 George Edmund Haynes’s ‘‘Clinical Methods in Interracial and Intercultural Relations’’ appeared in The Journal of Educational Sociology. Haynes was a cofounder of the National Urban League (1910) and the first African American to hold a U.S. government subcabinet post. His 1946 article, written while he was executive secretary of the Department of Race Relations at the Federal Council of the Churches of Christ in America, discussed the department’s urban clinics. The clinics were designed to deal with interracial tensions and conflicts by developing limited, concrete programs of action.

Contemporary Contributions

While publications mentioning clinical sociology appeared at least every few years after the 1930s, the number of publications increased substantially after the founding of the Clinical Sociology Association in 1978. The association, now called the Sociological Practice Association, made publications a high priority. Individuals were encouraged to publish and identify their work as clinical sociology, and the association established publication possibilities for its members. The Clinical Sociology Review and the theme journal Sociological Practice were published by the association beginning in the early 1980s. These annual journals were replaced in the 1990’s by Sociological Practice: A Journal of Clinical and Applied Sociology, a quarterly publication.

The Sociological Practice Association has had a central role in the development of American clinical sociology. The association helped make available the world’s most extensive collection of teaching, research, and intervention literature under the label of clinical sociology and it introduced the only clinical sociology certification process.

The Sociological Practice Association’s rigorous certification process for clinical sociologists is available at the Ph.D. and M.A. levels. The Ph.D.- level process was adopted in l983 and certification was first awarded in 1984. The association began to offer M.A.-level certification in 1986. Successful candidates at both the doctoral and master’s level are awarded the same designation—C.C.S. (Certified Clinical Sociologist).

Experienced clinical sociologists are encouraged to apply for certification. which is given for intervention work (assessing and changing social systems). As part of the application process, a candidate is required to identify her or his area of specialization (e.g., community, family counseling) and level of intervention (e.g., organization, individual). The certification process requires membership in the Sociological Practice Association, documentation of appropriate education and supervised training, documentation of interdisciplinary training, essays about ethics and theory, and a demonstration before peers and a reviewing committee.

The Sociological Practice Association, along with the Society for Applied Sociology, also has put in place a Commission on Applied and Clinical Sociology. The commission has set standards for the accreditation of clinical and applied sociology programs at the baccalaureate level and intends to do the same for graduate programs.

Clinical Sociology and Sociological Practice

The practical sociology of the l890s and early 1900s is now referred to as sociological practice. This general term sociological practice involves two areas, clinical sociology and applied sociology. Clinical sociology emphasizes hands-on intervention while applied sociology emphasizes research for practical purposes. Both specialties require different kinds of specialized training.

Some sociological practitioners are ‘‘clinical’’ in that they only or primarily do intervention work; others are ‘‘applied’’ in that they only or primarily conduct research that is of practical interest. Some practitioners do both. Clinical sociologists, for instance, may conduct research before beginning an intervention project to assess the existing state of affairs, during an intervention (e.g., to study the process of adaptation), and/or after the completion of the intervention to evaluate the outcome of that intervention. For some clinical sociologists, the research activity is an important part of their own clinical work. These sociologists have appropriate research training and look for opportunities to conduct research. Other clinical sociologists prefer to concentrate on the interventions and leave any research to other team members. Those clinical sociologists who decide not to engage in research may have research skills but prefer to conduct interventions, may not have enough expertise in the conduct of research, or may know that other team members have more expertise in research.

Theories, Methods, and Intervention Strategies

Clinical sociologists are expected to have education and training in at least one area in addition to sociology. This means that not only are clinical sociologists exposed to the range of theories (e.g., symbolic interaction, structural-functionalism, conflict, social exchange) and quantitative and qualitative research methods generally taught in sociology programs, but they also have additional influences from outside of their own programs. The result is that clinical sociologists integrate and use a broad range of theoretical and methodological approaches.

Clinical sociologists use existing theory to formulate models that will be helpful in identifying and understanding problems and also to identify strategies to reduce or solve these problems. Clinical sociologists also have shown that practice can have an influence on existing theories and help in the development of new ones.

While clinical sociologists use a wide variety of research methods and techniques (e.g., participatory action research, geographic information systems, focus group analysis, surveys), they probably are best known for their case studies. Case studies involve systematically assembling and analyzing detailed, in-depth information about a person, place, event, or group. This methodological approach involves many data-gathering techniques such as document analysis, life histories, in-depth interviews, and participant observation.

Clinical sociologists who have been in the field for ten or twenty years probably learned about intervention strategies primarily through courses and workshops given outside of sociology departments as well as through their work and community experiences. Clinical sociologists who have more recently entered the field also may have learned intervention techniques as part of their sociology programs. These sociology programs might include courses, for instance, on focus groups, mediation, or administration, as well as require supervised residencies or internships.

Clinical Sociology in International Settings

Clinical sociology is as old as the field of sociology and its roots are found in many parts of the world. The clinical sociology specialization, for instance, often is traced back to the fourteenth-century work of the Arab scholar and statesperson Abd-al- Rahman ibn Khaldun (1332–1406). Ibn Khaldun provided numerous clinical observations based on his varied work experiences such as Secretary of State to the rule of Morocco and Chief Judge of Egypt.

Auguste Comte (1798–1857) and Emile Durkheim (1858–1917) are among those whose work frequently is mentioned as precursors to the field. Comte, the French scholar who coined the term ‘‘sociology’’, believed that the scientific study of societies would provide the basis for social action. Emile Durkheim’s work on the relation between levels of influence (e.g., social compared to individual factors) led Alvin Gouldner (1965, p.19) to write that ‘‘more than any other classical sociologist (he) used a clinical model.’’

Interest in clinical sociology has been growing in a number of countries. For example, French is the predominant language of many, if not most, of the current international clinical sociology conferences, and books and articles have appeared with clinical sociology in the title in France and Frenchspeaking Canada. The French-language clinical sociologists emphasize clinical analysis. They have a solid international network and have done an excellent job of attracting nonsociologists to that network. Their literature is substantial. Particularly notable is the work of Jacques van Bockstaele and Maria van Bockstaele; Robert Sevigny, Eugene Enriquez, Vincent de Gaulejac, and Jacques Rheaume.

Beginning in the mid-1990’s, Italians hosted clinical sociology conferences, published clinical sociology books and articles and ran numerous clinical sociology training workshops. If one is interested in learning about clinical sociology in Italy, one would want to review the work of Michelina Tosi, Francesco Battisti, and Lucio Luison. Luison’s 1998 book, Introduczione alla Sociologia clinica (Introduction to Clinical Sociology), contains thirteen articles written by Americans. One is an original article written for the volume but all the others are translations of articles that appeared in the Sociological Practice Association’s Clinical Sociology Review or Sociological Practice. The volume concludes with the Sociological Practice Association’s code of ethics.

Clinical sociology also is found in other parts of the world. Of particular interest would be developments in Greece, Brazil, Mexico, Uruguay, and South Africa. In South Africa, for instance, one university’s sociology department has put a sociological clinic in place and another sociology department has developed a graduate specialization in counseling.

The international development of clinical sociology has been supported primarily by two organizations. The clinical sociology division of the International Sociological Association (ISA) was organized in 1982 at the ISA World Congress in Mexico City. The other major influence is the clinical sociology section of the Association internationale des Sociologues de Langue Francaise (International Association of French Language Sociologists).

It is clear that a global clinical sociology is beginning to emerge. American clinical sociology had a strong role in the early development of the global specialization but now it is only one of many influences. It will be interesting to see if the thrust of the international field will be as explicitly humanistic and intervention-oriented as American clinical sociology.

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