P S Y C H O L O GY A ND THE DEPARTMENT OF VETERANS AFFAIRS A Historical Analysis of Training, Research) Practice, and Advocacy RODNEY R. BAKER AND WADE E. PICKREN AMERICAN PSYCHOLOGICAL ASSOCIATION • WASHINGTON, DC Copyright © 2007 by the American Psychological Association. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, including, but not limited to, the process of scanning and digitization, or stored in a database or retrieval system, without the prior written permission of the publisher. Published by American Psychological Association 750 First Street, NE Washington, DC 20002 www.apa.org To order In the U.K., Europe, Africa, and the Middle APA Order Department East, copies may be ordered from P.O. Box 92984 American Psychological Association Washington, DC 20090-2984 3 Henrietta Street Tel: (800) 374-2721 Govern Garden, London Direct: (202) 336-5510 WC2E 8LU England Fax: (202) 336-5502 TDD/TTY: (202) 336-6123 Online: www.apa.org/books/ E-mail: [email protected] Typeset in Goudy by World Composition Services, Inc., Sterling, VA Printer: United Book Press, Inc., Baltimore, MD Cover Designer: Mercury Publishing Services, Rockville, MD Technical/Production Editor: Devon Bourexis The opinions and statements published are the responsibility of the authors, and such opinions and statements do not necessarily represent the policies of the American Psychological Association. Library of Congress Cataloging-in-Publication Data Baker, Rodney R. Psychology and the Department of Veterans Affairs : a historical analysis of training, research, practice, and advocacy / by Rodney R. Baker and Wade E. Pickren.—1st ed. p. cm. Includes bibliographical references. ISBN-13: 978-1-59147-453-1 ISBN-10: 1-59147-453-1 1. Mental health policy—United States—History. 2. Psychology—Research—United States—History. 3. Psychologists—Training of—United States—History. 4. Veterans— Medical care—United States—History. I. Pickren, Wade E. II. Title. [DNLM: 1. United States. Dept. of Veterans Affairs. 2. Mental Health Services— history—United States. 3. Veterans—history—United States. 4. Government Agencies— history—United States. WA 11 AA1 B168p 2006] RA790.6.B35 2006 362.20973—dc22 2006013193 British Library Cataloguing-in-Publication Data A CIP record is available from the British Library. Printed in the United States of America First Edition The VA's motto and mission statement is taken from Abraham Lincoln's second inaugural address given March 4, 1865, and appears on a plaque on the front of the VA Central Office building at 810 Vermont Street, NW, in Washington, DC. The photo above was taken circa 1984, prior to the agency's name change on the plaque in 1989 when the VA was elevated to Cabinet status and renamed the Department of Veterans Affairs. CONTENTS Acknowledgments ix Introduction 3 Chapter 1. Origins of VA Psychology and the 1st Decade of Training 17 Chapter 2. Growth and Maturation Years of VA Psychology and the VA Training Program 35 Chapter 3. Psychology and the VA Cooperative Research Programs 53 Chapter 4. VA Psychology and Internal Research Laboratories 75 Chapter 5. VA Psychology and Treatment Services 91 Chapter 6. Defining and Defending the Practice of Psychology in the VA 113 Chapter 7. Past to Present: Contributions of VA Psychology to Health Care and the Profession 137 Appendix: Timeline of VA and Psychology Historical Events and Key VA Psychology Leadership Appointments: 1930 Through 1999 149 References 157 Index 173 About the Authors 183 vn ACKNOWLEDGMENTS This history of psychology and the Veterans Administration, now the Department of Veterans Affairs (VA), benefited from the contributions of many. Formal interviews and personal correspondence with psychologists and other mental health leaders who helped shape psychology in the VA were of immeasurable assistance in filling information gaps in published material and providing insights into some of the forces shaping key events in this history. Current staff of the Mental Health Strategic Health Group (MHSHG) in the VA Central Office supplied material and helped us acquire information not otherwise easily obtained. James Williams, Executive Assistant for the Chief Consultant of MHSHG, was especially helpful in this regard. The staff of the VA Central Office Library were also helpful in accessing archival material in their collection. Special thanks are due to Caryl Kazen, Chief of the VA Central Office Library, and Cindy Rock, VA Central Office Librarian. J. Jack Lasky, C. James Klett, Lee Gurel, John Overall, William Pare, and Paul McReynolds not only provided richly nuanced oral histories of their careers in the VA but also proved to be reliable and critical reviewers of the research chapters. VA retirees Charles Stenger and Walter Penk reviewed and helped refine and focus the chapter on treatment, and Robert Gresen and Edmund Nightingale helped with the update on the current status of psychology in the VA in the summary chapter. Many thanks to all of them. The staff of the Arthur Melton Library at the American Psychological Association—Rennie Georgieva, Helen Suprunova, and Jay Staton—also provided generous assistance in obtaining obscure articles and books, check- ing facts, preparing materials for transcription, and many other thankless tasks. Our deep appreciation is extended to them. David Baker and his staff at the Archives of the History of American Psychology at The University of Akron were similarly helpful in locating archival materials and deserve our thanks. Finally, several staff members at the American Psychological Associa- tion Books Department generously supported research that went into the development of the book. We especially thank Gary VandenBos and Susan Reynolds for their support, guidance, and encouragement. ACKNOWLEDGMENTS PSYCHOLOGY AND THE DEPARTMENT OF VETERANS AFFAIRS INTRODUCTION Several agencies of the federal government played important roles in promoting psychology as a practice and research profession after World War II. These agencies included the Department of Defense, the National Science Foundation, the National Institute of Mental Health (NIMH), and the Veterans Administration (now the Department of Veterans Affairs). This is a historical resource volume on psychology and the Veterans Administration/ Department of Veterans Affairs (VA), which provided significant funding support for the training, research, and employment of psychologists that helped direct and establish the profession of psychology. The volume offers important insights into the expansion of psychology since World War II. It is one of many narrative threads in the story of the major changes in psychology and the reciprocal influence of psychology and government that was begun in the volume on the history of psychology and the NIMH (Pickren & Schneider, 2005). This book highlights the role of government in shaping the lives of its citizens through the assistance provided its veterans. This book is also intended to serve as a resource for scholars wishing to add to the specialized history of post-World War II psychology and government. The literature on the VA's contributions to the development of psy- chology has been largely confined to overview accounts of its role in the training of psychologists and the large-scale employment of psychologists after World War II (e.g., Benjamin & Baker, 2004; Moore, 1992; Wolman, 1965). This volume adds needed detail to available information and provides an analysis of historical forces shaping those training and employment contributions. The volume similarly chronicles the forces promoting psycho- logical research and practice. The role of the VA and its psychology leaders in influencing training accreditation and the credentialing of psychologists is provided similar coverage. PAST AS PROLOGUE This history of the contributions of VA psychology to the health care of veterans serves as prologue to the care being providing to veterans by psychologists today. Each war introduces new challenges for the care of veterans. The wars in Iraq and Afghanistan are no exception. Improved health care for those wounded in combat in our latest wars has increased the numbers of severely injured veterans with multiple and complex traumas. This complexity of injury led the VA to create four regional polytrauma centers in 2005 where psychologists join other health care specialists to coordinate needed rehabilitation care for these veterans. Treatment provided by psychologists in these centers for the pain and sequelae of head injury, irreversible physical disability, and the resulting emotional problems is complemented by their efforts in providing needed counseling to the wives, husbands, children, and parents of these veterans. In addition, psychologists are providing similar rehabilitation services to veterans in traumatic brain injury sites closer to the veterans' homes after discharge from the regional polytrauma centers. The extensive and prolonged use of National Guard and reserve units in the second Iraq war (Operation Iraqi Freedom) presented still another challenge. The disruption of the careers and family lives of these men and women, who were older than other combatants, and their response to extended periods of danger and stress resulted in treatment issues (including posttraumatic stress disorder, depression, and substance abuse) similar to those that emerged from the enlisted military population. In addition, reentry into community life after deployment raises adjustment issues of a magnitude not seen since World War II. The age and maturity of National Guard participants may, however, give them an edge over younger personnel in coping skills, although this factor has not yet been adequately researched. Special joint funding by the VA and the NIMH is being provided for studies looking at coping skills and resiliency factors for all returning veterans, with special attention to personnel from National Guard and reserve units. With eligibility for care in the VA for 2 years after their deployment, these veterans add still another responsibility for care by psychologists. PSYCHOLOGY AND THE DEPARTMENT OF VETERANS AFFAIRS