International Review of Psychiatry, October 2014; 26(5): 566–571
Current status of psychology and clinical psychology in India – An appraisal
BABOO SANKAR VIRUDHAGIRINATHAN1 & SUBBIAH KARUNANIDHI2 Institute of Behavioural Sciences, Chennai, Tamil Nadu, and 2Department of Psychology, University of Madras, Tamil Nadu, India
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1Care
Abstract This paper provides an overview of the social and cultural context for the emergence and development of psychology in India and also more specifically of the development of clinical psychology. It details the range of universities offering psychology programmes and the various bodies involved in supporting the development of the psychology. The paper also describes the development of clinical psychology in India and the variety of roles undertaken by clinical psychologists. Finally, it raises a number of issues facing the development of Indian psychology into the future.
Introduction India, a subcontinent in south Asia, is the seventh largest country by area and second largest by population. It is pluralistic, multilingual, multi-ethnic, multicultural, and the second largest democratic country in the world with a growing population of more than 1.3 billion people (Government of India, 2011). In this article we outline the major psychological concerns for India and the development of psychology and clinical psychology in the country.
Major psychological concerns in India The current population of India consists of a sizeable number of children, adolescents and young adults, which, though seeming to add strength to the human resources of the country, also brings in concerns about their mental health. The Indian Council for Medical Research (ICMR), reported that 12.8% of children suffer from mental health problems (ICMR, 2009). Various screening surveys report that 1–20% of the children in India were found to have attention deficit hyperactivity disorder (ADHD), with a vast increase over the last few years (Mukhopadhyay et al., 2003). According to the National Institute of Mental Health, Bangalore, India, schizophrenia is prevalent among 1.1% of the total population, while the overall lifetime prevalence rate of mental disorders is 10–12% (NIMHANS, 2003). The report points out that while the indian government has a
separate programme for mental health, there is a lack of adequate psychologists, counsellors and infrastructure facilities. Epidemiological studies carried out in India report that 2–30% of adolescents have psychological problems, of whom 8% have psychological distress, and 6% of adolescent boys and 12% of girls have emotional disturbances (Bhola & Kapur, 2003; Bhola, 2010). In general, 7.5% of Indians face some sort of emotional disorder. Research shows depression to be a major cause of suicide in Tamil Nadu (Ranimohanraj, 2006). India has many distinctive issues which are of paramount importance in terms of impacting on quality of life. Some of the notable issues are: • Increases in the rates of learning disabilities and underachievement among school children. • Psychological issues of children in need of care and protection housed in juvenile homes. • A decline in joint family systems and migration of educated youngsters leading to adjustment problems and ageing parents being isolated, leading to geriatric issues such as loneliness, elder abuse and victimization among older people. • Increasing employment opportunities for women in information technology-based industries resulting in changed relationship opportunities and patterns which may lead to changes and adjustment issues for all family members, which may have a range of psychological effects; constant pressure on the young to get gainful and meaningful employment
Correspondence: B. S. Virudhagirinathan, Care Institute of Behavioural Sciences, Chennai, Tamil Nadu, India. Tel: 044–28275747. Fax: 044–28275747. E-mail: [email protected] (Received 4 July 2014 ; accepted 4 July 2014 ) ISSN 0954–0261 print/ISSN 1369–1627 online © 2014 Institute of Psychiatry DOI: 10.3109/09540261.2014.942604
Current status of psychology and clinical psychology in India – An appraisal
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Int Rev Psychiatry Downloaded from informahealthcare.com by University of Ulster at Jordanstown on 03/31/15 For personal use only.
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on the basis of increasing competition with more people being educated and fewer employment opportunities created. Psychological impact of poverty, discrimination due to caste, class, religion, gender, language, for example, resulting in conflicts which may affect social well-being. Psychosociological issues relating to migrant labourers (from rural to urban and from underdeveloped to developing states within India). Refugees. Availability of an alternative support system. Most of the time this is through religion, faith healers (swamijis, saints, palmists, soothsayers), pseudo counsellors (who offer counselling after reading a self-help book); rituals, for example, are used as a counselling or therapeutic technique to address psychological issues. Ultimately, when the issue becomes serious they go to a psychiatrist who sometimes prescribes only drugs even for simple psychological problems such as anger, exam fear, lack of concentration, anxiety, tension, for example.
However, according to the World Health Organization (WHO) estimate (2005), there are only 0.03 psychologists per 100,000 people in India (0.2 psychiatrists and 0.05 psychiatric nurses), which is insufficient to handle the number of people affected with any mental and behavioural disorder. Even the available psychologists are mostly working in urban areas where less than 28% of the population live. Considering that 72% of the population live in rural areas, it can be concluded that there is a dire need for more professional psychologists in India. Emergence of psychology in India Psychology in India emerged out of the subject of philosophy when Girindra Shekar Bose established the first Indian psychological laboratory in the University of Calcutta in 1915, which ultimately led to the establishment of the first psychology department in 1916. In 1922 he established the first psychoanalytic society in India, and in 1924 Mysore University established their department of psychology followed by creation of a psychology department in Lucknow University in 1929. In 1943, G.D. Boaz, an eminent psychologist of international repute created a separate psychology department at the University of Madras in Tamil Nadu, branching out from the philosophy department. Psychology departments in the universities started with courses in general psychology, developmental psychology and applied psychology. The emergence of several new industries due to industrialization necessitated a rapid expansion in courses on industrial psychology. Courses in clinical psychology and
567
community psychology followed as the attention shifted from the laboratory to the community. Subsequently, clinical psychology and organizational behaviour became established standard courses in psychology. Sports psychology, cognitive psychology, health psychology, and rehabilitation and counselling psychology have also emerged as newer branches in psychology during the last two decades. Table 1 shows the major universities in India offering psychology courses. Undergraduate courses in psychology are being conducted in government, government-aided and private colleges in many parts of the country. Of late, many colleges in the private sector have been keen to start courses in psychology both at the undergraduate and postgraduate level, offering selffinancing courses, which is a further indication of the increasing popularity of psychology in India. Multidisciplinary approaches in psychology have also started to develop in psychological studies, incorporating techniques and applications from other disciplines such as social sciences, business management, medicine, human resources and philosophical disciplines such as yoga therapy. The field is also expanding, with emerging trends in political governance, forensic studies, and cognitive development. All these developments pose a challenging task for psychologists to update their professional knowledge and skills to move progressively with emerging global developments to achieve holistic and progressive developments. Apart from the major universities and colleges, there are many private independent institutions offering academic courses as well as professional certifications. Notable among them are the Tata Institute of Social Sciences, Mumbai, the A.N. Sinha Institute of Social Sciences, Patna, the National Brain Research Centre, Gurgaon, and the Centre for Organization Development, Hyderabad. The Defence Institute of Psychological Research, Delhi, is a unique institution attached to the Ministry of Defence, Government of India, which applies psychological methods and strategies for assessment, training and building cadres of defence officers based on psychological profiling. They also conduct experimental research on various areas of psychology including psycho-physiological changes in high altitudes and stress tolerance, and sponsor research in psychology by granting funds. The Indian Society of Applied and Behavioural Sciences, New Delhi, is another professional association providing opportunities for professional development of behavioural scientists based on laboratory methods. There are also national level professional associations and societies that have been functioning for more than three decades in India: the Indian Academy of Applied Psychology (IAAP), Chennai, the National Academy
568
B. S. Virudhagirinathan & S. Karunanidhi
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Table 1. Major universities in India offering psychology courses with specialization.
University
Year of establishment
Calcutta University
1916
Mysore University
1924
Lucknow University
1929
University of Madras Osmania University
1943 1950
Delhi University
1957
Utkal University
1958
Mumbai University Andhra University
1959 1967
Bangalore University
1974
Calicut University
1976
Saurastra University
1989
of Psychology, Mumbai, the Indian Psycho-Analytical Society, Kolkatta, the Indian Association of Clinical Psychology (IACP), New Delhi, the Indian School Psychology Association, Pondicherry, the Indian Psychological Association, New Delhi, as well as the newly created Neuropsychological Society of India in Chennai. Most of the academic societies regularly conduct conferences, symposia workshops and events to disseminate current research trends in various fields of psychology. They also provide opportunities for young psychologists to interact with senior psychologists and for networking. To cite an example, the Indian Academy of Applied Psychology has conducted 47 national conferences during its 50 years of existence. These conferences are conducted in various parts of the country focusing on cuttingedge themes of psychology. The following are some of the themes explored by conferences organized by various professional societies during the last five years: Challenges of Applied Psychology for Societal Transformation (IAAP, Calcutta, 2008), Applied Psychology in Changing Cultural Perspectives (IAPP,
Specialization Clinical psychology Developmental psychology Social psychology Cognitive neuropsychology Learning disability Counselling and health psychology Organizational psychology Social psychology Experimental psychology Organizational behaviour Human resource development Child development Human resource development psychology Child psychology Industrial psychology Rehabilitation psychology Counselling psychology Applied psychology Cognitive psychology Organizational psychology Developmental psychology Counselling psychology Applied psychology Para-psychology Counselling psychology Clinical psychology Industrial psychology Child guidance Clinical psychology Organizational behaviour Clinical psychology Social psychology Psychological testing Applied psychology
Aurangabad, 2009), the National Annual Conference of the IAP on Enabling the Disabled (IACP, Calcutta, 2009), Quality of Life and Globalization: Effective Self-Care Interventions (IAAP, Vishakhapatnam, 2010); Clinical Psychology for a Changing World: Practices, Training and Research (IACP, Bangalore, 2010), Life Skills for Enhancing Quality of Life (IAAP, Mysore, 2011), Clinical Forensic Psychology: An Emerging Scientific Discipline (IACP, Ahmadabad, 2011); and Applied Psychology in Transforming Education and Management Sciences in the Context of Globalization (IAAP, Cochin, 2012). As well as these various bodies and institutions, the following main academic journals in psychology are published in India, allowing researchers to showcase their research to the world. They include Psychological Studies, the Indian Journal of Clinical Psychology, the Journal of Indian Academy of Applied Psychology, the Journal of Psychological Research, the Journal of Community Psychology, the Indian Journal of Applied Psychology, the Indian Psychological Review, and the Journal of Indian Health Psychology.
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Current status of psychology and clinical psychology in India – An appraisal
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Clinical psychology in India
Rehabilitation Council of India
Clinical psychology in India is a distinct and independent field of science providing mental health services. It draws heavily from the biological, medical and social sciences. The first postgraduate course in clinical psychology was started by the government of India in 1955 with a view to creating specialists in mental health (NIMHANS, 2000, 2010). The first course was a diploma in medical psychology (DMP) which later was termed a diploma in medical and social psychology (DM & SP). Presently, it is a master of philosophy (MPhil) in medical and social psychology. The duration of the training is 2 years, and to be eligible the student must already have an MA or MSc in psychology. There is also an MPhil in clinical psychology which is a 2-year course; admission is on the basis of an entrance examination consisting of a written test, interview and practice, and a doctorate of psychology (PhD) which is a four year course and requires an MA or MSc degree in psychology. The IACP was established in 1969 with the aims of promoting teaching, research and practices of clinical psychology, formulating and advising on standards of education in clinical psychology at university level and at professional level, developing an objective and experimental approach to the problems of clinical psychology among professionals and research workers, extending clinical psychological services to the field of mental health and related areas, advising central and state governments and other bodies on the various aspects of causation, treatment, rehabilitation and prevention of mental disorders and allied conditions, including legislative and administrative matters without affiliating to any political parties, cooperating and collaborating with agencies and scientific bodies interested in clinical psychology and/ or allied subjects outside India. Fig. 1 shows the membership of the IACP which currently has 1,072 members.
Another important body for clinical psychologists within India is the Rehabilitation Council of India (RCI) which was set up as a registered society in 1986. In September 1992, the RCI Act was passed by Parliament and the RCI became a statutory body on 22 June 1993. The Act was amended by Parliament in 2000 to make it more broadly based. The mandate given to the RCI is to regulate and monitor services given to people with disability, to standardize syllabuses and to maintain a Central Rehabilitation Register of all qualified professionals and personnel working in the field of rehabilitation and special education. The Act also prescribes punitive action against unqualified people delivering services to individuals with disabilities. The professionals registered with RCI are entitled to practise as rehabilitation professionals in any part of India. No one other than the rehabilitation professionals who possess a recognized rehabilitation qualification and are enrolled on the Central Rehabilitation Register can hold office as a rehabilitation professional or any such office (by whatever designation called) in government or in any institution maintained by a local or other authority. As well as clinical psychologists, other professionals can be registered with the RCI. The RCI also offers psychology courses in the fields of rehabilitation psychology such as the MPhil (rehabilitation psychology). Clinical psychologists in India are involved in a range of roles including testing and diagnostic assessment, psychological treatment, teaching and research. In India great importance is placed on testing. This is because of the role psychological testing plays in diagnosis, management and research. Lobar function tests are frequently carried out by neurophysiologists and surgeons. Family physicians and paediatricians also carry out psychological assessment for diagnosis and management in children and adolescents who have academic/behavioural difficulties. The terminology used for developmental disorders is very different in India; it is specific learning difficulty (dyslexia), learning disability or mental retardation. In India there is great pressure to succeed academically, from parents and teachers. HELP CHILD is a nongovernmental registered centre for learning disabled children under the Help Child Charitable Trust, Chennai, Tamil Nadu, established in 1994 exclusively for children with specific learning difficulty in reading, writing, spelling and mathematics in regular school education. It offers assessment and remedial teaching for children between 6 and 14 years. It also organizes screening camps for learning disability in schools and awareness and training programme for teachers and parents in Tamil Nadu. Another area where clinical psychologists work is in alcohol and addiction services. These are often
400
374
350 300 250
325
Annual Associate Members
255
Professional Annual members
200
Life Members
150 100 50 0
Fellow Members
Professional Life Members
77 32
Life Associate Members
9 Members
Figure 1. Membership of the Indian Association of Clinical Psychology (IACP). Total clinical psychologists in IACP, 1072. Source: Rehabilitation Council of India (RCI).
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inpatient services that focus upon the family and community as well as the individual. For example, for all inpatients there is an expectation that their partners (husband/wife) attend weekly sessions with them. The family and/or community are viewed as being the ‘primary carers’ with the staff as ‘secondary carers’ in supporting a person’s recovery. Psycho-education and support is usually offered to the family for up to 2 years (Agrawal et al., 2003; Dutt, 1993). Another area where clinical psychologists work is in the Schizophrenia Research Foundation (SCARF) which offers inpatient and outpatient services for adults experiencing psychotic symptoms. The focus is on rehabilitation and uses community psychology approaches that include identification of areas with high need, recruiting and training local people in mental health awareness to support families; mobile consultation clinics (i.e. on a SCARF bus) to work in the community; and research which may focus on the interaction between genetics and response to psychiatric medication. In India most of the clinical psychologists and psychiatrists work in liaison in the diagnosis and therapeutic management of their patients. Psychiatrists are also involved in teaching students in clinical psychology, learning disabilities, guidance and counselling courses. This interdisciplinary approach is very helpful for better patient care and effective knowledge sharing. Future developments – the need of the hour in psychology in India With these trends in mind, the following suggestions are made for what is required for the development of psychology and clinical psychology in India. 1. An increase in the number of colleges offering psychology courses, popularizing the course to ensure more enrolment and offering professional training and internships as part of the curriculum. 2. Any professional course in psychology such as clinical psychology, counselling psychology neuropsychology, rehabilitation psychology or similar should be started only after establishing linkages with a medical/healthcare institution. This will ensure practice-based supervised training for the students. 3. The time has come to establish an international professional body to recognize the curriculum and syllabuses of psychological courses conducted in various countries and to provide accreditation to graduates of such courses as professionals who can apply their knowledge and skills in countries when they move from one country to another. Such a body would also be
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able formulate and suggest a uniform curriculum in psychology for standardization. Globalization has made it easier for the migration of professionals from one country to another country. Often such professionals need to undergo courses to be eligible for certification to practise in those countries. Hence, there is a need for external professional bodies such as the British Psychological Society (BPS), the American Psychology Association (APA) to be involved in formulating, training, certifying and guiding research in improving continuous professional development (CPD) in India. Indexed journals and journals with strong impact factors are highly prized and are not easily accessible to academicians, researchers and students in India. Professional bodies such as the BPS and the APA should consider this and explore avenues for offering subsidized journals for low and middle income countries such as India. The WHO has devised a Dementia Survey Scale applicable to all countries. Similar psychological tests such as Wechsler Adult Intelligence Scale (WAIS), Wechsler Intelligence Scale for Children (WISC), Wechsler Memory Scale (WMS), Wide Range Achievement Test (WRAT) should be standardized across different countries. We also need to develop standardized culture-fair assessment tools and tests for rural and urban populations in India. There is a need to strengthen academic excellence through exchange programmes for postgraduate level students and teaching faculties between various universities in the UK, USA, Canada and India. Preference in admission, tuition fees and accommodation could be considered for Indian students based on merit criteria for pursuing higher studies in psychology in universities outside India. Similar to the Indian Council of Philosophical Research established to promote and fund philosophical studies, an Indian Council of Psychological Studies should be established to promote psychological studies all over India. This gap is felt very much today. Cross-cultural research needs to be conducted in collaboration with universities of various countries to accumulate universal knowledge in the field of psychology. Some of the areas which could be considered include: a) Learning disability among students. b) Psychological issues of underachievers. c) Psychological causes for people’s preference for alternative non-psychological support systems such as faith healing, seeking help
Current status of psychology and clinical psychology in India – An appraisal from saints, performing rituals, for example. d) Psychological impact of lifestyle changes due to globalization. e) Psychological impact of poverty eradication programmes (which are supported by international funding agencies and programmes implemented through bilateral cooperation between governments.
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Conclusion Hence, with the strong and growing need for the services of psychologists in India due to globalization and the increasing complexity of social and work life, it is the duty of academia to encourage students of psychology to take up careers in psychology and train them to become professionals to meet the increasing demand for psychological services with a high level of professionalism. Individuals completing academic courses need to be motivated and guided to equip themselves with more competencies and professional identity such as undergoing certification in assessment tools, specific counselling and therapeutic techniques. In India, there is not much opportunity for supervised training, for professional development catering to specific career avenues such as counselling in various settings (e.g. educational, marital and workplace counselling), training and development, organizational development, assessment and evaluation. At present the opportunities for such professional skills development in the field of psychology is limited. In India there is no centralized body to assess and certify/accredit psychologists as professionals. At present only the RCI gives approval for practising counsellors and special
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educators. Hence the recommendations listed above. Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. References Agrawal, S.P., Goel, D.S., Ichhpujani, R.L,Salhan, R.N., & Shrivastava, S. (2003). Mental Health: An Indian Perspective (1946–2003). New Delhi: Directorate General of Health Services, Ministry of Health and Family Welfare. Bhola, P., & Kapur, M. (2003). Child and adolescent psychiatric epidemiology in India. Indian Journal of Psychiatry, 45, 208–217. Bhola, P. (2010). Prevalence of emotional disturbance in Indian adolescent girls. Indian Journal of Clinical Psychology, 27, 217–222. Dutt, K. (1993). Clinical psychologist in India. Indian Journal of Clinical Psychology, 20, 1–4. Government of India. (2011). Census of India. Provisional Population Totals. Paper 1 Chapter 3: Size, Growth Rate and Distribution of Population 2011. Retrieved from http://www.censusindia. gov.in/2011-prov-results/prov_results_paper1_india.html ICMR. (2009). Mental Health Research in India. Indian Council of Medical Research Mental Health Studies Technical Monograph. Report submitted to Government of India New Delhi, India. Mukhopadhyay, M., Misra, S., Mitra, T., & Niyogi, P. (2003). Attention deficit hyperactivity disorder. Indian Journal of Pediatrics, 70, 789–792. NIMHANS. (2000, 2010). NIMHANS Departments. Handbook of All India Institute of Mental Health, National Institute for Mental Health and Neurosciences. Retrieved from http://www. nimhans.kar.nic.in/mhsp/default.htm NIMHANS. (2003). Attention Deficit Hyperactivity Disorder. Handbook of All India Institute of Mental Health, now National Institute of Mental Health and Neurosciences. Retrieved from www.nimhans.kar.nic.in/ Rani M. (2006). Psychosocial risk factors of depression in adolescents. (Unpublished Doctoral Dissertation). University of Madras, India. WHO. (2005). World Health Statistics. Geneva: World Health Organization.
Current status of psychology and clinical psychology in India – An appraisal
BABOO SANKAR VIRUDHAGIRINATHAN1 & SUBBIAH KARUNANIDHI2 Institute of Behavioural Sciences, Chennai, Tamil Nadu, and 2Department of Psychology, University of Madras, Tamil Nadu, India
Int Rev Psychiatry Downloaded from informahealthcare.com by University of Ulster at Jordanstown on 03/31/15 For personal use only.
1Care
Abstract This paper provides an overview of the social and cultural context for the emergence and development of psychology in India and also more specifically of the development of clinical psychology. It details the range of universities offering psychology programmes and the various bodies involved in supporting the development of the psychology. The paper also describes the development of clinical psychology in India and the variety of roles undertaken by clinical psychologists. Finally, it raises a number of issues facing the development of Indian psychology into the future.
Introduction India, a subcontinent in south Asia, is the seventh largest country by area and second largest by population. It is pluralistic, multilingual, multi-ethnic, multicultural, and the second largest democratic country in the world with a growing population of more than 1.3 billion people (Government of India, 2011). In this article we outline the major psychological concerns for India and the development of psychology and clinical psychology in the country.
Major psychological concerns in India The current population of India consists of a sizeable number of children, adolescents and young adults, which, though seeming to add strength to the human resources of the country, also brings in concerns about their mental health. The Indian Council for Medical Research (ICMR), reported that 12.8% of children suffer from mental health problems (ICMR, 2009). Various screening surveys report that 1–20% of the children in India were found to have attention deficit hyperactivity disorder (ADHD), with a vast increase over the last few years (Mukhopadhyay et al., 2003). According to the National Institute of Mental Health, Bangalore, India, schizophrenia is prevalent among 1.1% of the total population, while the overall lifetime prevalence rate of mental disorders is 10–12% (NIMHANS, 2003). The report points out that while the indian government has a
separate programme for mental health, there is a lack of adequate psychologists, counsellors and infrastructure facilities. Epidemiological studies carried out in India report that 2–30% of adolescents have psychological problems, of whom 8% have psychological distress, and 6% of adolescent boys and 12% of girls have emotional disturbances (Bhola & Kapur, 2003; Bhola, 2010). In general, 7.5% of Indians face some sort of emotional disorder. Research shows depression to be a major cause of suicide in Tamil Nadu (Ranimohanraj, 2006). India has many distinctive issues which are of paramount importance in terms of impacting on quality of life. Some of the notable issues are: • Increases in the rates of learning disabilities and underachievement among school children. • Psychological issues of children in need of care and protection housed in juvenile homes. • A decline in joint family systems and migration of educated youngsters leading to adjustment problems and ageing parents being isolated, leading to geriatric issues such as loneliness, elder abuse and victimization among older people. • Increasing employment opportunities for women in information technology-based industries resulting in changed relationship opportunities and patterns which may lead to changes and adjustment issues for all family members, which may have a range of psychological effects; constant pressure on the young to get gainful and meaningful employment
Correspondence: B. S. Virudhagirinathan, Care Institute of Behavioural Sciences, Chennai, Tamil Nadu, India. Tel: 044–28275747. Fax: 044–28275747. E-mail: [email protected] (Received 4 July 2014 ; accepted 4 July 2014 ) ISSN 0954–0261 print/ISSN 1369–1627 online © 2014 Institute of Psychiatry DOI: 10.3109/09540261.2014.942604
Current status of psychology and clinical psychology in India – An appraisal
•
•
Int Rev Psychiatry Downloaded from informahealthcare.com by University of Ulster at Jordanstown on 03/31/15 For personal use only.
• •
on the basis of increasing competition with more people being educated and fewer employment opportunities created. Psychological impact of poverty, discrimination due to caste, class, religion, gender, language, for example, resulting in conflicts which may affect social well-being. Psychosociological issues relating to migrant labourers (from rural to urban and from underdeveloped to developing states within India). Refugees. Availability of an alternative support system. Most of the time this is through religion, faith healers (swamijis, saints, palmists, soothsayers), pseudo counsellors (who offer counselling after reading a self-help book); rituals, for example, are used as a counselling or therapeutic technique to address psychological issues. Ultimately, when the issue becomes serious they go to a psychiatrist who sometimes prescribes only drugs even for simple psychological problems such as anger, exam fear, lack of concentration, anxiety, tension, for example.
However, according to the World Health Organization (WHO) estimate (2005), there are only 0.03 psychologists per 100,000 people in India (0.2 psychiatrists and 0.05 psychiatric nurses), which is insufficient to handle the number of people affected with any mental and behavioural disorder. Even the available psychologists are mostly working in urban areas where less than 28% of the population live. Considering that 72% of the population live in rural areas, it can be concluded that there is a dire need for more professional psychologists in India. Emergence of psychology in India Psychology in India emerged out of the subject of philosophy when Girindra Shekar Bose established the first Indian psychological laboratory in the University of Calcutta in 1915, which ultimately led to the establishment of the first psychology department in 1916. In 1922 he established the first psychoanalytic society in India, and in 1924 Mysore University established their department of psychology followed by creation of a psychology department in Lucknow University in 1929. In 1943, G.D. Boaz, an eminent psychologist of international repute created a separate psychology department at the University of Madras in Tamil Nadu, branching out from the philosophy department. Psychology departments in the universities started with courses in general psychology, developmental psychology and applied psychology. The emergence of several new industries due to industrialization necessitated a rapid expansion in courses on industrial psychology. Courses in clinical psychology and
567
community psychology followed as the attention shifted from the laboratory to the community. Subsequently, clinical psychology and organizational behaviour became established standard courses in psychology. Sports psychology, cognitive psychology, health psychology, and rehabilitation and counselling psychology have also emerged as newer branches in psychology during the last two decades. Table 1 shows the major universities in India offering psychology courses. Undergraduate courses in psychology are being conducted in government, government-aided and private colleges in many parts of the country. Of late, many colleges in the private sector have been keen to start courses in psychology both at the undergraduate and postgraduate level, offering selffinancing courses, which is a further indication of the increasing popularity of psychology in India. Multidisciplinary approaches in psychology have also started to develop in psychological studies, incorporating techniques and applications from other disciplines such as social sciences, business management, medicine, human resources and philosophical disciplines such as yoga therapy. The field is also expanding, with emerging trends in political governance, forensic studies, and cognitive development. All these developments pose a challenging task for psychologists to update their professional knowledge and skills to move progressively with emerging global developments to achieve holistic and progressive developments. Apart from the major universities and colleges, there are many private independent institutions offering academic courses as well as professional certifications. Notable among them are the Tata Institute of Social Sciences, Mumbai, the A.N. Sinha Institute of Social Sciences, Patna, the National Brain Research Centre, Gurgaon, and the Centre for Organization Development, Hyderabad. The Defence Institute of Psychological Research, Delhi, is a unique institution attached to the Ministry of Defence, Government of India, which applies psychological methods and strategies for assessment, training and building cadres of defence officers based on psychological profiling. They also conduct experimental research on various areas of psychology including psycho-physiological changes in high altitudes and stress tolerance, and sponsor research in psychology by granting funds. The Indian Society of Applied and Behavioural Sciences, New Delhi, is another professional association providing opportunities for professional development of behavioural scientists based on laboratory methods. There are also national level professional associations and societies that have been functioning for more than three decades in India: the Indian Academy of Applied Psychology (IAAP), Chennai, the National Academy
568
B. S. Virudhagirinathan & S. Karunanidhi
Int Rev Psychiatry Downloaded from informahealthcare.com by University of Ulster at Jordanstown on 03/31/15 For personal use only.
Table 1. Major universities in India offering psychology courses with specialization.
University
Year of establishment
Calcutta University
1916
Mysore University
1924
Lucknow University
1929
University of Madras Osmania University
1943 1950
Delhi University
1957
Utkal University
1958
Mumbai University Andhra University
1959 1967
Bangalore University
1974
Calicut University
1976
Saurastra University
1989
of Psychology, Mumbai, the Indian Psycho-Analytical Society, Kolkatta, the Indian Association of Clinical Psychology (IACP), New Delhi, the Indian School Psychology Association, Pondicherry, the Indian Psychological Association, New Delhi, as well as the newly created Neuropsychological Society of India in Chennai. Most of the academic societies regularly conduct conferences, symposia workshops and events to disseminate current research trends in various fields of psychology. They also provide opportunities for young psychologists to interact with senior psychologists and for networking. To cite an example, the Indian Academy of Applied Psychology has conducted 47 national conferences during its 50 years of existence. These conferences are conducted in various parts of the country focusing on cuttingedge themes of psychology. The following are some of the themes explored by conferences organized by various professional societies during the last five years: Challenges of Applied Psychology for Societal Transformation (IAAP, Calcutta, 2008), Applied Psychology in Changing Cultural Perspectives (IAPP,
Specialization Clinical psychology Developmental psychology Social psychology Cognitive neuropsychology Learning disability Counselling and health psychology Organizational psychology Social psychology Experimental psychology Organizational behaviour Human resource development Child development Human resource development psychology Child psychology Industrial psychology Rehabilitation psychology Counselling psychology Applied psychology Cognitive psychology Organizational psychology Developmental psychology Counselling psychology Applied psychology Para-psychology Counselling psychology Clinical psychology Industrial psychology Child guidance Clinical psychology Organizational behaviour Clinical psychology Social psychology Psychological testing Applied psychology
Aurangabad, 2009), the National Annual Conference of the IAP on Enabling the Disabled (IACP, Calcutta, 2009), Quality of Life and Globalization: Effective Self-Care Interventions (IAAP, Vishakhapatnam, 2010); Clinical Psychology for a Changing World: Practices, Training and Research (IACP, Bangalore, 2010), Life Skills for Enhancing Quality of Life (IAAP, Mysore, 2011), Clinical Forensic Psychology: An Emerging Scientific Discipline (IACP, Ahmadabad, 2011); and Applied Psychology in Transforming Education and Management Sciences in the Context of Globalization (IAAP, Cochin, 2012). As well as these various bodies and institutions, the following main academic journals in psychology are published in India, allowing researchers to showcase their research to the world. They include Psychological Studies, the Indian Journal of Clinical Psychology, the Journal of Indian Academy of Applied Psychology, the Journal of Psychological Research, the Journal of Community Psychology, the Indian Journal of Applied Psychology, the Indian Psychological Review, and the Journal of Indian Health Psychology.
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Current status of psychology and clinical psychology in India – An appraisal
569
Clinical psychology in India
Rehabilitation Council of India
Clinical psychology in India is a distinct and independent field of science providing mental health services. It draws heavily from the biological, medical and social sciences. The first postgraduate course in clinical psychology was started by the government of India in 1955 with a view to creating specialists in mental health (NIMHANS, 2000, 2010). The first course was a diploma in medical psychology (DMP) which later was termed a diploma in medical and social psychology (DM & SP). Presently, it is a master of philosophy (MPhil) in medical and social psychology. The duration of the training is 2 years, and to be eligible the student must already have an MA or MSc in psychology. There is also an MPhil in clinical psychology which is a 2-year course; admission is on the basis of an entrance examination consisting of a written test, interview and practice, and a doctorate of psychology (PhD) which is a four year course and requires an MA or MSc degree in psychology. The IACP was established in 1969 with the aims of promoting teaching, research and practices of clinical psychology, formulating and advising on standards of education in clinical psychology at university level and at professional level, developing an objective and experimental approach to the problems of clinical psychology among professionals and research workers, extending clinical psychological services to the field of mental health and related areas, advising central and state governments and other bodies on the various aspects of causation, treatment, rehabilitation and prevention of mental disorders and allied conditions, including legislative and administrative matters without affiliating to any political parties, cooperating and collaborating with agencies and scientific bodies interested in clinical psychology and/ or allied subjects outside India. Fig. 1 shows the membership of the IACP which currently has 1,072 members.
Another important body for clinical psychologists within India is the Rehabilitation Council of India (RCI) which was set up as a registered society in 1986. In September 1992, the RCI Act was passed by Parliament and the RCI became a statutory body on 22 June 1993. The Act was amended by Parliament in 2000 to make it more broadly based. The mandate given to the RCI is to regulate and monitor services given to people with disability, to standardize syllabuses and to maintain a Central Rehabilitation Register of all qualified professionals and personnel working in the field of rehabilitation and special education. The Act also prescribes punitive action against unqualified people delivering services to individuals with disabilities. The professionals registered with RCI are entitled to practise as rehabilitation professionals in any part of India. No one other than the rehabilitation professionals who possess a recognized rehabilitation qualification and are enrolled on the Central Rehabilitation Register can hold office as a rehabilitation professional or any such office (by whatever designation called) in government or in any institution maintained by a local or other authority. As well as clinical psychologists, other professionals can be registered with the RCI. The RCI also offers psychology courses in the fields of rehabilitation psychology such as the MPhil (rehabilitation psychology). Clinical psychologists in India are involved in a range of roles including testing and diagnostic assessment, psychological treatment, teaching and research. In India great importance is placed on testing. This is because of the role psychological testing plays in diagnosis, management and research. Lobar function tests are frequently carried out by neurophysiologists and surgeons. Family physicians and paediatricians also carry out psychological assessment for diagnosis and management in children and adolescents who have academic/behavioural difficulties. The terminology used for developmental disorders is very different in India; it is specific learning difficulty (dyslexia), learning disability or mental retardation. In India there is great pressure to succeed academically, from parents and teachers. HELP CHILD is a nongovernmental registered centre for learning disabled children under the Help Child Charitable Trust, Chennai, Tamil Nadu, established in 1994 exclusively for children with specific learning difficulty in reading, writing, spelling and mathematics in regular school education. It offers assessment and remedial teaching for children between 6 and 14 years. It also organizes screening camps for learning disability in schools and awareness and training programme for teachers and parents in Tamil Nadu. Another area where clinical psychologists work is in alcohol and addiction services. These are often
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Figure 1. Membership of the Indian Association of Clinical Psychology (IACP). Total clinical psychologists in IACP, 1072. Source: Rehabilitation Council of India (RCI).
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inpatient services that focus upon the family and community as well as the individual. For example, for all inpatients there is an expectation that their partners (husband/wife) attend weekly sessions with them. The family and/or community are viewed as being the ‘primary carers’ with the staff as ‘secondary carers’ in supporting a person’s recovery. Psycho-education and support is usually offered to the family for up to 2 years (Agrawal et al., 2003; Dutt, 1993). Another area where clinical psychologists work is in the Schizophrenia Research Foundation (SCARF) which offers inpatient and outpatient services for adults experiencing psychotic symptoms. The focus is on rehabilitation and uses community psychology approaches that include identification of areas with high need, recruiting and training local people in mental health awareness to support families; mobile consultation clinics (i.e. on a SCARF bus) to work in the community; and research which may focus on the interaction between genetics and response to psychiatric medication. In India most of the clinical psychologists and psychiatrists work in liaison in the diagnosis and therapeutic management of their patients. Psychiatrists are also involved in teaching students in clinical psychology, learning disabilities, guidance and counselling courses. This interdisciplinary approach is very helpful for better patient care and effective knowledge sharing. Future developments – the need of the hour in psychology in India With these trends in mind, the following suggestions are made for what is required for the development of psychology and clinical psychology in India. 1. An increase in the number of colleges offering psychology courses, popularizing the course to ensure more enrolment and offering professional training and internships as part of the curriculum. 2. Any professional course in psychology such as clinical psychology, counselling psychology neuropsychology, rehabilitation psychology or similar should be started only after establishing linkages with a medical/healthcare institution. This will ensure practice-based supervised training for the students. 3. The time has come to establish an international professional body to recognize the curriculum and syllabuses of psychological courses conducted in various countries and to provide accreditation to graduates of such courses as professionals who can apply their knowledge and skills in countries when they move from one country to another. Such a body would also be
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able formulate and suggest a uniform curriculum in psychology for standardization. Globalization has made it easier for the migration of professionals from one country to another country. Often such professionals need to undergo courses to be eligible for certification to practise in those countries. Hence, there is a need for external professional bodies such as the British Psychological Society (BPS), the American Psychology Association (APA) to be involved in formulating, training, certifying and guiding research in improving continuous professional development (CPD) in India. Indexed journals and journals with strong impact factors are highly prized and are not easily accessible to academicians, researchers and students in India. Professional bodies such as the BPS and the APA should consider this and explore avenues for offering subsidized journals for low and middle income countries such as India. The WHO has devised a Dementia Survey Scale applicable to all countries. Similar psychological tests such as Wechsler Adult Intelligence Scale (WAIS), Wechsler Intelligence Scale for Children (WISC), Wechsler Memory Scale (WMS), Wide Range Achievement Test (WRAT) should be standardized across different countries. We also need to develop standardized culture-fair assessment tools and tests for rural and urban populations in India. There is a need to strengthen academic excellence through exchange programmes for postgraduate level students and teaching faculties between various universities in the UK, USA, Canada and India. Preference in admission, tuition fees and accommodation could be considered for Indian students based on merit criteria for pursuing higher studies in psychology in universities outside India. Similar to the Indian Council of Philosophical Research established to promote and fund philosophical studies, an Indian Council of Psychological Studies should be established to promote psychological studies all over India. This gap is felt very much today. Cross-cultural research needs to be conducted in collaboration with universities of various countries to accumulate universal knowledge in the field of psychology. Some of the areas which could be considered include: a) Learning disability among students. b) Psychological issues of underachievers. c) Psychological causes for people’s preference for alternative non-psychological support systems such as faith healing, seeking help
Current status of psychology and clinical psychology in India – An appraisal from saints, performing rituals, for example. d) Psychological impact of lifestyle changes due to globalization. e) Psychological impact of poverty eradication programmes (which are supported by international funding agencies and programmes implemented through bilateral cooperation between governments.
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Conclusion Hence, with the strong and growing need for the services of psychologists in India due to globalization and the increasing complexity of social and work life, it is the duty of academia to encourage students of psychology to take up careers in psychology and train them to become professionals to meet the increasing demand for psychological services with a high level of professionalism. Individuals completing academic courses need to be motivated and guided to equip themselves with more competencies and professional identity such as undergoing certification in assessment tools, specific counselling and therapeutic techniques. In India, there is not much opportunity for supervised training, for professional development catering to specific career avenues such as counselling in various settings (e.g. educational, marital and workplace counselling), training and development, organizational development, assessment and evaluation. At present the opportunities for such professional skills development in the field of psychology is limited. In India there is no centralized body to assess and certify/accredit psychologists as professionals. At present only the RCI gives approval for practising counsellors and special
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educators. Hence the recommendations listed above. Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. References Agrawal, S.P., Goel, D.S., Ichhpujani, R.L,Salhan, R.N., & Shrivastava, S. (2003). Mental Health: An Indian Perspective (1946–2003). New Delhi: Directorate General of Health Services, Ministry of Health and Family Welfare. Bhola, P., & Kapur, M. (2003). Child and adolescent psychiatric epidemiology in India. Indian Journal of Psychiatry, 45, 208–217. Bhola, P. (2010). Prevalence of emotional disturbance in Indian adolescent girls. Indian Journal of Clinical Psychology, 27, 217–222. Dutt, K. (1993). Clinical psychologist in India. Indian Journal of Clinical Psychology, 20, 1–4. Government of India. (2011). Census of India. Provisional Population Totals. Paper 1 Chapter 3: Size, Growth Rate and Distribution of Population 2011. Retrieved from http://www.censusindia. gov.in/2011-prov-results/prov_results_paper1_india.html ICMR. (2009). Mental Health Research in India. Indian Council of Medical Research Mental Health Studies Technical Monograph. Report submitted to Government of India New Delhi, India. Mukhopadhyay, M., Misra, S., Mitra, T., & Niyogi, P. (2003). Attention deficit hyperactivity disorder. Indian Journal of Pediatrics, 70, 789–792. NIMHANS. (2000, 2010). NIMHANS Departments. Handbook of All India Institute of Mental Health, National Institute for Mental Health and Neurosciences. Retrieved from http://www. nimhans.kar.nic.in/mhsp/default.htm NIMHANS. (2003). Attention Deficit Hyperactivity Disorder. Handbook of All India Institute of Mental Health, now National Institute of Mental Health and Neurosciences. Retrieved from www.nimhans.kar.nic.in/ Rani M. (2006). Psychosocial risk factors of depression in adolescents. (Unpublished Doctoral Dissertation). University of Madras, India. WHO. (2005). World Health Statistics. Geneva: World Health Organization.
