Jan Marie Fritz



This paper defines clinical sociology and summarizes the history and development of the field. The general contributions of clinical sociologists are outlined and the field's prospects are discussed.

1. Defining clinical sociology

Clinical sociologists in many countries are writing about a range of important academic and practical topics (e.g., Aubert and Gaulejac (l99l) in France; Tosi (1991) in Italy; Clark, Fritz and Ricker (l990) and Lackey (l990) in the United States; Loicq (1992) in Belgium; Rigas (l99l) in Greece and Teixeira (1991) in Brazil). One of their interests has been the development of the field of clinical sociology -- its history, theories and methods.

In the United States, for instance, volumes about the field began appearing in the late 1970s (e.g., Straus, 1979; Glassner and Freedman, 1979; Fritz, 1985; Fritz and Clark, 1989; Rebach and Bruhn, 199l and Straus, 1993) and the Clinical sociology review, a journal, began publication in 1982. Clinical sociology also was being discussed in France (e.g., van Bockstaele, van Bockstaele, Barrot and Magny, 1963; Gaulejac, 1986; Enriquez, 1992), in the Netherlands (e.g., Ramondt, 1991; van de Vall, 1991) and by french-speaking sociologists in Canada (e.g., Sevigny, 1977; Houle, 1987). Two books on clinical sociology currently are under development in Greece.

In the United States the words "clinical" and "sociology" were first linked in print in 1930. Milton C. Winternitz (1930a,b), a physician and dean of the Yale university medical school, wrote about his proposal to establish a department of clinical sociology. That same year Abraham Flexner (1930), mentioned Winternitz' clinical sociology proposal in his Universities: American, English, German.

The first published discussion of clinical sociology by a sociologist appeared in l93l. That was the year Louis Wirth's (1931a) "Clinical sociology" was in The American journal of sociology and when Wirth (193lb), in a career pamphlet, identified clinical sociology as one of the "major divisions of sociology."

A discussion of the "clinical" approach of sociologists and of "clinical sociology" has appeared in American publications at least every few years during the last 60 years (Fritz, 1989b, 1991). The definition usually involved several threads -- analysis, research and intervention. The American literature, over the last ten years, particularly has emphasized intervention.

Clinical sociology is defined here as a multidisciplinary, humanistic field that assesses and reduces problems through analysis and intervention. Clinical analysis is the critical assessment of beliefs, policies and/or practices with an eye toward improving the situation. Intervention, the creation of new systems as well as the change of existing systems, is based on continuing analysis (Fritz, 1991a).

Clinical sociologists have speciality areas -- such as ethnic relations or organizational analysis -- and work in many capacities. They are, for example, community organizers, sociotherapists, conflict interventionists, social policy implementors and administrators. Many clinical sociologists combine their intervention work with full-time or part-time university teaching.

Clinical sociologists use the range of research methods and are very diverse in terms of their theoretical approaches. They most frequently undertake case analysis but use both qualitative and quantitative research skills for assessment and evaluation. Clinical sociologists are eclectic in their use of theory in that they bring together the approaches from the different disciplines they have studied. Usually one sociological approach -- e.g., systems theory, symbolic interaction, conflict theory -- is basic to the practitioner's work and is combined with one or more other approaches. A combination of approaches (e.g., conflict theory and behaviorism) may be determined to be the most useful in analyzing a problem or intervening in a system.

The role of the clinical sociologist can be at one or more levels of focus from the individual to the inter-societal. Even though the clinical sociologist specializes in one or two levels of intervention, the translation of social theory, concepts and methods into practice requires a special kind of skill. The clinical sociologist must not only be able to recognize the various levels of intervention but must move among the levels for analysis and intervention (Freedman, 1984).

2. The History of Clinical Sociology

The origins of the field date back at least five centuries -- to the work in North Africa of Arab historian and statesperson Abu Zaid Abdalrahman ibn Muhammad ibn Khaldun Wali-ad-Din-Hadrami, best known as Ibn Khaldun (1331-1406). He founded "the science of human social organization," the basis for what is now called sociology (Baali, 1988:xi, 107). In his Muqaddimah, Ibn Khaldun provided numerous clinical observations based on his work experiences, which included seal bearer, secretary of state, ambassador, negotiator and judge. In the latter role he was seen as a reformer who practiced with "strict honesty and great integrity" (Baali, 1988:1-3; Fritz, 1989b:73).

Ibn Khaldun was the first to use a scientific approach to the study of social life in combination with intervention. But he and many individuals now designated as early sociologists, were not called sociologists during the periods in which they lived. Identifying the earliest clinical sociologists is also difficult because many of them did not use the label for themselves. Nonetheless, a review of the work of the early scientists and practitioners allows us to identify precursors and clinicians.

Among those in Europe who would be included at the very least as precursors of contemporary clinical sociology were the classical sociologists Auguste Comte, Émile Durkheim and Karl Marx. Comte believed the scientific study of societies would provide the basis for social action. Durkheim and Marx provided a clinical perspective, a model or framework, for the analysis of social dilemmas (Fritz, 1989b:73). Among those whose work has been identified directly as clinical sociology is Beatrice Webb (1858-1943). Webb was active in the Fabian Society and helped to establish the London School of Economics. She identified herself with sociology and social investigation and had a strong influence on British social policy (Fritz, 1991c:17).

The early American sociologists were practitioners and professors, and some -- such as Frank Blackmar (Fritz, 1990c) in Kansas and W.E.B. Du Bois (Fritz, 1990a) in Georgia -- combined these roles. While sociology was taught beginning in the late 1800s in the United States, the earliest references to the label "clinical sociology" are in the late 1920s and 1930s. During those years there were clinical sociologists (e.g., Louis Wirth, Harvey Zorbaugh, Leonard Cottrell) who headed or worked in clinics for children and professors (e.g., Ernest Burgess, Louis Wirth, Harvey Zorbaugh) who taught courses entitled "clinical sociology" (Fritz, 1991a).

During the last sixty years there always has been some discussion of clinical sociology in the United States, but it wasn't until the late l970s that the field again gained some attention from the public and from other sociologists. The growth of clinical sociology has been due in large part to the efforts of the sociological practice Association (established in l978 as the clinical sociology Association). The directors of the organization put an extensive publishing schedule in place and established an innovative, competency-based certification process.

During the 1960s and 1970s interest in clinical sociology also was developing in several other countries, particularly in France and Canada. Among the significant contributors in France were Jacques van Bockstaele, Maria van Bockstaele, Max Pages and Eugene Enriquez and in Quebec one would have to note the pioneering work of Robert Sevigny and his colleagues.

3. The Utility of Clinical Sociology

Each country -- depending on its level of economic development, its priorities and its willingness to see and meet its needs -- will identify, analyze and take actions to alleviate social problems. Clinical sociologists, like those in many fields, can and are helping to solve or at least reduce the problems in their own countries as well as in multinational settings. At this point it might be helpful to focus on the kinds of contributions we might expect from clinical sociologists.

The major contributions will differ depending upon a number of factors such as a practitioner's level of training (B.A., M.A. or Ph.D.), length and type of experience and areas of competence. Many skilled practitioners in the United States apply for certification. We might expect the following contributions, in general, from doctoral-level certified practitioners (Fritz, l992c):

Theoretical analysis. The clinical sociologist has had extensive training in theory. The result is a working knowledge of a range of theories in two or more disciplines that affect her or his area of specialization. The clinical sociologist is expected to:

- have the ability to translate theories for practical use

- periodically reflect on her or his own theoretical approach and the possible effects of this approach on the work undertaken

- provide theoretical perspective, when the situation warrants, for clients, colleagues, employers and interested community members

Social systems perspective. A sociologist's training emphasizes understanding of (l) the social system -- a configuration of positions, roles and norms -- as a dynamic force and (2) the effects of membership in overlapping systems. Clinical sociologists are expected to be knowledgeable about systems, to move between theory and practice in working with systems and to assist individuals and groups in assessing and possibly changing systems.

Levels of analysis. The clinical sociologist is expected to concentrate on a level of analysis (e.g., individual, small group, organization, local community, international) when undertaking an intervention project. But the practitioner also should have the ability not only to recognize the various levels but to move among them for analysis and intervention.

Methodological sophistication. A sociologist receives extensive training in research methods. Clinical sociologists are expected to know the comparative strengths and weaknesses of qualitative and quantitative methods in their practice settings.

A clinical sociologist also is expected to recommend appropriate methods (e.g., participatory research, action research, focus groups) by taking into account the objectives of the involved parties, ethical considerations and available resources.

Intervention skills. A clinical sociologist will have interdisciplinary training and substantial intervention experience in her or his speciality area. The certified practitioner would get beyond simply pointing out a few of the difficulties in a situation. The practitioner will put a process in place which will allow for the analysis of situations and for the development of alternative ways of dealing with situations. The clinical sociologist, when possible, will initiate or facilitate interventions. In any intervention, the clinical sociologist is bound by a code of ethics and is expected to identify and address ethical issues that may arise.

Specialized body of knowledge. Each clinical sociologist has a frame of reference which emphasizes social factors (e.g., socio-economic conditions, ethnicity, gender) and at least one or two areas of special competence -- e.g., health promotion, criminology, counseling, community organization or social policy. A clinical sociologist is expected to work in areas where she or he has particular expertise, and to advise interested parties before undertaking work that goes beyond the special areas of knowledge or intervention.

Social problem identification. The clinical sociologist -- because of her/his critical approach, problem-solving outlook and multidisciplinary education -- is expected to be able to assist in the early identification of social problems and to help put a humane process in place that will reduce or resolve problems.

Certainly clinical sociologists are not the only ones who might make these kinds of contributions. It is true, however, that different disciplines generally emphasize one or more of the areas on the list and give minimal coverage to some others. Sociology programs, for instance, frequently stress certain explanatory factors (e.g., economic or political decisions, stratification systems), social theory and research methods. They often do not provide supervised training in intervention and so many clinical sociologists have had to receive this training outside of their major program.

4. The Market Situation for Clinical Sociology

Clinical sociology is a very diverse field. We intervene or analyze intervention projects at many levels (e.g., individual, interpersonal, neighbourhood, organization, intersocietal). We have a complex labor market situation and so it is difficult to be very specific about the demand for our work. As we have no data on our international labor market, I will rely here on information only from the United States in hopes that there are some general points that may be made from this one case.

The U.S. Department of Labor, in its Occupational Outlook Handbook, has identified clinical sociology as one of the growth areas within sociology in the United States (Clark and Fritz, 1991). Within the field of clinical sociology I think our current growth areas are prevention projects that encourage health or discourage delinquency or criminal behavior; conflict intervention; case management of the delivery of a range of social and economic services; market analysis (including focus groups); democratic renewal/development and economic development/revitalization of communities.

Clinical sociologists who work as part of multidisciplinary teams at major research institutions have been very successful at receiving federal funds particularly in mental health; alcohol and drugs; aging and education. The situation for funding of social science projects at the federal level is very much affected by which political party is in power and by the way in which a funding agency is organized. For instance, the national science Foundation (Nsf) will now have a directorate for social science research and this should assure at least a guaranteed presence for social science work.

The Consortium of social science Associations (Cossa) was established about ten years ago in the United States. It has helped see that federal funding for social science research has not disappeared during periods of economic or political difficulty. This is particularly important when one realizes that at the Institutes of Health each institute generally only spends 3-4% of its research budget on social science research. (Some institutes -- e.g., aging and child health -- do devote a higher percentage of their budget to social and behavioral research.) Cossa likes to think it has been helpful in seeing that NSF established a social science research directorate; in encouraging the U.S. Congress to suggest that each health institute report its funding for social science projects and in obtaining funding for a social science health survey at the institute responsible for studies on aging (Auerbach, 1992).

None of the federal funding sources is equally interested in all theoretical perspectives, all research topics, all methodologies or all kinds of applicants (e.g., unaffiliated research or from a university or college that does not have a national reputation for research). This means that federal funding is only a possibility for a limited number of American clinical sociologists.

Many clinical sociologists do receive funds for their projects from state governments and foundations. In most cases they are able to obtain funds because of their expertise about the subject not because they are sociologists. They are more successful when the reviewing panels are not connected to any particular discipline and when they work as part of a multidisciplinary team. Even saying this, however, attention still needs to be paid to the expectations from the funding source. For instance, tobacco-control projects in California that are funded by the California Department of health services expect certain staff members will be called "health educators" rather than clinical sociologists, sociologists or psychologists.

Some clinical sociologists are interested in important projects that will not easily attract funding. These may be ones, for instance, that are too hot in a political sense or that do not fall within current funding priorities.

Clinical sociologists are hired (on a full-time or part-time basis) by businesses and government units to conduct research or undertake intervention research around questions of marketing. Some of these individuals run consulting operations, others administer market research divisions or work as part of intervention research teams. It appears that employment in larger consulting groups seems to be steady as the larger companies prefer to hand assignments to outside groups now and keep their full-time employment "lean" during these economically difficult times. Unless a business has a sociologist doing the hiring, the fact that an applicant is a sociologist probably will not be seen as a particular advantage. During the hiring process many sociologists only define themselves as "market researchers" or "focus group trainers" rather than as sociologists.

Training opportunities for graduate students in intervention research and intervention are being limited in many ways in the United States. I recently visited a county department of mental health where there were different state employees whose jobs were to supervise graduate students in social work, counseling or administration. No such arrangement was easily possible for graduate students connected to other disciplines (including sociology). This was because state laws did not mandate participation; state organizations and licensing boards had not opened the doors for participation and sociologists were not seen as eligible for third-party payments. The movement on the part of some large professional organizations to see that only their students are eligible for jobs in certain areas may not affect the current employment of sociologists but will affect the number of sociology students that we attract and the viability of our graduate programs.

5. Conclusion

Clinical sociology is a multidisciplinary, humanistic field that assesses and reduces problems through critical analysis and intervention. Clinical sociologists in at least 25 countries are providing valuable research and intervention expertise to individuals, organizations, local communities, national governments and international bodies. Their work addresses the conditions which are basic to our perceived problems and focuses our efforts on analysis, prevention and early intervention.

The vitality of the field of clinical sociology is indicated in at least three ways:

- the rapidly growing body of literature

- the number of national and international conferences being held that focus on the field or feature clinical sociologists

- the number of professionals in many fields (e.g., psychology, social work, business) who are joining our organizations and conferences because they value clinical sociological perspectives.

The growth of the field of clinical sociology may be facilitated in a number of ways. An analysis of the American case indicates that at least three areas need to be addressed.

First, policymakers and the public need to see the value of our work in policy statements, magazine articles and popular books. This means that those doing intervention need to take the time to write about their work for a popular audience and that those who write need to clearly identify themselves as clinical sociologists.

Second, we need to see that "clinical sociology" is a category in personnel listings and included in funding priorities. (The visibility of clinical sociology is tied, of course, to the visibility of the general field of sociology. We need to see more instances, as in Spain, where a downtown building in Madrid is clearly labelled as the center of sociological research and where an employee, such as at one of the Mondragon cooperatives, has a business card that clearly labels him as a staff sociologist.)

Third, we need to establish clinical sociology (intervention and intervention research) programs within academic settings (Fritz and Clark, 1992). Sociologists and others who are interested in receiving clinical sociology training should have the possibility of doing so within a variety of established sociology programs.



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