Chapter Two: The Counseling Professions in Historical Perspective
Chapter Overview
The first chapter defined the term “clinical mental health counselor,” outlining the basic
tenets of these professionals and distinguishing them from others in the helping professions. The
second chapter builds on this foundation by reviewing the history of the counseling professions.
This chapter begins by exploring early views of mental health and illness, using such sources as
archaeological discoveries and the ancient writings of the early Greek philosophers and the
authors of the Old Testament. The Middle Ages brought contradictory perspectives on mental
illness, as some believed that mental illness was a result of demonic activity while others
developed centers for the humane care of the mentally ill. Systems of hospitals called asylums
had developed across Europe by the 16th century. In the 1700s, reformers successfully advocated
for “moral treatment” in these asylums.
The asylum supervisors were members of the medical health profession, and in 1844 they
formed the Association of Medical Superintendents of American Institutions for the Insane
(AMSAII). In 1927, this association changed its name to the American Psychiatric Association,
the professional home of psychiatrists today. In this time period, a physiological cause and cure
for paresis (syphilis of the brain) was discovered, leading doctors to search for other medical
roots of mental illness. Neurologist Sigmund Freud discovered that neuroses could be
successfully treated through hypnosis and talk therapy, and psychiatrist Emil Kraepelin
developed the first classification system for mental illnesses.
social work profession by the end of the 19th century. Meanwhile, Frank Parsons became
concerned by the problem of youth unemployment and founded the Boston Vocational Bureau in
1908, developing the role of vocational counselors and creating a self-administered questionnaire
that matched the interests and aptitudes of youth with appropriate occupations.
In the 1920s though 1960s, the counseling profession developed as new approaches to
Administration began to fund doctoral-level internships only, creating a boundary between
psychologists and counselors, who no longer had a professional home when APA restructured
Division 17 to be the Division of Counseling Psychology.
Due to these changes, other professional organizations emerged to provide professional
homes for non-doctoral level counselors. The American Association of Marriage and Family
Mental Health Centers Act which created centers across America to provide short-term inpatient
treatment, as well as outpatient treatment. As non-doctoral level counselors came to be the
primary providers of care in these mental health centers, CACREP established standards for
programs that trained counselors for community settings. APGA developed a new division in
1976 (the American Mental Health Counselors Association) to create a home for the
professionals in this area. Psychology and clinical social work had already set a precedent for
regulating their respective professions through state licensure, so APGA also sought licensure for
counselors. In 1976, Virginia became the first state to pass counselor licensure laws.
Learning Objectives
By the end of the chapter, students should be able to:
• Discuss early views of mental health and illness.
• Explain the professional development of psychiatry, psychology, and social work and
identify key people in this development.
• Chart the professionalization of counseling through APGA and explain the need for an
organization to represent master’s level counselors.
• Articulate the impact of the Community Mental Health Centers Act of 1963
• Understand events and processes leading to the consolidation of the clinical mental health
counseling profession.
• Explain the changing roles, tools, and contexts relevant to changes in the 21st century
• Identify the influence of positive psychology and research in wellness
Key Words/Terms
• Community Mental Health Centers Act of 1963– this act established mental health centers
across America which were mandated to provide inpatient treatment for short-term care,
outpatient treatment, partial hospitalization, crisis intervention, and consultation and
education services. This opened up many job opportunities for master’s-level counselors.
client. He also developed a lengthy self-administered questionnaire. His approach
targeted normal youth in developmental transition, focused on prevention, and utilized
the ecological context.
• Hippocrates– Greek philosopher who believed that behavioral tendencies were a result of
imbalances among the four bodily fluids (blood, black bile, yellow bile, and phlegm). He
• Water test– a trial by ordeal developed in the Middle Ages in which the accused was
bound and thrown into a body of water. If the person floated, they were accused of being
in league with the devil, but if the person sunk, he or she was considered innocent.
• Wilhelm Wundt– a philosopher/physiologist who defined psychology as the study of
immediate experience and established the first psychological laboratory at the University
of Leipzig, Germany.
• William Healy– a Freudian psychoanalyst who established the Juvenile Psychopathic
Lecture Outline for Chapter Two
The Counseling Professions in Historical Perspective
I. The Significance of Understanding the History of the Mental Health Professions
A. Return to the Journey Metaphor
B. Understanding who you are and where you are going is facilitated when you
know where you have been
C. “To ignore the past is to cut off a source of self–understanding.” (Leahey, 1980, p.
14)
II. Early Views and Treatment of Mental Health and Illness
A. Archaeological findings: trephines
B. Old Testament perspectives about “madness”
C. Greek philosophy: Hippocrates (460-377 BC)
D. Middle Ages
2. Witchcraft and the “water test”
3. Colony of Gheel (Belgium, 1300s)- humane treatment for the mentally ill
E. 1600s- development of asylums with deplorable conditions
F. 1700s- calls for “moral treatment”
2. Phillipe Pinél
3. William Tuke
III. Emergence of the Helping Professions
A. Psychiatry
1. The Asylum Supervisors were members of the medical profession.
2. In 1844, they created the Association of Medical Superintendents of
3. The Rise and Influence of Neurologists
4. American Medico-Psychological Association (1892)
6. Important Contributions of Early Psychiatry
a. Cause and cure for paresis (syphilis of the brain) was discovered,
leading to the belief that other mental illnesses might have
biological roots.
b. Freud, a neurologist, found that “talking therapies” could treat
nervous conditions. He established the Institute of Psychoanalysis.
B. Psychology
1. Has its roots in philosophy
3. 1892: American Psychological Association formed by philosophers,
educators, and physicians
5. 1908: William Healy- the Juvenile Psychopathic Institute
a. Utilizes a multidisciplinary approach
C. Social Work (late 1880s)
1. Charity Organization Society– help others to help themselves through a
process called “friendly visiting” (precursor to case management)
IV. Professionalization of Counseling
A. 1908: Frank Parsons: vocational counseling
2. Interview and Questionnaire methods
3. Integrated an ecological approach
B. 1908: Clifford Beers, A Mind that Found Itself
C. The private practice of Psychology
D. 1920s: Marriage and Family Counseling
2. Paul Popenoe developed American Institute for Family Relations
E. 1942: Carl Rogers’ book Counseling and Psychotherapy expounds upon the
importance of the therapeutic relationship
F. Impact of the World Wars
1. Psychiatry demonstrated its ability to treat persons experiencing the
traumas of war.
3. Counseling and psychology worked together to assist persons returning to
civilian life after WWII.
4. Master’s level counselors were shut out from VA training sites as the VA
funded doctoral-level internships only. This was because APA endorsed a
V. Professional Organizations: The Development of Professional Identity
A. 1952: American Personnel and Guidance Association
2. Provided a professional home for master’s-level counselors
4. Created NBCC so counselors could demonstrate competency by achieving
certification
6. Later became the American Counseling Association (ACA)
VI. Expansion of Mental Health Counseling
A. 1950s-1960s
1. Problems with mental health hospitals in the 1950s- inhumane care and
calls for reform
3. New theories and techniques in counseling developed
B. 1950s-1960s
1. The Community Mental Health Centers Act of 1963
a. Established nationwide network of mental health centers
b. Mandated five services: short-term care, outpatient treatment,
C. 1970s-present
2. 1976: Virginia is the first state to license professional counselors
4. 1994: CACREP distinguished between community counselors and mental
health counselors.
6. Present: Licensure in professional counseling is available in all 50 states
VII. Contemporary Trends
A. Managed care emphasizes cost-effectiveness, which places master’s-level
counselors in a good position
B. Applications of technology in basic research, mental health services, and
counselor education and supervision
C. Positive psychology and increased emphasis on mental health and wellness
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