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Vast changes in the knowledge and conceptualization of psychopathology have occurred in the last century. Today, the inextricable involvement of the central nervous system in severe psychopathology is no longer a debatable subject. Indeed, the body of knowledge pertaining to the interface of psychopathology and neuropsychology is now reaching a daunting size; much of it is relevant to clinical neuropsychologists.

The history of psychology has been traced through the behavior of early civilizations covering a span of 4,000 years (Kimble & Schlesinger, 1985a,Kimble & Schlesinger, 1985b). The history of modern scientific psychology is relatively brief, encompassing a little more than a century. Nevertheless, Pion (in press) noted that, since 1977, the demand for doctoral psychologists, as reflected by employment figures, has actually increased more rapidly than the employment of all other doctoral scientists. Further, Pion cited National Science Foundation statistics indicating that, in 1986, 94% of doctoral psychologists were actually working in psychology. This figure represents a higher percentage than in any other scientific field.

Psychological testing has been an integral part of the history of clinical psychology and plays an increasingly important role in the lives of individuals in our society (Dahlstrom, 1985; Klopfer, 1983). Within medical settings, psychological testing has grown rapidly in recent years and remains one of the most common practices of psychologists. The growth of such assessment-oriented specialties as clinical neuropsychology has even outdistanced the enormous growth in the treatment-oriented field of behavioral medicine (Wedding & Williams, 1983). Although more traditional personality assessment (especially projective testing) experienced some disfavor among clinicians and subsequent decreased use in the 1960s (Jackson & Wohl, 1966; Shemberg & Keeley, 1970), such testing again achieved widespread acceptability and emphasis in clinical training in the 1970s and 1980s (Ritzier & Alter, 1986). In fact, based on a survey of practicing clinical psychologists, (Wade & Baker, 1977; Wade, Baker, Morton, & Baker, 1978), it has been reported that the Rorschach ranks first among the tests most frequently recommended for clinical psychology students to learn.

Hospitals and medical settings, like any organization or institution, are made of innumerable spokes that emanate from the hub and support the structure of the wheel. The hub is the philosophy or mission, the spokes the professional people within the hospital. As the wheel moves forward, the spokes blend in the eye of the observer into a solid that carries the momentum of the hub forward to its goal, in this case, quality patient care, the genius loci. Modern clinical psychology in the medical setting has become a strong spoke in that organizational wheel. The clinical psychologist and psychological programs can play an integral part in carrying out the mission of each hospital or medical setting.

The problem of mistreatment of children in the United States has been receiving increasing amounts of attention by health care professionals ever since Kempe, Silverman, Steele, Droegemuller, and Silver (1962) first identified the battered child syndrome. This phrase captured the attention of Americans and resulted in massive efforts to discover the causes of child mistreatment and to develop effective intervention and treatment strategies that would ameliorate the problem. As a result, the National Center for the Prevention and Treatment of Child Abuse and Neglect was founded in 1972, and mandatory reporting laws and provisions for initiating protective services (DeFrancis & Lucht, 1974) have been established in every state in the country. In addition, a great amount of research literature has appeared purporting to describe persons who mistreat children and offering wide ranges of possible treatments for these persons. The focus of the present chapter will be on clinical intervention and treatment strategies that might be effective in dealing with mistreating parents. For a discussion of the theoretical formulations of child mistreatment, the reader can refer to the reviews of Sweet and Resick (1979) and Parke and Collmer (1975).