A “Question of Competency”: Child Guidance, Pediatrics, and the Origins of Child Psychiatry in America
During the 1920s and early 1930s, American psychiatrists and other experts in the field of child guidance engaged in debate about which discipline had professional competency over children’s mental health. Psychiatrists contested psychologists’ claims to expertise, arguing that children’s behavioral disturbances were medical problems of an emotional nature. As the child guidance movement gained steam through the proliferation of child guidance clinics, pediatricians protested their exclusion from it. Some hospital-based psychiatrists echoed their claim that the adoption of psychoanalysis at child guidance clinics without a hospital connection isolated psychiatry from scientific medicine. The authors examine the early work of some of these psychiatrists, who sought to collaborate with pediatricians in a hospital framework. They developed a medical model for the nascent discipline of child psychiatry, alternative to the model practiced at child guidance clinics. Eschewing psychoanalytic interpretations, they emphasized the interaction between physical and mental health problems from early childhood.