Angry Response Follows Appointment Of Psychologist to Head Yale Center

APA has conveyed its “deep disappointment” in a strongly worded protest to Yale University President Richard Levin, Ph.D., on his appointment of psychologist Alan Kazdin, Ph.D., as director of the Yale Child Study Center (CSC).

In a letter to Levin in late March, APA President Richard Harding, M.D., a child and adolescent psychiatrist, suggested that “Yale’s stature in higher education will be markedly enhanced by a courageous acknowledgement of error followed by a renewed search for a director with unimpeachable psychiatric credentials.”

Kazdin’s appointment as director “is simply a clear departure from [Yale’s] previous philosophy,” Harding explained in an interview. “While I have nothing against Dr. Kazdin—he’s done excellent research and so forth—it’s a wrong signal for the future of that institution.”

A reversal of a senior academic appointment would, of course, be highly unlikely; however, Yale Medical School Dean David Kessler, M.D., did respond with a letter to Harding.

Kessler, Harding told Psychiatric News, hoped that APA would give Kazdin a chance to show his administrative abilities. In addition, Kessler wrote, many of APA’s concerns regarding the absence of a medical background would be taken care of with the appointment of a child psychiatrist in the new position of chief of child and adolescent psychiatry.

According to Kessler, the person in that position will report directly to Kazdin and will oversee the “hospital and clinical service aspects of the center, as well as the residency program.”

The position of chief had not been filled as this issue of Psychiatric News went to press.

Kazdin took over the direction of the center April 1. He succeeded Donald Cohen, M.D., who died last October.

It appears that none of those critical of the appointment specifically target Kazdin’s professional accomplishments. Kazdin received his Ph.D. in clinical psychology from Northwestern University. Prior to arriving at Yale, he was a faculty member at the Pennsylvania State University, where he did research on the use of psychotherapy for childhood affective disorders. He then went to the University of Pittsburgh, where he oversaw both the inpatient and outpatient services for children with emotional disorders. At Yale since 1989, Kazdin has held a joint appointment in the department of psychology, which he chaired from 1997 to 2000, and the CSC. In addition to his duties as director of the CSC, he is the John M. Musser Professor of Psychology. Kazdin has published in excess of 500 articles and written or edited more than 30 books.

Yale’s choice of Kazdin, according to several psychiatrists who spoke with Psychiatric News but asked not to be named, was the result of a search process based on the CSC faculty’s insistence that the new director come from within the current ranks. According to the sources, Kessler was not completely satisfied with the leading psychiatrist candidates and turned to Kazdin, a current faculty member who had extensive experience in research, clinical psychology, and administration and was well known to all those involved.

As far as the decision on the whole, said Jerry Wiener, M.D., a former APA president and professor emeritus of psychiatry and pediatrics at George Washington University, “This was a bad decision on everyone's part. It has nothing to do with Dr. Kazdin. He's a fine man, a consummate researcher and clinical psychologist, but it's a bad model for students, residents, and faculty members, because it really says that there is nothing particularly special about child psychiatry. . . . The way the appointment was handled simply illegitimatizes the whole thing because it was not an honest search.”

Despite repeated requests, Kazdin, Yale Medical School Dean Kessler, and Yale President Levin declined to be interviewed for this article. However, in announcing the appointment of Kazdin, Levin described him as a “distinguished scholar” and predicted that the CSC, which Levin called one of Yale’s “great treasures,” would “flourish under his leadership.”

The prestigious Yale Child Study Center is known as one of the leading centers for child psychiatry in the world. It has long been recognized for its multidisciplinary programs of clinical as well as basic research, professional education—including its designation as a training site for Yale’s child and adolescent psychiatry residency program—clinical services, and advocacy for children and families.

The appointment of a psychologist, even a well-respected one, to head a highly esteemed psychiatric facility has stirred considerable debate throughout the psychiatric community.

Those who spoke with Psychiatric News and know Kazdin spoke very highly of him and pointed out that their uneasiness with his appointment is centered not on his own background or reputation, but rather on the fundamental differences in the training and background of psychologists versus psychiatrists.

In his letter to the president of Yale, Harding noted that the appointment of anyone other than a “highly reputed child and adolescent psychiatrist” threatens the reputation and standing of the center. The appointment shows disregard for the “fundamental importance of a medical education, residency training, and subspecialty credentials necessary for the leadership of a major clinical, training, and research institution in a premier academic health center,” Harding wrote on behalf of the Board of Trustees.

“We live,” Harding continued, “in a time of revolutionary advances in the neurosciences and in the genetics of psychiatric disorders. Clearly, biomedical leadership at the center and research in these areas will be adversely affected.”

The appointment of a psychiatrist as chief under Kazdin “is certainly better than not having anyone at all,” Harding said in an interview with Psychiatric News. “But I think the issue is that the highest level administrator in every other psychiatric institution that I am aware of is a person that is specifically trained in the biopsychosocial model and that has the background not only from research and clinical experience, but also from administrative experience, so that he or she can point the institution into the future.”

The APA Board of Trustees, Harding noted, has been “inundated” with calls and messages from every sector of psychiatry stating “bewilderment and shock” about the appointment.

Former APA Assembly Speaker Alfred Herzog, M.D., medical director of Hartford Hospital and president of the Connecticut Medical Society, agreed with Harding.

“The issue is not Dr. Kazdin,” Herzog told Psychiatric News. “It’s simply unfortunate that Yale did not appoint a psychiatrist at a time when the field is blossoming in terms of both the psychological and the neuroscience aspects. It’s important to have a physician leading the center. The biopsychosocial model is what [psychiatrists] live by, and I would like to think that Yale continues to live by that model, as it has in the past.”

In a statement released by the American Academy of Child and Adolescent Psychiatry, President Marilyn Benoit, M.D., also expressed disappointment over the choice of a psychologist to fill the position and hoped that board-certified child psychiatrists would continue to be prominent in the center’s administration.

“I continue to be very disappointed in the direction that Yale has chosen to go,” Harding concluded. “And I don’t even want to say that it can work, because I don’t know that yet. The center still has the potential and the demonstrated ability to be among the elite of American psychiatry. What will happen now is anyone’s guess.” ▪