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Training Issues in Clinical Psychology

Training Issues in Clinical Psychology. Created by Dr. Glenn Callaghan Edited by Dr. Steve Del Chiaro. Scientist-Practitioner (Boulder) Model. Developed by the American Psychological Association (APA) in 1949 Examined training issues for Ph.D.s

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Training Issues in Clinical Psychology

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  1. Training Issues in Clinical Psychology Created by Dr. Glenn Callaghan Edited by Dr. Steve Del Chiaro

  2. Scientist-Practitioner (Boulder) Model • Developed by the American Psychological Association (APA) in 1949 • Examined training issues for Ph.D.s • Attempted to join science and practice: scientist-practitioner model • Only when you practice can you know what needs to be researched; only if you research can you know how you’re practicing

  3. Advantages to the Scientist-Practitioner Model • Develop science-based or evidenced-based treatments • Conduct individual level science on own practice • Use science to influence others’ practice • ACCOUNTABILITY

  4. Scientist-Practitioner Model • The reality is that this doesn’t exist • Clinicians do not consume research (Cohen, Sargent, & Sechrest, 1986; Morrow-Bradley & Elliot, 1986) • Clinicians do not use empirical methods to evaluate their own treatments (Barlow, et al., 1987) • Clinicians do not contribute to the scientific community (Haynes, Lemsky, & Sexton-Radek, 1987)

  5. Scientist-Practitioner Model • Set up a new distinction called the Clinical-Scientist Model by APS • Boulder model still most popular, but the APA has created a practice guild • Guild’s interests are not always in advancement of science

  6. Professional Competence • Certification Process (licensing) • Attempt to protect the public by restricting the use of the title “psychologist” • Doesn’t restrict anybody from practicing as long as they don’t use the word “psychologist” • Some argue it just protects psychologists

  7. Licensing • Protect the public by specifying the nature of “psychologist”, the training required for licensure, and what professional activities can be billed • Requirements for licensure often include: • Receiving training at an accredited program • For “Psychologist” - must have a doctorate • For psychotherapist - can another advanced degree

  8. Licensing • Done by states • Term “psychologist” is protected • only those with Ph.D. and Psy.D. can use it • anyone can call him/her self a “counselor” • Requirements of licensing vary from state to state • Can require a Ph.D./Psy.D. in Clinical or Counseling psychology • but, “School Psychologist” = MA/MS • MFT, LCSW = MA/MS

  9. Licensing • Requirements of licensing • 1-2 yrs post-degree supervised experience is required • 3000 hours total for all licenses • Passing a written and/or oral examination • Being a resident of the state • Continuing education

  10. Graduate Training in Clinical Psychology • Assumptions about graduate training • (explicit) This is trainable • (explicit) This requires training • (explicit) There is a knowledge base in clinical science that should be known • (explicit) Some of this cannot be trained in class rooms • (implicit) Some of this requires apprenticing • Art-type of clinical epistemology

  11. Profile of Practitioners

  12. Clinical Psychology • Most common subspecialty of psychology • Focus on psychopathology and serious problems • Research, develop treatments, and intervene with depression, anxiety, personality disorders, etc. • Greatest proportion of Ph.D.s • Counseling Psychology is 2nd

  13. Ph.D. Areas by Popularity

  14. Counseling Psychology • 2nd most common subspecialty of psych • Historically - roots in career development • Focus on “normative” issues • Vs. clinical focus on abnormal behavior/disorder • Adjustment focus vs. disorder • Career search • Coping with divorce • Coping with illness • Enhancing effectiveness • Building self-confidence

  15. Training - Doctorate • Education • Ph.D. (Doctor of Philosophy) • Traditional research emphasis in addition • 3-4 yrs coursework/practicum • 1-? yrs dissertation research • 1500 hours internship (similar to residency) • Psy. D. (Doctor of Psychology) • 3-4 yrs coursework/practicum • 1500 hours internship (similar to residency) • 1-? yrs dissertation research

  16. Coursework for PhD • Training in statistics and research methodology • Training in theory • Training in psychotherapy • Conduct research (MA, then dissertation)

  17. Coursework for PhD • Clinical placement • Do qualifying exams/comps • Clinical internship (1500 hrs) • Postdoctoral internship (1500 hrs) • Job?….

  18. Training Example for Ph.D. • 4 yrs Bachelor degree – Psychology, University of California, Irvine • 1 yr Masters Program – MA Experimental Psych (CSU, Fullerton) • Research placement – UC Irvine Medical Center • 5 yrs Doctoral Program – Clinical Psychology, University of Nevada • Assistantship – Psychological Services Clinic Assistant • Practicum – UNR Student Services • Practicum – Victims of Crime Treatment Center • 1 yr dissertation • Development and testing psychotherapy coding system • 1 yr internship • University of California, San Diego/San Diego Veterans Administration Hospital consortium • Depression, substance abuse and outpatients services

  19. Dollars and cents

  20. Doctor of Psychology (PsyD) Model • Emphasis on the development of clinical skills and a relative de-emphasis on research competency • Heavy amount of clinical training • First developed at Univ. of Illinois in 1968 • By 1998, 36 programs accredited in U.S. • Click here for the article: Appreciating the PsyD: The Facts

  21. Psy.D Model • Debate continues • Some argue PsyDs indistinguishable to PhD’s when applying for internship and may have an advantage for clinical jobs • Some argue PhDs do more scholarly work and may be better equipped to evaluate and be critical of ideas, techniques, or theories handed to them

  22. Professional Schools • Schools that have no affiliation with universities that generally grant PsyD • Free-standing Universities • First was California School of Professional Psychology (CSPP) • By 1993, almost ½ doctorates in clinical psychology were awarded by professional schools

  23. Professional Schools • Pros • Lots of clinical training • Admit many students • Cons • Expensive • Usually not accredited • May be unstable (buyer beware)

  24. Roles of Clinical & Counseling Psychologists • Research • Assessment • Treatment • Teaching • Consultation • Administration

  25. Work Settings (PhD & PsyD)

  26. Masters Level Degrees for Practice • MS  MFT • MSW  LCSW • others…

  27. Training for Masters • Education • Masters level therapists • MS in clinical or counseling psychology • Marriage Family Therapists (MFT) • 2-4 years coursework/practicum • 2 years internship • Masters in Social Work • Licensed Clinical Social Worker (LCSW) • 2-4 years coursework/practicum • 2 years internship

  28. Coursework for Masters Level Clinicians • Some training in theory • Some training in applied research • Goal is to develop critical skills for consumers of research • Lots of training in psychotherapy • Do qualifying exams/comps • Pre-degree clinical placement/internship (750 hrs) • Post-degree internship (2250 hrs) • job?….

  29. Training Example for MS • 4 yrs Bachelor degree – Psychology, University of California Santa Cruz • 2 yr Masters Program – MS Clinical Psychology, San Jose State University • Fieldwork placement – Family & Children Services, San Jose • 2 yrs Internship • Franklin McKinley School • School problems, substance abuse, depression, anxiety

  30. Masters Level Degrees • Advantages • If don’t want to do research • Less overhead • More likely to be employed conducting therapy than Ph.D.s

  31. Masters Level Degrees • Disadvantages • Uncertain outcome • Lower rate of pay • Less skills with accountability (may be necessary skills)

  32. Critical Thinking Moment • Requiring therapy for training • APA has rules about who can do this and who cannot while in training • Hotly contested issue • Relevance of the student’s own therapy to conduct therapy • Personal development • Ties to history of psychotherapy • What do you think?

  33. Graduate School Degree Options

  34. Degree Choices • Many factors should influence this • What do you want to do when you are done with your degree? • e.g., Research, Service delivery • Let that determine what degree you pursue more than “prestige” • Some degrees will not let you do what you want • Consider the duties you want to perform, rather than a job title.

  35. Degree Choices • How much time do you want to spend getting your degree? • 2 years, 4 years, 7 years? • Are you able to move? • Can you assemble a competitive application? • How are your grades? • Do you have the requisite experience?

  36. Ph.D. or Masters? • Should I get a Ph.D. or a Masters? • Depends on what you want to do! • Do you want to do research? Masters in Experimental Psych Ph.D. • Do you want to focus on service delivery? Masters in applied area (clinical, I/O) (MS, MSW)

  37. Ph.D. or Masters? • Ph.D. • Research degree • Developing studies, carrying them out • Program evaluation • Administration • Academics • Often minimal practice or service delivery

  38. Ph.D. or Masters? • Ph.D. • Pros: • More flexibility in job choice • Can be better pay • More flexibility if move from state to state for some specialties

  39. Ph.D. or Masters? • Ph.D. • Cons: • Takes a long time to complete • Very focused area of expertise • Limited to research or administration (some areas) • More loans on average

  40. Ph.D. or Masters? • Masters • Tend to be practice or service delivery oriented • Do not typically focus on production of research • Do focus on consumption of research • Can lead to licensing • Marriage Family Therapist (MFT) • Masters in Social Work (MSW)

  41. Master of What? • Designation of MS or MA depends on school! • Masters of Science • Traditionally a “trade” or “applied science” degree • May be a terminal degree • SJSU’s MS in Clinical Psychology • May be a research degree • Masters of Arts • Traditionally more breadth • May be a research degree • SJSU’s MA in Experimental Psychology • May be terminal degree

  42. Ph.D. or Masters? • Masters • Pros • Shorter time to complete • Owe less money • Very focused training • Typically set up for licensing • Once finish hours (if required)

  43. Ph.D. or Masters? • Masters • Cons: • Often less pay than Ph.D. (but less overhead) • Less flexibility to move if licensed in one state • Harder to get a teaching position (if interested) • Will do less program administration and evaluation (typically) • NOTE: some programs will require you to have applied experience prior to applying

  44. Ph.D. or Masters? • Should I get a Masters first if I want to go on for a Ph.D.? • Yes, if you need to: • If you can’t get in yet OR didn’t get in yet • If you feel you are not ready yet and would benefit from more training • If the Ph.D. program you are interested in requires it

  45. Ph.D. or Masters • What kind of Masters should I get if I want to go on to a Ph.D.? • Often, it is an Masters (MA at SJSU) in General or Experimental psychology • Prepares you for research programs • Do NOT apply for a terminal masters (SJSU MS Clinical) if you want a Ph.D. • These do not prepare you for research

  46. The Route to a Graduate Degree BA/BS in Psych This is a straight path for researchers 4-7 years Ph.D. in specific area

  47. The Route to a Graduate Degree BA/BS in Psych This is a path to get into Ph.D. with a Masters 1-2 years On the way: Presentations, Publications, Thesis Masters in Experimental SJSU MA Experimental The MA prepares for Ph.D. programs 3-6 years Ph.D. in specific area

  48. The Route to a Graduate Degree BA/BS in Psych 2-4 years The Applied Masters prepares service providers Masters in Applied area (terminal degree) Ph.D. in specific area

  49. The Route to a Graduate Degree BA/BS in Psych 2-4 years The Applied Masters will not prepare students for a traditional academic Clinical Ph.D. program Masters in Applied area Ph.D. in specific area

  50. A Note on Licensing • Many hours required to get licensing • Clinical psychology • Ph.D. or Masters • 3,000 hours of clinical experience required to get licensed • Ph.D. = licensed psychologist • 1500 pre-degree on internship + 1500 post doctorate  THEN take licensing test • Masters = MFT or MSW • 500 pre-degree as trainee + 2500 post degree as intern  THEN take licensing test

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