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 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

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

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)

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

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

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

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

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

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

Profile of Practitioners

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

Ph.D. Areas by Popularity

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

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)

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

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

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

Dollars and cents

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

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

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

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

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

Work Settings (PhD & PsyD)

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

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)

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?….

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

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

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

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?

Graduate School Degree Options

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.

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?

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)

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

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

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

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)

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 SJSU’s MA in Experimental Psychology May be terminal degree

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)

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

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

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

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

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

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

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

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

Social Work Training is in placement of the individual into social system Greater focus on social dynamic than individual therapy Psychotherapy tends to be secondary in training Can practice therapy in CA and elsewhere Masters in social work leads to Licensed Clinical Social Worker (LCSW) Is this the best degree for you? It all depends…

Getting in: Pieces of the Puzzle Graduate School Getting in: Pieces of the Puzzle

Are you ready? Getting in Harder than undergrad Need several ingredients Some ingredients take time to build Need to set this up for yourself well in advance

Ingredients for graduate school applications These are slices of a pie Some slices can be less if others are more

Ingredients: Grades Grades They count! Overall GPA, Psych GPA, Last 2 years’ GPA Ph.D. programs – typically 3.5 and above Masters programs – 3.0 and above Need to make minimal cutoffs Demonstrate competence to move to specialty Remember, if you are short here, you have to make it up in another area

Ingredients: GREs Entrance Exams Most programs require these Many require the Graduate Record Exam (GREs) 3 Sections: V, Q, A Many look at Verbal (V) and Quantitative (Q) These two need to add up to over 1000 min PhD – 1200 and above Masters – over 1000

Ingredients: GREs (cont’d) Tips: Study! Take early Take more than once Remember caveats about size of slices

Ingredients: Statement Statement of Intent Needs to be clear and concise Answer questions that they ask Don’t over disclose Say why that program Revise and rewrite! DO NOT shotgun applications

Ingredients: Letters Letters of Recommendation/Reference Need to be from people who can evaluate your skills Ideally these skills relate directly to the program you are applying to Need the number they ask for Can typically do one more than that Need to be good letters not mediocre, especially not bad

Ingredients: Experience Needs to be in area related to type of program you are applying to If applied degree e get applied experience Show evidence of being around population or issues relevant to your work

Ingredients: Experience If research degree e get research experience Show evidence that you know what research is, what it is like, and that you are good at it Need to assemble a Curriculum Vitae (CV) or a resume summarize experience clearly

Getting in: Considering the Odds Graduate School Getting in: Considering the Odds

Considering the Odds Ph.D. programs and Masters programs have different acceptance rates These rates change depending on Ph.D. vs Masters The type of specialty program you apply to

Considering the Odds Ph.D. programs Lower odds of gaining admission Tend to accept fewer individuals Class of 5 to 10 Competition is more stringent May accept only 4 - 12% of applicants Depends on degree program

Considering the Odds Ph.D. in Health Service Provider Fields Clinical 0.12 Community 0.33 Counseling 0.14 Health 0.25 School 0.28 Other 0.20 Subtotal 0.17

Considering the Odds Ph.D. in Research / Other Fields Subtotal 0.23 Cognitive 0.25 Developmental 0.22 Educational 0.37 Experimental 0.24 Industrial/Organizational 0.14 Neuroscience/Physiological/Bio 0.20 Personality 0.17 Quantitative 0.40 Social 0.17 Other 0.32 Subtotal 0.23

Considering the Odds: Example Example with clinical psychology Much depends on type of program Overall acceptance rate: 12-13% Accredited by APA (very important) Private schools: 7511 applied 873 accepted 12% acceptance rate

Considering the Odds: Example Example with clinical psychology Accredited by APA (very important) Public schools: 15198 applied 1033 accepted 6% acceptance rate

Considering the Odds Ph.D. programs GRE averages for 1999-2000 Min V+Q = 1066 admitted score V+Q = 1161

Considering the Odds Ph.D. programs GPA averages (99-00) overall min = 3.04 Admitted in overall = 3.53 last 2 years = 3.61 Psych = 3.66 Masters = 3.77

Considering the Odds Masters programs Better odds of gaining admission Tend to accept more individuals Class of 15 to 20 Competition is less stringent May accept up to 25 to 50%

Considering the Odds Master's Programs in Health Service Provider Fields Clinical 0.56 Community 0.56 Counseling 0.67 School 0.44 Other 0.67 Subtotal 0.59

Considering the Odds Developmental 0.56 Educational 0.78 Master's Programs in Research / Other Fields Developmental 0.56 Educational 0.78 Experimental 0.59 Ind/Org 0.45 General 0.60 Social 0.38 Other 0.67 Subtotal 0.60

Considering the Odds Masters programs GPA averages (99-00) overall min = 2.90 Admitted in overall = 3.33 last 2 years = 3.45 Psych = 3.48

Considering the Odds Masters programs GRE averages for 1999-2000 Min V+Q = 975 admitted score V+Q = 1057

Considering the Odds Should I apply if I don’t meet minimal criteria? Not if you expect to get in If you can show another area is very strong, then make your case Be Persistent Many times takes more than one attempt

Considering the Odds Apply to your dream school Don’t let someone say you can’t get in Take your time with your decision Be thoughtful about your choices Be realistic about your possibilities Don’t turn down an offer that hasn’t been made

Useful Resources Your professors Your fellow students e Resources Getting in: www.apa.org/students Salaries in Psych jobs http://research.apa.org/99salaries.html Application statistics http://research.apa.org/doctoral.html Acceptance into Grad School Statistics http://research.apa.org/gs00tab18.pdf