Training Models in Clinical Psychology: Overview James H. Johnson, Ph.D., ABPP/Child

Variations in Training  Boulder (Scientist-Practitioner) Model – 1949  Vail (Scholar-Professional) Model – 1973  Clinical Science Model

WW II and the Need for Psychologists  WW II and focus of the government on increasing the pool of trained mental health professionals  Government initiatives involving VA and USPHS and APA  Grants to Psychology departments that provided clinical training  Funding for students pursuing graduate training in clinical psychology  VA provided practicum sites and internships  GI Bill to support graduate training

In Search of a Training Model  David Shakow, the Committee on Training in Clinical Psychology – The Shakow Report – 1947  Boulder Conference – 1949 (70 participants)  Equal weight to science and practice  PhD as the required degree  Training within a university setting  Psychologists were to be scientist-practitioners prepared to work in academia or clinical practice  Since 1949 has been the dominant model for Clinical Psychology Training

The Practitioner Model: In the Beginning  Questions about adequacy of the Boulder Model.  Interest in training for practice as is the case in law, dentistry, and medicine  1951 Gordon Derner (PhD from Columbia) developed the first scholar-practitioner program at Adelphi  Focus on training practitioners – Allow research finding to inform practice but without focus on development of research skills.  Was not able to get APA approval until 1957 and only after a battle and a number of appeals  Derner was the founding President of the National Council of Schools of Professional Psychology

Development of the PsyD Degree  First Doctor of Psychology Degree program – University of Illinois, 1968  Developed by Donald Peterson and designed to produce clinicians to engage in applied clinical work.  Coursework like Ph.D. students but focus on clinical work – and clinical project instead of research dissertation.  Program was found to be incompatible with the academic values of most Illinois faculty and was soon discontinued.

The California School of Professional Psychology  In the late 1960’s California Psychological Association notes lack of sufficient doctoral level psychologists in the state.  Lobbied state of CA get universities to increase number of clinical psychologists  Didn’t work and CPA on its own, under leadership of Nicholas Cummings, founded the California School of Professional Psychology

The California School of Professional Psychology  Branches in LA, Berkeley, San Diego, and others.  Focus on training practicing clinicians  Offered the Doctor of Psychology Degree  Programs housed in independent schools of Professional Psychology rather than University departments.  Very few full time faculty – mostly part-time training faculty  Large classes – little financial assistance  Primary organization is National Council of Schools of Professional Psychology

Vail Conference  In 1973 the national training conference in Vail Colorado was successful in legitimizing practitioner oriented clinical psychology training programs  Despite objections from academic types, such programs now turn out almost as many graduates as do Boulder Model programs

Growth of the Professional School Movement  In recent years the number of practitioner oriented training programs has increased dramatically  Such program are found in free-standing professional school, in psychology departments, and separate schools of psychology within universities.  Again, almost half of the doctorates graduating each year, come from professional schools

Boulder Model and Professional School Programs Compared  Boulder model programs still outnumber PsyD programs, the PsyD programs enroll three times the number of doctoral candidates.  Boulder model programs train clinical psychologist to conduct research; PsyD programs train graduates to be consumers of research  Ph.D graduates more likely to be employed in academic positions and in medical schools than are clinical psychologists with the PsyD degree.

Boulder Model and Professional School Programs Compared  Acceptance rates and financial support  Freestanding PsyD programs acceptance rates average about 40%  PsyD average number accepted = 46; Ph.D = 9  Ph.D programs accept on average about 15% of those applying.  70 – 80% of students in Ph.D programs get full financial assistance, while only 18% of students in PsyD programs get this.  Pay-as-you-go plan for about three-fourths of PsyD graduate students.  Student debt for PsyD students = 53 – 60 thousand; Debt for Ph.D students is about $ 22,000 (median)

Boulder Model and Professional School Programs Compared  Length of Training  Students in Ph.D. programs take about 1 to 1.5 years longer to complete graduate training  Licensure Exam performance  PsyD students, on average, perform significantly lower on the Examination for Professional Practice in Psychology (EPPP). Difference likely applies to larger free-standing PsyD programs.  Strong link between smaller classes and more faculty and better scores on licensure exam.

The Clinical Science Model  Impetus for Clinical Science training was “Manifesto for a Science of Clinical Psychology” (McFall 1991)  Presidential address for Section 3 of Division 12 (Section for the Development of Clinical Psychology as an Experimental Behavioral Science)  Began a movement that has resulted in a number of clinical science programs and the development of the Academy of Psychological Clinical Science.

The Clinical Science Model: Cardinal Principles and Corollaries Scientific Clinical Psychology is the only Legitimate and Acceptable form of Clinical Psychology  Psychological services should not be administered to the public (except under strict experimental control) until they have satisfied four minimal criteria:  The exact nature of the service must be described clearly  The claimed benefits of the service must be stated explicitly  These claimed benefits must be validated scientifically  Possible negative side effects that might outweigh benefits must be ruled out empirically

The Clinical Science Model: Cardinal Principles and Corollaries  The primary and overriding objective of doctoral training programs in clinical psychology must be to produce the most competent clinical scientists possible.  General focus is on becoming a clinical scientist and this may or may not involve applied clinical activities.  All applied clinical work engaged in needs to be evidence-based.

So What Type of Training  Scientist-Practitioner ?  Scholar-Practitioner ?  Clinical Scientist ? Pros? Cons? Preferences?