Council of University Directors of Clinical Psychology Cynthia D. Belar, PhD, ABPP January 2012

RootsRoots

ObjectivesObjectives Key issues addressed in 2011 Key changes and implications for training in clinical psychology Future issues for clinical psychology education and training

Education Directorate Mission Advance Education in Psychology –Education and Training of Psychologists –Teaching of Psychology Advance Psychology in Education

Promoting Excellence and Innovation BEA Award for Innovations in Graduate Education with COGDOP ($5000) Grants for conferences or workshops (graduate and undergraduate) CUDCP Diversity Reception

BEA Award for Interdisciplinary Training University of Florida, Department of Clinical and Health Psychology, interdisciplinary science, practice and teaching LIFE- Universities of Michigan and Virginia with international partnerships – interdisciplinary virtual institute re human development

Promoting Excellence and Innovation NSF Grants – –National Science Digital Library (online psych experiments) –Specialized High Schools –Undergraduate Education DoE/IES Grant - school based research training to increase psychologys human capital in education research Foundation support (Dreyfus, APF)

APA On-Line Psychology Laboratory Pageviews

Key Policies Adopted National Standards for High School Psychology Curricula (2011) Principles for Quality Undergraduate Education (2011) Major Goals for Undergraduate Major in Psychology

Education has changed.

New New Leadership Alliance for Student Learning and Accountability Assuring Quality, Accounting for Learning: Guidelines for Gathering and Reporting Evidence of Student Learning and Using It To Improve Outcomes Release: January 24, 2012

APA Accreditation Renewal of Recognition –Department of Education –CHEA Five Year Report 235/374 doctoral programs are in Clinical Psychology

Graduate Study in Psychology Data: –# of degrees awarded –# of students applied, accepted, enrolled –admission criteria –tuition costs –employment data –internship data Graduate and Postgraduate Education and Training

Taxonomy CRSPPP Major area of study Emphasis Experience Exposure

Advancing the Culture of Competence Website

Promoting Professional Development in Psychology APA Online Academy Monitor CE Feature Clinician's Corner National Webcasts Convention –Unlimited CE at Convention –RFID "automatic scanning in CE Sessions

ELC 2011 Interdisciplinary and Interprofessional Teaching, Research and Practice

Interdisciplinarity is a 21 st Century imperative.

MultidisciplinaryMultidisciplinary MultidisciplinaryInterdisciplinary Tress, Tress & Fry, 2003

Psychology is a hub science.

Backbone of Science Boyack, Klavans & Borner (2005)

The world has problems, but universities have departments Brewer, 1999

AcademiaAcademia Centers Splitting indirect costs Roving professors Cluster hiring Course credit sharing Research hotels New curricula/degree programs

Growth of Interdisciplinary Team Science NSF Total Funding Single investigators 88% 38% Multiple Investigators 12% 62% NIH Roadmap for Medical Research

January 3, 2012 OBSSR/NIH launches first online genetics course for social and behavioral scientists To support interdisciplinary research Genetics and Social Science: Expanding Transdisciplinary Researcj

BEA/BSA Task Force on Training Psychologists to Participate in Multidisciplinary Team Science Involving Other STEM Disciplines T&P guidelines Hiring practices Presidential Working Group (TBA)

Interprofessional Practice

Values and ethics Work with individuals of other professions to maintain a climate of mutual respect and shared values. Work in cooperation with those who receive care, those who provide care and others who contribute to or support the delivery of prevention and health services. Demonstrate high standards of ethical conduct and quality of care in ones contributions to team-based care. Manage ethical dilemmas specific to interprofessional patient/population centered care situations.

Roles and Responsibilities Use the knowledge of ones own role and those of other professions to appropriately assess and address the healthcare needs of the patients and populations served. Explain the roles and responsibilities of other care providers and how the team works together to provide care. Communicate with team members to clarify each members responsibility in executing components of a treatment plan or public health intervention. Use unique and complementary abilities of all members of the team to optimize patient care.

Interprofessional Communication Communicate with patients, families, communities, and other health professionals in a responsive and responsible manner that supports a team approach to the maintenance of health and treatment of disease. Choose effective communication tools and techniques Give timely, sensitive, instructive feedback to others about their performance on the team, responding respectfully as a team member to feedback from others. Recognize how ones own uniqueness…contributes to effective communication, conflict resolution and positive interprofessional working relationships.

Teams and Teamwork Apply relationship-building values and the principles of team dynamics to perform effectively in different team roles to plan and deliver patient- and population-centered care that is safe, timely, efficient, effective and equitable. Integrate the knowledge and experience of other professions appropriate to the specific care situation… Share accountability…for outcomes relevant to prevention and healthcare. Perform effectively on teams and in different team roles in a variety of settings.

Major Reports IOM, 2003 IOM, 2001 IOM, 2000

Interprofessional Partners in Action IPPIA is an interprofessional public-private partnership between federal agencies (HRSA, VA), foundations (Macy, RWJF, ABIMF) and the Interprofessional Education Collaborative and key stakeholders from education, practice and policy. Mission: Ensure that new and current health professionals are proficient in the competencies essential for patient-centered, interprofessional collaborative practice.

Interprofessional Professionalism Collaborative Interprofessional Professionalism Collaborative

Interprofessional Education When students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes (WHO, 2010)

Working with psychology trainees improves my communication with patients, families, communities, and other health professionals. (Cubic, 2011) Percentage of Respondents

The presence of psychology trainees at the family residency sites has lead to an increased emphasis on psychosocial issues overall. (Cubic, 2011) Percentage of Respondents

Unresolved Issues For what? When? How? By Whom? In what context?

BEA Primary Care Training Task Force Amber Shifflett; Barbara Cubic, PhD, Chair; Bruce Rybarczyk, PhD; Nancy Ruddy, PhD; Bob McGrath, PhD; Lisa Kearney, PhD; Cathi Grus, PhD; Tony Zamudio, PhD; Chris Neumann, PhD

APA Board of Educational Affairs Primary Care Training Task Force Preliminary Survey Results 54% of doctoral programs

Primary Care Training APPIC Directory APA accredited internships 101 (22%) major rotation 195 (42%) minor rotation 47 (37%) postdoctoral residencies

Similarity to Training in General Professional Psychology % Agreement Radically different23% Moderately different60% More similar than different 15% Synonymous2%

Patient-Centered Primary Care Collaborative

Executive Committee Members Abbott; Aetna, Inc; Alliance for Home Health Quality and Innovations; AllScripts; American Academy of Family Physicians; American Academy of Nurse Practitioners; American Academy of Pediatrics; American College of Physicians; The American Psychological Association; American Osteopathic Association; AMERIGROUP Community Care; Amgen; BlueCross BlueShield; Boehringer Ingelheim; Bon Secours Medical Group; Bristol-Myers Squibb; CIGNA HealthCare; CVS Caremark; DMAA: Care Continuum Alliance; EHE International; Geisinger Health Plan; GlaxoSmithKline; Healthcare Facilities Accreditation Program; Healthways; Hooper Holmes; Humana, Inc.; IBM; Interim HealthCare, Inc; Intuit Health Group; Johnson & Johnson; The Joint Commission; Kaiser Permanente; King Pharmaceuticals, Inc; Lilly USA; Living Well for Coca-Cola North America; McKesson Corporation; MedAssurant, Inc.; Medco; Merck & Company; Microsoft; MidMichigan Health; MVP Health Care; NCQA; National Changing Diabetes Program (Novo Nordisk); NextGen Healthcare Information Systems; American College of Nurse Practitioners; National Association of Pediatric Nurse Practitioners; Pfizer; Philips Healthcare; PhRMA; Phytel; Priority Health; PRISM; Robert Bosch Healthcare; Sanofi- Aventis; Taconic IPA, Inc.; Thomson Reuters; TransforMED; The TriZetto Group; UnitedHealthcare; Universal American Corp.; UPMC Health Plan; Walgreens; and Wellpoint, Inc.

PCPCCPCPCC Education and Training Task Force PCPCC Summit October 21 – 2 panels Webinar on interdisciplinary training. Barbara Cubic, PhD. ry-training-your-workforce-promote- integrated-care Curriculum Resources, submit your entries:

Meeting Societal Needs

White House Summit on Bullying Prevention 2011

Campus Care and Counseling Act Signed into law as part of Garrett Lee Smith Memorial Act in October 2004 Acknowledges significant toll that mental and behavioral health problems take on a students ability to succeed in college Resources for college counseling centers and psychology training clinics Approximately $48 million since 2005Approximately $48 million since 2005

Center for Deployment Psychology (Defense GPE Program) Training military and civilian health professionals to provide services for returning military personnel and their families TriService

Support for Internship Training Website resources

Graduate Psychology Education Program (GPE) Health service psychologists, interdisciplinary, underserved populations Total funding for GPE since 2002: $31.7 millionTotal funding for GPE since 2002: $31.7 million

Federal Education Advocacy Coordinators 10 Regions 20 FEDACs 450 Campus Training Representatives

The New York 22 Collaborative Advocacy APA (ED, APAGS, Dr. Ellen Garrison) APPIC – Dr. Gene DAngelo NYSPA – Tracy Russell Jason Edgar Alexandra Morris Akeisha Mitchell Carolyn George Kristen Horan Kerry Torrell

Conscience Clause Legislation House Bill 5040 (Michigan) shall not discipline or discriminate against a student in a counseling, social work, or psychology program because the student refuses to counsel or serve a client as to goals that conflict with a sincerely held religious belief or moral conviction of the student, if the student refers the client to a counselor who will provide the counseling or services

BEA Virtual Working Group on Restrictions Affecting Diversity Training in Graduate Education Arizona, Michigan legislation Tracking system in place Prepare materials for programs Values Statement of Counseling Psychology

EdATEdAT

Education and Training for Health Service Psychologists Work Group (E&THSP) APA, CCTC, COGDOP Met 3 times Blueprint expected March 2012

2010 Survey CCTC and ED ~1300 respondents 68% doctoral programs 71% clinical psychology programs 84% interacted with PhD students 46% interacted with PsyD students

Emerging/expanding practice opportunities to meet societal needs Balance between E&T in science that informs practice and E&T in practice that is evidence-based Economics of training (including costs, funding reimbursement for trainees) E&T in prevention, dx, rx within context of integrated care Important Topics to be Addressed in Next 5-10 years 2010 Survey

E&THSP Focus Health Service Providers Psychologists are recognized as Health Service Providers if they are duly trained and experienced in the delivery of preventive, assessment, diagnostic and therapeutic intervention services relative to the psychological and physical health of consumers based on: 1) having completed scientific and professional training resulting in a doctoral degree in psychology; 2) having completed an internship and supervised experience in health care settings; and 3) having been licensed as psychologists at the independent practice level. (APA, 1996)

Conceptual Model

Overlap

Health Service Psychology

Mental Disorders Psychology and Health

7 Major Issues

Issue #1. There should be guidelines for qualifications to enter doctoral programs that prepare health service psychologists. Issue #1. There should be guidelines for qualifications to enter doctoral programs that prepare health service psychologists. More biology? Psychology Field Test of ETS? Draft criteria

Issue #2. The competencies of psychologists who provide health services should be clearly articulated and understood by faculty, students, regulators and the public Scientific Knowledge and Methods Research/Evaluation Professional Values and Attitudes Individual and Cultural Diversity Ethical and Legal Standards and Policy Reflective Practice Relational Evidence-based Practice Assessment Intervention Consultation Teaching Supervision Interdisciplinary Systems Professional Leadership Development Advocacy

Implications for Clinical Psychology E&T More focus on biology Interprofessional competence Self-assessment and lifelong learning Practice based research skills QI, outcomes research, program eval, needs assessment, cost-benefit models

Go To: Go To:

Issue #3. Psychology needs to establish the standard of self-regulation for its education and training in the profession. BEA Statement ASPPB

Issue #4. Psychology needs to evaluate and articulate the learning objectives for each level in its sequence of education and training of health service providers, as well as examine the sequence itself.

Issue #5. There needs to be increased focus on competency assessment in psychology education and training for the delivery of health care services. Issue #5. There needs to be increased focus on competency assessment in psychology education and training for the delivery of health care services.

Issue #6. The future of health service psychology rests on the integration of science and practice. Education and training should be an integrative endeavor, both within and across content and levels in the curriculum as well as across the activities of research and health service provision. Issue #6. The future of health service psychology rests on the integration of science and practice. Education and training should be an integrative endeavor, both within and across content and levels in the curriculum as well as across the activities of research and health service provision.

Issue #7. Psychology needs more research relevant to the preparation of health service psychologists and must have a comprehensive workforce analysis.

SCENARIOSSCENARIOS How would your program need to change? How would you facilitate what you believe to be positive elements in the scenario? How would you deter what you believe to be negative elements in the scenario?

ScenarioScenario To be licensed for practice, all health professionals must demonstrate competence in outcomes research and conducting practice based quality improvement studies.

ScenarioScenario Students enter professional psychology programs with strong backgrounds in psychology and pursue 3-4 years of intensive study designed to develop specified competencies. When they demonstrate competence in core psychology, clinical science, basic general clinical skills, the ability to think critically and learn independently as well as ethical behavior they are granted the doctoral degree. They then attend an intensive 2 year supervised training program in professional psychology. These programs vary according to various dimensions (e.g., specialty, prevention, research emphasis). Only those programs that are preparing psychologists for the provision of health care services are accredited by the APA, and training in an accredited program is required for licensure for independent practice as a health service psychologist

ScenarioScenario Programs offering PhDs in psychology are required to demonstrate that their graduates are capable of both creating and synthesizing new knowledge. Programs offering PsyDs in psychology are required to demonstrate that their graduates are competent in evidence- based practice. Programs that provide education and training that results in both outcomes award both the PhD and the PsyD.

ScenarioScenario With respect to the health care system, professional psychologists continue to be employed as teachers, administrators, researchers and practitioners. However, masters level professionals are hired to provide the bulk of the psychotherapy services in the health care system.

ScenarioScenario Doctoral education training of health service psychologists occurs in a setting that includes, as an integral part, faculty from other disciplines and professions, a health service system, experience with other health profession trainees and faculty conducting cutting edge research related to both clinical practice and health services research.

ScenarioScenario All programs are required to demonstrate that they provide education and training for students to achieve demonstrated competence in interprofessional functioning, practice based quality improvement, self- assessment, clinical decision-making, and telehealth.

ScenarioScenario The baccalaureate degree becomes a 3 year enterprise.

ScenarioScenario Doctoral education and training in professional psychology is comprised of a diverse set of programs. Some programs graduate students who are competent to practice with children and families and others with competence to prescribe medications, to consult with industry, to design prevention programs or to perform neuropsychological assessments.

ScenarioScenario Psychology remains a very attractive field of study. More people want to obtain doctorates and demand access to doctoral programs. Eager to generate credit hours and revenues, programs open their doors and become increasingly inclusive of the general population. Class sizes are large initially, but the curriculum is designed to weed out all but the most talented as students progress in the program.

ScenarioScenario All required content is delivered online. Because of student demand for portability the sequence is the same across programs. Student demand for access to various training opportunities results in swirling across programs. What implications does this have for program management, student tracking, attainment /assessment of clinical skills, and the role of the faculty?