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

Training Issues in Clinical Psychology

Created by Dr. Glenn Callaghan Edited by Dr. Steve

Del Chiaro

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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

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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

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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)

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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

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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

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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

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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

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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

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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

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Profile of Practitioners

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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

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Ph.D. Areas by Popularity

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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

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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

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Coursework for PhD Training in statistics and research

methodology Training in theory Training in psychotherapy Conduct research (MA, then

dissertation)

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

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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

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Dollars and cents

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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

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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

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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

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Professional Schools Pros

Lots of clinical training Admit many students

Cons Expensive Usually not accredited May be unstable (buyer beware)

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Roles of Clinical & Counseling Psychologists

Research Assessment Treatment Teaching Consultation Administration

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Work Settings (PhD & PsyD)

Private and Group practice 35%Colleges and Universities 25%Hospitals & Medical Schools 25%Outpatient Clinics 16%Business and Industry 9%Military 2%Other locations (schools, prisons, etc…)

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Masters Level Degrees for Practice MS MFT MSW LCSW others…

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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

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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?….

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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

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Masters Level Degrees Advantages

If don’t want to do research Less overhead More likely to be employed

conducting therapy than Ph.D.s

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Masters Level Degrees Disadvantages

Uncertain outcome Lower rate of pay Less skills with accountability (may be

necessary skills)

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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

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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.

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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?

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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)

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Ph.D. or Masters? Ph.D.

Research degree Developing studies, carrying them out Program evaluation Administration Academics Often minimal practice or service

delivery

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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

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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

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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)

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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

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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)

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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

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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

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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

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The Route to a Graduate Degree

BA/BS in Psych

Ph.D. in specific

area

This is a straight path for researchers

4-7 years

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The Route to a Graduate Degree

BA/BS in Psych

Ph.D. in specific

area

This is a path to get into Ph.D. with a Masters Masters in

Experimental

SJSU MA Experimental

1-2 yearsOn the way: Presentations, Publications, Thesis

3-6 yearsThe MA prepares for Ph.D. programs

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The Route to a Graduate Degree

BA/BS in Psych

Ph.D. in specific

area

Masters in Applied area

(terminal degree)

2-4 years

The Applied Masters prepares service providers

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The Route to a Graduate Degree

BA/BS in Psych

Ph.D. in specific

area

Masters in Applied area

2-4 yearsThe Applied Masters will not prepare students for a traditional academic Clinical Ph.D. program

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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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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…

Graduate School

Getting in: Pieces of the Puzzle

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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

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Statement

GREs

GPA

Letters

Experience

Ingredients for graduate school applications These are slices of a pie

Some slices can be less if others are more

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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

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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

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Ingredients: GREs (cont’d) GREs Tips:

Study! Take early Take more than once

Remember caveats about size of slices

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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

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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

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Ingredients: Experience Experience

Needs to be in area related to type of program you are applying to

If applied degree get applied experience

Show evidence of being around population or issues relevant to your work

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Ingredients: Experience Experience

If research degree 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

Graduate School

Getting in: Considering the Odds

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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

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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

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Considering the OddsPh.D. in Health Service Provider FieldsClinical 0.12 Community 0.33 Counseling 0.14 Health 0.25 School 0.28Other 0.20 Subtotal 0.17

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Considering the OddsPh.D. in Research / Other FieldsCognitive 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

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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

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Considering the Odds: Example Example with clinical psychology Accredited by APA (very important) Public schools:

15198 applied 1033 accepted 6% acceptance rate

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Considering the Odds Ph.D. programs

GRE averages for 1999-2000 Min V+Q = 1066 admitted score V+Q = 1161

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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

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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%

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Considering the Odds

Master's Programs in Health Service Provider Fields

Clinical 0.56Community 0.56 Counseling 0.67 School 0.44 Other 0.67 Subtotal 0.59

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Considering the OddsMaster'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

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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

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Considering the Odds Masters programs

GRE averages for 1999-2000 Min V+Q = 975 admitted score V+Q = 1057

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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

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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

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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