Transcript 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
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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
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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 ScientistPractitioner Model
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Develop science-based or evidencedbased treatments
Conduct individual level science on own
practice
Use science to influence others’ practice
ACCOUNTABILITY
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Scientist-Practitioner Model
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The reality is that this doesn’t exist
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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
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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
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Guild’s interests are not always in
advancement of science
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Professional Competence
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Certification Process (licensing)
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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
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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:
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Receiving training at an accredited program
For “Psychologist” - must have a doctorate
For psychotherapist - can another advanced
degree
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Licensing
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Done by states
Term “psychologist” is protected
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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
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Can require a Ph.D./Psy.D. in Clinical or Counseling
psychology
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but, “School Psychologist” = MA/MS
MFT, LCSW = MA/MS
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Licensing
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Requirements of licensing
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1-2 yrs post-degree supervised experience
is required
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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
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Assumptions about graduate training
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(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
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Art-type of clinical epistemology
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Profile of Practitioners
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Clinical Psychology
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Most common subspecialty of
psychology
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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
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2nd most common subspecialty of psych
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Historically - roots in career development
Focus on “normative” issues
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Vs. clinical focus on abnormal behavior/disorder
Adjustment focus vs. disorder
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Career search
Coping with divorce
Coping with illness
Enhancing effectiveness
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Building self-confidence
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Training - Doctorate
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Education
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Ph.D. (Doctor of Philosophy)
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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)
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3-4 yrs coursework/practicum
1500 hours internship (similar to residency)
1-? yrs dissertation research
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Coursework for PhD
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Training in statistics and research
methodology
Training in theory
Training in psychotherapy
Conduct research (MA, then
dissertation)
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Coursework for PhD
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Clinical placement
Do qualifying exams/comps
Clinical internship (1500 hrs)
Postdoctoral internship (1500 hrs)
Job?….
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Training Example for Ph.D.
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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
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1 yr dissertation
 Development and testing psychotherapy coding system
1 yr internship
 University of California, San Diego/San Diego Veterans
Administration Hospital consortium
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Depression, substance abuse and outpatients services
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Dollars and cents
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Doctor of Psychology (PsyD)
Model
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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
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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
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Schools that have no affiliation with
universities that generally grant PsyD
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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
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Pros
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Lots of clinical training
Admit many students
Cons
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Expensive
Usually not accredited
May be unstable (buyer beware)
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Roles of Clinical & Counseling
Psychologists
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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
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MS  MFT
MSW  LCSW
others…
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Training for Masters
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Education
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Masters level therapists
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MS in clinical or counseling psychology
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Marriage Family Therapists (MFT)
2-4 years coursework/practicum
2 years internship
Masters in Social Work
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Licensed Clinical Social Worker (LCSW)
2-4 years coursework/practicum
2 years internship
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Coursework for Masters Level
Clinicians
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Some training in theory
Some training in applied research
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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
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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
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School problems, substance abuse, depression, anxiety
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Masters Level Degrees
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Advantages
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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
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Disadvantages
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Uncertain outcome
Lower rate of pay
Less skills with accountability (may be
necessary skills)
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Critical Thinking Moment
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Requiring therapy for training
APA has rules about who can do this and who
cannot while in training
Hotly contested issue
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Relevance of the student’s own therapy to conduct
therapy
Personal development
Ties to history of psychotherapy
What do you think?
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Graduate School
Degree Options
Degree Choices
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Many factors should influence this
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What do you want to do when you are done with
your degree?
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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
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How much time do you want to spend
getting your degree?
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2 years, 4 years, 7 years?
Are you able to move?
Can you assemble a competitive
application?
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How are your grades?
Do you have the requisite experience?
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Ph.D. or Masters?
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Should I get a Ph.D. or a Masters?
Depends on what you want to do!
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Do you want to do research?
Masters in Experimental Psych
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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?
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Ph.D.
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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?
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Ph.D.
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Pros:
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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?
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Ph.D.
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Cons:
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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?
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Masters
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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
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Marriage Family Therapist (MFT)
Masters in Social Work (MSW)
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Master of What?
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Designation of MS or MA depends on school!
Masters of Science
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Traditionally a “trade” or “applied science” degree
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May be a terminal degree
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SJSU’s MS in Clinical Psychology
May be a research degree
Masters of Arts
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Traditionally more breadth
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May be a research degree
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SJSU’s MA in Experimental Psychology
May be terminal degree
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Ph.D. or Masters?
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Masters
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Pros
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Shorter time to complete
Owe less money
Very focused training
Typically set up for licensing
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Once finish hours (if required)
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Ph.D. or Masters?
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Masters
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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?
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Should I get a Masters first if I want to
go on for a Ph.D.?
Yes, if you need to:
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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
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What kind of Masters should I get if I
want to go on to a Ph.D.?
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Often, it is an Masters (MA at SJSU) in
General or Experimental psychology
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Prepares you for research programs
Do NOT apply for a terminal masters (SJSU
MS Clinical) if you want a Ph.D.
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These do not prepare you for research
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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
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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
Masters in Experimental
SJSU MA Experimental
The MA
prepares for
Ph.D. programs
On the way:
Presentations,
Publications,
Thesis
3-6 years
Ph.D. in
specific area
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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
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The Route to a Graduate Degree
BA/BS in Psych
2-4 years
Masters in Applied area
Ph.D. in
specific area
The Applied
Masters will not
prepare students
for a traditional
academic Clinical
Ph.D. program
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A Note on Licensing
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Many hours required to get licensing
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Clinical psychology
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Ph.D. or Masters
3,000 hours of clinical experience required to
get licensed
Ph.D. = licensed psychologist
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1500 pre-degree on internship + 1500 post
doctorate  THEN take licensing test
Masters = MFT or MSW
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500 pre-degree as trainee + 2500 post degree as
intern  THEN take licensing test
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Social Work
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Training is in placement of the individual into
social system
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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?
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It all depends…
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Graduate School
Getting in: Pieces of the Puzzle
Are you ready?
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Getting in
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Harder than undergrad
Need several ingredients
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Some ingredients take time to build
Need to set this up for yourself well in
advance
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Ingredients for graduate
school applications
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These are slices of a pie
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Some slices can be less if others are more
Experience
Statement
Letters
GREs
GPA
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Ingredients: Grades
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Grades
 They count!
 Overall GPA, Psych GPA, Last 2 years’ GPA
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Need to make minimal cutoffs
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Ph.D. programs – typically 3.5 and above
Masters programs – 3.0 and above
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
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Entrance Exams
Most programs require these
Many require the Graduate Record Exam
(GREs)
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3 Sections: V, Q, A
Many look at Verbal (V) and Quantitative (Q)
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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)
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GREs
Tips:
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Study!
Take early
Take more than once
Remember caveats about size of slices
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Ingredients: Statement
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Statement of Intent
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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
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Letters of Recommendation/Reference
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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
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not mediocre, especially not bad
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Ingredients: Experience
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Experience
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Needs to be in area related to type of
program you are applying to
If applied degree e get applied
experience
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Show evidence of being around population or
issues relevant to your work
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Ingredients: Experience
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Experience
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If research degree e get research
experience
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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
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summarize experience clearly
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Graduate School
Getting in: Considering the Odds
Considering the Odds
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Ph.D. programs and Masters programs
have different acceptance rates
These rates change depending on
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Ph.D. vs Masters
The type of specialty program you apply to
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Considering the Odds
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Ph.D. programs
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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
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Depends on degree program
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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
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Considering the Odds
Ph.D. in Research / Other Fields
Cognitive
Developmental
Educational
Experimental
Industrial/Organizational
Neuroscience/Physiological/Bio
Personality
Quantitative
Social
Other
0.25
0.22
0.37
0.24
0.14
0.20
0.17
0.40
0.17
0.32
Subtotal
0.23
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Considering the Odds:
Example
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Example with clinical psychology
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Much depends on type of program
Overall acceptance rate: 12-13%
Accredited by APA (very important)
Private schools:
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7511 applied
873 accepted
12% acceptance rate
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Considering the Odds:
Example
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Example with clinical psychology
Accredited by APA (very important)
Public schools:
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15198 applied
1033 accepted
6% acceptance rate
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Considering the Odds
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Ph.D. programs
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GRE averages for 1999-2000
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Min V+Q = 1066
admitted score V+Q = 1161
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Considering the Odds
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Ph.D. programs
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GPA averages (99-00)
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overall min = 3.04
Admitted in
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overall = 3.53
last 2 years = 3.61
Psych = 3.66
Masters = 3.77
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Considering the Odds
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Masters programs
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Better odds of gaining admission
Tend to accept more individuals
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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
0.56
Community
0.56
Counseling
0.67
School
0.44
Other
0.67
Subtotal
0.59
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Considering the Odds
Master's Programs in Research / Other Fields
Developmental
Educational
Experimental
Ind/Org
General
Social
Other
Subtotal
0.56
0.78
0.59
0.45
0.60
0.38
0.67
0.60
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Considering the Odds
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Masters programs
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GPA averages (99-00)
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overall min = 2.90
Admitted in
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overall = 3.33
last 2 years = 3.45
Psych = 3.48
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Considering the Odds
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Masters programs
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GRE averages for 1999-2000
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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?
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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
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Take your time with your decision
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Don’t let someone say you can’t get in
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
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Your professors
Your fellow students
e Resources
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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
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