Training Models in Clinical Psychology Overview

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					Training Models in Clinical
  Psychology: Overview

    James H. Johnson, Ph.D.,
    Variations in Training

 Boulder (Scientist-Practitioner)
  Model – 1949
 Vail (Scholar-Professional) Model –
 Clinical Science Model - 1990
          WW II and the Need for
 WW II and focus of the government on
    increasing the pool of trained mental health
   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 –
 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
 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
 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
 Very few full time faculty – mostly part-time training
 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
Growth of the Professional School
 In recent years the number of practitioner
  oriented training programs has increased
 Such program are found in free-standing
  professional school, in psychology departments,
  and separate schools of psychology within
 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
 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
 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
    The claimed benefits of the service must be stated
    These claimed benefits must be validated
    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?