CLINICAL PSYCHOLOGY TRAINING IN THE CLINICAL PSYCHOLOGY TRAINING IN THE UNITED STATES : PAST, PRESENT, & FUTUREUNITED STATES : PAST, PRESENT, & FUTURE

JAMES E. MADDUXJAMES E. MADDUXDEPARTMENT OF PSYCHOLOGYDEPARTMENT OF PSYCHOLOGY

CENTER FOR THE ADVANCEMENT OF WELL-BEINGCENTER FOR THE ADVANCEMENT OF WELL-BEINGGEORGE MASON UNIVERSITYGEORGE MASON UNIVERSITY

JMADDUX@GMU.EDUJMADDUX@GMU.EDU

WHY DOES THIS MATTER?WHY DOES THIS MATTER?

1.1. WE CAN LEARN FROM THE SUCCESSES & WE CAN LEARN FROM THE SUCCESSES & FAILURES OF OTHERS.FAILURES OF OTHERS.

2.2. MAY HELP YOU THINK MORE CRITICALLY MAY HELP YOU THINK MORE CRITICALLY ABOUT . . .YOUR OWN TRAININGABOUT . . .YOUR OWN TRAINING

3.3. . . . AND YOUR CLINICAL WORK.. . . AND YOUR CLINICAL WORK.

4.4. YOU MAY BE INVOLVED IN TRANING.YOU MAY BE INVOLVED IN TRANING.

5.5. YOU MAY BE INVOLVED IN SELF-YOU MAY BE INVOLVED IN SELF-REGULATION OF PROFESSION.REGULATION OF PROFESSION.

MAJOR SOURCESMAJOR SOURCES

BAKER, T. B., MCFALL, R. M., SHOHAM, V. (2009). CURRENT STATUS AND FUTURE BAKER, T. B., MCFALL, R. M., SHOHAM, V. (2009). CURRENT STATUS AND FUTURE PROSPECTS OF CLINICAL PSYCHOLOGY. PROSPECTS OF CLINICAL PSYCHOLOGY. PSYCHOLOGICAL SCIENCE IN THE PUBLIC INTEREST, PSYCHOLOGICAL SCIENCE IN THE PUBLIC INTEREST, 9, 9, 67-103.67-103.

BENJAMIN, L. T. (2005). HISTORY OF CLINICAL PSYCHOLOGY AS A PROFESSION IN AMERICA BENJAMIN, L. T. (2005). HISTORY OF CLINICAL PSYCHOLOGY AS A PROFESSION IN AMERICA (AND A GLIMPSE AT ITS FUTURE.(AND A GLIMPSE AT ITS FUTURE. ANNUAL REVIEW OF CLINICAL PSYCHOLOGY, 1, ANNUAL REVIEW OF CLINICAL PSYCHOLOGY, 1, 1-30.1-30.

BEUTLER, L. E. MAKING SCIENCE MATTER IN CLINICAL PRACTICE: REDEFINING BEUTLER, L. E. MAKING SCIENCE MATTER IN CLINICAL PRACTICE: REDEFINING PSYCHOTHERAPY. PSYCHOTHERAPY. CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, 16, CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, 16, 301-322.301-322.

MCFALL, R.M., DOCTORAL TRAINING IN CLINICAL PSYCHOLOGY. MCFALL, R.M., DOCTORAL TRAINING IN CLINICAL PSYCHOLOGY. ANNUAL REVIEW OF ANNUAL REVIEW OF CLINICAL PSYCHOLOGY, 2, CLINICAL PSYCHOLOGY, 2, 21-49.21-49.

REISMAN, J. M. (1991). REISMAN, J. M. (1991). A HISTORY OF CLINICAL PSYCHOLOGY (2A HISTORY OF CLINICAL PSYCHOLOGY (2NDND EDITION). EDITION). NEW YORK: NEW YORK: HEMISPHERE.HEMISPHERE.

STRICKER, G. (1995). THE LOCAL CLINICAL SCIENTIST: A BRIDGE BETWEEN SCIENCE AND STRICKER, G. (1995). THE LOCAL CLINICAL SCIENTIST: A BRIDGE BETWEEN SCIENCE AND PRACTICE. PRACTICE. AMERICAN PSYCHOLOGIST, 50, AMERICAN PSYCHOLOGIST, 50, 995-102.995-102.

CLINICAL PSYCHOLOGY IN THE U.S.CLINICAL PSYCHOLOGY IN THE U.S.

• ABOUT 125 YEARS OLD.ABOUT 125 YEARS OLD.

• ABOUT 120,000 PSYCHOLOGISTS (POP. OF 310 ABOUT 120,000 PSYCHOLOGISTS (POP. OF 310 MILLION)MILLION)

• ABOUT 90,000 PRACTITIONERS—MOSTLY CLINICAL OR ABOUT 90,000 PRACTITIONERS—MOSTLY CLINICAL OR COUNSELING.COUNSELING.

• 250+ DOCTORAL PROGRAMS IN CLINICAL AND 30+ IN 250+ DOCTORAL PROGRAMS IN CLINICAL AND 30+ IN COUNSELING PSYCHOLOGYCOUNSELING PSYCHOLOGY

• NATIONAL (NON-GOVT) ACCREDITING AGENCY (APA)NATIONAL (NON-GOVT) ACCREDITING AGENCY (APA)

• 53 DIFFERENT LICENSING AGENCIES (STATE 53 DIFFERENT LICENSING AGENCIES (STATE GOVERNMENTS, DC, PUERTO RICO, GUAM)GOVERNMENTS, DC, PUERTO RICO, GUAM)

• AMERICAN PSYCHOLOGICAL ASSOCIATION—1892AMERICAN PSYCHOLOGICAL ASSOCIATION—1892

• 150,OOO + MEMBERS150,OOO + MEMBERS

HISTORY OF CLINICAL PSYCHOLOGY IN THE HISTORY OF CLINICAL PSYCHOLOGY IN THE US—US—

A STRUGGLE FOR…A STRUGGLE FOR…

•   IDENTITY—IDENTITY—• THE PROFESSION’S ATTEMPTS TO THE PROFESSION’S ATTEMPTS TO DEFINE ITSELF. . .DEFINE ITSELF. . .

. . .AND. . .AND

RESPECTABILITY WITHRESPECTABILITY WITH

•OTHER DISCIPLINES WITHIN PSYCHOLOGYOTHER DISCIPLINES WITHIN PSYCHOLOGY

•SCIENCE VERSUS PRACTICESCIENCE VERSUS PRACTICE

•OTHER HEALTH AND MENTAL HEALTH OTHER HEALTH AND MENTAL HEALTH PROFESSIONSPROFESSIONS

•ESPECIALLY MEDICINE AND PSYCHIATRYESPECIALLY MEDICINE AND PSYCHIATRY

•POLICY MAKERSPOLICY MAKERS

•THE PUBLICTHE PUBLIC

CONTINUAL INTERACTIONS AMONG…CONTINUAL INTERACTIONS AMONG…

PROFESSIONAL PSYCHOLOGY ORGANIZATIONS (APA)PROFESSIONAL PSYCHOLOGY ORGANIZATIONS (APA)

OTHER DISCIPLINES (PSYCHIATRY)OTHER DISCIPLINES (PSYCHIATRY)

STATE GOVERNMENTSSTATE GOVERNMENTS

FEDERAL GOVERNMENTFEDERAL GOVERNMENT

UNIVERSITIESUNIVERSITIES

PRIVATE INDUSTRY—INCLUDING HEALTH INSURANCE COMPANIESPRIVATE INDUSTRY—INCLUDING HEALTH INSURANCE COMPANIES

CANADIAN PSYCHOLOGYCANADIAN PSYCHOLOGY

EUROPEAN PSYCHOLOGYEUROPEAN PSYCHOLOGY

IT MAY HELP TO UNDERSTAND THE US IT MAY HELP TO UNDERSTAND THE US CONSTITUTIONCONSTITUTION

• LIMITS POWERS OF FEDERAL GOVERNMENT.LIMITS POWERS OF FEDERAL GOVERNMENT.

• GIVES A LOT OF POWER TO STATE GOVERNMENTSGIVES A LOT OF POWER TO STATE GOVERNMENTS

• PRO—50 + 10 LABORATORIES FOR INNOVATIONPRO—50 + 10 LABORATORIES FOR INNOVATION

• CON—DIFFICULT TO DEVELOP CONCENSUS AND CON—DIFFICULT TO DEVELOP CONCENSUS AND CONSISTENCYCONSISTENCY

• CREDENTIALING, TRAINING STANDARDS. ETC.CREDENTIALING, TRAINING STANDARDS. ETC.

  

    

FOR THIS REASON . . .FOR THIS REASON . . .

NATIONAL LICENSING LAW WAS NEVER A NATIONAL LICENSING LAW WAS NEVER A POSSIBILITYPOSSIBILITY

NOR WERE GOVERNMENT-MANDATED NOR WERE GOVERNMENT-MANDATED TRAINING STANDARDS.TRAINING STANDARDS.

RESPONSIBILITY LEFT TO STATESRESPONSIBILITY LEFT TO STATES

AND PROFESSIONAL ORGANIZATIONSAND PROFESSIONAL ORGANIZATIONS

ALSO . . .ALSO . . .

INTER-CONNECTED WITH THE HISTORY OF PSYCHIATRY.INTER-CONNECTED WITH THE HISTORY OF PSYCHIATRY.

SOMETIMES AS ALLY AND CO-WORKER.SOMETIMES AS ALLY AND CO-WORKER.

BUT OFTEN AS ADVERSARY.BUT OFTEN AS ADVERSARY.

PSYCHIATRY CHALLENGED PSYCHOLOGY FROM BEGINNINGPSYCHIATRY CHALLENGED PSYCHOLOGY FROM BEGINNING

FIRST REGARDING ASSESSMENT & DIAGNOSIS.FIRST REGARDING ASSESSMENT & DIAGNOSIS.

LATER REGARDING PSYCHOTHERAPY.LATER REGARDING PSYCHOTHERAPY.

IRONY: PSYCHOLOGY NOW CHALLENGED BY SOCIAL WORK IRONY: PSYCHOLOGY NOW CHALLENGED BY SOCIAL WORK AND OTHERS WITH MASTER’S DEGREES.AND OTHERS WITH MASTER’S DEGREES.

SOME KEY DATES AND EVENTSSOME KEY DATES AND EVENTS

1892: FORMATION OF THE AMERICAN PSYCHOLOGICAL 1892: FORMATION OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (26 MEMBERS).ASSOCIATION (26 MEMBERS).

1896: LIGHTNER WITMER (STUDENTS OF WUNDT) 1896: LIGHTNER WITMER (STUDENTS OF WUNDT) ESTABLISHED THE FIRST “PSYCHOLOGICAL CLINIC” AT ESTABLISHED THE FIRST “PSYCHOLOGICAL CLINIC” AT UNIVERSITY OF PENNSYLVANIA.UNIVERSITY OF PENNSYLVANIA.

WITMER WAS THE FIRST TO USE THE TERM “CLINICAL WITMER WAS THE FIRST TO USE THE TERM “CLINICAL PSYCHOLOGIST.”PSYCHOLOGIST.”

CONCERNED MAINLY WITH CHILDREN’S ACADEMIC PROBLEMS.CONCERNED MAINLY WITH CHILDREN’S ACADEMIC PROBLEMS.

FIRST CLIENT—14 YEAR OLD BOY WITH “SPELLING FIRST CLIENT—14 YEAR OLD BOY WITH “SPELLING PROBLEMS.”PROBLEMS.”

MORE SIMILAR TO WHAT IS NOW CALLED SCHOOL MORE SIMILAR TO WHAT IS NOW CALLED SCHOOL PSYCHOLOGY.PSYCHOLOGY.

• 1907: NEW JOURNAL BY WITMER: “1907: NEW JOURNAL BY WITMER: “THE THE PSYCHOLOGICAL CLINIC.”PSYCHOLOGICAL CLINIC.”

• 1906: 1906: JOURNAL OF ABNORMAL PSYCHOLOGY (JOURNAL OF ABNORMAL PSYCHOLOGY (MORTON MORTON PRINCE). PRINCE).

• 1908: H.H. GODDARD OF CLARK U. VISITS EUROPE 1908: H.H. GODDARD OF CLARK U. VISITS EUROPE TO STUDY TESTING WORK OF A. BINET & T. SIMON.TO STUDY TESTING WORK OF A. BINET & T. SIMON.

• 1916—U.S. VERSION OF BINET-SIMON TEST OF 1916—U.S. VERSION OF BINET-SIMON TEST OF INTELLIGENCE PUB. IN 1916 (“STANFORD BINET”).INTELLIGENCE PUB. IN 1916 (“STANFORD BINET”).

• ““MENTAL TESTING” FIRMLY ESTAB. AS KEY ACTIVITY MENTAL TESTING” FIRMLY ESTAB. AS KEY ACTIVITY OF CLINICAL PSYCHOLOGISTS. OF CLINICAL PSYCHOLOGISTS.

19091909

• FREUD AND JUNG VISIT CLARK UNIVERSITY (MASS.)FREUD AND JUNG VISIT CLARK UNIVERSITY (MASS.)

• PSYCHOANALYTIC THEORY SOON FIRMLY ESTABLISHED PSYCHOANALYTIC THEORY SOON FIRMLY ESTABLISHED IN U.S. IN U.S.

• ALSO ESTABLISHED THE STUDY OF PERSONALITY AS ALSO ESTABLISHED THE STUDY OF PERSONALITY AS A KEY INTEREST OF PSYCHOLOGISTS.A KEY INTEREST OF PSYCHOLOGISTS.

• FURTHER ESTABLISHED WHEN DAVID LEVY BROUGHT FURTHER ESTABLISHED WHEN DAVID LEVY BROUGHT BACK THE RORCHACH FROM SWITZERLAND IN 1921.BACK THE RORCHACH FROM SWITZERLAND IN 1921.

• LATER CHALLENGED BY BEHAVIORAL (SKINNER) AND LATER CHALLENGED BY BEHAVIORAL (SKINNER) AND HUMANISTIC (MASLOW, ROGERS) THEORISTS.HUMANISTIC (MASLOW, ROGERS) THEORISTS.

• 1917—ILLINOIS PASSED LAW ALLOWING 1917—ILLINOIS PASSED LAW ALLOWING PSYCHOLOGISTS TO CERTIFY ELIGIBILITY FOR PSYCHOLOGISTS TO CERTIFY ELIGIBILITY FOR COMMITMENT TO INSTITUTIONS FOR THE MENTALLY COMMITMENT TO INSTITUTIONS FOR THE MENTALLY RETARDED. RETARDED. 

• CHALLENGED IN COURT BY THE NEW YORK CHALLENGED IN COURT BY THE NEW YORK PSYCHIATRICAL SOCIETY PSYCHIATRICAL SOCIETY

• TRIED TO BAN PSYCHOLOGISTS FROM ANY KIND OF TRIED TO BAN PSYCHOLOGISTS FROM ANY KIND OF CLINICAL WORK.CLINICAL WORK.

PSYCHOLOGY TRIES TO ESTABLISH PSYCHOLOGY TRIES TO ESTABLISH STANDARDS FOR PROFESSIONSTANDARDS FOR PROFESSION

1917—APA COMMISSION TO SET STANDARDS FOR 1917—APA COMMISSION TO SET STANDARDS FOR “PSYCHOLOGICAL EXAMINER”“PSYCHOLOGICAL EXAMINER”

1917—FOUNDING OF THE AMERICAN ASSOCIATION OF 1917—FOUNDING OF THE AMERICAN ASSOCIATION OF CLINICAL PSYCHOLOGISTS.CLINICAL PSYCHOLOGISTS.

LATER BECAME SECTION OF CLINICAL PSYCHOLOGY LATER BECAME SECTION OF CLINICAL PSYCHOLOGY WITHIN APA. WITHIN APA.

LETA HOLLINGSWORTH PROPOSES GUIDELINES FOR A LETA HOLLINGSWORTH PROPOSES GUIDELINES FOR A “DOCTOR OF PSYCHOLOGY” DEGREE.“DOCTOR OF PSYCHOLOGY” DEGREE.

INCLUDED A ONE-YEAR “APPRENTICESHIP.”INCLUDED A ONE-YEAR “APPRENTICESHIP.”

•1918—AMERICAN MEDICO-PSYCHOLOGICAL 1918—AMERICAN MEDICO-PSYCHOLOGICAL ASSOCIATION (LATER AMERICAN PSYCHIATRIC ASSOCIATION (LATER AMERICAN PSYCHIATRIC ASSOCIATION) ISSUED FIRST OFFICIAL SET OF ASSOCIATION) ISSUED FIRST OFFICIAL SET OF DIAGNOSTIC CATEGORIES.DIAGNOSTIC CATEGORIES.

•STATISTICAL MANUAL FOR THE USE OF STATISTICAL MANUAL FOR THE USE OF INSTITUTIONS OF THE INSANE.INSTITUTIONS OF THE INSANE.

•EVENTUALLY DEVELOPED INTO THE FIRST DSM IN EVENTUALLY DEVELOPED INTO THE FIRST DSM IN 1952.1952.

•ANOTHER AREA OF PSYCHOLOGY & PSYCHIATRY ANOTHER AREA OF PSYCHOLOGY & PSYCHIATRY CONFLICT & COOPERATION.CONFLICT & COOPERATION.

ALSO IN 1917…ALSO IN 1917…U.S. ENTERS WORLD WAR IU.S. ENTERS WORLD WAR I

PSYCHOLOGISTS BECOME INVOLVED IN MILITARY:PSYCHOLOGISTS BECOME INVOLVED IN MILITARY:– PERSONNEL ASSESSMENT & SELECTION.PERSONNEL ASSESSMENT & SELECTION.– INTELLECTUAL ASSESSMENT & SCREENING.INTELLECTUAL ASSESSMENT & SCREENING.– PERSONALITY ASSESSMENT TO IDENTIFY PERSONALITY ASSESSMENT TO IDENTIFY SOLDIERS LIKELY TO DEVELOP “SHELL SOLDIERS LIKELY TO DEVELOP “SHELL SHOCK” (NOW PTSD) SHOCK” (NOW PTSD)

– WORDSWORTH PERSONALTY DATA SHEET WORDSWORTH PERSONALTY DATA SHEET (1919).(1919).

– ESTAB. PERSONALITY ASSESSMENT AS KEY ESTAB. PERSONALITY ASSESSMENT AS KEY ACTIVITY OF CLINICAL PSYCHOLOGISTS.ACTIVITY OF CLINICAL PSYCHOLOGISTS.

AFTER WORLD WAR IAFTER WORLD WAR I

1921—FORMATION OF THE PSYCHOLOGICAL 1921—FORMATION OF THE PSYCHOLOGICAL CORPORATION (TESTING)CORPORATION (TESTING)

BEGINNING OF PSYCHOLOGY AS A BIG BUSINESS IN BEGINNING OF PSYCHOLOGY AS A BIG BUSINESS IN THE PRIVATE SECTOR.THE PRIVATE SECTOR.

1921—APA ISSUES GUIDELINES FOR THE 1921—APA ISSUES GUIDELINES FOR THE CERTIFICATION OF CLINICAL PSYCHOLOGISTS.CERTIFICATION OF CLINICAL PSYCHOLOGISTS.

ABONDONED EFFORT SEVERAL YEARS LATER DUE TO ABONDONED EFFORT SEVERAL YEARS LATER DUE TO LACK OF IMPACT.LACK OF IMPACT.

SEVERAL MAJOR UNIVERSITIES ESTABLISH SEVERAL MAJOR UNIVERSITIES ESTABLISH PSYCHOLOGICAL CLINICS FOR STUDENTS.PSYCHOLOGICAL CLINICS FOR STUDENTS.

1924—EARLY ATTEMPT AT SELF-1924—EARLY ATTEMPT AT SELF-REGULATIONREGULATION

APA’S SECTION OF CLINICAL PSYCHOLOGY APA’S SECTION OF CLINICAL PSYCHOLOGY RECOMMENDS STANDARDS FOR PRACTICING CLINICAL RECOMMENDS STANDARDS FOR PRACTICING CLINICAL PSYCHOLOGISTSPSYCHOLOGISTSA PHD A PHD FOUR YEARS OF PROFESSIONAL TRAININGFOUR YEARS OF PROFESSIONAL TRAININGONE YEAR OF SUPERVISED CLINICAL WORKONE YEAR OF SUPERVISED CLINICAL WORK

NOT FAR FROM WHAT WE HAVE NOWNOT FAR FROM WHAT WE HAVE NOW

H.G. WELLS IN THE H.G. WELLS IN THE AMERICAN AMERICAN MAGAZINE (1924) MAGAZINE (1924)

“ “THE ADVANCES THAT HAVE BEEN MADE IN THE ADVANCES THAT HAVE BEEN MADE IN PSYCHOLOGY . . .HAVE BEEN ENORMOUS. THE PSYCHOLOGY . . .HAVE BEEN ENORMOUS. THE COMING HUNDRED YEARS OR SO WILL BE, I COMING HUNDRED YEARS OR SO WILL BE, I BELIEVE, ESSENTIALLY A CENTURY OF BELIEVE, ESSENTIALLY A CENTURY OF APPLIED PSYCHOLOGY. . . .IT WILL MARK A APPLIED PSYCHOLOGY. . . .IT WILL MARK A REVOLUTION IN HUMAN AFFAIRS.”REVOLUTION IN HUMAN AFFAIRS.”

1930s…CONTINUED GROWTH1930s…CONTINUED GROWTH

• 1930—OVER 500 CLINICS OFFER PSYCHOLOGICAL 1930—OVER 500 CLINICS OFFER PSYCHOLOGICAL SERVICES.SERVICES.

• 1932—FOUNDED THE 1932—FOUNDED THE JOURNAL OF CONSULTING JOURNAL OF CONSULTING PSYCHOLOGY.PSYCHOLOGY.

• LATER CHANGED TO LATER CHANGED TO JOURNAL OF CONSULTING AND JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY CLINICAL PSYCHOLOGY (APA).(APA).

• 1935—APA REPORT DEFINES CLINICAL PSYCHOLOGY AS 1935—APA REPORT DEFINES CLINICAL PSYCHOLOGY AS “THE ART AND TECHNOLOGY WHICH DEALS WITH THE “THE ART AND TECHNOLOGY WHICH DEALS WITH THE ADJUSTMENT PROBLEMS OF HUMAN BEINGS.”ADJUSTMENT PROBLEMS OF HUMAN BEINGS.”

• RECOMMENDS THAT ANYONE USING TITLE “CLINICAL RECOMMENDS THAT ANYONE USING TITLE “CLINICAL PSYCHOLOGIST” SHOULD HAVE A PHD AND A YEAR OF PSYCHOLOGIST” SHOULD HAVE A PHD AND A YEAR OF SUPERVISED CLINICAL EXPERIENCE.SUPERVISED CLINICAL EXPERIENCE.

• WILL RETURN LATER TO THE ISSUE OF PHD VERSUS WILL RETURN LATER TO THE ISSUE OF PHD VERSUS OTHER DEGREES OTHER DEGREES

WORLD WAR IIWORLD WAR II

US MILITARY EMPLOYS OVER 1700 PSYCHOLOGISTS.US MILITARY EMPLOYS OVER 1700 PSYCHOLOGISTS.PERSONNEL SELECTION AND TRAINING.PERSONNEL SELECTION AND TRAINING.EQUIPMENT DESIGN (HUMAN FACTORS)EQUIPMENT DESIGN (HUMAN FACTORS)COUNSELING AND PSYCHOTHERAPY.COUNSELING AND PSYCHOTHERAPY.

END OF WORLD WAR II—ALMOST 45,000 PSYCHIATRIC END OF WORLD WAR II—ALMOST 45,000 PSYCHIATRIC PATIENTS IN HOSPITALS FOR VETERANSPATIENTS IN HOSPITALS FOR VETERANS

VA CLAIMS IT NEEDS 4700 PSYCHOTHERAPISTS AND VA CLAIMS IT NEEDS 4700 PSYCHOTHERAPISTS AND COUNSELORS.COUNSELORS.

PSYCHIATRY CANNOT MEET THIS NEED . . .THEREFORE. . .PSYCHIATRY CANNOT MEET THIS NEED . . .THEREFORE. . .

1942—CONGRESSIONAL ORDER TO VETERAN’S 1942—CONGRESSIONAL ORDER TO VETERAN’S ADMINISTRATIONADMINISTRATION

• EXPAND THE POOL OF MENTAL HEALTH EXPAND THE POOL OF MENTAL HEALTH PROFESSIONALS, ESPECIALLY CLINICAL PROFESSIONALS, ESPECIALLY CLINICAL PSYCHOLOGISTSPSYCHOLOGISTS

• 1944—US GOVERNMENT PROVIDES FUNDS FOR 1944—US GOVERNMENT PROVIDES FUNDS FOR TRAINING CLINICAL PSYCHOLOGISTS IN TRAINING CLINICAL PSYCHOLOGISTS IN UNIVERSITIES .UNIVERSITIES .

• REQUIRES THAT THEY BE TRAINED IN REQUIRES THAT THEY BE TRAINED IN PSYCHOTHERAPY.PSYCHOTHERAPY.

• PSYCHIATRY OBJECTS (BUT LOSES)PSYCHIATRY OBJECTS (BUT LOSES)

• VA HOSPITALS PROVIDE PRATICUM TRAINING.VA HOSPITALS PROVIDE PRATICUM TRAINING.

PSYCHOLOGISTS BECOME PSYCHOTHERAPISTSPSYCHOLOGISTS BECOME PSYCHOTHERAPISTS

BY 1947—1500 CLINICAL PSYCHOLOGY PHD BY 1947—1500 CLINICAL PSYCHOLOGY PHD STUDENTS FUNDED AT 50 UNIVERSITIES.STUDENTS FUNDED AT 50 UNIVERSITIES.

• VA CREATES 100s OF NEW JOBS FOR CLINICAL VA CREATES 100s OF NEW JOBS FOR CLINICAL PSYCHOLOGISTS.PSYCHOLOGISTS.

• LARGEST SINGLE EMPLOYER OF CLINICAL LARGEST SINGLE EMPLOYER OF CLINICAL PSYCHOLOGISTS.PSYCHOLOGISTS.

• TODAY—THE VETERANS ADMINISTRATION REQUIRES TODAY—THE VETERANS ADMINISTRATION REQUIRES AN APA-ACCREDITED DOCTORAL PROGRAM AND AN APA-ACCREDITED DOCTORAL PROGRAM AND INTERNSHIPINTERNSHIP

• BY 1970s CLINICAL PSYCHOLOGISTS ARE THE MAJOR BY 1970s CLINICAL PSYCHOLOGISTS ARE THE MAJOR PROVIDERS OF PSYCHOTHERAPY. PROVIDERS OF PSYCHOTHERAPY. 

1946--LICENSING1946--LICENSING

1946—CONNECTICUT BECOMES FIRST STATE TO PASS 1946—CONNECTICUT BECOMES FIRST STATE TO PASS LAW REGULATING PRACTICE OF PSYCHOLOGY WITH LAW REGULATING PRACTICE OF PSYCHOLOGY WITH LICENSE REQUIREMENTS.LICENSE REQUIREMENTS.

1948—VIRGINIA BECOMES FIRST STATE TO REQUIRE 1948—VIRGINIA BECOMES FIRST STATE TO REQUIRE A DOCTORAL DEGREE FOR LICENSE.A DOCTORAL DEGREE FOR LICENSE.

1977—MISSOURI BECOMES LAST STATE TO PASS 1977—MISSOURI BECOMES LAST STATE TO PASS PSYCHOLOGY LICENSING LAW.PSYCHOLOGY LICENSING LAW.

2004 NEW MEXICO AND LOUISIANA GRANT CLINICAL 2004 NEW MEXICO AND LOUISIANA GRANT CLINICAL PSYCHOLOGIST PRESCRIPTION PREVILEGES.PSYCHOLOGIST PRESCRIPTION PREVILEGES.

WILL RETURN TO LICENSING ISSUE LATER WILL RETURN TO LICENSING ISSUE LATER

1946--NIMH1946--NIMH

PRESIDENT TRUMAN SIGNED INTO LAW BILL PRESIDENT TRUMAN SIGNED INTO LAW BILL CREATING THE NATIONAL INSTITUTE OF MENTAL CREATING THE NATIONAL INSTITUTE OF MENTAL HEALTH.HEALTH.

OPENED IN 1946OPENED IN 1946

MISSION: “TO TRANSFORM THE UNDERSTANDING AND MISSION: “TO TRANSFORM THE UNDERSTANDING AND TREATMENT OF MENTAL ILLNESS THROUGH BASIC AND TREATMENT OF MENTAL ILLNESS THROUGH BASIC AND CLINICAL RESEARCH, PAVING THE WAY FOR CLINICAL RESEARCH, PAVING THE WAY FOR PREVENTION, RECOVERY, AND CURE.”PREVENTION, RECOVERY, AND CURE.”

NOW HAS ANNUAL BUDGET OVER $1.5 BILLION.NOW HAS ANNUAL BUDGET OVER $1.5 BILLION.

SO MANY NEW CLINICAL PSYCHOLOGY SO MANY NEW CLINICAL PSYCHOLOGY PROGRAMS SO QUICKLYPROGRAMS SO QUICKLY

NEED FOR QUALITY CONTROL AND NEED FOR QUALITY CONTROL AND CONSISTENCY.CONSISTENCY.

FEDERAL GOVERNMENT GIVES APA A FEDERAL GOVERNMENT GIVES APA A CHOICE. . .CHOICE. . .

EITHER . . .YOU DEVELOP STANDARDS AND EITHER . . .YOU DEVELOP STANDARDS AND PROCESS FOR EVALUATION (ACCREDITATION) PROCESS FOR EVALUATION (ACCREDITATION) OR . . .OR . . .

A FEDERAL AGENCY WILL DO FOR YOU.A FEDERAL AGENCY WILL DO FOR YOU.

SO APA TOOK ON THE TASK.SO APA TOOK ON THE TASK.

1947—APA PROPOSES FOUR-YEAR 1947—APA PROPOSES FOUR-YEAR PROGRAM FOR CLINICAL PHDPROGRAM FOR CLINICAL PHD

1.1. COURSEWORK IN MAJOR AREAS OF PSYCHOLOGYCOURSEWORK IN MAJOR AREAS OF PSYCHOLOGY

2.2. COURSEWORK IN PSYCHOTHERAPY THEORY & RESEARCHCOURSEWORK IN PSYCHOTHERAPY THEORY & RESEARCH

3.3. COURSEWORK IN RESEARCH METHODS & STATISTICSCOURSEWORK IN RESEARCH METHODS & STATISTICS

4.4. RESEARCH TRAINING (DOCTORAL DISSERTATION)RESEARCH TRAINING (DOCTORAL DISSERTATION)

5.5. PRACTICUM TRAININGPRACTICUM TRAINING

6.6. ONE-YEAR FULL-TIME INTERNSHIPONE-YEAR FULL-TIME INTERNSHIP

DDÉJÀÉJÀ VU OF 1924 VU OF 1924

1949—APA TRAINING CONFERENCE AT 1949—APA TRAINING CONFERENCE AT BOULDER, COLORADOBOULDER, COLORADO

SPONSORED BY THE NATIONAL INSTITUTE OF MENTAL SPONSORED BY THE NATIONAL INSTITUTE OF MENTAL HEALTH—A FEDERAL GOVERNMENT AGENCY HEALTH—A FEDERAL GOVERNMENT AGENCY ESTABLISHED SHORTLY AFTER WORLD WAR 2.ESTABLISHED SHORTLY AFTER WORLD WAR 2.

US VETERANS ADMINISTRATION.US VETERANS ADMINISTRATION.

US PUBLIC HEALTH SERVICEUS PUBLIC HEALTH SERVICE

AMERICAN PSYCHOLOGICAL ASSOCIATIONAMERICAN PSYCHOLOGICAL ASSOCIATION

WE SHALL RETURN TO THIS WE SHALL RETURN TO THIS CONFERENCE IN A MINUTE…CONFERENCE IN A MINUTE…

ONE MORE VERY IMPORTANT DATE…1963.ONE MORE VERY IMPORTANT DATE…1963.

COMMUNITY MENTAL HEALTH CENTERS ACT.COMMUNITY MENTAL HEALTH CENTERS ACT.

INITIATIVE OF PRESIDENT JOHN F. KENNEDY.INITIATIVE OF PRESIDENT JOHN F. KENNEDY.

OUTPATIENT TREATMENT CENTERS.OUTPATIENT TREATMENT CENTERS.

ALL COMMUNITIES OVER 30,000ALL COMMUNITIES OVER 30,000

ACCOMPANIED BY “DEINSTITUTIONALIZATION” OF ACCOMPANIED BY “DEINSTITUTIONALIZATION” OF 1000s OF PEOPLE WITH SEVERAL MENTAL DISORDERS.1000s OF PEOPLE WITH SEVERAL MENTAL DISORDERS.

INCREASED NEED FOR PSYCHOLOGISTS.INCREASED NEED FOR PSYCHOLOGISTS.

FURTHER SHIFTED PROVISION OF MENTAL HEALTH FURTHER SHIFTED PROVISION OF MENTAL HEALTH SERVICES FROM PSYCHIATRY TO PSYCHOLOGY AND SERVICES FROM PSYCHIATRY TO PSYCHOLOGY AND OTHER PROFESSIONS.OTHER PROFESSIONS.

BACK TO 1949BACK TO 1949—APA TRAINING CONFERENCE —APA TRAINING CONFERENCE AT BOULDER, COLORADO—THE “BOULDER AT BOULDER, COLORADO—THE “BOULDER

MODEL”MODEL”

CLINICAL PSYCHOLOGISTS SHOULD BE TRAINED AS CLINICAL PSYCHOLOGISTS SHOULD BE TRAINED AS SCIENTISTS AND PRACTITIONERS.SCIENTISTS AND PRACTITIONERS.

RESEARCH SKILLS AND CLINICAL SHOUD BE INTEGRATED.RESEARCH SKILLS AND CLINICAL SHOUD BE INTEGRATED.

CLINICAL PSYCHOLOGISTS SHOULD BE BOTH CLINICIANS CLINICAL PSYCHOLOGISTS SHOULD BE BOTH CLINICIANS & RESEARCHERS THROUGHOUT THEIR CAREERS.& RESEARCHERS THROUGHOUT THEIR CAREERS.

SHOULD EMPIRICALLY EVALUATE THEIR CLINICAL WORK.SHOULD EMPIRICALLY EVALUATE THEIR CLINICAL WORK.

SHOULD MAINTAIN CURRENT KNOWLEDGE OF CLINICAL SHOULD MAINTAIN CURRENT KNOWLEDGE OF CLINICAL RESEARCH.RESEARCH.

SHOULD CONTRIBUTE TO THE KNOWLEDGE BASE.SHOULD CONTRIBUTE TO THE KNOWLEDGE BASE.

THIS MODEL WAS A COMPROMISE.THIS MODEL WAS A COMPROMISE.

VETERANS ADMINISTRATION WAS FUNDING MOST OF VETERANS ADMINISTRATION WAS FUNDING MOST OF THE CLINICAL TRAINING AND WANTED MAINLY THE CLINICAL TRAINING AND WANTED MAINLY PRACTIONER TRAINING.PRACTIONER TRAINING.

APA COMPRISED MAINLY OF UNIVERSITY-BASED APA COMPRISED MAINLY OF UNIVERSITY-BASED RESEARCH PSYCHOLOGISTS WHO BELIEVED THAT THE RESEARCH PSYCHOLOGISTS WHO BELIEVED THAT THE PHD SHOULD BE A RESEARCH DEGREE.PHD SHOULD BE A RESEARCH DEGREE.

TRAINING WOULD INCLUDETRAINING WOULD INCLUDE

ACADEMIC COURSEWORK IN ALL MAJOR AREAS OF PSYCHOLOGY.ACADEMIC COURSEWORK IN ALL MAJOR AREAS OF PSYCHOLOGY.

COURSES IN PSYCHOLOGICAL ASSESSMENT AND INTERVENTIONS COURSES IN PSYCHOLOGICAL ASSESSMENT AND INTERVENTIONS (PSYCHOTHERAPY).(PSYCHOTHERAPY).

COURSES IN RESEARCH METHODS AND STATISTICS.COURSES IN RESEARCH METHODS AND STATISTICS.

SUPERVISED CLINICAL PRACTICUM (IN HOUSE & EXTERNAL SUPERVISED CLINICAL PRACTICUM (IN HOUSE & EXTERNAL SETTINGS).SETTINGS).

EMPIRICAL DISSERTATION (DATA BASED)EMPIRICAL DISSERTATION (DATA BASED)

ONE-YEAR FULL-TIME CLINICAL INTERNSHIP IN SETTING EXTERNAL ONE-YEAR FULL-TIME CLINICAL INTERNSHIP IN SETTING EXTERNAL TO PROGRAMTO PROGRAM

REQUIRED COURSEWORKREQUIRED COURSEWORK

• Biological bases of Biological bases of behaviorbehavior

• cognitive-affective cognitive-affective bases of behaviorbases of behavior

• social bases of social bases of behaviorbehavior

• lifespan lifespan developmentdevelopment

• Assessment & Assessment & diagnosisdiagnosis

• Treatment & Treatment & interventionSinterventionS

• research methods & research methods & statisticsstatistics

• Ethical & Ethical & professional professional standards.standards.

FIRST CLINICAL PROGRAMS ACCREDITED BY APA IN FIRST CLINICAL PROGRAMS ACCREDITED BY APA IN 1948.1948.

FIRST CLINICAL INTERNSHIPS ACCREDITED IN 1956.FIRST CLINICAL INTERNSHIPS ACCREDITED IN 1956.BY 2005:BY 2005:

OVER 220 ACCREDITED DOCTORAL PROGRAMS IN OVER 220 ACCREDITED DOCTORAL PROGRAMS IN US.US.

OVER 450 ACCREDITED INTERNSHIP PROGRAMS IN OVER 450 ACCREDITED INTERNSHIP PROGRAMS IN US.US.

GROWING PROBLEM: TOO MANY CLINICAL GROWING PROBLEM: TOO MANY CLINICAL STUDENTS AND NOT ENOUGH INTERNSHIP STUDENTS AND NOT ENOUGH INTERNSHIP POSITIONS. POSITIONS.

BUT SKEPTICISM & DISSATISFACTIONBUT SKEPTICISM & DISSATISFACTION SOON SET IN SOON SET IN

CAN YOU TRAIN SOMEONE TO BE COMPETENT AT BOTH PRACTICE CAN YOU TRAIN SOMEONE TO BE COMPETENT AT BOTH PRACTICE AND RESEARCH IN 5 YEARS?AND RESEARCH IN 5 YEARS?

VAST MAJORITY OF CLINICAL PHD STUDENTS NEVER PUBLISHED VAST MAJORITY OF CLINICAL PHD STUDENTS NEVER PUBLISHED RESEARCH AFTER GETTING DEGREE. RESEARCH AFTER GETTING DEGREE.

ALL CLINICAL PROGRAMS WERE IN UNIVERSITY DEPARTMENTS ALL CLINICAL PROGRAMS WERE IN UNIVERSITY DEPARTMENTS OF PSYCHOLOGY.OF PSYCHOLOGY.

VAST MAJORITY OF UNIVERSITY PSYCHOLOGISTS WERE VAST MAJORITY OF UNIVERSITY PSYCHOLOGISTS WERE RESEARCHERS—NOT INTERESTED IN TRAINING IN CLINICAL RESEARCHERS—NOT INTERESTED IN TRAINING IN CLINICAL PRACTICE.PRACTICE.

TENSIONS QUICKLY DEVELOPED BETWEEN PRACTICE-ORIENTED TENSIONS QUICKLY DEVELOPED BETWEEN PRACTICE-ORIENTED CLINICAL FACULTY AND NON-CLINICAL FACULTY.CLINICAL FACULTY AND NON-CLINICAL FACULTY.

REMAINS A PROBLEM IN MOST DEPARTMENTS OF PSYCHOLOGY IN REMAINS A PROBLEM IN MOST DEPARTMENTS OF PSYCHOLOGY IN THE US.THE US.

RISE OF PROFESSIONAL SCHOOLSRISE OF PROFESSIONAL SCHOOLS & THE ”DOCTOR OF PSYCHOLOGY” & THE ”DOCTOR OF PSYCHOLOGY”

(PSYD)(PSYD)

1951—FIRST PROFESSIONAL SCHOOL OF CLINICAL 1951—FIRST PROFESSIONAL SCHOOL OF CLINICAL PSYCHOLOGY AT ADELPHI UNIVERSITY IN NEW YORK.PSYCHOLOGY AT ADELPHI UNIVERSITY IN NEW YORK.

• INDEPENDENT OF DEPARTMENT OF PSYCHOLOGYINDEPENDENT OF DEPARTMENT OF PSYCHOLOGY

• 1970—FIRST FREE-STANDING (NOT AT A 1970—FIRST FREE-STANDING (NOT AT A UNIVERSITY)-- PROFESSIONAL SCHOOL OF UNIVERSITY)-- PROFESSIONAL SCHOOL OF PSYCHOLOGY IN CALIFORNIA.PSYCHOLOGY IN CALIFORNIA.

• 1973—FIRST CONFERENCE OF PROFESSIONAL SCHOOLS 1973—FIRST CONFERENCE OF PROFESSIONAL SCHOOLS AT VAIL COLORADO.AT VAIL COLORADO.

• 1997—PSYD PROGRAMS WERE GRADUATING TWICE AS 1997—PSYD PROGRAMS WERE GRADUATING TWICE AS MANY STUDENTS AS CLINICAL PHD PROGRAMSMANY STUDENTS AS CLINICAL PHD PROGRAMS

APA’S VAIL CONFERENCE--1973APA’S VAIL CONFERENCE--1973

DEVELOPED THE DEVELOPED THE SCHOLAR-PRACTITIONERSCHOLAR-PRACTITIONER MODEL OF MODEL OF CLINICAL TRAINING.CLINICAL TRAINING.

DOCTOR OF PSYCOLOGY OR PSYD.DOCTOR OF PSYCOLOGY OR PSYD.

EMPHASIZES TRAINING IN CLINICAL PRACTICE, NOT EMPHASIZES TRAINING IN CLINICAL PRACTICE, NOT RESEARCH.RESEARCH.

INFORMED AND CRITICAL CONSUMER OF RESEARCH.INFORMED AND CRITICAL CONSUMER OF RESEARCH.

““LOCAL CLINICAL SCIENTIST”LOCAL CLINICAL SCIENTIST”

APPLICATION OF KNOWLEDGE TO CLINICAL PRACTICE.APPLICATION OF KNOWLEDGE TO CLINICAL PRACTICE.

SAME STANDARDS OF ACCREDITATION BY APA.SAME STANDARDS OF ACCREDITATION BY APA.

EQUALLY ELIGIBLE FOR LICENSURE.EQUALLY ELIGIBLE FOR LICENSURE.

BY 2005—57 APA- ACCREDITED PSYD BY 2005—57 APA- ACCREDITED PSYD PROGRAMS IN USPROGRAMS IN US

ACCOUNT FOR 30% OF ALL DEGREES IN ACCOUNT FOR 30% OF ALL DEGREES IN PSYCHOLOGYPSYCHOLOGY

PSYD VS. PHD.PSYD VS. PHD.PSYD PROGRAMS IN BOTH UNIVERSITIES AND FREE-PSYD PROGRAMS IN BOTH UNIVERSITIES AND FREE-

STANDING PRIVATE SCHOOLSSTANDING PRIVATE SCHOOLS.. ACCEPT MORE STUDENTSACCEPT MORE STUDENTS

• LOWER STANDARDS OF ADMISSION.LOWER STANDARDS OF ADMISSION.

• HIGHER RATE OF ACCEPTANCE (50% VS 11%).HIGHER RATE OF ACCEPTANCE (50% VS 11%).

• LARGER ENTERING CLASSES (48 VS 10).LARGER ENTERING CLASSES (48 VS 10).

• HIGHER FACULTY-TO-STUDENT RATIONHIGHER FACULTY-TO-STUDENT RATION

• MORE PART-TIME FACULTY.MORE PART-TIME FACULTY.

• HIGHER TUITION BUT LESS FINANCIAL AIDHIGHER TUITION BUT LESS FINANCIAL AID

• STUDENTS DO NOT PERFORM AS WELL ON EPPP.STUDENTS DO NOT PERFORM AS WELL ON EPPP.

• BUT—NO EVIDENCE OF DIFFERENCES IN PERFORMANCE IN BUT—NO EVIDENCE OF DIFFERENCES IN PERFORMANCE IN CLINICAL PRACTICE SETTINGS.CLINICAL PRACTICE SETTINGS.

KEY IDEA IN PSY.D. PROGRAMSKEY IDEA IN PSY.D. PROGRAMS

SCIENTIFIC PRACTITIONER SCIENTIFIC PRACTITIONER

OR OR

““LOCAL CLINICAL SCIENTIST”LOCAL CLINICAL SCIENTIST”

““THE CLINICAL SETTING CAN BE REGARDED AS THE THE CLINICAL SETTING CAN BE REGARDED AS THE LABORATORY FOR THE CLINICIAN, AND IT MUST BE LABORATORY FOR THE CLINICIAN, AND IT MUST BE APPROACHED WITH THE SAME DISCIPLINE, APPROACHED WITH THE SAME DISCIPLINE, CRITICAL THINKING, IMAGINATION, OPENNES TO CRITICAL THINKING, IMAGINATION, OPENNES TO FALSIFICATION, AND RIGOR THAT CHARACTERIZES FALSIFICATION, AND RIGOR THAT CHARACTERIZES THE SCIENTIST IN THE TRADITIONAL THE SCIENTIST IN THE TRADITIONAL LABORATORY.”LABORATORY.”GEORGE STRICKER (1995).GEORGE STRICKER (1995).

LOCAL CLINICAL SCIENTISTLOCAL CLINICAL SCIENTIST

““THE LOCAL CLINICAL SCIENTIST MODEL THE LOCAL CLINICAL SCIENTIST MODEL RECOGNIZES THAT SCIENTIFIC TRAINING—EVEN RECOGNIZES THAT SCIENTIFIC TRAINING—EVEN WHEN IT DOES NOT PRESENT A SUBSTANTIVE WHEN IT DOES NOT PRESENT A SUBSTANTIVE SOLUTION—CAN PROVIDE AN ATTITUDE AND AN SOLUTION—CAN PROVIDE AN ATTITUDE AND AN ORIENTATION TO THE PROBLEM AT HAND THAT ORIENTATION TO THE PROBLEM AT HAND THAT WILL LEAD TO AN INFORMED SOLUTION THAT WILL LEAD TO AN INFORMED SOLUTION THAT IS THE BEST THE STATE OF THE ART CAN IS THE BEST THE STATE OF THE ART CAN GENERATEGENERATE

STRICKER (1995)STRICKER (1995)

LOCAL CLINICAL SCIENTISTLOCAL CLINICAL SCIENTIST

OBSERVING SYSTEMATICALLY AND OBJECTIVELY.OBSERVING SYSTEMATICALLY AND OBJECTIVELY. FORMING HYPOTHESES.FORMING HYPOTHESES. GATHERING DATA TO TEST HYPOTHESES.GATHERING DATA TO TEST HYPOTHESES. REFORMULATING HYPOTHESES IN RESPONSE TO DATA.REFORMULATING HYPOTHESES IN RESPONSE TO DATA. USES RESEARCH FINDINGS AS A SOURCE OF HYPOTHESES ABOUT USES RESEARCH FINDINGS AS A SOURCE OF HYPOTHESES ABOUT

CLIENTS.CLIENTS. BUT ALSO AWARE OF “LOCAL CONDITIONS” THAT INFLUENCE BUT ALSO AWARE OF “LOCAL CONDITIONS” THAT INFLUENCE

APPLICABILITY OF RESEARCH FINDINGS. APPLICABILITY OF RESEARCH FINDINGS.

CHARACTERISTICS OF THE LOCAL CHARACTERISTICS OF THE LOCAL CLINICAL SCIENTISTCLINICAL SCIENTIST

(STRICKER, 1995)(STRICKER, 1995)

1.1. OPEN TO MULIPLE APPROACHES.OPEN TO MULIPLE APPROACHES.

2.2. ABESENCE OF RIGIDITY & DOGMATISM.ABESENCE OF RIGIDITY & DOGMATISM.

3.3. VALUES EMPIRICAL SUPPORT—GENERAL & LOCAL.VALUES EMPIRICAL SUPPORT—GENERAL & LOCAL.

4.4. CLINICAL PROCESS BEGINS WITH THE PATIENT, CLINICAL PROCESS BEGINS WITH THE PATIENT, NOT THE RESEARCH.NOT THE RESEARCH.

5.5. SKEPTICAL ABOUT ONE’S OWN OBSERVATIONS AND SKEPTICAL ABOUT ONE’S OWN OBSERVATIONS AND HYPOTHESES.HYPOTHESES.

6.6. AWARE OF PERSONAL VALUES AND BIASES.AWARE OF PERSONAL VALUES AND BIASES.

7.7. NEED FOR COLLEGIAL INTERACTION & FEEDBACK.NEED FOR COLLEGIAL INTERACTION & FEEDBACK.

ETHICAL OBLIGATIONS?ETHICAL OBLIGATIONS?(STRICKER, 1995)(STRICKER, 1995)

IT IS NOT UNETHICAL TO PRACTICE WITHOUT IT IS NOT UNETHICAL TO PRACTICE WITHOUT COMPLETELY SUPPORTIVE SCIENTIFIC EVIDENCE.COMPLETELY SUPPORTIVE SCIENTIFIC EVIDENCE.

BUT IS IT UNETHICAL TO PRACTICE IN WAYS THAT BUT IS IT UNETHICAL TO PRACTICE IN WAYS THAT IGNORE OR CONTRADICT SCIENCE. IGNORE OR CONTRADICT SCIENCE.

““PREFERED THEORIES AND TECHNIQUES MUST GIVE PREFERED THEORIES AND TECHNIQUES MUST GIVE WAY OR BE REVISED IS DISCONFIRMATORY EVIDENCE WAY OR BE REVISED IS DISCONFIRMATORY EVIDENCE EXISTS.EXISTS.

BUT THEY REMAIN THE BASIS FOR ACTION IN THE BUT THEY REMAIN THE BASIS FOR ACTION IN THE ABSENCE OF SUCH EVIDENCE”ABSENCE OF SUCH EVIDENCE”

CORNERSTONE OF “EVIDENCE-BASED PRACTICE.”CORNERSTONE OF “EVIDENCE-BASED PRACTICE.”

IS THE BOULDER SCIENTIST-PRACTITIONER IS THE BOULDER SCIENTIST-PRACTITIONER MODEL WORKING?MODEL WORKING?

• RECENT SURVEY OF ALMOST 600 PSYCHOLOGISTS RECENT SURVEY OF ALMOST 600 PSYCHOLOGISTS IN PRIVATE PRACTICEIN PRIVATE PRACTICE

• MOST RELY MORE ON THEIR OWN CLINICAL MOST RELY MORE ON THEIR OWN CLINICAL EXPERIENCE AND THAT OF THEIR COLLEAGUES.EXPERIENCE AND THAT OF THEIR COLLEAGUES.

• NOT ON RESEARCHNOT ON RESEARCH

• ALARMING NUMBER UNAWARE OF EXPERICALLY-ALARMING NUMBER UNAWARE OF EXPERICALLY-SUPPPORTED INTERVENTIONS.SUPPPORTED INTERVENTIONS.

• MANY DO NOT EVEN SEE THE UTILITY OF MANY DO NOT EVEN SEE THE UTILITY OF CLINICAL RESEARCHCLINICAL RESEARCH

HOW WELL DOES BOULDER MODEL MEET HOW WELL DOES BOULDER MODEL MEET TODAY’S NEEDS?TODAY’S NEEDS?

DEVELOPED DURING 1945 & 1949DEVELOPED DURING 1945 & 1949

NOW COMPETITION FROM OTHER DISCIPLINESNOW COMPETITION FROM OTHER DISCIPLINES

SOCIAL WORKERS PROVIDED ABOUT 5% OF MENTAL SOCIAL WORKERS PROVIDED ABOUT 5% OF MENTAL HEALTH SERVICES IN THE US IN 1991.HEALTH SERVICES IN THE US IN 1991.

BY 1997, THEY WERE PROVIDING 56% (INCLUDING BY 1997, THEY WERE PROVIDING 56% (INCLUDING PSYCHOTHERAPY).PSYCHOTHERAPY).

PSYCHOLOGY TRAINING HAS BECOME INCREASINGLY PSYCHOLOGY TRAINING HAS BECOME INCREASINGLY SPECIALIZED.SPECIALIZED.

SCIENCE VERSUS PRACTICE: SCIENCE VERSUS PRACTICE: ACADEMY OF PSYCHOLOGICAL ACADEMY OF PSYCHOLOGICAL

CLINICAL SCIENCECLINICAL SCIENCE BY EARLY 1990s MANY BELIEVED CLINICAL PSYCHOLOGY BY EARLY 1990s MANY BELIEVED CLINICAL PSYCHOLOGY

PROGRAMS WERE NOT UPHOLDING THE SCIENTIST SIDE OF THE PROGRAMS WERE NOT UPHOLDING THE SCIENTIST SIDE OF THE MODEL.MODEL.

1994—FORMATION OF THE ACADEMY OF PSYCHOLOGICAL 1994—FORMATION OF THE ACADEMY OF PSYCHOLOGICAL CLINICAL SCIENCE.CLINICAL SCIENCE.

PROGRAMS “STRONGLY COMMITTTED TO RESEARCH TRAINING PROGRAMS “STRONGLY COMMITTTED TO RESEARCH TRAINING AND THE INTEGRATION OF SUCH TRAINING WITH CLINICAL AND THE INTEGRATION OF SUCH TRAINING WITH CLINICAL TRAINING.”TRAINING.”

NOW ALMOST 60 MEMBERS.NOW ALMOST 60 MEMBERS.

INCREASINGLY INVOLVED IN APA ACCREDITION.INCREASINGLY INVOLVED IN APA ACCREDITION.

ALSO DEVELOPING THEIR OWN ACCREDITATION STANDARDS.ALSO DEVELOPING THEIR OWN ACCREDITATION STANDARDS.

WHAT IS “CLINICAL SCIENCE”WHAT IS “CLINICAL SCIENCE”ACADEMY OF PSYCHOLOGICAL CLINICAL SCIENCE (1995)ACADEMY OF PSYCHOLOGICAL CLINICAL SCIENCE (1995)

• ““CLINICAL SCIENCE” IS DEFINED AS A CLINICAL SCIENCE” IS DEFINED AS A PSYCHOLOGICAL SCIENCE DIRECTED AT THE PSYCHOLOGICAL SCIENCE DIRECTED AT THE PROMOTION OF ADAPTIVE FUNCTIONING.PROMOTION OF ADAPTIVE FUNCTIONING.

• AT THE ASSESSMENT, UNDERSTANDING, AT THE ASSESSMENT, UNDERSTANDING, AMELIORATION, AND PREVENTION OF HUMAN PROBLEMS AMELIORATION, AND PREVENTION OF HUMAN PROBLEMS IN BEHAVIOR, AFFECT, COGNITION, OR HEALTH.IN BEHAVIOR, AFFECT, COGNITION, OR HEALTH.

• AND THE APPLICATION OF KNOWLEDGE IN WAYS AND THE APPLICATION OF KNOWLEDGE IN WAYS CONSISENT WITH SCIENTIFIC EVIDENCE.CONSISENT WITH SCIENTIFIC EVIDENCE.

• [AND A] COMMITMENT TO EMPIRICAL APPROACHES TO [AND A] COMMITMENT TO EMPIRICAL APPROACHES TO EVALUATING THE VALIDITY AND UTILITY OF EVALUATING THE VALIDITY AND UTILITY OF TESTABLE HYPOTHESES AND TO ADVANCING KNOWLEDGE TESTABLE HYPOTHESES AND TO ADVANCING KNOWLEDGE BY THE METHODBY THE METHOD

5 TRAINING GOALS5 TRAINING GOALS

1.1. TRAIN STUDENTS FOR CAREERS IN CLINICAL SCIENCE TRAIN STUDENTS FOR CAREERS IN CLINICAL SCIENCE RESEARCH.RESEARCH.

2.2. ADVANCE FULL RANGE OF CLINICAL SCIENCE THEORY AND ADVANCE FULL RANGE OF CLINICAL SCIENCE THEORY AND RESEARCH.RESEARCH.

3.3. FOSTER DEVELOPMENT OF AND ACCESS TO RESOURCES AND FOSTER DEVELOPMENT OF AND ACCESS TO RESOURCES AND OPPORTUNITIES FOR TRAINING, RESEARCH, FUNDING, AND OPPORTUNITIES FOR TRAINING, RESEARCH, FUNDING, AND CAREERS IN CLINICAL SCIENCE.CAREERS IN CLINICAL SCIENCE.

4.4. FOSTER THE APPLICATION OF CLINICAL SCIENCE TO HUMAN FOSTER THE APPLICATION OF CLINICAL SCIENCE TO HUMAN PROBLEMS IN RESPONSIBLE AND INNOVATIVE WAYS.PROBLEMS IN RESPONSIBLE AND INNOVATIVE WAYS.

5.5. FOSTER DISSEMINATION OF CLINICAL SCIENCE TO POLICY-FOSTER DISSEMINATION OF CLINICAL SCIENCE TO POLICY-MAKING GROUPS, PSYCHOLOGISTS AND OTHER SCIENTISTS, MAKING GROUPS, PSYCHOLOGISTS AND OTHER SCIENTISTS, PRACTITIONERS, AND CONSUMERS.PRACTITIONERS, AND CONSUMERS.

COMPARISONS OF THE 3 MODELSCOMPARISONS OF THE 3 MODELS

CLINICAL SCIENCE PHD FACULTY MOST ENGAGED IN CLINICAL SCIENCE PHD FACULTY MOST ENGAGED IN RESEARCH—PSYD FACULTY THE LEAST.RESEARCH—PSYD FACULTY THE LEAST.

CLINICAL SCIENCE FACULTY PUBLISH & PRESENT THE CLINICAL SCIENCE FACULTY PUBLISH & PRESENT THE MOST—PSYD FACULTY THE LEAST. MOST—PSYD FACULTY THE LEAST.

SAME PATTERN FOR STUDENTSSAME PATTERN FOR STUDENTS

IMPACT OF MANAGED CAREIMPACT OF MANAGED CARE

SHIFT FROM FEE-FOR-SERVICE MODEL TO THIRD-PARTY-PAYER SHIFT FROM FEE-FOR-SERVICE MODEL TO THIRD-PARTY-PAYER MODEL.MODEL.

ACCOUNTABILITY AND EVIDENCE-BASED DECISIONS.ACCOUNTABILITY AND EVIDENCE-BASED DECISIONS.

QUALITY CONTROL &COST-EFFECTIVENESS—GETTING THE MOST QUALITY CONTROL &COST-EFFECTIVENESS—GETTING THE MOST FOR YOUR MONEY.FOR YOUR MONEY.

EVEN GREATER SHRINKING OF PSYCHOLOGY’S SHARE OF MENTAL EVEN GREATER SHRINKING OF PSYCHOLOGY’S SHARE OF MENTAL HEALTH CARE.HEALTH CARE.

SOCIAL WORKERS NOW THE MAJOR PROVIDERS OF TRADITIONAL SOCIAL WORKERS NOW THE MAJOR PROVIDERS OF TRADITIONAL MENTAL HEALTH SERVICES.MENTAL HEALTH SERVICES.

DIMINISHING DEMAND FOR PSYCHOLOGISTS AS PROVIDERS OF DIMINISHING DEMAND FOR PSYCHOLOGISTS AS PROVIDERS OF DIRECT SERVICES—THAT IS, PSYCHOTHERAPY.DIRECT SERVICES—THAT IS, PSYCHOTHERAPY.

NEW ROLES FOR PSYCHOLOGISTS:NEW ROLES FOR PSYCHOLOGISTS:(IN ADDITION TO PROVIDING DIRECT SERVICES)(IN ADDITION TO PROVIDING DIRECT SERVICES)

DEVELOPING NEW ASSESSMENTS & INTERVENTIONS.DEVELOPING NEW ASSESSMENTS & INTERVENTIONS.

RESEARCH ON ASSESSMENTS &INTERVENTION RESEARCH ON ASSESSMENTS &INTERVENTION EFFECTIVENESS.EFFECTIVENESS.

PROGRAM DEVELOPMENT & EVALUATION.PROGRAM DEVELOPMENT & EVALUATION.

INDIRECT SERVICES (SUPERVISION, CONSULTATION, INDIRECT SERVICES (SUPERVISION, CONSULTATION, TEACHING).TEACHING).

ADMINISTRATION & MANAGMENTADMINISTRATION & MANAGMENT

MENTAL HEALTH POLICY (COMMUNITY PSYCHOLOGY)MENTAL HEALTH POLICY (COMMUNITY PSYCHOLOGY)

THE PROBLEM . . . THE PROBLEM . . .

“ “THE FAILURE TO TRANSLATE SCIENCE INTO THE FAILURE TO TRANSLATE SCIENCE INTO PRACTICE HAS MARGINALIZED CLINICAL PRACTICE HAS MARGINALIZED CLINICAL PSYCHOLOGY WITHIN THE EMERGING HEALTH PSYCHOLOGY WITHIN THE EMERGING HEALTH CARE SYSTEM AND LIMITED THE PUBLIC’S ACCESS CARE SYSTEM AND LIMITED THE PUBLIC’S ACCESS TO BENEFICIAL INTERVENTIONS.”TO BENEFICIAL INTERVENTIONS.”

BAKER, MCFALL, & SHOHAM (2009) BAKER, MCFALL, & SHOHAM (2009)

THE SOLUTIONS?THE SOLUTIONS?

APA TASK FORCE ON FUTURE OF APA TASK FORCE ON FUTURE OF PSYCHOLOGY PRACTICE (2009)PSYCHOLOGY PRACTICE (2009)

1.1. EXPANDING FOCUS OF TRADITIONAL PSYCHOLOGY PRACTICE EXPANDING FOCUS OF TRADITIONAL PSYCHOLOGY PRACTICE (INCLUDE RESEARCH AND EVALUATION SKILLS).(INCLUDE RESEARCH AND EVALUATION SKILLS).

2.2. INTEGRATING MENTAL HEALTH CARE AND HEALTH CARE.INTEGRATING MENTAL HEALTH CARE AND HEALTH CARE.

3.3. INTEGRATING TECHNOLOGY INTO PRACTICE.INTEGRATING TECHNOLOGY INTO PRACTICE.

4.4. ACCOUNTABILITY—SHOW THAT WHAT WE DO WORKS.ACCOUNTABILITY—SHOW THAT WHAT WE DO WORKS.

5.5. EVIDENCE-BASED PRACTICEEVIDENCE-BASED PRACTICE

6.6. MEETING NEEDS OF DIVERSE SOCIETYMEETING NEEDS OF DIVERSE SOCIETY

7.7. MOBILITY ISSUES (LICENSING LAWS)MOBILITY ISSUES (LICENSING LAWS)

8.8. PUBLIC EDUCATION AND “BRANDING”PUBLIC EDUCATION AND “BRANDING”

9.9. CHANGE TRAINING PROGRAMS TO MEET CHANGING WORLD.CHANGE TRAINING PROGRAMS TO MEET CHANGING WORLD.

THE FUTURE OF CLINICAL THE FUTURE OF CLINICAL PSYCHOLOGY?PSYCHOLOGY?

““THE CLINICAL PSYCHOLOGISTS TRAINED AS THE CLINICAL PSYCHOLOGISTS TRAINED AS SCIENTIST-PRACTITIONERS SHOULD HAVE NO SCIENTIST-PRACTITIONERS SHOULD HAVE NO DIFFICULTY FINDING INTERESTING WORK IN THE DIFFICULTY FINDING INTERESTING WORK IN THE FUTURE. THEY ARE TRAINED TO SOLVE BEHAVIORAL FUTURE. THEY ARE TRAINED TO SOLVE BEHAVIORAL PROBLEMS, AND THE WORLD PROMISES TO PROVIDE PROBLEMS, AND THE WORLD PROMISES TO PROVIDE NO SHORTAGE OF THOSE” NO SHORTAGE OF THOSE”

LUDY BENJAMIN, 2005LUDY BENJAMIN, 2005