The Professional Training of Clinical Psychologists

The Professional Training of Clinical PsychologistsMelody N. Mickens, B.A.3rd year Clinical Psychology Doctoral StudentVirginia Commonwealth University

+1Learning ObjectivesDescribe what clinical psychology is and how clinical psychologists are trainedDiscuss some of the career paths available to clinical psychologistsExplain key challenges for the field of clinical psychology

+What is Clinical Psychology?

The integration of science, theory and practice to understand, predict and alleviate maladjustment, disability and discomfort as well as to promote human adaptation, adjustment and personal development.-American Psychological Association, Society of Clinical Psychology (Division 12)

+ 3Clinical Psychology

+4Scientist-Practitioner Model of Training Scientist Practitioner

+5Ph.D versus Psy.D. : Whats the difference?Ph.D programsFollow a scientist-practitioner model of training Heavy emphasis on research and preparation for a career in clinical and academic settingsSmaller class sizes (4-15 students) and funding for studentsmasters thesis and dissertation research with data collectionPsy.D programsFollow a practitioner-scholar model of trainingHeavier emphasis on clinical work and research related to clinical practiceLarger class sizes (100+), high tuition costs, no financial support, lower internship match rates that result in students completing internships at non-accredited sitesRarely involves masters thesis and dissertation can be a theory paper in many programs

+6Counseling Psychology PhDLeads to same license as clinical psychology PhDSmaller number of programs, with slightly different emphasis (similar to D.O. vs. M.D. training)VCU Psychology Department has both programs (very unusual) with large overlap in courses and training. Both work on MCV campus and in primary care.

+Applying the Scientist-Practitioner Model

+The Training of Clinical PsychologistsUndergraduate educationGraduate education5-6 years to earn Ph.D.Internship required to earn Ph.D (shortage of accredited internships has created stress for students and training programs)Post-doctoral fellowship (Optional in some cases)Licensure and board certificationContinuing education to maintain license and certifications

Training Overview

+Two Tracks in Clinical Program at VCU Generalist training focused on psychopathology, assessment, treatment and research with adultsSpecialist training for research and clinical work in health settings* Also know as Health Psychology. VCU Counseling PhD has same track.

Training focused on understanding human development, family and social aspects of human development, research, assessment and the treatment of children and adolescents with psychopathology.Behavioral Medicine*Child and Adolescent

+10Year OneComplete courseworkIntellectual & personality assessment, psychopathology, biological basis of behavior, statistics, behavior therapy and clinical interviewing skills Work ~ 20 hours at an assistantshipTeaching a course or the lab/discussion section of an undergraduate or graduate courseRecruiting participants for a faculty members research, running intervention groups or collecting data from participants or analyzing dataIndependent researchCollaborating with a faculty advisor or mentorReading and discussing literature for thesisAnalyzing data for an abstract or poster for a conference

+Year TwoComplete courseworkResearch methodology, psychometrics, health psychology, learning and cognition and neuropsychologyWork ~ 20 hours at an assistantshipBegin clinical practicum at CPSDIndependent ResearchThesis proposal and data collection

+Clinical practicum at the Center for Psychological Services and Development (CPSD)2nd year students begin working as staff therapists at the CPSD in the fall semester CPSD is a clinic operated by VCUs Psychology department Services are provided on a sliding fee scale based on patients income and insuranceServices includeIndividual therapy for children and adultsCouples therapy Assessment (court ordered evaluations, ADHD/LD, therapeutic & neuropsychological)Family therapyGroup therapyCareer counseling

+Each therapist is assigned a supervisor and meets with the supervisor weekly to discuss current casesSupervisor trains students in his or her therapy orientation and associated techniques:Behavior therapyCognitive behavioral therapyInterpersonal therapyPsychoanalytic therapySupervisor trains students in case conceptualization and treatment planningEach student must maintain at least two therapy cases during the semester

13Additional Department Clinics Anxiety Clinic (CPSD)Cognitive Behavioral Therapy (CBT) focus for individuals with anxiety disordersTraining in exposure therapyPeer supervision modelPrimary Care Psychology ClinicStudents treat patients at MCVs ACC Resident Clinic for a variety of psychological and health related disordersWeight loss, depression, smoking cessation, diabetes management, anxiety and adjustment to chronic illnessStudents collaborate with residents, a medical social worker and pharmacist students to integrate patient care

Assessment Clinic (CPSD)Students administer, score and report findings from psychological assessmentsStudents gain experience in case conceptualization and assessment administration, scoring and report writingChild and Adolescent Primary Care ClinicSimilar to PCPC, but with children, adolescents and families at Childrens PavillionTo begin in January, 2011Funded by same HRSA grant as PCPC

+Year ThreeComplete elective courseworkWork ~ 20 hours at an assistantship (one option is Primary Care via grant funding)Complete clinical practicum at CPSD and apply for off-campus practicumIndependent researchThesis defenseobtain Masters degreeDissertation proposalComplete comprehensive examinations (50 page paper worthy of journal submission)

+Year FourBegin off-campus practicumContinue with clinical work at Anxiety clinic or Primary Care ClinicsIndependent researchInternship applications and interviewsWork ~ 20 hours at assistantship

+Off-campus Practicum Training3rd year students apply to work at several training sites within the Metro Richmond area or DC area

Training sitesHunter Holmes McGuire VAMCVirginia Treatment Center for ChildrenCentral State Psychiatric Hospital, Petersburg, VAUVA Center for Addiction Research and Education VCU Department of Psychiatry: burn unit, transplant and gastric bypass evaluations and treatment

+17Year Five or SixComplete internshipDefend dissertationGraduateOROff-campus practicumDissertation data collectionInternship applications and interviews

+18Internship Application process includes a written application, an invitation to interview, interviews and then match process similar to medical residencyInternships typically begin in July or August and include extensive training for one yearInternship allows students the opportunity to work autonomously in a new setting and to experience some of the challenges that licensed clinicians faceInterns continue to receive supervision and training through clinical rotations, where they often have the opportunity to practice in sub-specialties such as neuropsychology, forensic psychology, integrated primary care psychology, rehabilitation psychology, sports psychology, program evaluation and development.

+Internship sites Agency Types:VA hospitalsCommunity mental health centersMedical schoolsPrisons and correctional facilitiesPrivate and state owned hospitals (general or psychiatric)University counseling centers Outpatient clinics

+Post-graduate training Post-doctoral fellowship2 year training opportunityTraining in a sub-specialty area such as neuropsychology, addiction psychology, primary care psychology and health disparities researchMixture of research and clinical focus with some programs emphasizing one area over the otherProvides clinical hours needed to achieve board credentials in sub-specialty areasLicensure and credentialingLicensure by state board Credentialing by specialty boards and professional organizationsAmerican Board of Professional PsychologyContinuing education requirements

+What do clinical psychologists do?Assess intellectual development, psychopathology, adjustment and personal growth Treat psychological disorders and individuals experiencing symptoms of psychological distress in a variety of settingsTeach at university psychology and psychiatry departmentsConduct research in the communityConsult with government agencies, private institutions, businesses and organizationsLead and participate in professional organizationsPublish and edit journals and books

+Career paths of VCU grads65% work at academic medical centers or VA hospitals with adult or pediatric populations and are frequently involved in both clinical service and research20% work in private practice5-10% work at universities or colleges as tenure track professors5-10% work as administrators for various health care organizations

+Differentiating clinical psychologists from other mental health providers (MSW, MA level counselors, Psychiatrists)

Major differencesDifferent training models, professional degrees and areas of competencyDifferent ethical standardsAmerican Psychological AssociationPsychologists complete training in intellectual, cognitive and personality assessmentsResearch skills and clinical competencies provide leadership expertise

+Five challenges for the profession of clinical psychology:Are for-profit programs creating too many psychologists and how will this affect the field over time? Note: most limitations placed on the free market of training would be considered illegal Shortage of accredited internships, required by many programs and licensure boards Differentiating competencies and justifying higher reimbursement rates for doctoral trained psychologists relative to masters level mental health providersMoving toward an outcomes oriented reimbursement model that still embraces diverse orientations to practice Clinical psychologists continuing to find new niches that capitalize on unique expertise in measurement and research skills

+25SummaryComplete rigorous training to achieve a Ph.D. or Psy.D., licensure and credentialsUse their knowledge of science and research to understand and treat a variety of disorders or promote adjustmentPractice in a variety of settingsFulfill many roles as researchers, educators, consultants and clinicians Clinical psychologists:

+ReferencesSlide 3:Society of Clinical Psychology. (2010) What is Clinical Psychology? Available from http://www.div12.orgabout-clinical-psychologyComic courtesy of http://www.zjobs.com.au/imagespsychologist.jpgSlide 4:Graphic courtesy of http://www.uaa.alaska.edu/dssinformation/images/NM0504-PSYCHOLOGY.jpgSlide 5: Scientist comic courtesy of http://www.age-of-the-sage.orgpsychology/pavlov.htmlPractitioner comic courtesy of cartoonstock.comSlide 7:Graph courtesy of http://ed-web3.educ.msu.edu/CEPSE/cpimages/table.gifSlide 8:Comic courtesy of phdcomics.comSlide 9:Rat in Skinner box courtesy of http://www.superstock.com/stock-photos-images1566-0123734Photo courtesy of http://www.wm.edu/research/ideation/issues/2010-spring/facing-race-008.phpSlide 14: Photo courtesy of CPSD staffSlide 19:Photo courtesy of http://www.richmond.va.gov/Photo courtesy of http://yourunitedway.org/images/jewish_family_services.bmpPhoto courtesy of http://www.virginiakids.net/pics/logo.jpgPhoto courtesy of http://www.medicine.virginia.edu/clinical/departments/psychiatry/sections/neurobiologicalstudies/uvacare/home-pageSlide 20: Photo courtesy of http://2.bp.blogspot.com/_bWyMZGz_G0c/TNi5zjznt8I/AAAAAAAAA3c/oK95SU73EfQ/s1600/The+Light+At+the+End+of+the+Tunnel.jpgSlide 24:Photo courtesy of http://www.paranormalknowledge.com/articles/5-articles-on-psychology.html

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