Occupy the imbalance!

I hadn’t known about the release of the qualitative APPIC data at http://www.appic.org/Match/MatchStat...Imbalance.aspx (posted by futureapppsy2). Reading the comments made me furious.

I think a great many students are suffering in silence, believing in the need for change to the system in the direction of better controlling numbers of applicants but feeling like they don’t have much influence over policy.

So, it’s time for that to change. Graduate students represent a third of all APA members (http://www.apa.org/apags/about/index.aspx). This is one of the largest constituents of APA. But, individual students rarely act to leverage this membership power. This is unfortunate, because there are a lot of things students can do.

And here they are. First, we have to recognize that there’s a lot of misinformation and myths about what can be done about the imbalance that need to be dispelled. Linking accreditation and match rates is not violation of antirust laws (Stedman et al., 2009; two authors on this paper are actual lawyers and not just psycholoigsts talking about law). This is a misperception based on early proposals that were clearly violation of antitrust law (e.g., saying programs can only take 10 students a year). Match rates are a legitimate marker of program performance/outcomes for students and it is perfectly reasonable to link match rates and accreditation; anyone who says different is not informed about the legal issues surrounding this.

You can become move involved in APAGS. APAGS is our representation to APA. It’s made up of students. Most positions are elected, and people running for the position post their positions on issues online (and often do things like create a facebook campaign page). So, look at the applicants. See what their positions are. Ask them about their opinions on the imbalance through their facebook campaign pages. Vote for people who are going to make sure the internship crisis is a predominant topic in everything APAGS does. Run for APAGS positions yourself. Email APAGS governance members.

Talk to your APAGS campus rep. You should have one. Their job is to report to the Advocacy Coordinating Team of APAGS. Let them know that you want the internship imbalance clearly addressed by APAGS. If you don’t have a campus rep, become one.

Let APA know what you think about the imbalance. Multiple aspects of APA are involved in the imbalance. I’d suggest you look at the list of Councils of Chairs of Training Councils, who represent the interests of training councils (e.g., clinical psychology programs, counseling psych programs, professional schools, school psych). The list of members is here http://psychtrainingcouncils.org/members.html. Find who represents you and let them know that the imbalance is a serious problem that needs to be addressed immediately, and APA needs to make decisive actions and generate solutions.

The Board of Educational Affairs is another major player. http://www.apa.org/ed/governance/bea/index.aspx. Let them know what you think about the imbalance. Attend seminars and talks by the members, at APA and elsewhere, and encourage discussions about the internship crisis.

Go to the APA convention. Attend sessions about the internship and the imbalance and ask hard questions of members of APA governance. No one likes to ask these questions, but these difficult dialogues need to happen. Make governance know that this is a problem and we’re not going to let it continue to get worse.

Start discussions on professional listserves. Ask others what they think about the imbalance. Encourage difficult dialogues. Encourage divisions to weigh in about the imbalance. Become a student rep for divisions.

Students are the ones who suffer in this problem. Many others care, but their real investment is limited. We’re the ones who have risk and potential loss. We’re the ones who should be acting to make sure concrete actions to resolve the imbalance are taken. Posting on a message board is good for catharsis, but we all know that catharsis is a poor substitute for behavioral activation. ☺

Oh, and join my facebook group ☺ http://www.facebook.com/groups/223654767715768/

References
Stedman, J. M., Schoenfeld, L. S., Carroll, K., Allen, T. F. A. Jr. (2009). The internship supply–demand crisis: Time for a solution is now. Training and Education in Professional Psychology, 3(3), 135-139. doi: 10.1037/a0016048

Aye.

Can I wear my V for Vendetta mask?

Originally Posted by Rivi

Can I wear my V for Vendetta mask?

No. But you CAN kick it into gear and become an advocate for yourself, your colleagues, and the future of your profession.

Don't just read it, don't just talk about it. DO it.

Seeing there will be a lot of disgruntled, unmatched students in month or so, it would be a great idea to start a petition to send to APA. We could send it to the APPIC listserv, etc

Originally Posted by edieb

Seeing there will be a lot of disgruntled, unmatched students in month or so, it would be a great idea to start a petition to send to APA. We could send it to the APPIC listserv, etc

Brilliant! What should it say?

What are other ways to act to move toward solving the crisis?

Btw, though others may not realize it, the other petition had a very large effect. People at APA knew about it and it increased pressure to act.

What percentage of people never match? I know it sounds like a crisis, but the process works in a weird way. I mean, there isn't a crisis of psychologists is there? (Playing the devil's advocate).

Originally Posted by Rivi

Can I wear my V for Vendetta mask?

No. We will be using a santa clause mask like the one that freaked out Little Albert.


This is a good idea btw. I support. I am willing to do something. If we act now, maybe this will not be as big a problem in 5 years or so when I am trying to match.

Originally Posted by yeti2213

This is a good idea btw. I support. I am willing to do something. If we act now, maybe this will not be as big a problem in 5 years or so when I am trying to match.

Brilliant! We need people to be informed early and start acting! 5 years? In 5 years you can be in APAGS governance, acting with your state/provincial/territorial boards, acting within divisions as a student rep, etc. You can advocate for students and the profession while building networking and filling your CV with the leadership opportunities that are sorely missing among psych trainees.

I say we not re-invent the wheel and just use last year's petition. THis time, it would be great if there 1) could be a sticky on SDN, 2) the moderator of this forum had the petition password and 3) people would post it across listservs

Dear APA,

The internship match system is proving to be an increasingly arduous hurdle for many aspiring young psychologists. This year, 79% of students matched for internship through the APPIC system in both rounds 1 and 2, and, of those, an even smaller percentage matched to APA internships (http://www.appic.org/match/5_2_2_1_1..._2011Comb.html). Further, a substantial number in states such as California forgo APA/APPIC entirely, electing for unregulated internship experiences. It appears that the influence of APA is being marginalized. Rather than a set of minimum standards, APA compliance is becoming increasingly elite. If this trend continues, its influence on the direction of psychology will be further degraded.

There are now far more psychology graduate students applying for internship every year than there are positions. The imbalance and erosion of standards appear to be the product of rapid expansion of graduate schools in professional psychology (Parent & Williamson, 2010). The inflation in number of students over the past decade has not been matched by either the number of available APA accredited internship slots or the demand for clinical psychologists in the workforce. While it is clear that a few programs are responsible for much of these problems, we do not believe the "weeding out" process should be conducted on the back-end, after huge amounts of time and money have been invested, but on the front-end. Students entering into professional schools of psychology are at a particularly vulnerable period in their lives, most not yet having the economic savvy to understand the ramifications of debt, nor education in the realities of the field with respect to what it takes to be competitive, to secure quality internship and postdoctoral training, and to attain a professional level job (not one that is occupied just as easily by social workers or other masters level providers).

To address these problems, we suggest that the APA regulate the most grievous offenders that put our young professional population in greatest jeopardy, burdened with 6-figure debt, poor internship prospects, and exponentially expanding competition both from within, due to unjustified expansion by psychology graduate programs and without, due to trends to lesser training standards in healthcare. The current situation creates an environment ripe for a cascade effect that could be ruinous to both the livelihood and happiness of many of our workforce and the quality of the product that we offer as psychologists. This recommendation is consistent with recommendations by researchers on the topic of the internship imbalance (Parent & Williamson, 2010; Stedman, Schoenfeld, Carroll, & Allen, 2009). As it stands, this situation is akin to other predatory loan schemes and should fall within, at least, morally, the concept of usury laws.

We request that the APA sanction programs that use the student loan system as a method of existence, charging at the limits of what's borrowable. These programs are not good citizens in the psychology professional community. Further, we strongly suggest that APA remove accreditation from these programs, and advocate that state licensing boards deny licensure to new students after a target date (one that does not affect current students). This would serve many important goals for our field. 1) It would end the internship imbalance. 2) It would limit the amount of debt our professionals are saddled with upon graduation 3) It would improve the quality of internship opportunities by alleviating the burden of review that all sites face as they are bombarded with 100s of applications; limiting this would allow sites to conduct a more thorough evaluation of candidates 4) It would improve the quality of internship programs that students select (e.g., again, many programs in California encourage students to attend non-APA accredited sites, many unfunded; many students now match to non-APA accredited sites) 5) It would protect the public from overly-stressed and poorly educated professionals.


Sincerely,


People against the unethical treatment of students of psychology.


References

Parent, M. C. & Williamson, J. B. (2010). Program disparities in unmatched internship applicants. Training & Education in Professional Psychology, 4,116-120.

Stedman, J. M., Schoenfeld, L. S., Carroll, K., & Allen, T. F. (2009). The internship supply-demand crisis: Time for a solution is now. Training & Education in Professional Psychology, 3,135-139. lessDear APA,

The internship match system is proving to be an increasingly arduous hurdle for many aspiring young psychologists. This year, 79% of students matched for internship through the APPIC system in both rounds 1 and 2, and, of those, an even smaller percentage matched to APA internships (http://www.appic.org/match/5_2_2_1_1..._2011Comb.html). Further, a substantial number in states such as California forgo APA/APPIC entirely, electing for unregulated internship experiences. It appears that the influence of APA is being marginalized. Rather than a set of minimum standards, APA compliance is becoming increasingly elite. If this trend continues, its influence on the direction of psychology will be further degraded.

There are now far more psychology graduate students applying for internship every year than there are positions. The imbalance and erosion of standards appear to be the product of rapid expansion of graduate schools in professional psychology (Parent & Williamson, 20... more

Good idea edieb. I think it can be revised in light of the criticisms of it last year though, and come out stronger, more focused, and clearer. The first round was excellent but we can always move forward. I think more clear recommendations and suggestions can be added. What are peoples' thoughts about editing it?

Edit: Oh, "what JS said." :-)

I really wish I could count every signature as a citation. Oh, well.

Originally Posted by Jon Snow

Are there additional themes people would like to highlight? Perhaps, an acknowledgment of previous calls (the last petition, the referenced presidential addressed, more articles, maybe quantifying some of the themes of quotes in the appic survey) would be useful?

I agree with all of this.

The last thought was a tactical one. Once the letter is out and signed. A concerted effort to get some media attention would be good. Blogs, trade publications etc that people in the field pay attention to.

Have to be careful with that. If the petition gets less signatures this year, that would not aid the cause. I think several of these issues interrelate. One of the mistakes in this petition was highlighting the usury aspect as primary in the conclusion paragraph. You can see that there are many comments in the appic survey about over supply from professional schools. And I think the debt issue plays into that issue heavily. The motive for that oversupply appears to be money. And I think one of the ethical problems that apa faces is the influence of these programs on debt in our now modal graduates and it's at the expense of the field, hitting quality, diminishing apas influence and ability to dictate training standards, creating the internship imbalance, etc - all for profit/expanded existence (don't want to get into the nonprofit profit tax thing)

I should also add that those student that are directly dealing with debt and coming from a program with a low APA match rate should be MOST interested in reform and signing such a petition. I know many of the signatures on the petition from last year were, in fact, from those schools. The petition had broad support. I know many of the names on the list, some are training directors at clinical science programs, there are private practitioners, phd, psyd, older and younger professionals.

Here's my first whack at an expansion of last year's petition. Feel free to edit. Should probably add some stuff from the qualitative comments from the other thread in the match survey and maybe someone could look up linas bieliauskas presidential address from a few years back.


Dear APA,

The internship match system continues to be an increasingly arduous hurdle for many aspiring young psychologists. During the 2011 match cycle >20 percent of those that completed the match process did not match for an internship of any type (including both phase 1 and 2 of the match process). Further, of those that matched, only 56% matched to APA/CPA accredited sites. Last year, a petition was submitted with more than 500 signatures, requesting that APA address several of the contributing factors to this problem. This is not just a student issue. The problem is a symptom of a more systematic deterioration of doctoral level psychology. Rather than a set of minimum standards, APA compliance is becoming increasingly elite. If this trend continues, its influence on the direction of psychology will be marginalized.

There are now far more psychology graduate students applying for internship every year than there are positions. The imbalance and erosion of standards appear to be the product of rapid expansion of graduate schools in professional psychology (Parent & Williamson, 2010). The inflation in number of students over the past decade has not been matched by either the number of available APA accredited internship slots or the demand for clinical psychologists in the workforce. Students from professional schools now comprise >50% of new clinical psychology graduates, though professional schools represent a minority of doctoral level psychology programs. While it is clear that a few programs are responsible for much of these problems, we do not believe the "weeding out" process should be conducted on the back-end, after huge amounts of time and money have been invested, but on the front-end. Students entering into professional schools of psychology are at a particularly vulnerable period in their lives, most not yet having the economic savvy to understand the ramifications of debt, nor education in the realities of the field with respect to what it takes to be competitive, to secure quality internship and postdoctoral training, and to attain a professional level job (not one that is occupied just as easily by social workers or other masters level providers).

There are clear ethical issues with allowing these programs to continue to market doctoral psychology to whoever they can convince to attend, while saddling consumers of this educational model with six figure debt, poor internship prospects, and, following, poor post-doc and job prospects (students that complete a non-APA accredited internship are at a serious disadvantage in an increasingly challenging marketplace). In addition to the burden placed on our future colleagues, this is a public health threat.

1. By circumventing APA standards, we (psychology as a field) are losing control over what it means to be a psychologist. We cannot ensure quality/minimum competency. This is a risk.

2. Debt creates stress. This impacts the mindset/situation of our professionals. As more of our professionals are saddled with debt, this creates a potential public health risk.

The current situation creates an environment ripe for a cascade effect that could be ruinous to both the livelihood and happiness of many of our workforce and the quality of the product that we offer as psychologists. As it stands, this situation is akin to other predatory loan schemes and should fall within, at least, morally, the concept of usury laws.

We request that the APA sanction programs that do not match students to APA internships sites at an acceptable rate. These programs are not good citizens in the psychology professional community. We strongly suggest that APA remove accreditation from these programs, and advocate that state licensing boards deny licensure to new students after a target date (one that does not affect current students). Further, we suggest that APA amend the Accreditation Guidelines and Principles so that all school must publicly disclose the 25th percentile, median, and 75th percentiles of educational debt upon graduation for their students. These suggestions would serve many important goals for our field. 1) It would end the internship imbalance. 2) It would limit the amount of debt our professionals are saddled with upon graduation 3) It would improve the quality of internship opportunities by alleviating the burden of review that all sites face as they are bombarded with 100s of applications; limiting this would allow sites to conduct a more thorough evaluation of candidates 4) It would improve the quality of internship programs that students select (e.g., many programs in California encourage students to attend non-APA accredited sites, many unfunded; many students now match to non-APA accredited sites) 5) It would protect the public from overly-stressed and poorly educated professionals.


Sincerely,


People against the unethical treatment of students of psychology.


References

Parent, M. C. & Williamson, J. B. (2010). Program disparities in unmatched internship applicants. Training & Education in Professional Psychology, 4,116-120.

Stedman, J. M., Schoenfeld, L. S., Carroll, K., & Allen, T. F. (2009). The internship supply-demand crisis: Time for a solution is now. Training & Education in Professional Psychology, 3,135-139.

Has anyone sent it to Div 19? I've shared it on FB and twitter, got a couple more signatures.

Bump - keep it circulating!

Originally Posted by Jon Snow

could work toward getting practice oriented degrees into more upper tier universities.

Counseling Ph.D.'s?

Originally Posted by MCParent

I think a great many students are suffering in silence, believing in the need for change to the system in the direction of better controlling numbers of applicants but feeling like they don’t have much influence over policy.

You are not hitting on the reality of the situation. Universities want to make money and capitalize on a depressed economy. There is a push from the majority of universities to accept more students in order to increase graduate enrollment numbers due to the spiraling economy/more and more people going back to get advanced degrees. More numbers equal less opportunity to be matched.

Blame the business models of universities, and specifically the graduate schools, if you are going to blame anyone. It's called capitalism.

Originally Posted by minorityreport

Blame the business models of universities.

Um, we are. Did you even read the petition? Who did you think we were faulting?

Originally Posted by erg923

Um, we are. Did you even read the petition? Who did you think we were faulting?

Exactly! There is nothing you are going to be able to do about it. Money talks and people are going to continue being naive enough to think an advanced degree automatically equals a job.

Why do you think tuition keeps getting raised every year across the country while universities benefit from record numbers every year?

Originally Posted by minorityreport

Exactly! There is nothing you are going to be able to do about it. Money talks and people are going to continue being naive enough to think an advanced degree automatically equals a job.

Why do you think tuition keeps getting raised every year across the country while universities benefit from record numbers every year?

You might wanna reread the petition cause it doesnt really sound like you read it.

Again, the end goal is to, ultimately, have the APA revoke accreditation from these places for that very reason. For profit schools will continue to do what they do, but so long as we dont give them the ok to do it (accreditation), then they cant put the numbers they do now into the match every year.

Originally Posted by erg923

You might wanna reread the petition cause it doesnt really sound like you read it.

Again, the end goal is to, ultimately, have the APA revoke accreditation from these places for that very reason. For profit schools will continue to do what they do, but so long as we dont give them the ok to do it (accreditation), then they cant put the numbers they do now into the match every year.

Exactly. Throwing our hands up and saying there's nothing we can do about it because it's capitalism at work is both inaccurate (many other healthcare-related disciplines have controlled it, at least better than us) and counterproductive. We owe it to ourselves and the field as a whole to enact a minimal training standard while simultaneously ensuring that we aren't churning out more graduates than the market can (or will) bear.

We can't stop people from wanting to get an advanced degree (whether or not they actually should); however, we certainly can establish and enforce standards that will at least attempt to prevent the proliferation of subpar admissions and training criteria.

Originally Posted by 4410

The reason for students seeking out educational opportunities in PsyD programs is due to the high quality of clinical psychology training in these programs.

So let me get this right, students are passing up funded university programs to attend high quality clinical training at free standing professional programs?

Anyone believing that would need to examine the deleterious effects of their crack habit. Students are choosing these programs when they cannot gain admission to funded programs. Nearly no one wants to spend $100,000 or more on an education they could obtain for a greatly reduced cost at a more prestigious university with funding.

The EPPP is a poor indicator of clinical psychology training and is not an accurate outcome to measure the quality of a clinical psychology program. The EPPP needs to be adapted or changed to reflect what it purports to measure. Clinical Psychologist have already passed comprehensive exams during their training in their doctoral program, so why is it necessary to have another exam five years later over this subject matter?

Do you have any empirical support for this hypothesis? I somehow doubt it.

Graham, J. M. and Kim, Y.-H. (2011), Predictors of doctoral student success in professional psychology: characteristics of students, programs, and universities. J. Clin. Psychol., 67: 340–354. doi: 10.1002/jclp.20767

I'll let you read and evaluate the research for yourself.

Clinical Psychologists numbers are basically a minority in the Mental Health field as there are many more LPC, LCSW, and LMFT that will see clients for $60 to $100 per hours.

This is the reason for wage reductions not PsyD clinical psychologists.

I know some clinical psychologist who will not accept Medicaid/Medicare clients or insurance and are completely self-pay at a rate between $180 to $200 per hour.

They may only have ten clients whereas a LPC will charge $75.00 per hour and have 30 clients and they both have basically the same income. Maybe the psychologists should reduce their rate to $100 per hour.

So the answer is for psychologists to lower their fees? That sounds like autistic thinking.

Psychologists need to highlight the differences between psychologists and other allied mental health professionals.

Clinical psychologists bring something unique to the table just as Ph.D. trained psychologists bring a unique and valuable perspective to the table, a perspective that is different from our Psy.D. brethren who have their own unique and valuable training.

As much as many might like to equate a Ph.D. to a Psy.D., it's simply not possible, the training is different. Not better, not worse, but different. In general, many free standing professional programs attract a student population with lower level of overall educational success making it even more difficult to compare outcomes of the two training models side by side.

Originally Posted by Markp

Do you have any empirical support for this hypothesis? I somehow doubt it.

Graham, J. M. and Kim, Y.-H. (2011), Predictors of doctoral student success in professional psychology: characteristics of students, programs, and universities. J. Clin. Psychol., 67: 340–354. doi: 10.1002/jclp.20767

I'll let you read and evaluate the research for yourself.

I don't think 4410 reads anything that is to science-y...

I don't mean to change the subject here, but I was reading the American Psychologist monitor for May and I saw the candidates for APA president. I would like to know which candidate is the best candidate for addressing the imbalance. One candidate talked about the imbalance but I do not agree with his solution (APA should make more internships and he does not support requiring and encouraging APA accredited internships with the given imbalance). What do you think? Who is going to address this imbalance in the most productive way? I think that as students and APA student affiliates, we should think about this.

Originally Posted by PsyDLICSW

I don't mean to change the subject here, but I was reading the American Psychologist monitor for May and I saw the candidates for APA president. I would like to know which candidate is the best candidate for addressing the imbalance. One candidate talked about the imbalance but I do not agree with his solution (APA should make more internships and he does not support requiring and encouraging APA accredited internships with the given imbalance). What do you think? Who is going to address this imbalance in the most productive way? I think that as students and APA student affiliates, we should think about this.

Thanks for changing the subject away from 4410's ridiculousness. Pretty sure that person is not a real grad student anyway.

Are those candidate statements online?

I can make a request to each of the candidates to address the issues brought up in the petition and give their response. I think there's some ridiculous bureaucracy around what the candidates can and cannot say, but I can put it out there.

Originally Posted by MCParent

Thanks for changing the subject away from 4410's ridiculousness. Pretty sure that person is not a real grad student anyway.

Are those candidate statements online?

I can make a request to each of the candidates to address the issues brought up in the petition and give their response. I think there's some ridiculous bureaucracy around what the candidates can and cannot say, but I can put it out there.

I got the hard copy of the monitor yesterday and they ususally send me an e-mail later with an electronic copy. I can PM it to you as soon as I get it.

Originally Posted by PsyDLICSW

I don't mean to change the subject here, but I was reading the American Psychologist monitor for May and I saw the candidates for APA president. I would like to know which candidate is the best candidate for addressing the imbalance. One candidate talked about the imbalance but I do not agree with his solution (APA should make more internships and he does not support requiring and encouraging APA accredited internships with the given imbalance). What do you think? Who is going to address this imbalance in the most productive way? I think that as students and APA student affiliates, we should think about this.

Did you read the two letters where one psychologist indicates the need to unite training and internship attitudes for training of PsyD/PhD degree psychologists rather than dividing or claiming that there is a shortage of internships due to FSPS and PsyD schools. He indicates that the 2011 Match Statistics reveal only a 10% difference between PhD and PsyD trained psychologists and this is a small difference.

In 1987 there was a surplus of internships but in 1994 only seven years later there was a shortage of internship sites. Here we are almost 18 years later.

The second letter was from a psychologist who used to be the Training Director of a major medical facility in New York City that had clinical psychology internships. In the 90's when the shortage of internships was beginning she endorsed changes of the system with APA. It seems that there are labor laws or legal mandates restricting APA from labor/wage types of activities. APA accredits clinical psycholgy training programs including predoctoral and postdoctoral internships but it has no legal authorization to mandate increasing internship sites or restricting graduate school admission. Her solution is not to place blame on APA but on the individual graduate programs and they should be required to have in place internship sites for all of the students they admit into their program every year. She believes APA needs to mandate or require the individual graduate program to have dedicated internship sites for each of their students.

Their are four male candidates and one female candidate running for APA president this year. The female candidate wrote briefly about the imbalance of APA accredited internship sites. This is her brief statement:

"The ongoing crisis in our psychology educational system has resulted in a serious imbalance between the number of graduate students seeking internships and the availability of accedited positions. In addition, with our country's economic difficulties, the job market for early career psychologists is challenging. We must take bold steps toward collaboratively addressing these crises and establishing solutions and recommendations for model and novel internships and jobs."

One of the candidates has a PsyD degree from a professional school. His focus is on stereotypes of PsyD psychologists being scapegoated unfairly by the profession as not being competent, and in the future there will be a need for more psychologists. He indicates that APA membership is decreasing every year and less than half of all psychologists are now members of APA. APA needs to change so many of these former member will again become members of APA so the organization may be a political force representing all psychologists, not just PhD degree psychologists. If I could vote I wonder who you might believe I might endorse?

What's a "10% difference" supposed to mean? 10% in what? Sounds like a number either made up or misunderstood.

The idea that facts are scapegoating is so stupid it doesn't deserve a reply. The myopic, vain, and irresponsible ignoring of the facts by apa governance is one of the biggest contributors to the imbalance.