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APA internship requirement for employment

Discussion in 'Psychology [Psy.D. / Ph.D.]' started by O Gurl, Jun 14, 2011.

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  1. O Gurl

    O Gurl

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    Hi all,

    I'm not sure if you have been following a recent discussion on the APPIC post-doc network, but the topic of federal gov't positions (primarily VA) that require APA-accredited internships has been raised. It started with a poster who inquired as to whether exceptions can be made and upon what grounds. It think erupted (politely) into a discussion about the fairness of the requirement altogether. Just wanted to share and elicit thoughts from SNDers on this issue. I can say that I am squarely on the side of the pro-regulators on this one.

    Just as an FYI, here are two of today's postings.

    One from Dr. Keilin in response to the original question:

    And one from the opposite view:
  2. cara susanna

    cara susanna Predoctoral Intern

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    Though I disagree with the second view, I do think that they should give the PhD before internship.
  3. ForensicNeuro

    ForensicNeuro Intern

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    I totally agree with APA being the minimum standard at this point for the reasons previously stated (maybe I would feel differently if I did not secure an APA internship)...but what really enrages me is that after *some* students are able to secure APA accredited reputable doctoral programs, APA internships, complete full-on empirical dissertations (NOT doctoral projects, NOT ABD, NOT lit reviews, NOT case studies), and secure real fellowship post-doctoral positions NOT back-door pieced together private practice informal nonsense...there are all these ridiculous barriers to licensure! These barriers to licensure should be firmly in place for students from unaccredited/fake doctoral programs with unaccredited internships, ABD or not real dissertations, and pieced together post-doc work! I also feel that we should receive our doctorates before internship like MDs to resolve a host of issues, but that would never happen because the system is set up to exploit/underpay us for that year + post-doc.
    Also, not to go off on a tangent, but what is up with all these post-doc positions saying that they will take ABDs??! Umm I was under the impression that post-doctoral fellowships/positions meant that you received your doctorate/graduated and were working towards licensure/academia. How can these students receive their doctorates/graduate without completing their dissertation or dissertation equivalent?? That makes no sense to me.
  4. sydb1367

    sydb1367

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    For me, it hinges on whether psychologists who’ve completed an apa accredited internship are “better” psychologists, (e.g., have better treatment outcomes) than comparable psychologists who did not complete an apa internship.

    And what’s the VA’s reasoning behind foregoing this requirement for contract psychs?

    Re: post-docs taking ABDs, my understanding is it is yet another way to get some cheap labor. The work doesn’t count towards post-licensure hours till your degree posts, so it’s another case of work for little pay.
  5. Jon Snow

    Jon Snow Senior Member

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    Disagree. Outcomes studies are exceedingly complicated and difficult, especially when you're talking about something with such heterogeneity. We can set standards based on what people that have expertise determine to be important and agree upon. Think about a strong APA or board as more of a governing body for the profession. That outcomes argument is the argument that has been used like a battering ram to dumb down healthcare across the board (social workers, nurses, etc. . .). Rather than an outcomes study across the entire range of clinical applied options that we may participate in, how about a test of knowledge/competency/peer evaluation of reports, etc. . . And better yet, just make it impossible to get licensed without completing an APA certified internship and mandate getting APA approved board certification within 5 years of license.
  6. sydb1367

    sydb1367

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    hence the e.g. rather than i.e.
  7. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty Moderator Emeritus

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    Many people would probably be okay with this route....though it (obviously) would never happen. I wish more people pursued boarding, but that will never happen.
  8. erg923

    erg923

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    I am much more interested in parties that seem to think that ALL psychology positions should automatically be open to ALL who are psychologists. Whats with the sense of entitlement? We would never dream of demanding such presumption in other professions, or even in other environments that psychs could conceivably work in. You wanna tell me that just because you earned your doctorate you shouldn't have to pass any other bar in order to be considered for the FBI, Harvard...hell, even the CMH down the street?

    The doctorate shows that you have obtained the basic education/training necessary to be a psychologist. That's all. Institutions are well within their right to set additional standards above and beyond the educational attainment needed for the job description. Everyone (and I mean EVERYONE) does this...in every profession! This is nothing new.
    Last edited: Jun 15, 2011
  9. roubs

    roubs Ph.D. Student

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    ^ This.

    There's a strong undercurrent of "I got a doctorate, now give me what I deserve" across both this topic and the threads about compensation. I want access to a decent paying job as much as anyone, but I view these hoops more like much needed gates.
    Last edited: Jun 15, 2011
  10. I Think it is really unfair to have the weeding out process for psychology done only after getting your PhD/PsyD. I think it would be much more humane, efficient, and effective to limit the number of graduates from professional school programs and have the APA not accredit these programs from the onset if they don't produce good outcomes (e.g. good apa match rates, employment outcomes, class size that is equivalent to university based programs). APA accredidation should be more stringent for these programs and class size should be regulated based on university based programs (10-15 max). We should collectively propose/fight this with the APA itself.

    I have said this before, but the number of PhD and PsyD graduates these days that are completing APA internships is at a measly 59%. It is not possible to shut out half of new graduates from licensure/employment because they didn't complete an APA internship. This will never happen b/c half the field already didn't complete an apa internship. Also, why do we want to screw early career psychologists as opposed to taking the fight with the APA and professional school programs for their criminal and unethical marketing? Why don't we fight the people at the top instead of powerless students (I completed an apa internship btw)?

    APA accreditdation these days is not just important for the VA, but increasingly important for many employment positions and post-docs!
  11. AcronymAllergy

    AcronymAllergy Neuropsychology Fellow Moderator

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    I agree--the internship year shouldn't, and was never meant, to function as a weeding out process. However, because the APA has accredited such a wide variety of programs (in terms of quality of education) at the doctoral level, the pre-doc internship is now having to pull double duty, as are post-doc positions to a seemingly greater extent.

    Ideally, removing accreditation from the programs of questionable quality and establishing more-consistent, stringent, and universally-applied doctoral program criteria would be a better solution. However, it's also a longer-term solution; thus, in the mean time, we're stuck with the system having to find some sort of stop-gap to deal with the increasing numbers of psychologists being pumped out.

    Also, as another poster mentioned above, I don't at all feel that state licensing exam requirements are currently at all inappropriate or overly-burdensome. The required post-doc supervision could be a bit much (depending on whom you ask), but the EPPP and any additional state exams do seem appropriate, and are common in many professions. Simply having a PhD/PsyD shouldn't necessarily entitle you to immediately be able to practice, especially given the apparent quality disparity in training programs and routes.
  12. Many of the threads here also have the undercurrent of "blame the student" and "let's take our anger out on psychologists and blame the individual as opposed to the system." I think this is misdirected. If only 59% of graduates from both PhD and PsyD programs are getting apa internships, this may very easily happen to you or a close friend who is very competent and did everything right. Why aren't we outraged with the APA or professional schools for violating our ethics code as psychologists and accrediting all these programs to begin with?
  13. roubs

    roubs Ph.D. Student

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    I'm still outraged and I still think the system needs an overhaul. Part of that overhaul should look at programs that do not adequately prepare their students and actively mislead them. The gates definitely need to be adjusted, but they definitely need to be there. When I'm talking about entitlement I'm more thinking of posts like the diatribe I read the other day that concluded by bemoaning that continuing education credits exist, as if to say "Ugh, yet another burden upon me". If you're point is more that we have a broken system that needs fixing then we're in agreement.

    Also in reference to the post copied by OP

    These are also band-aids that are guiding people toward avoiding the APA accred process instead of fixing the process.
  14. Jon Snow

    Jon Snow Senior Member

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  15. I think the EPPP and other exams are completely appropriate as well as post-doc hours. I don't know if you guys are aware of this, but some states have decided to conduct the weed out process to a whole new level in order to reduced the number of licensed psychologists by requiring that the post-doc year involve 4 hours of supervision per week and 25 face to face hours in order to get licensed (NJ is one of these states) plus an oral exam (you can wait almost a year for them to make your appointment). I don't live in NJ, but have experience with students who attempted to get licensed here and it can take 3-4 years for someone with an APA internship and post-doc to get licensed in this state.

    Which post-docs actually provide 4 hours of supervision and 25 face to face client hours? Most don't. Plus we have these insane requirements without having a sufficient number of post-docs to begin with.
  16. I forgot to mention that even though i think its unfair for many students to have the weed out process done so late in their training, I still believe that the "do not harm" principle in our field should prevail. APA accred. should continue as a prerequisite for many employment positions, including the VA. There has to be some quality control in our field and protection of the public from poorly trained therapists and impaired psychologists. I think it would be difficult to get through an APA internship if one was impaired or unethical since there are stricter requirements and procedures in place compared to an unaccredited internship.
  17. ForensicNeuro

    ForensicNeuro Intern

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    That is exactly what I was talking about, ClinicalPhD5! In addition, as a couple of posters have mentioned in other threads, there is a period where you would need to apply for a provisional license before accumulating post-doc hours. In most states, this can be started immediately after you graduate. Just for the record, I fully support the EPPP and supervised practice hours for licensure, etc. What I do not support are these ridiculously drawn-out and completely arbitrary timelines that greatly vary between states...ESPECIALLY for good licensure candidates, the ones with APA doctoral programs, APA internships, formal post-doc fellowships, etc. In short, the ones who have not back-doored their training. This process needs to be streamlined and made universal across states. At the very least, there should much greater reciprocity btw states. Those poor souls who have survived the licensure trainwreck in New Jersey should be able to call that in for other states!
  18. AcronymAllergy

    AcronymAllergy Neuropsychology Fellow Moderator

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    Completely agree. The issue I have with some of the posts on the post-doc listserve is that people suggest APA accreditation is flawed without addressing the existence of lax and inconsistent criteria in the field. We already have a set of standards developed by our discipline's largest governing body; why not work on revising and promoting those criteria to help establish a universal standard rather than looking for ways to circumvent the accreditation concept entirely?
  19. Exactly!

    I wonder if these drawn-out state requirements have always existed or are more recent issues that came about to deal with the oversupply of psychologists and the professional schools' lax graduation requirements. The licensure process should be more streamlined for those of us that went to good training programs and completed APA internships/fellowships. I bet NJ has fewer psychologists who can command higher pay b/c of their ridiculous requirements.
  20. Even though i support the apa accredidation process, how do you uphold it when half the field is not completing an apa accredited internship? Its going to be widely unpopular to require apa accredidation when professional school graduates are becoming norm in our field.

    As an example of lax standards, i've seen appic member internships that were not apa accredited, take 12 interns each year with only 1-2 part-time psychologists on staff. These were also unpaid internships.
  21. erg923

    erg923

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    The compensation issue is separate here. Educational attainment should indeed automatically bump one up significantly in terms of their earning potential. (eg. a doctoral level clinician charges more for therapy than a master level clinician) Otherwise, time and effort spent in schooling is not worth it. Employers and the market generally reward specialized niches that required extended, specialized training. Its just that our services are undervalued, underutilized, and its generally our fault for letting it get to that point.

    This "discrimination" card that people are talking about here is ludicrous! Why would you think you are entitled to be considered for company? If you apply to a tenure track faculty postion at Harvard with ONE publication, you will be AUTOMATICALLY disqualified, trust me. Yes, yes, im sure you're a good psychologist and all, but you haven't met THEIR standard. Would you sue because of this? Of course not! Why would you think you have the right to dictate someone else's hiring practices/standards? You don't. The VA doesn't want the playing field "leveled." That's the whole point of the standard!

    Discrimination based on credentials within ones field is present in ALL fields and in ALL professions. Its the way the job market works. Some are deemed worthy, some are not. Its just a universally reality. I do not understand what all the fuss is about.
    Last edited: Jun 15, 2011
  22. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty Moderator Emeritus

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    Unfortunately there is an artificial market because the Tri-State area attracts more than enough psychologists, so getting a quality job is more competitive than many other places. I've been told licensure is a PITA, though there have been similiar complaints about FL and NY, though people jump through the hoops because of the location. The higher pay is mostly due to a much higher cost of living, at least for the northern part of the state, NYC, Westchester County, etc.

    People sue for far less. :laugh: This isn't discrimination, it is competition. If I were an employer, I'd want to recruit the most qualified applicant who is willing to work for what I am offering. The standard for the last 20+ years has been APA-acred. program and APA-acred. internship, so it should not be a surprise that employers expect these things. There are more than enough qualified applicants who meet these standards, so as an employer I'd have ZERO incentive to lower my requirements. If anything, I'd raise my expectation for the applicant because there is enough competition for the spot: 0-2 years of experience can now become 3-5 years of post-licensure experience. The competition drives down the salary/benefits, and the applicant would need to provide a clear ROI/benefit to the employer to get a higher salary.

    The system is broken, and I don't see meaningful change happening until there is a lawsuit and/or a significant lobbying effort (7-figure support & senior-level politicians who have pull). The APA can raise their standards for acred., but they are limited in what they can require because of anti-trust laws already on the books. I'd love to see tighter gatekeeping to drive down the front-end supply, a more affordable APA-acred. process that existing internship sites can utilize, and the psychology community & APA speak out against internship sites that are unpaid and outside of the APPIC system. We don't need more internship sites, though we'd benefit from making many/most/all of the existing APPIC sites transition to APA-acred sites.
  23. O Gurl

    O Gurl

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    I agree with Erg. Throwing around the term "discrimation" is ridiculous. When I hear that word, I think about a practice of not hiring women with children, or not hiring based on religion, race, age, orientation, things that have little to do with one's training and qualification. Excluding candidates based on their program/internship's accreditation is 100% relevant to the job in question. What is next? Can employers no longer require prior experience b/c that discriminates against those with no experience? Can people with a background in academia not get preference for a job that requires teaching because it discriminates against clinicians? I am also having a hard time having empathy for people in this situation. It seems as though the dangers of completing a non-accredited internship are well-known. The choice is ultimately personal. However, I do not get how one can make this decision and then ask that standards are changed to erase the decision that he/she made.
  24. stigmata

    stigmata

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    What the field really needs is an independent accrediting agency for programs and interships. APA is in it for $$ and it could not be more of a "fox guarding the henhouse" situation. Medical residencies are not accredited by the AMA, but by independent accreditation agencies. Their system is far from perfect, but it much better than APA's. I am as disgusted by university-based programs who get their on-site "internship" site accredited by default than I am with non-accredited schools. Lastly, once you have been licensed a few years what you "learned" in your internship, APA or otherwise, has very little to do with your competence, knowledge base, and expertise.
  25. I only disagree with this sentence. My apa internship involved 5-6 hours of mostly individual supervision per week, with videotape review. Several of my supervisors listened to tapes from start to finish and gave written feedback (this is common among supervisors at a VA i think). This was invaluable training that no unaccredited internship would probably be able to replicate and has made me a much more competent clinician.
  26. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty Moderator Emeritus

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    I also did my internship at a VA, and my experience mirrors the above. Our EBT training involved weekly group supervision, individual supervision, and our supervisors reviewed our full session tapes and provided feedback. The EBT training was on top of the major rotation, minor rotation, and Director supervision times, so we probably averaged 8-10hrs of supervision per week. It may sound excessive to some, but I felt incredibly well prepared and comfortable to practice independantly following that experience. Can an unacred. site provide the same level of supervision and training?
  27. psychmama

    psychmama

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    As someone doing a post-doc in NJ I can attest to this. A certain amount of safeguards for the public are appropriate, but NJ takes this to a level that is just unnecessarily burdensome.
  28. psychmama

    psychmama

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    Eh...IDK. NYC psychologists tend to charge more and their licensure requirements are less burdensome. I think NJ wants to keep out encroachment from NY and PA licensed psychologists as much a possible. Protectionism may be the real motivator behind the numerous NJ hoops.
  29. Got it. Basically, if you achieve licensure in NJ you really have to stay in NJ for personal reasons or are really stubborn/committed!
  30. psychmama

    psychmama

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    Or maybe you're just masochistic?;) j/k
  31. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty Moderator Emeritus

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    I'm not sure I agree with this. My graduate school training was decent, but nothing to write home about. I think internship (and post-doc) are setup to build upon a foundation of knowledge, and that really does have a lot to do with competence and expertise. It is implied that I need to remember what I learned in my Ethics class and Psychopathology, but what I actually use on a day to day basis....comes directly from my internship and fellowship. Maybe it is different for a generalist who focuses on therapy, but I find that my foundation is needed, but far from sufficient to practice competently.

    If your argument is that there isn't much difference between a good APPIC site and an average APA site...then I'd agree with you. The issue I have with APPIC sites is that they aren't officially acredited. They follow guidelines, but they do not go through the kind of self-study and review that happens with APA-acred. Does that mean they are not good? Absolutely not. I know of multiple APPIC sites that have great staff and produce solid scientist-practitioners, they just lack the funding to get APA-acred. My concern has nothing to do with those sites, it has to do with the non-acred. sites that use the professional equivilant to slave labor and have no real oversight. I have heard of some outlier sites that are APPIC, but again...I am sure the same can be said for APA-acred. sites. It is just at the end of the day there is the "standard" (APA-acred), and frankly that standard isn't even that great. I have little faith that it is a great metric, but it is the best metric we have at the moment.
  32. psyunknown

    psyunknown

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    If APA acred is not the standard to look at, then what should student's look for in sites they are applying to for internship? For me I have been told that as long as the site is APA, then you will receive necessary training.
  33. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty Moderator Emeritus

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    As a student, you want to attend an APA-acred internship, as this will allow you the opportunity to apply for any job. It is common to see the following phrase in a job posting: "Must have graduated from an APA-acred program and successfully completed an APA-acred internship." It is not in all postings, but there is no acred. above APA, so at least in regard to internship training, you will not be limited.

    Completing an APA-acred. internship does not guarantee that a student will be a proficient clinicians, it is just an attempt to ensure some level of uniformity from site to site. The hope is that if certain areas are covered by a site, they will be much more likely to produce proficient clinicians. My concern is the shift for many students to forego the APPIC Match, and instead complete internship training at unacred./unregulated sites. There are regional acred. options, but this isn't the "standard". Can they produce fine clinicians...yes. Is there enough quality control to ensure this....no, at least not in my opinion.
  34. Shatani

    Shatani Real Life Doctory Type

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    a friend of mine who is from New Jersey (licensed in new york) said that this was precisely the issue. so many people wanted to be psychologists in the northern NJ area where its assumed that there will be lots of affluence and neuroticism, so NJ made it more difficult to get liensed there.

    i havent verified her facts, but that is her home state and i assume she looked into it far before earning her doctorate.

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