Clinical supervision = additional areas of practice?

[psych844]

So I'm currently considering a School Psychology Masters (in Canada) that seems like a pretty good fit for me.
1. There is no restrictions on practice context (ie school, private practice, some agency)
2. Training is at a good/well respected University, and the training seems solid.

But essentially, my impression is that you get trained to do psycho-educational assessments. Technically you can diagnose anything in the DSM, and I'm sure you get training in other aspects, but not sure if it be enough to qualify as being competent in those areas.

So my question is..if you finish a degree, get licensed and start practicing..is there any opportunity at that point to get additional clinical supervision and in essence "upgrade" what assessments you can do? Would this require going back and passing certain oral exams, etc? What are the chances someone would accept/offer the supervision?

Cheers for any clarification

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[Justanothergrad]

Sure. People always want to respecialize and further their training. Attend conferences and workshops, read books and articles, and then get a supervisor with expertise to oversee you (most psychologists will provide supervision for fee). Depending what agency you are part of, there may be some that will do it there for free/part of their job.

However, if your interests are aligned heavily with something other than the area you are getting your degree in that this can be a lot of work and probably not the best route to rely on. If you want to conduct forensic evaluations, for instance, then the extra training plan isn't a good route. If you just want to know more assessments to use with a wider range of issues that you might see as a practitioner that aligns with your school of training then sure, knock your socks off. A lack of restriction for practice context does not ensure that you would be competent in other areas (as you mentioned). I would also try to explore gaining training in the areas you are interested in while part of graduate school. What diagnostic labels / evaluation contexts are the ones you are looking at/concerned you won't be competent to examine?

 

[deleted343839]

Licensed professionals expand their skills all the time. We are, in fact, obliged to do so. Your legal scope of practice is typically broader than the limits of your competence, which is where your ethics and conscience play a vital role.

You can enhance your competence in a given area by attending reputable training programs, keeping up with the literature, and receiving one-on-one consultation and mentoring. In practice we often do this to fill in the gaps in our professional training. For example, you might get a lot of experience with ID and learning disorders but feel less comfortable differentiating ADHD and autism spectrum disorders. You could certainly get training in and become more facile with the latter, though as a school psychologist no one should ever confuse you or substitute you for an autism expert. Similarly, you might want to familiarize yourself with the various ways in which your work could be used in a forensic setting, but that is not the same as becoming competent to start doing forensic evaluations on the side.

 

[psych844]

If you just want to know more assessments to use with a wider range of issues that you might see as a practitioner that aligns with your school of training then sure, knock your socks off.

This is exactly why I ask. If I was trained as essentially a School Psych (mostly psycho-educational) assessments. I'd love to get training that is related to that training that could expand my scope.

What diagnostic labels / evaluation contexts are the ones you are looking at/concerned you won't be competent to examine?

Maybe something like MMPI-A? (not sure psycho-educational specialists, or School Psych's would be trained to administer this?

 

[psych844]

or I guess I'd be a bit concerned if I couldn't administer at least some things that a Clinical Psych could. (I cant' really come up with the assessment instrument names, though).

 

[deleted343839]

or I guess I'd be a bit concerned if I couldn't administer at least some things that a Clinical Psych could. (I cant' really come up with the assessment instrument names, though).

Why would that concern you?

My guess is most of what you'd do outside your bread-and-butter psychoeducational testing is screening and referrals. You should learn your differential diagnosis and how to use screening tools effectively, and get to know the community of mental health professionals you'll be referring out to. I'm having trouble imagining how being able to interpret an MMPI would help you or your clients in that type of practice, though you might want to improve your ability to detect specific issues (eg, mood disorders) if you see them coming up often in your population.

If what you really want to do is comprehensive psychological assessment, then school psych training is going to come up short.

 

[psych844]

Why would that concern you?

My guess is most of what you'd do outside your bread-and-butter psychoeducational testing is screening and referrals. You should learn your differential diagnosis and how to use screening tools effectively, and get to know the community of mental health professionals you'll be referring out to. I'm having trouble imagining how being able to interpret an MMPI would help you or your clients in that type of practice, though you might want to improve your ability to detect specific issues (eg, mood disorders) if you see them coming up often in your population.

If what you really want to do is comprehensive psychological assessment, then school psych training is going to come up short.

Yeah. Part of the problem is that I don't know all the tools that a Clinical Psych could administer compared to let's say a School Psych/Psycho-educational Specialist. Maybe you can provide some examples of the different assessments each can administer?

But yeah, basically since a Canadian School Psych can technically diagnose anything in the DSM, I'd love to have at least a bit of training/or be able to do an assessment, that would be more in line with what a Clinical Psych does.

 

[Justanothergrad]

You would likely be trained on a wider array of intelligence and achievement tests (Wais, WJ, etc etc.). You would likely be trained on less symptom evaluations for things like schizophrenia but more for stuff such as autism. Licensed folks aren't limited in their ability to diagnosis a given diagnosis by license. they are by competency and ethics. The best advice would be to find out what assessments would be appropriate for your career goals and make sure your training fits those needs. Don't worry about being "a clinical psych".

 

[psych844]

The best advice would be to find out what assessments would be appropriate for your career goals and make sure your training fits those needs. Don't worry about being "a clinical psych".

That seems like good advice. Should I check with programs I want to attend if there would be opportunities with the program to get such experiences?

 

[psych844]

For those of you that are Clinical Psychologists, I'd love to hear what instruments that you currently administer would compliment the work of an Educational/School Psych?

 

[Justanothergrad]

It seems to me as though you are trying to get 'clinical psychology' training as part of a school/educational program. These are distinct specialties serving different populations, often utilizing distinctive approaches to assessment/treatment/etc. If the scope of your intended practice is not within those educational/school psych training goals, then why are you seeking that degree? If it is within the training goal, don't worry so much about it and know that you will be able to get continued education in other instruments that compliment that career trajectory if needed. You should check with your program that your goals match their training offerings.

 

[psych844]

If it is within the training goal, don't worry so much about it and know that you will be able to get continued education in other instruments that compliment that career trajectory if needed. You should check with your program that your goals match their training offerings.

It's the latter part of your statement. I'm just trying to figure out if there are personality assessments (more clinical assessments), that would be useful to know for an Educational/School Psych ..because that assessment might not be part of the typical program for School psych. I'd rather get it done as a Grad student, then have to do additional training after the fact!

 

[deleted343839]

It's the latter part of your statement. I'm just trying to figure out if there are personality assessments (more clinical assessments), that would be useful to know for an Educational/School Psych ..because that assessment might not be part of the typical program for School psych. I'd rather get it done as a Grad student, then have to do additional training after the fact!

If it's important for you to know, then hopefully it will be covered in your training.

Psychologists use tests to provide specific information for a specific purpose - diagnosis, treatment planning, monitoring treatment progress, etc. So without knowing why you would want additional training in psychological assessment, it's difficult to answer your question. What are you hoping to do in your career beyond what you think you will be trained to do?

 

[eremitestar]

I agree with others that being legally allowed to do something is not the same as being competent to do so. I'm just a few months away from being licensed as a psychologist, which would also qualify me to diagnose anything in the DSM. That said, I have almost no training or experience working with developmental or learning disorders. I know just enough about ASDs and LDs to know when to refer to a specialist. And that's totally fine. I don't have to do it all myself.

Also, some assessment tools are restricted by level of education. The MMPI, for example, is level C, which requires a doctorate, or supervision by someone with a doctorate.

http://www.pearsonclinical.com/psychology/qualifications.html

 

[psych844]

Also, some assessment tools are restricted by level of education. The MMPI, for example, is level C, which requires a doctorate, or supervision by someone with a doctorate.

http://www.pearsonclinical.com/psychology/qualifications.html

You missed the OR's there. You don't need a doctorate. I know Master's level people in Canada who administer them.

 

[eremitestar]

You missed the OR's there. You don't need a doctorate. I know Master's level people in Canada who administer them.

There's a difference between administer and interpret. It might be different in Canada, but I know here in the states a lot of Master's level people administer them, but then their reports and interpretation are overseen by PhDs. Also, in the states at least, licensure as a psychologist and member status in the APA require a doctorate, so the OR's don't change that.

Prior to entering my PhD program, I completed a license-eligible terminal master's. I was told in my assessment class that I could not independently administer and interpret level C tests as a master's-level clinician. It could be different in Canada, but I think it's worth asking about.

 

[psych844]

Prior to entering my PhD program, I completed a license-eligible terminal master's. I was told in my assessment class that I could not independently administer and interpret level C tests as a master's-level clinician. It could be different in Canada, but I think it's worth asking about.

Just checked with a friend who is a Masters-level Psychologist (Educational Psychologist) in Alberta, Canada. She said she can indeed administer and interpret C level tests. Any registered Psychologist can, assuming they are trained in it. But she says you can do a two day workshop to get training for the MMPI and use it.

 

[eremitestar]

Awesome, good to know! If that's the case, then I don't see any reason why you couldn't do that.

 

[MAClinician]

It's the latter part of your statement. I'm just trying to figure out if there are personality assessments (more clinical assessments), that would be useful to know for an Educational/School Psych ..because that assessment might not be part of the typical program for School psych. I'd rather get it done as a Grad student, then have to do additional training after the fact!

I can only speak to my experiences in Massachusetts and not sure about Canada. In the US/MA, School Psychologists assess for areas that interfere with Academic achievement and functioning. I have attended DOZENS of initial IEP evaluations and most of the testing consists of cognitive (WISC), academic achievement (Woodcock Johnson or WIAT), maybe a self report screener of depression like the BDI, and possibly the BASC. Depending on the district you might even get a sentence completion task. I have NEVER seen an MMPI-A, PIY, or any other personality inventory or projective tool used. They will diagnose intellectual disabilities and learning disabilities. Developmental delay Diagnoses usually come from an outside source (developmental pediatrician). School psychs will NOT diagnose ADHD, mood disorders, psychotic disorders, or developmental disorders in their evaluations. If the school questions something like that they might refer outside the district for more comprehensive psychological assessment from a PhD. Often times, if the parent wants an IEP for social/emotional disability, the parent must have a diagnosis from psychiatrist, psychologist or medical professional with evidence supporting (assessment, evaluation report etc). They also have to show diagnosis is impairing academic progress. School psychs generally provide consultations to teachers and recommend interventions in the report. It is rare they provide direct services to the student (school adjustment counselor job). If you want to do assessment outside school setting/practice, clinical psych PhD might be more appropriate. But I don't know how Canada handles things.

 

[psych844]

I can only speak to my experiences in Massachusetts and not sure about Canada. In the US/MA, School Psychologists assess for areas that interfere with Academic achievement and functioning. I have attended DOZENS of initial IEP evaluations and most of the testing consists of cognitive (WISC), academic achievement (Woodcock Johnson or WIAT), maybe a self report screener of depression like the BDI, and possibly the BASC. Depending on the district you might even get a sentence completion task. I have NEVER seen an MMPI-A, PIY, or any other personality inventory or projective tool used. They will diagnose intellectual disabilities and learning disabilities. Developmental delay Diagnoses usually come from an outside source (developmental pediatrician). School psychs will NOT diagnose ADHD, mood disorders, psychotic disorders, or developmental disorders in their evaluations. If the school questions something like that they might refer outside the district for more comprehensive psychological assessment from a PhD. Often times, if the parent wants an IEP for social/emotional disability, the parent must have a diagnosis from psychiatrist, psychologist or medical professional with evidence supporting (assessment, evaluation report etc). They also have to show diagnosis is impairing academic progress. School psychs generally provide consultations to teachers and recommend interventions in the report. It is rare they provide direct services to the student (school adjustment counselor job). If you want to do assessment outside school setting/practice, clinical psych PhD might be more appropriate. But I don't know how Canada handles things.

Thank you. That is generally correct in Canada. Differences...
1. I've seen Educational Psychologists diagnosing ADHD. In fact, that is one of their most common diagnoses, along with learning disabilities + slow learners (borderline IQ).
2. Some of our provinces register Psychologists at the Masters level. Ie 70% of Psychologists in the province of Alberta are Masters-level. So generally what that means is that there are no restrictions as long as you are a Registered Psychologist. So a person that did School Psych, (is really an educational psych) and can work in any context. There are provinces that have a special registration for School Psych and there they can't work outside of schools.

 

[Therapist4Chnge]

Masters-level psychologist...whenever I read that it rubs me the wrong way. I know the history, but the fact Canada still supports them...blah.

 

[Justanothergrad]

Just checked with a friend who is a Masters-level Psychologist (Educational Psychologist) in Alberta, Canada. She said she can indeed administer and interpret C level tests. Any registered Psychologist can, assuming they are trained in it. But she says you can do a two day workshop to get training for the MMPI and use it.

You need more than 2 days to be competent. Two days would hardly make you able to use it.

I'm not sure why you are obsessed with the MMPI. Its not the type of test you are likely to use.

No matter what type of clinical degree you get, you will need additional training in assessment as those tests change and as studies in them advance

 

[deleted343839]

You need more than 2 days to be competent. Two days would hardly make you able to use it.

Thank you. I started a reply to that, then I sighed and moved on.

 

[psych844]

Thank you. I started a reply to that, then I sighed and moved on.

Yah, to be clear, the workshop does technically mean that you would have the right to use it? I'm not saying that you would not need any additional help/experience.

I was having a conversation with this Psychologist who was giving me this info, and when she said that you can use it after a 2 day workshop..my response was actually.."that's it..seems short?". And she replied saying "Well you have to understand i'm already a Psychologist..and already have the base knowledge".

 

[deleted343839]

Yah, to be clear, the workshop does technically mean that you would have the right to use it? I'm not saying that you would not need any additional help/experience.

No, workshops and such are strictly educational. They don't serve any sort of gatekeeping function. It is really on you to ensure that you're sufficiently trained to administer any test, provide any treatment, etc. Once you are licensed in a profession, you are permitted to do anything within the scope of your licensed profession to the extent you are competent. For the most part the burden is on you to judge what you are and aren't competent to do.

To give you an example, I learned to administer the MMPI through a formal graduate course in assessment, closely supervised assessment cases in which a supervisor was reading my reports and giving feedback, and later with supervision of therapy cases in which I used the MMPI for assessment and treatment planning. However, I haven't administered an MMPI in years. So if I decided that I wanted to start using it again, I would probably bring myself back up to speed by reviewing my old course materials, examining the recent literature, taking a workshop from a reputable instructor, and consulting a more knowledgeable, assessment-savvy colleague. Similarly, if I've been using the MMPI but a new form came out, I'd want to get more orientation and training on the new version before I started using it clinically. But if someone wanted me to test their child's intelligence I would refer them out because I'm not even close to competent in child assessment and I don't have the time or interest to become so.

 

[psych844]

No, workshops and such are strictly educational. They don't serve any sort of gatekeeping function. It is really on you to ensure that you're sufficiently trained to administer any test, provide any treatment, etc. Once you are licensed in a profession, you are permitted to do anything within the scope of your licensed profession to the extent you are competent. For the most part the burden is on you to judge what you are and aren't competent to do.

To give you an example, I learned to administer the MMPI through a formal graduate course in assessment, closely supervised assessment cases in which a supervisor was reading my reports and giving feedback, and later with supervision of therapy cases in which I used the MMPI for assessment and treatment planning. However, I haven't administered an MMPI in years. So if I decided that I wanted to start using it again, I would probably bring myself back up to speed by reviewing my old course materials, examining the recent literature, taking a workshop from a reputable instructor, and consulting a more knowledgeable, assessment-savvy colleague. Similarly, if I've been using the MMPI but a new form came out, I'd want to get more orientation and training on the new version before I started using it clinically. But if someone wanted me to test their child's intelligence I would refer them out because I'm not even close to competent in child assessment and I don't have the time or interest to become so.

Thanks for the explanation. I apologize for frustrating you with my statements, but I was essentially forwarding what I was hearing from someone that I do respect and find reputable. (but could been a case of me misunderstanding her possibly)

As said, I was surprised to hear her say that after you take the two-day workshop, you'd be able to administer/interpret it.

 

[psych844]

If there is any unclear aspect of Psychological training, it be what we are talking about here. (issues of scope/competence). As you mentioned, it's on the person to judge what they are competent in. You essentially have no restrictions on a technical level, but you do ethically/competence wise.

Also, I doubt that many students understand that training can be so personalized. I'm sure most people assume that any student going into a Clinical Psych program is taught essentially the same instruments as everybody else..but apparently not. Part of it is also a lack of clarity on what kind of experience qualifies someone to use an instrument.. (ie does a course on using an instrument qualify you or actual training at some practicum..or both? and how long does that experience have to be (ie how long does the training in that instrument have to be).

 

[deleted343839]

Thanks for the explanation. I apologize for frustrating you with my statements, but I was essentially forwarding what I was hearing from someone that I do respect and find reputable. (but could been a case of me misunderstanding her possibly)

As said, I was surprised to hear her say that after you take the two-day workshop, you'd be able to administer/interpret it.

No, I apologize. I really appreciate your follow-up questions because it shows that you are genuinely curious about distinguishing competence v. scope of practice. Sometimes people just want the "path of least resistance" which is seldom the path to high competence.

 

[AcronymAllergy]

No, I apologize. I really appreciate your follow-up questions because it shows that you are genuinely curious about distinguishing competence v. scope of practice. Sometimes people just want the "path of least resistance" which is seldom the path to high competence.

Agreed, and this is what can then lead to confusion. Just because someone should monitor their competence in clinical practice and restrict their activities to those areas in which they're adequately trained doesn't mean they do.