If you were in charge of APA, what would you do differently?

[Rivi]

I want to pose this question to you all. I have been thinking a lot about this lately, and thought it would be interesting to discuss how we can help improve this field for our current and future practitioners. I remember a post in another thread which suggested that we should strive to be paid similarly to other doctorate-level, non-MD providers (i.e., optometrists, pharmacists, etc.) which seems reasonable to me. I think in some settings our pay is pretty consistent with this, but in many others we are lagging behind.

Here are some thoughts that I have:

1. Program evaluation and research skills put us in a unique position for leadership within the mental health field. We need to utilize this and market it more effectively.

I have worked in a lot of hospital settings, and observed many day treatment programs, inpatient units, etc. run by nurses, psychologists, social workers and psychiatrists. Of these professions, I believe that psychologists are generally more effective for several reasons. Given our training in research and consultation, we have skills in monitoring outcomes, staying up to date on research and integrating that into our treatment programs. It is important of course to have "in the trenches" experience in addition to the academic training in order to effectively lead these programs.

Another thing that I have observed is a separate "research and outcome evaluator" position popping up in a few places, which has gone to psychologists. This has the potential as well, as programs generally want to know how they are doing and how they can improve. Psychologists, given our research training, are the best equipped profession to answer those questions.

What is frustrating is that healthcare administrators don't seem as familiar with psychologists' skill set. Nurses, psychiatrists, etc. all have a more well-defined role and better understood skills. This is our fault, and we need to better market this skill. This brings me to my next point.

2. Fight less, collaborate more

Interdisciplinary team skills and promoting an understanding to other professions of what we do will help us exponentially. It seems that psychologists are pretty quick to fight with other mental health professionals, or with each other. This is reasonable to an extent, but we really have to shift the balance. Other professions, including psychiatry, don't seem really clear on what exactly we do or how we can best help them. I think helping graduate students learn to write more user-friendly reports will be helpful in this respect.

3. Put teeth on the internship and EPPP pass rate criteria for graduate school accreditation

Require a 50% EPPP pass rate and 40% APA-accredited internship match rate rate over a 5 year period, or with at least 20 students. If this is not met then you get placed on probation, which requires a written plan of action. If after 5 years, the match rate is still not up to the requirements, then accreditation of the program can be revoked.

An additional observation:

Psychiatrists are paid more by insurance panels for the same service (i.e., 45-minute psychotherapy) than we are. We are paid more than counselors or social workers for this service, but not by much. This issue needs to be further explored. I have doubts that pushing for RxP will improve our salary for the long-term for this reason.

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[WisNeuro]

I like some of the ideas. I definitely agree that APA could do a better job with funding outcome research in real-world settings.

I wholeheartedly disagree on the 50% pass rate and 40% match rates. Those are extremely low numbers. I'd go more for 75%, 65% respectively. Get the truly bad FSPS's to shape up or ship out.

Also, APA historically has been terrible at advocacy, they are getting better recently, but have a long way to go. They need to do something to get members back in the ranks after hemorrhaging them for years, and use some of those membership fees to actually advocate in the healthcare arena.

 

[MCParent]

Also, APA historically has been terrible at advocacy, they are getting better recently, but have a long way to go.

It's hard to successfully advocate for funding until the APA focuses accreditation on EBT training. The accreditation standards are so wide, broad, and vague, ostensibly to promote "holistic" evaluation of programs and allow for some diversity, that I'm aware of programs that don't really have much EBT training rigor. There will always be some fringe people who get Psych PhDs or MD/DO and then run around doing rebirthing and magic crystal magnet therapy, but we should cut them out as much as possible.

I think the most recent iterations of the Committee on Accreditation have been working to make the standards better and more rigorous, though.

 

[WisNeuro]

Totally agree MCP, you want to be a faith healer and peddle moon dust and snake oil, go nuts, just do it without a license and not under the title of Psychologist.

I think the APA needs to restructure it's funding sources though to become more independent and impartial. If they rely on funds from certain parties, they will be beholden to them and will tailor their standards to appease big donors. Same as Congress. They won't bite the hand that feeds them, even as they lose membership in their ranks.

 

[Rivi]

It's hard to successfully advocate for funding until the APA focuses accreditation on EBT training. The accreditation standards are so wide, broad, and vague, ostensibly to promote "holistic" evaluation of programs and allow for some diversity, that I'm aware of programs that don't really have much EBT training rigor. There will always be some fringe people who get Psych PhDs or MD/DO and then run around doing rebirthing and magic crystal magnet therapy, but we should cut them out as much as possible.

I think the most recent iterations of the Committee on Accreditation have been working to make the standards better and more rigorous, though.

But then what will become of Bob's House of Jungian Therapy?

 

[xXIDaShizIXx]

But then what will become of Bob's House of Jungian Therapy?

It would have to be the "NEW AND IMPROVED" Bob's House of Jungian Therapy.

 

[smalltownpsych]

I completely agree that a 40% match rate is too low. I think it should be at least 70% and then tied to enrollments. I really like your point about program evaluation and research which goes hand in hand with program development which you didn't state explicitly. I think that we need to be involved in the designing all types of mental health programs (suicide prevention, substance abuse, day treatment, partial hospitalization, depression awareness, etc.) because we do have the expertise. In the last few states that I have been in, psychologists were not involved in these key mental health programs. I have been involved in a few issues in the community and our contribution is greatly appreciated and needed. APA should be helping us get the word out on this.

 

[AcronymAllergy]

Agreed--inclusion of formal training/experience related to program development and evaluation would be great. I agree that these are roles we can fill quite well.

As for the match rate, the only way I'd be ok with 50% is if that were an initial target, after which it would increase regularly up to an appropriate threshold (say, 5% per year until it gets to 75%).

 

[smalltownpsych]

Agreed--inclusion of formal training/experience related to program development and evaluation would be great. I agree that these are roles we can fill quite well.

As for the match rate, the only way I'd be ok with 50% is if that were an initial target, after which it would increase regularly up to an appropriate threshold (say, 5% per year until it gets to 75%).

My vote goes to AA as APA president based on that solution!