Increasing Clout of Psychology Degrees

[473912]

I'm very interested in hearing idea on how both psychologists and I might be able to increase the clout.. respect... weight... prestige... and $$$ in psychology degrees. Psychology is seen as a joke by some people and a farce even by other professionals. There isn't even respect for all psychology degrees on this very forum.

I'd like to hear opinions on specifics actions that can be take that can affect the clout of psychology as a profession. I'll list a few that I've heard on the board and talked about with other students and professions. Are any of these already in action? Thoughts:

1) Undergrad requirements similar to medical school: I'm personally disgusted that UG students use psychology degrees as a fallback from hard science classes. It IS a science. No one takes a pre-med UG education as a fallback and psychology UG should be just as strenuous. Not in the same courses exactly, but revamped. This includes an MCAT style testing as part of the admissions processes at the graduate level, and perhaps better differentiation between pre-treatment psychology (BA) and pre-research (BS) psychology at the UG level and taking it more into consideration when applying to a better differentiated doctoral programs.

2) Trimming away diploma mills: setting requirements for APA accreditation and % passing EPPP. This is going to be hardest I think to do with so many people, including myself (though not at a mill), spending big money at university. Perhaps working the EPPP to emphasize evidence-based practices, but I don't know much about that exam. Are there any non-university-based med schools? If not, maybe there shouldn't be any similar psych schools. I thought about med school, but I know I wouldn't make it in. I'd have made my peace if psychology schools were just as tough.

3) Requiring doctor-level education for assessment and treatment: This is something I read on the boards here. BS levels can do basic levels of counseling, Masters level can do more... I've read here that psychology may be too spread out, so in the eye of the public, outcomes aren't representative of the best. Perception is reality. We should make sure that this PERCEPTION is based on the most educated at the top of the field. Maybe killing masters-level, non-research psychology degrees altogether, like med schools, and a bolder line between counseling degrees and psychology degrees. Everyone knows difference between doctors and nurses, but even those med professionals that I've spoken with barely know the difference between a psychologist, masters-level practices and counselors, and some unofficial guy running a help group with friends of friends.

4) Better lobbying in congress/APA: Perhaps none of the above will happen without this step. Or, perhaps all of the above will give more clout and allow better lobbying. I'm betting this is a situation that needs to be attacked by both sides. I don't know know who is supposed to represent psychologists on this front (APA? or do they just help set policy?), but according to a few on this boards, perhaps they need defibrillation?

5) Better outreach to the people: Maybe with better research and outcomes, the people will be swayed, but There are some communities that don't just think psychology is useless, but actively distrust it. Maybe it's cultural, maybe SES related, maybe it's because when do you get help with crappy insurance, you get crappy results mixed with a lack of skilled professionally willing to work and communicate these areas because money isn't flowing there... I have no idea. I imagine it's a combination of all.


These are a few ideas. I'd like to hear what your thoughts are or if you have more ideas. I want to do all I can to better my future profession.

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[wesleysmith]

\ Maybe killing masters-level, non-research psychology degrees altogether, like med schools

None of the medical degrees that I'm aware of (MD/DO, PA, NP) are research degrees...

 

[erg923]

I'm very interested in hearing idea on how both psychologists and I might be able to increase the clout.. respect... weight... prestige... and $$$ in psychology degrees. Psychology is seen as a joke by some people and a farce even by other professionals. There isn't even respect for all psychology degrees on this very forum.

I'd like to hear opinions on specifics actions that can be take that can affect the clout of psychology as a profession. I'll list a few that I've heard on the board and talked about with other students and professions. Are any of these already in action? Thoughts:

1) Undergrad requirements similar to medical school: I'm personally disgusted that UG students use psychology degrees as a fallback from hard science classes. It IS a science. No one takes a pre-med UG education as a fallback and psychology UG should be just as strenuous. Not in the same courses exactly, but revamped. This includes an MCAT style testing as part of the admissions processes at the graduate level, and perhaps better differentiation between pre-treatment psychology (BA) and pre-research (BS) psychology at the UG level and taking it more into consideration when applying to a better differentiated doctoral programs.

2) Trimming away diploma mills: setting requirements for APA accreditation and % passing EPPP. This is going to be hardest I think to do with so many people, including myself (though not at a mill), spending big money at university. Perhaps working the EPPP to emphasize evidence-based practices, but I don't know much about that exam. Are there any non-university-based med schools? If not, maybe there shouldn't be any similar psych schools. I thought about med school, but I know I wouldn't make it in. I'd have made my peace if psychology schools were just as tough.

3) Requiring doctor-level education for assessment and treatment: This is something I read on the boards here. BS levels can do basic levels of counseling, Masters level can do more... I've read here that psychology may be too spread out, so in the eye of the public, outcomes aren't representative of the best. Perception is reality. We should make sure that this PERCEPTION is based on the most educated at the top of the field. Maybe killing masters-level, non-research psychology degrees altogether, like med schools, and a bolder line between counseling degrees and psychology degrees. Everyone knows difference between doctors and nurses, but even those med professionals that I've spoken with barely know the difference between a psychologist, masters-level practices and counselors, and some unofficial guy running a help group with friends of friends.

4) Better lobbying in congress/APA: Perhaps none of the above will happen without this step. Or, perhaps all of the above will give more clout and allow better lobbying. I'm betting this is a situation that needs to be attacked by both sides. I don't know know who is supposed to represent psychologists on this front (APA? or do they just help set policy?), but according to a few on this boards, perhaps they need defibrillation?

5) Better outreach to the people: Maybe with better research and outcomes, the people will be swayed, but There are some communities that don't just think psychology is useless, but actively distrust it. Maybe it's cultural, maybe SES related, maybe it's because when do you get help with crappy insurance, you get crappy results mixed with a lack of skilled professionally willing to work and communicate these areas because money isn't flowing there... I have no idea. I imagine it's a combination of all.


These are a few ideas. I'd like to hear what your thoughts are or if you have more ideas. I want to do all I can to better my future profession.

The fundamantal problem is that psychological services are indeed very useful... in certain situations and when certain conditions or variables are meet. Psychologists, in my view, really overvalue some things we offer whilst, ironically, NOT lobbying them at all on the national front so that more momentum and clout can be gained for what we CAN offer.

 

[futureapppsy2]

The fundamantal problem is that psychological services are indeed very useful... in certain situations and when certain conditions or variables are meet. Psychologists, in my view, really overvalue some things we offer whilst, ironically, NOT lobbying them at all on the national front so that more momentum and clout can be gained for what we CAN offer.

What do you see as over-valued, erg?

 

[erg923]

What do you see as over-valued, erg?

The idea that psychotherapy is the universal treatment and is universally beneficial for anybody/everbody who is manfesting psychic distress.

I think the clinical benefits of psychological testing are largely oversold by the profession.

 

[Therapist4Chnge]

I think the clinical benefits of psychological testing are largely oversold by the profession.

Yes and no. In many instances differential dx isn't going to drastically change treatment interventions, at least based on what I've seen. However, in other instances (e.g. transplant, gastric bypass, stimulator implant) there is solid support that evaluation can produce better outcomes, at least decrease the likelihood of adverse/poor outcomes by screening out patients who may not be in a position to adequately support the post-surg needs. I am obviously biased because I see the latter much more frequently than the former, but I'd love to hear from others.

 

[erg923]

Yes and no. In many instances differential dx isn't going to drastically change treatment interventions, at least based on what I've seen. However, in other instances (e.g. transplant, gastric bypass, stimulator implant) there is solid support that evaluation can produce better outcomes, at least decrease the likelihood of adverse/poor outcomes by screening out patients who may not be in a position to adequately support the post-surg needs. I am obviously biased because I see the latter much more frequently than the former, but I'd love to hear from others.

Agree! And, I do bariatric and organ trans evals frequently as the primary care psych here.

 

[smalltownpsych]

Yes and no. In many instances differential dx isn't going to drastically change treatment interventions, at least based on what I've seen. However, in other instances (e.g. transplant, gastric bypass, stimulator implant) there is solid support that evaluation can produce better outcomes, at least decrease the likelihood of adverse/poor outcomes by screening out patients who may not be in a position to adequately support the post-surg needs. I am obviously biased because I see the latter much more frequently than the former, but I'd love to hear from others.

I would also add that solid testing can be of benefit for academic planning and interventions.

 

[erg923]

I would also add that solid testing can be of benefit for academic planning and interventions.

The healthcare system doesnt care about that.

 

[PsyDr]

If you want to increase prestige, I recommend the following:

1) Only accept jobs that pay 100k. Assuming a 35% overhead, 70% productivity, and an average of $98/hr fee, there is still meat on the bone.
2) Restrict professional statements to evidence based statements. And preferably cite the author. Like other professions (e.g., medicine, law, etc). When in doubt, give complex formulas.
3) Learn how to speak the professional language of other professions, especially medicine.
4) Work hard and make no excuses. You don't hear surgeons say, "I can't handle another case today, it's emotionally draining.".
5) When giving answers, give actionable steps.
6) Always answer your phone.
7) When people deride the profession, counter their arguments.
8) Know when to say no. There are many difficult things that people go through that are not disorders. There is no shame in offering brief supportive therapy, but there is no point in giving endless psychotherapy for normal life.
9) Avoid making vague declarations. This is immature. If you want something to happen, take actions to make it happen. This works for many actions in life: dating, the IRS, finances, car maintenance, health, etc.
10) Contribute real money to psychology causes.
11) Wear professional clothes. Look around at other doctors and dress like that. It's much easier to take a person in a thousand dollar suit seriously than a person who dresses in a flowery hippy shirt (e.g., Slipan, 2015).

 

[smalltownpsych]

The healthcare system doesnt care about that.

True and the schools care even less. Private pay parents of struggling kids do care, however, and will pay significant money for this service. In the troubled teen industry, the psychologists charge anywhere from 2k-5k for an assessment. There are a lot of people with deep pockets who are willing to pay top dollar for the best services. The two-tier system is happening and I would rather be the Nordstroms than the Walmart.

 

[erg923]

If you want to increase prestige, I recommend the following:

1) Only accept jobs that pay 100k. Assuming a 35% overhead, 70% productivity, and an average of $98/hr fee, there is still meat on the bone.
2) Restrict professional statements to evidence based statements. And preferably cite the author. Like other professions (e.g., medicine, law, etc). When in doubt, give complex formulas.
3) Learn how to speak the professional language of other professions, especially medicine.
4) Work hard and make no excuses. You don't hear surgeons say, "I can't handle another case today, it's emotionally draining.".
5) When giving answers, give actionable steps.
6) Always answer your phone.
7) When people deride the profession, counter their arguments.
8) Know when to say no. There are many difficult things that people go through that are not disorders. There is no shame in offering brief supportive therapy, but there is no point in giving endless psychotherapy for normal life.
9) Avoid making vague declarations. This is immature. If you want something to happen, take actions to make it happen. This works for many actions in life: dating, the IRS, finances, car maintenance, health, etc.
10) Contribute real money to psychology causes.
11) Wear professional clothes. Look around at other doctors and dress like that. It's much easier to take a person in a thousand dollar suit seriously than a person who dresses in a flowery hippy shirt (e.g., Slipan, 2015).

What emotions do surgeons deal with, lol. Im my experience, they don't. Hences its not draining for them.

Servicing the emotional life of 20-30 emotionally disturned, and generally quite unhappy individuals everyweek IS taxing and I don't think we shoudl feel shame about limiting our exposure to it beyond typical work hours.

Also, I hate ties. And so do many doctors, especially psychiatrists, that I know. Not sure we need those outside court.

 

[smalltownpsych]

If you want to increase prestige, I recommend the following:

1) Only accept jobs that pay 100k. Assuming a 35% overhead, 70% productivity, and an average of $98/hr fee, there is still meat on the bone.
2) Restrict professional statements to evidence based statements. And preferably cite the author. Like other professions (e.g., medicine, law, etc). When in doubt, give complex formulas.
3) Learn how to speak the professional language of other professions, especially medicine.
4) Work hard and make no excuses. You don't hear surgeons say, "I can't handle another case today, it's emotionally draining.".
5) When giving answers, give actionable steps.
6) Always answer your phone.
7) When people deride the profession, counter their arguments.
8) Know when to say no. There are many difficult things that people go through that are not disorders. There is no shame in offering brief supportive therapy, but there is no point in giving endless psychotherapy for normal life.
9) Avoid making vague declarations. This is immature. If you want something to happen, take actions to make it happen. This works for many actions in life: dating, the IRS, finances, car maintenance, health, etc.
10) Contribute real money to psychology causes.
11) Wear professional clothes. Look around at other doctors and dress like that. It's much easier to take a person in a thousand dollar suit seriously than a person who dresses in a flowery hippy shirt (e.g., Slipan, 2015).

Also, we shouldn't chase the average when it comes to income because there are way too many psychologists who do this as a part-time sort of gig. Hang out a shingle see about 10-15 patients a week and call it a full-time job. I love this post and my productivity is closer to 80% and my average fee is higher although my overhead is 40%. With those stats over 100k is easy.
12) I would also add that we need to fight harder for our profession and not be so accomodating to the MA level people as a group. As individuals, we have to work with them, yes, but as a group we should throw them under the bus all day long. Do you think the MDs hesitate to attack the skill set of NPs?

 

[futureapppsy2]

What emotions do surgeons deal with, lol. Im my experience, they don't. Hence it not draining for them.

Servicing the emotional life of 20-30 emotionally disturned, and generally quite unhappy individuals everyweek IS taxing and I don't think we shoudl feel shame about limiting our exposure to it beyond typical work hours.

Also, I hate ties. And so do many doctors, especially psychiatrists, that I know. Not sure we need those outside court.

Patients coding or dying, for one. Major complications. Minor complications.

 

[erg923]

Patients coding or dying, for one. Major complications. Minor complications.

Thye dont deal (ie., work with) with those emotions though, right? The fix those problems and/or minimize the risk.

 

[erg923]

As individuals, we have to work with them, yes, but as a group we should throw them under the bus all day long.

That ship has sailed, bro. Not sure who that helps?

 

[futureapppsy2]

Thye dont deal (ie., work with) with those emotions though, right? The fix those problems and/or minimize the risk.

Yes, but it can still be emotionally draining, not to mention physically draining as well.

 

[erg923]

Yes, but it can still be emotionally draining, not to mention physically draining as well.

I would think so. But, as Psydr wrote, they dont endorse it much. The emotional aspect I mean.

 

[PsyDr]

erg, I am not advocating extended work hours. I am sure not advocating my work hours to anyone on this planet. I am stating that it is my belief that if our profession is to be treated on par with other health professions, our productivity in terms of hours working needs to be on par. There are many many professions that deal with hard things and continue their productivity in the face of such things (e.g., judges, attorneys, physicians, LEOs, paramedics, etc).

While it will surprise no one, I socialize with several surgeons. They suffer immensely from a wide variety of things: patients dying, patients blaming them for things that are not possibly their fault, anger, frustration, sadness, feeling powerless, feeling lonely, feeling unappreciated, etc. Mostly the public presentation is a facade and there is a real human being under there. Had lunch last week with an attorney would talked about how an awful case had affected him.

smalltown: that's why I advocate a data centered approach and contributing real money. You are not going to affect the production or practice of MA level providers. You can demonstrate superiority day in and day out. When they say, "research indicates..." I ask them to cite the names and offer counter examples. My personal physicians all offer treatment options by citing research (e.g., Kazakhstan indicated that sleeping on your head offers a 30% chance of recovery, while Turkmenistan 2007 indicated that sleeping as the little spoon offered a 28% chance of recovery. You'll have to pick one.) , I can't see why psychologists do not.

 

[cara susanna]

The idea that psychotherapy is the universal treatment and is universally beneficial for anybody/everbody who is manfesting psychic distress.

I think the clinical benefits of psychological testing are largely oversold by the profession.

Erg, it's interesting because I'm currently doing some PCMHI work on internship and everything I've seen posted from you is ringing true.

 

[smalltownpsych]

That ship has sailed, bro. Not sure who that helps?

I am not talking about trying to limit their scope of practice, but more so this...

smalltown: that's why I advocate a data centered approach and contributing real money. You are not going to affect the production or practice of MA level providers. You can demonstrate superiority day in and day out. When they say, "research indicates..." I ask them to cite the names and offer counter examples. My personal physicians all offer treatment options by citing research (e.g., Kazakhstan indicated that sleeping on your head offers a 30% chance of recovery, while Turkmenistan 2007 indicated that sleeping as the little spoon offered a 28% chance of recovery. You'll have to pick one.) , I can't see why psychologists do not.

I have hired and supervised many MA level providers. Their level of skill, experience, education, and training tends to be much more variable than ours. Research is one key point, another is knowledge of law and ethics. Another one that I like to point out to people is that because of this variability in training at times it can be the blind leading the blind and I have had several MA level providers ask me for supervision (including my new neighbor) from me because they are receiving such subpar supervision.

 

[473912]

None of the medical degrees that I'm aware of (MD/DO, PA, NP) are research degrees...

I'm sorry, I meant "Non-research-based". my mistake.

Correction: I had it right the first time. ... and yeah, they aren't research degrees. But I'm talking about a differentiation between practicing degrees and research. Like you MD's and those with PhD in physiology.

 

[Therapist4Chnge]

smalltown: that's why I advocate a data centered approach and contributing real money. You are not going to affect the production or practice of MA level providers. You can demonstrate superiority day in and day out. When they say, "research indicates..." I ask them to cite the names and offer counter examples. My personal physicians all offer treatment options by citing research (e.g., Kazakhstan indicated that sleeping on your head offers a 30% chance of recovery, while Turkmenistan 2007 indicated that sleeping as the little spoon offered a 28% chance of recovery. You'll have to pick one.) , I can't see why psychologists do not.

Some do…myself included. I think it is very important to be able to utilize good solid research to support a recommendation/intervention/etc. It is more work (at least in the beginning) to incorporate citations in a report, but I've had a very positive response by most of my referring providers. I also use it as a way to educate providers, which has yielded better working relationships and increased my referral #'s.

 

[473912]

If you want to increase prestige, I recommend the following:

1) Only accept jobs that pay 100k. Assuming a 35% overhead, 70% productivity, and an average of $98/hr fee, there is still meat on the bone.
2) Restrict professional statements to evidence based statements. And preferably cite the author. Like other professions (e.g., medicine, law, etc). When in doubt, give complex formulas.
3) Learn how to speak the professional language of other professions, especially medicine.
4) Work hard and make no excuses. You don't hear surgeons say, "I can't handle another case today, it's emotionally draining.".
5) When giving answers, give actionable steps.
6) Always answer your phone.
7) When people deride the profession, counter their arguments.
8) Know when to say no. There are many difficult things that people go through that are not disorders. There is no shame in offering brief supportive therapy, but there is no point in giving endless psychotherapy for normal life.
9) Avoid making vague declarations. This is immature. If you want something to happen, take actions to make it happen. This works for many actions in life: dating, the IRS, finances, car maintenance, health, etc.
10) Contribute real money to psychology causes.
11) Wear professional clothes. Look around at other doctors and dress like that. It's much easier to take a person in a thousand dollar suit seriously than a person who dresses in a flowery hippy shirt (e.g., Slipan, 2015).

I love all of these, especially 2, 5, 7, and 8. Those are the key to changing public and professional perception. There's so much wishy-washy equivocation when talking to some in the profession. If we have a treatment theory, we should support it unequivocally and be prepared to give support connecting all the dots of your theory. If you can't do this, professionally it seems like don't have a solid base and your ducks aren't in a row... and as far as the public is concerned, you're just making it all up as you go and "You don't need a psychologist, I have a friend/bartender/mistress, etc."

Although I agree wholeheartedly with 8, that seems like it's the hardest because the incentive structure isn't there for it. Rich people who want to rant about some inanity and willing to pay your top rate per hour to do it seems like it would be very tempting. It's easy work paying the most directly. Hard to turn down, I bet. The justification: If I don't treat them, they'll doctor shop until they do. At least I can do better than some others. I'm not yet in the field, but unless you have a full schedule of top paying clients and no student loan debt, that sounds so hard to turn down. What is a good way to change that incentive structure?

 

[473912]

Also, we shouldn't chase the average when it comes to income because there are way too many psychologists who do this as a part-time sort of gig. Hang out a shingle see about 10-15 patients a week and call it a full-time job. I love this post and my productivity is closer to 80% and my average fee is higher although my overhead is 40%. With those stats over 100k is easy.
12) I would also add that we need to fight harder for our profession and not be so accomodating to the MA level people as a group. As individuals, we have to work with them, yes, but as a group we should throw them under the bus all day long. Do you think the MDs hesitate to attack the skill set of NPs?

I agree 100%. Sounds harsh, but it's true. We need to stop ceding ground and take some land back. Is there an example of a state that, through licensure and enforcement, has the best differentiation between MA counselors and psychologists?

 

[AcronymAllergy]

If you want to increase prestige, I recommend the following:

1) Only accept jobs that pay 100k. Assuming a 35% overhead, 70% productivity, and an average of $98/hr fee, there is still meat on the bone.
2) Restrict professional statements to evidence based statements. And preferably cite the author. Like other professions (e.g., medicine, law, etc). When in doubt, give complex formulas.
3) Learn how to speak the professional language of other professions, especially medicine.
4) Work hard and make no excuses. You don't hear surgeons say, "I can't handle another case today, it's emotionally draining.".
5) When giving answers, give actionable steps.
6) Always answer your phone.
7) When people deride the profession, counter their arguments.
8) Know when to say no. There are many difficult things that people go through that are not disorders. There is no shame in offering brief supportive therapy, but there is no point in giving endless psychotherapy for normal life.
9) Avoid making vague declarations. This is immature. If you want something to happen, take actions to make it happen. This works for many actions in life: dating, the IRS, finances, car maintenance, health, etc.
10) Contribute real money to psychology causes.
11) Wear professional clothes. Look around at other doctors and dress like that. It's much easier to take a person in a thousand dollar suit seriously than a person who dresses in a flowery hippy shirt (e.g., Slipan, 2015).

Agreed.

RE: #3, I've seen psychologists starting to get better about this as more and more of us are training and working in multi-/interdisciplinary settings. And I've also seen changes occurring in the opposite direction--a few of the neurologists and PCPs from whom I frequently field referrals often mention suspected contributions from anxiety/depression/emotional distress to reported cognitive dysfunction. Honestly don't know how common that would've been 10-15 years ago.

RE: #2, heck, even if we don't cite, just having numbers and/or short, definitive statements available can go a long way toward increasing perceived credibility. But at the same time, we also shouldn't let that lull us into a false sense of security. If you aren't sure about a diagnosis, prognosis, or whatever else, be honest about it, while providing what information you can, particularly if it's tailored to the referral question (e.g., "probably not X, Y, or Z because of A, B, and C; V or W presently seems most likely, for which D would be the expected course; F, G, and H would be helpful interventions; and I and J would assist in clarifying diagnosis").

 

[smalltownpsych]

I love all of these, especially 2, 5, 7, and 8. Those are the key to changing public and professional perception. There's so much wishy-washy equivocation when talking to some in the profession. If we have a treatment theory, we should support it unequivocally and be prepared to give support connecting all the dots of your theory. If you can't do this, professionally it seems like don't have a solid base and your ducks aren't in a row... and as far as the public is concerned, you're just making it all up as you go and "You don't need a psychologist, I have a friend/bartender/mistress, etc."

Although I agree wholeheartedly with 8, that seems like it's the hardest because the incentive structure isn't there for it. Rich people who want to rant about some inanity and willing to pay your top rate per hour to do it seems like it would be very tempting. It's easy work paying the most directly. Hard to turn down, I bet. The justification: If I don't treat them, they'll doctor shop until they do. At least I can do better than some others. I'm not yet in the field, but unless you have a full schedule of top paying clients and no student loan debt, that sounds so hard to turn down. What is a good way to change that incentive structure?

Actually I worked with adolescents and their wealthy families and if you don't provide results and are able to cite solid research to back up what you do, very few will waste their money on you. Also, many of the people I worked with were doctors, attorneys, and successful business owners so they can spot BS pretty quick. Now if you are referring to heirs of wealth that might be different, like the stupid rich on a recent TV commercial.

 

[473912]

I'm surprised I'm not hearing more about my point #1. I think that's one of the most fundamental steps in the process. Any thoughts?

 

[WisNeuro]

Point #1 is difficult. First, not every school actually offers a BA and a BS. Second, the requirements will vary pretty wildly across schools as to what constitutes the requirements for that degree. Also, the idea that BA is "pre-treatment" and the BS is "Pre-research" is not that accurate I feel. As far as my school went, everyone who planned on going to grad school went the BS route. Those who didn't plan on a professional career in psych went the BA. Get a quick survey here and you'll see the differences. For example, my BS in psych required Calculus, chemistry (class and lab), specific bio classes including anatomy & physio, statistics, research methods, ab psych, and a few more (this was more than a decade ago). Reputable programs require certain classes for admissions already. As for an entry exam, the GRE is used.

I think the only way we get change here is from the top-down. The APA needs to crack down on grad programs with laughable admissions criteria. What incentive do universities have to change their curriculum?

 

[473912]

Point #1 is difficult. First, not every school actually offers a BA and a BS. Second, the requirements will vary pretty wildly across schools as to what constitutes the requirements for that degree. Also, the idea that BA is "pre-treatment" and the BS is "Pre-research" is not that accurate I feel. As far as my school went, everyone who planned on going to grad school went the BS route. Those who didn't plan on a professional career in psych went the BA. Get a quick survey here and you'll see the differences. For example, my BS in psych required Calculus, chemistry (class and lab), specific bio classes including anatomy & physio, statistics, research methods, ab psych, and a few more (this was more than a decade ago). Reputable programs require certain classes for admissions already. As for an entry exam, the GRE is used.

I think the only way we get change here is from the top-down. The APA needs to crack down on grad programs with laughable admissions criteria. What incentive do universities have to change their curriculum?

That makes sense. Top down approach. At my school, I/O was a BS, everything else was a BA. There was no variance within a BA. Perhaps changing things at the UG level would be good for schools who want to get known for pumping up better quality BA psychology majors. It could work both ways.

 

[A Blue Duck]

I'm surprised I'm not hearing more about my point #1. I think that's one of the most fundamental steps in the process. Any thoughts?

Undergraduate education is about establishing a foundation. In most cases, this foundation is built upon through practical experience on the job. For others (i.e. those pursuing advanced degrees), the foundation allows for understanding of higher level concepts and, eventually, the synthesis of information into behavioral competence (i.e. practice) and new ideas (i.e. research).

The material making up the foundations for medicine, engineering, mathematics, physics, etc. is simply more difficult than the material that makes up an adequate foundation for clinical psychology. There are averages in aptitudes and attitudes. There are concepts that lie farther away from that average than others.

Everyone and their cousin wants to be a doctor. Most will find out they can't hack it and fall back to something they can efficiently conceptualize.

I don't necessarily disagree that the foundation for psychology needs to shift, and it likely will, towards a health services integrated approach. Yet, I would recommend you get over your disgust at "psychology as a fallback," because... that is not going to change.

 

[Chalupacabra]

I'm surprised I'm not hearing more about my point #1. I think that's one of the most fundamental steps in the process. Any thoughts?

I take some issue and I'm guessing others who did not come from an undergrad in psych will agree. I think programs having pre-req classes (usually 12-18 credits' worth) is a good way of establishing quality control, but requiring someone have a BA or BS in psychology may be a little extreme. Maybe this is just my own personal bias, but is there any data that suggests that people with a strictly psych background perform better than, say, a biology major who minored in psych?

That said, I will admit that one potential bonus to doing this I can see is being able to jump into more advanced coursework immediately, under the assumption that everyone would be on the same page in terms of their coursework.

As for the MCAT like test, we already have the GRE, EPPP and university-based assessments (pre-internship exams and defense of thesis, evaluations by practica supervisors, sometimes even more) in place to ensure quality control along the way from entrance to a program to licensure. I am reminded of the disaster we're seeing in public schools right now that comes with the idea that more assessments inherently means better outcomes and more accountability and not just greater stress (and often financial burden) for all parties involved, and a process that ultimately seems to benefit the test makers far more than anyone else involved.

 

[smalltownpsych]

For number one, I think it might be helpful if we exposed the fact that most BA psychology programs do not prepare you at all for admission to doctoral programs in psychology. The APA could work both from the top down and the bottom up to improve our discipline or they could just waste their time getting mired in a political issue like the torture stuff that my listserv mailbox has been filling up with.

p.s. and please don't derail this thread into a torture debate. My point was that I would prefer that APA focus more on the field of psychology and less on politics. Although we do get coverage from national news when we talk about a political issue so I might be wrong about that.

 

[Chalupacabra]

Some do…myself included. I think it is very important to be able to utilize good solid research to support a recommendation/intervention/etc. It is more work (at least in the beginning) to incorporate citations in a report, but I've had a very positive response by most of my referring providers. I also use it as a way to educate providers, which has yielded better working relationships and increased my referral #'s.

This seems to be the rule rather than the exception in neuropsychology reports I've read from outside providers during my internship. They tend to do an excellent job of citing the research linked to their interventions, which I appreciate since I learn a lot from what they write. They also tend to do an excellent job of recommending resources (websites, books, etc.) for parents/guardians. I think it demonstrates a level of both care and knowledge that people really respond to.

 

[LAPsyGuy]

If you want to increase prestige, I recommend the following:

1) Only accept jobs that pay 100k. Assuming a 35% overhead, 70% productivity, and an average of $98/hr fee, there is still meat on the bone.
2) Restrict professional statements to evidence based statements. And preferably cite the author. Like other professions (e.g., medicine, law, etc). When in doubt, give complex formulas.
3) Learn how to speak the professional language of other professions, especially medicine.
4) Work hard and make no excuses. You don't hear surgeons say, "I can't handle another case today, it's emotionally draining.".
5) When giving answers, give actionable steps.
6) Always answer your phone.
7) When people deride the profession, counter their arguments.
8) Know when to say no. There are many difficult things that people go through that are not disorders. There is no shame in offering brief supportive therapy, but there is no point in giving endless psychotherapy for normal life.
9) Avoid making vague declarations. This is immature. If you want something to happen, take actions to make it happen. This works for many actions in life: dating, the IRS, finances, car maintenance, health, etc.
10) Contribute real money to psychology causes.
11) Wear professional clothes. Look around at other doctors and dress like that. It's much easier to take a person in a thousand dollar suit seriously than a person who dresses in a flowery hippy shirt (e.g., Slipan, 2015).

I like the list, but as psychologists tend to do, it's only really addressing the issues on an individual basis. I would argue we also need to function as a profession. As Eliot Freidson argued, we need to control the entry into the profession, the knowledge-base of the profession, and both the content and context of our professional work. Like nurses, we've allowed ourselves to become more like hourly employees. If you look at the traditional professions including law, medicine, accounting, and religion, they've all followed this model. Some are fairing better than others at this point, but all do an excellent job of the basics of being a profession.

The APA needs advocate for the profession. It's difficult because the range of activities in psychology is broader than in most of the other fields. There are members who only research and others who do mostly treatment, but regardless we need to set the agenda. Other profession charge what they do, not only because of the value of the services, but because of the sacrifice of years of training. We get treated like masters graduates because we don't bother to differentiate ourselves. Assessment is linked to our profession, perhaps certain types of treatment should be too.

Perhaps if the APA would stop wasting time and our reputations on figuring out ways to support torture and then make excuses for it, we might make some headway.

 

[WisNeuro]

For certain types of treatment to be linked to psychology, we would first need to show that our our training makes us uniquely qualified to perform said treatment. Going to need some independent, well-designed studies for that. Also, I don't think we can do much to limit the scope of mid-level providers when we have diploma mills with arguably poorer training than those mid-level providers churning out hundreds of graduates. We'd have to clean house before we fight for some of those exclusive rights.

 

[LAPsyGuy]

For certain types of treatment to be linked to psychology, we would first need to show that our our training makes us uniquely qualified to perform said treatment. Going to need some independent, well-designed studies for that. Also, I don't think we can do much to limit the scope of mid-level providers when we have diploma mills with arguably poorer training than those mid-level providers churning out hundreds of graduates. We'd have to clean house before we fight for some of those exclusive rights.

You're making my point. Thank you. These are tasks the APA should be taking seriously. Professions gate-keep entry into their professions and the content of their profession, meaning they also control the educational process and structure. We turn out too many degree, and many are of poor quality. Let's clean it up as a profession.

We see the medical profession under attack from many angles. PAs and NPs attempting to practice independently, psychologists trying to prescribe, etc. Doctors have managed to control their practice with little research support, but they controlled their profession from the beginning. It will take work, but it needs to be done, and it will probably take research as support, but more than anything else, it's about public perception and politics.

 

[WisNeuro]

You're making my point. Thank you. These are tasks the APA should be taking seriously. Professions gate-keep entry into their professions and the content of their profession, meaning they also control the educational process and structure. We turn out too many degree, and many are of poor quality. Let's clean it up as a profession.

We see the medical profession under attack from many angles. PAs and NPs attempting to practice independently, psychologists trying to prescribe, etc. Doctors have managed to control their practice with little research support, but they controlled their profession from the beginning. It will take work, but it needs to be done, and it will probably take research as support, but more than anything else, it's about public perception and politics.

The size of the war chest plays into this. Mo money = mo money for lobbyists. One reason I imagine we have so many degrees being churned out, the FSPS's also have money and sponsor APA. I've written to the APA with regards as to my feelings about their decisions and why I am no longer a member. My money goes to my professional neuropsych orgs, who have done a reasonably good job at advocating for my needs.

But, as for thinking that the APA only deals with torture policies, I would actually charge people with looking into what the APAPO does. Recently, they have lobbied as part of the SGR mess, allowing psychologists to bill without certain referrals first, and issues related to shrinking reimbursement for certain billing codes. I don't think people really know what the APA/APAPO does and doesn't do. This information is freely available to those interested in it.

 

[smalltownpsych]

For certain types of treatment to be linked to psychology, we would first need to show that our our training makes us uniquely qualified to perform said treatment. Going to need some independent, well-designed studies for that. Also, I don't think we can do much to limit the scope of mid-level providers when we have diploma mills with arguably poorer training than those mid-level providers churning out hundreds of graduates. We'd have to clean house before we fight for some of those exclusive rights.

No, we don't need to show that we are superior to MA level people for treatment or even try to prevent them from providing treatment. The last few jobs that I have had hired me because they believe a psychologists has a superior skill set. We rely on research too much when the rest of the world doesn't care. We also need to market ourselves. It's just like the MDs don't need to cite research to demonstrate that their prescribing is superior and they win in state after state against us. It is great that we are experts on research and use it to guide our interventions, but sometimes your greatest strength is also your greatest weakness.

 

[WisNeuro]

No, we don't need to show that we are superior to MA level people for treatment or even try to prevent them from providing treatment. The last few jobs that I have had hired me because they believe a psychologists has a superior skill set. We rely on research too much when the rest of the world doesn't care. We also need to market ourselves. It's just like the MDs don't need to cite research to demonstrate that their prescribing is superior and they win in state after state against us. It is great that we are experts on research and use it to guide our interventions, but sometimes your greatest strength is also your greatest weakness.

That may be where we differ. Honestly, if a social worker can deliver a service with just as much efficacy, for a fraction of the cost, that is awesome. It's better for the patients. I'm not a fan of turf wars simply for the sake of the turf. If we want exclusivity in things, I think we should be able to show our value in those things. I think all areas of healthcare need to do this. We have a broken, bloated healthcare system. If we can streamline it and make it more cost effective, let's do it. If you want to be a valuable component of that system, show your worth.

 

[LAPsyGuy]

The size of the war chest plays into this. Mo money = mo money for lobbyists. One reason I imagine we have so many degrees being churned out, the FSPS's also have money and sponsor APA. I've written to the APA with regards as to my feelings about their decisions and why I am no longer a member. My money goes to my professional neuropsych orgs, who have done a reasonably good job at advocating for my needs.

But, as for thinking that the APA only deals with torture policies, I would actually charge people with looking into what the APAPO does. Recently, they have lobbied as part of the SGR mess, allowing psychologists to bill without certain referrals first, and issues related to shrinking reimbursement for certain billing codes. I don't think people really know what the APA/APAPO does and doesn't do. This information is freely available to those interested in it.

The torture statement was an intentional overstatement, but my point about the APA's crappy and misplaced priorities stands.

You're part of the problem because you're no longer demanding better advocacy. Bummer. Get it together. Think about rejoining and running for office, ya lazy bum (kidding, jeez). I do wonder if what qualify as your "needs" aren't a little too narrow and individualistic. Just wondering

Yes, the APA does get money from all of the mills students and programs, BUT the mill students are over-represented in advocacy and governance because of their disproportionate numbers (and perhaps less than ideal training). All it will take is for people from better programs to run for those slots instead of ceding them to those from mills. Mills are much better at pushing for advocacy, perhaps other training programs should be following suit.

Yes, the APA pursuing real status as a profession will take money, no doubt. My guess is that it would be a worthwhile investment. Medicine seems to be lettering go mental health treatment beyond medication, so maybe it's our time to make a move.

 

[LAPsyGuy]

No, we don't need to show that we are superior to MA level people for treatment or even try to prevent them from providing treatment. The last few jobs that I have had hired me because they believe a psychologists has a superior skill set. We rely on research too much when the rest of the world doesn't care. We also need to market ourselves. It's just like the MDs don't need to cite research to demonstrate that their prescribing is superior and they win in state after state against us. It is great that we are experts on research and use it to guide our interventions, but sometimes your greatest strength is also your greatest weakness.

Agreed, it's marketing and politics. We can do it too.

 

[WisNeuro]

All about priorities, I've no interest in rejoining and running for APA office at this time. I've considered e-board type stuff through my npsych orgs. Sometimes you have to pick your causes, can't fight for them all.

Also, I don't think the mills graduates are stacking the e-boards of these organizations, so I don't think it's a matter of simply making sure reputable programs get those seats.

 

[LAPsyGuy]

That may be where we differ. Honestly, if a social worker can deliver a service with just as much efficacy, for a fraction of the cost, that is awesome. It's better for the patients. I'm not a fan of turf wars simply for the sake of the turf. If we want exclusivity in things, I think we should be able to show our value in those things. I think all areas of healthcare need to do this. We have a broken, bloated healthcare system. If we can streamline it and make it more cost effective, let's do it. If you want to be a valuable component of that system, show your worth.

If only the world actually worked that way. Proving technical superiority doesn't guarantee anything. Being to send an effective message about that superiority is also key. There's a reason people waste millions of dollars per year on homeopathy, and most of it has to do with messaging.

One of the reasons the system is bloated is because of greed. Let me know how we rid our system of that particular sin.

 

[LAPsyGuy]

All about priorities, I've no interest in rejoining and running for APA office at this time. I've considered e-board type stuff through my npsych orgs. Sometimes you have to pick your causes, can't fight for them all.

Also, I don't think the mills graduates are stacking the e-boards of these organizations, so I don't think it's a matter of simply making sure reputable programs get those seats.

Understood, though my argument wasn't just for you. I was trying to make a bigger point, but too many people respond the way do, and that's one of the reasons we're in this mess.

 

[WisNeuro]

Yes, there is a reason sham treatments and empty proclamations work in today's world. I'd just rather have no part of it, personally. If people want to deliver a message about the superiority of something, I believe they should have some substance behind that message.

 

[LAPsyGuy]

Yes, there is a reason sham treatments and empty proclamations work in today's world. I'd just rather have no part of it, personally. If people want to deliver a message about the superiority of something, I believe they should have some substance behind that message.

Totally not my point, and did you really think it was? Hmm. I'm not suggesting we trumpet sham treatments. I'm suggesting we pay attention to our messaging and trumpet our real and effective offerings. Why isn't the APA putting up billboards about psychological treatment of depression and anxiety? (This is an example, don't get in a huff, everybody).

 

[futureapppsy2]

OP, you do realize that your program, while not a straight-up diploma mill, has many of characteristics of programs that have contributed to over-saturation and poorer quality control in this field, such as low APA match rate, large cohort, and little/no funding? I'm sure excellent psychologists have trained there--and teach there--but you can say the same for Argosy and Alliant. I do know excellent alum and faculty from Argosy and Alliant, but I still can't say that I think the institutions as whole are good for our field. It's the institutional practices as a whole that are problematic and have created a glut of people in this field, bottlenecks at internship, and lack of standardized, carefully overseen training or mentorship (I don't believe that you can mentor cohorts of 30-50 the same way that you mentor cohorts of 7-10).

 

[WisNeuro]

Totally not my point, and did you really think it was? Hmm. I'm not suggesting we trumpet sham treatments. I'm suggesting we pay attention to our messaging and trumpet our real and effective offerings. Why isn't the APA putting up billboards about psychological treatment of depression and anxiety? (This is an example, don't get in a huff, everybody).

I understood your message. I was commenting on the intent of trumpeting our superiority of certain things, even if we don't have evidence supporting that notion.

For the record, the APA spends a good deal of money on outreach and public education. One could always argue they do it in different ways, but it's there.

 

[LAPsyGuy]

I understood your message. I was commenting on the intent of trumpeting our superiority of certain things, even if we don't have evidence supporting that notion.

For the record, the APA spends a good deal of money on outreach and public education. One could always argue they do it in different ways, but it's there.

How would it be superior if there is no evidence supporting it?

Would you say the APA spending has been effective?