Internship, advocacy, and professional issues in psychology

[erg923]

I am glad to see that your program does not require an APA internship. Given the imbalance at current, it seems paternalistic of programs and an undue burdern on students.

That said, I still would never recommend anyone take an unaccredited internship. A legitimate healthcare profession should not even be offering internships that are not "accredited" by a peer reviewing body. Its embarrassing. I think this needs to be kept in mind when one is tempted to think that more intenrships in the answer to this problem. Decrease the supply. Even decreasing by 500 students would make a huge difference in the imbalance (maybe then only the bad eggs that slipped in are the ones that get weeded out). Thats a couple Alliants and 4 or 5 Argosy's probably?

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[WisNeuro]

Pssh, that's like only a few Argosy's given those crazy big class sizes. But yeah, non accredited internships are a bad idea, makes our profession look like a joke when I see these people practicing. Kind of the equivalent of the back-alley plastic surgeon who is using bathroom caulk in lieu of silicon implants.

 

[let it go]

However, if people didn't take APPIC sites, how many would actually match?

 

[WisNeuro]

The answer should never be loosening standards. This is a supply-side problem, not a demand side problem. Outside of rural areas (where all medical providers are scarce) there is no shortage of psychologists. In the several hospitals I've been at in the past 5 years, we have no problem filling vacant psych positions after receiving a slew of applications for each position. I'm sure my colleagues at other medical centers will corroborate. So, I don't see how loosening standards by not requiring APA accreditation does anything but actually make the root problem worse.

 

[PsyDr]

If this were a supply side problem then midlevel scope creep would not be an issue.

 

[WisNeuro]

If it were only a supply side problem that would not be an issue. However, we have historically been terrible at advocacy within the organization. Mid-level providers aren't getting hired due to a shortage of psychologists, they're getting hired because they will work for far less to do similar work. That in turn pushes PhD level salaries down.

 

[erg923]

However, if people didn't take APPIC sites, how many would actually match?

If unaccredited where phased out over next few years, enrollment would decrease at the highest offending instituitions.

 

[PsyDr]

If by advocacy, you mean legal scope restriction, then you are absolutely correct. SLPs are allowed to perform "neurocognitve testing" and do so. CRNAs are allowed and do perform language function testing in awake craniotomies. I am 100% certain you have experienced in this and that your departments do not advocate for this practice to stop. In the former case, I can see why payment would go down. In the latter, this argument does not hold.

 

[WisNeuro]

If by advocacy, you mean legal scope restriction, then you are absolutely correct. SLPs are allowed to perform "neurocognitve testing" and do so. CRNAs are allowed and do perform language function testing in awake craniotomies. I am 100% certain you have experienced in this and that your departments do not advocate for this practice to stop. In the former case, I can see why payment would go down. In the latter, this argument does not hold.

Yes there is scope creep. You are wrong in your assertion though. We have experienced this. Neurology wanted us to train a nurse to perform wada testing. We refused and asserted that it was our domain as neuropsychologists. They relented. In Minnesota, only board certified Npsych's are allowed to bill for certain CPT codes related to neurocog testing. Not everyone is a passive bystander in scope creep.

 

[member978]

This might not be the right topic for this question, but I have been wondering about the problem of the supply side. I am a PhD student and understand many of the concerns of certain PsyD training models but there is one thing i dont fully understand.

My question is that if these programs are so bad, then why are they still matching to APA sites (even if at a much lower rate and lower percentage)? Maybe it is wrong to assume that internship sites are making valid judgements of competency, but if some of those students are deemed qualified enough to complete an accredited internship, then wherein lies the precise problem? Simply reducing the number of total applicants would be great, and I know many very qualified applicants dont match for an internship every year, but at the same time, are those PsyD school students who do match and "take the spots" less deserving or less qualified?

 

[WisNeuro]

This might not be the right topic for this question, but I have been wondering about the problem of the supply side. I am a PhD student and understand many of the concerns of certain PsyD training models but there is one thing i dont fully understand.

My question is that if these programs are so bad, then why are they still matching to APA sites (even if at a much lower rate and lower percentage)? Maybe it is wrong to assume that internship sites are making valid judgements of competency, but if some of those students are deemed qualified enough to complete an accredited internship, then wherein lies the precise problem? Simply reducing the number of total applicants would be great, and I know many very qualified applicants dont match for an internship every year, but at the same time, are those PsyD school students who do match and "take the spots" less deserving or less qualified?

Because the # of internship slots is not static. Due to pressure (some likely financial) APA has accredited many more internships in recent years. If you are a site that can offer internships, why pass on that if it can be financially rewarding? Also, next time you are at the APA conference, look around and see who their financial sponsors are.

 

[edieb]

Yes there is scope creep. You are wrong in your assertion though. We have experienced this. Neurology wanted us to train a nurse to perform wada testing. We refused and asserted that it was our domain as neuropsychologists. They relented. In Minnesota, only board certified Npsych's are allowed to bill for certain CPT codes related to neurocog testing. Not everyone is a passive bystander in scope creep.

And in Louisana, only a psychologist who completes a formal post-doc in neuropsychology can call themselves a "neuropsychologist" and conduct neuropsych testing. Psychologists need to become involved in the advocacy process by joining your state psychological association and getting laws passed to protect, and expand, our scopes of practice

 

[AcronymAllergy]

Mod Note: I went ahead and moved these posts into their own thread so that A) the former one could remain tied to post-match vacancies, and B) the current topics could continue to be discussed.

Erg, as you're now the de facto thread "author," let me know if you would like the title changed.

 

[smalltownpsych]

This might not be the right topic for this question, but I have been wondering about the problem of the supply side. I am a PhD student and understand many of the concerns of certain PsyD training models but there is one thing i dont fully understand.

My question is that if these programs are so bad, then why are they still matching to APA sites (even if at a much lower rate and lower percentage)? Maybe it is wrong to assume that internship sites are making valid judgements of competency, but if some of those students are deemed qualified enough to complete an accredited internship, then wherein lies the precise problem? Simply reducing the number of total applicants would be great, and I know many very qualified applicants dont match for an internship every year, but at the same time, are those PsyD school students who do match and "take the spots" less deserving or less qualified?

Thank you for pointing this out. It made me think a little bit.

I do agree with some of the assertions regarding the supply side problem, but do not think that placing the all of blame on the Psy.D. programs is productive. If perhaps the Ph.D. programs weren't so exclusive, then more qualified practitioners would receive the excellent education and training they provide and this would lift the standards of our field overall. I believe protectionism is a doomed paradigm that arises from a fearful stance and does not serve the field of psychology well.

 

[QAsPsych]

I do agree with some of the assertions regarding the supply side problem, but do not think that placing the all of blame on the Psy.D. programs is productive. If perhaps the Ph.D. programs weren't so exclusive, then more qualified practitioners would receive the excellent education and training they provide and this would lift the standards of our field overall. I believe protectionism is a doomed paradigm that arises from a fearful stance and does not serve the field of psychology well.

PhD programs aren't "exclusive" in any sense other than that they receive slews of qualified applicants and can only effectively fund and train a very few. There is a direct connection between training fewer students and giving the excellent education and training you note. There is, as noted here already, absolutely no need for more psychologists right now; there is not a shortage, and it would be an error to train far more than we need (which is what we are doing now, and notice how this forum and others are full of people in the field right now are noting how it is damaging the field quite a lot already).

 

[AcronymAllergy]

Thank you for pointing this out. It made me think a little bit.

I do agree with some of the assertions regarding the supply side problem, but do not think that placing the all of blame on the Psy.D. programs is productive. If perhaps the Ph.D. programs weren't so exclusive, then more qualified practitioners would receive the excellent education and training they provide and this would lift the standards of our field overall. I believe protectionism is a doomed paradigm that arises from a fearful stance and does not serve the field of psychology well.

My take on the exclusiveness of Ph.D. programs is that it exists primarily because of financial factors--the departments are committed to fully funding their students, and as such can only offer admission to a very limited number of folks (and I wouldn't want that to change, per se). I have yet to meet a Ph.D. program supervisor who wouldn't take more students if they could.

As for protectionism, I see it more from a side of protecting patients and the efficacy of the services we provide more so than a staunch, "we got here first" stance. It's the same argument psychiatrists make against psychologists and RxP: how can we be sure that a standard of care is being maintained? (And no, I don't want to start up a RxP argument here, just using it as an analogy). Do I believe/have I been convinced, for example, that a master's-level "school neuropsychologist" is able to offer competently-administered and interpreted neuropsychological assessments on par with fellowship-trained neuropsychologists? Am I even convinced that these services are offered in a way that minimizes potential harm to the client/patient? No, hence it's an area that should be protected from this type of "scope creep."

We've all heard the, "you don't know what you don't know" statement umpteen times at this point, and as content experts in mental health and psychological principles, it falls on us to define/identify, espouse, and protect (by legal means as necessary) these principles, sometimes from folks who may not "know what they don't know."

 

[smalltownpsych]

I agree that we need to protect the patients and ensure standards. I think that our mistake is that fear leads to this aspect being emphasized too much when it would be more productive to sell/educate people (and not so much the general public, but rather other health care professionals) on why a psychologist brings more to the table than the mid-levels. At any setting that I have worked, head to head with mid-level practitioners, psychologists consistently demonstrate the benefit of our additional training and experience in research, assessment, legal and ethical concerns, organizational knowledge. We just aren't that good at tooting our own horn for a variety of reasons.

 

[AcronymAllergy]

I agree that we need to protect the patients and ensure standards. I think that our mistake is that fear leads to this aspect being emphasized too much when it would be more productive to sell/educate people (and not so much the general public, but rather other health care professionals) on why a psychologist brings more to the table than the mid-levels. At any setting that I have worked, head to head with mid-level practitioners, psychologists consistently demonstrate the benefit of our additional training and experience in research, assessment, legal and ethical concerns, organizational knowledge. We just aren't that good at tooting our own horn for a variety of reasons.

I agree that we need to be better about this as well, and in all regards, not just with mid-level providers (e.g., asserting ourselves in multidisciplinary settings, advocating for and educating about the expertise we offer, etc.). But unfortunately, psychologists can't be everywhere, and even when they're in a particular setting, their voice may never be heard and/or they may simply be let go and a less-squeaky wheel hired in their place. It's in these sorts of instances that legislation is most important; additionally, the legislative component adds a measure of gravity and credence to psychologists' arguments in these areas.

 

[MCParent]

My question is that if these programs are so bad, then why are they still matching to APA sites (even if at a much lower rate and lower percentage)? Maybe it is wrong to assume that internship sites are making valid judgements of competency, but if some of those students are deemed qualified enough to complete an accredited internship, then wherein lies the precise problem? Simply reducing the number of total applicants would be great, and I know many very qualified applicants dont match for an internship every year, but at the same time, are those PsyD school students who do match and "take the spots" less deserving or less qualified?

Many students who go to PsyD programs are great, and they match. The problem is, when you admit 50, 80, 100 students in a year, you are certainly taking many about whom you could make an actuarial decision prior to admission that they will not succeed. The PsyD model itself is not a problem, only how it is implemented in programs whose owners' primary motive is profit.

 

[smalltownpsych]

I agree that we need to be better about this as well, and in all regards, not just with mid-level providers (e.g., asserting ourselves in multidisciplinary settings, advocating for and educating about the expertise we offer, etc.). But unfortunately, psychologists can't be everywhere, and even when they're in a particular setting, their voice may never be heard and/or they may simply be let go and a less-squeaky wheel hired in their place. It's in these sorts of instances that legislation is most important; additionally, the legislative component adds a measure of gravity and credence to psychologists' arguments in these areas.

I agree completely with your points. I do think it is important to continue to beat the drum of individual responsibility and representation of the profession, as well. My own anecdote to illustrate. After licensure, my first job offer was a about $10k per year more than what I was making at my post-doc (they didn't want to pay me much more either). I did not feel that it was in the range of what a licensed psychologist should make and if I accepted, then I would be contributing to the overall devaluing of my profession. It was a hard decision to make at the time, but I secured a position a few months later that was slightly above the median pay for an early-career psychologist. I just wish more of us thought this way as it would counteract the downward slide of our compensation relative to inflation.

 

[cara susanna]

I agree that we need to protect the patients and ensure standards. I think that our mistake is that fear leads to this aspect being emphasized too much when it would be more productive to sell/educate people (and not so much the general public, but rather other health care professionals) on why a psychologist brings more to the table than the mid-levels. At any setting that I have worked, head to head with mid-level practitioners, psychologists consistently demonstrate the benefit of our additional training and experience in research, assessment, legal and ethical concerns, organizational knowledge. We just aren't that good at tooting our own horn for a variety of reasons.

The issue is that having so many applicants floods the system. Sites receive more applications and therefore have less time to devote to each. They may also use cutoffs to get rid of some applications, due to having so many. Think about it, if even 20% of a cohort of 100 matches to APA sites, that's 20 people being bumped.

 

[calimich]

I think another contributing factor is the general nature/philosophy of our training as psychologists. We've mostly learned how to intervene at the individual level, and how to remedy problems once they've presented themselves. Prevention, advocacy, and system level interventions are typically not the focus of our training. Social workers seem to think more about systems, advocacy, and to a lesser extent, prevention.

For at least a decade there has been debate within counseling psychology to move away from treatment of individuals and remediation of problems, to a focus on prevention at the system level. I think this would move psychologists away from private practice and delivery of service to individuals and position us at the training/program development/consultation/legislative level. I've heard some profs say our adherence to the medical model of "treating sick people" reflects our historical inferiority complex to physicians.

 

[erg923]

I think another contributing factor is the general nature/philosophy of our training as psychologists. We've mostly learned how to intervene at the individual level, and how to remedy problems once they've presented themselves. Prevention, advocacy, and system level interventions are typically not the focus of our training. Social workers seem to think more about systems, advocacy, and to a lesser extent, prevention.

For at least a decade there has been debate within counseling psychology to move away from treatment of individuals and remediation of problems, to a focus on prevention at the system level. I think this would move psychologists away from private practice and delivery of service to individuals and position us at the training/program development/consultation/legislative level. I've heard some profs say our adherence to the medical model of "treating sick people" reflects our historical inferiority complex to physicians.

Couldnt agree more. Service delivery can no longer be the sole training focus of programs, even practice oriented ones, if we want to stay relevant, differentiated, reputable, and sustainable. Meehl said this 40 years ago!

 

[Therapist4Chnge]

RE: Mid-level encroachment, title protection, etc.

Until psychologists make the effort AND investment in the form of political involvement, this will only get worse.

 

[calimich]

RE: Mid-level encroachment, title protection, etc.

Until psychologists make the effort AND investment in the form of political involvement, this will only get worse.

A beloved prof and former dept chair challenges us by saying if we really want to make a difference to get elected to local school board, city council, county supervisor, state gov't ....governor. We could use psychologists in those positions to advocate for system wide mental health reform.

 

[JeyRo]

Many students who go to PsyD programs are great, and they match. The problem is, when you admit 50, 80, 100 students in a year, you are certainly taking many about whom you could make an actuarial decision prior to admission that they will not succeed. The PsyD model itself is not a problem, only how it is implemented in programs whose owners' primary motive is profit.

I would say how the student loan system is structured contributes mightily to the problem. If student loans were 100% dischargeable in bankruptcy, and the system wasn't dominated by federal "sub prime" lending, the for-profit education market would most likely operate far more rationally.

As such, there's no real market incentive for private or federal lenders to economize what's lent out based on actuarial data. Terrible students get graduate school financing the same way that the great students do, and the professional schools do what profit-making (or, at least, revenue-generating) institutions do - they take their dollars and try to deliver them a saleable product - from the halfway decent (like PAU) to the downright terrible (Alliant, Argosy, etc).

I think gnashing teeth about the profit motive misses the point. It's not profit that's the problem, it's not even professional schools that are the problem necessarily, it's the massively distortionary effects of the student loan system that's the problem. Just my take.

 

[QAsPsych]

I would say how the student loan system is structured contributes mightily to the problem. If student loans were 100% dischargeable in bankruptcy, and the system wasn't dominated by federal "sub prime" lending, the for-profit education market would most likely operate far more rationally.

As such, there's no real market incentive for private or federal lenders to economize what's lent out based on actuarial data. Terrible students get graduate school financing the same way that the great students do, and the professional schools do what profit-making (or, at least, revenue-generating) institutions do - they take their dollars and try to deliver them a saleable product - from the halfway decent (like PAU) to the downright terrible (Alliant, Argosy, etc).

I think gnashing teeth about the profit motive misses the point. It's not profit that's the problem, it's not even professional schools that are the problem necessarily, it's the massively distortionary effects of the student loan system that's the problem. Just my take.

I find this argument a bit like saying, "Hey, we shouldn't complain about theft, thieves are just doing what thieves do! The problem is there aren't enough people locking the doors and we need to hire more police!" In my opinion, professional schools are acting immorally, and taking advantage a system that is broken. We should also fix the system, but the professional schools are in themselves the problem.

 

[smalltownpsych]

I think another contributing factor is the general nature/philosophy of our training as psychologists. We've mostly learned how to intervene at the individual level, and how to remedy problems once they've presented themselves. Prevention, advocacy, and system level interventions are typically not the focus of our training. Social workers seem to think more about systems, advocacy, and to a lesser extent, prevention.

For at least a decade there has been debate within counseling psychology to move away from treatment of individuals and remediation of problems, to a focus on prevention at the system level. I think this would move psychologists away from private practice and delivery of service to individuals and position us at the training/program development/consultation/legislative level. I've heard some profs say our adherence to the medical model of "treating sick people" reflects our historical inferiority complex to physicians.

I disagree just to the extent that I believe that the correct answer is psychologists should be: D. All of the above. To me that is our strength. I would not to throw out the fact that we are experts on psychotherapeutic interventions either.

 

[JeyRo]

I find this argument a bit like saying, "Hey, we shouldn't complain about theft, thieves are just doing what thieves do! The problem is there aren't enough people locking the doors and we need to hire more police!" In my opinion, professional schools are acting immorally, and taking advantage a system that is broken. We should also fix the system, but the professional schools are in themselves the problem.

Well, except that all other things being equal, professional schools aren't actually thieves, and if the student loan system was changed in the way I'm suggesting, there wouldn't be any need to hand-wring about licensure or accreditation standards, or demonize the profit motive.

 

[AcronymAllergy]

Well, except that all other things being equal, professional schools aren't actually thieves, and if the student loan system was changed in the way I'm suggesting, there wouldn't be any need to hand-wring about licensure or accreditation standards, or demonize the profit motive.

I just saw an article talking about how graduate student loan debt is "ballooning" right now, so between these sorts of pieces (of which I've been seeing more lately) and the proposed PSLF changes, I wonder if the "winds of change" are blowing for student loans.

 

[Therapist4Chnge]

PSLF Changes + Subsidized Loan Changes = $$$$ cost in the long run. Compound interest can be crushing at $50k, $100k, $200k+.

$120k @ 6.8% on a 10 yr repayment plan = ~$1380/mon
Interest paid = ~$46k
Total cost: $166k

$200k @ 6.8% on a 10 yr repayment plan = $2300/mon
Interest paid= ~$76k
Total cost: $276k

This assumes 10yrs…which is most likely not doable for most people unless you earn $150k+/yr.

 

[WisNeuro]

PSLF Changes + Subsidized Loan Changes = $$$$ cost in the long run. Compound interest can be crushing at $50k, $100k, $200k+. At 6.8% a $120k loan (assuming compounded interest, fees, etc are all included) will cost ~$1380/mon for 120 payments (10 years) and interest paid will be a hair under $46k…in just interest.

Yeesh, not an easy pay back with some salaries. Do the math before you take out the loans kids.

 

[psychrat]

The issue is that having so many applicants floods the system. Sites receive more applications and therefore have less time to devote to each. They may also use cutoffs to get rid of some applications, due to having so many. Think about it, if even 20% of a cohort of 100 matches to APA sites, that's 20 people being bumped.

I often times find myself feeling bitter towards professional schools. I go to a university based PhD program and did not match and feel that I have better training than many alliant and argosy students who matched this year and bumped me

 

[psychtalk1274]

I often times find myself feeling bitter towards professional schools. I go to a university based PhD program and did not match and feel that I have better training than many alliant and argosy students who matched this year and bumped me

I feel the exact same!

 

[erg923]

I often times find myself feeling bitter towards professional schools. I go to a university based PhD program and did not match and feel that I have better training than many alliant and argosy students who matched this year and bumped me

But you have also learned that selling your skills and your "fit" with a site is half the battle with that there internship. Its no different than the job market, really.

Employers cant really know your skills, or if you are ACTUALLY more skilled than joe bob at certain duties. Any hiring decision is based on a mix of presumed competencey and "fit"/personality, amongst other factors.

 

[cara susanna]

I often times find myself feeling bitter towards professional schools. I go to a university based PhD program and did not match and feel that I have better training than many alliant and argosy students who matched this year and bumped me

Yeah, I felt pretty bitter towards them as I was going through the application process.

 

[CheetahGirl]

...Those psychoanalytically trained at Argosy, Alliant, etc. would call that displacement...
especially for those unempathic (not saying anyone here, mind you), research-heavy, university-based, funded (well, almost a free-ride), phd folks.

Sublimation is the way to go. Challenge that anger into something productive. And I'll do the same. No "House of Cards" here (I won't run for Congress just yet), but when called do our part, support professional standards and perhaps it will mitigate the imbalance. Set the standards high, raise the bar, the whole nine yards. I like that anecdote about sucking it up but then making a conscious effort to be valued for what you are worth.

I support States imposing restrictions on licensure, like no APA-internship, no license in this town (move elsewhere if you can't stand the heat - or have to account for a non-APA eligible license b/c of the *#6@ imbalance). But eventually when the job market sifts through the highly-skilled professionals who are economically viable, the State agencies won't want sub-par clinicians who are tardy, unethical, lazy (not anyone here). And one by one, each State will learn to up their standards because their sister State is far more productive with their mental health management. Ideally.

 

[cara susanna]

...Those psychoanalytically trained at Argosy, Alliant, etc. would call that displacement...
especially for those unempathic (not saying anyone here, mind you), research-heavy, university-based, funded (well, almost a free-ride), phd folks.

What would the "real" target of our anger be then? APA? Because I didn't exactly have great feelings towards them, either.

And, yeah, I am going to try to make a productive use of that anger.

 

[CheetahGirl]

Perhaps the training program itself for being so slack (we can't readily hate those who we just spent months loving the potential and imagining ourselves there, can we?...not love & hate so quickly that's so blk/wht), and for not seeing greatness in us (compared to [X's program's] applicant).

...so the obvious targets have to be those 'professional students' (aka. those other 'doctoral trainees' - because no matter what, we are all lumped into that title during internship). I can imagine they are the trainees who still watch Dr. Phil and read Psychology Today as a means of 'peer-review' and secretly hope to publish there (!) because their program did not educate them on the contemporary, progressive-nature, and scientific-bases of the field enough to make a keen judgments between what is garbage and what is not (Wasn't there like some bird dissertation from one such program? Like a raven or something?).

 

[eowyne]

I find this argument a bit like saying, "Hey, we shouldn't complain about theft, thieves are just doing what thieves do! The problem is there aren't enough people locking the doors and we need to hire more police!" In my opinion, professional schools are acting immorally, and taking advantage a system that is broken. We should also fix the system, but the professional schools are in themselves the problem.

And they are rewarded because, among other reasons, APA won't use its accreditation power to crack down on them. It would be fairly straightforward to set restrictions such as only allowing programs to admit the number of students that they matched to APA internships in the previous year, or requiring programs to match an average of x% of students to APA internships. IMHO, APA needs to get a spine. It's a disgrace to the field and disservice to students that APA continues to give its seal of approval to programs with such poor outcomes.

Another place to intervene is with faculty who teach and advise undergraduates considering career options with their psych degrees. This is minimally emphasized in most programs and students don't know nearly enough about the different options. Then they sign up for programs that are "accredited" by APA, the government throws easy money at them, and they get screwed in the long term. Most faculty want to help their students, but I would wager that most, especially those from non-clinical areas of psych, have no idea about the scope of problems with doctoral training in psychology.

 

[AcronymAllergy]

And they are rewarded because, among other reasons, APA won't use its licensing power to crack down on them. It would be fairly straightforward to set restrictions such as only allowing programs to admit the number of students that they matched to APA internships in the previous year, or requiring programs to match an average of x% of students to APA internships. IMHO, APA needs to get a spine. It's a disgrace to the field and disservice to students that APA continues to give its seal of approval to programs with such poor outcomes.

Another place to intervene is with faculty who teach and advise undergraduates considering career options with their psych degrees. This is minimally emphasized in most programs and students don't know nearly enough about the different options. Then they sign up for programs that are "accredited" by APA, the government throws easy money at them, and they get screwed in the long term. Most faculty want to help their students, but I would wager that most, especially those from non-clinical areas of psych, have no idea about the scope of problems with doctoral training in psychology.

Just as a quick clarification, I think you might've meant APA's accreditation power, as APA doesn't have any licensing power itself (that's up to the states). However, I do think the APA (and other organizations) should take a larger role in further petitioning states for uniform licensing standards that includes a minimum bar of training at each level. If the APA is going to accredit graduate programs and internships, then they really should also see that this accreditation matters outside the field of psychology.

To speak to CheetahGirl's post, as I mentioned before, I agree that we need to take more active roles in our daily lives in advocating for our worth as independent, doctoral-level providers. but in my opinion, that's not enough. I honestly don't trust states to eventually wise up that they should increase/require minimum standards. And even if they do realize it at some point, who's to say who'll end up advising them on it if we don't proactively step up and lobby/advocate as experts in the area. Also, an individual doesn't really need to be tardy/lazy/unethical to be a bad hire; they simply need to be poorly trained, which is the greater danger, as they then won't throw up any highly-visible red flags to others.

 

[erg923]

If this were a supply side problem then midlevel scope creep would not be an issue.

Well, its a "supply issue" if you think about it strictly in terms of applicant to internship ratio. Should we be pumping out hundreds and hundreds more students than there are internship slots for? If your answer is yes, then I would have to ask: Why?

 

[JeyRo]

Perhaps the training program itself for being so slack (we can't readily hate those who we just spent months loving the potential and imagining ourselves there, can we?...not love & hate so quickly that's so blk/wht), and for not seeing greatness in us (compared to [X's program's] applicant).

...so the obvious targets have to be those 'professional students' (aka. those other 'doctoral trainees' - because no matter what, we are all lumped into that title during internship). I can imagine they are the trainees who still watch Dr. Phil and read Psychology Today as a means of 'peer-review' and secretly hope to publish there (!) because their program did not educate them on the contemporary, progressive-nature, and scientific-bases of the field enough to make a keen judgments between what is garbage and what is not (Wasn't there like some bird dissertation from one such program? Like a raven or something?).

So who are we to get angry about re. the mortgage loan crisis? The carrot-pickers and minimum-wage-earners who took out option-ARM loans on a monster home? I already said my piece about getting angry at the profit motive, that seems just silly and misplaced.

 

[JeyRo]

Well, its a "supply issue" if you think about it strictly in terms of applicant to internship ratio. Should we be pumping out hundreds and hundreds more students than there are internship slots for? If your answer is yes, then I would have to ask: Why?

The "why" answer from an economics perspective is pretty obvious - the professional schools have virtually no incentive to not to keep churning out graduates. This is because the way government and private lending institutions are currently set up, these institutions will supply any and all potential students $$$ to attend these programs, regardless of viability. Federal loans are given out to virtually anyone with a pulse. Non-dischargeability gives private institutions far less incentive to be choosy in terms of who they loan the money out to (because they can follow you to the grave).

Choke off the federal dollars, allow loans to be discharged in bankruptcy (equal protection under the law anyone? school loans shouldn't be treated differently than any other loans) - and bingo. We should all become fiscal conservatives on this issue, like, yesterday.

 

[eowyne]

Just as a quick clarification, I think you might've meant APA's accreditation power, as APA doesn't have any licensing power itself (that's up to the states).

Yes, I meant accreditation - sorry for the typo.

 

[erg923]

How bout ALL the above variables contribute to the problem. All can be faulted. I think the student loan system needs to be austered, I think many FSPS are unethical for taking that many students and setting their tuition at a figure suspiciously close to (or slightly over) the max yearly disbursement of fed loan money (Stafford loans). And yes, I blame students (although perhaps slightly less) for being financially naive/shortsighted (irrational?) and settling for training that is often supar, not research focused, and hurts the larger reputation of the profession. I think the simplest way to solve the crisis, if we could get any cooperation, would be to scale back enrollment by several hundred students each year for the next 4 or 5 years. Then phase out allowing "unaccredited internships" over the subsequent years.

We generate thousands of psychologists every year in this country, yet my state currently has about 4 openings (a few more if you count school psychologists and academic positions). Something doesn't match up here. Cutting back in order to be ethical in the admission and graduation of our professionals does not seem like it would be that big of a deal to me.

 

[erg923]

And all the above seems very rationale/logical and respectful to me. It doesn't throw anyone under the bus completely, yet both students and NCSPP folks seem up in arms about solutions similar to this? Why, exactly? Who does this hurt, exactly? FSPS can still exist, students can still be admitted, but we just keep it within reason and current market demands. Whats the problem?!

 

[smalltownpsych]

I really like the idea of limiting the number of students enrolled to the number of students matched to APA sites, or even better make a certain percentage be required to maintain APA accreditation. I feel this could go a long way toward remedying some of the current issues we face. The student loan issue would be harder for psychologists to effect much change although I agree that the easy money student loan bubble is a huge problem for the country as a whole.

 

[MCParent]

I think the simplest way to solve the crisis, if we could get any cooperation, would be to scale back enrollment by several hundred students each year for the next 4 or 5 years. Then phase out allowing "unaccredited internships" over the subsequent years.

I couldn't agree more with your post. In fairness to professional schools, if you look at C-20 data for many of them over the last 5 years, many really did drop enrollments, some to a pretty considerable extent. The problem is that a small number of programs (Adler has been mentioned on the board several times, and they definitely did this though there are more) scaled UP their enrollments and presumably grabbed up all the people who would not have gotten in elsewhere (and who will add to the applicant pool in 4-6 years). This speaks to me even more to move away from the "psyd vs phd" issue to individual program accountability, and bringing a hammer down on individual programs that do insane, unprofessional, and damaging practices like that.

It's never been clear to me, from years of working on this, why so many in APA admin are so resistant to the clear ideas you've mentioned. I certainly never shut up about them in meetings. Money is probably one thing (e.g., the funding of convention by professional schools), but my experience was that many of the musical chairs APA board members (i.e., the people who are on it forever and just rotate around boards) don't want to do anything that could make for the meetings to be actual work, rather than siting around a very fancy hotel and eating for free for a few days. A few years ago, I remember I was in an APPIC meeting and mentioned discrepancies in C-20 data and APPIC's data on program match rates, and was shouted down by the NCSPP chair. Now, several years later, there is recognition of widespread creative accounting of those statistics by programs. Oh, well. Never attribute to malice that which is adequately explained by laziness, I suppose. All the more reason for people like us to be involved--there is no magical "the APA" or "the state board" floating in the sky determining our fates; we can get on these boards and make people do things.

 

[member978]

I think the simplest way to solve the crisis, if we could get any cooperation, would be to scale back enrollment by several hundred students each year for the next 4 or 5 years. Then phase out allowing "unaccredited internships" over the subsequent years.

So if this is the solution, is this even possible with the current approach some schools take? And I'm not asking you specifically, but just posing the question more broadly, what possible incentive would professional schools have for reducing their enrollment when they are currently making good money off of large class sizes? It seems like some of these institutions operate more like a business than an education system, where the bottom line holds more decision power than ethics of quality training.

Would I be correct in thinking that might be one of the bigger issues standing in the way of a potential solution?