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Occupy the imbalance!

Discussion in 'Psychology [Psy.D. / Ph.D.]' started by MCParent, 01.10.12.

  1. MCParent

    MCParent SDN Bronze Donor Bronze Donor

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    I hadn’t known about the release of the qualitative APPIC data at http://www.appic.org/Match/MatchStatistics/CommentsaboutImbalance.aspx (posted by futureapppsy2). Reading the comments made me furious.

    I think a great many students are suffering in silence, believing in the need for change to the system in the direction of better controlling numbers of applicants but feeling like they don’t have much influence over policy.

    So, it’s time for that to change. Graduate students represent a third of all APA members (http://www.apa.org/apags/about/index.aspx). This is one of the largest constituents of APA. But, individual students rarely act to leverage this membership power. This is unfortunate, because there are a lot of things students can do.

    And here they are. First, we have to recognize that there’s a lot of misinformation and myths about what can be done about the imbalance that need to be dispelled. Linking accreditation and match rates is not violation of antirust laws (Stedman et al., 2009; two authors on this paper are actual lawyers and not just psycholoigsts talking about law). This is a misperception based on early proposals that were clearly violation of antitrust law (e.g., saying programs can only take 10 students a year). Match rates are a legitimate marker of program performance/outcomes for students and it is perfectly reasonable to link match rates and accreditation; anyone who says different is not informed about the legal issues surrounding this.

    You can become move involved in APAGS. APAGS is our representation to APA. It’s made up of students. Most positions are elected, and people running for the position post their positions on issues online (and often do things like create a facebook campaign page). So, look at the applicants. See what their positions are. Ask them about their opinions on the imbalance through their facebook campaign pages. Vote for people who are going to make sure the internship crisis is a predominant topic in everything APAGS does. Run for APAGS positions yourself. Email APAGS governance members.

    Talk to your APAGS campus rep. You should have one. Their job is to report to the Advocacy Coordinating Team of APAGS. Let them know that you want the internship imbalance clearly addressed by APAGS. If you don’t have a campus rep, become one.

    Let APA know what you think about the imbalance. Multiple aspects of APA are involved in the imbalance. I’d suggest you look at the list of Councils of Chairs of Training Councils, who represent the interests of training councils (e.g., clinical psychology programs, counseling psych programs, professional schools, school psych). The list of members is here http://psychtrainingcouncils.org/members.html. Find who represents you and let them know that the imbalance is a serious problem that needs to be addressed immediately, and APA needs to make decisive actions and generate solutions.

    The Board of Educational Affairs is another major player. http://www.apa.org/ed/governance/bea/index.aspx. Let them know what you think about the imbalance. Attend seminars and talks by the members, at APA and elsewhere, and encourage discussions about the internship crisis.

    Go to the APA convention. Attend sessions about the internship and the imbalance and ask hard questions of members of APA governance. No one likes to ask these questions, but these difficult dialogues need to happen. Make governance know that this is a problem and we’re not going to let it continue to get worse.

    Start discussions on professional listserves. Ask others what they think about the imbalance. Encourage difficult dialogues. Encourage divisions to weigh in about the imbalance. Become a student rep for divisions.

    Students are the ones who suffer in this problem. Many others care, but their real investment is limited. We’re the ones who have risk and potential loss. We’re the ones who should be acting to make sure concrete actions to resolve the imbalance are taken. Posting on a message board is good for catharsis, but we all know that catharsis is a poor substitute for behavioral activation. ☺

    Oh, and join my facebook group ☺ http://www.facebook.com/groups/223654767715768/

    References
    Stedman, J. M., Schoenfeld, L. S., Carroll, K., Allen, T. F. A. Jr. (2009). The internship supply–demand crisis: Time for a solution is now. Training and Education in Professional Psychology, 3(3), 135-139. doi: 10.1037/a0016048
  2. Jon Snow

    Jon Snow Senior Member

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  3. Rivi

    Rivi

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    Can I wear my V for Vendetta mask?
  4. MCParent

    MCParent SDN Bronze Donor Bronze Donor

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    No. But you CAN kick it into gear and become an advocate for yourself, your colleagues, and the future of your profession.

    Don't just read it, don't just talk about it. DO it.
  5. edieb

    edieb Senior Member

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    Seeing there will be a lot of disgruntled, unmatched students in month or so, it would be a great idea to start a petition to send to APA. We could send it to the APPIC listserv, etc
  6. MCParent

    MCParent SDN Bronze Donor Bronze Donor

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    Brilliant! What should it say?

    What are other ways to act to move toward solving the crisis?

    Btw, though others may not realize it, the other petition had a very large effect. People at APA knew about it and it increased pressure to act.
  7. PerhapsMaybeOk

    PerhapsMaybeOk

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    What percentage of people never match? I know it sounds like a crisis, but the process works in a weird way. I mean, there isn't a crisis of psychologists is there? (Playing the devil's advocate).
  8. MCParent

    MCParent SDN Bronze Donor Bronze Donor

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    In 2011, using the phase 1 and 2 data:

    There were 4199 applicants and 2339 APA/CPA spots filled. APA accreditation is the only systematic quality assurance available (YES of course there are many quality non-accredited internships... there are many more low-quality, unpaid, monkey labor ones).

    That's an APA/CPA rate of 56%.
  9. erg923

    erg923 Psychologist-Department of Veterans Affairs (VA)

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    Actually, I think many people have argued exactly this.

    That the profession, as a whole, has an "identity crisis", plummeting reimbursement for for all its primary services, is generally undervalued in the healthcare system whilst also overvaluing ourselves and our services in many ways, has ego problems, has amazing poor lobbying and professional unity, has profound variation in training quality and standards, and is overall misunderstood and poorly marketed to the public (I'm thinking of neuropsychology with that last point). I would call this a crisis of of sorts...
    Last edited: 01.11.12
  10. yeti2213

    yeti2213

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    No. We will be using a santa clause mask like the one that freaked out Little Albert.


    This is a good idea btw. I support. I am willing to do something. If we act now, maybe this will not be as big a problem in 5 years or so when I am trying to match.
  11. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty Moderator Emeritus

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    If you consider how many people don't even enter the APPIC match and/or do not re-apply to the match, the % of all newly trained psychologists completing APA or CPA-acred. internships is probably <50%. There are some programs that actively steer their students to CAPIC or alternative programs, which is a huge red flag to me. I know programs want to help their students by providing them ways to get hours towards licensure, but this is the wrong way to go about trying to help them. The spots are often unpaid, have less oversight, and limit where the student may be eligible to work. A quick look through job posting and you'll see the vast majority of jobs say, "must have completed an APA/APPIC internship".
  12. erg923

    erg923 Psychologist-Department of Veterans Affairs (VA)

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    Did anything ever come of the petition SDNers helped assemble last year? It had alot of signatures. There was some backlash I know though because of its targeting of professional schools (due to their average cohort size).
  13. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty Moderator Emeritus

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    I know it was mentioned on a couple of listservs, but I'm not sure it actually got submitted to the APA. I think the person who started it dropped off the radar, so there was no mechanism to actually submit it because only the person who starts the petition can submit it.
  14. Jon Snow

    Jon Snow Senior Member

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    I don't know of it was ever formally submitted by that website but my understanding is that the relevant committees at apa saw it and discussed the issues. We are also not the only people that have submitted such sentiments to apa and other organizations. For example linas bieliskas (sp) in his ins presidential address years ago talked about some of the issues that were referenced in the petition
  15. cara susanna

    cara susanna Predoctoral Intern

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    How is limiting the number of students a program can take violating anti-trust laws? I've heard it before so I'm not doubting you, I'm just wondering.
  16. AcronymAllergy

    AcronymAllergy Neuropsychologist Moderator

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    It's good to know that we aren't the only pocket of individuals concerned enough to have submitted something like that petition, and it's also good to know that APA/APPIC saw it.

    That being said, submitting another one this year (and every year thereafter) probably isn't going to hurt. It's perhaps just one less time people in the position to effectively do something about the issue will have to hear it before change starts to occur.
  17. MCParent

    MCParent SDN Bronze Donor Bronze Donor

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    The petition was seen. It had a substantial impact.
  18. PerhapsMaybeOk

    PerhapsMaybeOk

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    Why? Let's say we doubled the internship sites; what good would that do? Either way, the field is over-saturated. Reducing the number of those who pursue doctoral degrees is the only option, and, as long as there is profit from that, it is unlikely to happen until the system implodes.
  19. AcronymAllergy

    AcronymAllergy Neuropsychologist Moderator

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    I wonder if maybe you quoted the wrong post? I didn't at all mean to infer that I support attempting to increase the number of internship spots rather than decreasing the number of applicants (personally, I think the latter is a healthier, more realistic, and more sustainable short- and long-term goal).
  20. PerhapsMaybeOk

    PerhapsMaybeOk

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    I was asking 'why do another petition?' I have a hard time believing it had much effect. Do you think it had an effect?
  21. sacredrage

    sacredrage

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    I lurk these forums because my significant other is applying to Clinical PhD programs. I agree with PerhapsMaybeOk's perspective as quoted above in that there are simply too many psychologists. If people choose to attend a program with historically poor placement performance they are also choosing to accept the risk that comes with finding placement with said institution. A quick google search takes you to the APPIC which prominently displays match data for each school. I am not insensitive to the frustration that many good people/students feel in this regard, but I can tell you my significant other and I have had some tension (and downright fights) over my insistence that she only apply to top tier programs. The aforementioned concern was directly a result of my discovery of those issues addressed in this thread. If I, a lowly lurker on these forums, can find this information and am well aware of the situation why wouldn't the consumers of graduate psychology education be well aware of this risk as well?

    I would think the easy thing to do is increase the standards for APA accreditation. This would simultaneously improve the average quality of the admitted student pool by increasing the scarcity (and thus the competition for) psychology doctorates and force institutions to improve the rigor/quality of the education that they offer to meet the new standards. This ultimately benefits the consumer of psychology services by limiting the practicing psychologist pool to more adept, better trained, practitioners. Bottom Line: The availability of internships is a reflection of market demand, and the location of the bottleneck tells you this isn't a supply issue. Subsidizing more internships where there is no real need is not the solution to the problem. Get rid of the diploma mills and the lowest tier of students and the bottleneck should be substantially alleviated.

    Just my humble 2 cents.

    Good luck to everyone.
    Last edited: 01.11.12
  22. MCParent

    MCParent SDN Bronze Donor Bronze Donor

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    It had an effect. Doing another one demonstrates that the body of psychology students is not satisfied and is not letting up about it. Yes, it was and will be effective. I can be varied (online petition, letter campaign, etc.).

    In conjunction with other actions (e.g., the stuff I listed in my first post, such as supporting APAGS candidates who draw a hard line on the imbalance).

    What are YOU doing, or suggest doing, that you think WILL have an effect? It's really easy to generate a culture of "no, that's a bad idea, it won't work" and criticize the ideas of others. It's a lot harder to buck up and actually take action.
  23. MCParent

    MCParent SDN Bronze Donor Bronze Donor

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    Brilliant! We need people to be informed early and start acting! 5 years? In 5 years you can be in APAGS governance, acting with your state/provincial/territorial boards, acting within divisions as a student rep, etc. You can advocate for students and the profession while building networking and filling your CV with the leadership opportunities that are sorely missing among psych trainees.:)
  24. AcronymAllergy

    AcronymAllergy Neuropsychologist Moderator

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    As best I can recall, the previous petition--and the posts here leading up to its creation--addressed many of the same points, and suggested many of the same solutions (e.g., hold programs accountable for match rates, limit class sizes by tying them to internship placement numbers, etc.). Setting up another petition, if nothing else, would convey the point that last year's situation didn't represent an aberration in the form of a particularly vocal cohort.
  25. Jon Snow

    Jon Snow Senior Member

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    Are there additional themes people would like to highlight? Perhaps, an acknowledgment of previous calls (the last petition, the referenced presidential addressed, more articles, maybe quantifying some of the themes of quotes in the appic survey) would be useful?
  26. edieb

    edieb Senior Member

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    I say we not re-invent the wheel and just use last year's petition. THis time, it would be great if there 1) could be a sticky on SDN, 2) the moderator of this forum had the petition password and 3) people would post it across listservs

    Dear APA,

    The internship match system is proving to be an increasingly arduous hurdle for many aspiring young psychologists. This year, 79% of students matched for internship through the APPIC system in both rounds 1 and 2, and, of those, an even smaller percentage matched to APA internships (http://www.appic.org/match/5_2_2_1_1..._2011Comb.html). Further, a substantial number in states such as California forgo APA/APPIC entirely, electing for unregulated internship experiences. It appears that the influence of APA is being marginalized. Rather than a set of minimum standards, APA compliance is becoming increasingly elite. If this trend continues, its influence on the direction of psychology will be further degraded.

    There are now far more psychology graduate students applying for internship every year than there are positions. The imbalance and erosion of standards appear to be the product of rapid expansion of graduate schools in professional psychology (Parent & Williamson, 2010). The inflation in number of students over the past decade has not been matched by either the number of available APA accredited internship slots or the demand for clinical psychologists in the workforce. While it is clear that a few programs are responsible for much of these problems, we do not believe the "weeding out" process should be conducted on the back-end, after huge amounts of time and money have been invested, but on the front-end. Students entering into professional schools of psychology are at a particularly vulnerable period in their lives, most not yet having the economic savvy to understand the ramifications of debt, nor education in the realities of the field with respect to what it takes to be competitive, to secure quality internship and postdoctoral training, and to attain a professional level job (not one that is occupied just as easily by social workers or other masters level providers).

    To address these problems, we suggest that the APA regulate the most grievous offenders that put our young professional population in greatest jeopardy, burdened with 6-figure debt, poor internship prospects, and exponentially expanding competition both from within, due to unjustified expansion by psychology graduate programs and without, due to trends to lesser training standards in healthcare. The current situation creates an environment ripe for a cascade effect that could be ruinous to both the livelihood and happiness of many of our workforce and the quality of the product that we offer as psychologists. This recommendation is consistent with recommendations by researchers on the topic of the internship imbalance (Parent & Williamson, 2010; Stedman, Schoenfeld, Carroll, & Allen, 2009). As it stands, this situation is akin to other predatory loan schemes and should fall within, at least, morally, the concept of usury laws.

    We request that the APA sanction programs that use the student loan system as a method of existence, charging at the limits of what's borrowable. These programs are not good citizens in the psychology professional community. Further, we strongly suggest that APA remove accreditation from these programs, and advocate that state licensing boards deny licensure to new students after a target date (one that does not affect current students). This would serve many important goals for our field. 1) It would end the internship imbalance. 2) It would limit the amount of debt our professionals are saddled with upon graduation 3) It would improve the quality of internship opportunities by alleviating the burden of review that all sites face as they are bombarded with 100s of applications; limiting this would allow sites to conduct a more thorough evaluation of candidates 4) It would improve the quality of internship programs that students select (e.g., again, many programs in California encourage students to attend non-APA accredited sites, many unfunded; many students now match to non-APA accredited sites) 5) It would protect the public from overly-stressed and poorly educated professionals.


    Sincerely,


    People against the unethical treatment of students of psychology.


    References

    Parent, M. C. & Williamson, J. B. (2010). Program disparities in unmatched internship applicants. Training & Education in Professional Psychology, 4,116-120.

    Stedman, J. M., Schoenfeld, L. S., Carroll, K., & Allen, T. F. (2009). The internship supply-demand crisis: Time for a solution is now. Training & Education in Professional Psychology, 3,135-139. lessDear APA,

    The internship match system is proving to be an increasingly arduous hurdle for many aspiring young psychologists. This year, 79% of students matched for internship through the APPIC system in both rounds 1 and 2, and, of those, an even smaller percentage matched to APA internships (http://www.appic.org/match/5_2_2_1_1..._2011Comb.html). Further, a substantial number in states such as California forgo APA/APPIC entirely, electing for unregulated internship experiences. It appears that the influence of APA is being marginalized. Rather than a set of minimum standards, APA compliance is becoming increasingly elite. If this trend continues, its influence on the direction of psychology will be further degraded.

    There are now far more psychology graduate students applying for internship every year than there are positions. The imbalance and erosion of standards appear to be the product of rapid expansion of graduate schools in professional psychology (Parent & Williamson, 20... more
  27. MCParent

    MCParent SDN Bronze Donor Bronze Donor

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    Good idea edieb. I think it can be revised in light of the criticisms of it last year though, and come out stronger, more focused, and clearer. The first round was excellent but we can always move forward. I think more clear recommendations and suggestions can be added. What are peoples' thoughts about editing it?

    Edit: Oh, "what JS said." :)

    I really wish I could count every signature as a citation. Oh, well.
  28. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty Moderator Emeritus

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    I agree with all of this.
  29. yeti2213

    yeti2213

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    The last thought was a tactical one. Once the letter is out and signed. A concerted effort to get some media attention would be good. Blogs, trade publications etc that people in the field pay attention to.
    Last edited: 01.17.12
  30. Jon Snow

    Jon Snow Senior Member

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    Have to be careful with that. If the petition gets less signatures this year, that would not aid the cause. I think several of these issues interrelate. One of the mistakes in this petition was highlighting the usury aspect as primary in the conclusion paragraph. You can see that there are many comments in the appic survey about over supply from professional schools. And I think the debt issue plays into that issue heavily. The motive for that oversupply appears to be money. And I think one of the ethical problems that apa faces is the influence of these programs on debt in our now modal graduates and it's at the expense of the field, hitting quality, diminishing apas influence and ability to dictate training standards, creating the internship imbalance, etc - all for profit/expanded existence (don't want to get into the nonprofit profit tax thing)
  31. Jon Snow

    Jon Snow Senior Member

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    I should also add that those student that are directly dealing with debt and coming from a program with a low APA match rate should be MOST interested in reform and signing such a petition. I know many of the signatures on the petition from last year were, in fact, from those schools. The petition had broad support. I know many of the names on the list, some are training directors at clinical science programs, there are private practitioners, phd, psyd, older and younger professionals.
  32. Jon Snow

    Jon Snow Senior Member

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    Here's my first whack at an expansion of last year's petition. Feel free to edit. Should probably add some stuff from the qualitative comments from the other thread in the match survey and maybe someone could look up linas bieliauskas presidential address from a few years back.


    Dear APA,

    The internship match system continues to be an increasingly arduous hurdle for many aspiring young psychologists. During the 2011 match cycle >20 percent of those that completed the match process did not match for an internship of any type (including both phase 1 and 2 of the match process). Further, of those that matched, only 56% matched to APA/CPA accredited sites. Last year, a petition was submitted with more than 500 signatures, requesting that APA address several of the contributing factors to this problem. This is not just a student issue. The problem is a symptom of a more systematic deterioration of doctoral level psychology. Rather than a set of minimum standards, APA compliance is becoming increasingly elite. If this trend continues, its influence on the direction of psychology will be marginalized.

    There are now far more psychology graduate students applying for internship every year than there are positions. The imbalance and erosion of standards appear to be the product of rapid expansion of graduate schools in professional psychology (Parent & Williamson, 2010). The inflation in number of students over the past decade has not been matched by either the number of available APA accredited internship slots or the demand for clinical psychologists in the workforce. Students from professional schools now comprise >50% of new clinical psychology graduates, though professional schools represent a minority of doctoral level psychology programs. While it is clear that a few programs are responsible for much of these problems, we do not believe the "weeding out" process should be conducted on the back-end, after huge amounts of time and money have been invested, but on the front-end. Students entering into professional schools of psychology are at a particularly vulnerable period in their lives, most not yet having the economic savvy to understand the ramifications of debt, nor education in the realities of the field with respect to what it takes to be competitive, to secure quality internship and postdoctoral training, and to attain a professional level job (not one that is occupied just as easily by social workers or other masters level providers).

    There are clear ethical issues with allowing these programs to continue to market doctoral psychology to whoever they can convince to attend, while saddling consumers of this educational model with six figure debt, poor internship prospects, and, following, poor post-doc and job prospects (students that complete a non-APA accredited internship are at a serious disadvantage in an increasingly challenging marketplace). In addition to the burden placed on our future colleagues, this is a public health threat.

    1. By circumventing APA standards, we (psychology as a field) are losing control over what it means to be a psychologist. We cannot ensure quality/minimum competency. This is a risk.

    2. Debt creates stress. This impacts the mindset/situation of our professionals. As more of our professionals are saddled with debt, this creates a potential public health risk.

    The current situation creates an environment ripe for a cascade effect that could be ruinous to both the livelihood and happiness of many of our workforce and the quality of the product that we offer as psychologists. As it stands, this situation is akin to other predatory loan schemes and should fall within, at least, morally, the concept of usury laws.

    We request that the APA sanction programs that do not match students to APA internships sites at an acceptable rate. These programs are not good citizens in the psychology professional community. We strongly suggest that APA remove accreditation from these programs, and advocate that state licensing boards deny licensure to new students after a target date (one that does not affect current students). Further, we suggest that APA amend the Accreditation Guidelines and Principles so that all school must publicly disclose the 25th percentile, median, and 75th percentiles of educational debt upon graduation for their students. These suggestions would serve many important goals for our field. 1) It would end the internship imbalance. 2) It would limit the amount of debt our professionals are saddled with upon graduation 3) It would improve the quality of internship opportunities by alleviating the burden of review that all sites face as they are bombarded with 100s of applications; limiting this would allow sites to conduct a more thorough evaluation of candidates 4) It would improve the quality of internship programs that students select (e.g., many programs in California encourage students to attend non-APA accredited sites, many unfunded; many students now match to non-APA accredited sites) 5) It would protect the public from overly-stressed and poorly educated professionals.


    Sincerely,


    People against the unethical treatment of students of psychology.


    References

    Parent, M. C. & Williamson, J. B. (2010). Program disparities in unmatched internship applicants. Training & Education in Professional Psychology, 4,116-120.

    Stedman, J. M., Schoenfeld, L. S., Carroll, K., & Allen, T. F. (2009). The internship supply-demand crisis: Time for a solution is now. Training & Education in Professional Psychology, 3,135-139.
    Last edited: 01.12.12
  33. Jon Snow

    Jon Snow Senior Member

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    There may be more interest in this once students don't match in this round
  34. cara susanna

    cara susanna Predoctoral Intern

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    Am I the only psychology student here feeling like I won't match? I'm pretty much convinced that I won't. Not even deep down do I think that I will.

    That's probably not a good thing. Have I been reading SDN too much?
  35. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty Moderator Emeritus

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    :laugh:

    You come from a good program, with a good match rate, so....you shouldn't freak out *too* much.
  36. PerhapsMaybeOk

    PerhapsMaybeOk

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    someone needs to do some stats on SDN posters' match rates. I wonder...
  37. Pragma

    Pragma

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    While I agree that this is an issue, I think that how it is framed here is a bit of a stretch. When making a case as petitioners, we might be better off sticking to the most solid points and not things that we can't quantify easily. They can't argue with numbers, but they can argue with inferences (e.g., "medical students have much more average debt and many of their subspecialities are having crises as well...perhaps it is just the economy").
  38. cara susanna

    cara susanna Predoctoral Intern

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    Thanks, T4C. I guess I'm just freaked out after reading those comments on the imbalance. We've also had a few really good students not match in my program, so that's scared me as well. Plus I don't think clinical work is my passion or strong point and I'm afraid that will come across in my applications/interviews.
  39. MCParent

    MCParent SDN Bronze Donor Bronze Donor

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    I've worked with what JS wrote. I tried to add some specificity in places. JS, let me know if there are aspects of your message you see missing here.

    Pragma, I've tried to address your comment with some added specificity over the origin of that concern (i.e., practicing outside of competence to make $$). Let me know if I heard your concern or if I missed your message.

    And join the FB group!!

    http://www.facebook.com/groups/223654767715768/



    *******

    An open letter to the American Psychological Association,

    The internship imbalance continues to be an increasingly arduous hurdle for aspiring psychologists. During the 2011 match cycle, more than 20 percent of those who entered the match process did not match to an APPIC member internship (including both phase 1 and 2 of the match process). Further, of those who matched, only 56% matched to APA/CPA accredited sites. Last year, a petition was submitted with more than 500 signatures, requesting that APA address several of the contributing factors to this problem. This petition reiterates the imbalance remains the most important issue in the training of psychologists and that we, the signers, are not satisfied with the actions taken by the APA and demand that this issue receive the attention and action that it deserves.

    As demonstrated by the many signatures from professional psychologists last year, this is not just a student issue. The problem is a symptom of a more systematic deterioration of doctoral level psychology. Specifically, the problem is largely due to the expansion of doctoral training sites in number and enrollment. Concurrently, APA accreditation as a standard of training for doctoral sites does not represent an acceptable level of training. If this trend continues, psychology continue to be marginalized as a legitimate science and as an important facet of integrated patient care.

    Accreditation of doctoral training programs must be revised to include internship match rates and student enrollment. Although such policies are “on the books” in the accreditation system, the findings of Parent and Williamson (2010) as well as APPIC’s data (APPIC, 2010) clearly indicate that these policies are not clearly enforced across all doctoral training program accreditation reviews, as many programs demonstrate large student numbers, weak match rates, and large contributions to the number of unmatched students before, during, and after accreditation review.

    Contrary to opinions expressed in some commentaries, use of relevant student outcome data in accreditation does not constitute restraint of trade or violation of antitrust law (Stedman et al., 2009).

    There are now far more psychology graduate students applying for internship every year than there are positions (http://www.appic.org/Match/MatchStatistics/MatchStatistics2011Combined.aspx). In 2011, 4199 applicants entered the match, and only 2339 APA/CPA-accredited internship positions were available. The imbalance and erosion of standards appear to be the product of rapid expansion of graduate schools in professional psychology (Parent & Williamson, 2010). The inflation in number of students over the past decade has not been matched by the number of available APA/CPA accredited internship slots. Further, it far exceeds estimates for social need or market demand for clinical psychologists in the workforce (Robiner & Crew, 2000). Students from professional schools now comprise over 50% of new clinical psychology graduates, though professional schools represent a minority of doctoral level psychology programs. Parent and Williamson’s (2010) analysis clearly indicated that the imbalance is not equally distributed among training programs, as 3% of doctoral programs produced over 30% of unmatched internship applicants. While it is clear that a few programs are responsible for much of these problems, we do not believe the "weeding out" process should be conducted on the back-end, after huge amounts of time and money have been invested. Rather, the APA needs to intervene to inform consumers of doctoral programs on the front-end. Students entering into professional schools of psychology are at a particularly vulnerable period in their lives, most not yet having the economic savvy to understand the ramifications of debt, nor education in the realities of the field with respect to what it takes to be competitive, to secure quality internship and postdoctoral training, and to attain a professional level job (not one that is occupied just as easily by social workers or other masters level providers).

    There are clear ethical issues with allowing programs that enroll large numbers of students and demonstrate consistently weak APA/CPA internship match rates to continue to market doctoral psychology to whoever they can convince to attend, while saddling consumers of this educational model with six figure debt, poor internship prospects, and, following, poor post-doc and job prospects (students that complete a non-APA accredited internship are at a serious disadvantage in an increasingly challenging marketplace). In addition to the burden placed on our future colleagues, this is a public health threat.

    1. By having subjective, nonstandardized criteria in APA accreditation, we (psychology as a field) are losing control over what it means to be a psychologist. We cannot ensure quality/minimum competency. This is a risk.

    2. Debt creates stress. This impacts the mindset/situation of our professionals. As more of our professionals are saddled with debt, this creates a potential public health risk for individuals to practice outside of their competencies in order to maintain a reasonable income.

    The current situation creates an environment ripe for a cascade effect that could be ruinous to the livelihood and happiness of many of our workforce and to the quality of the product that we offer as psychologists. As it stands, this situation is akin to other predatory loan schemes and should fall within, at least, morally, the concept of usury laws.

    We, the undersigned, endorse the following:

    1. We request that the APA sanction programs that do not match students to APA/CPA internships sites at an acceptable rate. These programs are not good citizens in the psychology professional community. We strongly suggest that APA place these programs on probationary accreditation status, and remove accreditation from these programs if they do not improve their match rates.

    2. We request that APA accreditation be revised. Current accreditation guidelines (available online at http://www.apa.org/ed/accreditation/) allow for accreditation teams to make inconsistent, subjective judgments about doctoral training programs, leading to inconsistent training standards. The accreditation system should be replaced by a point-based system that takes into account relevant student factors (e.g., enrollment, faculty-student ratio, average debt load of graduates, APA/CPA internship match rates, graduate EPPP scores, etc.). Such alterations would also make site self-studies easier and simpler.

    3. We request that APA amend the Accreditation Guidelines and Principles so that all doctoral training programs must publicly disclose the 25th percentile, median, and 75th percentiles of educational debt upon graduation for their students. These data MUST be presented in a standardized format and MUST be presented along with resources for potential applicants to better understand what internships are, average incomes for psychologists (i.e., the APA’s salary survey data), and potential career limitations for enrolling in a training site with a history of poor APA/CPA internship match rates. Such a required document would constitute informed consent only if linked to such informative resources. Current presentation of outcome data (i.e. C-20 data) are obscure and likely meaningless to most applicants.

    These suggestions would serve many important goals for our field. 1) It would be the single largest positive event in relation to the internship imbalance. 2) It would limit the amount of debt our professionals are saddled with upon graduation. 3) It would improve the quality of internship opportunities by alleviating the burden of review that all sites face as they are bombarded with 100s of applications; reducing the number of doctoral students would allow sites to conduct a more thorough evaluation of candidates. 4) It would improve the quality of internship programs that students select (e.g., many programs in California encourage students to attend non-APA/CPA accredited sites, many unfunded; many students now match to non-APA accredited sites). 5) It would protect the public from overly-stressed and poorly educated professionals. 6) it would facilitate the informed consent of doctoral training program applicants, who currently are not adequately informed about the realities of graduate training in psychology.

    Sincerely,

    People against the unethical treatment of students of psychology.

    References

    APPIC (2010). APPIC match: 2000 - 2010: Match rates by doctoral program. Retrieved from http://www.appic.org/downloads/APPIC_Match_Rates_2000-10_by_Univ.pdf

    Parent, M. C. & Williamson, J. B. (2010). Program disparities in unmatched internship applicants. Training & Education in Professional Psychology, 4,116-120.

    Robiner, W. N., & Crew, D. P. (2000). Rightsizing the workforce in
    healthcare: Trends from licensing boards, training programs, and managed
    care. Professional Psychology: Research and Practice, 31, 245–
    263.

    Stedman, J. M., Schoenfeld, L. S., Carroll, K., & Allen, T. F. (2009). The internship supply-demand crisis: Time for a solution is now. Training & Education in Professional Psychology, 3,135-139.
  40. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty Moderator Emeritus

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    Excellent edits.
  41. Jon Snow

    Jon Snow Senior Member

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    Yes, good job MC. Reads much better. Saw only one little typo in there, I'll fix later. Though, I'm not seeing the enthusiasm on the forum that we had before. Don't want this to hit like a 2 week old helium balloon. Thoughts?



    Concurrently, APA accreditation as a standard of training for doctoral sites does not represent an acceptable level of training. If this trend continues, psychology will be marginalized as a legitimate science and as an important facet of integrated patient care.
    Last edited: 01.16.12
  42. MCParent

    MCParent SDN Bronze Donor Bronze Donor

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    Good point. Are people checked out right now with internship and doc interviews? I'd hoped to have the petition out by match day. But, I can see how some folks would be really stressed by interview season and prefer not to think about this for a few weeks.

  43. cara susanna

    cara susanna Predoctoral Intern

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    Would it be possible to put something on the White House petition website? They guarantee a response if the petition gets a certain number of signatures.
  44. MCParent

    MCParent SDN Bronze Donor Bronze Donor

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    Good idea, though it looks like the current threshold is 25000 signatures in 30 days.That's about half of all psychologists, and more than double what APA gets for its salary data surveys. :( There are other ways of generating news buzz about this kind of thing, though.
  45. PerhapsMaybeOk

    PerhapsMaybeOk

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    You're not going to get any attention for this until people start whining about not matching; happens like this every year. People are in the middle of interviewing.
  46. wigflip

    wigflip

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    I like cara's idea. Even if the current White House petition threshold represents half of all psychologists, would those signing necessarily have to be restricted to psychologists (as opposed to prospective psychologists, academic allies, concerned others)? For example, one could probably attract solidarity signatures from allies by cross-posting links at various postacademic blogs/scamblogs, academic listserves (beyond the discipline of psych).

    Change.org gathers a huge number of signatures in a short amount of time, often by constructing a narrative focusing on one individual who's been "wronged" by some unfair policy/system ("So-and-so attended Prestigious U, authored 12 papers, and still couldn't graduate because of the internship debacle"). Many laypeople think of psychology primarily in terms of "helping" and "compassion"--highlighting that Deserving Individual X is being thwarted in her/his pursuit of a career dedicated to "helping others" by an unfair system might be one compelling narrative for a petition aimed at gathering signatures beyond current members of the profession.
  47. MCParent

    MCParent SDN Bronze Donor Bronze Donor

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    I'd not thought about that, good ideas! If signatures are being sought outside of psychology then the petition would have to be re-written to use less guild language and to make it clear it's open to everyone, is a public health concern, etc.

    The idea of exemplar victims of the imbalance is great! It would be really easy, unfortunately, to find such examples, and I think it's likely that many, though upset, will want to talk about their situations. Your point also indicates a weakness in the petition as currently written that I can fix (currently it might suggest that folks who don't match are weaker applicants, rather than emphasize that a glut in the system pushes out many qualified applicants). This would require some rewriting/clarifying to not give mixed messages about the problem (problem schools versus qualified applicants not getting in).

    If this doesn't pick up until match day that's fine, more time to revise and improve the petition to avoid the criticisms last year's got.

    And, join the FB group and encourage colleagues to join so that non-SDNers can get in on the process. http://www.facebook.com/groups/223654767715768/
  48. yeti2213

    yeti2213

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    does it makes sense to have two lines of attack? One from people within the "guild" for which this language makes sense. And maybe another from outside from whom the language would have to be changed to reflect public health concerns etc?

    Also hosting the letter on a website, the link to which can be sent out to people, and where people can sign the letter might be a good idea. There are several of these but the one I am familiar with is change.org (see http://www.change.org/start-a-petition)
  49. wigflip

    wigflip

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    Great ideas. just to clarify re: my last post, I wasn't necessarily suggesting supplanting one petition with another--multiple lines of attack is a great way to raise broad awareness of and support for the issue at hand. This strategy could also include guest blog posts on postacademic blogs or other online venues, media interaction by someone savvy and articulate, etc. Framing the imbalance as a "social justice issue" might render it interesting to folks at Pacifica Radio affiliates...you get the idea.
  50. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty Moderator Emeritus

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    I know docjohn posts on here (owner of psychcentral), maybe he'd be willing to post something on there, which would offer a good jumping off point for media outlets to pick it up.

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