Where else should I apply? PsyD

[Pragma]

Take a cue from history. http://en.wikipedia.org/wiki/Flexner_Report The issues are surprisingly quite similar. I don't know why I am supposed to take a few businesses devaluing my field for personal profit by lowering standards, flooding our infrastructure, changing our culture of education, and burdening more than half of new professionals calling themselves "psychologists" with stifling debt and welcome their product with open arms. Seems counterproductive. In my view, the faculty, who should know better, are committing an ethical violation by helping perpetuate the problem in affiliating with these programs. The APA has failed thus far for not reeling it in and thousands of students have been exploited because of the value of their government loan check. A professor I know described these programs as a malignancy and I think that's an apt metaphor. This isn't a matter of splitting, ivory tower elitism, guild protection, arrogance, narcissism, poor therapy skills, or general meanness (all things I've been accused of on this forum). It's simply blatantly and obviously bad for the field.

Interesting, I wasn't familiar with that report and the subsequent actions taken within medicine. While initially it perpetuated discrimination via limited access for minorities and women, those were broad cultural issues at the time and clearly have evolved. Obviously they've done a better job of maintaining uniform training standards, although I know things aren't perfect in their field either.

I was most struck by the "heads rolling" via firing faculty and closing down programs.

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[Buzzwordsoldier]

Buzzwordsoldier, can I ask you what you think that a PsyD program offers that is unique and, for some people, better than a balanced PhD science-practitioner model? I understand that PsyD programs made sense when they were created, but now there are plenty of programs that offer great clinical training and aren't just out to produce researchers/academics. So what is the purpose of the PsyD now? I am not trying to be snarky, I am genuinely wondering how you feel about this.

I can't speak for the entire field, but the mission, as I understand it, is to stand one step removed from science (or even take a crack at it) the better to utilize it most successfully should it seem to offer the better perspective on a challenge. Check out Brene Brown on "Leaning Into Our Vulnerability," especially 10:50 - 14:18.

http://www.onbeing.org/blog/brené-b...00603011184526":"og.likes"}&action_ref_map=[]

"My mission to control and predict had turned up the answer that the way to live is with vulnerability, and to stop controlling and predicting."

I wonder why some of the best superheroes are the ones submitting themselves to their own experiments or somehow made vulnerable by science...

 

[PHD12]

I can't speak for the entire field, but the mission, as I understand it, is to stand one step removed from science (or even take a crack at it) the better to utilize it most successfully should it seem to offer the better perspective on a challenge. Check out Brene Brown on "Leaning Into Our Vulnerability," especially 10:50 - 14:18.
.

Buzzwordsoldier, I think there is value in qualitative research and psychodynamic therapy even though this is not my primary model. However, since we already have university-based PhD and PsyD programs that train clinicians in qualitative research and psychodynamic therapy (many of the PhD clinical programs in NYC and sociology programs etc; good PsyD programs allow for qualitative research), then why do we need professional programs? What additional value do you guys add? Because of the large class sizes, you guys are not even getting adequate training in qualitative research. If you want to get good training in psychodynamic therapy and qualitative research, why not go to a university based PhD program that trains clinicians this way and is able to provide more supervision and mentoring (I know of at least 5-10 that are left out there)?

 

[AcronymAllergy]

It is a bit eery how closely the current training and practice situations and environments (e.g., limited regulation at the state level, limited curriculum-related and outcome-associated standards resulting in significant variability across programs), and the course of doctoral-level psychology training in general, mirror that of medicine as described in the Flexner Report.

 

[PHD12]

It is a bit eery how closely the current training and practice situations and environments (e.g., limited regulation at the state level, limited curriculum-related and outcome-associated standards resulting in significant variability across programs), and the course of doctoral-level psychology training in general, mirror that of medicine as described in the Flexner Report.

Currently, there are 141 accredited medical schools in the US. If you look at the APA website, there are around 400 APA Accredited doctoral programs in clinical, counseling, and school psychology (I can count the exact number later if I have time). Why do we need almost 3x the number of psychology programs compared to medical schools? This doesn't even include all the diploma mills that are training master's level practitioners. My state has almost 20,000 licensed psychologists.

 

[Therapist4Chnge]

Buzzwordsoldier, can I ask you what you think that a PsyD program offers that is unique and, for some people, better than a balanced PhD science-practitioner model? I understand that PsyD programs made sense when they were created, but now there are plenty of programs that offer great clinical training and aren't just out to produce researchers/academics. So what is the purpose of the PsyD now? I am not trying to be snarky, I am genuinely wondering how you feel about this.

I continue to struggle with this answer, partially because I am a Psy.D. from a uni-based program, and I get asked this frequently by prospective students because I'm a unicorn in the world of R1 AMCs. I think I mentioned on here that my former R1 institution didn't even HAVE Psy.D. in their ID system. As a fellow you could be a Ph.D., M.D., or M.D./Ph.D....that was it. I was classified as a Research Fellow, which was fine because I did some research, but it was frustrating that they had no idea that the Psy.D. even existed. At my current R1 they know of the degree, but I believe I am the only faculty member in the entire medical system/university to be a Psy.D. Go me!

I think when the Psy.D. was established there was a need for it because the vast majority of Ph.D. programs at the time focused more on research than on clinical practice. There was a need for clinicians who were trained to utilize research and apply it to clinical cases. As the field has evolved I believe more programs became more balanced, and then the differences were mostly semantic (for the balanced university-based Ph.D. & Psy.D. programs like a Rutgers or Baylor). Cheap $'s (in the form of student loans) provided an artificial ability for more programs to accept more people, while not needing to be responsible for funding. The burden of funding was shifted to the student (and gov't in the case of student loans), and that is when the train ran off the tracks.

Now there are growing differences in funding, training, and purpose for the various degree programs out there. The Ph.D. & Psy.D. have been hijacked and used to include all sorts of "training" that really isn't appropriate for the actual spirit of either degree. For instance, there are now "non-license eligible" programs in psychology that teach applied topics, but they aren't research degrees. Their purpose isn't to produce academics who only do research. Instead, they allow for the title of Dr. without the ability to practice clinically OR the training to being an academic. "Non-license eligible" programs have been around for 100+ years, but they were purely research degrees, so an entirely new paradigm has emerged. Ph.D. / Psy.D....it doesn't much matter, as the spirit of the training is much different. Unfortunately Psy.D. programs catch the brunt of the pushback, but most of the most insidious problems go much farther than 3 or 4 letters in the degree name.

 

[Pragma]

*

 

[Pragma]

Currently, there are 141 accredited medical schools in the US. If you look at the APA website, there are around 400 APA Accredited doctoral programs in clinical, counseling, and school psychology. Why do we need almost 3x the number of psychology programs compared to medical schools? This doesn't even include all the diploma mills that are training master's level practitioners.

Wow, I hadn't made those comparisons. I think it is hard to argue that a lot of the programs popping up and taking lots of students aren't marketing the popularity of being a "psychologist" for financial gain. Unfortunately, our professional organization is a ***** for revenue.

I must say, the whole idea being pushed by some FSPS folks that "growth" is needed and circumstances are "an opportunity for growth" is just BS. But the APA will continue to be a puppet because more members = more revenue (see "*****" above).

The reality is that we don't need more practitioners, we need to be improving our interventions. Mental health issues are a significant societal issue, but rather than throw more people at the problem, we need to throw better solutions at the problems out there. I fear that many practitioners out there are doing more harm than good.

 

[PHD12]

The reality is that we don't need more practitioners, we need to be improving our interventions. Mental health issues are a significant societal issue, but rather than throw more people at the problem, we need to throw better solutions at the problems out there. I fear that many practitioners out there are doing more harm than good.

APA has indeed whored itself out with 400 partners.

I do think that many practitioners are doing more harm than good. I've had a number of patients whose previous therapists committed ethical and boundary violations. I had a recent patient inform me that my therapeutic style was completely different than his previous long-term therapist because it was focused on him and not my personal life. I heard from someone who trains therapists and psychologists in CA, that many therapists in CA assume its okay to have sexual relationships with patients and previous patients.

 

[kpand]

Verbal = 154
Quant= 155
I didn't get a chance to cover all the content when preparing. I went in to the with the intention of canceling the score but decided that it was too late.
I ran out of time on one of the math sections, had to guess on like 6 questions, it was kind of ridiculous. On the way home i saw that average scores at good programs was 1200, and i literally thought i was 900 points off...that's how little i knew about this new scoring system. From what I've read online, my score is average...which is kind of what i was hoping for given my mediocre preparation.

I think your score should be sufficient to get into many PsyD programs if that is where you want to go. If you were applying to PhD programs or Rutgers/Baylor PsyD next year, I'd recommend giving it another go. But your application is more than just the GRE score, so I think you'll be just fine!

 

[AcronymAllergy]

Currently, there are 141 accredited medical schools in the US. If you look at the APA website, there are around 400 APA Accredited doctoral programs in clinical, counseling, and school psychology (I can count the exact number later if I have time). Why do we need almost 3x the number of psychology programs compared to medical schools? This doesn't even include all the diploma mills that are training master's level practitioners. My state has almost 20,000 licensed psychologists.

I think this might be one situation where a strict 1:1, psychology:medicine comparison breaks down a bit. I'd imagine that there are a good number more accredited doctoral programs at least in part because:

1) There are more general universities than medical schools
2) Many/most of those universities have psych departments that offer doctoral degrees in psychology
3) The average psych doctoral program is going to take significantly fewer applicants than the average med school class (150-200 isn't at all unusual for med school)

Thus, 400 psych programs, which sounds like a lot, could still (if they were all around the 6-10 student range in terms of incoming class size) educate far fewer psychologists than physicians.

That being said, more and more of these programs are moving to larger and larger class sizes. Which again, may not necessarily be a bad thing when working within the context of a professional rather than research degree. However, as has been mentioned, it's become pretty much a free-for-all to a large degree in terms of admissions, training, and outcome standards and goals.

 

[AcronymAllergy]

I think your score should be sufficient to get into many PsyD programs if that is where you want to go. If you were applying to PhD programs or Rutgers/Baylor PsyD next year, I'd recommend giving it another go. But your application is more than just the GRE score, so I think you'll be just fine!

Pretty much this. I believe you've mentioned that you already applied this year, so right now it's just a waiting game. If you do run into difficulty getting an admission offer, then you can always try contacting the programs to which you applied and see if they would be willing to offer feedback on their decision/your app.

Given that you've said your prep was less-than-ideal, it wouldn't at all be unheard of for a solid month or two of studying to raise your score a good bit. If you re-apply next year, that could definitely be an easily-identifiable area of focus. In the mean time, I would second one of the previous recommendations to also start checking out any RA job postings in your area as a plan B, just in case.

 

[futureapppsy2]

A couple of points about the numbers:

-Remember to include osteopathic school in your count. That's an additional 29 schools (significantly when you consider their class sizes).

-Most universities do not, in fact, offer PhDs in psychology or clinical/counseling/school psychology, although I agree that there is MUCH less infrastructure required to have a clinical psychology program than an MD or DO program.

-I completely agree that the problem lies heavily/predominantly in FSPS's and their huge class sizes. Not only do these contribute greatly to the internship and job market imbalances, but they also create unreasonable debt loads, and IMO, dilute the quality of training significantly. Even if you can go to one, the financial costs alone are reason enough not to, in my vie.

I think the well-regarded PsyD programs (Wright State, Rutgers, Baylor, Indiana U-Penn, Indiana State, etc) act like balanced PhD programs. They generally have smaller cohorts (PhD-size if they offer significant funding to all or most student, slightly larger [15-25-ish] if they do not), put greater emphasis on research but don't force students into high-end productivity beyond the thesis and dissertation, have greater expectations for faculty mentorship, etc. Although research-focused people can and do succeed coming out of balanced PhD programs, so do many clinically-oriented folks, some of who never desire to produce research beyond their dissertation. I'd argue that most of students at the university-based, well-respected PsyD programs could be just as comfortable at a balanced PhD program. Also, not all balanced PhD programs operate on a strict mentorship model. Of course, people can do excellently out of an FSPS, but even if you get wonderful training, is it worth the high debt, stigma in matching. etc.?

 

[Therapist4Chnge]

I must say, the whole idea being pushed by some FSPS folks that "growth" is needed and circumstances are "an opportunity for growth" is just BS. But the APA will continue to be a puppet because more members = more revenue (see "*****" above).

Not all "growth" is created equal. One of the scarier (and I believe completely irresponsible) trends I have seen in recent years is the proliferation of "psychology related" degrees that are non-clinical and non-research. These degrees are NOT in response to a market need, but instead they are trying to create a market demand where one does not currently exist. Those kind of degree programs target mostly non-traditional students and students who have not been able to go the school/counseling/clinical routes.

*edit*

Here are some of my favorites from Alliant SD that were mentioned earlier in the thread:
Consulting Psychology (PhD)
Leadership (PhD)
School Neuropsychology (CERT)


Uhm...really?

The reality is that we don't need more practitioners, we need to be improving our interventions. Mental health issues are a significant societal issue, but rather than throw more people at the problem, we need to throw better solutions at the problems out there. I fear that many practitioners out there are doing more harm than good.

We actually *do* need more practitioners.....in rural towns and less desirable areas of the country. Like many other professions, all of the major cities have an abundance of providers, though less populated/remote areas still hurt for any providers. Adding more students will simply increase the #'s in major cities and not in the areas of need. There is a lot of lip-service being paid to trying to serve the communities in need, but most early career people are avoiding those places. Usually the only people who seek out those communities have family/ties to them already. Our colleagues in medicine have attempted to address this issue by developing specific residencies in these areas of need, and they offer significant tuition reimbursement & bonuses to try and get physicians to stay after their commitment (usually residency and/or a couple years post-residency). All of the programs I know in rural areas struggle to keep staff, and they invest a large amount of time/$ trying to recruit a clinician to come/stay. I will be spending 1 day per week providing consultation to a rural hospital, and they have to offer premium pay and flexibility to attract clinicians from 60-100+mi away. There is definitely work available at rural hospitals, but adding more students will not increase participation at the rural placements, instead they will just add to the overly saturated markets.

As for practitioners doing more harm than good....yes they are out there, and I'll leave it at that.

 

[Pragma]

We actually *do* need more practitioners.....in rural towns and less desirable areas of the country. Like many other professions, all of the major cities have an abundance of providers, though less populated/remote areas still hurt for any providers. Adding more students will simply increase the #'s in major cities and not in the areas of need. There is a lot of lip-service being paid to trying to serve the communities in need, but most early career people are avoiding those places. Usually the only people who seek out those communities have family/ties to them already. Our colleagues in medicine have attempted to address this issue by developing specific residencies in these areas of need, and they offer significant tuition reimbursement & bonuses to try and get physicians to stay after their commitment (usually residency and/or a couple years post-residency). All of the programs I know in rural areas struggle to keep staff, and they invest a large amount of time/$ trying to recruit a clinician to come/stay. I will be spending 1 day per week providing consultation to a rural hospital, and they have to offer premium pay and flexibility to attract clinicians from 60-100+mi away. There is definitely work available at rural hospitals, but adding more students will not increase participation at the rural placements, instead they will just add to the overly saturated markets.

As for practitioners doing more harm than good....yes they are out there, and I'll leave it at that.

Yes there are underserved areas. Let me be a little more clear - we don't need the rate of graduating new practitioners to increase as it has been increasing in recent years with all of these new programs. As you noted, it just oversaturates the market in already saturated areas. There is definitely a need for providers in certain areas (e.g., rural areas). But there isn't an overall need for us to graduate more practitioners than we already have been graduating on an annual basis.

 

[Ollie123]

I think that is an important point - there is no denying that there is an enormous gap in care and lots of people who need services who aren't getting them. Of course, that doesn't mean these schools are the best solution to the problem (I fully believe they should not exist, at least not in their current form).

The problem is not necessarily the number of practitioners but about 1) Geographic access in less populated areas and 2) Financial access for those who cannot afford it. Pumping out another 1000 psychologists a year who won't/can't leave San Diego ain't gonna do much to fix things and I don't foresee Argosy opening an Idaho Falls campus anytime soon. Perhaps it indirectly affects financial access by driving up the supply of providers (and driving down reimbursement) but is that really the route to solving the problems?

The other issue is both pragmatic and ethical. Based on nearly every indicator imaginable, the folks graduating from these institutions are, on average, not trained as well as clinicians from other programs. There is certainly overlap in the distributions but by nearly every metric we look at, FSPS grads are pretty far behind the curve. Is bad care better than no care? I don't know the answer to that. Even if it is, aren't we essentially writing off these communities by offering them poorer quality care, rather than working to develop a system that provides better incentives to move to these areas/work with those populations? It seems a very lazy solution to just start pumping out as many psychologists as we can, many of whom are going to do little more than bilk money from already economically deprived populations through poorly thought out and/or unproven interventions. Ethically, I'm not comfortable with making that our "solution" to this problem.

 

[JeyRo]

The problem won't get resolved until the sub-prime loans (federal student loan programs and related programs) to graduate students stop. We can gnash our collective teeth about the Argosys and Alliants of the world until we're blue in the face, but money talks. Simple as that.

 

[futureapppsy2]

The problem won't get resolved until the sub-prime loans (federal student loan programs and related programs) to graduate students stop. We can gnash our collective teeth about the Argosys and Alliants of the world until we're blue in the face, but money talks. Simple as that.

However, that would also negatively affect students at other programs, including those who, for example, are funded but need to borrow on top of their stipend. That said, I agree that the funding source of loans is keeping these schools afloat. I really think the most practical (but still never going to happen) solution would be for APA to create class-size caps based on *APA* (or maybe APPIC, *definitely* not CAPIC) match results, as T4C and others have proposed before. These schools would then either reform and improve or fade away after losing APA accreditation. Although APA accreditation isn't required to operate, most people know enough to be wary of unaccredited programs.

 

[JeyRo]

However, that would also negatively affect students at other programs, including those who, for example, are funded but need to borrow on top of their stipend.

I don't see that as a problem at all. In fact, I can imagine loans at competitive market rates being offered to those kinds of students in a market free of this 'subprime' distortion I'm speaking of. They are good credit risks.

That said, I agree that the funding source of loans is keeping these schools afloat. I really think the most practical (but still never going to happen) solution would be for APA to create class-size caps based on *APA* (or maybe APPIC, *definitely* not CAPIC) match results, as T4C and others have proposed before. These schools would then either reform and improve or fade away after losing APA accreditation. Although APA accreditation isn't required to operate, most people know enough to be wary of unaccredited programs.

Money talks. I think it's not going to happen. I think APA has been corrupted, that train has left the station. Then again, I don't think federal student loans are going anywhere anytime soon either - too many vested interests there too.

 

[futureapppsy2]

I don't see that as a problem at all. In fact, I can imagine loans at competitive market rates being offered to those kinds of students in a market free of this 'subprime' distortion I'm speaking of. They are good credit risks.

Good credit risks how, if you don't mind me asking? Many are fairly young (straight of undergrad or having a couple years of poorly paid research experience) and thus don't have substantial assets or long credit histories. Plus, they're going into a fairly low paying profession --the banks can't count on a a high salary like they can for, say, physicians and dentists.

Regardless, I agree in that I don't think federal student loans are going anywhere soon. Pulling them would definitely have huge and far-reaching consequences for schools, students, banks, and parents, and would likely be unpopular with a large segment of voters.

 

[NotTheHoff]

Beyond the Parent article r.e. internship match rates and APPIC's released stats r.e. training data for internship applicants, can anyone point me to additional quantitative data that compares outcomes for those trained in Ph.D. programs vs. PsyD. programs vs. FSPS? There are obviously many more big-picture issues in training programs' long-term impact on clinical work beyond match rates and clinical hours during training.

To be clear: I'm not suggesting those outcomes are unimportant (they appear quite reflective of training)... I'm asking for more/different outcome data to point to in these types of discussions.

 

[Pragma]

Beyond the Parent article r.e. internship match rates and APPIC's released stats r.e. training data for internship applicants, can anyone point me to additional quantitative data that compares outcomes for those trained in Ph.D. programs vs. PsyD. programs vs. FSPS? There are obviously many more big-picture issues in training programs' long-term impact on clinical work beyond match rates and clinical hours during training.

To be clear: I'm not suggesting those outcomes are unimportant (they appear quite reflective of training)... I'm asking for more/different outcome data to point to in these types of discussions.

Here is one that looks at internship, EPPP pass rates, and Board certification using HLM

http://onlinelibrary.wiley.com/doi/...sCustomisedMessage=&userIsAuthenticated=false

(Graham & Kim, 2011) Predictors of doctoral student success in professional psychology: characteristics of students, programs, and universities

 

[le pamplemousse]

I'm not sure if this has been suggested before, but I think it might be a good idea for there to be a psychology doctorate that incorporates both psychotherapy and medical training. That way, psychologists will be fully equipped to address various aspects of mental illness--both the biological and emotional/psychological underpinnings.

So, it would be a merging of both psychiatry and psychology. But, it would be different from psychiatry in that one would not need to attend medical school. Instead, the 4 year training would solely focus on psychiatry/psychology, and would prepare students to do psychotherapy, assessments, and prescribe medication. Research would not be the focus, but one could choose to engage in research if one wishes.

This is similar to the doctor of podiatry specialty. Although they are not physicians (don't have to go to medical school), they still have to complete a 4 year doctorate, internship, residency, etc. (if I'm not mistaken). They are very skilled at their specialty (they can prescribe, perform surgery, etc.) and get paid quite well. I think it may be similar for doctors of optometry.

I think this may be the way to go for professional psychology, for those who would like to focus on clinical practice. If there was a professional school like that, I would definitely go! Of course, I would imagine that the admission prerequisites would require a solid science background (similar to medicine), and that admission would be more selective (also similar to medicine). But, I am sure that if psychologists had prescription rights their salaries would be significantly higher and their skills more marketable (much more marketable than research skills, that's for sure!). Plus, they would have more training in psychotherapy than psychiatrists, and perhaps more competent in this realm.

Just a suggestion!

 

[Psychadelic2012]

Not sure how cost effective that would be, because psychotherapy in general is so labor intensive. I think the advent of post-doctoral masters programs in psychopharm are basically the solution you're suggesting. Even that isn't going over terribly well (if I can be objective) and it is a 5-7 year doctorate + additional training!

 

[JeyRo]

Good credit risks how, if you don't mind me asking? Many are fairly young (straight of undergrad or having a couple years of poorly paid research experience) and thus don't have substantial assets or long credit histories. Plus, they're going into a fairly low paying profession --the banks can't count on a a high salary like they can for, say, physicians and dentists.

I'm not a loan underwriter, but think about it this way - you have a student that has been accepted to an extremely competitive, likely very high-quality doctoral program in clinical psychology (of which funded programs tend to be - highly competitive and compared to the average FSPS program, of top quality), and even better, they have gotten 80-90 percent of their costs already covered. Compared to a student taking out 20-30 times as much to attend a program that has a much poorer reputation, a student of a funded program is a far better credit risk, it would seem to me.

Besides, there already are private loans out there. Granted, currently their rates tend to be worse than the federal loans and have other downsides, but I'm also trying to encourage people to imagine a thought experiment where the federal 'subprime' loan system didn't exist (and also, where people had the same rights to bankruptcy protection that they do with all other consumer loans, which students don't have either). Tuition costs would be lower across the board at all institutions of higher learning, the student loan market would more than likely be far more competitive (absent the effective near-monopoly of the Federal Government over loans) and would be much more fair with bankruptcy protections in place.

Regardless, I agree in that I don't think federal student loans are going anywhere soon. Pulling them would definitely have huge and far-reaching consequences for schools, students, banks, and parents, and would likely be unpopular with a large segment of voters.

Phasing out the Federal Student Loan programs (as Ron Paul has suggested) would probably result in a recession in the higher education market which would most sharply effect the marginal players like the Apollo Group, University of Phoenix, Alliant, Argosy, etc. (which I'm sure everyone here would almost universally agree would be a good thing) - but would certainly affect all institutions significantly. It would probably result in tuition going down over time, and even top universities needing to cut costs significantly. College towns would probably suffer an economic downturn, which is a shame, but is the unavoidable consequence of an economic bubble bursting (and the student loan bubble will be burst, that is for sure).

Particularly if restoration of bankruptcy protections for student loan borrowers could take place at the same time, prospective students would potentially benefit greatly as federal loan programs were phased out - we might be able to return to the days where a middle-class family could provide substantial assistance to their children to attend a university, or tuition could be significantly paid for at graduate programs via a part time job (my 78 year old uncle paid for his law school tuition at Boalt Hall via a part time job aeons ago - unthinkable today). Access to higher education might actually improve over time, and the market would become far more competitive and overall quality of offerings would increase. This really would, on net, benefit everyone IMHO.

More specifically to clinical psychology, the constant, federally-subsidized cash infusions to outfits like Alliant and Argosy would cease and this would actually, forseeably begin to address the APA problem.

I see APA in a serious downward spiral. The Vail model of training was set up, I believe, with good intentions and some serious thought, and I think absent the distortionary effects of the (as I call it) 'subprime' federal student loan system, it would make complete sense in the evolution of clinical psychology as a discipline, but right now the professional clinical psychology degree seems like it's the source of clinical psychology's collective misery (I don't think it is - APA is not the proximal cause and professional psychology degree programs and FSPS aren't the proximal cause, it's like blaming banks or borrowers for the sub-prime bubble, it's missing the forest for the proverbial trees)

The fact is the APA is caught between a rock and a hard place. They have been losing membership progressively over the years (from what I recall), and they've been needing to replace the membership monies lost somehow, so they turn to FSPS outfits for support (like Alliant or whoever it was that sponsored their last convention a year ago). APA also sees FSPS as their only hope for replacing lost membership (as FSPS are notorious for churning out hordes of new clinical psychologists year after year). The problem is this is a terrible recipe for maintaining loyalty to an organization which is ostensibly supposed to be providing some measure of professional guild protection. The cure is worse than the disease - as APA turns off more and more members, with their watering down of standards that results from their incestuous relationship with FSPS, the APA is forced to get even closer to these schools in order to keep themselves afloat, which further waters down standards and their integrity as an organization. At least, this is what I see is going on.

But yes, phasing out student loan programs would be politically unpopular. Unfortunately, so many good ideas are politically unpopular, and so many bad ideas are wildly popular. Democracy is a pretty crappy political system, when you come right down to it.

 

[Qwerk]

Phasing out the Federal Student Loan programs (as Ron Paul has suggested) would probably result in a recession in the higher education market which would most sharply effect the marginal players like the Apollo Group, University of Phoenix, Alliant, Argosy, etc. (which I'm sure everyone here would almost universally agree would be a good thing) - but would certainly affect all institutions significantly. It would probably result in tuition going down over time, and even top universities needing to cut costs significantly. College towns would probably suffer an economic downturn, which is a shame, but is the unavoidable consequence of an economic bubble bursting (and the student loan bubble will be burst, that is for sure).

Since less-reputable programs disproportionately attract students who finance their education with large student loans, the federal government might be able to reduce the burden by capping student loan amounts based on performance. Measures like match rates, graduate employment, and alumni satisfaction could be tied to loan caps. This could apply to undergrad and grad programs in general. Schools that perform well, give generous grant aid, and/or have low tuition wouldn't be affected, while low-performing/high-cost programs would be forced to raise quality or lower tuition. The for-profits would fight it, of course, but it would at least prevent students from blindly taking on massive debt, and default rates would likely go down.

Some would argue that this curtails student choice, of course, but the caps wouldn't prevent students from attending these programs -- just from using federal money to do so. I can't use my student loan to go to a Ph.D. program that my uncle set up in his shed, and plenty of for-profit colleges are basically that.

 

[JeyRo]

Since less-reputable programs disproportionately attract students who finance their education with large student loans, the federal government might be able to reduce the burden by capping student loan amounts based on performance. Measures like match rates, graduate employment, and alumni satisfaction could be tied to loan caps. This could apply to undergrad and grad programs in general. Schools that perform well, give generous grant aid, and/or have low tuition wouldn't be affected, while low-performing/high-cost programs would be forced to raise quality or lower tuition. The for-profits would fight it, of course, but it would at least prevent students from blindly taking on massive debt, and default rates would likely go down.

Some would argue that this curtails student choice, of course, but the caps wouldn't prevent students from attending these programs -- just from using federal money to do so. I can't use my student loan to go to a Ph.D. program that my uncle set up in his shed, and plenty of for-profit colleges are basically that.

First reaction - who do you think would be intimately involved in drafting legislation like what you're proposing here? The education corporations, of course.

Second reaction - calls to mind the so-called "cycle of interventionism" that Austrian economists tend to talk about; e.g., some social problem is identified. A government solution is implemented. Government solution (invariably) has side effects (which tend to be blamed on the greed and avarice of corporations and private entities, what have you - rarely blamed on the existence of the program itself). Further government intervention is called for to fix the side effects. And the cycle intensifies.

Best solution is to eliminate the source of the problem. Absent that, I don't support any further nips and tucks, particularly given the corporatocratic nature of our federal government - it's just another opportunity for the piggies to feed further from the trough at worst, at best, it's just a way for well-connected players to use the levers of government to rewards themselves and cut out their competitors.

 

[Qwerk]

First reaction - who do you think would be intimately involved in drafting legislation like what you're proposing here? The education corporations, of course.

Second reaction - calls to mind the so-called "cycle of interventionism" that Austrian economists tend to talk about; e.g., some social problem is identified. A government solution is implemented. Government solution (invariably) has side effects (which tend to be blamed on the greed and avarice of corporations and private entities, what have you - rarely blamed on the existence of the program itself). Further government intervention is called for to fix the side effects. And the cycle intensifies.

Best solution is to eliminate the source of the problem. Absent that, I don't support any further nips and tucks, particularly given the corporatocratic nature of our federal government - it's just another opportunity for the piggies to feed further from the trough at worst, at best, it's just a way for well-connected players to use the levers of government to rewards themselves and cut out their competitors.

I still see merit in retaining a system of subsidized loans. You certainly have a point that tuition would be cheaper in a world without federal loans, and that students should have the same bankruptcy protection that other loans afford. However, tossing underinformed students into the private loan system would likely make the student debt problem worse, especially if you add loan marketing to the already-heavy college marketing. How would you keep private student loans from engaging in the same predatory lending practices that caused the mortgage crisis (and, less dramatically, the enormous credit card debt that a large percentage of households carry)? The federal government isn't doing a great job, but can you imagine what for-profit corporations would do?

 

[JeyRo]

I still see merit in retaining a system of subsidized loans. You certainly have a point that tuition would be cheaper in a world without federal loans, and that students should have the same bankruptcy protection that other loans afford. However, tossing underinformed students into the private loan system would likely make the student debt problem worse, especially if you add loan marketing to the already-heavy college marketing. How would you keep private student loans from engaging in the same predatory lending practices that caused the mortgage crisis (and, less dramatically, the enormous credit card debt that a large percentage of households carry)? The federal government isn't doing a great job, but can you imagine what for-profit corporations would do?

How could getting rid of the primary driver of student loan hyperinflation (the federal student loan program) make the student debt problem "worse"? I just don't see it. And I also see students making terribly misinformed decisions with subsidized student loan programs widely available already. If these programs went away, the Alliants and Argosys would likely go away as well and there would be that many less poor decisions students could potentially make, which would be a great thing.

BTW, I'm all for the profit incentive and competition. And I don't see the profit motive and "predatory lending" as being the proximal cause of the mortgage crisis, I see it as an excess of cheap credit (thank you, Federal Reserve) and a federal government with an explicit policy of encouraging subprime lending, and I can certainly agree that the intentions were on their face laudable (e.g., to increase access to credit to traditionally non credit-worthy borrowers, minority borrowers, etc).

Certainly, banks are, in their current form, profit-seeking entities. But that's not a problem absent the market distortions caused by monetary and fiscal policy - normally, profit motive and competition are what keeps prices low, quality high, and customers satisfied. Once you introduce market distortions via things like subsidies, prices rise, quality suffers, and customers get screwed.

 

[Buzzwordsoldier]

I think that is an important point - there is no denying that there is an enormous gap in care and lots of people who need services who aren't getting them. Of course, that doesn't mean these schools are the best solution to the problem (I fully believe they should not exist, at least not in their current form).

Ollie -- would you be willing to elaborate a bit regarding which form you believe these schools should take? Because by the looks of that statement, you imagine they could be retooled. Which would indicate you, too, see a growth potential.

The other issue is both pragmatic and ethical. Based on nearly every indicator imaginable, the folks graduating from these institutions are, on average, not trained as well as clinicians from other programs. There is certainly overlap in the distributions but by nearly every metric we look at, FSPS grads are pretty far behind the curve. Is bad care better than no care? I don't know the answer to that. Even if it is, aren't we essentially writing off these communities by offering them poorer quality care, rather than working to develop a system that provides better incentives to move to these areas/work with those populations? It seems a very lazy solution to just start pumping out as many psychologists as we can, many of whom are going to do little more than bilk money from already economically deprived populations through poorly thought out and/or unproven interventions. Ethically, I'm not comfortable with making that our "solution" to this problem.

You might be taking liberties here. First you state that by "nearly every indicator imaginable" FSPS grads are "behind the curve." But then you claim that one such indicator is quality of care. I have yet to see anyone on this site provide data supporting that claim.

I will, however, make the completely unsubstantiated claim that many FSPS students graduate ill-prepared to be leaders in their professional and broader communities. In that sense, I agree with the point you and others have made that it is not the best solution to simply recruit more students to participate in the current training opportunities.

I was asked a while back what I believe the professional schools offer. I have very little new to offer to that discussion, and certainly nothing that anyone here seems to find compelling. So all I will say is that I do not pretend that all professional schools are created equal. I happen to attend one with a longer and prouder tradition than most in the area. Indeed, I recognize that there is a lot of variability amongst professional schools, and I understand that this is precisely what others here find so bothersome -- a lack of standardization. But I tend to see diversity as a strength, and I am not convinced that uni-based programs are as monolithic as most here seem to pretend -- when the argument suits them.

 

[Edward3nigm4]

So i was talking to this girl that I was hoping to take out on a date soon. We were speaking about our careers/school and what not. She is a phd student in History. Anyways, I was talking about psychology and therapy and she sent a text saying that she "doesn't see a difference between seeing a psychologist and talking to a friend, except the $$"....

what a turn off...but I just wanted to share this on my thread because this girl is incredibly intelligent, is finishing doctorate in history at a prestigious university and doesn't have malicious intentions but genuinely doesn't really see the value in clinical psychology. I personally think research in history is a huge waste of effort/time/money but that's just me..I would never actually tell somebody that because I think it would be rude and wouldn't serve any purpose besides hurting a person's pride. She didn't discriminate between psyd or phd, she just said shrinks as a whole are nothing more than glorified friends.

Will I go on the date with her?
I don't know yet...

anyways. In regards to my GRE
I guess I will just let it go. If I do decide to apply again next year I might take it again...all this talk about risk makes me want to just pursue my dreams of being an actor again. If i'm gonna be risky, might as well just go all out. I'm not getting "respect" anyways so I don't see a difference. I don't think I'm ready to start grad school. I want to satisfy my thirst for the arts...I know I never mentioned that before...but I feel like I shouldn't start grad school until i'm 110% ready to do so. All this debate is making my head spin. I'm a really simple person and I like to lead a simple life. I love psychology, and I'll apply again if I don't get in. But I also love acting and filmaking, and I think I'm pretty good at it. it's incredibly rare to be successful in the entertainment industry, but I want to give it another shot (i tried after graduating for a few months but had to leave for family reasons). I think I'm okay with going to a sub-par program if I know I gave all my other dreams an equal chance.
Anyways, thanks for the help...even though nobody has even told me where else to apply!

 

[Qwerk]

But that's not a problem absent the market distortions caused by monetary and fiscal policy - normally, profit motive and competition are what keeps prices low, quality high, and customers satisfied.

Even libertarians would call that simplistic.

I'd love to discuss this stuff further, but I feel like we're derailing the thread a little. Maybe we could split it off into a different topic?

So i was talking to this girl that I was hoping to take out on a date soon. We were speaking about our careers/school and what not. She is a phd student in History. Anyways, I was talking about psychology and therapy and she sent a text saying that she "doesn't see a difference between seeing a psychologist and talking to a friend, except the $$"....

what a turn off...but I just wanted to share this on my thread because this girl is incredibly intelligent, is finishing doctorate in history at a prestigious university and doesn't have malicious intentions but genuinely doesn't really see the value in clinical psychology. I personally think research in history is a huge waste of effort/time/money but that's just me..I would never actually tell somebody that because I think it would be rude and wouldn't serve any purpose besides hurting a person's pride. She didn't discriminate between psyd or phd, she just said shrinks as a whole are nothing more than glorified friends.

Will I go on the date with her?
I don't know yet...

anyways. In regards to my GRE
I guess I will just let it go. If I do decide to apply again next year I might take it again...all this talk about risk makes me want to just pursue my dreams of being an actor again. If i'm gonna be risky, might as well just go all out. I'm not getting "respect" anyways so I don't see a difference. I don't think I'm ready to start grad school. I want to satisfy my thirst for the arts...I know I never mentioned that before...but I feel like I shouldn't start grad school until i'm 110% ready to do so. All this debate is making my head spin. I'm a really simple person and I like to lead a simple life. I love psychology, and I'll apply again if I don't get in. But I also love acting and filmaking, and I think I'm pretty good at it. it's incredibly rare to be successful in the entertainment industry, but I want to give it another shot (i tried after graduating for a few months but had to leave for family reasons). I think I'm okay with going to a sub-par program if I know I gave all my other dreams an equal chance.
Anyways, thanks for the help...even though nobody has even told me where else to apply!

I'm glad the thread made you think more about your decision. It's never a bad idea to take a little time off!

 

[JeyRo]

Even libertarians would call that simplistic.

What kind of libertarians? The Neil Boortz, Dennis Miller, Bill Maher "libertarians"? There's a lot of people these days who call themselves "libertarian" who simply wear the label because they feel it's fashionable.

I know a lot of liberty oriented folks - I think they all tend to agree that when market "failures" happen, they are rare, and that absent government coercion and interventionism, the strong tendency is for competition to result in the customer being treated well.

I'd love to discuss this stuff further, but I feel like we're derailing the thread a little. Maybe we could split it off into a different topic?

Sure.

 

[Doctor Eliza]

So i was talking to this girl that I was hoping to take out on a date soon. We were speaking about our careers/school and what not. She is a phd student in History. Anyways, I was talking about psychology and therapy and she sent a text saying that she "doesn't see a difference between seeing a psychologist and talking to a friend, except the $$"....

If you go into this field, this won't be the last time you hear this from friends, family, clients, etc. And also prepare yourself for the inevitable comparison to prostitution.

 

[Qwerk]

What kind of libertarians? The Neil Boortz, Dennis Miller, Bill Maher "libertarians"? There's a lot of people these days who call themselves "libertarian" who simply wear the label because they feel it's fashionable.

I know a lot of liberty oriented folks - I think they all tend to agree that when market "failures" happen, they are rare, and that absent government coercion and interventionism, the strong tendency is for competition to result in the customer being treated well.



Sure.

Branched: http://forums.studentdoctor.net/showthread.php?p=13555373

 

[Qwerk]

And also prepare yourself for the inevitable comparison to prostitution.

Oh, and the "therapy industry," which is obviously making boatloads of money off poor, stupid mentally ill folks. Now where did I put the keys to my Mercedes?

 

[Therapist4Chnge]

What kind of libertarians?

I'm a Constitutional Libertarian...ya know, the good kind.

 

[AcronymAllergy]

Oh, and the "therapy industry," which is obviously making boatloads of money off poor, stupid mentally ill folks. Now where did I put the keys to my Mercedes?

Probably left them sitting right next to mine...in the dealer's lockbox. Sigh.

 

[Edward3nigm4]

If you go into this field, this won't be the last time you hear this from friends, family, clients, etc. And also prepare yourself for the inevitable comparison to prostitution.

You had my curiosity, now you have my attention...do explain

 

[JeyRo]

I'm a Constitutional Libertarian...ya know, the good kind.

Ah. What some of us would call a "mini-statist."

 

[Doctor Eliza]

You had my curiosity, now you have my attention...do explain

Although it is super-insulting, people say that all the time. They say being a therapist is like being a prostitute because people are paying you for your time and paying you to "pretend" that you care. They don't say it as often as the other comment you mentioned, but it comes up with some regularity. Most people who have done a chunk of practice have heard it either socially or from clients.

I think it is one of those things you learn to laugh at.

Best,
Dr. E

 

[Ollie123]

Ollie -- would you be willing to elaborate a bit regarding which form you believe these schools should take? Because by the looks of that statement, you imagine they could be retooled. Which would indicate you, too, see a growth potential.



You might be taking liberties here. First you state that by "nearly every indicator imaginable" FSPS grads are "behind the curve." But then you claim that one such indicator is quality of care. I have yet to see anyone on this site provide data supporting that claim.

I will, however, make the completely unsubstantiated claim that many FSPS students graduate ill-prepared to be leaders in their professional and broader communities. In that sense, I agree with the point you and others have made that it is not the best solution to simply recruit more students to participate in the current training opportunities.

I was asked a while back what I believe the professional schools offer. I have very little new to offer to that discussion, and certainly nothing that anyone here seems to find compelling. So all I will say is that I do not pretend that all professional schools are created equal. I happen to attend one with a longer and prouder tradition than most in the area. Indeed, I recognize that there is a lot of variability amongst professional schools, and I understand that this is precisely what others here find so bothersome -- a lack of standardization. But I tend to see diversity as a strength, and I am not convinced that uni-based programs are as monolithic as most here seem to pretend -- when the argument suits them.

Well I suppose it depends how you are defining potential. These are schools - they don't have innate properties so of course they have the potential to be different. I actually don't expect that to happen since most of the things I think would need to occur for them to be a viable model (i.e. dramatically reduced class sizes - or at least faculty-student ratio, dramatically increased infrastructure) would render them insolvent.

The main things I think are needed are a substantial increase in admission standards, decrease in class size, greater control over practica, and substantially enhanced research/scientific training (even if the motivations and nature of this remain distinct from that of university programs). I look at the science training of the local FSPS, and they are graduating PhDs with research knowledge roughly equivalent to our better undergraduates. I'm not shy about voicing my beliefs that we should all be using evidence-based practice. However, I think even those who disagree should at least be qualified to make an informed choice. There is a major difference between someone who heard about the dodo bird verdict in lecture and decided that it doesn't matter what kind of therapy they practice, versus someone who has read the literature, understood it, and is capable of having an intellectual discussion about why or why not the conclusions drawn from it are valid. From what I've seen, too many FSPS students fall into the former category.

Ethically, I also think costs need to be reduced but I view that as a somewhat separate issue.

There is no doubt variability even with the FSPS model. However, I'm going to raise issues with the notion that diversity should be viewed as a strength. Diversity CAN be a strength, but I think its incredibly short-sighted to take the view that it is inherently positive. I think the call depends entirely on context and we have a case here where diversity doesn't mean "different", it means "worse". I'll avoid rehashing the same old arguments but I just find it really hard to believe anyone genuinely believes the prototypical FSPSs (think Argosy/Alliant) provide training that is just as good as other programs and just "different".

As for outcomes, I suppose you are right that I was jumping the gun on that. To my knowledge we don't have good data on therapy outcomes right now. In part I think that's because such a study would be extremely difficult to conduct since we can't randomly assign people to employment settings and therapy outcomes are difficult enough to work with when one can use well-behaved designs. That said, even if outcomes ARE the same that is really besides the point. In my view, a psychologist is more than a "therapist". They should have more skills than just being an effective therapist. Even if we had a wonderful study proving they have exactly equal therapy outcomes to graduates of the best PhD programs....unless their skills in assessment/research/etc. are the same they are still not anywhere close to equivalency. That doesn't mean their graduates are useless and it doesn't mean they may not have a role to play. It does mean they fall well short of the bar someone needs to meet in order to deserve the title of "psychologist" in my eyes.

 

[Edward3nigm4]

Although it is super-insulting, people say that all the time. They say being a therapist is like being a prostitute because people are paying you for your time and paying you to "pretend" that you care. They don't say it as often as the other comment you mentioned, but it comes up with some regularity. Most people who have done a chunk of practice have heard it either socially or from clients.

I think it is one of those things you learn to laugh at.

Best,
Dr. E

Wait a minute...are you telling me that Glitter is only pretending?...but...but she's so affectionate..and Nice...

 

[Edward3nigm4]

I honestly don't know what to do...even if i get into a psyd program ill be paying crazy tuition rates that don't match up with future income potential...i don't have the credentials to be accepted into a funded program. I don't want to take college classes anymore at my age. I'm just sick of being that old student taking undergraduate classes.
I'm starting to think that this entire idea of being a Psychologist was a mistake. This isn't a gold career to change into. You really gotta be committed early on. I think i will call the schools tomorrow and withdraw my application...no idea what I'm gonna do with my life...fml

 

[AcronymAllergy]

Personally, I don't know that I'd withdraw applications; they're already submitted, so you can see what sorts of offers you obtain and then decide on accepting/withdrawing at that time. Give yourself a little while longer for your head to clear up a bit.

This career path does take a good bit of dedication, yes. But try to think of it this way--any prep you put in on the front end (e.g., improving the strength of your application, thinking about your clinical and research interests and potential areas of future specialization, examining programs to determine which seem as though they would truly be a good fit for you) can save you exponential amounts of stress, frustration, and/or aggravation on the back end. Worst-case scenario, if you end up needing to put off applying for another year or two, that'll afford you the opportunity to save up additional money so that you might not need to take out any loans while in school. Being debt-free upon graduation is a GREAT position to be in.

Also, while these forums are a great resource, keep in mind that they are only one such resource. Talking with and reading about the experiences of other students and practitioners in the field (both locally and across the country) can help provide as well-rounded a view as possible. Also, spend some time thinking about what you'd do instead if you weren't to follow the clinical psych path. That's ultimately the question I've answered for myself when I had the occasional creeping doubt; I just couldn't see myself doing anything else, which is further supported the more time I spend here (particularly when working around peers in other professions).

Is it sometimes disheartening? Definitely, but what career path isn't? Success isn't guaranteed, but there are very few professions for which that's not the case (even medicine).

 

[Pragma]

Yeah it seems silly to withdraw at this point. You may as well see what interviews you get and soak up the experience. You are not obligated to accept any offers and it might give you a better sense for what these places are like. I doubt you will get your application money back, so may as well not waste it and get the experience.

 

[bmedclinic]

Edward, I wouldnt give up, and I wouldnt withdrawl. See what comes of it. Make it what you need it to be.
I'll tell ya, in my early to mid 20's, I certainly didnt think I belonged in this crowd. I had to grow into it. I did it by getting into an decent MA program in clinical psych and from there proving myself as being different en-route to gaining acceptance into a phd program. Am I the best of the best? Hardly. Do I belong now? Definitely. It just takes time and growth, and you cant rush either of those but you can put yourself in position to make growth happen. Best of luck to you!

 

[Lisa44201]

I'm 32, finishing up my Master's degree, going through my second round of PhD application season. After being rejected the first time around, I found a fully funded Master's program (yes, they exist), and spent the time building up my CV and stats knowledge. I'm definitely the oldest student in the room, but (n=1) it doesn't matter as much in grad school. Take this experience and learn from it. Like any other, this career path takes work.

 

[Psychadelic2012]

Yeah, it takes time. Being anxious, spontaneous, desperate (whatever you want to call it) does not help in any field, especially this one! There is great value in wrestling with your demons. This world plays a dirty trick on young adults, making them feel like life is a fast-moving freight train that leads to the pot of gold containing their ultimate dreams. Well, life just isn't like that. Much satisfaction can be found with exploration, experimentation, and mucking it up over and over, until you settle in and get down to work for the long haul. Use this time to learn and explore, and make a decision out of rationality and peace--that's when you know it's right.

 

[MBellows]

I'm a Constitutional Libertarian...ya know, the good kind.

And here I thought that anarchocapitalist libertarians were the good kind? Or maybe it was libertarian socialists (actually a thing)?