PhD/PsyD accelerated curriculum

[barryggg]

are you a psychologist licensed in the US?

No. Canada.

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[Justanothergrad]

Isn't the main point of teaching them original research so that they could end up doing original research themselves and advance the field?

No. It's to be able to understand and incorporate the science of psychology into practice. Why do you think the only purpose of research is to advance publication and not build a foundation of skills useful for clinicians? Assessment, one of the areas you think that doesn't need extra training, is a great example of an area that strong research skills are important for understanding.

 

[erg923]

I told this poster they did not seem to properly understand the scientist-practitioner model of training. They said they did. Then he wrote that.

 

[barryggg]

We agree that it is crucial to incorporate the science of psychology into practice..the difference is that you feel that doing original research makes you that much better at incorporating this into clinical practice..where I think these things are not as related as you think. I absolutely agree with you that to have a better understanding of statistics and research methods courses, students should have hands-on experience. We just disagree on the extent that doing very SPECIFIC research, and answering a very specific QUESTION, makes you that much more likely to better incorporate research into your practice.

 

[barryggg]

I told this poster they did not seem to properly understand the scientist-practitioner model of training. They said they did. The he wrote that.

You seem to be skipping over every time I agree with you that research is fundamental, and that it informs practice.

 

[Justanothergrad]

We agree that it is crucial to incorporate the science of psychology into practice..the difference is that you feel that doing original research makes you that much better at incorporating this into clinical practice..where I think these things are not as related as you think. I absolutely agree with you that to have a better understanding of statistics and research methods courses, students should have hands-on experience. We just disagree on the extent that doing very SPECIFIC research, and answering a very specific QUESTION, makes you that much more likely to better incorporate research into your practice.

Playing soccer makes you better at soccer than does just reading a book on how to play soccer.

Why is this hard?

 

[psych.meout]

You seem to be skipping over every time I agree with you that research is fundamental, and that it informs practice.

No, he hasn't, you just ignore the posts that you dislike or which are inconvenient to your arguments. The scientist practitioner model is not mean to simply produce scholars and researchers. It is meant to provide a balanced education so that psychologist will be proficient at multiple roles and thereby have flexibility.

Ever consider that the reason students are still incompetent, overconfident in their abilities, their scope of practice...is that the training is not done properly? (and I'm not referring to bad programs..but just in general?) Ever consider that the solution to this may not be more schooling or keeping the same amount? Ever consider that it might be a bad idea to make students spend so much time doing original research, even if their goal is to be a clinician? How does doing a specific experiment, where you answer a very specific question, help you be a better clinician overall? Is the suggestion that students would be unable to understand or appreciate Psychology as evidence-based, and to apply the latest research, if they don't spend at least 30-50% of their Phd career doing the original research themselves? Where is the proof for this? Isn't the main point of teaching them original research so that they could end up doing original research themselves and advance the field?

See, this is a perfect example. You keep harping on this strawman that performing original research is for psychologists to be researchers, but that is simply not true. Just go look at the websites for balanced clinical programs.

Furthermore, you keep demanding proof and evidence from everyone else and have never provided any to support your own assertions. Where is the evidence that master's level practitioners in other western nations are equivalent in skill, training, etc. with American and Canadian doctoral-level psychologists? What are their comparative levels of expertise in assessment and intervention? What are their scopes of practice? How proficient are each in consuming and incorporating empirical research?

Finally, ever consider that people go beyond their scope or are overconfident because so much of the education from undergrad to Phd is preparing people to be a Generalist, but then people end up specializing (a Generalist focuses mostly on anxiety disorders, or mood disorders) and then so much of what they learned is not all that relevant?

What isn't relevant? The generalist training for specialists? Do you seriously think that specialists are not utilizing their generalist skills and knowledge? You're really not doing yourself any favors here when you make comments like this while trying to push the narrative (sans evidence) that master's level practitioners are equally qualified to doctoral level ones.

 

[smalltownpsych]

You seem to be skipping over every time I agree with you that research is fundamental, and that it informs practice.

That is not the science-practitioner model of training. It is more like the scholar-practitioner model. Anyway, the way that you are speaking about the US system of training demonstrates the type of thinking that one sees in masters level practitioners and why in many settings psychologists are hired to oversee them. You might think that your training is sufficient for independent practice and determining what that scope of practice is and that the additional training that US psychologists receive is superfluous, but you might just be wrong.

I go back to what I said in another post. The question of what level of training is sufficient is not really a question that can be answered with the scientific method. It is a philosophical and socio-cultural political question.

 

[WisNeuro]

Many of my medical colleagues, some of who I have worked on research projects with, report that their research experience in med school was 1-2 month long rotations. I then have to explain to them why the table that they, which only has p-values in it, is completely useless, and just do the table myself, after also correcting for multiple comparisons, changing the significance of half of the results. I am a firm believer that one needs to actually do their own research to actually understand research. I've worked with way too many people who claim to have been trained in research, through didactics, who have no real understanding of study design, statistics, or how to properly evaluate research data.

 

[smalltownpsych]

Many of my medical colleagues, some of who I have worked on research projects with, report that their research experience in med school was 1-2 month long rotations. I then have to explain to them why the table that they, which only has p-values in it, is completely useless, and just do the table myself, after also correcting for multiple comparisons, changing the significance of half of the results. I am a firm believer that one needs to actually do their own research to actually understand research. I've worked with way too many people who claim to have been trained in research, through didactics, who have no real understanding of study design, statistics, or how to properly evaluate research data.

I agree completely and have experienced the same myself. The question I have is can we demonstrate that this improves patient outcomes and if we can't does that mean that doctoral training provides no additional benefit. I don't think so, but there are always going to be pressures to lower costs and decreasing standards is a great way to do that. So if we can't scientifically prove that psychologist is better than a mid-level. How do we make the case? What if the VA decides that psychologists are not cost effective as have many CMHs, for example?

 

[WisNeuro]

I agree completely and have experienced the same myself. The question I have is can we demonstrate that this improves patient outcomes and if we can't does that mean that doctoral training provides no additional benefit. I don't think so, but there are always going to be pressures to lower costs and decreasing standards is a great way to do that. So if we can't scientifically prove that psychologist is better than a mid-level. How do we make the case? What if the VA decides that psychologists are not cost effective as have many CMHs, for example?

We can find evidence for this, one just has to do the right kind of research. For example, the instance of utilizing EBP for certain disorders where we have clear signs of efficacy (e.g., CBT for Panic, or insomnia) vs non-supported outcomes. Easy research to do in certain settings, just takes time and some cost. You can also look at this in the larger healthcare context, prescription of certain medications with no clear benefit (benzos, AChEIs). In terms of studies designed to look at these things is easy, from a design standpoint. It just takes time and money. It's not that we can't demonstrate the outcomes, we simply need better research and more resources. There is research out there supporting this, we just lack the resources to do replications and larger scale studies to further study it in a world of declining research funds and anti-science sentiment at high levels.

 

[barryggg]

No, he hasn't, you just ignore the posts that you dislike or which are inconvenient to your arguments. The scientist practitioner model is not mean to simply produce scholars and researchers. It is meant to provide a balanced education so that psychologist will be proficient at multiple roles and thereby have flexibility.

You keep ignoring the fact that I'm indirectly always stressing balance between research and practice. I just think this balance can be obtained in a much more efficient and better way.

 

[barryggg]

am a firm believer that one needs to actually do their own research to actually understand research.

I actually agree with you. There is only so much you can learn from course content. However, I think Psychology students should start getting plenty of lab time, and a chance to do smaller experiments, throughout their undergrad.

I think my biggest problem with education as a whole is that the brick-and-mortar institutions are trying to solve a problem that doesn't exist anymore. In the past, a University education was a big advantage because you could access information/get knowledge, that other people couldn't. With the democratization of technology, information is now freely available. If you want to be a relevant educational institution, you have to teach people how to APPLY that knowledge, and think creatively. This should start from a very young age. Not at the Phd level.

The thing is, the limited TIME we have to obtain information is not an issue we can really solve any time soon...but this is especially true if the goal of education is memorization. We are wasting students time. You guys know better than anyone that at the Phd level, course content is a very small aspect of the big picture. Research and application of that research is what you spend the majority of your time doing. So my impression is if we start doing THIS from the very beginning, yes, we can train people better in less time.

 

[WisNeuro]

That's all fine and dandy, but the APA has no say over undergraduate education. What they do have so over, is accreditation of doctoral programs and higher. I would love it if undergrads were taught better, with higher level coursework and applied experiences. Pragmatically, it's just not going to happen. So, we focus on doctoral level education, the thing that our accrediting body does have some control over. Looks like we are arguing over the theoretical vs the practical implications of education. Arguments over how things could work in a super ideal setting, vs actually having to operate within the constraints of a clunky, piecemeal system. In this clunky, piecemeal system, lowering doctoral education standards will almost invariably lead to decrements in competence.

 

[smalltownpsych]

We can find evidence for this, one just has to do the right kind of research. For example, the instance of utilizing EBP for certain disorders where we have clear signs of efficacy (e.g., CBT for Panic, or insomnia) vs non-supported outcomes. Easy research to do in certain settings, just takes time and some cost. You can also look at this in the larger healthcare context, prescription of certain medications with no clear benefit (benzos, AChEIs). In terms of studies designed to look at these things is easy, from a design standpoint. It just takes time and money. It's not that we can't demonstrate the outcomes, we simply need better research and more resources. There is research out there supporting this, we just lack the resources to do replications and larger scale studies to further study it in a world of declining research funds and anti-science sentiment at high levels.

Demonstrating that CBT is an effective treatment for Panic Disorder is easy compared to demonstrating that a psychologist with a doctorate has better outcomes than a masters level therapist or to use a more neuro-based example, do you think we could demonstrate improved diagnostic reliability of common disorders such as ADHD or Learning Disabilities. Heck, I am sure that you could easily train masters level folks to detect malingering with validity measures. I am not arguing that a board-certified is not in reality more capable than say a school psychologist with a masters, but in the majority of cases it would probably be difficult to differentiate and the within groups variance would likely wash out the between groups variance.

 

[WisNeuro]

Demonstrating that CBT is an effective treatment for Panic Disorder is easy compared to demonstrating that a psychologist with a doctorate has better outcomes than a masters level therapist or to use a more neuro-based example, do you think we could demonstrate improved diagnostic reliability of common disorders such as ADHD or Learning Disabilities. Heck, I am sure that you could easily train masters level folks to detect malingering with validity measures. I am not arguing that a board-certified is not in reality more capable than say a school psychologist with a masters, but in the majority of cases it would probably be difficult to differentiate and the within groups variance would likely wash out the between groups variance.

Easier, but not that much harder with the right data. Retrospective chart review. Look at the long-term medical charts of patients. See what treatments they had, who treated them, how long they were in the treatment (compliance) and follow certain outcomes (psychiatric admissions, reported problems in occupational functions, reported social problems, symptom measures, etc). The data is available (e.g., CPRS) it just requires an IRB and a lot of effort to do.

 

[psych.meout]

That's all fine and dandy, but the APA has no say over undergraduate education. What they do have so over, is accreditation of doctoral programs and higher. I would love it if undergrads were taught better, with higher level coursework and applied experiences. Pragmatically, it's just not going to happen. So, we focus on doctoral level education, the thing that our accrediting body does have some control over. Looks like we are arguing over the theoretical vs the practical implications of education. Arguments over how things could work in a super ideal setting, vs actually having to operate within the constraints of a clunky, piecemeal system. In this clunky, piecemeal system, lowering doctoral education standards will almost invariably lead to decrements in competence.

Exactly. Doctoral programs already have difficulty comparing the undergraduate education quality for their applicants, but at least they, the APA, licensing boards, and other certifying bodies have some kinds of standards by which to compare and evaluate graduates of doctoral programs. So, are we supposed to introduce even more ambiguity in training for providers by reducing or eliminating doctoral programs, thereby leaving more training up to undergrad institutions? That seems like a slippery slope to reducing the quality of providers.

 

[barryggg]

That's all fine and dandy, but the APA has no say over undergraduate education. What they do have so over, is accreditation of doctoral programs and higher. I would love it if undergrads were taught better, with higher level coursework and applied experiences. Pragmatically, it's just not going to happen. So, we focus on doctoral level education, the thing that our accrediting body does have some control over. Looks like we are arguing over the theoretical vs the practical implications of education. Arguments over how things could work in a super ideal setting, vs actually having to operate within the constraints of a clunky, piecemeal system. In this clunky, piecemeal system, lowering doctoral education standards will almost invariably lead to decrements in competence.

Yes, that was all very idealistic.

But I still think that even in the current system we can train competent Psychologists at the Masters level if the institutions teaching it are solid.

 

[barryggg]

Exactly. Doctoral programs already have difficulty comparing the undergraduate education quality for their applicants, but at least they, the APA, licensing boards, and other certifying bodies have some kinds of standards by which to compare and evaluate graduates of doctoral programs. So, are we supposed to introduce even more ambiguity in training for providers by reducing or eliminating doctoral programs, thereby leaving more training up to undergrad institutions? That seems like a slippery slope to reducing the quality of providers.

eliminating doctoral programs? Nobody has ever suggested this. I guess you don't like being misconstrued but are very happy to attribute arguments to others that they didn't make.

 

[WisNeuro]

Yes, that was all very idealistic.

But I still think that even in the current system we can train competent Psychologists at the Masters level if the institutions teaching it are solid.

In certain areas, therapy, maybe. In other areas, assessment and research, doubtful.

 

[Justanothergrad]

And even with therapy, competency would be much more limited and less 'generalist' in nature.

 

[psych.meout]

eliminating doctoral programs? Nobody has ever suggested this. I guess you don't like being misconstrued but are very happy to attribute arguments to others that they didn't make.

Firstly, I was talking about eliminating them as the standard for providers of psychological services in favor of being just being oriented around research and teaching, not getting rid of them entirely. I was alluding your earlier comment:

I believe that a Phd should be required if you're going to do research and teach. (even if only part time). I just don't think it makes sense for a large group of people who know that they mainly want to do assessment or therapy. I think at least 50% of candidates fit into this category. (but it's probably a much bigger majority)

Secondly, based on your posts here, why would you have a problem getting rid of them?

Not comparing Psychology to Psychic mediums..but psychic mediums also get a lot of attention in the US (and make billions of dollars) compared to a lot of the world..all that means is that they're taking this a lot more seriously, and have come up with more angles to justify their "expertise".

Sure..as a Phd standard makes no sense for Psychology. Most of the world realizes this. The field is so far back of many fields..that it just makes no sense. It's sort of like creating a Phd system for chefs. Sure, there are better chefs and worse ones, but you don't need 10 yrs to figure that out. It's just that the Universities want cheap labor.

It has very little to do with higher standards, and everything to do with using students.

You seem to be proof that doing extra years of schooling = pointless.

 

[barryggg]

Secondly, based on your posts here, why would you have a problem getting rid of them?

Very simple. I think if you want to be a triple threat..be a clinician, conduct original research, and teach at a high level...I think it's a good investment and makes sense...especially considering how education is structured right now.

 

[Chyby]

Guys, I am a licensed psychologist working in an European Union country. Many years ago we had a standard of 5 years of school and then people could practice. Then there was some kind of education reform, and Bologna system has been installed.

We can be licensed to practice clinical psychology after the Bachelor's Degree, which only takes three years. We can get out of the "supervision" years with a master's degree in clinical psych + one year of supervised work. That supervised work is actually a meeting once a month for 4 hours and you pay the supervisor. A masters degree level of training is not sufficient! My supervisor never heard of BVRT! I have changed many supervisors until I've given up because everyone wants low quality work. I was scolded by my supervisor for writing an eight pages report for a malingering case. It didn't matter for him that was a complex case (some of you would have probably written more). His excuse was that nobody reads a report that long and that I should keep a one page report of findings. Yet, every single doctor that examined the patient turned my report into some lecture time. They did read it and used my findings.

I work with neurosurgical population and by the way, there is no neuropsychology training here. Everyone with a clinical psych license can do neuropsych evaluations and most of my colleagues believe MMSE is a complex neuropsych test and act like some superstars when using it.

Many doctors don't care about these services. Neurosurgeries are made without neuropsych evaluations, they don't care. If the patient is a cake they want every piece of it, they don't give to others for the sake of providing multidisciplinary care. They don't care about the cognitive issues a patient might have. If the patient is alive, case solved, neeeext!

I had to convince my colleagues that neuropsych is needed, but I work with three neurosurgeons, others are looking at me like I am some kind of clown when I talk to them about neuropsych. Others are scared because a such evaluation can prove malpractice.

There is no specialization here. Just because I am a psychologist, everyone seems to expect that I can evaluate, diagnose, treat (whatever) everything. It doesn't matter if I place a big banner on the homepage of my practice stating that I don't evaluate let's say autism (for professional reasons like not having experience with that), I get calls from parents requesting my services.

Masters level practitioners can provide some services but that training is not enough. We have many psychologists because it is a field that produces money for trainers. Imagine that you can get a Bachelor degree from a diploma-mill institution, you don't need to study too much, all your exams are multiple choice tests that you can pass by clicking random answers, your degree exam is also a multiple questions test, you get the questions in advance and learn the answers, then you click the right answer. Two weeks later you have your diploma and you can become a licensed clinical psychologist. The license process is also a joke. Some of them are providing therapy with angels and archangels, the use the power of Jesus, Gaia, professional services for cleaning the aura (or whatever that is), historical myths reinterpreted, spirituality sessions.

Many of my medical colleagues, some of who I have worked on research projects with, report that their research experience in med school was 1-2 month long rotations. I then have to explain to them why the table that they, which only has p-values in it, is completely useless, and just do the table myself, after also correcting for multiple comparisons, changing the significance of half of the results. I am a firm believer that one needs to actually do their own research to actually understand research. I've worked with way too many people who claim to have been trained in research, through didactics, who have no real understanding of study design, statistics, or how to properly evaluate research data.

I have also done that. I have even given them some of my first year statistics books to read and they were happy and enthusiastic like children receiving candies.


And now...I am studying for GRE, doing research and plan for applying to PhD programs in US to go through all the training there to become a neuropsychologist. I have too many horror stories from this side of the world. If I start talking with a screen writer we will produce the horror version of Grey's Anatomy

 

[barryggg]

I think you're taking yourself a bit too seriously.

Neuropsychologists in the USA know very little. We are not saving lives here. Just trying to make people's lives a bit more comfortable.

 

[barryggg]

It's just important to realize that we are NOT doctors. I don't care if you have a Phd. Police officers save more lives. Most mental disorders resolve on their own, or get better as you get older. We help people through hard time.

 

[psych.meout]

I think you're taking yourself a bit too seriously.

Neuropsychologists in the USA know very little.

And you're basing this on.........?

We are not saving lives here. Just trying to make people's lives a bit more comfortable.

I'm curious. You claim to be a provider of mental health services, but make these wild, unsubstantiated claims, e.g. that lives aren't being saved.

Have you honestly never worked with someone with serious suicidal ideation? What about dual diagnosis patients that are at risk of early mortality from substance misuse?

It's just important to realize that we are NOT doctors. I don't care if you have a Phd.

Except that's, you know, part of the definition of what a doctor is, someone holding a doctorate.

Police officers save more lives.

Source? Is that in absolute terms, per capita, etc.?

Most mental disorders resolve on their own, or get better as you get older. We help people through hard time.

Again, source?

 

[barryggg]

I have come across such patients. I try my best to do something for them, and follow what I've learned to a tee..do I think I helped all that much? Not really. I feel we can't help the sickest patients..the rest, well..a lot of them could have been helped by a friend, themselves, but a lot of them lack motivation, are lazy, dumb, and just lack self-insight. We are mostly babysitters and parents, but we get to call ourselves Psychologists.

 

[barryggg]

And I'm totally being serious, btw. Take therapy. It's often like trying to make someone get exercise and get on a diet because they want to lose weight. The goal is to lose weight, and you know it will work if they exercise and diet..but these people lack the motivation, insight, etc to get it done. That's why they are there in the first place. A lot of these people lack brain power..(very stupid people). Most of these people just need a kick in the butt.

 

[Therapist4Chnge]

I think you're taking yourself a bit too seriously.

Neuropsychologists in the USA know very little. We are not saving lives here. Just trying to make people's lives a bit more comfortable.

Should I ignore all of the patients who told me that I helped save their lives? Whether it be from getting them proper treatment (wrong dx), rehabilitation following brain injury, admitted bc they had a psychotic break, help establish gaurdianship bc they couldn't care for themselves following injury, getting their financial decision-making back, etc.

I normally would have stopped replying by now, but I don't want prospective students getting the idea that services they would provide don't make a difference.

 

[Therapist4Chnge]

I have come across such patients. I try my best to do something for them, and follow what I've learned to a tee..do I think I helped all that much? Not really. I feel we can't help the sickest patients..the rest, well..a lot of them could have been helped by a friend, themselves, but a lot of them lack motivation, are lazy, dumb, and just lack self-insight. We are mostly babysitters and parents, but we get to call ourselves Psychologists.

Just because *you* feel like you haven't been effective doesn't mean that others have had the same experience.

I don't provide traditional therapy, but I provide some cog rehab and education to help them better understand their deficits (primarily brain injuries, but also stroke, MS, and a variety of neurologic disorders). These patients aren't going to get better on their own. Typically they get worse without intervention....but keep going on about how psychologists are ineffective.

To be clear...you are a licensed (Phd/PsyD) psychologist? Or neuropsychologist...as you said, "we" in your comment. I ask bc your posts don't reflect the training (i.e. lack of awareness about specific practice).

 

[deleted343839]

This thread reminds me of:
(1) The body of psychological research on burnout and attribution
(2) That Groucho Marx quote

 

[barryggg]

Just because *you* feel like you haven't been effective doesn't mean that others have had the same experience.

I don't provide traditional therapy, but I provide some cog rehab and education to help them better understand their deficits (primarily brain injuries, but also stroke, MS, and a variety of neurologic disorders). These patients aren't going to get better on their own. Typically they get worse without intervention....but keep going on about how psychologists are ineffective.

We don't actually help...we coordinate. So yes, that is some level of help..but we aren't actually saving lives,

 

[neurobain]

It's just important to realize that we are NOT doctors. I don't care if you have a Phd. Police officers save more lives. Most mental disorders resolve on their own, or get better as you get older. We help people through hard time.

1) You are a doctor if you have a PhD or PsyD, although not in the sense that the general public thinks of doctors. This is similar to how someone with a PhD in another discipline is called Dr. Smith, for example. When you say doctor in your posts, do you mean to say physician?

2) Sure, many police offices have saved people. That is a red herring in this case. What does that have to do with anything? A general practitioner, unlike a cardiac surgeon or an emergency department physician, may never have actually saved a life. If this is the case, are they not doctors since some police officers might have saved more lives than the neighborhood general practitioner?

3) Untreated mental illness can lead to maladaptive behaviors (i.e. substance abuse, binge eating, risk taking behaviors, self-harm, suicide), occupational difficulties, increased social withdrawal, and can interfere with a person's physical health. So, while some people might get better with time and age, is this truly always the case? So, unless you know of some papers that support your generalization, I would very much like to see them!

We don't actually help...we coordinate. So yes, that is some level of help..but we aren't actually saving lives,

Coordination is part of it (i.e. recommendation, treatment teams, etc), but what about directed intervention (i.e. CBT, substance abuse counseling, cognitive remediation)? Aren't those things helpful? Further, if therapy helps a patient overcome an addiction, isn't that indirectly saving their life? I grant that it isn't as immediate as an EMT reviving someone, but it still is certainly life altering for the patient.

And I'm totally being serious, btw. Take therapy. It's often like trying to make someone get exercise and get on a diet because they want to lose weight. The goal is to lose weight, and you know it will work if they exercise and diet..but these people lack the motivation, insight, etc to get it done. That's why they are there in the first place. A lot of these people lack brain power..(very stupid people). Most of these people just need a kick in the butt.

How are you measuring brain power? FSIQ? Functional connectivity? Observed power in the beta range? Clinician disdain for the patient?

Are there not intelligent, successful people that also maybe struggle with weight loss?

 

[psych.meout]

I have come across such patients. I try my best to do something for them, and follow what I've learned to a tee..do I think I helped all that much? Not really. I feel we can't help the sickest patients..the rest, well..a lot of them could have been helped by a friend, themselves, but a lot of them lack motivation, are lazy, dumb, and just lack self-insight. We are mostly babysitters and parents, but we get to call ourselves Psychologists.

And I'm totally being serious, btw. Take therapy. It's often like trying to make someone get exercise and get on a diet because they want to lose weight. The goal is to lose weight, and you know it will work if they exercise and diet..but these people lack the motivation, insight, etc to get it done. That's why they are there in the first place. A lot of these people lack brain power..(very stupid people). Most of these people just need a kick in the butt.

Nope, no irony here in making unsubstantiated claims that contradict the field's research while simultaneously arguing against empirical research training as a requirement for training psychologists.

 

[psych.meout]

1) You are a doctor if you have a PhD or PsyD, although not in the sense that the general public thinks of doctors. This is similar to how someone with a PhD in another discipline is called Dr. Smith, for example. When you say doctor in your posts, do you mean to say physician?

2) Sure, many police offices have saved people. That is a red herring in this case. What does that have to do with anything? A general practitioner, unlike a cardiac surgeon or an emergency department physician, may never have actually saved a life. If this is the case, are they not doctors since some police officers might have saved more lives than the neighborhood general practitioner?

3) Untreated mental illness can lead to maladaptive behaviors (i.e. substance abuse, binge eating, risk taking behaviors, self-harm, suicide), occupational difficulties, increased social withdrawal, and can interfere with a person's physical health. So, while some people might get better with time and age, is this truly always the case? So, unless you know of some papers that support your generalization, I would very much like to see them!

But that also depends on how we define "saving lives." Sure, surgeons performing emergency heart bypasses, ER docs preventing people from bleeding out from gunshot wounds, and oncologists treating cancer are all super-salient examples of professionals "saving lives," but are they really comprehensive of the more subtle ways that lives are saved? What about the dermatologist who diagnoses someone's melanoma early so that they have the best chance of survival? What about the general practitioner who detects someone's subtle heart murmur or correctly diagnoses someone's long QT? What about the psychologist who treats a person's substance abuse problem or anorexia that might otherwise kill them, to say nothing about the disability? What about the neuropsychologist whose assessment that a patient is not a good candidate for neurosurgery might have saved their life or spared them from further neurocognitive problems?

Barryggg is incredibly obtuse and pushing a clear agenda that ignores the nuance and complexity of so many fields, topics, issues, etc.

 

[Chyby]

I think you're taking yourself a bit too seriously.

Neuropsychologists in the USA know very little. We are not saving lives here. Just trying to make people's lives a bit more comfortable.

This statement is based on what research? You know...proof, or it didn't happen.

And yes! Yes! We should not be serious! Let's just write wrong diagnosis and wrong recommendations based on them. Let's practice without minimum standards and less knowledge.

Please, come to that part of the world where you can be useless and a waste of money for employers! That part when most doctors/physicians don't take psychologists seriously because they have low knowledge/education. That part where these services are poorly covered by health insurance because they don't want to pay for non evidence based services. You can join the army of folks that are not taking themselves too seriously! You can even practice neuropsychology here, all you need is a MMSE and the clock drawing test. You don't need a PhD, you don't need to know anything! If you know how to use a scissors, you will become the perfect psychologist, providing supportive services for children and treat trauma by cutting Micky Mouse. You don't need evidence based therapies, you will have the perfect therapy program based on cutting paper and coloring activities. Some people will even appreciate your work and will consider it a high standard.

Just let diploma-mills institutions take advantage of lower standards, they make so much money here.

But that also depends on how we define "saving lives." Sure, surgeons performing emergency heart bypasses, ER docs preventing people from bleeding out from gunshot wounds, and oncologists treating cancer are all super-salient examples of professionals "saving lives," but are they really comprehensive of the more subtle ways that lives are saved? What about the dermatologist who diagnoses someone's melanoma early so that they have the best chance of survival? What about the general practitioner who detects someone's subtle heart murmur or correctly diagnoses someone's long QT? What about the psychologist who treats a person's substance abuse problem or anorexia that might otherwise kill them, to say nothing about the disability? What about the neuropsychologist whose assessment that a patient is not a good candidate for neurosurgery might have saved their life or spared them from further neurocognitive problems?

Barryggg is incredibly obtuse and pushing a clear agenda that ignores the nuance and complexity of so many fields, topics, issues, etc.

Obtuse or just a troll.

 

[barryggg]

This statement is based on what research? You know...proof, or it didn't happen.

And yes! Yes! We should not be serious! Let's just write wrong diagnosis and wrong recommendations based on them. Let's practice without minimum standards and less knowledge.

Please, come to that part of the world where you can be useless and a waste of money for employers! That part when most doctors/physicians don't take psychologists seriously because they have low knowledge/education. That part where these services are poorly covered by health insurance because they don't want to pay for non evidence based services. You can join the army of folks that are not taking themselves too seriously! You can even practice neuropsychology here, all you need is a MMSE and the clock drawing test. You don't need a PhD, you don't need to know anything! If you know how to use a scissors, you will become the perfect psychologist, providing supportive services for children and treat trauma by cutting Micky Mouse. You don't need evidence based therapies, you will have the perfect therapy program based on cutting paper and coloring activities. Some people will even appreciate your work and will consider it a high standard.

Just let diploma-mills institutions take advantage of lower standards, they make so much money here.



Obtuse or just a troll.

This statement is based on what research? You know...proof, or it didn't happen.

And yes! Yes! We should not be serious! Let's just write wrong diagnosis and wrong recommendations based on them. Let's practice without minimum standards and less knowledge.

Please, come to that part of the world where you can be useless and a waste of money for employers! That part when most doctors/physicians don't take psychologists seriously because they have low knowledge/education. That part where these services are poorly covered by health insurance because they don't want to pay for non evidence based services. You can join the army of folks that are not taking themselves too seriously! You can even practice neuropsychology here, all you need is a MMSE and the clock drawing test. You don't need a PhD, you don't need to know anything! If you know how to use a scissors, you will become the perfect psychologist, providing supportive services for children and treat trauma by cutting Micky Mouse. You don't need evidence based therapies, you will have the perfect therapy program based on cutting paper and coloring activities. Some people will even appreciate your work and will consider it a high standard.

Just let diploma-mills institutions take advantage of lower standards, they make so much money here.



Obtuse or just a troll.

Let's cut out the sarcasm.

What's the standard to be a psychiatrist in EU?

 

[smalltownpsych]

It's just important to realize that we are NOT doctors. I don't care if you have a Phd. Police officers save more lives. Most mental disorders resolve on their own, or get better as you get older. We help people through hard time.

Either you are not really a practitioner, which is what I strongly suspect, or you are a really, really poor one.

Either way. I think I'm done with this discussion. I actually appreciated some of the points that you have made, but don't appreciate the ignorant and demeaning statements.

Just another millennial troll, who thinks that being able to access information on the internet makes them smarter than anyone else.

I am out.

 

[deleted343839]

but we aren't actually saving lives

My terminally ill and dying patients have all been pretty clear on that point, and yet they still show up for some reason.

But in broad strokes, sure, most of us are not in the business of averting imminent death on the regular. If that's what you need to feel worthwhile in your occupation, this may not be the job for you. There are psychologists who specialize in suicide prevention and high-risk populations, and they do measure their outcomes in terms of mortality. Frankly, though, you've given every indication that this kind of work is not for you.

Lest you complain that we don't save every person, go have a chat with a first responder some time. Or a trauma surgeon. Or an oncologist. You get the point.

 

[barryggg]

How are you measuring brain power? FSIQ? Functional connectivity? Observed power in the beta range? Clinician disdain for the patient?

Are there not intelligent, successful people that also maybe struggle with weight loss?

I have requested IQ tests on patients that just seemed to have the worst logic. Obviously I ruled out other issues (ie drugs, head injuries, etc)...but my perceptions were always substantiated. On a very rare occasion, I'd bring out my official IQ test and compare my results to theirs, for them to get a sense of where they have issues.

Intelligent people can struggle with weight, but they might be lazy. What I'm getting at is that it's often problems that they can solve if they really want to..but they make excuses. "I'm just big boned" "I just love food so much!" etc.

 

[barryggg]

Either you are not really a practitioner, which is what I strongly suspect, or you are a really, really poor one.

Either way. I think I'm done with this discussion. I actually appreciated some of the points that you have made, but don't appreciate the ignorant and demeaning statements.

Just another millennial troll, who thinks that being able to access information on the internet makes them smarter than anyone else.

I am out.

I'm sorry you feel that way, but I just think it's wrong to act like we have these big standards in NA, we are so advanced, yet I feel that we are not much more than parents and babysitters..and that if we didn't exist..psychiatrists and other health professionals could easily step in and replace us.

Our job is to state the obvious, or give "fluff" to people.

 

[Chyby]

It is not sarcasm it is reality and I wasn't joking. A painful reality, but unfortunate something that is going on for years. When psychology and neuropsychology was developing in USA many years ago, it was banned by the communism in this country, so many people are now taking advantages. When I started to practice I wasn't allowed to do neuropsych evaluations. Those were the standards established by the "board", an institution whose role is a combination of APA+the state boards in USA for licensure+board certification (ex ABPP). Six months later they've changed the standards and I was allowed. They did not require training, an MA or a PhD, all you had to do is have a clinical psychology license. They have lowered the standards, no diploma needed anymore. Did I become competent to do them over night? On paper yes, in reality no. Do you really think this is ok? Maybe the PhD diploma itself makes no difference in general, but the training needed to practice at a competent level is very important. Five years of training in EU don't compare to all those years of training in USA. I've only met two neuropsychologists from USA and they were both well above my knowledge, like they should be after all these years of education. I dropped out from the best and most wanted MA in clinical psych program in my town because it was useless for my job and got myself admitted to the best in my country, even if that meant to travel 300 miles away from home every two weeks for courses. Now I thank to myself that I took everything too seriously and made that choice. You should have known how important is to know your limits, don't practice outside your boundaries/competencies, look for better training and supervision and take the profession seriously. That requires more than BA+MA years of education. Telling someone that is taking this profession too seriously is a red flag for me that it's not for you.

And to answer your question, the standard is medical school + residency for psychiatry like anywhere else. In my country the standard is 6 years of medical school + 4 years of residency (it was 5 years a couple of years ago). There is no pre-med or anything like that, you can get in to medical school straight after high school. In UK, they need a medical degree (5 years), a foundation training (2 years) where they extend the knowledge gained in medical school, a specialty training (6 years) where they gain experience from different areas of psychiatry and the last three years they can choose from child and adolescent/general adult/psychotherapy/ forensic/learning disabilities/old age and geriatrics.

In my country residency is standard: either you choose pediatrics or you choose adults. Psychotherapy training is done at the same institutions where psychologists are training. Psychiatrists pay for psychotherapy training, unless they've had less than six years of medical school paid by the government and are doing the training at master's degree level at a University. Most psychotherapy training programs are offered by associations, where you go to courses for one weekend/month (8-10 hours/day), little to no practicum requirement for graduation.

Now they are also moving clinical psychology training at these associations because they make a lot of money, lowering the standard. This training is not even recognized in other EU countries and some of my colleagues that moved abroad had to do the clinical psychology training all over again because it was completed at an association. They have even invented a 2 year expert course in forensics, very expensive, organised by an association, giving "graduates" a diploma that allows them to offer forensic evaluations for court and banned all other psychologists with many years of practice to do them. I don't think that if you need an evaluation in court, that evaluation to be the first one done by that psychologist, just because he has a fancy diploma and others with years of practice don't.

Lower standards = lower qualifications = poor practitioners = great chances for others to destroy parts or the entire profession

I'm sorry you feel that way, but I just think it's wrong to act like we have these big standards in NA, we are so advanced, yet I feel that we are not much more than parents and babysitters..and that if we didn't exist..psychiatrists and other health professionals could easily step in and replace us.

Our job is to state the obvious, or give "fluff" to people.

That's arguable, depending on the psychiatrist. I know lots of them that prefer to do 20 minutes consults in private practice, rather than 50-60 minutes of psychotherapy sessions because they are paid more for one consult. One 20 minutes consult here means the same money for 50 minutes of psychotherapy. I also know some that are offering psychotherapy for their patients. Of course, you can choose your fees, but here higher fees means loosing patients, many are not going to therapists for financial reasons, choose a psychiatrist that gives them pills and hope their mental issues will go away. I don't know what is going on from this financial point of view in US. Also, the psychologist-psychiatrist relationship is very bad

 

[Therapist4Chnge]

On a very rare occasion, I'd bring out my official IQ test and compare my results to theirs, for them to get a sense of where they have issues.

Uh-huh....tell us more about how you practice psychology...

 

[neurobain]

I have requested IQ tests on patients that just seemed to have the worst logic. Obviously I ruled out other issues (ie drugs, head injuries, etc)...but my perceptions were always substantiated. On a very rare occasion, I'd bring out my official IQ test and compare my results to theirs, for them to get a sense of where they have issues.

Intelligent people can struggle with weight, but they might be lazy. What I'm getting at is that it's often problems that they can solve if they really want to..but they make excuses. "I'm just big boned" "I just love food so much!" etc.

So on rare occasions, you would directly compare your IQ to theirs during their therapy session? Am I interpreting that sentence correctly? I cannot see how that would not rupture rapport, assuming rapport was already established. Or are you referring to the normative sample to your "official IQ test"?

 

[deleted343839]

On a very rare occasion, I'd bring out my official IQ test and compare my results to theirs, for them to get a sense of where they have issues.

Ooooh, you tipped your hand a bit far there...

 

[barryggg]

It is not sarcasm it is reality and I wasn't joking. A painful reality, but unfortunate something that is going on for years. When psychology and neuropsychology was developing in USA many years ago, it was banned by the communism in this country, so many people are now taking advantages. When I started to practice I wasn't allowed to do neuropsych evaluations. Those were the standards established by the "board", an institution whose role is a combination of APA+the state boards in USA for licensure+board certification (ex ABPP). Six months later they've changed the standards and I was allowed. They did not require training, an MA or a PhD, all you had to do is have a clinical psychology license. They have lowered the standards, no diploma needed anymore. Did I become competent to do them over night? On paper yes, in reality no. Do you really think this is ok? Maybe the PhD diploma itself makes no difference in general, but the training needed to practice at a competent level is very important. Five years of training in EU don't compare to all those years of training in USA. I've only met two neuropsychologists from USA and they were both well above my knowledge, like they should be after all these years of education. I dropped out from the best and most wanted MA in clinical psych program in my town because it was useless for my job and got myself admitted to the best in my country, even if that meant to travel 300 miles away from home every two weeks for courses. Now I thank to myself that I took everything too seriously and made that choice. You should have known how important is to know your limits, don't practice outside your boundaries/competencies, look for better training and supervision and take the profession seriously. That requires more than BA+MA years of education. Telling someone that is taking this profession too seriously is a red flag for me that it's not for you.

I appreciate the reply.

I only know what is required to become a Psychologist in much of Europe..generally, I have no clue how competent these people are. My overall point was not to say that Europe is the ideal model of how to train Psychologists. I have after-all maintained throughout these discussions that education as a whole has to change, and if that change did occur, we could train competent Psychologists in less time, especially if these individuals were interested in just assessment/therapy. I do maintain that despite the education system not being ideal, we do still in fact train competent Psychologists at the Masters level, and Canada is proof of this imo. I realize that this is an opinion...but it is my experience.

My main purpose of comparing NA qualifications vs. European qualifications in training Psychologists, is to question WHY western nations, with some of the strongest economies, high standards of living, good healthcare systems in general, some of the happiest people in the world (see the Nordic nations), are comfortable with the standards they have for Psychologists.

This is an important question for all of us to ask ourselves. After practicing for some years, I feel I have the answer. That answer is that unfortunately our services are not really a necessity. There are other providers that can do what we do with less education, and imo, do it competently and at similar levels. This is why I say "you take yourself too seriously".

 

[barryggg]

That's arguable, depending on the psychiatrist. I know lots of them that prefer to do 20 minutes consults in private practice, rather than 50-60 minutes of psychotherapy sessions because they are paid more for one consult. One 20 minutes consult here means the same money for 50 minutes of psychotherapy. I also know some that are offering psychotherapy for their patients. Of course, you can choose your fees, but here higher fees means loosing patients, many are not going to therapists for financial reasons, choose a psychiatrist that gives them pills and hope their mental issues will go away. I don't know what is going on from this financial point of view in US. Also, the psychologist-psychiatrist relationship is very bad

Well, yes..of course they prefer to do treatments that will provide more income. But there is a reason you get less for psychotherapy, and more for a shorter session where you prescribe meds...for most serious mental illness, medication is the main form of treatment. We take the less serious stuff..which CAN BE dealt with by less trained individuals. Yes..Masters level people..if they are trained correctly.

 

[psych.meout]

I appreciate the reply.

I only know what is required to become a Psychologist in much of Europe..generally, I have no clue how competent these people are. My overall point was not to say that Europe is the ideal model of how to train Psychologists. I have after-all maintained throughout these discussions that education as a whole has to change, and if that change did occur, we could train competent Psychologists in less time, especially if these individuals were interested in just assessment/therapy. I do maintain that despite the education system not being ideal, we do still in fact train competent Psychologists at the Masters level, and Canada is proof of this imo. I realize that this is an opinion...but it is my experience.

My main purpose of comparing NA qualifications vs. European qualifications in training Psychologists, is to question WHY western nations, with some of the strongest economies, high standards of living, good healthcare systems in general, some of the happiest people in the world (see the Nordic nations), are comfortable with the standards they have for Psychologists.

No, the purpose of your posts is pretty clear to denigrate doctoral level providers and training in the US with absolutely no empirical evidence to support your position.

This is an important question for all of us to ask ourselves. After practicing for some years, I feel I have the answer. That answer is that unfortunately our services are not really a necessity. There are other providers that can do what we do with less education, and imo, do it competently and at similar levels. This is why I say "you take yourself too seriously".

2016, the year of feels over reals

Well, yes..of course they prefer to do treatments that will provide more income. But there is a reason you get less for psychotherapy, and more for a shorter session where you prescribe meds...for most serious mental illness, medication is the main form of treatment. We take the less serious stuff..which CAN BE dealt with by less trained individuals. Yes..Masters level people..if they are trained correctly.

This is completely inconsistent with the extant research in mental health and EBTs. But please, tell us more about masters-level provider are equally competent at consuming and employing the research literature.

Ok, I'm calling it as trolling now.

 

[barryggg]

Funny. When I am more sarcastic in my posts, trying to bring a little humour, you address the points seriously and want answers. When I make a totally serious post, with no jokes, and with valid points and things to think about, then I'm trolling.