Article on legal "case" against the internship imbalance

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cara susanna

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Hi fellow SDNers,

This article has been making the rounds through my department and everyone is talking about it. In it, the authors (two of whom are lawyers) discuss the potential legal case that a psych doctoral student could have against their program if they don't match to an internship. I know that we've discussed this idea here before, but I don't know if anyone prior to this had actually conducted scholarly research on the topic.

http://psycnet.apa.org/psycinfo/2013-24408-001/

Thoughts?

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Hi fellow SDNers,

This article has been making the rounds through my department and everyone is talking about it. In it, the authors (two of whom are lawyers) discuss the potential legal case that a psych doctoral student could have against their program if they don't match to an internship. I know that we've discussed this idea here before, but I don't know if anyone prior to this had actually conducted scholarly research on the topic.

http://psycnet.apa.org/psycinfo/2013-24408-001/

Thoughts?

I didn't read the article, but I'm happy to see that someone FINALLY had the courage to discuss the legal ramifications of the imbalance and possibly raise a legal argument that may hold programs more accountable in the future. I do believe that students are going to have to sue professional programs with very low match rates and the APA for accrediting them before anything gets done. I believe the APA should get sued for continuing to accredit programs that have 4% match rates. The fact that they have a conflict of interest and financial incentive to accredit as many programs as possible seems very shady to me.
 
Somehow I think that psychologists should be opposed to this. The egregious offenders who pour the most students into the pool aren't going to bow out of the process while there's still money to be made, and the APA isn't going to risk reducing its growing membership. The only result I see is that there will be more internships being made available through funding by FSPS programs and a price cut on internship accreditation by the APA, resulting in more psychologists and lower than the already abysmal salaries psychologists get already for the field they work in.
 
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Somehow I think that psychologists should be opposed to this. The egregious offenders who pour the most students into the pool aren't going to bow out of the process while there's still money to be made, and the APA isn't going to risk reducing its growing membership. The only result I see is that there will be more internships being made available through funding by FSPS programs and a price cut on internship accreditation by the APA, resulting in more psychologists and lower than the already abysmal salaries psychologists get already for the field they work in.

Isn't going to risk reducing it's growing membership? Their membership is actually declining over the past several years. Less than half of all doctoral level psychologists are members. And, I think this is one of the things driving this trend. The APA CoA is a joke. I'm not paying money to prop up an organization that is doing all it can to water down my degree by loosening accreditation standards so that the for-profits who donate money can be happy and make more money. Until APA actually gets serious about the FSPS programs, among other problems, this won't change.
 
The "contribute internships" idea has always struck me as short-sighted and weak. It's also seemed to me to be nonsensical. If traditional academic programs did the "captive internship" thing, it would be FSPS left in the dust for the most part. i.e., I went to UF, which has two programs, both of which take about 6-7 people a year. The counseling center takes 6 interns and the clinical health program takes, I think, 6, and the VA (good affiliation with the clinical program) takes another half dozen. That's not a directly grown internship, but the relationships with the academic programs strongly grow the internships. What if traditional academic programs decided that, hey, they're just going to rank students from their own programs first and other people can fill in the gaps? People would have a fit.

The problem is pretty clear; a small number of doc sites take an enormous number of students. Limit the number of students and you absorb a huge amount of the variance in the problem, and it returns to a problem of people not matching due mostly to geographic restriction or competency, not a nonsensical game of musical chairs.(The article's problems with reducing class sizes seem, to me, nonsensical.)
 
Somehow I think that psychologists should be opposed to this. The egregious offenders who pour the most students into the pool aren't going to bow out of the process while there's still money to be made, and the APA isn't going to risk reducing its growing membership. The only result I see is that there will be more internships being made available through funding by FSPS programs and a price cut on internship accreditation by the APA, resulting in more psychologists and lower than the already abysmal salaries psychologists get already for the field they work in.


I like the plan that was proposed, as I think it is a step in the right direction. The oversupply of students is the main factor contributing to the imbalance. Limiting class size through the accrediting body isn't possible from a legal standpoint (as far as I am aware), so making schools share the financial burden or at least some basic legal/ethical accountability for match rates may reduce FSPS's interest in taking on more students, building more schools, etc. when there are other degrees that they can market that don't require the hassle.
 
We can limit class size and proliferation of professional schools in other ways. Make the EPPP harder (students from those programs already have a hard time passing). Make APA internship required. Fall below a certain 1st time pass rate of the EPPP or APA match rate and your program is no longer accredited. Can also change requirements with respect to resource needs at universities (full time tenured professor/student ratios, library size, journal access, faculty research productivity). Lobby states to not accept licensure requests from grads of said programs, mission accomplished.

I agree with the idea that programs should lose accreditation and/or be placed on probation for poor EPPP pass rates and internship match rates. The APA have never adequately addressed this idea, which is incredibly frustrating. I don't agree that making the EPPP harder or requiring an APA-internship is helpful, at least in the near future, given that this contributes to the bottle-neck issue that created this discussion in the first place. If the EPPP wasn't such a cluster%$%% of a test, and matching to an accredited internship didn't require a four-leaf clover and a rabbit's foot, then I would agree.

This raises the question, why the hell doesn't the APA integrate EPPP pass rates and internship match rate cutoffs into the accreditation criteria?
 
I agree with the idea that programs should lose accreditation and/or be placed on probation for poor EPPP pass rates and internship match rates. The APA have never adequately addressed this idea, which is incredibly frustrating. I don't agree that making the EPPP harder or requiring an APA-internship is helpful, at least in the near future, given that this contributes to the bottle-neck issue that created this discussion in the first place. If the EPPP wasn't such a cluster%$%% of a test, and matching to an accredited internship didn't require a four-leaf clover and a rabbit's foot, then I would agree.

This raises the question, why the hell doesn't the APA integrate EPPP pass rates and internship match rate cutoffs into the accreditation criteria?

None of this will change as long as APA has a HUGE financial stake in accrediting and re-accrediting programs. The decision making should be completed by a 3rd party that is not getting paid by programs themselves. Maybe another organization like APS composed of psychologists who are volunteers should be doing the evaluation of programs. As it stands, APA gets paid more $ if the program admits more than 50 students. Conflict of interest, no?

Fee schedule effective 2013. Program will be invoiced annually each summer with payment due on Dec. 31.
Doctoral Programs (1-50 Students) — invoiced Aug. 1 $3,750
Doctoral Programs (51+ Students) — invoiced Aug. 1 $4,250


There shouldn't even be a 51+ option for a PhD/PsyD program!!!
 
None of this will change as long as APA has a HUGE financial stake in accrediting and re-accrediting programs. The decision making should be completed by a 3rd party that is not getting paid by programs themselves. Maybe another organization like APS composed of psychologists who are volunteers should be doing the evaluation of programs. As it stands, APA gets paid more $ if the program admits more than 50 students. Conflict of interest, no?

Fee schedule effective 2013. Program will be invoiced annually each summer with payment due on Dec. 31.
Doctoral Programs (1-50 Students) — invoiced Aug. 1 $3,750
Doctoral Programs (51+ Students) — invoiced Aug. 1 $4,250


There shouldn't even be a 51+ option for a PhD/PsyD program!!!

100% agree. Anyone want to draft a boycott letter to the APA up? See how many psychologists we can get to sign it?
 
This raises the question, why the hell doesn't the APA integrate EPPP pass rates and internship match rate cutoffs into the accreditation criteria?

This came up when I was on APAGS. APA's legal person was clear that this would be totally fine to do, and not restraint of trade or something ridiculous like some authors say.

Why they don't do it, seems to me in a large part because it involves actually making hard decisions and having hard conversations. This problem got so bad, literally because no one wanted to talk about it for 10 years.
 
This came up when I was on APAGS. APA's legal person was clear that this would be totally fine to do, and not restraint of trade or something ridiculous like some authors say.

Why they don't do it, seems to me in a large part because it involves actually making hard decisions and having hard conversations. This problem got so bad, literally because no one wanted to talk about it for 10 years.

Yeah, I am sick of hearing of "restraint of trade" where there is no evidence of this at all and other fields have been able to engage in effective quality control (MD).

The real problem is that we have a lack of strong leadership, integrity and courage at the top of our field. Nobody has stepped up as a strong leader with courage to make these difficult decisions.
 
The real problem is that we have a lack of strong leadership, integrity and courage at the top of our field. Nobody has stepped up as a strong leader with courage to make these difficult decisions.

It doesn't help that last year, APA released the applications for APA board positions literally days before they were due, and they require paperwork, getting nominations, etc. This from the same "good governance" that gives lip service to wanting more ECPs to join. Unless you were watching for the forms, you'd never have been able to know when it was possible to apply for positions. It's a ridiculous buddy-buddy musical chairs system, but if you want to shake people up, you have to raise a little hell... ;)
 
Limiting class size through the accrediting body isn't possible from a legal standpoint (as far as I am aware).

Where do you get this from? One could easily set a student:full time instructor ratio and it would hardly bother traditional programs but would cripple the profits for FSPS.

Also, aren't accrediting bodies private organizations that can do pretty much whatever they want?
 
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Where do you get this from? One could easily set a student:full time instructor ratio and it would hardly bother traditional programs but would cripple the profits for FSPS.

Also, aren't accrediting bodies private organizations that can do pretty much whatever they want?

An accrediting body can't do whatever it wants; it has to answer to the US Dept of Education. They do monitor things like, how many students are going into debt and how much. Psychology was on their radar (but it's not like we're really the most important thing the Dept of Ed handles).

It would be illegal to say, arbitrarily, "schools can only take 10 students a year." That would certainly be restraint of trade, very clearly. Medical schools set their numbers by a different enrollment metric, which has to do with the resources the school has (super basic version: the med school adds a microsurgery program? It can take 5 more students. It adds four faculty? I can take 5 more students, etc. [this is an oversimplification but it sorta works like that]). From my understanding it would not be impossible for psych to switch to that way of doing things, although our resources are, traditionally at least, less material than fMRIs and surgical beds. That would require a total overhaul of accreditation (though it would allow for things like near-instant accreditation of internships, because they could be accredited very soon after they met the metrics for resources).

But, using the accreditation system APA now has, it is totally reasonable to sanction programs based on standards like APA match rate and EPPP. In fact, it was in the CoA guidelines (which, on the books, required a 75% match rate). The APA lawyers look over the guidelines and for it to be in there obviously means it went across their table. This appears to me to have never been enforced, though (programs with horrid match rates in the APPIC documents have 7-year reaccreditations on the CoA list of accredited sites).
 
100% agree. Anyone want to draft a boycott letter to the APA up? See how many psychologists we can get to sign it?

You would have my signature. This doesn't seem too bad of an idea. On a related note, I recently had an email exchange with an APA rep after I stated that I wasn't going to APA this year while it was being sponsored by NOVA and Argosy. This is the response I got:

The APA rep's response to my initial email:
"Dear -------------,

Thank you for expressing your concerns. I want to assure you that the APA Commission on Accreditation (APA-COA) is a self-supporting unit within the APA; the fees charged by the APA-CoA for accreditation are used exclusively to support the program accreditation process. Moreover, APA-CoA's decision-making regarding programs seeking initial or continuing accreditation is solely within the purview of the Commission and all policy regarding accreditation is formulated by the APA-CoA. There has been, and continues to be, a firewall between APA as a membership organization and the decision-making activities of the Commission on Accreditation.

APA also shares you concern about the internship imbalance and has committed up to $3 million to facilitating the development of new accredited internships. In addition, APA's federal advocacy program, in which students participate, has resulted in over $35 million in grants to training programs. There are multiple other initiatives underway as well.

Concerning the Association's advertising and convention sponsorship policies, this has been formally addressed in that APA policy limits advertising and/or sponsorship opportunities to accredited programs only if the program is in the area of clinical, counseling or school psychology. Programs in other areas of psychology may advertise. For your information the revenue generated by convention ads and/or sponsorships is less than 5% of the total convention budget; it is not used to support the accreditation program.

To the extent that others share your concerns, I also want to note that policy formation can be initiated through representatives to the APA Council of Representatives or one of APA's governance groups. I hope this is responsive to your inquiry.

Sincerely,

Cynthia"

My Response:

"Hi Cynthia,

I appreciate your thorough response, and I thank you for your time in responding. I am pleased to see a lot of the steps that APA has taken to resolve the internship crisis, with the formation of this new task force, things have modestly improved. I also understand the need for the division between APA and the Commission on Accreditation.

My main concerns are these:
1. There has been a steady increase in newly minted psychologists, which appears to be only increasing (I am basing this off of the data on the APPIC website)
2. This steady increase appears to be the largest contributing factor in the internship crisis
3. The internship crisis is part of a larger problem, i.e., an increased supply of psychologists, and a decreased demand. In other words, if you create 1000 new internship positions, you still will have issues with a lack of post-docs and jobs. Thus, the internship squeeze is better than a post-doc squeeze, etc.

Although I have seen APA discuss this issue, I have yet to see proposed solutions that effectively and comprehensively address these issues, particularly with the supply side of things. As you mentioned earlier, this may not be possible with the way the accreditation system works, in which case I think there needs to be an overhaul or a restructuring of that system. If universities can't consistently match their students with accredited internships, then that should be grounds for losing accreditation or being place on probation, etc. The universities should share some of this burden, as opposed to it being placed solely on students. The American Medical Association seems better able to deal with this type of issue, and I think we would benefit from modeling our program development from them.

I apologize if my ADD is flaring up and I missed something here. Again, I appreciate your earlier response, and my main point in writing was to express the concerns that I hear from listserv and early career members to someone within the APA. Thanks again.

-----------"

Her response:

"Yes, clearly understood. Actually the accreditation guidelines ARE under review, and just finished two periods of public comment in which these kinds of view could find expression (according to how accreditation policy is formulated). There will definitely be other opportunities, as their first draft will also go out for public comment, and I encourage you and your colleagues to participate actively in this process.

The other need is for APA to complete a workforce analysis the can inform E&T institutions. Keep asking for it!

Cynthia"
 
...On a related note, I recently had an email exchange with an APA rep after I stated that I wasn't going to APA this year while it was being sponsored by NOVA and Argosy. This is the response I got:...

Good for you! Thanks! Gotta keep em knowing students are breathing down their necks!

I don't think you talked to just some APA rep, btw, you were probably emailing with Dr Cynthia Belar, the executive director of the APA education directorate ;)


I thought about the article a little more, and I think the premise is flawed. It suggests that programs could be sued for requiring an internship, implying an APA/APPIC internship. But it isn't REALLY the programs that requires this, it's (some) state boards. If a student didn't match, and decided to take a ramshackled "internship" just to hang a shingle later (risks for that aside), I don't think the programs are REALLY able to stop that (and I know students who did this; indeed, this is why the entire group of unmatched students does NOT reenter the match yearly). The program-level strong suggestion for an APA (or APPIC, or CAPIC, or whatever) internship is protective of the student for future work, but I don't think a program can really make someone not get the degree for not doing an accredited internship. If they really barred someone from doing anything other than an APA internship, maybe then they could be sued, but that's different from just a student not matching and then suing. Some of the legal precedent cited also seems to not be relevant to me, because it seems to suggest that anyone can sue if they didn't get an internship (even if they only apply to one internship program).
 
You would have my signature. This doesn't seem too bad of an idea. On a related note, I recently had an email exchange with an APA rep after I stated that I wasn't going to APA this year while it was being sponsored by NOVA and Argosy. This is the response I got:

The APA rep's response to my initial email:
"Dear -------------,




Concerning the Association's advertising and convention sponsorship policies, this has been formally addressed in that APA policy limits advertising and/or sponsorship opportunities to accredited programs only if the program is in the area of clinical, counseling or school psychology. Programs in other areas of psychology may advertise. For your information the revenue generated by convention ads and/or sponsorships is less than 5% of the total convention budget; it is not used to support the accreditation program.

To the extent that others share your concerns, I also want to note that policy formation can be initiated through representatives to the APA Council of Representatives or one of APA's governance groups. I hope this is responsive to your inquiry.

Sincerely,

Cynthia"

My Response:

Good work Rivi!!!

Even though revenue generated by the sponsorship from Argosy etc. is only 5% of the total convention budget, this still poses a conflict of interest and should not be allowed since the same organization is required to accredit them annually. We all know how powerful reciprocity can be.
 
If they really barred someone from doing anything other than an APA internship, maybe then they could be sued, but that's different from just a student not matching and then suing.
Good point.

However, all (or at least the vast majority of) programs require internship. Correct? Can't be a clinical psych doctorate without internship. Yet the programs are not providing these internships (doesn't have to be APA, APPIC, CAPIC, they are not making internships for you). Thus, the schools are not providing a viable path for the completion of the tacit agreement between the student and the university. Or at least that seems an argument one can easily make in court.
 
As one of the contributing authors of the article, I am happy to further discuss it and hope that it engages conversation across many departments. As with any article it has its limitations, however, I think this article is the type of kick the field needs to push it towards being accountable towards students.

IMO, It really won't be long before a program is sued (and probably one of the larger ones, if we're thinking in terms of probability) and then issues like this will have substantive progress made towards them. We should also focus on the training bottlenecks that still exist like externships (or lack thereof in over-populated student areas) and post-docs, and other systemic issues in the field like reimbursement and ensuring our workforce can meet the demands the public needs.

Lastly, Mike is totally right. Programs on a whole have to reduce the number of students they take, AND, IMO as stated in the article, increase the number of internships they offer to be equal to the number of students they take (or engage in cost-sharing models, etc).
 
Hi there. Welcome to the forum. I don't see how the programs themselves are going to be able to provide good internship experiences. Most of the match problems rest with schools whose existence is driven heavily by loan dollars. Their professors don't have research grants. Their universities don't have large donors. They barely provide adequate training experiences as it is. Why would we expect them to not botch the internship experience? I think the answer here is to maintain APA standards for internships (including pay), require APA internship for graduation and tie that to accredidation, and require programs to reduce the number of students they have over a certain time period to match their APA internship match rates. Better yet, just eliminate professional schools. It has been done before (e.g. Flexner).

Actually, captive internships (though at a school location) go through the same vetting process by APA and APPIC, including all aspects of what it takes to become accredited in terms of quality and pay. Look at captive internships like The Adler School and other programs have--they are competitive internships and do not go solely to the students of that institution. We advocated in our paper for accredited captive internships, not fly by the seed of your pants create your own "comparable" internships that barely get you licensed in X state, which many programs (and albeit, professional schools) help students create to get them out the door and the responsibility off of the program. Accreditation is key, and not impossible for affiliated/captive internships. I think if anything, we as a community should decrease systemic barriers which prohibit innovative internships from being created (including those that are captive) and improve access- such as the APA stimulus for one, and the new partnership with the trust which could have significant financial implications for training should APA be so pressured in utilizing the 6.5 million dollars it just received this year alone from that partnership.
 
Hi there. Welcome to the forum. I don't see how the programs themselves are going to be able to provide good internship experiences. Most of the match problems rest with schools whose existence is driven heavily by loan dollars. Their professors don't have research grants. Their universities don't have large donors. They barely provide adequate training experiences as it is. Why would we expect them to not botch the internship experience? I think the answer here is to maintain APA standards for internships (including pay), require APA internship for graduation and tie that to accredidation, and require programs to reduce the number of students they have over a certain time period to match their APA internship match rates. Better yet, just eliminate professional schools. It has been done before (e.g. Flexner).

I agree with this.

The medical schools in the Caribbean (equivalent to many professional schools of psychology in some ways) are not in the US and are pretty much blacklisted. They are not accredited by the AMA and are not accepted in the US. Our professional schools of psychology currently outnumber traditional universities, are accredited by the APA, and have a lot of lobbying power with the APA. The number of graduates that don't complete APA internships are now higher than the graduates that complete APA internships (if you include the number that forgo the match entirely). More and more graduates are also taking on unpaid/low stipend, unaccredited internships and postdocs as the availability of accredited internships cannot keep up with the growing supply of graduates.

As a field, we need to step up, get some courage, and take some pretty aggressive, immediate action because the situation is beyond grim, dangerous to the public, and downright abusive of psychologists and graduate students. As intelligent people, I don't understand why we put up with our reckless and poor APA leadership. They are like members of congress---harming our interests with no regard for the long-term viability of our field. I will be voting and trying to get these spineless, reckless individuals out of our leadership offices.
 
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Look at captive internships like The Adler School and other programs have--they are competitive internships and do not go solely to the students of that institution. We advocated in our paper for accredited captive internships, not fly by the seed of your pants create your own "comparable" internships that barely get you licensed in X state, which many programs (and albeit, professional schools) help students create to get them out the door and the responsibility off of the program. Accreditation is key, and not impossible for affiliated/captive internships. I think if anything, we as a community should decrease systemic barriers which prohibit innovative internships from being created (including those that are captive) and improve access- such as the APA stimulus for one, and the new partnership with the trust which could have significant financial implications for training should APA be so pressured in utilizing the 6.5 million dollars it just received this year alone from that partnership.

I'm confused. I just checked online and Adler's captive APA internships is only offered to 4-7 students from its program each year, and not to outsiders.

You just posted in another thread that you left Adler because they had an incoming class of 115 and obviously couldn't support good training. They have an internship for 5 students each year. Are you honestly using them as a model of good citizenship? They leave out 95% of their students and are one of the worst offenders. You lost credibility on that end. Come on, do you really think they can create a high-quality internship for 115 students each year? What are your interests here?

*Update*: checked out Adler's APA internship on the APPIC website. I am surprised that it got accredited at all. http://www.appic.org/directory/program_cache/186.html. They only have 3 full-time licensed psychologists on staff and 7 interns this year. As a comparison, most of the VA internships have 30 psychologists on staff and take on 5 interns.
 
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As one of the contributing authors of the article, I am happy to further discuss it and hope that it engages conversation across many departments. As with any article it has its limitations, however, I think this article is the type of kick the field needs to push it towards being accountable towards students.
Yes, welcome to the forum. While I hope you are correct I doubt this article will give any of the major offenders a kick in anything. Maybe a lot of us on here are just jaded b/c we see all the greed and unethical behavior while simultaneously no remorse from the programs. I swear that the training directors seem to be completely blind to their exploitative actions. I mean look at Adler, half of their graduates never get licensed in the past 8 classes. I doubt that the majority go into academia yet they obviously don't care.

IMO, It really won't be long before a program is sued (and probably one of the larger ones, if we're thinking in terms of probability) .
It seems you would have been the perfect person if you stayed at Adler. I hope a lawsuit comes soon but nothing has happened for a long time.
 
I'm confused. I just checked online and Adler's captive APA internships is only offered to 4-7 students from its program each year, and not to outsiders.

You just posted in another thread that you left Adler because they had an incoming class of 115 and obviously couldn't support good training. They have an internship for 5 students each year. Are you honestly using them as a model of good citizenship? They leave out 95% of their students and are one of the worst offenders. You lost credibility on that end. Come on, do you really think they can create a high-quality internship for 115 students each year? What are your interests here?

*Update*: checked out Adler's APA internship on the APPIC website. I am surprised that it got accredited at all. http://www.appic.org/directory/program_cache/186.html. They only have 3 full-time licensed psychologists on staff and 7 interns this year. As a comparison, most of the VA internships have 30 psychologists on staff and take on 5 interns.

No, I definitely do not think Adler is the perfect model, and just used it because it is one of the few professional schools that have an affiliated internship, I obviously DO NOT think their training in the doc. program is fantastic, though I can't judge the internship because ACHS actually has a stellar reputation in the community--and Adler has developed other internships that are in the process of getting APA accreditation, such as the prison program, etc....but not at the rate that it accepts students, that's for sure.

I am just listing one model of captive internships, there are others, and others that are better linked to smaller class sizes--listed in the manuscript. I feel like you might be missing the larger issue that I am trying to point out, and perhaps i'm not doing that as clearly as I could- I'm still jetlagged from Hawaii and am bogged down trying to get my LSAT up so I can get a funded law program. :)

I don't think a program can feasibly create high-quality internships for 115 students, but that's my personal opinion and I could always be corrected if a school stepped up to the plate and did so...this is partially why I think the captive internship model is helpful. It would have the consequence of reducing class sizes to manageable levels in which the programs could realistically support (or cost share with outside organizations) internship development. I don't think "down with the PsyDs" is the appropriate channeling of the energy the field needs, but I think, collectively, professional programs get the bad rep (and for legit reasons) of exploiting their students, and we need to change that. I'm a firm believer that if you feel there are problems within the system-work to change them, and that's what I (and others) have aimed to do through our scholarship and advocacy. I also served on the APAGS Board for 2 years, and though I am not speaking directly for APAGS, can say that their influence within APA and relationships with CCTC and all the training councils is impressive and has lead to strides in the right direction. Do you have any direct actions you've taken to change the system? I'd be excited to hear them as we probably agree on more than we disagree, and I think we could all come together and bring down the system we talk so passionately against.
 
Yes, welcome to the forum. While I hope you are correct I doubt this article will give any of the major offenders a kick in anything. Maybe a lot of us on here are just jaded b/c we see all the greed and unethical behavior while simultaneously no remorse from the programs. I swear that the training directors seem to be completely blind to their exploitative actions. I mean look at Adler, half of their graduates never get licensed in the past 8 classes. I doubt that the majority go into academia yet they obviously don't care.


It seems you would have been the perfect person if you stayed at Adler. I hope a lawsuit comes soon but nothing has happened for a long time.

Thank you for the welcome to the forum. I share the sentiment about the being jaded, and think my opinion has greatly changed from when I first started at Adler and on the APAGS board until I subsequently left Adler 3 years later because I felt I could no longer ethically participate and support such an institution. Frankly, too personal of a story to share on here, but I did talk to several attorneys and as always, there are always two arguments in a legal battle and I didn't have the energy to go through with it. Emotionally I had to get in a better place so I could be successful in my JD/PhD program applications, which I ended putting off another year as I'm finishing up some manuscripts, etc. But don't think that once I'm licensed as an attorney this issue will be far from my mind.

PS- Licensure for any program is pretty hard to track, and I'd say that more than half of their graduates are actually licensed. I don't speak very highly of the program anymore, which is why I should really shut up about them because I'm a broken record when it comes to them, but really, once you've invested 100K+ in a program that is less than ideal, you have to make the best decision for yourself, work towards your professional goals despite circumstances that work towards that not happening (i.e., competing against 114 people in your program) and kick ass and take names. Programs that have this climate ultimately do struggle- either in terms of match rates, student climate, attrition, lack of core faculty--the list goes on, eventually adds up, and eventually raises enough red flags for concern. Don't kid yourself- if enough students wrote legit complaints to CoA--they are receptive to this and adequately investigate actions that are not commiserate with the G&P. Frankly, I'd like to see this happen more. Despite being in positions of less power, we as students do hold more cards than we traditionally think, and sometimes that starts with having hard discussions that make people uneasy. Sometimes it takes energizing our base- and not always with negative jaded affect. And sometimes it just takes a glass of wine. :)
 
I'm confused. I just checked online and Adler's captive APA internships is only offered to 4-7 students from its program each year, and not to outsiders.

You just posted in another thread that you left Adler because they had an incoming class of 115 and obviously couldn't support good training. They have an internship for 5 students each year. Are you honestly using them as a model of good citizenship? They leave out 95% of their students and are one of the worst offenders. You lost credibility on that end. Come on, do you really think they can create a high-quality internship for 115 students each year? What are your interests here?

*Update*: checked out Adler's APA internship on the APPIC website. I am surprised that it got accredited at all. http://www.appic.org/directory/program_cache/186.html. They only have 3 full-time licensed psychologists on staff and 7 interns this year. As a comparison, most of the VA internships have 30 psychologists on staff and take on 5 interns.

I haven't heard anything positive about Adler from anyone I've known who has been associated with it. Just an aside.
 
A captive internship by a program like Adler is almost by necessity funded by loan money, meaning they need way more students than they can place in order to have the internship program. It seems like it is not an economically feasible solution to me. I'd rather just keep upping reqs until the professional schools close. We don't need them. They are bad for the field. They are clearly operating at a substandard level. Just start emphasizing 1st trial pass rate of the eppp, APA internship match rate, faculty to student ratios, faculty board certification rates, faculty publication rates, university endowments, ratio of funding source from student loans and close the mfers down.

As far as things I have done and members of this forum have done, some of us have published papers, some have created advocacy groups, discussing the issue here is also a form of advocacy. But I agree, more involvement at the higher levels of lobbying state licensing boards and member organizations is necessary. Certainly a lot of noise about professional schools has come at the higher levels of our field just not enough to stop the cancer. Those programs have nothing to offer. They litterally can't stop exploiting their student AND continue to exist. Their model only works financially by exploiting their students. It's not fixable.

Agree 100%

APA-accreditation should include a minimum EPPP pass rate and APA-internship match rate. Programs with 50% or less EPPP and APA-match rates over a 5-year period are not consistently producing competent psychologists,period.
 
*Update*: checked out Adler's APA internship on the APPIC website. I am surprised that it got accredited at all. http://www.appic.org/directory/program_cache/186.html. They only have 3 full-time licensed psychologists on staff and 7 interns this year. As a comparison, most of the VA internships have 30 psychologists on staff and take on 5 interns.

I certainly don't want to defend Adler in any way - I have colleagues who went there and they have very little good to say about the program. However, you do realize there are many quality APA accredited internships that only have 2 or 3 full-time psychologists on staff, don't you? I think you would be hard-pressed to find many internships at CMHCs or residential treatment centers with more than that. I am currently at an APA accredited internship and my site has 2 full-time psychologists and two part-time psychologists to help with supervision and didactics. So far (about a month in), I feel I have had a pretty good training experience.This is to say that the number of full-time Psychologists on staff is probably a poor metric to use when judging the quality of an internship site.
 
i certainly don't want to defend adler in any way - i have colleagues who went there and they have very little good to say about the program. However, you do realize there are many quality apa accredited internships that only have 2 or 3 full-time psychologists on staff, don't you? I think you would be hard-pressed to find many internships at cmhcs or residential treatment centers with more than that. I am currently at an apa accredited internship and my site has 2 full-time psychologists and two part-time psychologists to help with supervision and didactics. So far (about a month in), i feel i have had a pretty good training experience.this is to say that the number of full-time psychologists on staff is probably a poor metric to use when judging the quality of an internship site.

+1.
 
I certainly don't want to defend Adler in any way - I have colleagues who went there and they have very little good to say about the program. However, you do realize there are many quality APA accredited internships that only have 2 or 3 full-time psychologists on staff, don't you? I think you would be hard-pressed to find many internships at CMHCs or residential treatment centers with more than that. I am currently at an APA accredited internship and my site has 2 full-time psychologists and two part-time psychologists to help with supervision and didactics. So far (about a month in), I feel I have had a pretty good training experience.This is to say that the number of full-time Psychologists on staff is probably a poor metric to use when judging the quality of an internship site.

I wouldn't necessarily say it's an entirely poor metric, as it can reflect things such as how much supervision will be available, how many differing orientations and/or approaches you might be exposed to, and the various other benefits that come with being in an environment where there's a multitude of potential supervisors and where psychology is likely somewhat thoroughly-entrenched. Psychologist-to-intern ratio may better capture parts of this concept, though, as a site that has 4 licensed staff and takes 4 interns is much different than one that has 4 staff and then tries to take 12 interns.

Slight aside--my general opinion is that there are actually enough (or nearly enough) internship spots, there are just too many students; we should be focusing our greatest efforts on remedying the latter problem, not the former. Although on the internship side of things, I think serious time should be spent lobbying to allow intern services to be billed to insurance.
 
What about making the internship post-doctoral?
 
What about making the internship post-doctoral?

There's a decent historical argument for that, as it used to be that internship was the FIRST clinical experience, and now students apply with more hours than old interns ever accrued. However, under the current systems, I think it's nonsense as a solution to the imbalance--there would only be MORE extreme levels of accepting huge numbers of students, accepting students paying through massive loans they'll never pay back, etc. It would be a weak solution with bad long-term effects, though after large sites are made to be accountable and responsible it might be worth looking at.
 
There's a decent historical argument for that, as it used to be that internship was the FIRST clinical experience, and now students apply with more hours than old interns ever accrued. However, under the current systems, I think it's nonsense as a solution to the imbalance--there would only be MORE extreme levels of accepting huge numbers of students, accepting students paying through massive loans they'll never pay back, etc. It would be a weak solution with bad long-term effects, though after large sites are made to be accountable and responsible it might be worth looking at.

I agree. Once we handle the bolded portion above, which I believe to be step 1, then we can start addressing these other potential solutions (e.g., make the internship post-doctoral and/or lobby for making intern services billable, encourage the development of more internships, etc.).

Until we get a hand on the spigot controlling the number of graduate students being accepted each year, everything else is just going to be a temporary and/or ineffectual stopgap.
 
Agree 100%

APA-accredidation should include a minimum EPPP pass rate and APA-internship match rate. Programs with 50% or less EPPP and APA-match rates over a 5-year period are not consistently producing competent psychologists,period.

I think that minimum should be around 75% for internship match rates and EPPP pass rates, as an average over 5 years.

There are a ton of great ideas floating around on this forum that nobody from the APA will see. Can we email our suggestions to the APA office of accredidation? Who can we contact there. I found this leadership and governance office link: http://www.apa.org/ed/governance/index.aspx

It has cynthia belar, PhD as the main person. There was also a link to the APA senior executive staff. CEO is Norman Anderson, PHD. http://www.apa.org/about/apa/senior-staff/index.aspx
 
I agree that making large cohort programs accountable is the best solution, but I'm a little cynical about it ever happening. APA is too enmeshed with these programs, IMO.
 
...
You just posted in another thread that you left Adler because they had an incoming class of 115 ...

lol. So much for the NCSPP claims that they are self-policing this. That's so stupid it's laughable. Everyone in those programs should be screaming at the administration to stop this.

Edit: I just did some checking on this, and it looks like several of the NCSPP programs actually ARE reducing class sizes over the last few years (e.g., some Argoses dropped from 40ish people to just over a dozen, etc.), though many also still remain at 60ish class sizes (e.g., http://mia.albizu.edu/web/academic_programs/psychology/downloads/IR_C_20.pdf) or have actually grown (e.g, http://www.adler.edu/page/programs/...l-psychology/student-admissions--outcome-data). So, whatever is happening there isn't consistent and hopefully they'll crack down on the programs that are probably just absorbing the folks rejected by other programs that are trying to be more responsible ($$$$).
 
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I just asked them about it; let's see if that doesn't get deleted off the FB page...
 

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I just asked them about it; let's see if that doesn't get deleted off the FB page...

Have you tried emailing the CEO of APA or the education directorate, Dr. Belar?
 
I think that minimum should be around 75% for internship match rates and EPPP pass rates, as an average over 5 years.

Both are great ideas....and reasonably attainable for all but a handful of programs already. The challenge is have multiple criterion, as some programs may have a very high EPPP (e.g. teach to the test) or high match rate (e.g. captive internship site).

There are a ton of great ideas floating around on this forum that nobody from the APA will see. Can we email our suggestions to the APA office of accredidation?
Many of these ideas have been forwarded to various people in APA leadership, with mixed responses. I know multiple people (myself included) have contacted the APA CoA, though it is a slow and arduous process. Lobbying at the state level could provide some movement, but obviously it would only really matter if it could happen in CA, which unfortunately is not a realistic option considering the other challenges facing the state. Short of having a private benefactor throw money at the problem (at the national level and using connections to get the legislation sponsored/co-sponsored), going through APA will be required.

Having someone run for an open seat on the APA CoA or similar board is the most logical step if the above are ineffective routes. I'd encourage people to keep an eye out for STUDENT rep positions, as those seem more attainable and provide some visibility. There are also Early Career Psychologist (ECP) seats on some/most committees, but good luck securing one of them without already being significantly involved with the APA.
 
Have you tried emailing the CEO of APA or the education directorate, Dr. Belar?

Well, I did send the petition a while back and got the reply posted here and to the FB group. On this specific problem, I'd need a bit more data on the schools before I sent something to the APA (i.e., I'd want to say there are problems with more schools than just Adler). The NCSPP is the member organization for all professional schools, so they'd be on the email list too, and probably be able to put more immediate pressure on than APA itself.
 
Here is the public comment section from the Coa about what proximal and distal outcome data should be used to evaluate programs. I am surprised that nobody mentioned requiring APA match rates at a specific minimum, like 75% in the June 2013 comments.

http://apaoutside.apa.org/AccredSurvey/Public/ViewComments.asp?t=143957&SectionID=128

Many of the public comments endorsed the NCPP position below:

Representing: NCSPP
Role in Group: President
Members in Group: 86
Date Edited: 10/08/2012
Comments:
We would recommend that CoA should play no role in addressing issues surrounding the match imbalance. CoA performs a Quality Assurance Function, not a role in solving funding, incentives, and other political issues for the discipline or the profession. Since the inception of the Boulder model, practicum training has increasingly taken the place that internship training used to occupy. Most students now receive the kind of experience, the length, sequence and complexity of field training in practicum that used to be reserved for internship training 20 or 30 years ago. We have a tendency to want to teach our students everything, everywhere, and not let them go until long after most other professions have independently licensed their graduates. We have the longest duration of education and training post-baccalaureate to licensure of any of the health professions (Olvey, Hogg, & Counts, 2002). Is this necessary? What is the rationale for such a training model? Do we think psychology students are so much more dangerous than medical students or dental students? Given the evolution of pre-internship practicum training, it may be time to consider making internship post-doctoral and give the degree and license at the end of the doctoral program, particularly for programs that demonstrate a commensurate level of training is occurring at the pre-internship level."

Also, if you are an APA member do they send you a link for public comment? They didn't send this to me last time.
 
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Here is the public comment section from the Coa about what proximal and distal outcome data should be used to evaluate programs. I am surprised that nobody mentioned requiring APA match rates at a specific minimum, like 75% in the June 2013 comments.

http://apaoutside.apa.org/AccredSurvey/Public/ViewComments.asp?t=143957&SectionID=128

Many of the public comments endorsed the NCPP position below:

Representing: NCSPP
Role in Group: President
Members in Group: 86
Date Edited: 10/08/2012
Comments:
We would recommend that CoA should play no role in addressing issues surrounding the match imbalance. CoA performs a Quality Assurance Function, not a role in solving funding, incentives, and other political issues for the discipline or the profession. Since the inception of the Boulder model, practicum training has increasingly taken the place that internship training used to occupy. Most students now receive the kind of experience, the length, sequence and complexity of field training in practicum that used to be reserved for internship training 20 or 30 years ago. We have a tendency to want to teach our students everything, everywhere, and not let them go until long after most other professions have independently licensed their graduates. We have the longest duration of education and training post-baccalaureate to licensure of any of the health professions (Olvey, Hogg, & Counts, 2002). Is this necessary? What is the rationale for such a training model? Do we think psychology students are so much more dangerous than medical students or dental students? Given the evolution of pre-internship practicum training, it may be time to consider making internship post-doctoral and give the degree and license at the end of the doctoral program, particularly for programs that demonstrate a commensurate level of training is occurring at the pre-internship level."

Also, if you are an APA member do they send you a link for public comment? They didn't send this to me last time.

I don't remember getting a link to this public comment (I posted in the initial CoA public comment though).

What a ridiculous comment from the NCSPP. Particularly ridiculous is the "particularly for programs that demonstrate a commensurate level of training is occurring at the pre-internship level" given that NCSPP programs do much worse on the EPPP. Ugh.

Edt: Also, G&P Roadmap II was about competencies, not the imbalance, so the comment makes no real sense in light of that. My guess is that the poster, the NCSPP, is simply aware of NCSPP program problems and that was on his mind as he wrote it, rather than the content of the actual public comment.
 
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I don't remember getting a link to this public comment (I posted in the initial CoA public comment though).

What a ridiculous comment from the NCSPP. Particularly ridiculous is the "particularly for programs that demonstrate a commensurate level of training is occurring at the pre-internship level" given that NCSPP programs do much worse on the EPPP. Ugh.

Edt: Also, G&P Roadmap II was about competencies, not the imbalance, so the comment makes no real sense in light of that. My guess is that the poster, the NCSPP, is simply aware of NCSPP program problems and that was on his mind as he wrote it, rather than the content of the actual public comment.

I agree. Until the CoA actually does a good job of verifying that "commensurate...training is occurring at the pre-internship level," then outcome variables such as EPPP pass rates, internship placement statistics, etc., NEED to be considered. And besides, if commensurate training were actually happening, then wouldn't these outcome variables be similar across programs to begin with? I mean, I would imagine they're fairly similar across many traditional departments.

As for this...

Given the evolution of pre-internship practicum training, it may be time to consider making internship post-doctoral and give the degree and license at the end of the doctoral program, particularly for programs that demonstrate a commensurate level of training is occurring at the pre-internship level.

While I think some would agree that making the internship post-doctoral could help, in this case (i.e., as mentioned by the NCSPP), I think it's potentially highly self-serving. After all, the programs then aren't shackled with large numbers of students who have trouble landing internships (and thereby potentially increasing their legal liability). I mean, who cares if these folks have trouble finding spots so long as they've already graduated?
 
I just asked them about it; let's see if that doesn't get deleted off the FB page...

Good post! I am interested to see how they respond to this as well.
 
Well, they didn't reply, but they posted this a few hours after I posted my question:


Adler School of Professional Psychology shared a link.
17 hours ago
Some great info to pass on that reflects so well on our Psy.D. students, faculty and training staff: As a result of this year’s Internship Match Day, our Psy.D. in Clinical Psychology students’ total match rate of 92% and overall APA match rate of 55% are well above national averages. Schools and students can look at a number of variables in comparing a school with national averages. Following Phase 1 match earlier this year, we wrote about some of the questions you can ask schools when comparing internship rates.


("Total match rate" appears to mean any internship at all, even if it's to Bob's House of Discount Therapy)

I get a little concerned about coming off as an internet crackpot sometimes, if anyone else would care to challenge that post. ;)
 
How is an overall APA match rate of 55% "well above the national average"?

My question as well. Although the APPIC stats don't appear to list the APA match rate nationwide, just the overall match rate (which for ten years through 2010 was 73.7%).
 
MCParent, correct me if I'm wrong...didn't you do a follow up paper to the 2010 that looked more closely at c-20 reporting of data and the variance in presentation by program? Did you capture the APA match rate per program, as it'd be really interesting to look at that data compared to the "blended" rates that many programs tout. If not....I'd be down to do some analysis. :D
 
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