Decline of the Field & APA's Role?

[deleted343839]

The Monitor shows students taking f'ing field trips to other countries. Notice medicine or law trying that?

Medicine, yes. Increasingly. Do a quick Google search for global health programs in medical schools.

The focus upon social ills is just about the second dumbest thing our profession does.

To the extent that the field goes beyond invoking explanations or solutions grounded in behavioral science. Which it does... a lot. But social determinants of health is an important aspect of most health professions' curricula and ours should be no exception.

And that speaks to a general point others have made, which is that psychology too long squandered the opportunity to find its place in the healthcare ecosystem. The field is trying to make up for lost time but we're paying a steep price for decisions made decades ago that, as best as I can tell, were made as a result of both arrogance and ignorance.

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[Therapist4Chnge]

We had a large on-site clinic run by the faculty for clinical psych, school psych, and MHC students to do training and offer low-cost assessment and treatment to the community. Off-site practica sites varied greatly in regard to therapy v. assessment....and in quality of training.

We had three (?) required assessment classes over the first 2-3 years. I took nearly every elective assessment course offered, minus the advanced projective class bc...projective assessments are the essential oils of clinical psych.

We really do need more of a standardized training bc my training was very different than my therapy heavy/minimal assessment friends from my program and other programs.

 

[PsyDr]

@MamaPhD

The global health programs for medical schools are exceptionally different in kind than anything I have ever seen discussed in trade publications. I have never seen a program’s international trip being used for similar purposes. To me, they always seem like field trips to “understand other cultures”.

 

[Spydra]

I've heard mention of a trend of recent graduate students getting less and less training in assessment. The causes are probably multifocal, including having fewer faculty in training programs who are themselves comfortable with assessment. More and more folks are leaving graduate school with single-digit numbers of integrated reports, if they have any at all. It's disheartening.

This was what I gathered when I attended conferences and met students in other programs who were also saying they were pretty lost when it came to assessments. In my program half the faculty had no experience with assessments after finishing their graduate programs so they do say they may not be the best to provide assessment training. And while I get that its far too simple to just say then hire psychologists that have better assessment training to provide that training to students, I don't get why the solution instead has been to just do nothing.

Regardless, I'm doing everything I can to obtain the training I need, but it shouldn't be an uphill battle to have access to it and I am very aware of the possibility that my efforts won't be enough when its time to apply to internships. My program doesn't offer elective assessment courses and there isn't an APA accredited Counseling program at my University. We are allowed to take courses at other Universities, but no one does that due to the cost and additional time/commute commitment. If anyone has any suggestions I'm all ears.

 

[AcronymAllergy]

My most helpful assessment training came from practica (i.e., just doing the assessments). We of course had coursework as well, both on administration and basic interpretation (1 or 2 semesters), and more specialized topics relating to neuropsych (3 or 4 semesters), which was in addition to a class or two on test development. The coursework was great for laying the foundation, but it was through writing dozens and dozens of reports in grad school (in close supervision with my advisor) that I, personally, learned the most. It sounds like you're doing what I would recommend by continuing to look for community providers. It's unfortunate that your program isn't providing more support.

You can also plan ahead and start looking into internship sites that offer additional assessment opportunities related to your areas of interest. And if they haven't provided it already, you can see if your current practicum supervisor has any recommended readings you can go through on your own time.

 

[deleted343839]

@MamaPhD

The global health programs for medical schools are exceptionally different in kind than anything I have ever seen discussed in trade publications. I have never seen a program’s international trip being used for similar purposes. To me, they always seem like field trips to “understand other cultures”.

Admittedly as a medical school faculty member I'm more familiar with the medical training side of this.

APA's international program focuses on understanding local needs and service organization and delivery in other countries, and is open to graduate students, but it's definitely extracurricular and may be the exception to the rule.

 

[cara susanna]

I actually learned a lot of my assessment skills from my Assessment courses. Practica and internship helped a ton (I didn't do any assessment on post doc) but the foundation of my knowledge came from those classes.

Then again, I've been told that apparently my program has a reputation for strong assessment training.

 

[oathkeeper]

There's a bunch of ways, but it gets ignored.

1) Psychologists can admit in some states. This is profitable as hell.
2) Psychologists can be paid for the behavioral component of fMRI testing. Few actually do this.
3) IIRC JCAHO requires a psychologist to be on staff at every psychiatric hospital.
4) RxP.

I could not agree more with many of these but especially 1- we need to fight for more privileges in a hospital that would allow us to practice to the full extent of our scope. my state sets a lot of limits on what psychologists can do (at least I have found) and it limits our monetary value. The hospital I am in is trying to argue for higher salaries for psychologists bc we can provide evidence based, effective work-which, of course, true. but not enough to get us the appropriate increased status and salary.

 

[Justanothergrad]

I've heard mention of a trend of recent graduate students getting less and less training in assessment. The causes are probably multifocal, including having fewer faculty in training programs who are themselves comfortable with assessment. More and more folks are leaving graduate school with single-digit numbers of integrated reports, if they have any at all. It's disheartening.

To be fair, the decline in integrative reports is likely a result of internship directors valuing them less than other things in selection of folks to interview and rank (Just another Grad, in prep). It varies by site, but people want assessment administration hours that we can train undergrads to do more than the skill of interpretation. The decrease in value may also relate to the folks who report having 100+, it becomes so hard to define what is useful in those reports and number of wais administrations can be used to check the number of hours listed to determine what that 'means' for development.

again. it's an issue of standardization



Is this a good time for me to plug division 12, section IX (assessment) membership? come join us!

 

[Spydra]

Is this a good time for me to plug division 12, section IX (assessment) membership? come join us!

Thanks for mentioning this, I hadn't heard of it before. I noticed that under Student Resources some kind of list of assessment oriented internships is in development. Do you know if this is actually being worked on or if its just been talked about forever and maybe one day in the far future when I no longer need it then it'll happen?

 

[Justanothergrad]

Thanks for mentioning this, I hadn't heard of it before. I noticed that under Student Resources some kind of list of assessment oriented internships is in development. Do you know if this is actually being worked on or if its just been talked about forever and maybe one day in the far future when I no longer need it then it'll happen?

That's one of the things that has taken a bit of a back seat - the board is limited with how many things they can do on their own (small section membership, consistent with declining assessment focus impacts this as well). I'm not sure when that started but it hasn't been the focus of conversations in the past 6 months (we have focused more on the BOP guidelines for assessment training, etc.). I'll mention it to some other board members and see if we can start progress on it again. I'd like to make sure it is useful, and that (in my mind right now) means specific as to type of training /level of training (which likely would require some sort of consensus of the board)

depending on what you're looking for, I may he able to help. PM me

 

[LadyHalcyon]

I was just contacted by someone about a job like this, but it is soooooo far from my interest areas. But maybe I should reconsider.....

A bigger one than those, only psychologists, psychiatrists, and Psych NPs/PA have the ability to bill medicaid/medicare for services in a skilled nursing facility. A big reason I moved towards geriatrics work.

 

[WisNeuro]

I was just contacted by someone about a job like this, but it is soooooo far from my interest areas. But maybe I should reconsider.....

Check compensation rates. I get contacted about jobs in NH/SNF/ALF all the time, pay and benefits almost universally suck.

 

[Ollie123]

Well that was a marathon. Think I got everyone who wanted a copy, but if I missed you please let me know!

Genuinely interested to hear thoughts/feedback too.

 

[Sanman]

Well that was a marathon. Think I got everyone who wanted a copy, but if I missed you please let me know!

Genuinely interested to hear thoughts/feedback too.

Not to create more work for you, but can you add me to the list? Thanks.

 

[Sanman]

Check compensation rates. I get contacted about jobs in NH/SNF/ALF all the time, pay and benefits almost universally suck.

Yeah, if they are contacting you, the rates likely will suck. If you need more guidance, feel free to PM me.

 

[LadyHalcyon]

I want one!

Well that was a marathon. Think I got everyone who wanted a copy, but if I missed you please let me know!

Genuinely interested to hear thoughts/feedback too.

 

[LadyHalcyon]

Thank you! I have definitely been getting some great advice via the PM function

Yeah, if they are contacting you, the rates likely will suck. If you need more guidance, feel free to PM me.

 

[Spydra]

Well that was a marathon. Think I got everyone who wanted a copy, but if I missed you please let me know!

Genuinely interested to hear thoughts/feedback too.

I sent a pm asking for a copy too. Thanks!

 

[Spydra]

depending on what you're looking for, I may he able to help. PM me

I think your PMs may be turned off since I couldn't get it to go through. However you (and everyone else!) has provided lots of food for thought, so thank you!

 

[attitudelikeasunrise]

I see a lot of problems:

1) The decade of the brain was about the stupidest thing a professional organization that specializes in behavior could have done.
2) The focus upon social ills is just about the second dumbest thing our profession does. We're not trained as diplomats, policy makers, etc. The world has politicians, lobbyists, and attorneys for that. Ignoring that we have next to no training in the subject and attempting to practice in that arena is beyond narcissistic. And the APA goes along with it. The Monitor shows students taking f'ing field trips to other countries. Notice medicine or law trying that? Me neither.
3) The entire "fight the power" nonsense makes the profession look immature. Most professions keep private problems private.
4) Feels over reals is terrible. If you have a doctorate, you should be able to quote stats and research just like MDs or JDs.
5) People complaining about professional dues, while also complaining about the APA getting revenue elsewhere.

Agree with this 100%. The main reason I let my APA membership lapse this year was because they have chosen to prioritize subjective social justice/advocacy pursuits in lieu of promoting general evidence-based psychology. I think this is a bad move for a multitude of reasons, the main two being: (1) Psychologists are supposed to be there to serve the community at large and by having our leadership take hard stances on divisive political/social issues they are unnecessarily excluding entire segments of the population (2) The field of psychology is constantly fighting to be seen in the same scientific esteem as STEM fields. By diverging from objective/evidence-based protocols, and engaging ever more heavily in emotionally laden advocacy, it makes it that much harder for us to be taken seriously by anyone who considers scientific backing to be an essential component of treatment protocols.

 

[Grenth]

This was what I gathered when I attended conferences and met students in other programs who were also saying they were pretty lost when it came to assessments. In my program half the faculty had no experience with assessments after finishing their graduate programs so they do say they may not be the best to provide assessment training. And while I get that its far too simple to just say then hire psychologists that have better assessment training to provide that training to students, I don't get why the solution instead has been to just do nothing.

Regardless, I'm doing everything I can to obtain the training I need, but it shouldn't be an uphill battle to have access to it and I am very aware of the possibility that my efforts won't be enough when its time to apply to internships. My program doesn't offer elective assessment courses and there isn't an APA accredited Counseling program at my University. We are allowed to take courses at other Universities, but no one does that due to the cost and additional time/commute commitment. If anyone has any suggestions I'm all ears.

Spydra, I just want to echo your concerns as a fellow student in an APA university-based funded PhD who has received wholly inadequate assessment training. We get three courses on assessment, one on intellectual/achievement testing, one on personality testing, and one on neuropsych. Each course had really minimal hands-on time and practice with both admin and report-writing. We have no in house clinic and only one dept lab does any adult assessment research. It's not uncommon for students to count a BDI as an assessment to scrabble up hours (not okay obviously). Out of around forty practicums available to our school in our large metro area, only three are adult assessment focused and maybe ten have any substantial adult assessment component.

I've already completed two pracs (UCC and AMC) where I hustled (stayed late, sent out my CVs to other psychs in the dept, offered to do kid testing, scoring, anything) and managed to get ~50 assessment hours (in contrast I have ~750 legit face to face therapy hours). Classmates in the same pracs got close to zero because that was the way they were set-up. I also only have one hard-fought integrated report and my only goal this summer before internship apps is to get as many more as I can. Because I know this is important I also found a local boarded neuropsychologist to take me on for a part-time assessment practicum. It's frustrating because I feel I shouldn't have to do all this extra work in a legit program to get the training that should be standard for all psychologists.

 

[foreverbull]

Spydra, I just want to echo your concerns as a fellow student in an APA university-based funded PhD who has received wholly inadequate assessment training. We get three courses on assessment, one on intellectual/achievement testing, one on personality testing, and one on neuropsych. Each course had really minimal hands-on time and practice with both admin and report-writing. We have no in house clinic and only one dept lab does any adult assessment research. It's not uncommon for students to count a BDI as an assessment to scrabble up hours (not okay obviously). Out of around forty practicums available to our school in our large metro area, only three are adult assessment focused and maybe ten have any substantial adult assessment component.

I've already completed two pracs (UCC and AMC) where I hustled (stayed late, sent out my CVs to other psychs in the dept, offered to do kid testing, scoring, anything) and managed to get ~50 assessment hours (in contrast I have ~750 legit face to face therapy hours). Classmates in the same pracs got close to zero because that was the way they were set-up. I also only have one hard-fought integrated report and my only goal this summer before internship apps is to get as many more as I can. Because I know this is important I also found a local boarded neuropsychologist to take me on for a part-time assessment practicum. It's frustrating because I feel I shouldn't have to do all this extra work in a legit program to get the training that should be standard for all psychologists.

I concur that I was not prepared practice-wise despite the relevant coursework. I do personally think that all programs should have a minimum standard of assessment practice and help students meet that standard via ensuring a selection of sites with assessment experience and requiring an assessment practicum (or strongly encouraging it?). At the very least, it makes students more marketable and gives them more career options.

What I didn't realize in grad school was that once I graduated and completed postdoc without an assessment-based practicum, I'd largely be locked out of assessment and assessment-related jobs (non-neuropsych assessment, I should clarify) regardless of my prior foundational assessment coursework and practice administration during the courses (the exception being paying for extensive consultation, which is not particularly realistic for early career psychologists). No one warned me about this while I was in grad school, so I hope that current grad students are aware of this.

Having said that, I recognize that many have no interest in assessment practice, so I'm sure there's room for debate on either side.

 

[Spydra]

Spydra, I just want to echo your concerns as a fellow student in an APA university-based funded PhD who has received wholly inadequate assessment training. We get three courses on assessment, one on intellectual/achievement testing, one on personality testing, and one on neuropsych. Each course had really minimal hands-on time and practice with both admin and report-writing. We have no in house clinic and only one dept lab does any adult assessment research. It's not uncommon for students to count a BDI as an assessment to scrabble up hours (not okay obviously). Out of around forty practicums available to our school in our large metro area, only three are adult assessment focused and maybe ten have any substantial adult assessment component.

I've already completed two pracs (UCC and AMC) where I hustled (stayed late, sent out my CVs to other psychs in the dept, offered to do kid testing, scoring, anything) and managed to get ~50 assessment hours (in contrast I have ~750 legit face to face therapy hours). Classmates in the same pracs got close to zero because that was the way they were set-up. I also only have one hard-fought integrated report and my only goal this summer before internship apps is to get as many more as I can. Because I know this is important I also found a local boarded neuropsychologist to take me on for a part-time assessment practicum. It's frustrating because I feel I shouldn't have to do all this extra work in a legit program to get the training that should be standard for all psychologists.

Nice to hear another student chime in. I'm doing a similar hustle and the lack of action from my program is just unacceptable. It also isn't just important that we learn how to do assessments well to properly diagnose and inform treatment plans, but it matters for research. My research is heavily assessment dependent and I just learned *surprise surprise* that in one case I chose the wrong measure and in another I interpreted a key measure incorrectly. Pretty much having to start over is so much fun *sarcasm.* If I had known that my training was going to be this bad I wouldn't have bothered.

What I didn't realize in grad school was that once I graduated and completed postdoc without an assessment-based practicum, I'd largely be locked out of assessment and assessment-related jobs (non-neuropsych assessment, I should clarify) regardless of my prior foundational assessment coursework and practice administration during the courses (the exception being paying for extensive consultation, which is not particularly realistic for early career psychologists). No one warned me about this while I was in grad school, so I hope that current grad students are aware of this.

Assessments were one of the primary draws to the field for me so yes I absolutely know this and that's why I'm working so hard at my own hustle. I always expected to have an assessment practice once licensed and was open to the possibility of training other students, but now I am not sure how realistic that is without sufficient training. Yes its still possible since I still have time in my program, internship, and postdoc but it is seriously a struggle to find opportunities without a strong foundation which should be standard in every program. Honestly I'd like to do something that helps push for broad change in this area, but have no idea what I could do given my student status.

 

[Justanothergrad]

I think your PMs may be turned off since I couldn't get it to go through. However you (and everyone else!) has provided lots of food for thought, so thank you!

FYI.

 

[PsyDWannabe]

5) People complaining about professional dues, while also complaining about the APA getting revenue elsewhere.

But this does not change the fact that the cumulative cost of professional orgs memberships can be on the chunky side, especially when compared to the pittance of a paycheck from internships and the slghtly less of a pittance of a paycheck offered by some fellowships. You are speaking about young adults likely in their 30's or older who have financial strains related to phase of life change, increased healthcare costs (we're not as young and spry as we used to be), families to support, increasing living expenses etc. Let's no toss that baby out with the bathwater.

I wonder what the sentiment would be from those not in a 2-income household/with generational/familial wealth/rich spouse/no loans etc

 

[PsyDr]

But this does not change the fact that the cumulative cost of professional orgs memberships can be on the chunky said, especially when compared to the pittance of a paycheck from internships and the slghtly less of a pittance of a paycheck offered by some fellowships. You are speaking about young adults likely in their 30's or older who have financial strains related to phase of life change, increased healthcare costs (we're not as young and spry as we used to be), families to support, increasing living expenses etc. Let's no toss that baby out with the bathwater.

I'll grant financial things as a very valid excuse until licensure. Everything after that is simply a matter of choice. If you don't want to invest in the future of your field, you're being short sighted. No different than not saving for retirement. Lifestyle creep is a choice.