Future Psy D / PhD Programs

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Mike Grisonich

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I know that there’s a lot of skepticism regarding online and hybrid doctoral programs, much of it well-earned.

However, it seems to me that online education isn’t going anywhere, and that it’s trajectory will be up — from lower-level degrees (bachelor’s) to higher, and from degree mills to quality universities.

My question: can you foresee a time in the next decade or two where there are credible and, more importantly, accredited hybrid psych doctoral programs? With, perhaps, yearly in-person practicums?

Might these programs be designed in such a way as to provide comparable training to brick-and-mortar programs?

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I agree that online education isn't going anywhere. But, its reputation took a HUGE hit in the pandemic. The online programs in psych were already known to be diploma mills, of which most do not lead to licensure. So, can a hybrid model theoretically be done? Maybe. But, where is the incentive to do so?
 
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Medicare is still paying for telehealth, so I would say it's a mistake to rule anything out.

As the virtual world expands and is normalized, I think all graduate programs will increasingly utilize Zoom for things like supervision, classes, and treatment. But the faculty:student ratio at the good schools won't change. Massive online learning doesn't work in our field. Does it work in any?
 
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That’s interesting. In Canada, where we have a well-established and publicly funded online-only uni (Athabasca), Im not sure that the pandemic did anything but bolster online Ed’s reputation. But tbh I haven’t paid much attention, so could be missing some details.

As for incentives, I could imagine two:
1) many students would want such programs, and would pay for them.
2) universities might view such programs as a way of attracting students from remote areas (ie Alaska), which could in turn help produce trained clinicians willing to spend their careers in these regions.
 
That’s interesting. In Canada, where we have a well-established and publicly funded online-only uni (Athabasca), Im not sure that the pandemic did anything but bolster online Ed’s reputation. But tbh I haven’t paid much attention, so could be missing some details.

As for incentives, I could imagine two:
1) many students would want such programs, and would pay for them.
2) universities might view such programs as a way of attracting students from remote areas (ie Alaska), which could in turn help produce trained clinicians willing to spend their careers in these regions.

As to #1, programs currently have little to no problem recruiting students. In fact, most get 10-40X the number of applications than they have slots to fill. As to #2, rural areas have generally always had a hard time filling healthcare positions, and increases in supply have not really moved the needle, so I'd be skeptical that this would do anything of significance here aside from saddling even more people with unmanageable levels of debt.
 
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Medicare is still paying for telehealth, so I would say it's a mistake to rule anything out.

As the virtual world expands and is normalized, I think all graduate programs will increasingly utilize Zoom for things like supervision, classes, and treatment. But the faculty:student ratio at the good schools won't change. Massive online learning doesn't work in our field. Does it work in any?
interesting. So you think it’s possible, and potentially valuable, but only so far as it doesn’t lead schools to take on insanely large cohorts?
 
As to #1, programs currently have little to no problem recruiting students. In fact, most get 10-40X the number of applications than they have slots to fill. As to #2, rural areas have generally always had a hard time filling healthcare positions, and increases in supply have not really moved the needle, so I'd be skeptical that this would do anything of significance here aside from saddling even more people with unmanageable levels of debt.
Fair enough. But what about schools which don’t cover tuition costs but are still capable of getting accredited? Might it not be in their financial interest?
 
Medicare is still paying for telehealth, so I would say it's a mistake to rule anything out.

As the virtual world expands and is normalized, I think all graduate programs will increasingly utilize Zoom for things like supervision, classes, and treatment. But the faculty:student ratio at the good schools won't change. Massive online learning doesn't work in our field. Does it work in any?

The available evidence does not look good. There's a lot out about didactics in online and hybrid models during the pandemic, and largely negative. I wouldn't say that it can't be done, but no one really seems to know how to do it well.
 
Fair enough. But what about schools which don’t cover tuition costs but are still capable of getting accredited? Might it not be in their financial interest?

Yes, but even these diploma mills already have no problem recruiting applicants/people willing to be exploited.
 
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The available evidence does not look good. There's a lot out about didactics in online and hybrid models during the pandemic, and largely negative. I wouldn't say that it can't be done, but no one really seems to know how to do it well.
Agreed. Forcing schools overnight to switch to that model did not, in all likelihood, produce great outcomes.

I was teaching at a uni in Vietnam at the time and the level of online education our faculty provided was abysmal.
 
Agreed. Forcing schools overnight to switch to that model did not, in all likelihood, produce great outcomes.

I was teaching at a uni in Vietnam at the time and the level of online education our faculty provided was abysmal.

Even programs in psychology that were set up this way and have done this for years have terrible outcomes. So, as of yet, we really don't have any demonstrated models that show anything that even remotely resembles competence in this area.
 
As for incentives, I could imagine two:
1) many students would want such programs, and would pay for them.
2) universities might view such programs as a way of attracting students from remote areas (ie Alaska), which could in turn help produce trained clinicians willing to spend their careers in these regions.
1) Students want all sorts of things. Admissions does not operate based upon what students want.
2) Universities have no shortage of students seeking admission.
 
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Even programs in psychology that were set up this way and have done this for years have terrible outcomes. So, as of yet, we really don't have any demonstrated models that show anything that even remotely resembles competence in this area.
one exception to this is the Masters Counseling program at Athabasca in Canada. While I’ve not attended it, and it is of course only a masters, I know that it’s highly competitive and even well-respected in the field here.

Perhaps Canadians employers might wish to challenge this, but I seriously doubt if any clinic would make much of a distinction in the hiring process between a MC Athabasca and a MC from any of our traditional unis.
 
one exception to this is the Masters Counseling program at Athabasca in Canada. While I’ve not attended it, and it is of course only a masters, I know that it’s highly competitive and even well-respected in the field here.

Perhaps Canadians employers might wish to challenge this, but I seriously doubt if any clinic would make much of a distinction in the hiring process between a MC Athabasca and a MC from any of our traditional unis.

I cannot speak much to the Canadian programs as I do not know the outcome literature here. Here we can look at licensure rates, match rates, and EPPP pass rates for indirect measures of quality. And, this specific forum is geared towards doctoral level providers, different ballgame.
 
Medicare is still paying for telehealth, so I would say it's a mistake to rule anything out.

As the virtual world expands and is normalized, I think all graduate programs will increasingly utilize Zoom for things like supervision, classes, and treatment. But the faculty:student ratio at the good schools won't change. Massive online learning doesn't work in our field. Does it work in any?

This. In the course of my education, I have taken lectures with 500+ people and I have taken graduate classes where the faculty: student ratio was 1:1 and the course was the basis of my dissertation. The first psych class I ever took was 500+ people. I could have taken that class online and managed to learn the same amount of information as I did in person. The professor that taught that class was also my first mentor, the first person who gave me a lab position, and now a friend that turned a young pre-med onto the path to be a psychologist. Would I have built that relationship in an online environment if I had not stayed after class to ask questions and talk? Would I gain anything from attending a 1:1 class in grad school virtually? The issue becomes what are you trying to accomplish with your education. Seems great for throw away lectures if that is all you want. However, if you are trying to build a close relationship with a mentor I am not sure if this is the way to do so.
 
I think that the main barrier is lack of incentive for instructors/professors to adjust standard (in-person) pedagogy to that which yields success for virtual learning. And as long as there isn’t any current incentive or pressure for universities to create online psychology doctoral programs, even if they could make additional revenue or increase the pipeline, all will remain as is.

I don’t think that means that one couldn’t be developed or even be successful and produce successful graduates..but I think that doing so would require a lot of time, money, labor resources that for most people and institutions, just aren’t there.. or at the least are (seem to be) currently better spent elsewhere.
 
I think that the main barrier is lack of incentive for instructors/professors to adjust standard (in-person) pedagogy to that which yields success for virtual learning. And as long as there isn’t any current incentive or pressure for universities to create online psychology doctoral programs, even if they could make additional revenue or increase the pipeline, all will remain as is.

I don’t think that means that one couldn’t be developed or even be successful and produce successful graduates..but I think that doing so would require a lot of time, money, labor resources that for most people and institutions, just aren’t there.. or at the least are (seem to be) currently better spent elsewhere.

I can't see a reason to move it to a doctoral program. A masters will do for most people and if we are democratizing education a licensable masters is less costly and more democratic. From a workforce perspective this is what is needed. An online doctoral degree is just for vanity.

Secondly, this is psychology. In order to implement this, we will need studies, followed by studies that refute those studeis , followed by a pilot program, and a conference to discuss guidelines. There will already be a 100,00 LCSWs and Counselors graduated from an online program before the first online doctoral program is accredited and taking students. Also, trying to democratize a fundamentally elitist institution is swimming against the tide.
 
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I can't see a reason to move it to a doctoral program. A masters will do for most people and if we are democratizing education a licensable masters is less costly and more democratic. From a workforce perspective this is what is needed. An online doctoral degree is just for vanity.

Secondly, this is psychology. In order to implement this, we will need studies, followed by studies that refute those studeis , followed by a pilot program, and a conference to discuss guidelines. There will already be a 100,00 LCSWs and Counselors graduated from an online program before the first online doctoral program is accredited and taking students. Also, trying to trying to democratize a fundamentally elitist institution is swimming against the tide.
I agree fully minus the doctorate just for vanity and trying to democratize a fundamentally elitist institution is swimming against the tide part.
 
I agree fully minus the doctorate just for vanity and trying to democratize a fundamentally elitist institution is swimming against the tide part.
I'm curious as to why/ in what way you disagree with those parts.
 
Re doctorate not just for vanity: I mean, you’re basically asking why anyone gets a PhD/PsyD other than for the title. Unless you’re saying that ppl who would pursue it online would only be interested in it for the title and I’m not sure why that would be the case? I personally have no interest in the title in itself. I pursued a PhD bc it was the only path to reach my goals of directing my own line of research and to use my research and skills to significantly affect small and large change in my areas of interest with populations of interest. I can imagine that those interested in a more traditional clinical career may be interested in gaining a deeper grasp of why in addition to what to do. Our research, statistical, and measurement training affords is a larger toolkit for investigation. There’s also our hold on assessments, general salary expectations, unique administration and leadership opportunities, pursuits within academia and government and so forth.

Re fundamentally elitist:
First I guess I’d need to know precisely what you mean by swimming against the tide and secondly I’m curious as to, so what?

I agree fully that elitism has been fundamental to clinical psychology (and academia)’s history but I don’t think that it has to be its future. In fact, I think the efforts that have been undertaken to diversify psychology have already resulted in underrepresented and previously-excluded psychologists highlighting the importance of an array of previously-ignored (by mainstream) concepts, shifting long-held paradigms, reducing stigma and increasing equity and positive outcomes for individuals, communities, and so on. I think more of these scholars are also shifting and challenging the notions of what clinical psychology can be and are implementing that in their work. Of course the road has been difficult for these scholars and clinicians, as it always is and has been for those whose mere presence, let alone the content/works they produce, is inherently a challenge to the status quo. But just because something is difficult doesn’t mean it is not possible or worthwhile.

Re online doctorate, given the current barriers and other priorities, I don’t know whether it is currently worthwhile nor do I know when or if anyone else will deem it worthwhile enough to pursue. I certainly think it is possible and I think that it could be done well, even while acknowledging the many many challenges that would have to be overcome to do so.
 
Re doctorate not just for vanity: I mean, you’re basically asking why anyone gets a PhD/PsyD other than for the title. Unless you’re saying that ppl who would pursue it online would only be interested in it for the title and I’m not sure why that would be the case? I personally have no interest in the title in itself. I pursued a PhD bc it was the only path to reach my goals of directing my own line of research and to use my research and skills to significantly affect small and large change in my areas of interest with populations of interest. I can imagine that those interested in a more traditional clinical career may be interested in gaining a deeper grasp of why in addition to what to do. Our research, statistical, and measurement training affords is a larger toolkit for investigation. There’s also our hold on assessments, general salary expectations, unique administration and leadership opportunities, pursuits within academia and government and so forth.

I specifically stated online doctorate, not doctorates in general. Relating to my previous quote, training a doctoral candidate (not doc student, I am talking post masters and comps) is generally a resource intensive process that encompasses a professor training 1 or 2 people per year. There is no benefit to translating this to the online medium as there already plenty of candidates willing to do it in person. The bottleneck is the time the professor put in, not the accessibility. If the presumption is that each professor is taking on more students, you change the fundamental resources allocated. My pre-masters years were 1:10 faculty to students, my post-masters candidate classes were never more than 1:4 (2 doctoral candidates, a neuropsych track intern, and a post-doc). At that point, you are doing what I view Pharmacy, Physical therapy, NPs, and other health fields have done...issuing vanity doctorates for folks with a masters or professional level of training. The country did just fine with all of those degrees were masters equivalents. Why do we need a doctor of everything again?

Re fundamentally elitist:
First I guess I’d need to know precisely what you mean by swimming against the tide and secondly I’m curious as to, so what?

I agree fully that elitism has been fundamental to clinical psychology (and academia)’s history but I don’t think that it has to be its future. In fact, I think the efforts that have been undertaken to diversify psychology have already resulted in underrepresented and previously-excluded psychologists highlighting the importance of an array of previously-ignored (by mainstream) concepts, shifting long-held paradigms, reducing stigma and increasing equity and positive outcomes for individuals, communities, and so on. I think more of these scholars are also shifting and challenging the notions of what clinical psychology can be and are implementing that in their work. Of course the road has been difficult for these scholars and clinicians, as it always is and has been for those whose mere presence, let alone the content/works they produce, is inherently a challenge to the status quo. But just because something is difficult doesn’t mean it is not possible or worthwhile.

Re online doctorate, given the current barriers and other priorities, I don’t know whether it is currently worthwhile nor do I know when or if anyone else will deem it worthwhile enough to pursue. I certainly think it is possible and I think that it could be done well, even while acknowledging the many many challenges that would have to be overcome to do so.

While I agree that there is more racial and gender diversity, academia is by it's nature a elitist institution and there is intellectual elitism as well. Why can Harvard University command so much money? Why do Medical schools, law schools and Psychology doctoral programs brag about the low number of admissions compared to applications? Nursing and Social work programs don't do this. The reason is elitism. The title 'Doctor', like the title 'Harvard grad', signals that you are part of an intellectual elite. If everyone is a doctor or Harvard grad there is no reason to be one or pay so much money to be one. Certainly it is not the instruction. We both know that the same professors that teach in the Ivy leagues or teach doctoral students also teach masters folks and even community college folks. They all have access to the same great mind. So, what exactly is academia selling? Elitism and access. This is why we have PCSAS and APA, Board Certification, etc. Having a doctorate is not enough bona fides...how can I prove I am the elite of the elite? Take away my degrees and I was still the smartest kid in many of my classes. Most of us were. Why do I need to prove this over and over again?

Put another way, the NBA is an elite group of basketball players. Not just anyone gets in...otherwise it would be playground ball and no one pays to watch middle school basketball. Instead you get Michael Jordan vs Magic Johnson and LeBron vs Steph Curry. That is elitism. Now, that does not mean that every great basketball player makes it to the NBA. There is some degree of subjective choice by recruiters and coaches (just like there is by professors and admissions committees) because there are more players than spots. There are several greats of Rucker Park that never played in the NBA (Earl Manigault, Joe Hammond, PeeWee Kirkland) but beat NBA players on the court. What happens if the NBA just let anyone with a $30k suit up and play? So, if we are democratizing education start with community colleges and public universities. Not with doctoral degrees that make up 1% of the U.S. population.
 
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I think there are really several related but ultimately independent questions here: (1) Can an online/hybrid degree ever be developed that provides sufficient training for the safe/ethical clinical practice of psychology; (2) Will the field as a whole accept/endorse such a model for purposes of credentialing; and (3) Will the program be viewed as equivalent (versus "lesser than") to traditional degrees.

I believe #1 is theoretically possible, but very difficult to do well. I do not believe I've seen a model I would say does this effectively. #2 is a complicated question. I have little faith in APA as an entity and I could see greed coercing them into this even against the better judgment of many/most members. #3 I think is likely to be a hard no, at least from me and most people I know. That doesn't mean all of their graduates will be viewed negatively, but like prof schools I think it will be an uphill battle for these folks.

Reflecting on my own experiences over the previous few years, I just don't see how an online-only model could work. I actually think its more viable for clinical training than it is for research training. While there are exceptions, a huge portion of research in psychology simply must be done in-person due to equipment needs or just the nature of the topics in question. I've been trying - desperately - to figure out a way to create a lab culture that replicates my grad school experience during COVID and have yet to find a way to do it. Without in-person interaction you just miss too much. Same goes for faculty colleagues/collaborators. A lot of good has come out of this and some things CAN be moved online, but some things are missing. I moved institutions mid-COVID and it has been exceedingly slow to get collaborations going because we simply never see each other. The proverbial "water cooler" conversations we all despised are actually pretty important in hindsight. I think that's even more true at the graduate student level folks are still being oriented to the field and being exposed to new ideas. A paper just came out showing that virtual meetings are effective for run-of-the-mill stuff, but suck for idea generation (Virtual communication curbs creative idea generation - Nature). That certainly jives with my experience. We can do quick updates on the status of papers, but the "essence" of science where we wax philosophical about the fundamental meaning of xyz, brainstorm whole new ways of analyzing a dataset that bridges multiple fields, etc. simply don't happen. In part because zoom is an awkward venue for it. In part because no one is going to set up a zoom meeting for random informal discussion about articles they read until areas of overlap are discovered and collaborations are born. We can coast for a bit without those things and I think we've been doing that in science, but true progress and innovation is going to slow down eventually.

Long story short, I think online is a great venue for training "technician" type positions, but we'll quickly run into problems using it for higher-level more cognitively demanding positions. That doesn't mean elements can't be transitioned online, but I don't think the core experience can be.
 
I specifically stated online doctorate, not doctorates in general. Relating to my previous quote, training a doctoral candidate (not doc student, I am talking post masters and comps) is generally a resource intensive process that encompasses a professor training 1 or 2 people per year. There is no benefit to translating this to the online medium as there already plenty of candidates willing to do it in person. The bottleneck is the time the professor put in, not the accessibility. If the presumption is that each professor is taking on more students, you change the fundamental resources allocated. My pre-masters years were 1:10 faculty to students, my post-masters candidate classes were never more than 1:4 (2 doctoral candidates, a neuropsych track intern, and a post-doc). At that point, you are doing what I view Pharmacy, Physical therapy, NPs, and other health fields have done...issuing vanity doctorates for folks with a masters or professional level of training. The country did just fine with all of those degrees were masters equivalents. Why do we need a doctor of everything again?



While I agree that there is more racial and gender diversity, academia is by it's nature a elitist institution and there is intellectual elitism as well. Why can Harvard University command so much money? Why do Medical schools, law schools and Psychology doctoral programs brag about the low number of admissions compared to applications? Nursing and Social work programs don't do this. The reason is elitism. The title 'Doctor', like the title 'Harvard grad', signals that you are part of an intellectual elite. If everyone is a doctor or Harvard grad there is no reason to be one or pay so much money to be one. Certainly it is not the instruction. We both know that the same professors that teach in the Ivy leagues or teach doctoral students also teach masters folks and even community college folks. They all have access to the same great mind. So, what exactly is academia selling? Elitism and access. This is why we have PCSAS and APA, Board Certification, etc. Having a doctorate is not enough bona fides...how can I prove I am the elite of the elite? Take away my degrees and I was still the smartest kid in many of my classes. Most of us were. Why do I need to prove this over and over again?

Put another way, the NBA is an elite group of basketball players. Not just anyone gets in...otherwise it would be playground ball and no one pays to watch middle school basketball. Instead you get Michael Jordan vs Magic Johnson and LeBron vs Steph Curry. That is elitism. Now, that does not mean that every great basketball player makes it to the NBA. There is some degree of subjective choice by recruiters and coaches (just like there is by professors and admissions committees) because there are more players than spots. There are several greats of Rucker Park that never played in the NBA (Earl Manigault, Joe Hammond, PeeWee Kirkland) but beat NBA players on the court. What happens if the NBA just let anyone with a $30k suit up and play? So, if we are democratizing education start with community colleges and public universities. Not with doctoral degrees that make up 1% of the U.S. population.
It seems that you have taken the position that any mostly online doctorate program would not provide sufficient training, be of lower quality, and have large, unwieldy cohorts. To Ollie’s points 1 and 3 below, those seem like questions to answer or decisions to make, not something that is or must be inherent.

Next, to “democratize” the PhD doesn’t inherently mean to increase numbers. It could I guess. To me, it minimally means equitably increasing access. And I suppose one could argue that if it is more accessible, the numbers will increase, but if standards are maintained, again I am unsure why that would inevitably be the case or why it would be bad. Relatedly, I am not opposed to an increase in the number of PhDs. Seemingly that increase would be in proportion to an increase in masters-level providers…given the presence of additional requisite funding for training and for mental health service delivery more broadly. So mostly, why are you arguing for lowering of standards for online?
I think there are really several related but ultimately independent questions here: (1) Can an online/hybrid degree ever be developed that provides sufficient training for the safe/ethical clinical practice of psychology; (2) Will the field as a whole accept/endorse such a model for purposes of credentialing; and (3) Will the program be viewed as equivalent (versus "lesser than") to traditional degrees.

I believe #1 is theoretically possible, but very difficult to do well. I do not believe I've seen a model I would say does this effectively. #2 is a complicated question. I have little faith in APA as an entity and I could see greed coercing them into this even against the better judgment of many/most members. #3 I think is likely to be a hard no, at least from me and most people I know. That doesn't mean all of their graduates will be viewed negatively, but like prof schools I think it will be an uphill battle for these folks.

Reflecting on my own experiences over the previous few years, I just don't see how an online-only model could work. I actually think its more viable for clinical training than it is for research training. While there are exceptions, a huge portion of research in psychology simply must be done in-person due to equipment needs or just the nature of the topics in question. I've been trying - desperately - to figure out a way to create a lab culture that replicates my grad school experience during COVID and have yet to find a way to do it. Without in-person interaction you just miss too much. Same goes for faculty colleagues/collaborators. A lot of good has come out of this and some things CAN be moved online, but some things are missing. I moved institutions mid-COVID and it has been exceedingly slow to get collaborations going because we simply never see each other. The proverbial "water cooler" conversations we all despised are actually pretty important in hindsight. I think that's even more true at the graduate student level folks are still being oriented to the field and being exposed to new ideas. A paper just came out showing that virtual meetings are effective for run-of-the-mill stuff, but suck for idea generation (Virtual communication curbs creative idea generation - Nature). That certainly jives with my experience. We can do quick updates on the status of papers, but the "essence" of science where we wax philosophical about the fundamental meaning of xyz, brainstorm whole new ways of analyzing a dataset that bridges multiple fields, etc. simply don't happen. In part because zoom is an awkward venue for it. In part because no one is going to set up a zoom meeting for random informal discussion about articles they read until areas of overlap are discovered and collaborations are born. We can coast for a bit without those things and I think we've been doing that in science, but true progress and innovation is going to slow down eventually.

Long story short, I think online is a great venue for training "technician" type positions, but we'll quickly run into problems using it for higher-level more cognitively demanding positions. That doesn't mean elements can't be transitioned online, but I don't think the core experience can be.
To your point about difficulties doing higher-level thinking, idea generation, and collaboration virtually, I agree that it can be challenging. With intentionality, authenticity, and vulnerability, it is definitely possible. Over these past two virtual years I have had immense success with all of these things in research, clinical work, and community engagement. I have also developed a relationship with a new collaborator I met at a virtual conference. While I don’t think that my experience is the norm, I also don’t think it is an exception. I have noticed a sort of generational and cultural/personality difference in willingness and ability to establish and foster these kinds of relationships and styles of communication online (only or in addition to in person). Those differences are not all of course, but I think its similar to my earlier point about adjusting pedagogy that the same methods that work in person may not be effective for what is needed for success online.

All of that said, besides actual clinical work needing to occur in person *edit: clinical work does not need to occur in person..only the assessments that need to be do* clinical research that extends beyond survey administration and focus groups etc. needs to be done in person and I’m not sure the logistics of how that would be completed. Luckily though, I am not interested in starting an online psych doctoral program. That will be something for someone else to figure out.
 
To your point about difficulties doing higher-level thinking, idea generation, and collaboration virtually, I agree that it can be challenging. With intentionality, authenticity, and vulnerability, it is definitely possible. Over these past two virtual years I have had immense success with all of these things in research, clinical work, and community engagement. I have also developed a relationship with a new collaborator I met at a virtual conference. While I don’t think that my experience is the norm, I also don’t think it is an exception. I have noticed a sort of generational and cultural/personality difference in willingness and ability to establish and foster these kinds of relationships and styles of communication online (only or in addition to in person).
Ahh, but how many new ideas and collaborations would bizarro ccool - who lives in a world where the only effective COVID "vaccine" is frequent in-person contact with colleagues - have formed? What about bizarro #2 where things continued as normal? And what was the relative quality of those collaborations in both worlds? Maybe "continued as normal" ccool published an extra few papers and "social vaccination" ccool cured cancer?

We don't have a control group here and that is what makes this tricky. I've had a number of new collaborations develop over the last few years, have gotten new grants funded in different lines of research and have several other irons in the fire that could lead to other new collaborations in the coming months/years. I don't in any way deny its possible, but to me and most people I've spoken to it certainly "feels" more difficult than it did in the past. If science was rate-limited more than it is and we were all just looking to build a finite number of collaborations to publish x papers a year, secure tenure and keep our jobs I think we could find ways to sustain that but that's not how most people in the research world operate.

For the last few years and to some lesser extent still today, we've had no choice but to operate in a virtual environment. Some things have gone well. I love greater flexibility in working from home and generally greater flexibility and understanding of work/life balance. Others have been frustrating - I've encountered many staff members who simply do...not....do....their....frikkin....job and I used to be able to go badger them at their desk until they did but now I can't even do that.

Virtual work is clearly sustainable in the short-term. I'm concerned it may be rate-limiting in the long term. Emerging data seem to suggest the latter may be true. Can we find ways around that? I'm certainly not ruling out that possibility, but I also certainly don't see an obvious solution and at least in the near future I don't see any conceivable way a virtual graduate program could replicate an in-person one. Not even close. Intentionality, authenticity and vulnerability are critical for in-person collaborations too. They also will only get you so far. What else is missing?
 
It seems that you have taken the position that any mostly online doctorate program would not provide sufficient training, be of lower quality, and have large, unwieldy cohorts. To Ollie’s points 1 and 3 below, those seem like questions to answer or decisions to make, not something that is or must be inherent.

Agreed that it does not need to be that way. However, what is the justification for reinventing the wheel so that one professor can teach 1 or 2 students? Certainly there are plenty willing to show up in person and learn because there are no programs begging students to attend. Universities are a business at the end of the day. One selling a premium product.
Next, to “democratize” the PhD doesn’t inherently mean to increase numbers. It could I guess. To me, it minimally means equitably increasing access. And I suppose one could argue that if it is more accessible, the numbers will increase, but if standards are maintained, again I am unsure why that would inevitably be the case or why it would be bad. Relatedly, I am not opposed to an increase in the number of PhDs. Seemingly that increase would be in proportion to an increase in masters-level providers…given the presence of additional requisite funding for training and for mental health service delivery more broadly. So mostly, why are you arguing for lowering of standards for online?
The definition of democratize is to make accessible to everyone (who is interested in access anyway). You can make something more equitable and not increase access in any way. You are simply rearranging who receives preference for a limited number of positions. You mention an increase in proportion to masters level providers and funding for training. That is whole additional set of assumptions that make implementation harder and creates new bottlenecks. That is still limiting supply to fewer than all of those interested and able to be an adequate healthcare provider/researcher/professor. Regarding equity, the only way to truly do that is through funded education. Otherwise, a PhD is simply more equitable among a population that can defer work for a decade while meeting their physical needs.

To your point about difficulties doing higher-level thinking, idea generation, and collaboration virtually, I agree that it can be challenging. With intentionality, authenticity, and vulnerability, it is definitely possible. Over these past two virtual years I have had immense success with all of these things in research, clinical work, and community engagement. I have also developed a relationship with a new collaborator I met at a virtual conference. While I don’t think that my experience is the norm, I also don’t think it is an exception. I have noticed a sort of generational and cultural/personality difference in willingness and ability to establish and foster these kinds of relationships and styles of communication online (only or in addition to in person). Those differences are not all of course, but I think its similar to my earlier point about adjusting pedagogy that the same methods that work in person may not be effective for what is needed for success online.
Again, I agree it can be done but there are additional barriers. However, why are we doing this if we are not increasing access to more people (not just different people)?
All of that said, besides actual clinical work needing to occur in person *edit: clinical work does not need to occur in person..only the assessments that need to be do* clinical research that extends beyond survey administration and focus groups etc. needs to be done in person and I’m not sure the logistics of how that would be completed. Luckily though, I am not interested in starting an online psych doctoral program. That will be something for someone else to figure out.

I am not taking the position that it cannot be done. Simply that doing so for the number of people that can and will leave the workforce for 10 years is pointless. As a clinician, I find our training to be the most inefficient method of creating a licensed provider. If the goal is to better increase access to mental healthcare in shorter periods of time, training mid-levels and case managers makes more sense. If it is to create professors and researchers, where are those jobs? If the goal is to increase only doctoral level providers, how many are going to want to go to school for so many years to be paid poorly and treat those of lesser means? I say this as a person that have spent more than a decade treating those of lesser means. At the end of the day, I don't understand the point of reinventing this particular wheel.
 
@Ollie123 @Sanman

:shrug: I don’t have skin in this fight.

I’m just saying there’s nothing wrong with being open to possible futures that blow past the limits of the past, particularly when we’ve seen glimpses that suggest those futures could be feasible.

I don’t know if it would be worthwhile and given the current state of things, including major lack of personal and institutional incentives, I certainly don’t see even a serious inquiry being realistic in the next 40/50yrs… barring some serious sci-fi/sociopolitical mess that would necessitate it.
 
@Ollie123 @Sanman

:shrug: I don’t have skin in this fight.

I’m just saying there’s nothing wrong with being open to possible futures that blow past the limits of the past, particularly when we’ve seen glimpses that suggest those futures could be feasible.

I don’t know if it would be worthwhile and given the current state of things, including major lack of personal and institutional incentives, I certainly don’t see even a serious inquiry being realistic in the next 40/50yrs… barring some serious sci-fi/sociopolitical mess that would necessitate it.

I'm not trying to make it personal, I don't have anymore skin in the fight than anybody else. I am actually a fan of virtual psychotherapy and virtual learning. I just don't think it has much to offer doctoral level training, though in-room supervision is easier and less intrusive. I do think it can close the equity gap for things like college lectures that often involve rote memorization. However, interactive experiences and discussion is still limited. I also think that of all the problems in academia, making doctorates in psychology more accessible is the the definition of trying to fix a first world problem.
 
Even programs in psychology that were set up this way and have done this for years have terrible outcomes. So, as of yet, we really don't have any demonstrated models that show anything that even remotely resembles competence in this area.
As to your first point, I would guess a lot of this is a "GIGO" effect (garbage in, garbage out). The whole "you can't prove the nul hypothesis" thing aside, I think you need to be cautious about taking some of these outcomes as evidence that online/hybrid models don't work. It'd be an interesting study to see the effect of these programs with students who were accepted to traditional mentor-model, small cohort, funded Ph.D. programs. As to your second point, yep- we're really flying blind with this stuff. When my classed went to zoom, it was basically "take all you stuff that was designed to be deliviered in person- lectures, white-board stuff, materials, interactive exercises, tests, etc.- and deliver it via zoom next week!". My experience was that some of it didnt' work.
 
As to your first point, I would guess a lot of this is a "GIGO" effect (garbage in, garbage out). The whole "you can't prove the nul hypothesis" thing aside, I think you need to be cautious about taking some of these outcomes as evidence that online/hybrid models don't work. It'd be an interesting study to see the effect of these programs with students who were accepted to traditional mentor-model, small cohort, funded Ph.D. programs. As to your second point, yep- we're really flying blind with this stuff. When my classed went to zoom, it was basically "take all you stuff that was designed to be deliviered in person- lectures, white-board stuff, materials, interactive exercises, tests, etc.- and deliver it via zoom next week!". My experience was that some of it didnt' work.

We agree, I stated that I think it is theoretically possible that it could work well, just that there are no current models that have shown any semblance of adequacy. Given the right resources, including staff and funding, I could see a hybrid option working. But fully online, I still believe is untenable for a doctoral clinical psych degree.
 
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As to your first point, I would guess a lot of this is a "GIGO" effect (garbage in, garbage out). The whole "you can't prove the nul hypothesis" thing aside, I think you need to be cautious about taking some of these outcomes as evidence that online/hybrid models don't work. It'd be an interesting study to see the effect of these programs with students who were accepted to traditional mentor-model, small cohort, funded Ph.D. programs. As to your second point, yep- we're really flying blind with this stuff. When my classed went to zoom, it was basically "take all you stuff that was designed to be deliviered in person- lectures, white-board stuff, materials, interactive exercises, tests, etc.- and deliver it via zoom next week!". My experience was that some of it didnt' work.

The bigger question is how does a program arrange and vet clinical experiences if students are not local. This has always been one of the bigger issues with online training.
 
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I have had experience with and prefer in-person interactions for learning, teaching, clinical supervision, and psychotherapy. The one that I perceive has the least necessity of being in person is one on one clinical supervision. Obviously, my personal preference and experience is not sufficient scientific evidence to make any type of generalization or guide policy. Rather, it means it would take more solid evidence to overcome my own personal perceptions. For years, there was a lot of hype about online being equivalent in education circles and not much solid research, but a lot of pressure to begin adopting this. One good thing about the pandemic is that we have a little more understanding as a culture that virtual can be beneficial but also that it can’t replace in-person. Didn’t Harlow demonstrate something similar with other primates at one point?
 
I haven't had the energy to respond to everything on this thread, but this one issue I think is the biggest one from my perspective.
I don't know- I think it is possible to vet a practicum experience from a distance. I've been a practicum site for students from several local (and some not so local) training programs, and none of them did a site visit. Sure- there's the chance that being local you might get some word of mouth info that you wouldn't get from a distance. Most just wanted proof that we were offering and appropriate amount of supervision from a licensed psychologist, relative to the number of hours of direct clinical services the student engaged in.

I think the bigger issue is related to content delivery and progress evaluation. I think it's also important that some of us "olds" resist the temptation to de facto say "it wasn't how I trained, and I can't imagine it working out well for others," when a more appropriate response would be "If the literature shows it can be just as effective as and offer benefits beyond in-person training (such as better accesibility, cost reduction, etc.) then let's give it a shot." Do we really think that "Cappella sucked!" is reason to damn remote doctoral training for eternity!

There's a lot of stuff I remember fondly about my in-person graduate experience that I couldn't imagine would be there in an online program, but I'm not sure how much of those things actually contributed to my competency as a clinician. As a current graduate instructor who has tought the past 2 years remotely, I can say that I personally prefer in person teaching. I also have not spent my entire life communicating with others electronically, and I have never participated in an online class as a student, so it all seems a little more foreign to me that it potentially would for someone from a more recent cohort.
 
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I don't know- I think it is possible to vet a practicum experience from a distance. I've been a practicum site for students from several local (and some not so local) training programs, and none of them did a site visit. Sure- there's the chance that being local you might get some word of mouth info that you wouldn't get from a distance. Most just wanted proof that we were offering and appropriate amount of supervision from a licensed psychologist, relative to the number of hours of direct clinical services the student engaged in.

I think the bigger issue is related to content delivery and progress evaluation. I think it's also important that some of us "olds" resist the temptation to de facto say "it wasn't how I trained, and I can't imagine it working out well for others," when a more appropriate response would be "If the literature shows it can be just as effective as and offer benefits beyond in-person training (such as better accesibility, cost reduction, etc.) then let's give it a shot." Do we really think that "Cappella sucked!" is reason to damn remote doctoral training for eternity!

There's a lot of stuff I remember fondly about my in-person graduate experience that I couldn't imagine would be there in an online program, but I'm not sure how much of those things actually contributed to my competency as a clinician. As a current graduate instructor who has tought the past 2 years remotely, I can say that I personally prefer in person teaching. I also have not spent my entire life communicating with others electronically, and I have never participated in an online class as a student, so it all seems a little more foreign to me that it potentially would for someone from a more recent cohort.


I'm curious what kind of proof you provided regarding supervision other than your word and proof that there is a licensed psychologist on staff?
 
I'm curious what kind of proof you provided regarding supervision other than your word and proof that there is a licensed psychologist on staff?
Not much, and we could've been lying the whole time (though any respectable program would have a system in place for trainees to be systematically asked about what they were receiving from practicum). There may have been an occasional phone call review. Nobody ever did an onsite visit for a practicum students.

We used/do use formal supervision documentation forms, that listed dates and duration of supervision, as well as period and hours covered by the supervision. Students could, of course, share those with their departments, but we we never asked for them.
 
Again - couple issues at play here:

I think the benefits of local practica are not the ability to do site visits, so much as continuity and reputation. While I don't have any doubts that ClinicalABA provides a great training experience, for all we know some of the other practicum sites that school has does not - we can't really know that one way or another. My university wasn't exactly having weekly meetings with sites or requesting evidence of supervision. They just knew the folks who ran the practicum and had developed trust over many years of working together. If/when folks did have crappy experiences or practicums had students doing sketchy things, they were quickly addressed and/or dropped from the list of approved practica sites.

It seems more plausible to run a "remote" program with practica available in a multitude of large cities that are vetted and none of this ad hoc "Student in rural-wherever found themselves a practicum at Jimmy's therapy clinic/flower shop - their tuition check cleared so good enough for us!". That isn't traditionally how remote programs have operated...but it COULD be and I think is a viable model albeit one that would take some effort to scale up. Initially establishing/vetting practica in all these places would likely be a full time job itself.

# of students is also likely an issue. Part of the problem with large-cohort professional schools is that you simply can't be too picky about practica when you need to place a bajillion students. I know an Argosy student who had to take an extra year because of one her "practica" turned out to be working as someone's PP office secretary and she got precisely zero clinical hours. Program did bunk about it because they just wanted to say they had enough placements for students. In some ways, moving online could help with this (likely to have fewer students in any one city - can be more pick), in some ways it could hurt this (more difficult to know reputation of individual practitioners, sheer number of practica difficult to vet).

To me, that feels a difficult but conceivably solvable problem. Other issues I'm much less certain about.
 
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Again - couple issues at play here:

I think the benefits of local practica are not the ability to do site visits, so much as continuity and reputation. While I don't have any doubts that ClinicalABA provides a great training experience, for all we know some of the other practicum sites that school has does not - we can't really know that one way or another. My university wasn't exactly having weekly meetings with sites or requesting evidence of supervision. They just knew the folks who ran the practicum and had developed trust over many years of working together. If/when folks did have crappy experiences or practicums had students doing sketchy things, they were quickly addressed and/or dropped from the list of approved practica sites.

It seems more plausible to run a "remote" program with practica available in a multitude of large cities that are vetted and none of this ad hoc "Student in rural-wherever found themselves a practicum at Jimmy's therapy clinic/flower shop - their tuition check cleared so good enough for us!". That isn't traditionally how remote programs have operated...but it COULD be and I think is a viable model albeit one that would take some effort to scale up. Initially establishing/vetting practica in all these places would likely be a full time job itself.

# of students is also likely an issue. Part of the problem with large-cohort professional schools is that you simply can't be too picky about practica when you need to place a bajillion students. I know an Argosy student who had to take an extra year because of one her "practica" turned out to be working as someone's PP office secretary and she got precisely zero clinical hours. Program did bunk about it because they just wanted to say they had enough placements for students. In some ways, moving online could help with this (likely to have fewer students in any one city - can be more pick), in some ways it could hurt this (more difficult to know reputation of individual practitioners, sheer number of practica difficult to vet).

To me, that feels a difficult but conceivably solvable problem. Other issues I'm much less certain about.

Agreed. My program did not do regular site visits, but nearly all external practica were former grads that the program had graduated and trusted or a major medical center (VA, local hosptials with program affiliations, etc). There was another program in town that was less selctive about this stuff and it showed when we met their students. I also met a distance learning MSW student setting up community practicas on their own. The person's mother worked in healthcare on the admin side and was calling in favors for the kid to get practica. From the discussion with me, the kid was getting no real training and just doing busy work. No reason this person won't eventually be a clinician with really poor training.
 
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To expand on Ollie’s point, one issue I see with students completing local practica (which would be necessary for at least assessment, since much/all of it needs to be in person) is that they would frequently be either the first at their site or one of a few students scattered across years where it’s difficult for the site to develop consistent practices and standards. If the program intends to rely heavily on student report of quality, since it’s probably very cost inefficient for them to vet each practicum for each student in random places across the country, they face the problem of students not knowing what they don’t know. All students in my program get two years of in-house training in therapy and assessment, so even if we are the first in a new prac site or with a new external supervisor, we have a known bar to compare our experiences with. This simply isn’t possible in the case I described above, so it would be difficult for students to recognize gaps in their training or subpar quality.

This could certainly be avoided if initial or the majority clinical experiences were online and through the program, but that begs the questions raised about whether this kind of training can be shown to be at minimum equivalent to in person training through quality empirical studies.
 
To expand on Ollie’s point, one issue I see with students completing local practica (which would be necessary for at least assessment, since much/all of it needs to be in person) is that they would frequently be either the first at their site or one of a few students scattered across years where it’s difficult for the site to develop consistent practices and standards. If the program intends to rely heavily on student report of quality, since it’s probably very cost inefficient for them to vet each practicum for each student in random places across the country, they face the problem of students not knowing what they don’t know. All students in my program get two years of in-house training in therapy and assessment, so even if we are the first in a new prac site or with a new external supervisor, we have a known bar to compare our experiences with. This simply isn’t possible in the case I described above, so it would be difficult for students to recognize gaps in their training or subpar quality.

This could certainly be avoided if initial or the majority clinical experiences were online and through the program, but that begs the questions raised about whether this kind of training can be shown to be at minimum equivalent to in person training through quality empirical studies.

Not to mention students being coerced. I am sure there are a lot of students desperate to get their hours that would trade signed documentation for free office work/labor rather than learning the profession properly. We all know that teaching is the time/money suck, so I can see this happening.

The issue with online clinical experiences is you then run into state law/licensing issues for the supervisors.
 
I do not foresee psych programs going totally hybrid BUT, I will say that I think programs will start to offer more of their classes remotely. This is something I have seen firsthand in my own program. If the requirements for a course are basically weekly readings, writing a few reflection papers, and stuff like that, then there is no real reason why that sort of course MUST be done in person. Same things goes for statistics type courses. There are definitely some courses in our field that can be done remotely and my school has started to offer some of them remotely when it did not before.

But there are a lot of other parts of the experience that just don't work as well online, especially when you are JUST learning to do things for the first time.
 
I do not foresee psych programs going totally hybrid BUT, I will say that I think programs will start to offer more of their classes remotely. This is something I have seen firsthand in my own program. If the requirements for a course are basically weekly readings, writing a few reflection papers, and stuff like that, then there is no real reason why that sort of course MUST be done in person. Same things goes for statistics type courses. There are definitely some courses in our field that can be done remotely and my school has started to offer some of them remotely when it did not before.

But there are a lot of other parts of the experience that just don't work as well online, especially when you are JUST learning to do things for the first time.
N=1 but my program hates virtual courses is transitioning everything back to in-person as quickly as possible and I doubt they will do any courses virtually in the future because of the negative experience and perception from the faculty.
 
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