My frustration with the profession

[BSWdavid]

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I decided to write this in hopes that it might bring some of us closer together vs. further apart.

I have become increasingly disappointed in the lack of respect we, as mental health professionals, have for one another. I have read numerous threads where individuals argue about the differences between PhD vs. PsyD; look down upon master level therapists; MD's arguing with PhD's about "who's more qualified" or "who had the most rigorous training". I have read complaints that social work is stealing the frontline from psychology; I have also read that psychologists are infringing on psychiatrists' rights to prescribe. Many psychologists look down at social workers, while many social workers consider psychologists to be pompous and arrogant.

What the heck is happening here? Don't we realize that we are all more similar than different. Hopefully, we all entered this profession in order to help others by utilizing our own unique backgrounds and trainings. How dare we belittle each other in order to make ourselves feel superior.

I would like each of you to answer and respond to this one simple question: Why did you decide to become the professional that you are today?

 

[erg923]

I How dare we belittle each other in order to make ourselves feel superior.

I don't view it this way at all. I think its an attempt to insure that your respective profession stays the highest quality that it can. Naturally, when one trains in a model they will feel passionately that their training model has something substantial to offer. And indeed it does. Everyone can make this argument (social work, psychiatry, clinical psych). I don't think anyone disputes this. But again, I think it is natural for people to advocate for their model.

As an example, the erosion of science/research as the base of this profession is concerning to many. That is what the Psy.D/Ph.d issue debate is about (its not "I am a better psychologist than you" at the individual level), and its a worth while one to have.

Everyone has a role in patient care, but this constant push to make everything equal is just delusional. Am I a better professional/clinician than you because I have a ph.d? No, I'm a different kind though and probably have knowledge and skills that a masters level person doesn't. It would be kinda scary if i didn't, right? If didn;t, whats the point of a doctorate, right? Is a psychiatrist a better clinician than me cause they have an MD.? No, but they are a different kind and they have some skills and knowledge that I dont. We are not all equal in our training, thats just the way it is...

All the issues you raised are real and are very legitimate issues/cocerns. They are not going away anytime soon...

 

[aequitasveritas]

Perhaps territorial disputes can occasionally overwhelm levity but the arguments are necessary as the lines of competence are being blurred in American mental modernity.

I don't devalue a social worker...but it's not intellectually honest to claim they have the same clinical competence that a psychologist has and they weren't meant to. I don't mind debating with a medical doctor as long as I admit I know relatively little about medicine compared to him and that he, by virtue of his training as it typically exists, knows relatively little about psychotherapy and assessment.

You see these boundaries need to be disputed or there is no role prescription. Role prescription is fundamental for quality insurance and much more.

 

[BSWdavid]

Perhaps territorial disputes can occasionally overwhelm levity but the arguments are necessary as the lines of competence are being blurred in American mental modernity.

I don't devalue a social worker...but it's not intellectually honest to claim they have the same clinical competence that a psychologist has and they weren't meant to. I don't mind debating with a medical doctor as long as I admit I know relatively little about medicine compared to him and that he, by virtue of his training as it typically exists, knows relatively little about psychotherapy and assessment.

You see these boundaries need to be disputed or there is no role prescription. Role prescription is fundamental for quality insurance and much more.

This all makes sense but it does amaze me that psychologists feel that social workers are infringing on their territory, but many of the same psychologists are also infringing on the rights of psychiatrists by demanding Rx benefits.

You can't make the argument "Stay out of my corner" while running over and invading the psychiatry corner.

 

[aequitasveritas]

This all makes sense but it does amaze me that psychologists feel that social workers are infringing on their territory, but many of the same psychologists are also infringing on the rights of psychiatrists by demanding Rx benefits.

You can't make the argument "Stay out of my corner" while running over and invading the psychiatry corner.

I actually agree, mostly. I don;t think a psychologist should prescribe without a post doctoral masters in clinical psychopharmacology.

What do you think a MSW or LCSW should not be allowed to provide that a psychologist should be?

 

[BSWdavid]

I actually agree, mostly. I don;t think a psychologist should prescribe without a post doctoral masters in clinical psychopharmacology.

What do you think a MSW or LCSW should not be allowed to provide that a psychologist should be?

Personally, I think that MSWs can make fine clinicians, so long as they attend a rigorous program; however, I don't feel it is appropriate for social workers to provide psychological testing. We are not trained in this.

 

[erg923]

The right to prescribe? Did god grant this right?

No one is infringing on anyones "rights" here....

Morerover, no one is arguing to "stay out of my corner."

Push to expand scope of practice comes from perceived needs or concerns regarding patient care. For example, pro Rx clinical psychs are arguing 1.)that with additional training psychs can prescribe safely 2.) that this will benefit patients for reasons x, y, and z. Not sure I really buy it, but thats the rationale. However, the last thing anyone should be concerned about is infringing on some perceived "rights" of another profession. Its not copyrighted...

Personally, I am less interested in obtaining Rx privledges for myself as I am in having them taken away from some of the MDs I have encountered...., but thats a different story.

In terms of the concerns about masters level provders doing therapy, this is also not a stay out my corner area. No one has sugested, with maybe the excption of Jon Snow, that MSWs never see patients for therapy. They can surely make good therapists. However, the argument has been that because clinical psychs have, on average, more training in therapy and are arguably more empirically trained and grounded than the average MSW (again, not in all cases) that in-depth psychotherapy is probably better done by clinical psychs. Again, its based around legitimate patient care arguments, not simply a "stay out my sandbox" mentality.

 

[aequitasveritas]

Personally, I think that MSWs can make fine clinicians, so long as they attend a rigorous program; however, I don't feel it is appropriate for social workers to provide psychological testing. We are not trained in this.

I don't mean to demean...but a 2 yr program is not enough to make someone a fine clinician in general. Are there great therapists who come from MSW or LCSWs...sure. But, if I was to evaluate the program rather than the outliers I would say much more training is needed. An MSW is not meant to be a therapist...that's why it's called a social worker....social work. On the same token, I would be a terrible social worker by virtue of my training.

Most psychs do 5-6 yrs of a doctorate and then specialize post doctorally. In addition to my PhD I'll have a fellowship from the psychoanalytic institute and a two year post doctoral psychodynamic certification. That's 9 years of training (not that omnibus hours are necessarily virtous). And, when all of that is said and done I'll consider myself to be a beginner with alot to learn.

Based on comparative training, do you think an MSW should get paid the same rate for psychotherapy and should be allowed to practice without a licensed psychologist as a supervisor?

 

[Donkeykiss]

Yea there are incompetent people in every profession and congratulations you encountered one....but understanding the biochemistry of the human body, pharmacology, and ability to monitor a pt on drugs takes more than a correspondence course...it takes medical school...don't give me the NP argument cause I don't agree with it

 

[BSWdavid]

I don't mean to demean...but a 2 yr program is not enough to make someone a fine clinician in general. Are there great therapists who come from MSW or LCSWs...sure. But, if I was to evaluate the program rather than the outliers I would say much more training is needed. An MSW is not meant to be a therapist...that's why it's called a social worker....social work. On the same token, I would be a terrible social worker by virtue of my training.

Most psychs do 5-6 yrs of a doctorate and then specialize post doctorally. In addition to my PhD I'll have a fellowship from the psychoanalytic institute and a two year post doctoral psychodynamic certification. That's 9 years of training (not that omnibus hours are necessarily virtous). And, when all of that is said and done I'll consider myself to be a beginner with alot to learn.

Based on comparative training, do you think an MSW should get paid the same rate for psychotherapy and should be allowed to practice without a licensed psychologist as a supervisor?

I think you have a misconception about what it means to be a social worker. Social work isn't just advocating for social justice, organizing community efforts, or working as a case manager. The skill set we obtain in school is much more broad than that. Additionally, depending on your program and clinical concentration will determine the scope of your coursework. I think it is unfair to state that MSW's aren't qualified to do therapy just because of the inaccurate view you have of the profession. Remember, at one time, most therapists were psychiatrists, and psychologists had to fight tooth and nail to become respected clinicians.

 

[BSWdavid]

Also, MSWs don't necessarily get paid at the same rate as psychologists. I do believe that clinical social workers should continue their education post-masters, and that is why I am applying to a clinical social work program that is centered around psychodynamic theory. Even then, will I get the same respect as a psychologist? Probably not. I'm not interested in being a psychologist but I would like to be acknowledged for the skills and advanced knowledge I do have.

 

[BSWdavid]

The right to prescribe? Did god grant this right?

No one is infringing on anyones "rights" here....

Morerover, no one is arguing to "stay out of my corner."

Push to expand scope of practice comes from perceived needs or concerns regarding patient care. For example, pro Rx clinical psychs are arguing 1.)that with additional training psychs can prescribe safely 2.) that this will benefit patients for reasons x, y, and z. Not sure I really buy it, but thats the rationale. However, the last thing anyone should be concerned about is infringing on some perceived "rights" of another profession. Its not copyrighted...

Personally, I am less interested in obtaining Rx privledges for myself as I am in having them taken away from some of the MDs I have encountered...., but thats a different story.

In terms of the concerns about masters level provders doing therapy, this is also not a stay out my corner area. No one has sugested, with maybe the excption of Jon Snow, that MSWs never see patients for therapy. They can surely make good therapists. However, the argument has been that because clinical psychs have, on average, more training in therapy and are arguably more empirically trained and grounded than the average MSW (again, not in all cases) that in-depth psychotherapy is probably better done by clinical psychs. Again, its based around legitimate patient care arguments, not simply a "stay out my sandbox" mentality.

Perhaps, but MDs might argue that it takes a lot more that a few extra courses to be able to prescribe medication.

 

[erg923]

Its much more than a few courses, so don't play that stupid crap! But in general, I don't support the Rx movement (mostly for other reasons)....but lets steer back to original topic and not get side tracked. Take into account my first response here, as i think its much more relevant to your question.

 

[BSWdavid]

Maybe it isn't possible for the different professions to respect each other. It appears similar to religion: for one to exist all others must be ridiculed and devalued for fear of one religion loosing its superiority over all other. Kind of sad that this is what we have come to.

 

[erg923]

reread my first post on this thread and tell me what you disagree with?

What you perceive as disrespecting many will argue is simply pointing out the real differences between training models and foci. What exactly is the problem here? I don't get it? If you want me to tell you that you are valuable and have important role in patient care,so be it, but if you want me to validate that all professions are equal in their mental health care competencies, I'm not gonna do that. Its just not true. And you know what? Its ok!

 

[Donkeykiss]

It's a few courses compared to med school

 

[erg923]

we get it pal, there is whole sticky on this at the top. Go there and debate it.

 

[BSWdavid]

reread my first post on this thread and tell me what you disagree with?

No, I respect you comments and generally agree with what you said. We all have different skill sets (none necessarily being better than the other) just different. I can say that I have looked at some clinical PhD programs and was surprised at the lack of clinical coursework. I actually took clinical interventions I and II through the local psych department, just to see what I was missing. Sadly, they were concepts that I had already learned. Just because a program leads to a PhD doesn't mean that it is more clinically rigorous than a master level program. Many of the additional courses that a PhD takes are in fact research courses, which don't necessarily help the student refine his/her clinical skill set.

 

[erg923]

Just because a program leads to a PhD doesn't mean that it is more clinically rigorous than a master level program. Many of the additional courses that a PhD takes are in fact research courses, which don't necessarily help the student refine his/her clinical skill set.

First, coursework it not what the ph.d is about. I would also bet that the courses were more geared towards theory and underlying mechanisms of change rather than teaching techniques. That is a good thing frankly, a ph.d program is not a trade a school! Moreover, 4 years of practica has given me plenty of outlets to learn specific techniques.

Second, two years of MSW program vs 5-6 years of doctoral program (4 of which have practicum training). You do the math.

Third and most importantly, your last sentence is not only completely misinformed, is shows an unfortunate ignorance of how the "think like a scientist attitude" influences clinical practice. The sad fact is that when you're at the stage you are, "you dont know what you don't know." Its not meant as an insult at all, its just a fact. Damn straight my scientific training (yes, even mutivariate statistics courses) has informed my clinical decision making! A small example; you have no idea how many people ignore basic principles of base rate probabilities in their clinical work/judgments! Its pretty appalling to me!

 

[PsychGraduate]

No, I respect you comments and generally agree with what you said. We all have different skill sets (none necessarily being better than the other) just different. I can say that I have looked at some clinical PhD programs and was surprised at the lack of clinical coursework. I actually took clinical interventions I and II through the local psych department, just to see what I was missing. Sadly, they were concepts that I had already learned. Just because a program leads to a PhD doesn't mean that it is more clinically rigorous than a master level program. Many of the additional courses that a PhD takes are in fact research courses, which don't necessarily help the student refine his/her clinical skill set.

I generally agree with the views as well, but you point to an important issue many students and even those within social work or psychology fail to recognize; alot of the terms and degree types contain semantic descriptions not always necessarily representative of the actual degree or courses. Also there are many course overlaps or high similarity between similar major course offerings. Many counselors for example end up working with severely mentally ill clients very effectively at the master's level, and at the PhD level which short of you, no one cared to mention. Your education and training are what you decide to get out of it. There are PhD's in nursing for example who put many seasoned board certified attendings to shame😱 This of course is not always the case and I agree that when we look at averages and not more anomolous outliers we, do get a more representative average in most cases. Still, I support the RX push in pschology provided they have the proper training. Then again I took pharmacology, Organic and Biochemistry in undergrad, and so it is not as much of a leap for me to go get more training, but it is not necessarily a bad thing.

 

[ClinPsycMasters]

Maybe it isn't possible for the different professions to respect each other. It appears similar to religion: for one to exist all others must be ridiculed and devalued for fear of one religion loosing its superiority over all other. Kind of sad that this is what we have come to.

No, that's not true of religion nor our professions. There are degrees of that but not as black and white as you seem to suggest. Territorial disputes are part of life. There is competition for limited resources. Just because most of us are here to help people doesn't mean that we don't want to make decent living or that we don't worry about job security, etc.

 

[PsychGraduate]

First, coursework it not what the ph.d is about. I would also bet that the courses were more geared towards theory and underlying mechanisms of change rather than teaching techniques. That is a good thing frankly, a ph.d program is not a trade a school! Moreover, 4 years of practica has given me plenty of outlets to learn specific techniques.

Second, two years of MSW program vs 5-6 years of doctoral program (4 of which have practicum training). You do the math.

Third and most importantly, your last sentence is not only completely misinformed, is shows an unfortunate ignorance of how the "think like a scientist attitude" influences clinical practice. The sad fact is that when you're at the stage you are, "you dont know what you don't know." Its not meant as an insult at all, its just a fact. Your damn straight my scientific training (yes, even mutivariate statistics courses) has informed my clinical decision making! A small example; you have no idea how many people ignore basic principles of base rate probabilities in their clinical work/judgments! Its pretty appalling to me!

The doctoral program is very intensive and time consuming.
You do learn new concepts and advanced statistical methods for many different ares of interest in psychology and medicine, (Bayes and the like as well) however study of and relevant application of (and importance of) such methods should really start in undergrad and be well mastered in the masters program.

 

[PsychGraduate]

No, that's not true of religion nor our professions. There are degrees of that but not as black and white as you seem to suggest. Territorial disputes are part of life. There is competition for limited resources. Just because most of us are here to help people doesn't mean that we don't want to make decent living or that we don't worry about job security, etc.

👍

 

[erg923]

You do learn new concepts and advanced statistical methods for many different ares of interest in psychology and medicine, (Bayes and the like as well) however study of and relevant application of (and importance of) such methods should really start in undergrad and be well mastered in the masters program.

That's utter nonsense, You cannot possibly think that I have mastered the vast array of design and statistical application models in the first 2-3 years of my program, Getting proficient in the application of all these in order to produce quality meaningful research takes years, years after the doctorate even. Otherwise, we wouldn't really need research-oriented post-docs would we...🙂

 

[ClinPsycMasters]

That's utter nonsense, You cannot possibly think that I have mastered the vast array of design and statistical application models in the first 2-3 years of my program, Getting proficient in the application of all these in order to produce quality meaningful research takes years, years after the doctorate even. Otherwise, we wouldn't really need research-oriented post-docs would we...🙂

I think "nonsense" is harsh. You do have a good grasp of the stats, specially if you have an interest in stats and take additional optional courses in undergrads, and if your masters program is very research oriented. However, there is no denying that PhD and postdoc students know much more about research. My own program was very research oriented and the biggest difference between masters and PhD students was their knowledge of stats. Clinical experience was surprisingly not that different, and we were being trained to do research in future, and that's why I decided not to continue.

 

[PsychGraduate]

That's utter nonsense, You cannot possibly think that I have mastered the vast array of design and statistical application models in the first 2-3 years of my program, Getting proficient in the application of all these in order to produce quality meaningful research takes years, years after the doctorate even. Otherwise, we wouldn't really need research post-docs would we...🙂

I do not doubt your intelligence or that proper training is important, I just know it does not have to take that long and 2-3 years of careful study and training can produce enormous results beyound what you have depicted.

Everyone is different in what they excel in and what they do not, however, I have not found what you mentioned here to be of great challenge even in undergrad...😉

For those who may be confused about see here about base rate:

https://www.cia.gov/library/center-...sychology-of-intelligence-analysis/art15.html

Eh... Bayes, Ven, tree diagrams, derivatives, integrals all the same old story after awhile. Unless you do very high level math, one the number of equation necessary equals the number of unknowns. In all of math all we can do is: add, subtract, divide, or multiply. Bayes is touched on in many non-majors general stats courses as are: conditional, subjective and empirical probability. Confidence intervals are maybe confusing for 5 or 10 minutes, etc... I have seen clinical social worker graduates, fresh with their masters, doing quite sophisticated multi-variate analyses and hypothesis testing. I mean how long does it really take to be able to work with H0 and H1 really in a meaningful way? it should not take more than 2 courses, but 1 course with determined self study and a few questions to the professor and you should be on your way.

Those outliers... hmmm; I don't know, don't just look at averages, but at medians and midranges; how hard is it to understand central tendency and limitations thereof? The weighted mean is elementary and when use these methods and analyze prior probability observations/calculations we get the bigger picture. This is taught in intro courses at the undergraduate level. If you read every word of a basic stats textbook, do problems from every section, make sure you are using the correct methods to derive the correct answers, and remember to review it from time to time when on vacation or even during other related courses the constructive processes both in the cognitive and mathematical sense work very well for long term memory storage.

I think doctoral programs are relevant, applicable and necessary in many cases, but I am biased😎

 

[erg923]

Maybe it isn't possible for the different professions to respect each other. It appears similar to religion: for one to exist all others must be ridiculed and devalued for fear of one religion loosing its superiority over all other. Kind of sad that this is what we have come to.

I'm sorry, but this bugs me too. My wife and I are pretty devout Catholics and I grew up going to Catholic schools. However, I have never once felt that I needed to devalue other cultures and/or religions because of my faith. In fact, with the exception of nutty fringe groups/sects, I don't know any religious person who has ever felt this way about their faith.

 

[PsychGraduate]

I think "nonsense" is harsh. You do have a good grasp of the stats, specially if you have an interest in stats and take additional optional courses in undergrads, and if your masters program is very research oriented. However, there is no denying that PhD and postdoc students know much more about research. My own program was very research oriented and the biggest difference between masters and PhD students was their knowledge of stats. Clinical experience was surprisingly not that different, and we were being trained to do research in future, and that's why I decided not to continue.

However, the understanding of internal and external validity, the ideology of say Bayes theorem, its limitations and rational for using a particular statistical method should begin long before the doctoral program. Each undergrad and master's course should be treated as if that is one's major so that the student holds themselves to the highest level of intellectual rigor, self training capacity and ethical guidelines as stated by the APA. AND: Application begins as soon as the student can tie their shoes so to speak with a particular method or concept(s) of research design.

 

[erg923]

I do not doubt your intelligence or that proper training is important, I just know it does not have to take that long and 2-3 years of careful study and training can produce enormous results beyound what you have depicted.

Everyone is different in what they excel in and what they do not, however, I have not found what you mentioned here to be of great challenge even in undergrad...😉

For those who may be confused about see here about base rate:

https://www.cia.gov/library/center-...sychology-of-intelligence-analysis/art15.html

Eh... Bayes, Ven, tree diagrams, derivatives, integrals all the same old story after awhile. Unless you do very high level math, one the number of equation necessary equals the number of unknowns. In all of math all we can do is: add, subtract, divide, or multiply. Bayes is touched on in many non-majors general stats courses as are: conditional, subjective and empirical probability. Confidence intervals are maybe confusing for 5 or 10 minutes, etc... I have seen clinical social worker graduates, fresh with their masters, doing quite sophisticated multi-variate analyses and hypothesis testing. I mean how long does it really take to be able to work with H0 and H1 really in a meaningful way? it should not take more than 2 courses, but 1 course with determined self study and a few questions to the professor and you should be on your way.

Those outliers... hmmm; I don't know, don't just look at averages, but at medians and midranges; how hard is it to understand central tendency and limitations thereof? The weighted mean is elementary and when use these methods and analyze prior probability observations/calculations we get the bigger picture. This is taught in intro courses at the undergraduate level. If you read every word of a basic stats textbook, do problems from every section, make sure you are using the correct methods to derive the correct answers, and remember to review it from time to time when on vacation or even during other related courses the constructive processes both in the cognitive and mathematical sense work very well for long term memory storage.

I think doctoral programs are relevant, applicable and necessary in many cases, but I am biased😎

Tell me why relying on the assessment of normality to determine whether to use parametric vs. nonparametric tests is flawed? Tell me why stepwise variable selection in regression or any other generalized linear model is controversial? Tell me about varimax, quartimax, and equamax rotation models and when each should and should not be used. Tell me why it is not appropriate to use MANOVA as an omnibus test prior to conducting a series of univariate ANOVAs. Tell me about bootstrapping...

Those are the things you need to know to do research, I wasn't talking about means and standard deviations here...

 

[ClinPsycMasters]

hahaha, Erg you gonna give me a heart attack! Regression analysis, ANOVA, MANOVA...were the reasons I decided not to pursue my PhD. I was misled. They told me during the interview that the program was research/stats heavy BUT we would also get plenty of clinical experience. Instead I was swimming in stats homework with a professor and teaching assistant who did not coordinate with each other, were never available, had terrible handwriting, and on top of that, spoke broken English.

I was on top of my undergrad stats class but was miserable in grad school. I'm just glad it's over. Phew!

 

[PsychGraduate]

Wow, you're online program really is as rigorous as a traditional scientist practitioner program....

Tell me why relying on the assessment of normality to determine whether to use parametric vs. nonparametric tests is flawed? Tell me why stepwise variable selection in regression or any other generalized linear model is controversial? Tell me what the difference statistical philosophy between varimax, quartimax, and equamax rotation models and when each should and should not be used. Tell me why it is not appropriate to use MANOVA as an omnibus test prior to conducting a series of univariate ANOVAs. Tell me about bootstrapping...

Im not talking about means and standard deviations here...

z, t and F tests are parametric tests that test for things like: means, variances, and proportions. These kind of tests make an assumption as you alluded to that the populations the samples come from are normally (Gaussian distribution) distributed. Nonparametric tests (again as you alluded to) are tests involving an assumption that the population is not normally distributed. Nonparametric tests are distribution free. When the sample size is too small non-parametric tests work as well.

Okay so why is the assessment of normailty flawed to determine whether to use parametric vs non parametric test flawed?

Answer: The t test can be used with great accuracy even when Gaussian distribution is violated (normalcy) Empirical evidence has shown that the t test does not inflate Type I errors and it does not falsely produce a type II error. In terms of normal distributions the t test does have a little more power than the Mann-Whitney, however, for any non normal distributions the Mann-Whitey tends to be far better. However the major flaw for these two tests is as follows: both tests are used for continuous variables. When baseline score is added as a covariate of in a linear regression ANCOVA is a more powerful test than t.

Also receiver operating characteristic analysis (ROC) is a preferred method to find the area under the curve (AUC) for evaluating diagnostic tests with continuous scales as the result.

Normality tests are very sensitive to sample size of course, however, histograms can be used for workable normality assumptions like in the case of blood pressure.

The generalized linear model forms the foundation of: t test, ANOVA and ANCOVA along with many other multivariate methods. Model specification for this method is a challenge. The equation is: y=b0 + bx + e where y = a set of outcomes, x = a set of preprogram variables or covariates, b0 = the set of intercepts and b= a set of coefficients. If the model does not specify with the appropriate equation an accurate summary of the data then the coefficients, the b values will most likely be biased. We will have curvilinearity problem.

Further assumptions to consider are for Regression Discontinuity analysis and are as follows:

1.) The cutoff criterion
2.) The pre-post distribution
3.) Comparison group pre-test variance
4.) Continuous pretest distribution
5.) Program implementation.

If there is a fit for the true function then we have a model that is exactly specified. If the model is overspecified with too many terms then we have an inefficient estimate and if we have left out some terms we have an underspecified model resulting in a biased estimate.

RD deals with various design basically compares pretest and posttest program-comparison group strategy.

Bootstrapping in some cases provides better estimates of sampling distributions than the theory of normalcy does.
Essentially, bootstrapping is a resampling method. The statistic being considered might be variable but we do not know how variable it is. In calculus we measure the rate of change of a function or rate of variance. Stats is based upon the theorems of calculus, however even when they differ as disciplines or in ideology they can be combined as in statistical thermodynamics, biostatistics and so forth. Monte Carlo simulations might also be involved, like in the examination of the bootstrap test of phi divergence statistics. Bootstrapping seems to be good at estimating the rejection probabilities. Monte Carlo simulations are used in quantum mechanics and other applications of random numbers. In this method we:

1.) List all possible outcomes of an experiment.
2.) Derermine the probability of each outcome.
3.) Set up correspondence between the outcomes of the experiment and the random numbers.
4.) Select random numbers from a table and conduct the experiment.
5.) Repeat the experiment and tally the outcomes.
6.) Compute any statistics and state the conclusions.

Back to bootstrapping: We may look at P-values of some divergence like aforementioned and so we use the probability density function, our stat model, our set, closed intervals, and a bunch of partial derivatives, thetas, functions that do and do not depend upon theta.

In factor analysis there is exploratory factor (data) analysis (EFA) and Confirmatory factor (data) analysis (CFA) EFA looks for the number of factors and the relationship between each variable and factor. CFA validates the factor structure in the presumption of the analysis and it measures the relationship between each factor.
For EFA the assumptions are:
Fi and epsiloni are independent,
E (F) = 0,
Cov (F) = I - key assumption in EFA - uncorrelated factors.
E (ep) = 0
Cov (ep) psi where psi is a diagonal matrix. This is taken from the equation: Xi = mu + D Fi + epi

EFA involves coming to the analysis with no prejudice. CFA involves: hypothesis testing, confidence intervals, and estimation.


Varimax solutions have a tendency to towards an equal sum of squared loadings for all factors. Quartimax rotation tends to produce solutions with a dominating factor. However varimax solutions do not always translate that way and need a little tinkering🙂 A term may have to be added to the varimax objective function in order to modify the varimax criterion.

Learn how to use MATLAB.

Rotation can be used to assist in the interpretation of of extracted factors and Varimax, Quatrimax and Equamax are used to find orthogonal rotations. To find Oblique (non-orthogonal) rotations in order to get better interpretation through correlation we use: Promax, Procrustes and Harris Kaiser.


Eigenvectors of a transformation is in the preserved direction and the amount of stretch is the Eigenvalue. These aforementioned Eigenvalues are mulitipliers. Eigenvectors eigenspaces and eigenvalues are properties of a mtraix. Generally speaking matrices will act upon a vector by changing both its magnitude and direction, however, a matrix may also just change the mag and leaving the direction unchanged or reversed. These are the so called eigenvectors.

The factor that is multiplied by the eigenvector magnitude is the eigenvalue. Eigenvectors and eigenvalues originate with physics and are used extensively in early advanced courses in undergraduate as well as undergraduate physical chemistry I and II. These courses are very statistical in nature and are based upon algebraic derivations and calculus, both single variable and multi variable. They are used in various differential equations and like Monte Carlo, quantum mechanics. P Chem is based upon the 5 postulates of quantum mechanics.
In brief: An eigenvector is a vector that keeps its direction after undergoing a linear transformation and an eigenvalue is a sclar value that the eigenvector was multiplied by during the linear transformation.


Question: how might this affect a stat analysis when using a matrix? How might results become skewed if an inappropriate matrix is applied?

 

[Donkeykiss]

we get it pal, there is whole sticky on this at the top. Go there and debate it.

Ain't your pal kitty

My eyes just rolled out of my head..undergrad orgo...please..

 

[PsychGraduate]

Ain't your pal kitty

My eyes just rolled out of my head..undergrad orgo...please..

Not like P-chem that is for certain... That is when the wavefunction becomses real😎

 

[PsychGraduate]

The Biochemical Basis of Neuropharmacology😀

 

[Donkeykiss]

I was being saracastic

 

[PsychGraduate]

I was being saracastic

😳

 

[Therapist4Chnge]

What a mess of a thread. Degree creep, RxP, stats, etc...it is like all of the lightning rod topics gravitated to one thread all at once. Plenty to resond to, but I've got patients..err...clients...uhm...consumers...or... people with whom seek services to treat. Maybe this afternoon I'll pop back in and everything will have been resolved, just like most of the other conflict out there in the world. 😀

 

[Therapist4Chnge]

It's a few courses compared to med school

MOD NOTE: Please keep the RxP stuff out of this thread. There is a sticky up top for RxP discussion. -t4c

 

[progter]

Many of the additional courses that a PhD takes are in fact research courses, which don't necessarily help the student refine his/her clinical skill set.

I stopped reading when you wrote this

You come here wanting to "cease fire" yet you seem to be another masters level student who is upset that PhD students "look down on you."

If you seriously think that the research training does not help ones clinical skill sets then you truly do not know a damn thing about this profession.

 

[jdawgg]

I stopped reading when you wrote this

You come here wanting to "cease fire" yet you seem to be another masters level student who is upset that PhD students "look down on you."

If you seriously think that the research training does not help ones clinical skill sets then you truly do not know a damn thing about this profession.

I'm not necessarily saying that I disagree with you, but I wonder... if you're correct, then why have there been no published, peer-reviewed studies indicating that therapy with psychologists produces better clinical outcomes than therapy with, say, a social worker.

 

[erg923]

z, t and F tests are parametric tests that test for things like: means, variances, and proportions. These kind of tests make an assumption as you alluded to that the populations the samples come from are normally (Gaussian distribution) distributed. Nonparametric tests (again as you alluded to) are tests involving an assumption that the population is not normally distributed. Nonparametric tests are distribution free. When the sample size is too small non-parametric tests work as well.

Okay so why is the assessment of normailty flawed to determine whether to use parametric vs non parametric test flawed?

Answer: The t test can be used with great accuracy even when Gaussian distribution is violated (normalcy) Empirical evidence has shown that the t test does not inflate Type I errors and it does not falsely produce a type II error. In terms of normal distributions the t test does have a little more power than the Mann-Whitney, however, for any non normal distributions the Mann-Whitey tends to be far better. However the major flaw for these two tests is as follows: both tests are used for continuous variables. When baseline score is added as a covariate of in a linear regression ANCOVA is a more powerful test than t.

Also receiver operating characteristic analysis (ROC) is a preferred method to find the area under the curve (AUC) for evaluating diagnostic tests with continuous scales as the result.

Normality tests are very sensitive to sample size of course, however, histograms can be used for workable normality assumptions like in the case of blood pressure.

The generalized linear model forms the foundation of: t test, ANOVA and ANCOVA along with many other multivariate methods. Model specification for this method is a challenge. The equation is: y=b0 + bx + e where y = a set of outcomes, x = a set of preprogram variables or covariates, b0 = the set of intercepts and b= a set of coefficients. If the model does not specify with the appropriate equation an accurate summary of the data then the coefficients, the b values will most likely be biased. We will have curvilinearity problem.

Further assumptions to consider are for Regression Discontinuity analysis and are as follows:

1.) The cutoff criterion
2.) The pre-post distribution
3.) Comparison group pre-test variance
4.) Continuous pretest distribution
5.) Program implementation.

If there is a fit for the true function then we have a model that is exactly specified. If the model is overspecified with too many terms then we have an inefficient estimate and if we have left out some terms we have an underspecified model resulting in a biased estimate.

RD deals with various design basically compares pretest and posttest program-comparison group strategy.

Bootstrapping in some cases provides better estimates of sampling distributions than the theory of normalcy does.
Essentially, bootstrapping is a resampling method. The statistic being considered might be variable but we do not know how variable it is. In calculus we measure the rate of change of a function or rate of variance. Stats is based upon the theorems of calculus, however even when they differ as disciplines or in ideology they can be combined as in statistical thermodynamics, biostatistics and so forth. Monte Carlo simulations might also be involved, like in the examination of the bootstrap test of phi divergence statistics. Bootstrapping seems to be good at estimating the rejection probabilities. Monte Carlo simulations are used in quantum mechanics and other applications of random numbers. In this method we:

1.) List all possible outcomes of an experiment.
2.) Derermine the probability of each outcome.
3.) Set up correspondence between the outcomes of the experiment and the random numbers.
4.) Select random numbers from a table and conduct the experiment.
5.) Repeat the experiment and tally the outcomes.
6.) Compute any statistics and state the conclusions.

Back to bootstrapping: We may look at P-values of some divergence like aforementioned and so we use the probability density function, our stat model, our set, closed intervals, and a bunch of partial derivatives, thetas, functions that do and do not depend upon theta.

In factor analysis there is exploratory factor (data) analysis (EFA) and Confirmatory factor (data) analysis (CFA) EFA looks for the number of factors and the relationship between each variable and factor. CFA validates the factor structure in the presumption of the analysis and it measures the relationship between each factor.
For EFA the assumptions are:
Fi and epsiloni are independent,
E (F) = 0,
Cov (F) = I - key assumption in EFA - uncorrelated factors.
E (ep) = 0
Cov (ep) psi where psi is a diagonal matrix. This is taken from the equation: Xi = mu + D Fi + epi

EFA involves coming to the analysis with no prejudice. CFA involves: hypothesis testing, confidence intervals, and estimation.


Varimax solutions have a tendency to towards an equal sum of squared loadings for all factors. Quartimax rotation tends to produce solutions with a dominating factor. However varimax solutions do not always translate that way and need a little tinkering🙂 A term may have to be added to the varimax objective function in order to modify the varimax criterion.

Learn how to use MATLAB.

Rotation can be used to assist in the interpretation of of extracted factors and Varimax, Quatrimax and Equamax are used to find orthogonal rotations. To find Oblique (non-orthogonal) rotations in order to get better interpretation through correlation we use: Promax, Procrustes and Harris Kaiser.


Eigenvectors of a transformation is in the preserved direction and the amount of stretch is the Eigenvalue. These aforementioned Eigenvalues are mulitipliers. Eigenvectors eigenspaces and eigenvalues are properties of a mtraix. Generally speaking matrices will act upon a vector by changing both its magnitude and direction, however, a matrix may also just change the mag and leaving the direction unchanged or reversed. These are the so called eigenvectors.

The factor that is multiplied by the eigenvector magnitude is the eigenvalue. Eigenvectors and eigenvalues originate with physics and are used extensively in early advanced courses in undergraduate as well as undergraduate physical chemistry I and II. These courses are very statistical in nature and are based upon algebraic derivations and calculus, both single variable and multi variable. They are used in various differential equations and like Monte Carlo, quantum mechanics. P Chem is based upon the 5 postulates of quantum mechanics.
In brief: An eigenvector is a vector that keeps its direction after undergoing a linear transformation and an eigenvalue is a sclar value that the eigenvector was multiplied by during the linear transformation.


Question: how might this affect a stat analysis when using a matrix? How might results become skewed if an inappropriate matrix is applied?

Dude, my questions were rhetorical examples of things that people will not master in the first 2 or 3 years of a clinical program (as you basically stated that its not realy that hard and the doctorate adds little more knowledge of research than a masters)...For goodness sake! Lets knock this rather silly tangent off and let the thread get back.

 

[stigmata]

Psychologists are trained to think critically and scientifically. I wonder why so many come out of school with rigid and dogmatic beliefs, and spend years defending the often unrealistic and concrete constructs delivered to us by academia? It is weird....

 

[aequitasveritas]

It seems as though there are some posts on the clin psych sdn that tend to repeatedly stray into a defense of one particular training model etc. It's incredible how minimally related threads have drifted over to the first factor of debates here: pro schools, onlines, for profits. Lets not let this one do that.

Remember...we don't need to reify our screen names on here. We're just titles on a forum so there's no sense in making your own CV or competence a cause de jour because nobody knows who the heck you are.

So lets drop the various inferiority complexes and debate pertinent issues.

I suggest continuing the the notion of defining professional boundaries, why do so, and what is necessary to refine them?

 

[jnine]

What a mess of a thread. Degree creep, RxP, stats, etc...it is like all of the lightning rod topics gravitated to one thread all at once. Plenty to resond to, but I've got patients..err...clients...uhm...consumers...or... people with whom seek services to treat. Maybe this afternoon I'll pop back in and everything will have been resolved, just like most of the other conflict out there in the world. 😀

Can we rename this thread "Pandora's Box?"

 

[IT514]

I have become increasingly disappointed in the lack of respect we, as mental health professionals, have for one another. I have read numerous threads where individuals argue about the differences between PhD vs. PsyD; look down upon master level therapists; MD's arguing with PhD's about "who's more qualified" or "who had the most rigorous training". I have read complaints that social work is stealing the frontline from psychology; I have also read that psychologists are infringing on psychiatrists' rights to prescribe. Many psychologists look down at social workers, while many social workers consider psychologists to be pompous and arrogant.

What the heck is happening here? Don't we realize that we are all more similar than different. Hopefully, we all entered this profession in order to help others by utilizing our own unique backgrounds and trainings. How dare we belittle each other in order to make ourselves feel superior.

I would like each of you to answer and respond to this one simple question: Why did you decide to become the professional that you are today?

After having about 2,000 in practicum training, I've worked with and under a lot of different professionals. I have never had a bad interaction with anyone. However, I have been told many times by fellow students, before being supervised or seeing a patient with another provider that "so and so is a real jerk so watch out." However, this typically turns out not to be the case. I usually can see why others saw the person as a jerk, but I just use my social skills to get along with him/her and focus my energy on the task at hand. This isnt to say I've never had a disagreement or have someone go off on me, I'm just saying its never been due to the program I attend or the field I'm in. And when disagreements do occur, I learn a lot from them.

I've also seen, more often than not, folks from different fields work well together and get along well. I worked in a dementia clinic where there was neuropsychology (me), neurology, psychiatry, geriatrics, and social work, and I honestly looked forward those days more than any other. There were usually disagreements on a patient, but the discussion usually helped the patient and helped everyone to learn from each other.

Others may have a different experience, but mine is that the discussions in this forum are much more contentious than the real world.

 

[aequitasveritas]

I think you have a misconception about what it means to be a social worker. Social work isn't just advocating for social justice, organizing community efforts, or working as a case manager. The skill set we obtain in school is much more broad than that. Additionally, depending on your program and clinical concentration will determine the scope of your coursework. I think it is unfair to state that MSW's aren't qualified to do therapy just because of the inaccurate view you have of the profession. Remember, at one time, most therapists were psychiatrists, and psychologists had to fight tooth and nail to become respected clinicians.

Yes...one at a time psychologists, who went through lengthy and in depth training, became the primary providers of psychotherapy and assessment. But that was after 5-7 yrs grad school and specialized training post doctorally...not 2 yrs. Sorry if this bothers you but you've got to admit that boundary definitions have a purpose, the most important of which is quality control for consumers. I have a MA in clinical right now. I am not qualified to provide independent therapy with my MA in clinical...why should someone with a masters in social work be granted access to therapy? Someone with a clinical masters has more clinical training than an MSW....yet there is no movement to consider them as "fine psychotherapists" because everyone knows you can't truly master a subject with a masters.

Furthermore, if I have distorted view of social work education then please enlighten me. What exactly is your clinical training within your program? Please provide a link to verify coursework. (and please outside viewers...lets not go down the road of "real knowledge is not gained by coursework" I know...not the point of this post)

 

[PsychGraduate]

What a mess of a thread. Degree creep, RxP, stats, etc...it is like all of the lightning rod topics gravitated to one thread all at once. Plenty to resond to, but I've got patients..err...clients...uhm...consumers...or... people with whom seek services to treat. Maybe this afternoon I'll pop back in and everything will have been resolved, just like most of the other conflict out there in the world. 😀

I am new here so I do not want to continue in a manner not conducive to productive conversation. We had a little bit of a spill over from previous threads. I did respond to a specific but now deleted opneing line, but I see that is gone now. I want to continue in a spirited debate and conversation that leads to understanding and not to off topic and aggressive verbal wars, so I am putting the earlier issues behind me and move forward back to the topic at hand. I for one have seen many excellent social workers, counselors and psychologists and while there is some overlap and semantics in some of the courses/training they receive, the unique specialized training each receives is clinically relevant, but variable. I think we should all respect each other from different educational and training backgrounds in the mental health professions.

 

[PsychGraduate]

It seems as though there are some posts on the clin psych sdn that tend to repeatedly stray into a defense of one particular training model etc. It's incredible how minimally related threads have drifted over to the first factor of debates here: pro schools, onlines, for profits. Lets not let this one do that.

Remember...we don't need to reify our screen names on here. We're just titles on a forum so there's no sense in making your own CV or competence a cause de jour because nobody knows who the heck you are.

So lets drop the various inferiority complexes and debate pertinent issues.

I suggest continuing the the notion of defining professional boundaries, why do so, and what is necessary to refine them?

This is why I like reading your posts; thank you.

 

[Therapist4Chnge]

I don't view it this way at all. I think its an attempt to insure that your respective profession stays the highest quality that it can.

As an example, the erosion of science/research as the base of this profession is concerning to many. That is what the Psy.D/Ph.d issue debate is about (its not "I am a better psychologist than you" at the individual level), and its a worth while one to have.

I am in total agreement wiht erg923. The role of science and research in practice *IS* one of the biggest differences in training between different professions, and sadly it is an issue within our profession. I've written before about the "stats/research is icky" crowd, so I won't repeat that, though there is definitely a threat to the overall profession when people discount/devalue the role research plays in clinical practice. Science/Research/Statistics inform our work, yet people seem to be pulling away from it instead of embracing it.

In terms of the concerns about masters level provders doing therapy, this is also not a stay out my corner area. No one has sugested, with maybe the excption of Jon Snow, that MSWs never see patients for therapy. They can surely make good therapists. However, the argument has been that because clinical psychs have, on average, more training in therapy and are arguably more empirically trained and grounded than the average MSW (again, not in all cases) that in-depth psychotherapy is probably better done by clinical psychs. Again, its based around legitimate patient care arguments, not simply a "stay out my sandbox" mentality.

I have become more conservative with my views as I've spent more time interacting with othe professionals. While I am not in the "no therapy should be provided by an MSW" camp, I do have some concerns about MSWs diagnosing and treating severe pathology. A good portion of my time is spent doing differential dx assessment (mostly neuro, though also personality, mood, capacity, etc), so I review medical records in much more detail than the average clinician. I have seen issues across disciplines, which includes social work, psychiatry, PA/NP, and GP/FP/EM, etc. I am a stickler for differential Dx, but in some cases it makes a HUGE difference.

I believe supportive therapy, which I think is appropriate for MSW-trained therapists, is quite different than a more in-depth therapeutic approach. I am much more supportive of LCSWs doing traditional therapy, and MSWs doing more supportive therapy and case management. I believe the extra training and supervision an LCSW receives better prepares them to handle more Dx's, though it still isn't ideal.

 

[Therapist4Chnge]

I think you have a misconception about what it means to be a social worker. Social work isn't just advocating for social justice, organizing community efforts, or working as a case manager. The skill set we obtain in school is much more broad than that. Additionally, depending on your program and clinical concentration will determine the scope of your coursework. I think it is unfair to state that MSW's aren't qualified to do therapy just because of the inaccurate view you have of the profession. Remember, at one time, most therapists were psychiatrists, and psychologists had to fight tooth and nail to become respected clinicians.

I think the depth and breadth of training is a fair critique, as only so much can be covered in a 2-year program. The training appears to be quite diverse at times, which may conflict with the amount of training the student gets in actual therapy. One of the issues that psychology has is the diverse amount of training available, and I see the same problem in social work. In psychology it can be spread out over a few more years, though it is still an issue....which I hope gets addressed sooner than later.

Also, MSWs don't necessarily get paid at the same rate as psychologists. I do believe that clinical social workers should continue their education post-masters, and that is why I am applying to a clinical social work program that is centered around psychodynamic theory. Even then, will I get the same respect as a psychologist? Probably not. I'm not interested in being a psychologist but I would like to be acknowledged for the skills and advanced knowledge I do have.

"Should" is one of the sticking points for a lot of people. The problem some people have is the minimum requirements allowed for someone to practice "therapy". Some of the best clinicians I know are MSWs and LCSWs, but every one of them sought out more training, even though they were not required to do so.

Competency is a BIG issue in doctoral training in the past few years, though it is pretty hard to quantify. As I mentioned above, there are so many requirements pulling trainees in different directions, that the current system (both masters and doctoral) leaves a lot to be desired in regard to competency and training.