1) Why there is a constant repetition of the difference in time for a Psy.D. versus Ph.D. is a mystery to me. The American Psychological Association requires nearly identical training, including a dissertation. Some Psy.D. programs use a "CRP" model (case analysis) verus large scale research, and others don't. But the time demands over the long haul are the same, the classwork is virtually identical, with the Psy.D. requiring more clinical and less research training (
http://www.apa.org/ed/graduate/phd_psyd.html) . Since the APA is responsible for credentialing these programs (internship site and post-doc sites), if you think I'm incorrect, please post the URL demonstrating the 3-4 year training requirement. Thanks.
2) The average time from onset to completion is 6 years with an SD of approximately 1 year. The speculation is that the extension of time from 4 years (the percentage of people completing in 4 years is 2 SD's below the mean . . . ) to the mean of 6 is related to amount of material + clinicals occuring at the same time as the didactics. Unlike medical school, students are not required to go through the lock-stepped training method so that all 1st years stay together throughout the training (generally speaking). *IF* a person in a PsyD or PhD program COULD finish by going straight through, there are 3 years of didactics, coupled simultaneously with 2 years of clinicals (1 is diagnostic and the other focuses on treatment), another year of clinical only, and then the completion of the dissertation. (
http://www.apa.org/ed/graduate/time.html) In order to sit for national boards and state licensing exams, psychologists have to complete a years of additional post-doc. Most complete 2 additional years of post-doc because of the requirements for specialty board certification (ABPP - American Board of Professional Psychology). Without the post doctoral years, the person may be able to be licensed, but would be unable to gain "Health Provider Status" and would not be able to "diagnose and treat." (
http://www.apa.org/ed/graduate/license.html)
You said:
"The majority of psychologists practice "eclectic" therapy....meaning they take pages from anyone's book as they see fit, while many psychologists do not adhere even to that particular school of thought. It's basically Dr. Phil-esque fly-by-the-seat-of-your-pants therapy and say whatever makes sense and won't harm"
3) The research you quote about the "eclectic" psychotherapy is over 35 years old. Where have you been? That earlier research suggested that while psychologists were well-versed in a particular form of treatment when they left schoool (which tended to be defined by 2 distinct schools at the time, analytic and behavioral), 5 years out from school they views became more eclectic and a reducing percentage defined their models as pure (but more "eclectic"). Subsequent psychotherapy research demonstrated that patients were more likely to improve when 3 variables were generally constant through therapy: 1) They liked the therapist; 2) They believed that the therapist liked them, and; 3) the therapist approached the treatment along a consistent school of thought or within a consistent paradigm. Consider going back and taking a look at current psychotherapy research. The American Psychological Association produces a quarterly journal of abstracts in psychotherapy research that you'd probably find useful. By the way, most psychologists define their treatments now as being more integrative, applying techniques from Social Learning Theory, Cognitive, and Interpersonal schools of thought.
As for Dr. Phil (and I know Dr. Phil), he's an outlier and an entertainer . . . just like Peter Breggin (
www.breggin.com) is an outlier. It doesn't make any sense to try to define these two fields by people who are "out standing in a field."
🙂
As for bad therapy not killing people . . . I know you know better, so I'll let this slide.
Okay, 6 years for residency is extreme. I think that integrating better psychotherapy training into residency is critical. Otherwise, we should admit that we're really better off becoming behavioral neurologists. Heck, studying along side with Mesulam wouldn't be that bad.
In the end, I suspect that psychiatrists, in general, really have no clue about how psychologists are trained. I don't know that psychologists really know what goes on in a psychiatrist's training, although I think that the mystery is related to "what kind of training goes on in their residencies?"
What psychologist HAVE learned is that FP's get a 6 week rotation through psych during their residency, that rotation is universally weak, and the FP is often expected to remain on a med-surg rotation simultaneously.
