PsyD vs PhD: Addressing Anti-Psyd Sentiments

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Status
Not open for further replies.
Not sure you have been making this argument, though I can understand why you'd want to. I know others who are anti-FSPS aren't. I guess I'll take a look at the article since it seems counter-intuitive to suggest there is no material difference...

What I've said is the line between FSPS and university based PsyD is blurry, that, given certain characteristics (admission rates, debt level), there are many university based psyd programs that are about the same as FSPS (see my repetitive posts pointing to the list of ncccp member schools).

Members don't see this ad.
 
Changing standards to meet those deemed appropriate for a different model would homogenize the field


. . . with good students who have low debt levels. Hmm.

Let's think about this from a medical school perspective:

I can't imagine, "Hey, we need less academically capable students to diversify the field," flying well.
 
So in, brief, if entrance standards were homogenized I have no doubt we'd still be having this argument.

Probably, but there would be less fear that we were giving away degrees through a crackerjack box distribution method; you know, to all comers for a price. You wouldn't see arguments about dumbing down the field. What you might see is arguments about the role of science in training good clinicians, which is also part of the current debate. I'd be less aggressive about the whole thing if I hadn't spent time with students and faculty from a few of these program or if I didn't keep getting poorly written reports from "neuropsychologists" from certain programs. These were the things that sparked my interest in checking this situation out, you know, "How the F did this person get into graduate school for clinical psychology? What is a psyd? 50% of our field you say? Oh ****." This is not a condemnation of all students that attend PsyD or FSPS programs. It's a condemnation of the programs for appearing to be profit/money driven with respect to expansion/admission decisions. Lack of truncated student population, basically it's a wide open door.
 
Last edited by a moderator:
Members don't see this ad :)
I think it's important to note that, in my opinion, having similar entrance standards that are at least somewhat reflective of areas important to the practice of clinical psychology regardless of training or theoretical orientation (e.g., research knowledge and methods, psychopathology theory and treatment, psychometric principles and assessment) does not seem to me that it would homogenize the field. Given the significant variability in training methods and focuses from just one Boulder-model program to another (for example, the way my particular university does things greatly surprised various faculty at other R1 institutions with whom I spoke during internship interviews, and they were all interested in hearing more about the differences), I don't think we're in danger of becoming homogenized.

I do also agree with one of the previous posters--no one's making the argument that FSPS don't produce some stellar clinicians, or that they don't provide some great clinical training opportunities; however, given the sheer number of individuals they admit, is there any way we could expect that ALL of their trainees are GUARANTEED these excellent placements? My program, for example, seems to be on the higher end of the spectrum in terms of the sheer number and breadth of externship sites available (an advantage of being one of the only accredited clinical psych programs in the state). Yet even with our relatively average cohort sizes (10-15 students/year), there is still always some finagling required to be sure that all students are able to secure the placements they want, which often requires some to either work part-time and in unfunded spots on top of their regular placements, or to wait a year for the current externs to cycle through. I could be entirely mistaken, but I simply can't fathom how a program would be able to provide this same level of training individualization and parity between its students when there are 400+ of them walking around.

Finally, perhaps one of the reasons that research hasn't yet be conducted on the outcomes of FSPS students and the clients with which they work is that most of these students likely aren't terribly interested in conducting research in general, and this type of research in particular? That's not at all meant as a dig or to be facetious; I just don't know that I'd see many individuals even willing to cooperate with researchers looking at these areas, let alone conducting the studies themselves. Hell, even the researchers themselves can sometimes have difficulty cooperating with one another despite knowing full well that their studies are aimed at the best interests of the field.
 
Last edited:
No, simply that the argument is made that our training is not as solid because it is not consolidated in a clinical department but more likely scattered throughout the community.

You're right. The more I think about it, the more I have to agree with you and Ollie in realizing the debate is about practical training as well as academic rigor. Many boulder model programs place students in sites within the community, so that part is similar. The difference probably lies in oversight once students are placed.

For my own part, I have had plenty of opportunity to be grateful that my department can provide a unitary front and is willing to step in on students' behalf when issues with training arise. When a site fails to meet our standards, we no longer send students there. (I'm thinking of one site in particular that was dropped as a placement when the supervision clearly shifted far afield of EBP.) How does your program handle things like this?

Come now. They are concerned about that, too. As for the course learning -- how many times is it said that a "B = PhD?" It'd be interesting to talk about faculty contact. Am I going to be told how much I don't get?

Well, I suppose that depends on how much you do get. The B = PhD motto is repeated as a way of demonstrating that some of the more important learning occurs outside of the classroom--outside the classroom, but still within the department. Consequently, faculty contact is going to be an important issue for some. Faculty contact within the classroom is also an interesting discussion.
 
So in, brief, if entrance standards were homogenized I have no doubt we'd still be having this argument. Human problems are simply too diverse for one model to encompass -- most folks I talk with support a plurality of models rather than a uniform scientist practitioner model. From this perspective, there can be no winning argument in favor of homogenizing entrance standards, and to lament one model as having lax standards misses the point. The outcome measures would likely follow suit: to cry foul because one model doesn't meet the other's standards is all so much noise, but to demand that the entire tradition be scuttled is beyond silly. Class size, EPPP and internship data are simply not the measures to use in determining which programs should be flagged for abusive, exploitative practices.

But the Vail Model was established in order to provide better, more comprehensive clinical training. So why would many of the schools that apply this model underperform on indices of clinical work? You seem to suggest that these measures are biased in favor of PhD programs, but how is EPPP pass rate biased? What should we use to evaluate whether or not the model has effectively met its goals if not these measures?
 
You seem to suggest that these measures are biased in favor of PhD programs, but how is EPPP pass rate biased?

The article that JonSnow cited mentioned a few reasons why the use of the EPPP as an outcome measure might be flawed. The one that seemed most persuasive to me is that EPPP scores are highly correlated with GPA and GRE. Thus, students in clinical Ph.D. programs (who are selected for high GPA/GRE) are very likely to also do well on the EPPP -- not necessarily because of the program's training but because of their own inherent test-taking skills and/or academic abilities.

I also believe that admissions and training standards should be raised (and cohort sizes lowered) for the FSPSs of the world. And perhaps some of the most egregious offenders closed. But when it comes to outcome measures, I agree with Buzz that this one might not be it.
 
The article that JonSnow cited mentioned a few reasons why the use of the EPPP as an outcome measure might be flawed. The one that seemed most persuasive to me is that EPPP scores are highly correlated with GPA and GRE. Thus, students in clinical Ph.D. programs (who are selected for high GPA/GRE) are very likely to also do well on the EPPP -- not necessarily because of the program's training but because of their own inherent test-taking skills and/or academic abilities.

I also believe that admissions and training standards should be raised (and cohort sizes lowered) for the FSPSs of the world. And perhaps some of the most egregious offenders closed. But when it comes to outcome measures, I agree with Buzz that this one might not be it.


Ok. It doesn't sound like the outcome measure is the problem, but rather the people being admitted into these programs do not have the skill set to perform well academically from the start. In this way, the measure is doing exactly what it should be doing in terms of outcome measurement--highlighting the difference between graduates by program (whether due to selections processes, training, or both). The only way to test if training is the cause for the difference is to first even out the admissions requirements.
 
Ok. It doesn't sound like the outcome measure is the problem, but rather the people being admitted into these programs do not have the skill set to perform well academically from the start. In this way, the measure is doing exactly what it should be doing in terms of outcome measurement--highlighting the difference between graduates by program (whether due to selections processes, training, or both). The only way to test if training is the cause for the difference is to first even out the admissions requirements.


My point was that using the EPPP as an outcome may only be evaluating this question: "Can the students who tend to do well on one type of standardized test go on to do well on another type of standardized test?" Or perhaps "Can the students who excel at the traditional academic success markers (GPA/GRE) continue to excel at those markers?"

I think those questions are much less interesting and relevant than this one: "Do students from clinical Ph.D. programs go on to be better practitioners and/or better scientists, in actual day-to-day practice?" I think different outcome measures would be needed to evaluate that -- ones that are unfortunately a lot more subjective and difficult to assess.
 
My point was that using the EPPP as an outcome may only be evaluating this question: "Can the students who tend to do well on one type of standardized test go on to do well on another type of standardized test?" Or perhaps "Can the students who excel at the traditional academic success markers (GPA/GRE) continue to excel at those markers?"

I think those questions are much less interesting and relevant than this one: "Do students from clinical Ph.D. programs go on to be better practitioners and/or better scientists, in actual day-to-day practice?" I think different outcome measures would be needed to evaluate that -- ones that are unfortunately a lot more subjective and difficult to assess.


Not that this particular point is a huge deal -- I just wish there was more evidence looking at the latter question. Personally, I believe that once an institution takes a stance on something (in this case, the APA handing over accred. to FSPSs), they're unlikely to admit they made a mistake and correct course. That is, unless there is some solid evidence that forces them to. I think that's why they're trying to correct the internship imbalance by creating more internships (including captive ones) instead of facing the issue of FSPSs, immense cohort sizes, and poor training quality. It's a pessimistic view, but I've seen people and institutions do a lot worse in order to save face.
 
My point was that using the EPPP as an outcome may only be evaluating this question: "Can the students who tend to do well on one type of standardized test go on to do well on another type of standardized test?" Or perhaps "Can the students who excel at the traditional academic success markers (GPA/GRE) continue to excel at those markers?"

I think those questions are much less interesting and relevant than this one: "Do students from clinical Ph.D. programs go on to be better practitioners and/or better scientists, in actual day-to-day practice?" I think different outcome measures would be needed to evaluate that -- ones that are unfortunately a lot more subjective and difficult to assess.

Perhaps the academic capabilities superceeds the practice competencies? It is an expectation that professionals in our society will have a solid foundation of intellectual ability and work ethic. They may not be "perfect", but traditional measures of academic ability are standardized tests and GPA. I agree that having some practice-oriented metrics would be very useful, but like you pointed out, they are nearly impossible to develop. Do we use patient ratings? Those are vulnerable to personality issues and not necessarily clinical skill. Do we use colleague ratings? Also vulnerable to personal biases. Do we count the number of times someone has been sued or brought up for ethical violations? Low occurence and only captures the negative end. The only potential metric right now might be board certification. Perhaps that could serve as an index that someone has achieved a certain level of profeciency in an area of practice. I don't know. One thing that is known, however, is that increasing the numbers of underachievers (on the metrics we do have) in psychology cannot be a good thing.
 
Not that this particular point is a huge deal -- I just wish there was more evidence looking at the latter question. Personally, I believe that once an institution takes a stance on something (in this case, the APA handing over accred. to FSPSs), they're unlikely to admit they made a mistake and correct course. That is, unless there is some solid evidence that forces them to. I think that's why they're trying to correct the internship imbalance by creating more internships (including captive ones) instead of facing the issue of FSPSs, immense cohort sizes, and poor training quality. It's a pessimistic view, but I've seen people and institutions do a lot worse in order to save face.

I hope you were being sarcastic about it not being a big deal. Or maybe I just don't get it. Without the measures you've discussed, optimal cohort size and preferred training remain open for debate, no? And wouldn't the design of valid measures be hugely -- almost prohibitively -- complex (aka political)? So much easier to point fingers, talk annectdotaly, and bemoan what we do not have!
 
Members don't see this ad :)
Buzz,

There seems to be an issue that you keep talking around, and that is the admissions standards. So I have to ask simply: would you be comfortable under the care of a physician who did not take the MCAT or hire an attorney who had a low GPA or low LSAT score?
 
And wouldn't the design of valid measures be hugely -- almost prohibitively -- complex (aka political)? So much easier to point fingers, talk annectdotaly, and bemoan what we do not have!

Going to get back to the previous post sometime this weekend, but can you clarify what you are saying here because now I am even more confused about your stance. You were the one calling for a definitive study to be done, and now it sounds as though you are saying that it will be impossible to conduct one. I'm not sure you can have it both ways. That isn't how science works...if we can't find the perfect measure we don't just throw up our arms and say "Oh well, nothing to be done - I guess the null hypothesis is true" we use the best available proxies we can to get that evidence. Right now, pretty much all available evidence points towards professional schools letting in weaker students and graduating weaker students (acknowledging that those measures are far from perfect).

I'll try and get to the rest later, but suffice it to say I think we are going to have to agree to disagree based largely on some core beliefs about who the responsibility lays with. If I'm understanding you correctly, I fear that your world is one that leads to declining standards until the profession bottoms out completely. Prof schools are the new kid on the block as far as psychology education goes, if they want to employ a dramatically different training model for producing people I am to call my peers, I think the onus is on them to prove they are producing people who are least equally capable - otherwise I can open up a school tomorrow where all we do is watch Intervention, Hoarders, and that disgusting new pile of crap Seacrest is putting together to make fun of people with Tourette's and the burden would be on others to prove this was a bad idea. This is a difference in philosophy that we are unlikely to resolve, but it won't keep me from fighting for what I believe in. You are free to do the same.
 
Last edited:
Buzz

There seems to be an issue that you keep talking around, and that is the admissions standards. So I have to ask simply: would you be comfortable under the care of a physician who did not take the MCAT or hire an attorney who had a low GPA or low LSAT score?

OG -- thanks for reminding me about your earlier question.

You seem to assume the medical model is an apt one for psychology. I do not.
 
Not saying it can'or shouldn't be done, just extremely complex and likely more about industry politics and competing philosophies of science. Not an FSPS vs. Unie thing. Which is my main gripe. Quit blaming the FSPS as a class. So i'm more than happy to agree to disagree, and will also stand for the things I believe in. Actually, it's more than that: Stop dissing FSPS students. Not necessarily you, O123.

Going to get back to the previous post sometime this weekend, but can you clarify what you are saying here because now I am even more confused about your stance. You were the one calling for a definitive study to be done, and now it sounds as though you are saying that it will be impossible to conduct one. I'm not sure you can have it both ways. That isn't how science works...if we can't find the perfect measure we don't just throw up our arms and say "Oh well, nothing to be done - I guess the null hypothesis is true" we use the best available proxies we can to get that evidence. Right now, pretty much all available evidence points towards professional schools letting in weaker students and graduating weaker students (acknowledging that those measures are far from perfect).

I'll try and get to the rest later, but suffice it to say I think we are going to have to agree to disagree based largely on some core beliefs about who the responsibility lays with. If I'm understanding you correctly, I fear that your world is one that leads to declining standards until the profession bottoms out completely. Prof schools are the new kid on the block as far as psychology education goes, if they want to employ a dramatically different training model for producing people I am to call my peers, I think the onus is on them to prove this is effective - otherwise I can open up a school tomorrow where all we do is watch Intervention, Hoarders, and that disgusting new pile of crap Seacrest is putting together to make fun of people with Tourette's and the burden would be on others to prove this was a bad idea. This is a difference in philosophy that we are unlikely to resolve, but it won't keep me from fighting for what I believe in. You are free to do the same.
 
Last edited:
What you count as "dissing", others count as valid criticism. That's an impasse.

That's not an impasse. That's hypocrisy (e.g., naivety, self-righteousness, laziness, ill-informedness, etc.).

How's this JSnow: Stop dissing FSPS students and/or rationalizing the actions of those that do.
 
. . .and what does that have to do with FSPS?

Touche. So I am guilty of occasionally overgeneralizing about FSPSs, too, JSnow.

Some FSPS emphasize the community psychology model of participatory research, some emphasize the scholarship of application and integration. Some. Not all.
 
Right, because FSPS don't have the resources to do much training themselves so they farm it out to local psychologists for a heavy fee. It's quite the racket. But, as far as population (patients), the universities see the same people.

One SDNers racket is another's industry. Nice try.

And I wonder if anybody can say the unies see the same population. See, here in my neck of the woods, that's a laughable assertion. There's just no way the unies can meet the community demand. Add to that the previous poster's suggestion that some unies tend to dump "less desirable" agencies (rather than take them on in an effort to raise the agencies that serve the community?), and I wonder...

Meanwhile we have OG and others seemingly astonished that there can be enough people seeking services in the community for FSPS to fill the breach -- maybe the implied criticism is that FSPS students are twiddling there thumbs in empty rooms, pathologizing vast swaths of the population in order to pretend we are working, AND/OR simply imposters. Too funny, except that it bespeaks a lack of awareness of the true scope of community distress.
 
I know you did, but your answer doesn't make much sense to me. Broken down, you seem to be arguing that FSPS serve a different clinical population and that shutting them down would take away these services; this is not true. Further, you make a distinction between community psychology and academic; there is no such distinction. In addition, you suggest that in academic psychology, the research model is mostly "lab" science; this is not true.

I don't see why we need less capable students trained by less capable faculty who score lower on every objective measure of competence and are burdened with massive financial debt as the new modal model in psychology. Seems like a dumbing down of the field for the benefit of a few (businesses that offer the psyd) and the detriment of many. One of the main creators of the psyd degree regretted it toward the end of his career for this reason; that's not someone biased by traditional academia.

Shutting down my FSPS and the others in this area would certainly leave the area with a gaping hole in its service net. The unies are simply not able to do it all -- this is akin to the old argument that launched the Vail model, no? It's genetic, so to speak. Academic psychology is largely scientist-practitioner, not practitioner-scholar and certainly not participant-collaborator.

You can ball that the students and faculty drawn to these models are less capable, but the fact is, they are the ones doing the lion's share of the work here, and we are lauded for it by those who "get it."
 
What I've said is the line between FSPS and university based PsyD is blurry, that, given certain characteristics (admission rates, debt level), there are many university based psyd programs that are about the same as FSPS (see my repetitive posts pointing to the list of ncccp member schools).

This explains my confusion. I originally thought you'd had a brain fart (imagine that!) and were trying to argue that there's no material difference between FSPSs and PhDs. Ha!

Even so, you do make the argument the line between the FSPS and uni-based PsyD is blurry, but apparantly that line is analogous to a one way mirror: No FSPS ever rise to the level of the sacrosanct unie programs, FSPS alone are being interrogated and would be condemned.
 
. . . with good students who have low debt levels. Hmm.

Let's think about this from a medical school perspective:

I can't imagine, "Hey, we need less academically capable students to diversify the field," flying well.

As I put it to OG, while I may buy into a terrible horrible no good very bad FSPS, I do not buy into the medical model. You may see the latter as an error inseparable from the former.
 
Probably, but there would be less fear that we were giving away degrees through a crackerjack box distribution method; you know, to all comers for a price. You wouldn't see arguments about dumbing down the field.

Yet the field would be dominated by folks with knee jerk tendencies to slam one another over the slightest insults, who seek retribution by annihilation, etc. Oops! Did I just overgeneralize? Maybe SDN would be over-populated by such folks.

What you might see is arguments about the role of science in training good clinicians, which is also part of the current debate.

Perhaps bigger than you've acknowledged. See my previous points about the med-model analogies you and OG seem to adhere to.

I'd be less aggressive about the whole thing if I hadn't spent time with students and faculty from a few of these program or if I didn't keep getting poorly written reports from "neuropsychologists" from certain programs. These were the things that sparked my interest in checking this situation out, you know, "How the F did this person get into graduate school for clinical psychology? What is a psyd? 50% of our field you say? Oh ****." This is not a condemnation of all students that attend PsyD or FSPS programs. It's a condemnation of the programs for appearing to be profit/money driven with respect to expansion/admission decisions. Lack of truncated student population, basically it's a wide open door.

Uhhh....Your experience with "a few of these programs" leads you to actively seek to annihilate a class? Yipes.
 
Uhhh....Your experience with "a few of these programs" leads you to actively seek to annihilate a class? Yipes.

No, it prompted me to do some research and I found lax admission standards, exploitative practices with respect to finances, limited value provided by the businesses (e.g., some get good educations, but do so because they were fortunate enough to get a practicum with a well known supervisor, from ANOTHER UNIVERSITY COMPLETELY UNAFFILIATED WITH THE BUSINESS, who graciously agreed to let them work for free, while they paid their program many thousands of dollars for the priviledge; this is why I use terms like "racket" and "scam."), unaccomplished faculty, marginal quality performance, poor general knowledge levels, rapid expansion for no apparent reason other than profit/increasing their political power, etc. . . I think "cancer" is a fair term.
 
No FSPS ever rise to the level of the sacrosanct unie programs, FSPS alone are being interrogated and would be condemned.


If it were up to me, I'd shut them all down (the ones that contribute more greatly to the internship balance, leave their students in the most debt, have the most lax admission standards), but I don't mind trimming off the FSPS (if it were possible).
 
There's just no way the unies can meet the community demand. Add to that the previous poster's suggestion that some unies tend to dump "less desirable" agencies (rather than take them on in an effort to raise the agencies that serve the community?), and I wonder...

You cannot meet the community demand with inadequate supervision/training. You can be in the room.
 
Universities can't meet community demand? Yeah, because therapy jobs are just going so unfilled now.
 
As someone who isn't a student and is in the real world.....there are too many clinicians (mid-level and doctoral) for too few spots. The market is flooded, which is screwing a lot of early career psychologists.
 
And I wonder if anybody can say the unies see the same population. See, here in my neck of the woods, that's a laughable assertion. There's just no way the unies can meet the community demand. Add to that the previous poster's suggestion that some unies tend to dump "less desirable" agencies (rather than take them on in an effort to raise the agencies that serve the community?), and I wonder...

No, what he said was:

For my own part, I have had plenty of opportunity to be grateful that my department can provide a unitary front and is willing to step in on students' behalf when issues with training arise. When a site fails to meet our standards, we no longer send students there. (I'm thinking of one site in particular that was dropped as a placement when the supervision clearly shifted far afield of EBP.) How does your program handle things like this?

That is called having standards of training and being willing to advocate for students. What you described, Buzz, is turning a blind eye to poor training and being grateful that someone will take on your students. That is the difference between attending a program at a university where the primary concern is educating you versus attending a program at a business that is concerned with raking in govt money.

Also, in terms of my references to other professionals, the point is about STANDARDS--not models. I don't care if we are talking about the attorney handling your contracts/claims, the surgeon conducting your lasik, your investment banker, or whoever. I am asking if you'd be comfortable knowing that person did not pass the standard professional requirement for entry into their field. I'm betting you would NOT be OK with this. But, if you are like most of us, we do not research very thoroughly. You probably search by location, go to whoever is covered by your insurance, look at online reviews, or if you are a tad smarter, go by word of mouth. The problem with FSPSs is that the MH consumers are also not likely to research their providers. Nor should they have to because their should be solid and consistent standards for our field.
 
Universities can't meet community demand? Yeah, because therapy jobs are just going so unfilled now.

Hmmm?

1) The argument is made to shut FSPS
2) FSPS are a major player in town (ok, there are some unies, too)
3) As you so rightly impy, there is ample demand (we are turning away referrals because even we, with our "inappropriately massive" cohort don't have the capacity to meet the demand
4) Who closes the gap when Unies are the only game in town?
 
You cannot meet the community demand with inadequate supervision/training. You can be in the room.

Nor can you meet it with nothing. Thank goodness I train at a decent program, ample supervision and rich training. Oh but you were going to prove that just because I go to an FSPS that cannot be so, that as an FSPS student I must be sitting there with my thumb up my bum :thumbup:, pathologizing folks :)scared:), playing doctor :beat:....
 
As someone who isn't a student and is in the real world.....there are too many clinicians (mid-level and doctoral) for too few spots. The market is flooded, which is screwing a lot of early career psychologists.

Guess we're all on cloud nine here? Maybe the market itself needs reform to allow greater accessibility. Or, more likely, maybe psychologists have to re-examine their values and re-position the profession to root out and transform the forces of oppression.
 
Last edited:
If it were up to me, I'd shut them all down (the ones that contribute more greatly to the internship balance, leave their students in the most debt, have the most lax admission standards), but I don't mind trimming off the FSPS (if it were possible).

Holy c-r-a-p. A glimmer of a concession, on both points?
 
Last edited:
OG -- I repudiate the hegemony of the model you seem to be touting. Actually, its hegemony is illusory, but that's basically saying the same thing. There is never enough expertise to go around. It is by nature a rare quality, the heroic "it" factor, nurturing a fascination that leads people to covet it, often at the expense of examining the irrationality not simply of their covetousness but of the system that breeds oppression and status anxiety. So your question does not get at the heart of my predicament. Funny, but I think we may be saying somewhat of the same thing in this regard, but for entirely different reasons.

I think there is both a labor surplus and a labor shortage in the field. There are too many people entering the field for socially if not personally regressive reasons, or, there aren't nearly enough people involved in the healing of systemic irrationality. I find it deeply ironic that you would claim FSPS would contribute/have contributed squat, but mostly because I don't think the traditionalists (with all their glittering tests and measures, their wealth of training and firm grasp of pure science) have done much but promote irrationality and arbitrariness. So I am torn -- I see both a surplus and a shortage. Your argument is one dimensional inasmuch as you would seek to address the surplus alone, and then -- by contraction? -- while simply nay saying any idea of a shortage? Woe is us. It just strikes me as oddly out of touch both with the nature and extent of suffering and oppression in this society, and with the nature and limitations of what you call science.

So I hope you'd see that this is not a concern common to all FSPSs, I can even imagine you'd argue that some Unies are fighting the good fight. All the more reason to reconsider the dream of shutting them down, unless you are scared of the values I would promote for industry reform and social change...

Now if you'll excuse me I have to go pay my taxes. I haven't decided if that's ironic or not :boom:


That is called having standards of training and being willing to advocate for students. What you described, Buzz, is turning a blind eye to poor training and being grateful that someone will take on your students. That is the difference between attending a program at a university where the primary concern is educating you versus attending a program at a business that is concerned with raking in govt money.

Also, in terms of my references to other professionals, the point is about STANDARDS--not models. I don't care if we are talking about the attorney handling your contracts/claims, the surgeon conducting your lasik, your investment banker, or whoever. I am asking if you'd be comfortable knowing that person did not pass the standard professional requirement for entry into their field. I'm betting you would NOT be OK with this. But, if you are like most of us, we do not research very thoroughly. You probably search by location, go to whoever is covered by your insurance, look at online reviews, or if you are a tad smarter, go by word of mouth. The problem with FSPSs is that the MH consumers are also not likely to research their providers. Nor should they have to because their should be solid and consistent standards for our field.
 
Guess we're all on cloud nine here? Maybe the market itself needs reform to allow greater accessibility. Or, more likely, maybe psychologists have to re-examine their values and re-position the profession to root out and transform the forces of oppression.

Students often have a very different view of the state of psychology, whether it is due to a lack of exposure to "real world" issues, confirmation bias, and/or other reasons. Many of the day to day discussions are not about theory or purpose, but instead about billing codes and justifying budgets to the hospital administrators. Accessibility is going the other way in most hospitals/CMHCs/clinics, as less people can get services and providers are fighting over smaller pieces of the pie. Psychologists aren't going to "root out and transform the forces of oppression", as we are too concerned with getting pushed out of our jobs be lesser qualified, lower paid, and often less effective providers.
 
Hmmm?

1) The argument is made to shut FSPS
2) FSPS are a major player in town (ok, there are some unies, too)
3) As you so rightly impy, there is ample demand (we are turning away referrals because even we, with our "inappropriately massive" cohort don't have the capacity to meet the demand
4) Who closes the gap when Unies are the only game in town?

I don't know where you live, but that is NOT the norm. Wait until you get out of school and you'll see, I suppose.
 
I don't know where you live, but that is NOT the norm. Wait until you get out of school and you'll see, I suppose.

While I'll be generous in saying that there still *might* be some unmet demand in very rural areas, everything else seems to point to a flooding of therapy market (too many applicants, too few jobs). The reason one might see more demand in a school-based clinic is that it's free/extremely low cost therapy, which just isn't feasible in the real world (according to one of our clinical professors, we actually lose money for every client we see in our clinic--as a training program, we can kinda sorta justify that, but in the "real world"? Not workable).
 
OG -- I repudiate the hegemony of the model you seem to be touting. Actually, its hegemony is illusory, but that's basically saying the same thing. There is never enough expertise to go around. It is by nature a rare quality, the heroic "it" factor, nurturing a fascination that leads people to covet it, often at the expense of examining the irrationality not simply of their covetousness but of the system that breeds oppression and status anxiety. So your question does not get at the heart of my predicament. Funny, but I think we may be saying somewhat of the same thing in this regard, but for entirely different reasons.

I assure you we are not saying the same thing. You speak about having standards for graduate school admissions as a form of oppression. You "repudiate the hegemony" of a model that calls for those who seek advanced degrees to be smart, studious, and dilligent. I am not sure what kind of model you envision in your perfect world, but I suspect that when it comes down to something that you value and that has enormous consequences on your well-being, you would choose to have it handled by a professional from a real, established university and not from Devry. Whether you admit that or continue to talk around it is up to you.
 
I assure you we are not saying the same thing. You speak about having standards for graduate school admissions as a form of oppression. You "repudiate the hegemony" of a model that calls for those who seek advanced degrees to be smart, studious, and dilligent. I am not sure what kind of model you envision in your perfect world, but I suspect that when it comes down to something that you value and that has enormous consequences on your well-being, you would choose to have it handled by a professional from a real, established university and not from Devry. Whether you admit that or continue to talk around it is up to you.

Overall a disquieting post, OG.

I see areas of overlap and a few pages ago you seemed to as well, but things change.

Too strange -- I never meant to imply that I think admissions standards for graduate school amounts to oppression. But I may have been less than completely careful in explaining my positions...

As for my perfect world, let me get super way out in the dreamland: there, we'd have no need for a mental health profession or psychology in general. Should I apologize for that?

In this world, on matters of consequence I do look to the experts. There is almost no scenario under which I could imagine referring friends and relations to seek psychological help. However, thankfully, the truly unimaginable happens. If it did/when it does (for example, in the case of psychological trauma, or newfound desires to get out of their own way), I would not rule out their seeing a university trained psychologist. But education would be one of the more minor points of consideration. Now, if my friends and relations went to a psychologist who subscribed to the medical model (per your original question) -- I'd feel pretty awful about their choice.

As for my own care -- you're asking me to try out an alien sense of self in the world. Unless I was some sort of political prisoner and simply had no choice, there is zero chance I'd work with a psychologist so inclined. If the psychologist endorsed the medical model I don't care where that person went to school/got trained, what tests were passed or failed, etc. Before anyone gets all hot and bothered, I am not saying I doubt the mind body connection. Some of the best sessions I've had have been while at the sharp end of my acupuncturists' needles or the sweatiest of my yoga practices. Nor am I saying I don't think psychologists have a role to play in primary care -- I've worked in hospital-based behavioral health for a couple of years...
 
Students often have a very different view of the state of psychology....Many of the day to day discussions are not about theory or purpose, but instead about billing codes and justifying budgets to the hospital administrators. Accessibility is going the other way in most hospitals/CMHCs/clinics, as less people can get services and providers are fighting over smaller pieces of the pie. Psychologists aren't going to "root out and transform the forces of oppression", as we are too concerned with getting pushed out of our jobs be lesser qualified, lower paid, and often less effective providers.

Yes, this.
:cry:
 
I don't know where you live, but that is NOT the norm. Wait until you get out of school and you'll see, I suppose.

Where I live/work is there for everyone to see -- it's one of the major population centers in the nation.

Also -- It's not like I'm a total newb. I've been at the mental health racket for over twenty years now.
 
Overall a disquieting post, OG.

I see areas of overlap and a few pages ago you seemed to as well, but things change.

Too strange -- I never meant to imply that I think admissions standards for graduate school amounts to oppression. But I may have been less than completely careful in explaining my positions...

As for my perfect world, let me get super way out in the dreamland: there, we'd have no need for a mental health profession or psychology in general. Should I apologize for that?

In this world, on matters of consequence I do look to the experts. There is almost no scenario under which I could imagine referring friends and relations to seek psychological help. However, thankfully, the truly unimaginable happens. If it did/when it does (for example, in the case of psychological trauma, or newfound desires to get out of their own way), I would not rule out their seeing a university trained psychologist. But education would be one of the more minor points of consideration. Now, if my friends and relations went to a psychologist who subscribed to the medical model (per your original question) -- I'd feel pretty awful about their choice.

As for my own care -- you're asking me to try out an alien sense of self in the world. Unless I was some sort of political prisoner and simply had no choice, there is zero chance I'd work with a psychologist so inclined. If the psychologist endorsed the medical model I don't care where that person went to school/got trained, what tests were passed or failed, etc. Before anyone gets all hot and bothered, I am not saying I doubt the mind body connection. Some of the best sessions I've had have been while at the sharp end of my acupuncturists' needles or the sweatiest of my yoga practices. Nor am I saying I don't think psychologists have a role to play in primary care -- I've worked in hospital-based behavioral health for a couple of years...

I think something is getting lost in translation between the two of us. I never said anything about psychologists adopting the medical model. I will be very clear: When it comes to matters of consequence in your life, would you factor in credentials, academics, and training when deciding which professional to go to? Let's make it super specific: You have a critical legal issue (facing criminal charges, contract dispute, divorce) would you be OK with a lawyer from Devry (or similar free-standing law school) or would you want someone from a university school of law?

That is the question.
 
While I'll be generous in saying that there still *might* be some unmet demand in very rural areas, everything else seems to point to a flooding of therapy market (too many applicants, too few jobs). The reason one might see more demand in a school-based clinic is that it's free/extremely low cost therapy, which just isn't feasible in the real world (according to one of our clinical professors, we actually lose money for every client we see in our clinic--as a training program, we can kinda sorta justify that, but in the "real world"? Not workable).

Just got out of a conversation with a bunch of seasoned local LCSWs, MSWs, etc. Their perspective: We have nowhere near enough psychological help for the community here.

I think you'll agree it's not being too radical to suggest that accessibility is an ethical issue. The distribution of wealth is an ethical issue, too. I think it's abominable that FSPS and university based students take on debt so that the community's need for free to low cost services can be more fully met. I'd love to see the wealth redistributed such that communities could better support and grow the psychological services they seek. I'm not sure how battering and/or shutting down the FSPSs does that. I'd be more interested in that analysis.
 
I think something is getting lost in translation between the two of us. I never said anything about psychologists adopting the medical model. I will be very clear: When it comes to matters of consequence in your life, would you factor in credentials, academics, and training when deciding which professional to go to? Let's make it super specific: You have a critical legal issue (facing criminal charges, contract dispute, divorce) would you be OK with a lawyer from Devry (or similar free-standing law school) or would you want someone from a university school of law?

That is the question.

Well, here's where I may have misread you:

Beyond this is the very real issues of advanced degree fields--particularly in health services. I have said plenty of times that a doctorate in psychology is the highest degree possible in mental health service delivery (at least the part that has data to demonstrate its efficacy ;))....I also have no qualms about admitting that when I look for a PCP, optometrist, OB-GYN, dentist, etc--I would run for the hills if one was trained a vocational/trade model school. Not sure if you'd do the same. It may not sound pleasant, but for many people, this is a reality. A degree and license at a certain level should come with a certain implied quality and rigor of training. FSPSs do not.

Buzz,

There seems to be an issue that you keep talking around, and that is the admissions standards. So I have to ask simply: would you be comfortable under the care of a physician who did not take the MCAT...?

So no, you did not specifically say anything about psychologists adopting the medical model -- you simply adopted the medical model as a valid analogy....slippery slope, at best.

As for law, I'll simply say I've had one or two occasions when I've relied on a court assigned public defender to help me out, and didn't ask about credentials. Not sure that answers your question in any satisfying way. Would I have preferred someone from Donald Trump's legal corps? Sure, but this isn't a fantasy world, now, is it?
 
Well, here's where I may have misread you:





So no, you did not specifically say anything about psychologists adopting the medical model -- you simply adopted the medical model as a valid analogy....slippery slope, at best.

As for law, I'll simply say I've had one or two occasions when I've relied on a court assigned public defender to help me out, and didn't ask about credentials. Not sure that answers your question in any satisfying way. Would I have preferred someone from Donald Trump's legal corps? Sure, but this isn't a fantasy world, now, is it?

Medicine was ONE discipline that I used as an analogy. You cut out the sections where I specifically mentioned law and business. I suspect you decided to focus on the medical side of my argument because it gave you a way to get around the question--which is about credentials. I get that people have used public defenders and people see LCSWs in CMHCs and people see NPs at CHCs to save money. I am only pointing out that for most people a professionals degree is important, particularly when it comes to a serious matter. Your dismissal of academic metrics of achievement is not realistic for our society. Sure people see less rigorously trained professionals when insurance/finances restrict them. But given a CHOICE they would go for the more traditionally trained option. The idea that people don't need high marks or high test scores to pursue advanced degrees contradicts the way these professions are defined in our society. Thus, the issues we are raising with the way FSPSs lower admissions standards are valid. We have a right to be concerned. The public does as well.
 
Medicine was ONE discipline that I used as an analogy. You cut out the sections where I specifically mentioned law and business. I suspect you decided to focus on the medical side of my argument because it gave you a way to get around the question--which is about credentials. I get that people have used public defenders and people see LCSWs in CMHCs and people see NPs at CHCs to save money. I am only pointing out that for most people a professionals degree is important, particularly when it comes to a serious matter. Your dismissal of academic metrics of achievement is not realistic for our society. Sure people see less rigorously trained professionals when insurance/finances restrict them. But given a CHOICE they would go for the more traditionally trained option. The idea that people don't need high marks or high test scores to pursue advanced degrees contradicts the way these professions are defined in our society. Thus, the issues we are raising with the way FSPSs lower admissions standards are valid. We have a right to be concerned. The public does as well.

Not only one, but, tellingly, the first parallel you drew. You argue about ideal choice only by downplaying the very real ways choice is restricted. I have to ask -- by what mechanisms does an industry contraction help ease these restrictions vis-a-vis the mental health choices consumers would have/make?

Then there's this:

It is an expectation that professionals in our society will have a solid foundation of intellectual ability and work ethic. They may not be "perfect", but traditional measures of academic ability are standardized tests and GPA. I agree that having some practice-oriented metrics would be very useful, but like you pointed out, they are nearly impossible to develop. Do we use patient ratings? Those are vulnerable to personality issues and not necessarily clinical skill. Do we use colleague ratings? Also vulnerable to personal biases. Do we count the number of times someone has been sued or brought up for ethical violations? Low occurence and only captures the negative end. The only potential metric right now might be board certification. Perhaps that could serve as an index that someone has achieved a certain level of profeciency in an area of practice. I don't know. One thing that is known, however, is that increasing the numbers of underachievers (on the metrics we do have) in psychology cannot be a good thing.

You haven't demonstrated that this is a bad thing for the public, and perhaps not even for what you call psychology.
 
I personally don't see how decreased admissions standards could be a good thing, but that's just me.

As for the issue at hand, I still believe that one of the more viable short-term solutions to the internship match problem specifically is to hold ALL programs responsible for their match rates. Those programs matching significantly below-average numbers of students should be restricted to taking in approximately the number of people they're able to successfully place. I'd of course be willing to work in some sort of "fudge factor" (e.g., match rate + some additional % of students admitted), given that not all students fail to match because of shortcomings in their programs, but rather because of their own choices in practicum and site selections, application and interview prep, etc.
 
Status
Not open for further replies.
Top