PsyDs speak out

[PsychWDC]

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Hi everyone,

I have read through several of the threads on this forum and it seems that one of the repeating themes is bashing of PsyDs and PsyD programs. I have responded a couple of times to particularly concerning statements, but I thought it would be helpful for some of us PsyD enthusiasts to offer a balanced word on our own thread.

I personally believe that it is important to distinguish between freestanding professional schools and university based PsyDs. The best PsyD programs are difficult to get into, and several of my classmates turned down offers from well known PhD programs because of the positive reputation of our program.

I have found the PsyD to be an excellent education and I feel I will be competitive when I apply for internship. Talented classmates have received Ivy League internship placements and excellent post docs, and some have become leaders in their areas of specialty.

So, who else is proud of their PsyD training? Can you share stories/experiences about the uniqueness of your program, or the way it has prepared you for your career?

 

[Dr.JT]

Hi everyone,

I have read through several of the threads on this forum and it seems that one of the repeating themes is bashing of PsyDs and PsyD programs. QUOTE]

This is not a theme and we regularly draw a distinction between the "top" PsyD programs and professional school programs. What you are seeing in the threads are warnings aimed at students considering entering these programs with no understanding about the nature of the training or the ridiculous debt they will acquire.

 

[Neuro-Dr]

So, the suggestion is for University PsyDs to bash the Professional School PsyDs....uh huh.... well enjoy your thread.

 

[Therapist4Chnge]

There definitely seems to be a slant toward PhDs, and when PsyDs are concerned....definitely more caution (some of it warranted, some of it not). I tend to look at clinical programs with less emphasis on their 'model', and more emphasis on the quality of their clinician, regardless of degree (PhD vs PsyD). There seems to be a general knock against PsyDs are being 'weaker' candidates, but I'm not really sure that is the case, nor do I believe academic scores can predict the 'quality' of the clinician. I am concerned with the lower tiered future colleagues.....but you have a bell curve of ability/competence in every profession.

I think it also depends on what you plan on using your degree for. Cost is definitely a factor, but the total cost of education has gone up across the board....so you have to make an allowance for cost, regardless of the program. Personally, I'm going back into business, so I'm focusing less on things that will impact traditional clinicians....though I still keep an eye out because I worry about our industry. I am more concerned with the MAs, MSs, and LCSWs...etc. I fear that Doc vs MA will be another case of In-Sourcing....with the Docs getting the shaft. Look at the shift in Customer Service in the last 4-5 years. Cheaper, less qualified overtook the more costly (albeit better trained) option. Just because we may be the better option, doesn't mean we'll be the chosen option.

-t

ps. This post wasn't meant as a knock against MS-level people, because I definitely think there is value in an MS and areas of need, but there are limitations, and if clinicans are not careful, we will work ourselves into the same areas, and then it will be a real mess of differentiation for all parties.

 

[PsychWDC]

Neuro-Dr,

Yes, you are right. I'm sorry about that emphasis as it does not fully match my experience. There are so many PsyDs from freestanding schools (hundreds every year in this area) so there is a big range. But when I think about the very best of these students, there are some truly excellent clinicians.

So please forgive me.

 

[sasevan]

Neuro-Dr,

Yes, you are right. I'm sorry about that emphasis as it does not fully match my experience. There are so many PsyDs from freestanding schools (hundreds every year in this area) so there is a big range. But when I think about the very best of these students, there are some truly excellent clinicians.

So please forgive me.

Thanks Neuro-Dr for confronting what I was going to just ignore since I've gotten tired of arguing this issue; I keep asking for empirical evidence that PsyDs are weaker clinicians and students than PhDs and all I get, at best, are opinions based on anecdotal evidence.
Thanks too PsychWDC for apologizing.
I found it ironic that on a thread confronting the prejudicial bias against PsyDs there was exhibited the same kind of unsubstantiated beliefs about the prof school PsyDs.
I think social psychology informs us that often times when a minority group feels excluded by the majority that it will try to ingratiate itself to that group by emphasizing what it has in common with it and by minimizing what it has in common with an even more disliked minority. I wonder if some of that is at play in these discussons of PhDs (funded vs. unfunded) vs. PsyDs (university vs. prof. schools).
Again, thanks Neuro-Dr and PsychWDC as well as all the rest who have articulated similar sentiments.
Peace. 🙂

 

[Neuro-Dr]

You don't have to apologize to me, this is not my issue. I just think you might have alienated half of your intended audiance and frankly engaged in the type of behavior you were initially complaining about. Namely, ways to demarcate portions of the field into better/worse psychologists.

 

[Neuro-Dr]

"I personally believe that it is important to distinguish between freestanding professional schools and university based PsyDs."

-am I missing the intended meaning of this statement? If so, then ignore my post.

 

[sasevan]

You've been provided empirical evidence over and over again about the differences in student quality between PsyDs and PhDs. . . in addition to the debt issues. Also, the OP shouldn't be apologizing for their post, they didn't suggest we bash free standing insitutions as NeuroDr suggested. This "I'm ok, you're ok" stuff is what prevents us from critically examining the field. . . It's silly. The PsyD institutions that do have high standards and don't saddle their students with huge debt should be trying to distance themselves from the programs that don't have high standards and do saddle their students with huge debt. Unfortunatley for them, most PsyD insitutions fall in the second category. That's not bashing the schools that do it, but pointing out a distinction that actually exists and should be credited.

Actually, I don't recall a single instance of empirical evidence; but I could be wrong.
So, please provide that now. What empirical study do you have that demonstrates a significant difference in student quality between PsyDs and PhDs.
BTW, the debt issue is one consideration among many that goes into the decision of what program one chooses; different individuals have different priorities, e.g., someone may well rather go into debt and be able to stay in her/his local area than the alternative.
Additionally, debt free programs are not by definition superior to other models, especially in regards to producing better clinical psychologists, since, again, there is no empirical evidence that has demonstrated this. Or is there?
Thanks in advance.

 

[Neuro-Dr]

OK that was not how I took the statement. However, the way it is currently framed reflects my concerns as well.

 

[amy203]

National Survey of Psychotherapy Training in Psychiatry, Psychology, and Social Work
Myrna M. Weissman, PhD; Helen Verdeli, PhD; Marc J. Gameroff, PhD; Sarah E. Bledsoe, MSW; Kathryn Betts, DClinPsy; Laura Mufson, PhD; Heidi Fitterling, BA; Priya Wickramaratne, PhD


Arch Gen Psychiatry. 2006;63:925-934.

Context Approximately 3% of the US population receives psychotherapy each year from psychiatrists, psychologists, or social workers. A modest number of psychotherapies are evidence-based therapy (EBT) in that they have been defined in manuals and found efficacious in at least 2 controlled clinical trials with random assignment that include a control condition of psychotherapy, placebo, pill, or other treatment and samples of sufficient power with well-characterized patients. Few practitioners use EBT.

Objective To determine the amount of EBT taught in accredited training programs in psychiatry, psychology (PhD and PsyD), and social work and to note whether the training was elective or required and presented as a didactic (coursework) or clinical supervision.

Design, Setting, and Participants A cross-sectional survey of a probability sample of all accredited training programs in psychiatry, psychology, and social work in the United States. Responders included training directors (or their designates) from 221 programs (73 in psychiatry, 63 in PhD clinical psychology, 21 in PsyD psychology, and 64 in master's-level social work). The overall response rate was 73.7%.

Main Outcome Measure Requiring both a didactic and clinical supervision in an EBT.

Results Although programs offered electives in EBT and non-EBT, few required both a didactic and clinical supervision in EBT, and most required training was non-EBT. Psychiatry required coursework and clinical supervision in the largest percentage of EBT (28.1%). Cognitive behavioral therapy was the EBT most frequently offered and required as a didactic in all 3 disciplines. More than 90% of the psychiatry training programs were complying with the new cognitive behavior therapy requirement. The 2 disciplines with the largest number of students and emphasis on clinical training—professional clinical psychology (PsyD) and social work—had the largest percentage of programs (67.3% and 61.7%, respectively) not requiring a didactic and clinical supervision in any EBT.

Conclusion There is a considerable gap between research evidence for psychotherapy and clinical training. Until the training programs in the major disciplines providing psychotherapy increase training in EBT, the gap between research evidence and clinical practice will remain.

 

[amy203]

If you want to read the full article (above) you should be able to access it here: http://archpsyc.ama-assn.org/cgi/content/full/63/8/925

Note that the percentage of Ph.D. Programs not requiring didactic and clinical supervision in any EBT was about 40%, which isn't a number to be incredibly proud of either, especially compared to psychiatry programs.

I wish the article provided more info on the types of programs they surveyed - there doesn't seem to be anything on professional vs university-based schools. It might make a difference...

 

[amy203]

Tried to pull some highlights from this article. I definitely recommend reading the whole thing: http://www.liu.edu/cwis/CWP/clas/psych/doctoral/psyd.pdf

Norcross, J.C., Castle, P.H., Sayette, M.A., Mayne, T.J. The PsyD: Heterogeneity in Practitioner Training. Professional Psychology: Research and Practice
2004, Vol. 35, No. 4, 412–419


The overriding objective of our study was to disseminate objective
data about APA-accredited PsyD programs and, in so
doing, to dispel several of the nagging myths and unfounded
generalizations about practitioner training. As with many myths,
the PsyD myths contain a kernel of truth. It is true, for example,
that freestanding PsyD programs offer admission to a far higher
percentage of applicants, but certainly not “Almost anyone can be
admitted.” It is also true that PsyD programs provide comparatively
little financial aid to their students, but it is inaccurate to
declare “No financial assistance is provided.”

A second aim of the PsyD Project was to highlight the heterogeneity
of the PsyD programs, largely as a function of their
institutional settings. The different types of PsyD programs shared
similar financial assistance levels, faculty theoretical orientations,
student demographics, and time to complete training. By contrast,
the freestanding programs differed from both types of universitybased
PsyD programs on several dimensions. In particular, the
former programs received more applications and accepted more
students than did the latter programs.

The high rates of acceptance into APA-accredited freestanding
PsyD programs—one half of all applicants—raise understandable
concerns about quality control. Previous studies (e.g., Mayne et al.,
1994; Murray & Williams, 1999; Norcross, Hanych, & Terranova,
1996; Norcross, Sayette, Mayne, Karg, & Turkson, 1998) invariably
found that higher acceptance rates were associated with lower
GRE scores and GPAs.

Differences among the three types of PsyD programs pale in
comparison with differences between all PsyD programs and PhD
programs in clinical psychology, particularly research-oriented
PhD programs (Maher, 1999). Research-oriented PhD programs
accepted a much smaller percentage of their applicants but were
far more likely to provide financial aid than did PsyD programs.
Students at research-oriented PhD programs required more time to
complete their degree and were more likely to gain admittance to
an APA internship compared with PsyD students.

The disparities in financial aid between PsyD and PhD programs
were indeed pronounced. Fully 84% of students entering researchoriented
clinical PhD programs received full financial assistance
compared with 6% of students entering freestanding PsyD programs.
The probability of receiving full financial assistance in a
freestanding PsyD program is 14 times less than in a researchoriented
PhD program, but the acceptance rate is 4 to 5 times
greater. This difference in financial assistance is undoubtedly
related to the differential debt experienced by recent graduates in
clinical psychology. Graduates of PsyD programs reported a median
debt of $53,000 to $60,000 related to graduate education.
Recipients of Boulder-model clinical PhDs, by contrast, reported a
median level of debt of $22,000 (Kohout & Wicherski, 1999).

One consistent finding from previous studies is that PsyD graduates
do not perform as well as PhD graduates on the national
licensing examination for psychologists (Kupfersmid & Fiola,
1991; McGaha & Minder, 1993; Yu et al., 1997). …. Unfortunately,
the previous research did not systematically compare EPPP scores
as a function of the type of institutional setting for the PsyD
degrees nor of the length of training.
Ultimately, the PsyD Project has underscored, in quantitative
measures, the heterogeneity in training of clinical psychologists.
McFall (2002, pp. 660–661) observed: “It is mythical to treat
clinical psychology as though it were a homogeneous, unified
field, standing all in one place, conveniently marked by a ‘you are
here’ arrow.” The once-presumed homogeneity in clinical psychology
training has vanished; students and advisors alike confront
expanding choices with consequences that carry forward well into
one’s career.

 

[amy203]

this article was discussed here earlier. . . there are some methodological flaws that skew things towards portraying psychiatry in a positive light.

Hi Jon - I definitly don't want to highjack this thread. Can you remember where (which thread) the article was discussed? Archives of General Psychiatry is a very well respected journal, so I'm surprised to hear about the study's flaws. I actually know people who cite this article pretty often!

 

[PsychWDC]

Sasevan wrote:

I found it ironic that on a thread confronting the prejudicial bias against PsyDs there was exhibited the same kind of unsubstantiated beliefs about the prof school PsyDs.
I think social psychology informs us that often times when a minority group feels excluded by the majority that it will try to ingratiate itself to that group by emphasizing what it has in common with it and by minimizing what it has in common with an even more disliked minority. I wonder if some of that is at play in these discussons of PhDs (funded vs. unfunded) vs. PsyDs (university vs. prof. schools).

Sasevan,

Your analysis of the unconscious dynamic behind my comment was right on target. You might even describe it in psychodynamic terms as "identification with the aggressor". Thanks for your insight.

 

[sasevan]

this article was discussed here earlier. . . there are some methodological flaws that skew things towards portraying psychiatry in a positive light.

Good point.
I've read this article and the conclusion, if I recall correctly, was that psychiatry residency programs are significantly better, in EBT training, than comparable psychology or social work programs. This conclusion, if accurate, might suggest that psychiatrists are better psychotherapists than other mental health practitioners.
One of he critiques of this study is, I believe, the way EBT was defined.

 

[sasevan]

Hi amy203,
Thank you for bringing up these two articles. I am truly grateful since what I'm looking for is an actual discussion of any empirical evidence that supports the hypothesis that there is a significant difference between PhD and PsyD programs in producing clinical psychologists and that this difference favors the former model.
I am familiar with the first but not the second so I intend to review it and get back to you. Again, thanks. 🙂

 

[sasevan]

Sasevan wrote:

I found it ironic that on a thread confronting the prejudicial bias against PsyDs there was exhibited the same kind of unsubstantiated beliefs about the prof school PsyDs.
I think social psychology informs us that often times when a minority group feels excluded by the majority that it will try to ingratiate itself to that group by emphasizing what it has in common with it and by minimizing what it has in common with an even more disliked minority. I wonder if some of that is at play in these discussons of PhDs (funded vs. unfunded) vs. PsyDs (university vs. prof. schools).

Sasevan,

Your analysis of the unconscious dynamic behind my comment was right on target. You might even describe it in psychodynamic terms as "identification with the aggressor". Thanks for your insight.

A definite possibility.
However, I prefer now to address the purported evidence and not speculate on unconscious motivations. IMO, as scientist we need to deal with empirical facts and amy203 has provided us with a starting point to do just that.
p.s. i do not mean by the preceding to discount psychodynamic theory but only to continue the dialogue that has been initiated by amy203.

 

[LM02]

Hi Jon - I definitly don't want to highjack this thread. Can you remember where (which thread) the article was discussed? Archives of General Psychiatry is a very well respected journal, so I'm surprised to hear about the study's flaws. I actually know people who cite this article pretty often!

One of the issues is that psychiatry residencies are mandated to provide training in certain specific psychotherapies, CBT being included as one. So the high rate reported in the journal essentially reflects that residency programs are complying with their ACGME (?) requirements. I actually think this is a great thing!

But the other issue that arises, and this is across the board for all training programs, is the quality of the training. Just because a program reports that it offers training in CBT or any other kind of therapy, it doesn't mean that the training is especially good or otherwise emphasized.

For example, where I am, the residents actually get a great didactic course in CBT, taught by a very respected psychologist. The issue is that this psychologist is only given 6 months to provide the seminar - whereas the residents get 2 full years of didactics on psychodynamic psychotherapy. So even if the quality is good, the overall culture of the program doesn't especially promote the use of CBT.