restructuring the Ph.D/PsyD

[Psyduck]

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I just read an interesting article mainly about revising the focus of PhD programs. Basically the authors (Craighead & Craighead, 2006) want clinical psychology to follow the medical training model, with PsyDs as the only applied route and licensure occuring after completion, while PhDs would be for research only. Anyone who wants to practice and do research would do a joint degree (like an MSTP). PhD programs that are currently equal-emphasis would become the PhD/PsyDs. For more technical aspects of how this would work, see article. They argue, I think quite successfully, that this would eliminate many of the problems currently associated with the dual clinical psych degrees- such as non research oriented people applying to PhD programs, the sometimes second-class status PsyDs, consumer confusion, etc.

What do you all think about this? Is is there any word on whether the APA, or whoever is responsible for this kind of thing, is considering it?

 

[sasevan]

sounds like an interesting propoal.
do u have a link to the article?

 

[Psyduck]

http://www.blackwell-synergy.com/doi/full/10.1111/j.1468-2850.2006.00030.x?cookieSet=1

I hope that works. I have a hard copy but searched for it on Google Scholar. Craighead & Craighead "PhD Training in Clinical Psychology: Fix it Before it Breaks"

 

[Livethedream]

but thats what they're doing? restructuring the whole course!so i presume they will take all your points into account. will there be a psychopharmacology element to the new psy.d version?

 

[Livethedream]

but thats what they're doing? restructuring the whole course!so i presume they will take all your points into account. will there be a psychopharmacology element to the new psy.d version?

 

[sasevan]

http://www.blackwell-synergy.com/doi/full/10.1111/j.1468-2850.2006.00030.x?cookieSet=1

I hope that works. I have a hard copy but searched for it on Google Scholar. Craighead & Craighead "PhD Training in Clinical Psychology: Fix it Before it Breaks"

thanks for trying but access is denied unless one purchases an authorization. thanks again.

 

[sasevan]

All well and good, but the current PsyD programs don't work for this. . .we'd be ceding clinical work to the least talented among us and to the fringe of academia in one fell swoop by eliminating the PhD programs from the fray.

Do you have any empirical evidence that PsyDs are less talented clinicians than PhDs? Is this a fact or is this an opinion? Thanks in advance.

 

[Logic Prevails]

Jon, I see your point, but I think you are more arguing the establishments offering education (academic vs. private), and not the structure of the program itself.

i.e. Would you be on board with this change if Stanford were to offer a PsyD?

 

[Pterion]

Less talented students. . .yes. The clinician thing is a little more challenging; for example, do you have any empirical evidence that nurses are less talented clinicians than MDs, or any empirical evidence that the last person in the class at a particular med school is less talented than their peers, etc. . . They do tend to get lower level internships as well, which is suggestive. . . I can't get past the lower quality in suspension of disbelief, meaning I find it hard to believe that, with the lower quality students, PsyD programs with their lesser resources, produce the same quality product.

Although a PsyD myself, I am afraid I have to agree with this. The problem is the professional schools, as he has pointed out. My program was strong - university based, basic research dissertation required, practica, etc. I often wondered why we were a PsyD and not a PhD program. But my experience has been that despite the greater number of hours in "clinical training" - which is defined differently at different schools - the PsyDs are academically weaker and ironically, much more eager for the opportunity to dispense pills.

If it were possible to "split the degree" so to speak, with a PhD as a researcher and a PsyD as a clinician, then broadly speaking I see the merits of the argument. In medicine, the MDs (for the most part) are the clinicians, the PhDs the researchers.

Unfortunately, the current state of the two titles likely precludes the success of such a move. When you say "professional school" you should put the emphasis on the first word, not the last. These places are making money. They are businesses despite the independence or ecclesiastical affiliation many proclaim. I doubt they would be in a hurry to cede control of this vast amount of Stafford dollars just so the Universities can take over and provide truly standardized and thorough training. Call it curmudgeonly, I see it as pragmatism.

 

[Livethedream]

Well yes, I am arguing about the offerers, but I also disagree with the format of the PsyD programs currently as well. The clinical work so early and heavily is a bad strategy for training in my opinion. There should be heavier and more in depth coursework on theory, mechanism, and application. Take advantage of the extra non-research time and fill it with coursework, not what amounts to indentured service. What should differentiate us from other practitioners/fields is our knowledge base. We should keep the internship system and beef-up the curriculum. Also, drop the misguided prescription drugs nonsense.

completely agree👍 i also think that internship should be longer.

 

[Psyduck]

ok i downloaded the pdf for those who don't have electronic access. hopefully the attachment works

 

[Psyduck]

All well and good, but the current PsyD programs don't work for this. . .we'd be ceding clinical work to the least talented among us and to the fringe of academia in one fell swoop by eliminating the PhD programs from the fray... It would also result in knocking a lot of talent out of considering clinical psychology at all due to ceding training to mostly for profit institutions. Anyone with a modicum of economic sense would not attend a professional school.

If the PsyD were the only route to practice, wouldn't the very talented people who go to PhD programs but have no interest in research necessarily migrate to the PsyDs? Furthermore, some university-based clinical psych programs may be encouraged to convert to PsyDs. I do agree that the economic issue would remain a big problem and many students would no longer be able to pursue clinical psych, but this is something that all professional schools deal with. I also think the money and curriculum issues are problems that should be addressed now, regardless of the changes proposed by this article.

 

[Logic Prevails]

ok i downloaded the pdf for those who don't have electronic access. hopefully the attachment works

I think this article spells out what really needs to happen in this field. I suggest that others give it a good read. The authors argue, I think quite persuasively, the need for current programs to adopt several degrees: PhD (research degree), PsyD (practice degree), & PhD/PsyD (both). There are some really good points about how this approach models what is already done in medicine and how it would produce better researchers and more prepared clinicians. They implicitly suggest that the current business programs need to go and these changes could be made at the university level. I don't think it would be easy to implement, but I think this is a good place to start.

 

[Psyduck]

uh, ok it's gone. i don't really know how that stuff works. i guess if anyone wants a copy they can PM me. but if your institution subscribes to electronic databases you should be able to find it on your own

 

[Livethedream]

where is the link? could you put it back up for two seconds and then take it way!!🙁

 

[sasevan]

Less talented students. . .yes. The clinician thing is a little more challenging; for example, do you have any empirical evidence that nurses are less talented clinicians than MDs, or any empirical evidence that the last person in the class at a particular med school is less talented than their peers, etc. . . They do tend to get lower level internships as well, which is suggestive. . . I can't get past the lower quality in suspension of disbelief, meaning I find it hard to believe that, with the lower quality students, PsyD programs with their lesser resources, produce the same quality product.

Why less talented students? What are you measuring? Similar question regarding lower level internships. Is there any data that we can discuss?
Compairing PsyDs with PhDs is not the same as compairing RNs with MDs, is it? I mean in the former u have two psychologists while in the latter u have a nurse and a physician. Maybe it would have been better to suggest a comparison with DOs and MDs. Or perhaps AMGs and IMGs. In any case, PsyDs and PhDs are licensed by the same Psychology Boards and take the same licensing examinations and go thru the same fellowship and internship process. For all I know u may be correct but I haven't since any evidence to corraborate ur point and am interested in reviewing any such studies if in fact they do exist.

 

[Psyduck]

hi all. it appears that we can't attach documents to private messages. the best i can do is copy and paste the abstract for you. hope you can find it on your own!

 

[Livethedream]

$29? is there any other way of getting it?

 

[joetro]

Do you have access through your college library, either in print or on-line? It was an interesting read, but whatever changes will be a bit of time away.

 

[Livethedream]

no🙁 there is no chance you could email it to me?

[email protected]

i'd really appreciate it if you could😀 its just money is a bit tight at the moment and spending $29 on a simple article seems a bit unwise in my current situation!

 

[Neuro-Dr]

I feel that I need to make a couple of comments here. Having sat on the accreditation committee in the past and having done self studies, I'm amazed at how bad all programs are at helping their own students understand the models we use to determine program's identities. I've said this before on other threads. There are bi-directional concerns:

Take Indiana University (a place I know well since I've taught there)
The clinical Science specialization is 4 class, that should cover assessment, therapy, abnormal and psychopath. It is accredited by the APA, Skinner taught there and is a great research program. It's model is for academia. I would argue that there is little in this program to prepare anyone for serious clinical work although they certainly can get a license to do so.

Let's compare that to ISPP, one of the worrisome professional schools. There are six courses in assessment:
Initial Interviewing
Cog Assess
Object Assess
Project Assess
Battery

Five required therapy courses, plus an intro
Basic Interventions
Person Centered/Process Experiential
CBT
Family
Group
Psycho-analysis
plus a diversity course and a required advanced course in one of the five basics

Two psychopathology courses

In addition, the PsyD model intended that the faculty, because of the lack of publication requirement, would practice in their area. This program requires a minimum of 2000 hours of practum experience compared to the PhD average of 1200.

I looked at the faculty bios:
Michign State x 2, Northwestern x 3, Texas Tech, Loyola, York U in Canada. These are quality programs.

I have said previously that I understand the concerns of others regarding professionals schools and the quality of the students. I think everyone needs to understand that the accreditation process looks at the school, faculty, resources, etc.

The issues that I have with the professional school model are admissions, not training models. All would do well to ask more questions of their own programs about their self-study, requirements, etc.
My 2 cents.

 

[Neuro-Dr]

As for Linas' article, and he does these workshops every year, remember, boarding is currently irrelevant. Less than 1% of all licensed psychologist hold a board
less than 3% of all APA psychologists hold a board
less then 15% of all neuropsychologists hold a board and some say that number may be less than 5%

Until the field makes boarding a needed component, it is a vanity and I hold two (so I'm very vain-haha)

 

[Therapist4Chnge]

less then 15% of all neuropsychologists hold a board and some say that number may be less than 5%

Until the field makes boarding a needed component, it is a vanity and I hold two (so I'm very vain-haha)

WOW!

I thought this would be on the other side (85%). I thought to call yourself a neuropsychologist, you need to be board certified?

-t

 

[PsiKo]

The issues that I have with the professional school model are admissions, not training models. All would do well to ask more questions of their own programs about their self-study, requirements, etc.
My 2 cents.

Can an argument be made for the ability of a well-grounded program with top-flight faculty to take the less-than-elite student and transform him/her into a high-caliber practitioner? Or is this possible only at the Walt Disney School of Professional Psychology?

 

[Neuro-Dr]

I have read the application (for affiliation with ABPP) and actually am impressed. They have two Harvard faculty, one stanford, UM, Tulane, JMU, 1000+ publications, current editor of Archives, previous editor and 50+ members. since there are only 55-60 pediatric people in ABCN, that is about the same. The difference is ABCN is self-report as opposed to evaluated and I am not in favor of competency by self report.

I think their examination process is more stringent and since ABCN/ABPN does not evaluate for competency in pediatrics, I don't see why their application to ABPP should not be approved. I'm glad to see they applied for ABPP and this is similar to what happened when Child & Adolescent went through seperate from Clinical. I don't know if they are still talking about a sub-specialty within ABCN, but whatever.

 

[Neuro-Dr]

I understand what you are saying, but I still have mixed feelings. The reality is that they are boarding almost as many people as ABCN and more than ABPN since 2003. This would mean that more than half of the best new peds NPs would be going outside of ABPP and I don't think that is good. If ABCN wanted peds as a subspecialty, it should have been done a while ago. I talked with the ED of ABPdN and he sent me the emails from the ED of AACN and two prominent peds NPs within ABCN and none had any intention of pursuing a sub-specialty. This is what is done in neurology and psychiatry, so it is a little hard to argue. Again, I don't think anyone should be able to go through with adult samples, take an exam (with only 10-12 legitimate peds questions) and then start seeing peds patients. It really is a special skill set. My other issue is that no fellowships can advertise a specialty in peds np without recognition by CRSPP or ABPP, so I think this could help the field if the quality is there and ABCN and ABPdN can work together a little.

 

[PsychWDC]

Dear Dr. Snow,

It is amazing how consistently negative your posts are. Not all PsyD programs are "mills," and it would be helpful to distinguish between the independent professional schools and those PsyD programs associated with universities. Although we may be in a minority these days, many of us university based PsyDs are receiving excellent educations and taking full advantage of our larger universities to enrich our training. The Argosy and Alliant programs are a completely different case, and your experience with these students is not surprising. Those programs exist primarily to generate money. University based PsyD programs tend to be much smaller and more difficult to get into. Several of my classmates received attractive offers from competitive PhD programs, but decided to pursue our PsyD program because of the outstanding curriculum, supervision, faculty, and focus on clinical training/practicums.

 

[psychwhy]

Jon Snow: Negativity is in the eye of the beholder. . . . Most of the university based PsyD programs have the same negatives as the standalones, especially the debt issue. There are, to my knowledge, less than one handful of programs that offer full tuition waivers and stipends and have the same level of competiveness as Boulder model PhD programs.

So Jon, as this debt issue is a cornerstone of your longstanding criticism of professional programs, may one ask why you have ignored the thread concerning the report that it can no longer be assumed that one will graduate debt free from a conventional PhD programs?

Leaving with a PhD and an average $50,000 debt seems to put a pretty significant dent in your argument.

 

[perfektspace]

I took from the PhD debt article that they were looking at all PhD programs. Without data relevant to this forum the 50K figure doesn't mean much.

 

[psychwhy]

perfektspace: I took from the PhD debt article that they were looking at all PhD programs. Without data relevant to this forum the 50K figure doesn't mean much.

Sorry, but I thought psychology PhDs were just that ... PhDs.

How do you justify dismissing information relating to ALL doctoral programs because it is not specific to psychology? Now if you had provided some refutation based specifically on psych programs, you'd have made a valid point.

But to dismiss the information because it wasn't wrapped up in a psychology bow is just lazy logic.

 

[homoscedastique]

APA's GRADpsych magazine reported earlier this year that the median debt for CLINICAL PhD graduates is now 50,000. Is that clear enough?

Here's the link, my doubtful colleagues:
http://gradpsych.apags.org/sep06/debt.html

 

[homoscedastique]

Oh, I'm sorry. I should have said 50,000 DOLLARS. That's AMERICAN dollars. Pardon my ambiguitique.

 

[Dr.JT]

APA's GRADpsych magazine reported earlier this year that the median debt for CLINICAL PhD graduates is now 50,000. Is that clear enough?

Here's the link, my doubtful colleagues:
http://gradpsych.apags.org/sep06/debt.html

Compared to 90,000 for Psy.d. I am not sure what your argument is.

I can tell you i graduated in 03, and my debt was way less than 20,000, and i consider my program an average boulder model program. 50k seems awfully high. Seems like something is skewing the data.

 

[perfektspace]

Sorry, but I thought psychology PhDs were just that ... PhDs.

How do you justify dismissing information relating to ALL doctoral programs because it is not specific to psychology? Now if you had provided some refutation based specifically on psych programs, you'd have made a valid point.

But to dismiss the information because it wasn't wrapped up in a psychology bow is just lazy logic.

It would be a mistake to generalize debt load across all disciplines and say the data is accurate for clinical psychology PhD programs. I'm speaking from the point of view of colleagues who are current students or recent grads of PhD programs and have assumed little debt. Not claiming to be an expert and I would be interested to see data specifically aimed at debt in clin psych. PhD's. I have no stake in this and would be very curious to see how the finanicial picture has changed for grad students in the field. Whatever that is, so be it.

Such vitriol! No need to flame and call me lazy. If you have something more in depth and helpful to say please do so.

 

[homoscedastique]

Compared to 90,000 for Psy.d. I am not sure what your argument is.

I can tell you i graduated in 03, and my debt was way less than 20,000, and i consider my program an average boulder model program. 50k seems awfully high. Seems like something is skewing the data.

No argument, Dr. JT. Just here is the report that several people (including yourself) here seem to find so difficult to fathom.

And I can tell you that I also graduated in 03 with a PsyD, natch, and that I graduated with far less debt than more than 50% of clinical PhDs. Well, lucky old me and you, but no matter what our own personal experiences may be, these figure are MEDIANS.

 

[perfektspace]

Compared to 90,000 for Psy.d. I am not sure what your argument is.

I can tell you i graduated in 03, and my debt was way less than 20,000, and i consider my program an average boulder model program. 50k seems awfully high. Seems like something is skewing the data.

+1

 

[psychwhy]

perfektspace Such vitriol! No need to flame and call me lazy. If you have something more in depth and helpful to say please do so.

I said it was "lazy logic" if you are so bent on finding offense where none is forwarded ... oh, nevermind ... (preparing for the flamefest to follow)

 

[psychwhy]

homoscedastique: No argument, Dr. JT. Just here is the report that several people (including yourself) here seem to find so difficult to fathom.

And I can tell you that I also graduated in 03 with a PsyD, natch, and that I graduated with far less debt than more than 50% of clinical PhDs. Well, lucky old me and you, but no matter what our own personal experiences may be, these figure are MEDIANS.

Defending fundamental attribution errors does seem to have risen to an Olympic level event here.

Yes, there is a wide variety of experiences represented on this board. What has grown tiresome is the passionate criticism of those whose experience differs from your own. If I have debt, according to you (royal "you"), then I must be somehow inferior/lacking in savvy/lazy, etc.

But wait, PhDs have increasing debt.
"That doesn't mean psych PhDs specifically"

Here, look, even psych PhDs.
"Didn't happen to me (or my friends)."

Throughout history, there has always been a group that has suffered at the hands of the current majority. Time passes and people tend to come to believe, "Oh, that was ignorant and unnecessarily cruel."

Well, folks, the training paradigm has shifted -- I think we can all agree that is irrevocable.

So instead of casting aspersions on those who have come up the "new" path, can't we work to improve the entire profession?

 

[psychanon]

I'm in my third year of a fully-funded clinical Ph.D. program, and I have not taken out a cent in loans (and barring a financial disaster, I don't plan to). My funding is comparable to other fully-funded Ph.D. programs, and I live in a high cost of living area. There is absolutely no reason why anyone in a funded program should have to take more than minimal loans, unless they have a family or an expensive lifestyle to support.

I don't think that it's accurate to pit the actual degrees against each other (Ph.D vs PsyD). There are lots of crappy Ph.D. programs out there, housed in professional schools that charge monstrous tuition (Alliant has one, for example- it charges the same amount as it's PsyD program, $825 per credit hour). The distinction is between fully funded, reptutable Ph.D (or PsyD) programs and poor quality, expensive PsyD/PhD programs. There is just no way to make the argument that the debt in funded programs is anywhere close to the debt in non-funded programs, when non-funded programs cost ~25k per year, plus ~20k in living expenses, and funded programs charge nothing and give you ~20k per year. That's 45k difference per year, for five years!

 

[psychwhy]

Jon Snow: Sort of, I think it has splintered, not shifted. The "new" path degrades the profession. Let's just keep merrily dancing down it?

First, I do not grant your premise that it has "degraded" the profession, but be that as it may, while so much energy is being expended over the PhD/PsyD status battle, the Master's professions are swooping in and gaining more and more ground.

It wouldn't surprise me if in the next decade or so (the APA's doctorate = psychologist resolution notwithstanding) to see the PhD/PsyD disappear from clinical practice.

Is that Rome I smell burning ... ?

 

[perfektspace]

I said it was "lazy logic" if you are so bent on finding offense where none is forwarded ... oh, nevermind ... (preparing for the flamefest to follow)

You seem intent on addressing me in a somewhat "different" way when I am essentially saying the same thing as others with a similar position. Still mad about something?

 

[anybutpretty]

[Deleted]

 

[Therapist4Chnge]

....what is a PsyD supposed to do?

[John Snow] Rack up debt!!![/John Snow]

😉

I happen to agree with real danger being encroaching MS level people, into areas that traditionally were the clinician's realm.

-t