Specialist clinical training: A response to Martin

Abstract

Paul Martin (1989), in the March issue of the Australian Psychologist, published a commendably provocative paper on specialist clinical psychologists and professional training in clinical psychology which should inspire some debate in the professional and academic community. This is a significant concern for that majority of psychologists in this country who are practising professional psychology, for those who are teaching professional training programs, and in the end, for the clients who are at the end of this chain. The issue is much broader in that psychology itself is changing rapidly, both to meet new societal demands and to create and adapt to new philosophies of service provision. Martin raises the very difficult issues of generalist versus specialist training for professional psychologists, and in what way and by whom any identified needs should be accommodated. This has indeed been of concern to the APS in its deliberations about continuing education in the profession. Martin notes changes which have been seen as desirable or which have actually occurred in other countries, particularly the U.K., and offers some suggestions for solutions to the need to adapt to change. However, in reaching the conclusion that “Training in Clinical Psychology is in danger of being left behind” (p. 10) and that post-masters specialist training programs are required, Martin makes a number of assumptions which are debatable. Assumption 1. Training programs ought to be able to produce “finished products,” that is, graduates ready to go out and practise if only at a generalist level, in a fully competent and well-trained manner. No training program can hope to achieve this aim. Graduates usually become good practitioners by practising and continuing to learn. In addition they frequently, themselves, opt to explore different approaches from those taught in their masters course once they are out in the “real world.” This is entirely appropriate since it is after a training program and some experience that psychologists can best take advantage of other offerings in a mature and reflective way. Probably the best a training program can hope to achieve is to provide a framework in which a graduate may work initially with a sense of confidence (e.g., psychodynamic, behavioural), and from which he/she can test other waters. It is here that Martin's other concerns also published in this issue become salient. For the model we try to teach is the scientist-practitioner one, through which we try to ensure, not so much that the graduate will continue to produce publishable research although that is emphatically to be encouraged, but that graduates will continue to critically and evaluatively question assumptions and practices in the profession and insist on a data-based and empirical justification of treatment methods, diagnostic practices, etc., rather than an unquestioning acceptance of dogma or fashion. That is, it is the scientist practioner frame of mind which is important. Current training programs can only be seen as “left behind” if there are unrealistic expectations about what they can do.