Doctoral Training In Clinical Psychology Research Articles

The impact of expert by experience involvement in teaching in a DClinPsych programme; for trainees and experts by experience.

There is a growing acknowledgement of the value of creating partnerships between those delivering and those accessing health services. Less is known about this in the context of clinical psychology doctoral training programmes. This study explores the models of involvement of experts by experience (EbEs) in teaching on a DClinPsych course in England; the impact of this both for EbEs and trainee clinical psychologists and whether improvements are required to better meet their needs. An audit of current involvement was conducted by reviewing course records. Two survey questionnaires designed around commonly used frameworks of participation and reflective learning were completed by EbEs and trainees. Thematic Analysis was used to evaluate the written feedback from the surveys. Records of current EbE involvement were found to be lacking in detail and sometimes missing. Key themes extrapolated from the surveys highlighted the importance of EbE involvement in supporting the wellbeing of EbEs and the learning experiences of trainees. Recommendations with regard to the processes for future involvement of EbEs in teaching are put forward. A carer of a service user was consulted about the design of the participant information sheet, consent form and the survey questionnaire which was sent to the EbEs. A trainee clinical psychologist was also consulted to provide a trainee perspective on the above forms and the survey questionnaire that was sent to trainees. Further to this, the first author's supervisor identifies as a user of physical and mental health services and provided continued supervision and support regarding the direction of the study including the research questions, design, methodology and interpretation of results.

Workforce challenges in digital health implementation: How are clinical psychology training programmes developing digital competences?

ObjectivesDigital practice in psychological services is a rapidly expanding and innovative area which is supporting continuation of clinical provision during the COVID-19 pandemic. Training the workforce to deliver safe and effective online psychological provision is key to service success and relies on accurate mapping of competences and current training needs. This paper discusses the initial stage for developing the first digital mental health competence framework for applied psychology in the UK. It reports on the digital training currently provided nationally and barriers/facilitators to acquiring these competencies.MethodsEighteen of the thirty UK Clinical Psychology Doctoral training programmes completed a 16-item survey. This mapped current digital health teaching and skills acquisition for trainee Clinical Psychologists throughout their 3-year pre-registration training. Furthermore, potential barriers and facilitators to developing these digital skills for both trainee and qualified Clinical Psychologists were investigated.ResultsThe quantitative analysis highlighted the majority of respondents viewed developing digital mental health competencies with importance, but were not integrating this into teaching or clinical placements activity. The qualitative, inductive content analysis revealed seven key themes influencing the development of digital mental health skills, with the majority of respondents identifying with two themes; the need for practice guidelines (50% of respondents) and opportunities for digital mental health experience.ConclusionsThe findings suggest the need for a greater focus on developing the digital health knowledge, skills, and confidence across trainee and qualified Clinical Psychologists. Strategic analysis indicated the need to develop a framework for digital mental health competences across the curriculum and placement experience. Easily accessible learning packages may support the implementation of training nationally.

Felicisima C. Serafica (1932–2019).

Presents an obituary for Felicisima C. Serafica (1932-2019). When Felicisima "Ping" C. Serafica became one of the first tenured Filipino American professors of psychology in the United States, she paved the way for many future generations. In 1956, Serafica moved back to the Philippines, where she helped establish one of the country's first hospitals for children with mental disabilities and the country's first interdisciplinary mental health clinic. She returned to the United States to complete her doctoral training in clinical psychology at Clark University, before becoming a faculty member at The Ohio State University (OSU) in 1977. As a faculty member in clinical child psychology, her work focused on children and youth-particularly those with learning disabilities and from racial minority backgrounds. She authored two books, Social Cognitive Development in Context (1982) and Mental Health of Ethnic Minorities (1990). She retired as Emeritus Associate Professor of Psychology in 2002. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Ethics of Empathy: Walking a Fine Line in Forensic Evaluations

ABSTRACTObjectivity is often cited as the most important characteristic of the forensic evaluator. However, emerging evidence indicates bias continues to exist, despite evaluators’ best attempts to mitigate the influence of their internal processes. One type of bias, termed empathy bias, continues to engender debate in the field, as the evaluator’s experience of empathy has been conceptualized as a hindrance to the supposed objective forensic evaluation process. We conceptualize the issue of empathy as multipronged: a means to foster the assessment process, an instrument for gathering data, and an ethical imperative. From this point of view, we note empathy is a core characteristic fostered throughout clinical psychology doctoral training. Moreover, due to the well-documented bias associated with racial or ethnic minority status and the stigma of mental illness, the forensic evaluator’s experience of empathy for the individual being assessed likely enhances the interpersonal aspects of the evaluation process. However, the forensic literature often cautions the examiners to carefully manage their emotional reactions to defendants as a way in which to preserve the integrity of the evaluation. We argue that this caution is slightly off the mark, as the internal reaction of the examiner may provide valuable information to the evaluation process. Finally, we suggest further research is warranted in the forensic evaluator’s experience of empathy, as well as how empathy may either enhance or negatively influence the evaluation.

Doctoral training in clinical psychology across 23 years: Continuity and change.

Doctoral training in clinical psychology has undergone substantial changes in recent decades, especially with the increasing heterogeneity of training models and graduate students. To document these changes, we analyzed program, student, and faculty characteristics of American Psychological Association (APA)-accredited clinical psychology programs over a 23-year span. We surveyed directors of clinical training about their doctoral programs every 2 years from 1991 to 2013, securing 90%-98% response rates. With minimal exceptions, the survey questions remained constant. Percentages of female and racial/ethnic minority students continued to grow, such that women now comprise about three quarters of trainees and ethnic minorities about one quarter. There has been a decisive shift in faculty theoretical orientation toward cognitive/cognitive-behavioral and away from psychodynamic/psychoanalytic. Internship match rates were relatively high and stable until the early 2010s but have recently rebounded. We discuss the limitations of these survey results and their implications for the future of doctoral training in clinical psychology.

Clinical psychology training in neoliberal times

Neoliberal ideology has insidiously colonised almost every facet of Western society. How is doctoral training in clinical psychology affected and how can it resist collusion?

Disruptive change and health service psychology transform a clinical psychology doctoral training clinic.

Disruptive change and health service psychology transform a clinical psychology doctoral training clinic.

Developing a Peer Mentorship Program to Increase Competence in Clinical Supervision in Clinical Psychology Doctoral Training Programs.

Supervision has recently been recognized as a core competency for clinical psychologists. This recognition of supervision as a distinct competency has evolved in the context of an overall focus on competency-based education and training in health service psychology, and has recently gained momentum. Few clinical psychology doctoral programs offer formal training experiences in providing supervision. A pilot peer mentorship program (PMP) where graduate students were trained in the knowledge and practice of supervision was developed. The focus of the PMP was to develop basic supervision skills in advanced clinical psychology graduate students, as well as to train junior doctoral students in fundamental clinical and practical skills. Advanced doctoral students were matched to junior doctoral students to gain experience in and increase knowledge base in best practices of supervision skills. The 9-month program consisted of monthly mentorship meetings and three training sessions. The results suggested that mentors reported a 30% or more shift from the category of not competent to needs improvement or competent, in the following supervision competencies: theories of supervision, improved skill in supervision modalities, acquired knowledge in supervision, and supervision experience. Furthermore, 50% of the mentors reported that they were not competent in supervision experience at baseline and only 10% reported that they were not competent at the end of the program. Satisfaction data suggested that satisfaction with the program was high, with 75% of participants indicating increased knowledge base in supervision, and 90% indicating that it was a positive addition to their training program. This program was feasible and acceptable and appears to have had a positive impact on the graduate students who participated. Students reported both high satisfaction with the program as well as an increase in knowledge base and experience in supervision skills.

A survey of UK clinical psychology doctoral training on specialty issues

A survey of UK clinical psychology doctoral training on specialty issues

The buds and shoots of what I’ve grown to become: the development of reflective practice in Trainee Clinical Psychologists

Within literature regarding Personal Professional Development (PPD) in Clinical Psychology training, personal and professional development are largely conceptualised as separate processes. Yet models of reflective practice would suggest that an awareness of the personal self is necessary for effective clinical work. This study explored newly qualified Clinical Psychologists’ (CPs) experiences of PPD, and in particular their identities, during their clinical psychology doctoral training. The main research question was ‘How do newly qualified CPs experience their personal and professional identities during doctoral training?’ Seven newly qualified CPs were interviewed regarding their experiences of their personal and professional identities during training. A qualitative research design was employed and Interpretative Phenomenological Analysis was used to analyse the data. Three superordinate themes were identified: Enhancing awareness of self and others; Taking risks and managing uncertainty; Developing self-acceptance. Within these results there was a strong message of an inextricable link between personal and professional identities. Enhancing awareness of self was understood as a personal process within PPD and an important aspect of reflective practice, thus it is proposed that PPD is an effective tool for training reflective practitioners. Within PPD, learning to manage uncertainty and take risks within relationships was seen to contribute to reflective practice, as CPs may be more able to attend to process issues within the therapeutic context. Furthermore, greater self-awareness seemed to help trainees find a balance between self-development and self-acceptance. Maintaining a stable and accepting sense of self may contribute to a CP’s professional development and personal wellbeing.

Is clinical psychology doctoral training becoming less intellectually diverse? And if so, what can be done?

Longitudinal data of psychotherapy theoretical orientations (PTO) for faculty from within clinical psychology programs were analyzed for a period of over two decades. Results from multilevel modeling demonstrated that clinical psychology has moved from a field that was relatively balanced in percentages of faculty from cognitive-behavioral (CBT), psychodynamic, humanistic, behavioral, and family PTOs to one that has shown highly significant linear growth for a single PTO: CBT. All other PTOs (except family) showed significant linear decline. To some extent, important research findings from other PTOs have been co-opted into CBT, but essential aspects of this work have been stripped down, muddied, or lost in a conflation with CBT treatments. We suggest that the field has lost significant intellectual diversity during the past two decades and identify how intellectual monocultures have been damaging to the success of other scientific disciplines and research groups. Tangible solutions are offered to correct this trend, including the establishment of an intellectual diversity task force, the APA's dissuasion of the establishment of monocultures within its evaluation of training, increased support for research investigation of more diverse approaches to psychotherapy, organizing of minority PTOs in order to lobby for larger research and professional training goals, and increased mentoring opportunities from minority PTO faculty.

A river runs through it: enhancing learning via emotional connectedness. Can problem-based learning facilitate this?

The ability to undertake therapeutic work either directly or indirectly is central to many Clinical Psychology posts. This paper focuses on the acquisition of skills and knowledge gained through experiential learning components of a clinical psychology doctoral training programme following the introduction of Problem-Based Learning (PBL) into its academic curriculum in 2006. At UH, PBL began life for many trainees as a content-focused exercise developed to highlight how one might assess, formulate and intervene with issues presented within a case. Over time the task has increasingly incorporated a process focus, in which the content facilitates PBL groups to reflect on a broad range of concurrent processes, including personal contexts, interactions with others, and the influence of wider systems. This paper explores the overall learning experiences of PBL for trainees within one PBL group and how the exploration of underlying personal and group processes may facilitate a personal and emotional connection with the ‘client’. Further, we consider modes of conveying this information to enable an audience to emotionally connect with the case and the experiences of the group members. We conclude with a consideration of what we may learn for the benefit of future PBL groups within other disciplines.

The narrowing of theoretical orientations in clinical psychology doctoral training.

The focus of this article is the increasingly narrow range of therapeutic orientations represented in clinical psychology graduate training programs, particularly within the most research-oriented programs. Data on the self-reported therapeutic orientations of faculty at “clinical science” Ph.D. programs, Ph.D. programs at comprehensive universities in clinical and in counseling psychology, Psy.D. programs at comprehensive universities, and Ph.D. or Psy.D. programs at freestanding specialized institutions reveal a strong predominance of faculty with cognitive-behavioral orientations at the more science-focused programs, and a narrower range of orientations than in the more practice-focused programs. We discuss the implications of this trend for the future development of clinical psychology and provide suggestions for addressing the attendant concerns.

Science and practice in clinical psychology doctoral training.

I evaluate the claim by Heatherington et al. (2012) that most clinical psychology graduate students are primarily educated in cognitive-behavioral theory and therapy. I point out some limitations with their data, in part by describing my own experience in a “CBT” training program. I further contend that even if better data are needed, there may be cause for concern, especially with reference to recent training guidelines. I believe that it is important to consider how young clinical psychology is as a profession and a science and that graduate students in clinical psychology need both pluralism and a thorough grounding in history in order to keep our field moving forward.

Fallacies of a family member: recovery in progress

I have worked in mental healthcare with people living with serious mental illness for almost 12 years, and I am in my third year of doctoral training in clinical psychology. My brother has lived with “schizophrenia” for over 10 years. I write from the perspectives of a training clinician and a family member – a family member who did not realize how clinically insensitive her experiences with her brother were until now. This is an essay of humility and hope.

Research and publication: reflections on the research writing process during clinical psychology training and on writing for publication once qualified

Clinical psychology trainees often do not publish their research thesis or pursue research post qualification. This paper describes the author's reflections on writing for publication following clinical psychology doctoral training. The paper focuses on how this task was achieved alongside other competing demands as a newly qualified psychologist. The paper aims to offer encouragement to newly qualified and final year trainees who may be considering writing for publication.

Research Activity in British Clinical Psychology Training Staff: Do We Lead by Example?

Sixty-two members of staff from clinical psychology doctoral training programmes across Britain completed a survey about their level of research output, the extent to which they felt this met their own expectations and job requirements, and how it influenced promotion prospects. In addition, they listed perceived barriers to and facilitators of research activity. There was wide variation in research activity, such that many participants had limited or no publications while a smaller proportion had many. Respondents were as, or more, dissatisfied than satisfied with their publications, submissions and grant applications and over half felt that the number of grant applications failed to meet their expectations. Support from and collaboration with colleagues was the main facilitator for research, while a lack of time was viewed as the main barrier.

Getting in and getting money: A comparative analysis of admission standards, acceptance rates, and financial assistance across the research–practice continuum in clinical psychology programs.

The diversification and proliferation of doctoral programs in clinical psychology call for their periodic comparative analysis to inform prospective applicants, their advisors, and the entire field. The authors surveyed directors of the 232 American Psychological Association (APA)–accredited doctoral programs in clinical psychology (98% response) regarding application numbers, acceptance rates, financial assistance, and credentials of incoming students. Results are summarized for all clinical programs and then separately for 6 types of programs along the practice–research continuum: freestanding PsyD, university professional school PsyD, university department PsyD, practice-oriented PhD, equal-emphasis PhD, and research-oriented PhD. Lower acceptance rates and higher Graduate Record Examination scores were strongly associated with programs oriented toward more research training; for example, research-oriented PhD programs admitted far fewer applicants (7% vs. 50%) than did freestanding PsyD programs. Freestanding PsyD programs awarded significantly less full financial assistance to incoming students (1% vs. 89%) and required 1 less year to complete than did PhD programs. Overall, PhD-level students were more likely to secure an APA or Association of Psychology Postdoctoral and Internship Centers internship than were PsyD students. The authors conclude with observations about the historical changes and heightened differentiation of doctoral training in clinical psychology.

Current Status and Future Prospects of Clinical Psychology: Toward a Scientifically Principled Approach to Mental and Behavioral Health Care.

The escalating costs of health care and other recent trends have made health care decisions of great societal import, with decision-making responsibility often being transferred from practitioners to health economists, health plans, and insurers. Health care decision making increasingly is guided by evidence that a treatment is efficacious, effective-disseminable, cost-effective, and scientifically plausible. Under these conditions of heightened cost concerns and institutional-economic decision making, psychologists are losing the opportunity to play a leadership role in mental and behavioral health care: Other types of practitioners are providing an increasing proportion of delivered treatment, and the use of psychiatric medication has increased dramatically relative to the provision of psychological interventions. Research has shown that numerous psychological interventions are efficacious, effective, and cost-effective. However, these interventions are used infrequently with patients who would benefit from them, in part because clinical psychologists have not made a convincing case for the use of these interventions (e.g., by supplying the data that decision makers need to support implementation of such interventions) and because clinical psychologists do not themselves use these interventions even when given the opportunity to do so. Clinical psychologists' failure to achieve a more significant impact on clinical and public health may be traced to their deep ambivalence about the role of science and their lack of adequate science training, which leads them to value personal clinical experience over research evidence, use assessment practices that have dubious psychometric support, and not use the interventions for which there is the strongest evidence of efficacy. Clinical psychology resembles medicine at a point in its history when practitioners were operating in a largely prescientific manner. Prior to the scientific reform of medicine in the early 1900s, physicians typically shared the attitudes of many of today's clinical psychologists, such as valuing personal experience over scientific research. Medicine was reformed, in large part, by a principled effort by the American Medical Association to increase the science base of medical school education. Substantial evidence shows that many clinical psychology doctoral training programs, especially PsyD and for-profit programs, do not uphold high standards for graduate admission, have high student-faculty ratios, deemphasize science in their training, and produce students who fail to apply or generate scientific knowledge. A promising strategy for improving the quality and clinical and public health impact of clinical psychology is through a new accreditation system that demands high-quality science training as a central feature of doctoral training in clinical psychology. Just as strengthening training standards in medicine markedly enhanced the quality of health care, improved training standards in clinical psychology will enhance health and mental health care. Such a system will (a) allow the public and employers to identify scientifically trained psychologists; (b) stigmatize ascientific training programs and practitioners; (c) produce aspirational effects, thereby enhancing training quality generally; and (d) help accredited programs improve their training in the application and generation of science. These effects should enhance the generation, application, and dissemination of experimentally supported interventions, thereby improving clinical and public health. Experimentally based treatments not only are highly effective but also are cost-effective relative to other interventions; therefore, they could help control spiraling health care costs. The new Psychological Clinical Science Accreditation System (PCSAS) is intended to accredit clinical psychology training programs that offer high-quality science-centered education and training, producing graduates who are successful in generating and applying scientific knowledge. Psychologists, universities, and other stakeholders should vigorously support this new accreditation system as the surest route to a scientifically principled clinical psychology that can powerfully benefit clinical and public health.

Integrating graduate primary care mental health workers with clinical training: The Selby & York PCT/Hull & York Universities Scheme

This article describes the experiences of five graduate primary care mental health workers (GPCMHWs) based in York and Selby PCT, forming part of a unique graduate scheme linking the PCT and York University to the Hull Clinical Psychology Doctoral Training Course.