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MODELS OF TRAINING IN CLINICAL PSYCHOLOGY:PROFESSIONAL SCHOOLS

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Clinical Psychology­ (PSY401)
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LESSON 07
MODELS OF TRAINING IN CLINICAL PSYCHOLOGY
BACKGROUND TO THE PhD TRAINING MODEL: THE BOULDER CONFERENCE
As doctoral training in clinical psychology expanded during and following the Second World War, there
was a need to regulate and monitor the type of training that students received in such programs. The
American Psychological Association took the initiative to establish accreditation criteria that included
course curricula, research training, qualifying examinations, and clinical training (APA Committee on
Training in Clinical Psychology, 1947). Carl Rogers, the president of APA, appointed David Shakow to
formulate a model for training in clinical psychology. Shakow recommended that training in clinical
psychology should produce professionals who are well equipped to conduct research, assessment, and
psychotherapy. This training should be accomplished in four years of study at the doctoral (PhD) level,
including course work in psychology, psychological research, and supervised clinical practicum
experiences in assessment and psychotherapy. The curriculum should include courses in research
methods, core areas of psychology (e.g., biology, sociology), the psychodynamics of behavior,
diagnostic (assessment) methods, and methods of psychotherapy.
Shakow proposed that the third year of training should consist of a year-long full-time internship in a
clinical setting followed by a final year of training that is devoted to doctoral dissertation research. The
report also recommended that master's-level training in clinical psychology should be discontinued and
that the professional field should be identified only at the doctoral level.
Spurred by Shakow's report, a land mark event in the development of clinical psychology as a
profession occurred with the conference on training in clinical psychology in Boulder, Colorado in
1949. The outcome of this meeting, often called the Boulder Conference, was the formulation of a
"scientist-practitioner" model of training for clinical psychologists. The recommendation of this
meeting was that students in clinical psychology should be trained as psychologists first and
practitioners second. That is, clinical psychologists were defined as individuals who are trained and
skilled in both the science of psychology and the application of psychological knowledge. This two-
pronged approach, still referred to as the Boulder model, has set the standards for training in clinical
psychology for over 50 years.
1. THE SCIENTIST-PRACTITIONER (PhD) TRAINING MODEL
The scientist-practitioner model of training is represented in PhD clinical psychology programs. This
model of training was first formally articulated in a report commissioned by the APA and chaired by
David Shakow in 1947 and subsequently at a conference in Boulder, Colorado. It is typically referred to
as the Boulder Model of training in clinical psychology. Students are required to develop skills both as
psychological researchers and as practicing psychologists. Although the balance of these two types of
training activities is rarely exactly 50-50 in any single program, all Boulder Model programs share a
commitment to a relative balance of training in the science and the application of clinical psychology.
These programs are housed mostly in university-based departments of psychology that are also
committed to educating undergraduates in psychology and to the graduate training of students in other
areas of psychology (e.g., learning, developmental, cognitive, social). Students complete course work in
basic areas of psychology and also participate in specialized seminars on topics in clinical psychology.
Students are required to carry out at least two pieces of original research: a master's thesis or its
equivalent and a second research project that constitutes their doctoral dissertation.
This research is usually on a topic relevant to clinical psychology and often involves applied research on
the nature, measurement, etiology, prevention, or treatment of some form of psychopathology or health-
related problem. In addition, students must complete a specific number of hours of training in clinical
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Clinical Psychology­ (PSY401)
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practice (typically psychological assessment and psychotherapy) during their years in graduate school,
followed by a full-year, 40-hours-per-week internship in an applied setting under the supervision of
licensed clinical psychologists.
Programs that have achieved accreditation by the APA must comply with a set of guidelines regarding
the types of courses and research and clinical training experiences that are required of students for
completion of the degree. A typical Boulder Model program requires four years of work at a university
(course work, research, clinical practica) followed by an internship in the fifth year.
THE RATIONALE FOR THE SCIENTIST- PRACTITIONER MODEL
The rationale for the balance of training in research and practice is that, regardless of the specific career
they pursue, clinical psychologists will need to draw on both sets of skills. For clinical psychologists
who are actively involved in research, it is essential to be able to draw on experience working with
people who have clinical significant problems. This experience keeps researchers in touch with the
issues and problems that are faced by such people. Without this contact with people who are suffering
from psychological problems, it is too easy for researchers to select research questions and problems
because they are the ones that are most easily answered, are the most fashionable in the field, or are best
suited for the methodologies that are available.
Similarly, it is essential for clinical psychologists who are primarily involved in clinical practice to have
a solid foundation in psychological research. Without training in research methods, practicing clinicians
will be unable to stay informed of the latest developments in research concerned with psychopathology,
assessment, or treatment. Clinicians need to be trained in research so that they can be educated
consumers of the research advances that will emerge during the course of their career.
CRITICISM OF SCIENTIST- PRACTITIONER MODEL
Most recently, this training model came under attack by clinicians as being unrealistic in its emphasis on
research in the training of clinical psychologists. The majority of clinical psychologists who are in
clinical practice do not engage in research activities either due to the lack of time or lack of interest. In
either way, their time spent in research training seems meaningless.
The critics also charge this model as being unresponding to the needs of the students who aspire only to
clinical practice. For example, Drabman (1985) describes students who arrive at their internship site
without an adequate knowledge of how to administer, score, and interpret psychological tests. These
students also sometimes show a surprising lack of experience with clinical populations. Although well
versed in the technicalities of research, they have little skill in the practical application of their
knowledge.
Nevertheless a majority of clinical programs still subscribe to the scientist-practitioner model in varying
degrees. It is this model that differentiates clinical psychologists from the rest of the mental health pack.
BACKGROUND TO PSY.D TRAINING MODEL: THE VAIL CONFERENCE
The wisdom of trying to train clinical psychologists to be both competent scientists and practitioners
was questioned vigorously in the years following the Boulder Conference. In a series of conferences and
papers, some clinical psychologists argued for the need of an alternative approach to training, one that
placed greater emphasis on clinical training and less emphasis on scientific training. An alternative
approach emerged in 1968 when Donald Peterson presented the model for the first professionally
oriented clinical psychology training program at the University of Illinois. His efforts culminated in
another training conference, this time held in Vail, Colorado, in 1973.
At this meeting there was, as expected, a reaffirmation of support for the Boulder model as one
approach to the training of clinical psychologists. But a second approach, a professional model of
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training, also emerged from the Vail Conference with significant support. The professional model
validated the importance of knowledge of psychological research but deemphasized the importance of
training in research skills for clinical psychologists.
Training programs could now receive accreditation from the APA by following either the scientist-
practitioner model or the new professional model. During this time period the number of programs
offering the Psy.D (doctor of psychology) degree grew rapidly, and most of the programs that offered
this degree developed in freestanding professional schools of psychology; schools that were independent
of universities.
This development of university-independent professional schools contributed further to the widening
gap between practicing clinical psychologists and psychologists involved in basic research. Professional
schools were not designed to train students in research in basic areas of psychology, and their faculties
did not include researchers in these core areas. The number of clinical psychology training programs has
grown rapidly in recent years, due primarily to the increase in the number of Psy.D programs.
Due to its emphasis on clinical practice, the Psy.D program is also referred to as the "Practitioner-
oriented Model of Training".
2. Psy.D TRAINING MODEL
Programs that grant a Psy.D degree in clinical psychology to their graduates differ from PhD programs
in the balance of training devoted to research and clinical practice. Although some Psy.D programs are
based in universities, most exist in separate freestanding professional schools devoted solely to the
training of professional psychologists. In these programs, relatively little emphasis is given to clinical
research and relatively more training is devoted to skills in psychological assessment and intervention.
Although students in these programs may conduct original clinical research for their dissertation, Psy.D
programs allow students an alternative to complete this requirement through other means, such as a
review of the literature on a topic relevant to clinical psychology or a detailed case study.
The first of these programs was developed at the University of Illinois in 1968. Psy.D programs are not
substantially different from PhD programs during the first two years of training. The real divergence
begins with the third year. At that point, increasing experience in therapeutic practice and assessment
becomes the rule. The fourth year continues the clinical emphasis with a series of internship
assignments. More recently, Psy.D programs have moved toward compressing formal course work into
the first year and expanding clinical experience by requiring such things as five-year practices.
THE RATIONALE BEHIND PRACTITIONER-ORIENTED (Psy.D) MODEL OF TRAINING
The rationale behind practitioner-oriented models of training is twofold. First, there is a large body of
knowledge and skills that a student needs to learn to become a competent clinician, and competence in
the skills needed for clinical practice requires more time than can be devoted to them in a program that
emphasizes both research and practice.
Second, because most clinical psychologists do not go on to conduct research, they need relatively less
training in research. Proponents of this model contend that it is no longer possible to acquire the
necessary foundation of both clinical and research skills in the span of four to five years of doctoral
training.
EVALUATION OF Psy.D MODEL OF TRAINING
Psy.D programs have gained an increasing foothold in the profession. Researchers such as Peterson,
Eaton, Levine and Snepp (1982) hold that Psy.D practitioners are more satisfied with their graduate
training and careers than are clinicians trained in traditional programs. They encounter few problems in
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becoming licensed and report that the Psy.D degree is an advantage in competing for clinical positions.
However, finding academic jobs is difficult for them. Further, when resources and incentives in the
workplace permit, PhD graduates engage in scholarly activities more often than do Psy.D graduates.
3. PROFESSIONAL SCHOOLS
Although the Psy.D model represents a clear break with tradition, an even more radical innovation is the
development of professional schools. Many of these schools have no affiliation with universities; they
are autonomous, with their own financial and organizational framework. Often referred to as "free-
standing" schools, these schools mostly offer the Psy.D degree. Most schools emphasize clinical
functions and generally have little or no research orientation in the traditional sense. Faculty are chiefly
clinical in orientation and therefore are said to provide better role models for students. The first such
free-standing school was the California School of Professional Psychology. It was founded by the
California State Psychological Association and offers several mental health degrees.
The proportion of doctorates in clinical psychology awarded by professional schools has increased
dramatically: by 1993, almost half (1,107 out of 2,220, or 49.9 %) of the doctorates in clinical
psychology were awarded by professional schools. These programs tend to admit far more students than
traditional, university-based scientist-practitioner programs.
EVALUATION OF FREE-STANDING SCHOOLS
Whether such schools ultimately will survive is still uncertain. One of their greatest problems is stability
of funding. Many such institutions must depend on tuition as their chief source of funds, which does not
generate enough money to make them financially secure. They often depend heavily on part-time
faculty whose major employment is elsewhere. As one consequence, it is sometimes difficult for
students to have the frequent and sustained contact with their professors that is so vital to a satisfactory
educational experience.
Although some professional schools are fully accredited by the APA, they are the exception rather than
the rule. This is a major handicap that such schools will have to overcome if their graduates are to find
professional acceptance everywhere. Recent conferences on training suggest that both PhD and Psy.D
programs are secure. However, they continue to recommend that all doctorate programs be at or
affiliated with regionally accredited universities.
4. CLINICAL SCIENTIST MODEL
Over the past decade, empirically oriented clinical psychologists have become increasingly concerned
that clinical psychology, as currently practiced, is not well grounded in science. According to this view,
many of the methods that practitioners employ in their treatment have not been demonstrated to be
effective in controlled clinical studies. In some cases, empirical studies of these techniques have not
been completed; in other cases, research that has been completed does not support continued use of
these techniques. Similarly, the use of assessment techniques that have not been shown to be reliable
and valid and to lead to positive treatment outcome has been called into action.
THE "CALL TO ACTION" FOR CLINICAL SCIENTISTS
The "call to action" for clinical scientists appeared in 1991, in the "Manifesto for a Science of Clinical
Psychology" (McFall, 1991). In this document, McFall argued:
1. "Scientific clinical psychology is the only legitimate and acceptable form of clinical psychology"
2. "Psychological services should not be administered to the public (except under strict experimental
control) until they have satisfied these four minimal criteria:
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a. The exact nature of the service must be describe clearly.
b. The claimed benefits of the service must be stated explicitly.
c. These claimed benefits must be validated scientifically.
d. Possible negative side effects that out-weigh any benefits must be ruled out empirically".
3. "The primary and overriding objective of doctoral training programs in clinical psychology must be
to produce the most competent clinical scientist possible".
Like-minded clinical psychologists were urged to help build a "science" of clinical psychology by
integrating scientific principles into their own clinical work, differentiating between scientifically valid
techniques and pseudoscientific ones, and focusing graduate training on methods that produce "clinical
scientists" - individuals that "think and function as scientists in every respect and setting in their
professional lives".
OUTCOME OF THE "MANIFESTO FOR A SCIENCE OF CLINICAL PSYCHOLOGY"
This document has proved to be quite provocative. One outgrowth of this model of training is the newly
formed Academy of Psychological Clinical Science. The academy consists of graduate programs that
are committed to training in empirical methods of research and the integration of this training with
clinical training. The academy is affiliated with the American Psychological Society (APS). As of 1999,
it included 43 member programs.
The primary goals of the academy are:
1. To foster the training of students for careers in clinical science research. Who skillfully will produce
and apply scientific knowledge.
2. To advance the full range of clinical science research and theory and their integration with other
relevant sciences.
3. To foster the development of and access resources and opportunities for training, research, funding,
and careers in clinical science.
4. To foster the broad application of clinical science to human problems in responsible and innovative
ways.
5. To foster the timely dissemination of clinical science to policy-making groups, psychologist and other
scientist, practitioners and consumers.
EVALUATION OF THE CLINICAL SCIENTIST MODEL
Essentially, a network of graduate programs that adhere to the clinical science model has developed.
These programs share ideas, resources, and training innovations. Further, they collaborate on projects
aimed at increasing grant funding from governmental agencies, addressing state licensing requirements
for the practice of psychology, and increasing the visibility of clinical science programs in
undergraduate education. The ultimate success and influence of this new model of training remains to be
seen.
5. COMBINED PROFESSIONAL-SCIENTIFIC TRAINING PROGRAMS
A final alternative training model involves a combined specialty in counseling clinical, and school
psychology. As outlined by Beutler and Fisher (1994), this training model assumes that
(1) These specialties share a number of core areas of knowledge.
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(2) The actual practices of psychologists to graduate from each of these specialties are quite similar. The
curriculum in these combined training programs focuses on core areas within psychology and exposes
students to each sub specialty of counseling, clinical and school psychology.
EVALUATION OF COMBINED PROFESSIONAL-SCIENTIFIC TRAINING PROGRAMS
The combined training model emphasizes breadth rather than depth of psychological knowledge.
However, this feature can also be seen as a potential weakness of the model. Graduates from this type of
training program may not develop a specific sub-specialty or area of expertise by the end of their
doctoral training. Further this model of training appears to be better suited for the future practitioners
than for the future academician or clinical scientist. By the end of 1998 there were nine APA-accredited
programs in combined professional-scientific psychology-one of which offers a Psy.D degree.
CONCLUSION
In many ways, the changes in graduate training over the past 30 years have mirrored the market place
for clinical psychologists. Starting in the mid-1960s, a shift occurred from university-based academic
jobs to jobs in private practice. Not surprisingly, complaints about the limitation of the scientist-
practitioners model of training surfaced soon thereafter. These complaints focused by primarily on the
perceived inadequacy of the Boulder model of training for future practitioners according to the critics
training in clinical skills was deficient and faculty members were oblivious to the training needs of
future practitioners.
Out of the Vail Training Conference in 1973 came an explicit endorsement of alternative training
models to meet the needs of the future practitioners. Clearly, these alternative training programs are
becoming increasingly influential.
However, several recent trends may affect the viability and success of the various training models. First,
some believe that there may be an over supply of practice-oriented psychologists. If true, this may
ultimately affect the number of students entering and finishing graduate program in clinical psychology.
In recent years, there have been many more applicants for internship position than slots available. If the
internship and job market tighten, the programs that primarily train practitioners (professional schools,
schools awarding the Psy.D degree) will likely feel the brunt of this effect. This will be especially true
for professional schools whose economic viability is heavily dependent on tuition fees and large
numbers of students.
Second, the managed health care revolution will likely affect the demand for clinical psychologist in the
future as well as curriculum in training programs. More emphasis will be placed on course work
involving empirically supported brief psychological interventions and focal assessment. Training
programs that do not employ faculty with expertise in these areas may produce graduates without the
requisite skills to compete in the market place.
Finally, several authors have noted that there may be an undersupply of academic and research-oriented
clinical psychologists. If true, scientist-practitioner and clinical scientist programs may be in a better
position to meet this need.
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Table of Contents:
  1. MENTAL HEALTH TODAY: A QUICK LOOK OF THE PICTURE:PARA-PROFESSIONALS
  2. THE SKILLS & ACTIVITIES OF A CLINICAL PSYCHOLOGIST:THE INTERNSHIP
  3. HOW A CLINICAL PSYCHOLOGIST THINKS:Brian’s Case; an example, PREDICTION
  4. HISTORICAL OVERVIEW OF CLINICAL PSYCHOLOGY:THE GREEK PERIOD
  5. HISTORY OF CLINICAL PSYCHOLOGY:Research, Assessment, CONCLUSION
  6. HOW CLINICAL PSYCHOLOGISTS BECAME INVOLVED IN TREATMENT
  7. MODELS OF TRAINING IN CLINICAL PSYCHOLOGY:PROFESSIONAL SCHOOLS
  8. CURRENT ISSUES IN CLINICAL PSYCHOLOGY:CERTIFICATION, LICENSING
  9. ETHICAL STANDARDS FOR CLINICAL PSYCHOLOGISTS:PREAMBLE
  10. THE ROLE OF RESEARCH IN CLINICAL PSYCHOLOGY:LIMITATION
  11. THE RESEARCH PROCESS:GENERATING HYPOTHESES, RESEARCH METHODS
  12. THE CONCEPT OF ABNORMAL BEHAVIOR & MENTAL ILLNESS
  13. CAUSES OF MENTAL ILLNESOVERVIEW OF ETIOLOGY:PANDAS
  14. THE PROCESS OF DIAGNOSIS:ADVANTAGES OF DIAGNOSIS, DESCRIPTION
  15. THE CONCEPT OF PSYCHOLOGICAL ASSESSMENT IN CLINICAL PSYCHOLOGY
  16. THE CLINICAL INTERVIEW:The intake / admission interview, Structured interview
  17. THE ASSESSMENT OF INTELLIGENCE:RELIABILTY AND VALIDITY, CATTELL’S THEORY
  18. INTELLIGENCE TESTS:PURPOSE, COMMON PROCEDURES, PURPOSE
  19. THE USE AND ABUSE OF PSYCHOLOGICAL TESTING:PERSONALITY
  20. THE PROJECTIVE PERSONALITY TESTS:THE RORSCHACH
  21. THE OBSERVATIONAL ASSESSMENT AND ITS TYPES:Home Observation
  22. THE BEHAVIORAL ASSESSMENT THROUGH INTERVIEWS, INVENTORIES AND CHECK LISTS
  23. THE PROCESS AND ACCURACY OF CLINICAL JUDGEMENT:Comparison Studies
  24. METHODS OF IMPROVING INTERPRETATION AND JUDGMENT
  25. PSYCHOLOGICAL INTERVENTIONS AND THEIR GOALS:THE EXPERT ROLE
  26. IMPORTANCE OF PSYCHOTHERAPY:ETHICAL CONSIDERATIONS
  27. COURSE OF NEW CLINICAL INTERVENTIONS:IMPLEMENTING TREATMENT
  28. NATURE OF SPECIFIC THERAPEUTIC VARIABLES:CLIENT’S MOTIVATION
  29. THE BEGINNING OF PSYCHOANALYSIS:THE CASE OF ANNA, THE INSTINCTS
  30. PSYCHOANALYTIC ALTERNATIVES:EGO ANALYSIS, CURATIVE FACTORS
  31. CLIENT CENTERED THERAPY:PURPOSE, BACKGROUND, PROCESS
  32. GESTALT THERAPY METHODS AND PROCEDURES:SELF-DIALOGUE
  33. ORIGINS AND TRADITIONAL TECHNIQUES OF BEHAVIOR THERAPY
  34. COGNITIVE BEHAVIORAL THERAPY:MODELING, RATIONAL RESTRUCTURING
  35. GROUP THERAPY: METHODS AND PROCEDURES:CURATIVE FACTORS
  36. FAMILY AND COUPLES THERAPY:POSSIBLE RISKS
  37. INTRODUCTION AND HISTORY OF COMMUNITY PSYCHOLOGY:THE ENVIRONMENT
  38. METHODS OF INTERVENTION AND CHANGE IN COMMUNITY PSYCHOLOGY
  39. INTRODUCTION AND HISTORY OF HEALTH PSYCHOLOGY
  40. APPLICATIONS OF HEALTH PSYCHOLOGY:OBESITY, HEALTH CARE TRENDS
  41. NEUROPSYCHOLOGY PERSPECTIVES AND HISTORY:STRUCTURE AND FUNCTION
  42. METHODS OF NEUROLOGICAL ASSESSMENT:Level Of Performance, Pattern Analysis
  43. FORENSIC PSYCHOLOGY:Qualification, Testifying, Cross Examination, Criminal Cases
  44. PEDIATRIC AND CHILD PSYCHOLOGY: HISTORY AND PERSPECTIVE
  45. INTERVENTIONS & TRAINING IN PEDIATRIC AND CLINICAL CHILD PSYCHOLOGY