CHAPTER 3 Flashcards
Many contemporary issues challenge the field of clinical psychology. To begin with, several training models are available, each with different emphases and outcomes.
MODELS OF TRAINING IN CLINICAL PSYCHOLOGY
This model integrates scientific principles with clinical practice, aiming to produce professionals who can both conduct research and provide clinical services.
- There is an ongoing debate about the effectiveness of this model. Some argue that it remains a durable and balanced approach, while others criticize it as a poor educational model. The profession is increasingly divided between those focused on clinical practice and those interested in research.
The Scientist Practitioner Model
This model emphasizes clinical skills with less emphasis on research, as reflected in the Doctor of Psychology (Psy.D) degree. Initially questioned for employability, but studies show Psy.D. graduates face no significant issues.
- Concerns have been raised about the perceived qualifications of Psy.D. graduates compared to those with Ph.D.s. However, studies have shown that Psy.D. graduates do not necessarily face more challenges in employment.
The Doctor of Psychology (Psy. D) Degree
These autonomous schools, often offering the Psy.D., prioritize clinical functions over research. Challenges include funding instability and reliance on part-time faculty.
- Funding instability is a significant problem for professional schools, which heavily depend on tuition. Additionally, reliance on part-time faculty poses a shaky foundation for academic structure.
Professional Schools
This model emerged as a response to concerns that clinical psychology lacks a strong scientific foundation. It emphasizes research and empirically supported approaches to assessment and intervention.
- Concerns have been raised about the lack of empirical support for certain clinical techniques and questioning the reliability of certain assessment techniques within the field of clinical psychology.
Clinical Scientist Model
This model combines counseling, clinical, and school psychology, emphasizing breadth over depth in psychological knowledge.
- Graduates may lack a specific subspecialty or area of expertise, making this model more suitable for future practitioners than academics or clinical scientists.
Combined Professional-Scientific Training Programs
Changes in graduate training have mirrored shifts in the marketplace for clinical psychologists, with criticisms of the inadequacy of the Boulder model or inadequacies in clinical skills training.
- There are concerns about an oversupply of practice-oriented psychologists and the potential impact of the managed health care revolution on the demand for clinical psychologists.
Graduate Programs: Past and Future
Involves methods aimed at protecting the public interest and assuring competence. It is, however, complicated by the fact that no national standard exists; the requirements for both certification and for licensure can vary markedly from state to state.
Professional Regulation
A relatively weak form of regulation, restricting the use of the title “psychologist” to those certified by a state board.
- does not prevent unqualified individuals from offering psychological services as long as they avoid using the title “psychologist”
Certification
A stronger form of regulation than certification, specifying training requirements, professional activities, and often excluding master’s candidates. Increasingly restrictive, facing challenges in standardization and academic freedom concerns.
- There are debates about the validity of licensing measures for professional competence. Academic freedom concerns are raised, and challenges include establishing a national standard for licensure and addressing issues related to telehealth.
Licensing
was established in 1947
American Board of Examiners in Professional Psychology
In 1968, ABEPP was shortened to _______________
- it offers certification of professional competence in the fields:
● Clinical child and adolescent psychology
● clinical psychology
● clinical health psychology
● clinical neuropsychology
● cognitive and behavioral psychology
● counseling psychology
● couple and family psychology
● forensic psychology
● group psychology
● organization and business consulting psychology
● police and public safety psychology
● psychoanalysis in psychology
● rehabilitation psychology
● and school psychology
Benefits:
- reduced liability insurance, increased status as a clinician or expert witness, and increased ease of mobility if one chooses to move to another state
American Board of Professional Psychology (ABPP)
American Board of Professional Psychology (ABPP) candidates are required to submit:
practice samples (videotaped), provide a written statement regarding professional expertise and handling of clinical cases, and successfully complete an oral examination conducted by three expert peers.
In 1975, the first ________ of Health Service Providers in Psychology was published.
● is a kind of self certification
● listing only those practitioners who are licensed or certified in their own states and
● who submit their names for inclusion and pay to be listed.
National Register
The idea that began as an honest and dedicated attempt to improve training, provide continuing professional growth, protect the public, and improve the common good will end in a selfish posture of vested interest.
- Traditional fee-for-service __________ is a thing of the past (Baker et al., 2009; McFall, 2002, 2006); managed health care now dominates the scene.
- Training programs must ensure that future clinical psychologists are not sent out into the real world lacking the requisite skills and knowledge demanded by managed health care systems.
Private Practice
What Future Practicing Clinical Psychologists Need to Know?
- Knowledge of new and evolving health care delivery systems.
- Sensitivity to ethical issues relevant to managed care settings.
- Experience in multidisciplinary environments
- Managed-care-relevant clinical skills
- Expertise in “applied” research.
- Management and business skills.
- Technology
- Empirically supported and evidenced-based practices (EBPs) in clinical assessment and intervention
- Training in supervision
- Sensitivity to cultural differences and knowledge of empirical findings
Health care costs continue to rise. According to the World Health Organization the United States spends more money on health care. It is estimated that the United States spent $2.5 trillion dollars on health care in 2009, approximately $8,086 per person.
The Costs of Healthcare
The initial attempt to address high costs for health care in general and mental health care in particular.
- The focus became cost containment, with corporations expanding into a kind of medical-industrial complex and emphasizing a marketplace mentality (Kiesler & Morton, 1988)
Managed Care
The old, traditional, fee-for-service mental health care system was “__________” in the sense that there was little control over which doctoral-level practitioners could be used, the amount paid for services, the quality of services, and the frequency of service utilization.
Unmanaged
Insurance plans become “_______________” as provider networks become more selective, as utilization of services is evaluated with regard to appropriateness and effectiveness, and as managed care organizations institute quality improvement programs.
More Managed
Three Major Types of Managed Care Systems:
1) Health Maintenance Organization (HMO)
2) Preferred Provider Organization (PPO)
3) Point of Service (POS)
