APA Passes Resolution on Non accredited programs and internships

[WisNeuro]

There was a surplus of internships to applicants this year. What exactly are you gripping about?

Are you that "modern psychologist" dude again?

I don't think so, the sentence structure and syntax aren't as atrocious. So, unless he picked up a copy of Strunk &White, I'd wager it's a different person.

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[psych.meout]

I don't think so, the sentence structure and syntax aren't as atrocious. So, unless he picked up a copy of Strunk &White, I'd wager it's a different person.

And this person is claiming to be a current student in an unaccredited program, while Modern Psychologist claimed to be a licensed and practicing psychologist. Also, I don't think Modern Psychologist could resist the compulsion to self-promote their laughable website.

 

[psych.meout]

The APIC and CAPIC match program is a joke, and the APA has done nothing to alleviate the discrepancy in supply and demand as numerous students of APA doctoral programs wait years or sometimes never get an APIC matched internship.

There has been a mental health crisis in the US for sometime, as the demand for competent mental health practitioners has far outpaced the available supply of competent clinicians. The APA has done little or nothing to increase accessibility to training programs to increase the number of competent clinicians because by regulating the pace of available clinicians, they decrease competition and protect their jobs. This is in direct contrast to the APA's own Ethical general principles of Beneficence, Nonmaleficience, Integrity, and Responsibility.

Hate to sound cynical, but this is the system APA has created.

You're just upset that you chose to go to an unaccredited program and don't want to accept the consequences, e.g. being shut out of many job opportunities.

Should we license and board physicians that attend unaccredited medical schools? Do you not see how lowering the standards of training and education below the already low bar of APA accreditation conflicts with the ethical principles you cite?

 

[Anthropopsychophile]

Respectf

There was a surplus of internships to applicants this year. What exactly are you gripping about?

Are you that "modern psychologist" dude again?

Respectfully "erg" I'm really not sure where you get your data, but the current APIC website shows all the data for 2016 which represents a slight improvement in internship match process over previous years, but still a long way from acceptable. According to the 2012 phase 1 match results there were 2074 more applicants than accredited positions available, and in 2016 that number declined to 1020 more applicants than accredited positions available. (3235 positions were filled out of 3,999 applicants, and this number includes 821 non-accredited internships. On that note, 821 students took APA non-accredited internships, which as you know as VA psychologist, is a deal breaker for a VA position or a lot of others.

The "surplus" of positions you speak of is based on APICs assessment of positions that were offered, not actually matched. All of this data is not withstanding the rankings of programs and students, and the offerings not always fair or possible for students. A student with a family and living in CA cannot be expected to realistically be matched by APIC as is customary to an internship in Utah and take it just because it is available.

It's nice that you had the benefit of your ducks lining up in a row from whatever point in life, but not everyone is so fortunate. It's easy to judge from our vantage point what should or shouldn't happen based on our own experiences or what we think should happen, but it might be a bit a lofty to presume that all should follow that mold. I would think a psychologist would be a bit more appreciative of diversity. I don't think anyone asking to compromise quality, just to make the process fair.

Respectfully,

I am not that "modern psychologist" dude.


https://www.appic.org/Match/MatchStatistics/MatchStatistics2016PhaseII.aspx


Match Statistics - 2016 - Phase I

 

[WisNeuro]

Not everyone in the Match, is actually ready for internship. There should be an imbalance. If anything, the imbalance should be larger than it currently is.

 

[Anthropopsychophile]

And this person is claiming to be a current student in an unaccredited program, while Modern Psychologist claimed to be a licensed and practicing psychologist. Also, I don't think Modern Psychologist could resist the compulsion to self-promote their laughable website.

You're right psych.meout, I am not "Modern Psychologist, nor do I claim to be a licensed practicing psychologist. Without knowing "Modern Psychologist", I don't know what they might do but I hardly think I am compulsive.

 

[MCParent]

A student with a family and living in CA cannot be expected to realistically be matched by APIC as is customary to an internship in Utah and take it just because it is available.

So the implied solution is.... what? People should be able to submit a list of all the reasons they can't relocate and get prioritized? Or some other situation that places refusal to be inconvenienced or sacrifice anything as the primary factor in matching? Or to just chuck accreditation? You know that even the person who cuts your hair has to go to an accredited beauty school and they have a license hanging on the wall, right? You think our profession should have a lower bar than cosmetology or plumbing?

 

[Anthropopsychophile]

You're just upset that you chose to go to an unaccredited program and don't want to accept the consequences, e.g. being shut out of many job opportunities.

Should we license and board physicians that attend unaccredited medical schools? Do you not see how lowering the standards of training and education below the already low bar of APA accreditation conflicts with the ethical principles you cite?

Psych.meout, first and most importantly I am not upset. I am very gainfully employed as a clinician and have been for the past several decades since graduating in 1998 with a Masters in Counseling Psychology. I have very little desire to test or label people for the purpose of benefits, as I am much more concerned with helping them live their lives and effectively alleviate their symptoms. I have been a highly effective licensed therapist in both the eyes of my clients and the agencies for which I work.

I am not suggesting that we license or board physicians that attend unaccredited medial schools, as that really is a preposterous supposition as medicine is a very different and more exacting discipline than psychology. I am not talking either about lowering standards in psychology but accepting that APA may not have the monopoly on setting standards. I have yet to see a study that affirms that psychologists of APA accredited doctoral programs are more effective in diagnosing or alleviating symptoms, or that they act more ethically. If anything I have seen more buffoonery from psychologists that have managed to pander their way through APA psychology programs, get their piece of paper, and practice independently only to misdiagnose, mistreat, act unethically, and spread their sometimes infectious ideals in academic settings. Many individual states (24-28 I believe) don't require APA accreditation for licensure but rely more on EPPP and jurisprudence exams.

What I am suggesting is that the APA (or other organizations heaven forbid) create a system that is based on the merit of highly trained and quality individuals rather simply create a cookie cutter system ruled by those that pass the litmus test of paying their tuition to the highest bidder. For example, some possible solutions might be for APA to 1) certify more APIC internship sites and lower fees and accreditation process for schools , 2) open the process up to individuals who pass rigorous academic and experiential standards other than just APA schools, 3) allow students to be more in control of placement, and 4) create a wider diversity of educational and clinical experiences and parameters for completing internships.

Standards are a good thing but creating standards that are absolute and inflexible, some might call dictatorial or monopolistic. - Nothing is more dangerous than an idea, when you have only one idea Émile Chartier

I don't claim to have all the answers , but I do claim to be able to see when something doesn't work.

 

[PsyDr]

So you're not a psychologist, do not have the same education, belong to a profession that has a different professional association, but feel as if you have a better view on the profession of which you are not a member than the relevant professional association.

 

[Anthropopsychophile]

So the implied solution is.... what? People should be able to submit a list of all the reasons they can't relocate and get prioritized? Or some other situation that places refusal to be inconvenienced or sacrifice anything as the primary factor in matching? Or to just chuck accreditation? You know that even the person who cuts your hair has to go to an accredited beauty school and they have a license hanging on the wall, right? You think our profession should have a lower bar than cosmetology or plumbing?

Nobody is talking about limiting accreditation. In the same regard, people should not be subject to the single standard and method of training. I think this argument came up at least once before and resulted in the Denver versus Vail models of psychology training. I think we are just at that point again.

The illustration you use is talking about two different standards. A cosmetology license is an administrative permission granted to allow a person to practice cosmetology, which is subject to sanctions if the consumer is somehow violated or the grantee violates the conditions for practice (effective bookkeeping, taxes, regulatory compliance, health code, etc.). The license is taken away if the licensee violates the stipulations.

The education one receives is a condition that could be met in a variety of ways according to the standards set as acceptable by both the consumer and the granter of the license. There may be many accepted ways to apply make-up and it would be wrong for anyone to limit the training as long as the consumer is not subjected to likely harm. The program just might appreciate and foster the diversity and creativity of the cosmetologist in determining what the method should be rather than being dictated to as long as it is sound practice.

 

[MCParent]

Psych.meout, first and most importantly I am not upset. I am very gainfully employed as a clinician and have been for the past several decades since graduating in 1998 with a Masters in Counseling Psychology. I have very little desire to test or label people for the purpose of benefits, as I am much more concerned with helping them live their lives and effectively alleviate their symptoms. I have been a highly effective licensed therapist in both the eyes of my clients and the agencies for which I work.

I am not suggesting that we license or board physicians that attend unaccredited medial schools, as that really is a preposterous supposition as medicine is a very different and more exacting discipline than psychology. I am not talking either about lowering standards in psychology but accepting that APA may not have the monopoly on setting standards. I have yet to see a study that affirms that psychologists of APA accredited doctoral programs are more effective in diagnosing or alleviating symptoms, or that they act more ethically. If anything I have seen more buffoonery from psychologists that have managed to pander their way through APA psychology programs, get their piece of paper, and practice independently only to misdiagnose, mistreat, act unethically, and spread their sometimes infectious ideals in academic settings. Many individual states (24-28 I believe) don't require APA accreditation for licensure but rely more on EPPP and jurisprudence exams.

What I am suggesting is that the APA (or other organizations heaven forbid) create a system that is based on the merit of highly trained and quality individuals rather simply create a cookie cutter system ruled by those that pass the litmus test of paying their tuition to the highest bidder. For example, some possible solutions might be for APA to 1) certify more APIC internship sites and lower fees and accreditation process for schools , 2) open the process up to individuals who pass rigorous academic and experiential standards other than just APA schools, 3) allow students to be more in control of placement, and 4) create a wider diversity of educational and clinical experiences and parameters for completing internships.

Standards are a good thing but creating standards that are absolute and inflexible, some might call dictatorial or monopolistic. - Nothing is more dangerous than an idea, when you have only one idea Émile Chartier

I don't claim to have all the answers , but I do claim to be able to see when something doesn't work.

You need to go look into how accreditation works and how the department of education endows organizations with the power to accredit programs. Some of your points are valid but you're muddling your argument by not having an understanding of how complex accreditation is.

 

[PsyDr]

Nobody is talking about limiting accreditation. In the same regard, people should not be subject to the single standard and method of training. I think this argument came up at least once before and resulted in the Denver versus Vail models of psychology training. I think we are just at that point again.

The illustration you use is talking about two different standards. A cosmetology license is an administrative permission granted to allow a person to practice cosmetology, which is subject to sanctions if the consumer is somehow violated or the grantee violates the conditions for practice (effective bookkeeping, taxes, regulatory compliance, health code, etc.). The license is taken away if the licensee violates the stipulations.

The education one receives is a condition that could be met in a variety of ways according to the standards set as acceptable by both the consumer and the granter of the license. There may be many accepted ways to apply make-up and it would be wrong for anyone to limit the training as long as the consumer is not subjected to likely harm. The program just might appreciate and foster the diversity and creativity of the cosmetologist in determining what the method should be rather than being dictated to as long as it is sound practice.

You mean like how there is a licensing body, accreditation body, etc for licensed professional counselors? And there is another set for psychologists. Only one of those applies to you.

 

[psych.meout]

Psych.meout, first and most importantly I am not upset.

Sure, you aren't.

The bad of being in these programs is that if you're not in the APA good ole boy club and pledge your eternal loyalty, than they will blackball you and lock you out of gainful employment.

The good thing about going to an APA school is that they have give you the privilege of contributing to their coffers both through the association and through the educational monopoly that they hold at various institutions. Not to say that you wont possibly get a quality education (and you may well not) but you very well be limited to the views and the accepted treatment modality of the school.

No ifs , and, or buts.

Nope, not upset at all.

I am very gainfully employed as a clinician and have been for the past several decades since graduating in 1998 with a Masters in Counseling Psychology. I have very little desire to test or label people for the purpose of benefits, as I am much more concerned with helping them live their lives and effectively alleviate their symptoms. I have been a highly effective licensed therapist in both the eyes of my clients and the agencies for which I work.

Ok, then why are you attending an unaccredited PsyD program?

I am not suggesting that we license or board physicians that attend unaccredited medial schools, as that really is a preposterous supposition as medicine is a very different and more exacting discipline than psychology.

Ah, so you can just hand-waive away the analogy, because medicine is "a very different and more exacting discipline than psychology?" How convenient. It's almost like medicine does very well with its rigid training structure and singular (well, dual if you include DO schools) accrediting authority, as well as its treatment of students from Caribbean medical schools and other similarly poorly regarded programs being eerily similar to students from unaccredited doctoral programs in clinical psychology.

I am not talking either about lowering standards in psychology but accepting that APA may not have the monopoly on setting standards.

Ok, so what exactly is specifically wrong with the current standards? What about them would you change? What would having another accrediting authority change and why would this be for the better?

If unaccredited programs can't currently meet the minimal standards of APA accreditation, then if they were accredited once another accreditation organization came into play, wouldn't that necessarily mean that the standards were lowered if the programs didn't change anything about themselves?

I have yet to see a study that affirms that psychologists of APA accredited doctoral programs are more effective in diagnosing or alleviating symptoms, or that they act more ethically. If anything I have seen more buffoonery from psychologists that have managed to pander their way through APA psychology programs, get their piece of paper, and practice independently only to misdiagnose, mistreat, act unethically, and spread their sometimes infectious ideals in academic settings. Many individual states (24-28 I believe) don't require APA accreditation for licensure but rely more on EPPP and jurisprudence exams.

So, you're essentially demanding the people with whom you are debating to provide empirical research supporting their positions, but then using anecdotes to support your own position?

[/QUOTE]What I am suggesting is that the APA (or other organizations heaven forbid) create a system that is based on the merit of highly trained and quality individuals rather simply create a cookie cutter system ruled by those that pass the litmus test of paying their tuition to the highest bidder.[/QUOTE]

Where has anyone here argued that this is the "litmus test" of the current system or advocated that it should be? If anything the people here always warn prospective students to not attend expensive programs, but instead aimed for fully funded programs which actually pay students stipend to attend and do not charge tuition. If you look at the match statistics, these are the programs that have at or near 100% match rates year after year.

For example, some possible solutions might be for APA to 1) certify more APIC internship sites and lower fees and accreditation process for schools , 2) open the process up to individuals who pass rigorous academic and experiential standards other than just APA schools, 3) allow students to be more in control of placement, and 4) create a wider diversity of educational and clinical experiences and parameters for completing internships.

1. I think you're understating the complexity of the internship accreditation process.

2. How would these students have "passed rigorous academic and experiential standards" if they received all their didactic and experiential training through programs that could not meet the minimal standards of APA accreditation? Do you really think that, say, passing the EPPP is a valid and reliable way of assessing the totality of a person's qualifications as a doctoral level psychologist?

3. I don't know what you mean. Are you talking about externship placements?

4. How is this not simply mealy-mouthed code for lowering the standards for accredited internships as well?

Standards are a good thing but creating standards that are absolute and inflexible, some might call dictatorial or monopolistic. - Nothing is more dangerous than an idea, when you have only one idea Émile Chartier

I don't claim to have all the answers , but I do claim to be able to see when something doesn't work.

And how are you operationalizing that it "doesn't work" and where is your evidence to support it? If anything the standards for accreditation need to be even more stringent and many of the crappy PsyD and PhD programs that are currently accredited need to have their rescinded.

 

[singasongofjoy]

A few years back I proposed only allowing programs to have as many students as they have been able to match to APA-acred programs over the prior (5?) years. A reasonable cap is needed, though I think that would mostly self-regulate. If APA-acred. is linked to meeting a certain threshold this should address much of the imbalance within 5-6 years (or enough time for caps to go into effect and have that initial cohort of students apply to match).

I really like that idea. I think it could get complicated by other factors so such a rule might need to be a little more nuanced. For example, does the above leave good programs much room to grow their incoming classes? What if they hire new faculty- you'd expect the incoming class to grow by a couple, right?

Also external factors might affect how many students are taken certain years, and thus a program might have fewer applying and matching to internship a few years later. For instance, my program had (and still has) a great match rate. But while I was there, in one year the state significantly cut the school's budget and there was a rather sudden decision to privatize the places 75% of my lab worked; there was also a faculty retirement and school hiring freeze. That meant that there were a couple of years that the incoming cohort was half (or maybe even less than half that first year, I think) the size of my cohort, just because they couldn't guarantee funding and solid externships for any more than that. Fortunately that turned around relatively quickly- but it was an unusual few years.

Maybe your proposal, which I really like, would work better if you couldn't have an incoming class any bigger than the highest number of matched interns in any individual year over the past 5 years, +10% or +2 depending on the size of the program/new faculty hires, or something like that. I don't know how such would be enforced, but if it could be I think it would be more effective than the spector of losing APA accreditation because it hurts more immediately and is something that has to be revisited every year (rather than waiting for things to get so terrible that APA accreditation is revoked or put on provisional status).

 

[smalltownpsych]

The APIC and CAPIC match program is a joke, and the APA has done nothing to alleviate the discrepancy in supply and demand as numerous students of APA doctoral programs wait years or sometimes never get an APIC matched internship.

There has been a mental health crisis in the US for sometime, as the demand for competent mental health practitioners has far outpaced the available supply of competent clinicians. The APA has done little or nothing to increase accessibility to training programs to increase the number of competent clinicians because by regulating the pace of available clinicians, they decrease competition and protect their jobs. This is in direct contrast to the APA's own Ethical general principles of Beneficence, Nonmaleficience, Integrity, and Responsibility.

Hate to sound cynical, but this is the system APA has created.

I see this mental health crisis and demand being more than supply used all the time. If that was really the case, then why aren't salaries rising? What many want are more and cheaper mental health practitioners of various stripes, which typically means less competent and less trained and less capable people providing services.

 

[WisNeuro]

In none of the places I have been at, has supply been an issue. Whenever we have had an open position, we are inundated with applications for psychologists. I'm sure in rural areas, where nearly every profession has a shortage, this is true, but it does not seem to be so in any thing resembling a metro area.

Bottom line. You want to free from the "shackles" of the APA, call yourself a lifecoach and practice your pseudoscience wherever you like.

 

[Sanman]

I see this mental health crisis and demand being more than supply used all the time. If that was really the case, then why aren't salaries rising? What many want are more and cheaper mental health practitioners of various stripes, which typically means less competent and less trained and less capable people providing services.

Exactly, the mental health crisis in this country has more to do with the poor reimbursement for services and the unwillingness of providers to see these clients due to that. Certainly allowing programs that are not accredited and leave grads with $100k or more in debt will not allow more people to take $40k community mental health jobs.

 

[Anthropopsychophile]

So you're not a psychologist, do not have the same education, belong to a profession that has a different professional association, but feel as if you have a better view on the profession of which you are not a member than the relevant professional association.

That makes no sense and has nothing to do with anything. Sheep are not lions but the sheep might have some thoughts and feelings about how the lions eat. As I understand it this site is not a site for psychologists but a site for students. I didn't say my view is better. I said that maybe your view isn't the only one that works.

 

[WisNeuro]

Wait, since when did psychologists start eating MFT practitioners? Also, can psychologists only be carnivores, and not omnivores? If they can be omnivores, what profession is plant matter in this poorly chosen analogy?

 

[Anthropopsychophile]

You need to go look into how accreditation works and how the department of education endows organizations with the power to accredit programs. Some of your points are valid but you're muddling your argument by not having an understanding of how complex accreditation is.

I realize and appreciate that accreditation is a complicated process and don't claim to either have all the answers about it nor I am attempting to undermine the value of it. Of course establishing standards of quality is very important however when the standards are made to such a degree that they result ij negative outcomes, isn't it up to us to explore the possibilities that decrease that increase positive outcomes?

In none of the places I have been at, has supply been an issue. Whenever we have had an open position, we are inundated with applications for psychologists. I'm sure in rural areas, where nearly every profession has a shortage, this is true, but it does not seem to be so in any thing resembling a metro area.

What you say is correct if you use "available positions" as the definition of demand. If you use incidences of untreated mental illness such as depression and anxiety as the definition of demand, then there are by far not enough clinicians that exist. By and large there are far many semi rural and rural areas in the US than anything resembling a metro area.

Bottom line. You want to free from the "shackles" of the APA, call yourself a lifecoach and practice your pseudoscience wherever you like.

The only "shackles" the APA holds are what many see to be maintaining the barriers that exist to quality mental health care and access for people by limiting the amount of "qualified practitioners. The argument is valid that we don't want "pseudoscience" like Dianetics or Scientology as the basis for mental health treatment and so I would think the APA would make more efforts to increase the available legitimate training venues. As to my credentials about my "pseudoscience", I have been practicing Cognitive Behavioral Therapy and Emotion Focused Therapy (Evidence based practices) for 20 years, have studied with some very notable psychiatrists and psychologists, and have probably as much or more formal training in it than many psychologists that I know, who are incidentally APA accredited.

 

[WisNeuro]

The only "shackles" the APA holds are what many see to be maintaining the barriers that exist to quality mental health care and access for people by limiting the amount of "qualified practitioners.

What barriers are you talking about here? How does the APA limit access to providers? Especially in many saturated markets?

 

[psych.meout]

Wait, since when did psychologists start eating MFT practitioners? Also, can psychologists only be carnivores, and not omnivores? If they can be omnivores, what profession is plant matter in this poorly chosen analogy?

Are MD/PhDs and JD/PhDs apex predators?

 

[Anthropopsychophile]

I see this mental health crisis and demand being more than supply used all the time. If that was really the case, then why aren't salaries rising? What many want are more and cheaper mental health practitioners of various stripes, which typically means less competent and less trained and less capable people providing services.

As you say in a typical supply and demand context, salaries should rise. However supply and demand is usually based on wants not needs, and mental health services don't fair high on the priority list for society. Cheaper services are needed to make them more accessible, which is why sliding scale works. But you're right that less competent or trained clinicians providing services is not acceptable as a lot fall through the cracks. So wouldn't it be prudent to decrease the amount of less competent clinicians by providing greater access to "acceptable" training?

 

[PsyDr]

That makes no sense and has nothing to do with anything. Sheep are not lions but the sheep might have some thoughts and feelings about how the lions eat. As I understand it this site is not a site for psychologists but a site for students. I didn't say my view is better. I said that maybe your view isn't the only one that works.

So my viewpoint makes no sense and has nothing to do with anything; but you are not saying your view is better.

 

[Justanothergrad]

As you say in a typical supply and demand context, salaries should rise. However supply and demand is usually based on wants not needs, and mental health services don't fair high on the priority list for society. Cheaper services are needed to make them more accessible, which is why sliding scale works. But you're right that less competent or trained clinicians providing services is not acceptable as a lot fall through the cracks. So wouldn't it be prudent to decrease the amount of less competent clinicians by providing greater access to "acceptable" training?

Let me outline the flaws in this argument line:

1. unaccredited programs provide acceptable training
2. the goal should be to increase the number of service providers
3. we should charge less for services because cost is the most prominent reason for not seeking services
4. increasing the number of providers will resolve people not coming into services

let me explain why these are problems:

1. cause factually, nope. there isn't anything to explore here. its been explored. its been demonstrated that accreditation helps increase standards. this happens in literally all fields and areas for this very reason.
2. this is a logical flaw. the goal should be to decrease mental health problems. this is not the same thing, ipso facto.
3. again, nope. it is a major barrier to care, but outside of severely underserved areas it is not the biggest pony in the show.
4. nope. see all the stigma research about both initiation and retention.

 

[smalltownpsych]

I work in a severely underserved area about 30 miles from a town that is famous for being the furthest incorporated community in the continental US that is furthest from any major league team. In fact, we are closest to the Calgary Flames than any other team. Nevertheless, we have three active psychologists in the community, several social workers and our admin said "if you turn over a rock in this town you'll find a Licensed Professional Counselor." What we don't have is an extensive list though and it has nothing to do with bringing in more lower qualified providers. How about group homes, assisted living for severely mentally ill, treatment for intellectually disabled, an occupational therapist would be nice, residential treatment somewhere in the state for substance abuse that I don't have to wait two weeks to get a willing patient into and hope they don't die while they are waiting, residential treatment for adolescents that don't require active suicidal ideation to provide treatment, day treatment for SPMI, sober living opportunities for people discharged from inpatient settings, a psychiatrist...I could go on for a while. Some of this exists in less rural communities, but it also tends to be poorly run, funded, and overburdened.

 

[Anthropopsychophile]

I see this mental health crisis and demand being more than supply used all the time. If that was really the case, then why aren't salaries rising? What many want are more and cheaper mental health practitioners of various stripes, which typically means less competent and less trained and less capable people providing services.

So what you're saying is that despite the millions of clinicians, agencies, and consumers who use the words "mental health crisis" because they see the effects of, agree on, and live with unaddressed mental health issues, you say there is no mental health crisis?

 

[singasongofjoy]

So what you're saying is that despite the millions of clinicians, agencies, and consumers who use the words "mental health crisis" because they see the effects of, agree on, and live with unaddressed mental health issues, you say there is no mental health crisis?

I think the biggest roots of the mental health crisis have to do with lack of adequate insurance coverage, stigma, difficulties finding/making time to go to regular therapy (see retention/dropout referenced by one of the above posters) and lack of government/other financial and structural support. For example, it's not for lack of willing providers that a lot of the folks I see with ID and psychiatric issues are having such a hard time. It's that I keep working in states where a year or two into my time there the states defund and/or privatize (to disasterous effect) the existing specialized group homes / facilities that serve these folks. If the pay was there, the providers would show up, but I can't continue working in a residential facility no matter how much i loved my job if no one is going to pay for the psychologists and therapists anymore. No doubt similar things are occurring in other areas (e.g., tx for substance abuse).

 

[smalltownpsych]

So what you're saying is that despite the millions of clinicians, agencies, and consumers who use the words "mental health crisis" because they see the effects of, agree on, and live with unaddressed mental health issues, you say there is no mental health crisis?

Mental health problems are always going to be with us, just like crime or physical health problems. Crisis is an emotionally charged word that is more of a political term than anything else. I don't dispute that mental health issues are a problem, but it can be debated whether we are doing worse or better in helping these patients and what strategies to use to address these problems. I don't think that APA accreditation is a part of that problem and that is coming from someone who frequently criticizes the APA.

 

[psych.meout]

Mental health problems are always going to be with us, just like crime or physical health problems. Crisis is an emotionally charged word that is more of a political term than anything else. I don't dispute that mental health issues are a problem, but it can be debated whether we are doing worse or better in helping these patients and what strategies to use to address these problems. I don't think that APA accreditation is a part of that problem and that is coming from someone who frequently criticizes the APA.

For all the crap that the APA does (or doesn't do), having too strict criteria in accrediting doctoral programs in clinical psychology is not one of them. If anything, the restrictions are not tight enough if some of the more infamous programs with poor outcomes (e.g. APA-accredited internship match rates) are still accredited. Sorry if you miss out on training and job opportunities, because you chose to attend an unaccredited program and everyone won't give you special treatment for being such a unique, talented snowflake despite the poor training you chose.

 

[msc545]

If I ever meet a psychologist from, or who trained in, CA, I will always have questions about their ability to perform services in a competent and ethical manner. California just sucks in general (personal opinion) and the standards are lower for a lot of these programs. The sad part is that there are some really great psychologists that come out of CA programs, and they just have to get used to explaining where they came from because of the awful ones.

Agreed. We have some truly crappy school in California that are nothing more than diploma mills. We also have some really good programs as well.

 

[msc545]

I work in a severely underserved area about 30 miles from a town that is famous for being the furthest incorporated community in the continental US that is furthest from any major league team. In fact, we are closest to the Calgary Flames than any other team. Nevertheless, we have three active psychologists in the community, several social workers and our admin said "if you turn over a rock in this town you'll find a Licensed Professional Counselor." What we don't have is an extensive list though and it has nothing to do with bringing in more lower qualified providers. How about group homes, assisted living for severely mentally ill, treatment for intellectually disabled, an occupational therapist would be nice, residential treatment somewhere in the state for substance abuse that I don't have to wait two weeks to get a willing patient into and hope they don't die while they are waiting, residential treatment for adolescents that don't require active suicidal ideation to provide treatment, day treatment for SPMI, sober living opportunities for people discharged from inpatient settings, a psychiatrist...I could go on for a while. Some of this exists in less rural communities, but it also tends to be poorly run, funded, and overburdened.

I think that this has a lot to do with the fact that most people, myself included, simply feel that their quality of life would be degraded by living in a small, rural area.

 

[smalltownpsych]

I think that this has a lot to do with the fact that most people, myself included, simply feel that their quality of life would be degraded by living in a small, rural area.

This type of statement is kind of insulting to the people that live in rural locations. It also misses the point that I was making and doesn't speak to the issue of mental health workers being any different from any other profession that is necessary in the small towns.

 

[WisNeuro]

This type of statement is kind of insulting to the people that live in rural locations. It also misses the point that I was making and doesn't speak to the issue of mental health workers being any different from any other profession that is necessary in the small towns.

Meh, it's a personal desire thing. That particular statement is true for a lot of us. I grew up in rural Midwest, but do not want to go back. My qol would be lower, personally, without access to certain things in a metro area.

 

[Justanothergrad]

This type of statement is kind of insulting to the people that live in rural locations.

As a country boy, I'd just repeat what I've always been told to tell city folk who are scared of rural life: "Yes, its horrible out here. Don't come. You'll hate it. Stay far away. I'll let you know if it becomes better, but I don't expect it to ever be good. I promise you'll be the first one to know."

I'm always a fan of the 'briar patch defense'.

 

[erg923]

I personally, love, urban crime.

 

[Mad Jack]

A student with a family and living in CA cannot be expected to realistically be matched by APIC as is customary to an internship in Utah and take it just because it is available.

You mean like physicians do all the time? It's plenty realistic, what is unrealistic is that you want your dream career but are not willing to sacrifice for it.

 

[psych.meout]

You mean like physicians do all the time? It's plenty realistic, what is unrealistic is that you want your dream career but are not willing to sacrifice for it.

Exactly. Anthropopsychophile wants all the benefits without doing much of the work. They want their educational history in an unaccredited doctoral program to be treated as equivalent to accredited doctoral programs, because they didn't want to sacrifice by getting the requisite experience to get into an accredited program and/or did not want to move to another area or state. They want to be eligible and competitive for the same jobs as psychologists who completed APA-accredited internships, but without the sacrifices and effort involved in matching and completing the APA internship.

Meh, it's a personal desire thing. That particular statement is true for a lot of us. I grew up in rural Midwest, but do not want to go back. My qol would be lower, personally, without access to certain things in a metro area.

That's understandable, but rural and suburban areas generally have lower costs of living than urban areas, which means that your money will go further in the former than the latter. Thus, it depends on how we are operationalizing "quality of life" and will vary depending on "rural" an area is, e.g. how far it is from a metropolitan area where you'd have access to the benefits of urban living.

I personally, love, urban crime.

Ok, but the "urban crime" thing is a bit overblown by the media. If you look at a place like Chicago, sure, the violent and property crime stats are quite high compared to rural and suburban areas, but Chicago's recent stats for the past several years are still quite low compared to 20-25 years ago and the majority of the crime is relegated to several high crime areas.

 

[smalltownpsych]

Meh, it's a personal desire thing. That particular statement is true for a lot of us. I grew up in rural Midwest, but do not want to go back. My qol would be lower, personally, without access to certain things in a metro area.

Of course it is a personal desire thing and I live away from mountains right now which affects my own personal quality of life, especially during ski season. Just thought the comment sounded like it was putting down small town or rural life as opposed to just stating a personal preference. Us small town folk are sensitive to that sort of thing. On the other hand, a lot of the small town folk think people in the city are crazy to live there so the bias goes both ways. I see the pluses and minuses to both and am vacationing in SoCal right now and loving every minute of the benefits of the urban environment.

 

[WisNeuro]

Of course it is a personal desire thing and I live away from mountains right now which affects my own personal quality of life, especially during ski season. Just thought the comment sounded like it was putting down small town or rural life as opposed to just stating a personal preference. Us small town folk are sensitive to that sort of thing. On the other hand, a lot of the small town folk think people in the city are crazy to live there so the bias goes both ways. I see the pluses and minuses to both and am vacationing in SoCal right now and loving every minute of the benefits of the urban environment.

I get that. I just took the original statement more in line with the thinking that location preference is indeed a variable in quality of life. You can have all of the objective amenities of qol (access to good food sources, medicine, healthcare, etc) but if you hate where you live, your qol due to those subjective variables is gonna suck. Different strokes for different folks.

 

[Justanothergrad]

On the other hand, a lot of the small town folk think people in the city are crazy to live there so the bias goes both ways.

City living would be better without the people. ;p