Report of the APA Board of Directors Work Group on the Recommendations of the Commission on Education and Training Leading to Licensure in Psychology

June 29, 2005

In February 2000, the APA Council of Representatives approved funding for a 30 member, presidentially-appointed, cross-constituency Commission on Education and Training Leading to Licensure in Psychology (hereafter referred to as the Commission).  The Commission, chaired by Norine G. Johnson, Ph.D., with Ronald F. Levant, Ed.D. and Ruth Ullmann Paige, Ph.D. serving as co-chairs, met twice during the year 2000.  Its charge was to report back to the Board of Directors within one year with recommendations regarding—among other issues—education, training, examination, and supervision requirements leading to licensure.  As a frame of reference for its recommendations, the following question had been posed to the Commission:

At what point in the education and training sequence is competency for independent practice at the journeyperson level achieved?

In February 2001, the Council of Representatives received the Commission’s final report from the Board of Directors and referred it broadly for review and comment by groups and organizations within and external to APA.  In February 2002, on the recommendation of the Board of Directors following its review of the comments received from various communities of interest, the Council deferred action until August 2005 on the Commission’s first two recommendations (Recommendations A and B) on policy change related to eligibility for licensure, and approved the Board’s recommendation that the Board of Educational Affairs (BEA), the Board of Professional Affairs (BPA), and the Committee for Advancement of Professional Practice (CAPP) develop an implementation plan for the remaining Commission recommendations (Recommendations C through J), many of which were items that would need to be addressed prior to or concurrently with any policy change on licensure.  In June 2002, the Board of Directors approved in principle the implementation plan prepared by BEA, BPA, and CAPP for Commission Recommendations C through J.

In December 2004, the Board of Directors received a progress report from BEA, BPA, and CAPP on implementation of these items.  In February 2005, the Board of Directors approved funding for a work group to address the Commission recommendations related to licensure (Recommendations A and B) that had been deferred by Council in the context of progress made on the other Commission recommendations.  The work group was to meet in sufficient time for the Board of Directors to report back to Council in August 2005.  2005 APA President Ronald Levant, Ed.D. appointed Board of Directors members Ruth Ullman Paige, Ph.D. and Thomas J. DeMaio, Ph.D. to co-chair the work group, with president-elect Gerald P. Koocher, Ph.D. also to serve on the work group.  Other members of the work group were to represent BEA, BPA, CAPP, the American Psychological Association of Graduate Students (APAGS), and the Committee on Early Career Psychologists (CECP) from within the APA.  External to the APA were to be two representatives from the Association of State and Provincial Psychology Boards, and one representative each from the Council of Executives of State, Provincial, and Territorial Psychological Associations, the Council of Credentialing Organizations in Professional Psychology, and the Council of Chairs of Training Councils.  The list of persons serving on the work group and the organizations represented is presented in Appendix A of this report.

The Work Group met initially for an informal exchange at the time of the March 2005 Consolidated Meetings, but its major meeting was held on June 16-18.  At its June meeting, the Work Group considered the issues and concerns that need to be addressed in the context of the Commission’s Recommendations A and B on eligibility for licensure.  They also reviewed progress to date on the other Commission recommendations (C-J) that had been charged to BEA, BPA, and CAPP to oversee and coordinate.  The Commission’s recommendations and progress to date are summarized in Appendix B of this report.  The Work Group devoted the second day to preparing its report through a combination of breakout groups and plenary sessions. 

This report contains a draft policy statement, a section on context for that statement, and sections that discuss and make recommendations for further action in regard to two major areas related to the draft policy statement that remain in need of being addressed, namely doctoral education issues and statutory and regulatory issues.  The report concludes with a few general recommendations for APA governance.

Given that the Work Group was authorized and supported by the APA Board of Directors, this report was prepared to be forwarded to that body for its determination of the appropriate action to recommend in reporting back to the APA Council of Representatives in August 2005, as originally requested by Council.

In forwarding its report to the Board, the Work Group wishes to make clear that neither the draft policy statement nor the recommendations in other sections of the report should be interpreted as having the formal endorsement at this time of any of the groups or organizations represented on the Work Group. 

Section I:  Draft APA Policy Statement

To replace the Commission’s Recommendations A and B, the Work Group drafted the following policy statement for consideration by the Board of Directors:

The American Psychological Association affirms the doctorate as the minimum educational requirement for entry into professional practice as a psychologist.

The American Psychological Association recommends that for admission to licensure applicants demonstrate that they have completed two years of supervised experience, which can be completed prior or subsequent to the granting of the doctoral degree.

The American Psychological Association affirms that postdoctoral education and training remains an important part of the continuing professional development and credentialing process for professional psychologists.  Postdoctoral education and training is a foundation for practice improvement, advanced competence, and inter-jurisdictional mobility.

The first and third parts of the draft policy statement affirm what has been APA policy for many years. What is recommended for change relative to the APA and ASPPB Model Licensure Acts and current practices of all but two licensure jurisdictions is the required sequencing of the supervised experience described in the second part. While the draft policy maintains the recommended requirement in current APA policy for two years of supervised experience, a requirement common to most licensure jurisdictions, it allows flexibility as to when those two years may be obtained.  Consequently, it is more generic in accommodating different doctoral degree models in psychology than the policy statement proposed in the Commission’s Recommendation A.  It is important to emphasize that the draft policy statement in no way reduces either the academic degree requirement or the requirement for appropriate supervised experience prior to licensure. 

Section II:  Context for the Draft Policy Statement

The Work Group recognizes that significant work has been done related to Recommendations C through J of the 2001 report of the Commission, and now believes that it is time to address APA policy with regard to this issue in ways that are consistent with changes in education, training, and practice, and is more responsive to external marketplace realities affecting psychologists.  The Work Group recognizes that implementing the policy change it is recommending in 60 of 62 licensing jurisdictions will involve a significant investment of financial and human resources by APA, State, Provincial, and Territorial Psychological Associations (SPTAs), and education and training programs, and provides some recommendations for approaching these changes in the sections that follow. 

Based on its review and discussion, the Work Group believes that APA policies regarding credentialing of health service provider psychologists have failed to keep pace with changes in the health care delivery system and with other APA policies on professional education and training. In particular, the Work Group examined the current impact of state licensing requirements consistent with the recommendation articulated in APA’s 1987 Model Act for State Licensure of Psychologists that the second year of supervised experience occur following completion of the degree and before licensure.  In the current heath care environment, the Work Group believes that this requirement has unintended negative consequences for: 1) early career psychologists individually; 2) for the professional practice of psychology; 3) for the quality and funding of advanced training opportunities;  and 4) for the delivery of services to underserved populations. The impact of current policies in each of these areas is explored in more detail in the following sections.

Impact on Early Career Psychologists

When the postdoctoral supervised experience requirement was initially recommended nearly 40 years ago, aspiring psychologists in most professional training programs received virtually no supervised experience prior to the internship.  Since then, the length of time to obtain the doctoral degree has lengthened considerably.  The supervised experienced that students in most training programs in clinical, counseling, and school psychology currently receive prior to the internship (an average of 1800 to 2000 hours) is equal to or more than the amount of experience that the postdoctoral requirement was originally intended to provide.  Relatively few standardized, appropriately funded postdoctoral training experiences are available.  This results in the year of supervised experience being of highly variable quality, with many early career psychologists describing it as little better than indentured servitude.  There is no objective evidence that this experience improves professional performance.  Requiring that half the supervised training experience needed for licensure occur after completion of the doctorate also prevents early career psychologists or the institutions in which they practice from being reimbursed for the services they provide, when such reimbursement could be used to support quality postdoctoral training experiences.  Unlicensed postdoctoral psychologists are also ineligible to participate in federal loan repayment programs.  Similarly, the requirement that supervised experience following completion of the doctorate and prior to licensure imposes difficulties for early career psychologists who wish to pursue academic careers and also wish to be licensed—for example, in order to be legally able to supervise students or to function as an appropriate model—but who are forced to accrue the required supervised hours before they can focus on launching their academic careers

Impact on Practice

Current policies related to the timing of supervised experience in relationship to the doctoral degree and licensure contribute to significant obstacles for psychology as a health profession. Existing APA policy defines psychologists as health service providers if they are duly trained and experienced in the delivery of preventive, assessment, diagnostic, and therapeutic intervention services relative to the psychological and physical health of consumers based on: 1) having completed scientific and professional training resulting in a doctoral degree in psychology; 2) having completed an internship and supervised experience in health care settings; and 3) having been licensed as psychologists at the independent practice level.   Further, APA has added “health” to its mission statement by vote of the membership, and has focused substantial advocacy and marketplace efforts on psychology’s rightful place as a health profession. 

However, psychology’s policies regarding the unlicensed postdoctoral year are out of step with those of other health professions, whose members are legally authorized to practice upon completion of their terminal degree.  Psychology places itself in the difficult position of having to explain to health systems, payers, members of other health professions, patients, and other stakeholders why psychologists are ineligible to be legally authorized health service providers when they have completed a doctoral degree and formal internship.  Moreover, unlicensed individuals who have completed their doctoral education and training require special supervision arrangements that in some states may require the supervisor to be physically present during patient contacts, and in many states cannot even refer to themselves as psychologists.  This is hardly a position of strength for entry into the health care team environment.  This situation diminishes the appreciation of psychologists’ extensive education and training and undermines the status of the field.

Moreover, there is increasing demand for contemporary health care organizations to be accountable for the quality of the services they provide.  As part of this emphasis, they are generally required for accreditation (e.g., by the National Commission on Quality Assurance) and for risk management purposes to deliver services using licensed health care professionals.  Yet, psychology’s model of licensure requires our new graduates to spend a year providing health care services—most often outside the formal structure of a postdoctoral program—at a time when they are not yet licensed, a practice that is inconsistent with other health care professions.  Psychologists—the most highly trained providers of psychological and behavioral services—are therefore fundamentally disadvantaged in their entry of its professionals into the health care marketplace, particularly in relationship to professions whose members are licensed with less education and training.  Indeed, it might be argued that this has contributed to the proliferation of subdoctoral mental health providers within the health care system.

Impact on Education and Training

As noted, the original rationale for establishing the requirement of a postdoctoral training year for licensure eligibility no longer applies.  At the time that the requirement was established, there was consensus that two years of practice training were necessary for entry level competence while only one was being provided by the predoctoral internship.  Over the years, doctoral programs have progressively included significant amounts of organized practicum experience prior to the internship, in addition to the one-year internship itself.

The present structure of the postdoctoral requirement has a significant impact on education and training processes.  It diffuses responsibility by rendering doctoral and internship programs less accountable for the outcomes of their education and training because the relationship between the entry into practice and the completion of training is unclear. An integrated system of practicum experiences monitored by the graduate education programs and leading to an appropriately certified internship would make the graduate education and internship training programs mutually accountable for developing the competencies required for licensure at the entry level of practice. 

The current requirement of supervised postdoctoral experience also obscures the boundary between entry level and advanced competence.  This impedes optimal sequencing of advanced training and entry into postdoctoral programs aimed at the development of advanced competency in specialty and proficiency areas that require postdoctoral training and experience.  The fact that licensed psychologists have already had to arrange postdoctoral supervision and document postdoctoral training prior to licensure contributes to the widely held view that any expectation of additional postdoctoral training is onerous and unnecessary.  Newly licensed psychologists therefore are less likely to pursue additional training experiences or certifications related to advanced competency. 

De-linking licensure from the postdoctoral year would clarify this issue.  Licensed psychologists in advanced training would then be eligible for third-party reimbursement and participation in numerous federally funded programs. Postdoctoral training programs would also be expected to have greater access to funding resources given that their postdoctoral psychology trainees would be licensed.

Impact on the Public

The change in the sequencing of training would have a positive impact on delivery of services in the public domain.  The high cost of health care has affected public as well as private sector care.  Many public sector facilities now rely on reimbursement for services provided in order to keep their doors open.  It is increasingly difficult for these facilities to fund training programs, particularly when they cannot be reimbursed for services that trainees provide.   Licensing new psychologists at the completion of the doctoral degree would allow such service delivery to be reimbursed, therefore providing funding mechanisms for advanced training with the populations (e.g., individuals living with serious mental illness) served by these institutions.  Additionally, new psychologists are currently unable to take advantage of federally funded loan repayment programs such as the National Health Service Corps during the postdoctoral year because they are unlicensed. This new sequence of training would bring more psychologists into the public sector, and would help to reduce the shortage of qualified mental health professionals working with underserved populations.

Section III:  Doctoral Education Issues and Recommendations

Existing APA policy in the Guidelines and Principles for Accreditation of Programs in Professional Psychology (2005) states that training in doctoral graduate and internship programs are integral parts of students’ entry level practice preparation for careers in professional psychology, and that postdoctoral education and training provide one avenue of preparation for practice at advanced levels of competency in professional psychology.  The development of guidelines and principles for the accreditation of postdoctoral programs in professional psychology within the past decade likewise attests to the importance of postdoctoral education and training.  The draft policy statement developed by the Work Group is consistent with these policies in accreditation in maintaining that the completion of doctoral education and training in professional psychology is the educational standard for entry to practice and in emphasizing that postdoctoral education and training is an important part of continuing professional development and credentialing. 

Recommendations Related to Doctoral Education 

In the context of the progress made in addressing the recommendations regarding education and training made by the Commission, the Work Group offers the following additional recommendations.  It is important to note that none of these recommendations is conditioned on the approval of the draft policy statement and that the Work Group recommends their immediate implementation regardless of whether the draft policy is ultimately approved.

• That the approach used in the development of core competencies at the practicum level in doctoral education be similarly applied to the definition of core competencies expected at the completion of the internship .

• That mechanisms be developed for improved communication between doctoral and internship programs in terms of the level and types of competencies expected of each.

• That the context for assessing the development of core competencies for professional psychology give adequate attention to professional issues that form the legal, regulatory and practice contexts in which professional services are provided.

• That doctoral programs remain accountable for the outcomes of their students in meeting state and national standards for entry level practice (a recommendation consistent with the Accreditation Guidelines and Principles for doctoral programs (Domain F, Paragraphs 2 (b) and (c)).

• That the EPPP as an objective national standard examination be offered to students at an appropriate time in their doctoral education by jurisdictional licensing boards.

• That the Committee on Accreditation take cognizance of accountability measures such as licensing examination scores of program graduates.

• That funding for graduate education and training through direct grants and loan forgiveness programs (including eligibility for federal funding) be a priority for APA.

Section IV:  Statutory and Regulatory Issues and Recommendations

In the current professional environment, psychology’s model of training leading to licensure is creating barriers for new psychologists and for service provision.  The changes recommended by the Work Group are intended to lead to more consistency and accountability in doctoral training and improved services to the public. 

The proposed changes will potentially impact the statutes and regulations of 62 jurisdictions.  The sequence of training and licensure that the Work Group endorses is already consistent with licensing laws in Washington, which were recently changed as part of a broader effort to reduce barriers to entry into the health professions.  Alabama had never required a year of postdoctoral supervised experience for licensure in psychology. 

Statutory and regulatory change at the level of the profession is extremely complex given the substantial variations in laws and regulations among jurisdictions.  There are also important issues related to the timing and politics of changing these laws, particularly in relationship to other legislative and regulatory priorities.  One of the most important considerations in making these changes is how to do it in a way that supports the continued evolution and expansion of professional mobility.  Considerable effort has been expended to address the longstanding challenges psychologists have faced in achieving interjurisdictional mobility, and these efforts have been embraced by a majority of the licensing boards (in 50 of 62 jurisdictions).  The progress in achieving mobility benefits both the profession and the public by increasing the public’s access to qualified professionals. 

In considering statutory and regulatory change, it will be important to keep in mind that jurisdictions will differ in their readiness to make changes.  It is also helpful to realize that psychology licensing laws are regularly “opened up” without adverse consequences.  For example, 18 states have introduced prescriptive authority bills, and most states, provinces, and territories have implemented one or more of the mechanisms for mobility (such as the ASPPB Certificate of Professional Qualification, credentialing by the National Register of Health Service Provider in Psychology, or diplomate status with the American Board of Professional Psychology), all of which required statutory and/or regulatory modifications. 

While recognizing that change will not take place overnight, it is critical for APA to facilitate these changes by providing support and assistance through various mechanisms, including the Education Leadership Conference (ELC), the State Leadership Conference (SLC), and CAPP seed grants for pilot legislative projects in the states.   It is anticipated that a small number of states will move forward on their own initiative to change the sequencing of education and training leading to licensure, and that these naturally occurring “experiments” will be useful in providing an opportunity to evaluate the impact of changes and in guiding the efforts of other states.  As states begin to make this change, new licensees should be strongly encouraged to obtain a year of postdoctoral supervision for purposes of facilitating further professional development through advanced competency and specialization, professional mobility, and interjurisdictional practice (e.g., telehealth, consulting and forensic practice across state lines, etc).   It is important that there be appropriate mechanisms for documenting this experience.

Statutory/Regulatory Recommendations

With regard to statutory and regulatory change, the Work Group offers the following additional recommendations.  The Work Group recommends that relevant groups begin with implementation of those recommendations (e.g., advocacy templates, seed grants, consultation) that support the ongoing exchange of information and coordination between organizations in advance of Council action on the policy change.

That templates for advocating legislative and regulatory changes be developed.

1.   That APA coordinate assistance for SPTAs wishing to move forward with legislative initiatives, including special involvement by APAGS members and early career psychologists

2.  That CAPP announce the availability of seed grants for SPTAs wishing to make statutory and regulatory changes consistent with the recommendations of this report.

3.   That the APA Practice Directorate provide consultation to SPTA legislative initiatives in this area in order to coordinate them with other legislative activities and priorities.

 4.   That consultation and support by APA to SPTAs be coordinated with similar involvement and coordination by ASPPB with state licensing boards.

5.   That advocacy on behalf of these changes be encouraged among the practice, education, and training communities, and particularly among graduate students and early career psychologists.

6.   That joint advocacy by SPTAs and doctoral training programs in support of these changes be encouraged.

7.   That the outcomes of the changes in Washington and any other state changing the sequencing of education and training be carefully evaluated.

8.   That programs at ELC and SLC be devoted to increasing awareness of this issue.

9.   That related issues and efforts be publicized through Monitor articles and SPTA newsletters.

10.   That an ongoing exchange of information regarding educational programs, advocacy efforts, and legislative progress be maintained to facilitate collaboration among APA and external stakeholders such as ASPPB, National Register of Health Service Providers in Psychology, the American Board of Professional Psychology, the Council of Chairs of Training Councils, the Council of Credentialing Organizations in Professional Psychology, and other relevant organizations.

Section V: Recommendations for Immediate Action by the Board of Directors

The Work Group recommends:

• That the Board forward the report and recommendations of the Work Group for review and comment by BEA, BPA, and CAPP prior to the August 2005 Board of Directors meeting.

• That the Board forward the report and recommendations of the Work Group, along with the Board's recommendations and comments and those BEA, BPA and CAPP, to the Council of Representatives meeting in August 2005.

• That the Board request that BEA, BPA, and CAPP begin coordinated implementation of the Work Group recommendations aside from the proposed policy statement.  These include recommendations related to education and training that are not directly tied to passage of the policy statement and recommendations that support the ongoing exchange of information and coordination between organizations in advance of Council action on the policy change. 

• That the Board request that BEA, BPA, and CAPP provide a progress report to the Board in December 2005 and to Council in February 2006.

• That the Board recommend that the Council of Representatives authorize distribution of the Work Group report to external communities of interest for review and comment prior to action on the proposed policy chance by Council in February 2006.

Board of Directors Work Group on the Recommendations of the Commission on Education and Training Leading to Licensure in Psychology

American Psychological Association Representatives

Ruth Ullman Paige, Ph.D., Board of Directors, Co-chair

Thomas J. DeMaio, Ph.D., Board of Directors, Co-chair

Gerald P. Koocher, Ph.D., Board of Directors and President-Elect

Jennifer F. Kelly, Ph.D., Board of Professional Affairs

Christopher W. Loftis, Ph.D., Committee on Early Career Psychologists

Michael B. Madson, American Psychological Association of Graduate Students

Katherine C. Nordal, Ph.D., Committee for Advancement of Professional Practice

Nathan W. Perry, Jr., Ph.D., Board of Educational Affairs

Association of State and Provincial Psychology Boards Representatives

Stephen T. DeMers, Ed.D., Director of Professional Affairs

Kim R. Jonason, Ph.D., President

Council of Credentialing Organizations in Professional Psychology Representative

Judy E. Hall, Ph.D., Executive Director

National Register of Health Service Providers in Psychology

Council of Executives of State, Provincial and Territorial Psychological Associations

Elena J. Eisman, Ed.D., Chair

Council of Chairs of Training Councils Representative

Raymond E. Crossman, Ph.D., Chair

APA Staff

Paul D. Nelson, Ph.D.

Joan Freund

Education Directorate

Geoffrey M. Reed, Ph.D.

Michael J. Sullivan, Ph.D.

Laura Kay-Roth

Practice Directorate

Progress Report on Recommendations of the

APA Commission on Education and Training Leading to Licensure in Psychology 

June 2005

Commission Recommendation A:  That the APA adopt as policy the recommendation that psychologists be eligible to sit for licensure upon completion of the following education and training:

• A doctoral degree from an APA- or CPA-accredited program in psychology. Where accreditation in the program’s substantive area is not available, the program will be required to be designated as a doctoral program in psychology by the Association of State and Provincial Psychology Boards or the National Register of Health Service providers in Psychology.

1. The equivalent of two years of organized, sequential, supervised professional experience, one year of which is an APA- or CPA-accredited predoctoral internship, or one that meets the APPIC membership criteria, or, for school psychologists, a predoctoral internship based in a school setting which meets CDSPP Doctoral Level Internship Guidelines.  The other year of experience also may be completed prior to receiving the doctoral degree.

Commission Recommendation B:  That, if necessary to implement the prior recommendation, the APA pursue changes in state licensing laws when appropriate.

Action taken:  In February 2002, the Council of Representatives deferred action on Recommendations A and B until 2005.  With this in mind, the Board of Directors at its February 2005 meeting allocated funding for a Work Group to discuss how Recommendations A and B might be addressed.  The Work Group will consist of two members of the Board of Directors to be appointment by the APA President, representatives of the Board of Educational Affairs (BEA), Board of Professional Affairs (BPA), and the Committee for the Advancement of Professional Practice (CAPP) appointed by those groups, respectively, one representative appointed by the Council of Executives of State and Provincial Psychological Associations (CESPPA), two representatives appointed by the Association of State and Provincial Psychology Boards (ASPPB), and one representative appointed by the Council of Credentialing Organizations in Professional Psychology (CCOPP).  One representative also was invited from the Council of Chairs of Training Councils (CCTC).

The Work Group met in June 2005 to review issues related to Recommendations A and B, and will summarize its action recommendations by report to the Council of Representatives in August 2005.

Commission Recommendation C:  Define competencies expected of graduates of doctoral programs in professional psychology over the next decade, and design developmentally informed education and training guidelines for their achievement and assessment, to include:

(C.1) Guidelines on practicum training related to definitions and minimum requirements, quality of training sites and supervision, curriculum and competency objectives at different stages of training, trainee performance assessment, and relationship between doctoral program and practicum sites; and,

(C.2) Guidelines for communication between graduate programs and internship sites related to articulation of student competencies expected of each by the other, the assessment of those competencies prior to, during, and at the end of internship training, and working with student problems. 

Action taken: A number of actions have been taken, a summary of which follows.

Recommendations C and C.1:  In November 2002, under the leadership of the Association of Psychology Postdoctoral and Internship Centers (APPIC) with co-sponsorship of APA and others, a national conference was held to define the competencies expected of graduates of doctoral students in professional psychology.  Participants invited to the conference (Appendix A) represented psychology’s educators, scientists, and practitioners, as well as the individual and cultural diversity of our science and profession. An overview of the conference and its outcomes is published in a special issue (July 2004) of the Journal of Clinical Psychology (Kaslow et al, pp. 699-712), accompanied by other articles on specific competency domains.  The identification and definition of competencies, good practices of training to develop the competencies for entry level into the profession, and how they might be assessed in training were common themes of multiple work groups at the conference.  By some, conceptual differentiation was made as well between foundational competencies (knowledge, skills, attitudes, and values that serve as the foundation for the functions a psychologist is expected to carry out, e.g., ethics, individual and cultural diversity, scientific foundations of psychology); core functional competencies (the major functions that a psychologist is expected to carry out, each of which requires reflective integration of foundational competencies in problem identification and resolution, e.g., assessment, intervention, consultation, research); and specialized competencies (the functions more distinctive to practice in particular specialties of the profession).  In addition to the publications, three additional developments followed the conference, building on these outcomes.

• The Board of Educational Affairs (BEA) recommended that a task force develop a position paper on methodological models for assessing competence (and its elements, i.e. competencies) at different stages of professional development (from early stages of doctoral education through postdoctoral continuing education), based on the conceptual domains identified in the national Competencies Conference and recent developments in other professions.  With representation from BEA, BSA, BAPPI, BPA, and CAPP, as well as two external consultants on competency assessment, the task force was approved and funded by the Council of Representatives for one meeting in 2004.  The BEA Task Force on Competency Assessment Models met in October 2004 and in June 2005 and will issue its report to the BEA in the Fall of 2005.

• In addition to discussion of the Competency Conference outcomes and their implications at mid-year annual meetings of national organizations representing the directors of professional psychology doctoral, internship, and postdoctoral programs, the umbrella organization to which these organization belong, the Chairs of Councils of Training Directors (CCTC), initiated a committee of its members to begin to develop guidelines for the competencies expected of doctoral students at different stages of practicum training leading to their preparation for internship training.  This has never been done in psychology, one of the results being that the practicum experience of doctoral students has been historically the least defined aspect of their training.  Far too much attention has been given to hours of practicum training, and far too little to the competencies expected as a result of the training.  The APAGS liaison to CCTC also initiated an APAGS committee to consider this issue in concert with the CCTC committee. An initial draft entitled, Report on Practicum Competencies, has been developed (Appendix B), and is under consideration for further development and utilization by CCTC at this time.  The document will be the focus of the March 2006 meeting of the Association of Directors of Psychology Training Clinics  (ADPTC) at which time Dr. Nadine Kaslow, current chair of the BEA Task Force on Competency Assessment Models, will summarize the work of that task force.  Current plans are being made also for the 2006 Educational Leadership Conference (ELC) to provide a forum for implementation strategies for assessing practicum competencies at early and advance stages of training prior to internship in doctoral programs. 

• The Council of Credentialing Organizations in Professional Psychology (CCOPP) had been in the process of developing a conceptual framework for understanding specialties and specialization in the profession of psychology.  Subsequent to the Competencies Conference, CCOPP adopted for use in its document, A Conceptual Framework for Specialization in the Health Service Domain of Professional Psychology, a conceptual framework the includes the constructs of competency and their relevance to specialties and specialization from a developmental perspective that resulted from the conference workgroup focused on specialties.  The Commission for the Recognition of Specialties and Proficiencies in Professional Psychology (CRSPPP), as the APA member organization of CCOPP, sought review and comment on drafts of the document from APA boards and committees.  Following review and discussion of the document at its recent May 2005 meeting, CRSPPP decided to use the document as a guide in reviewing and updating its policy documents. 

In regard to the recommendations related to practicum training sites, their supervision, and their relationship with the doctoral programs of students, the Committee on Accreditation Guidelines and Principles for Accreditation of Programs in Professional Psychology (Section III.B.4) make clear that the (doctoral) program requires that its students receive adequate and appropriate practicum experiences.  To this end, the program should:

• Place students in settings that: are clearly committed to training; supervise students using an adequate number of appropriate professionals; and provide a wide range of training and educational experiences through applications of empirically supported intervention procedures;

• Integrate the practicum component of the students’ education and training with other elements of the program and provide adequate forums for discussion of the practicum experience;

• Ensure that the sequencing, duration, nature, and content of these experiences are both appropriate for and consistent with the program’s immediate and long-term training goals and objectives; and,

• Describe and justify the sufficiency of practicum experiences required of students in preparation for an internship.

An additional action of significance to the recommendations regarding supervision of students, whether at the practicum, internship, or postdoctoral level of professional development, is the Guidelines on Supervision document developed and promulgated widely by the Association of State and Provincial Psychology Boards (ASPPB).  In as much as the construct supervised experience is at least in regulatory language for many if not most licensing boards in psychology, this important document affords standard guidance for the profession and for use in the education and training of professional psychologists.  A copy can be accessed at the ASPPB website http://www.asppb.org/.

Recommendation C.2:  CCTC has developed (a) guidelines to enhance communication between graduate programs and internship sites related to student development (Appendix C), and (b) guidelines for comprehensive evaluation of student-trainee competence in professional psychology programs (Appendix D).  The latter includes reference to intrapersonal, interpersonal, and professional development.  These guidelines have been broadly disseminated within the professional education and training community, doctoral and internship programs alike, and have been discussed at several of the mid-year annual meetings of CCTC member groups.  APPIC, as the major umbrella organization within CCTC for internship and postdoctoral programs in psychology, makes these and many other such guidelines available as training resources on its website http://www.appic.org/training/ (Appendix E).  The previously cited guidelines on practicum competency objectives and assessment is responsive as well to the part of this recommendation that speaks to clarification of the competencies expected by internships when students begin that part of their professional training, the sequel to which is the expectation that doctoral and internship programs have of the “value added” in competency development by the internship experience.

Commission Recommendation D:  That the Committee on Accreditation (CoA) reexamine and consider revising Domain B (Program Philosophy, Objectives, and Training Plan) of the Accreditation Guidelines and Principles with regard to competency objectives, curriculum plan, and guidelines for practicum and internship training.

Action taken:  Action on this recommendation has not been considered necessary at this time.  The major competency domains expected of doctoral students remain valid in line with those articulated at the 2002 Competencies Conference, and guidance for practicum and internship training and supervision also remains consistent with the more recent work of CCTC on guidelines related to these issues.  The CoA is responsible for ensuring that its guidelines remain valid and periodically addresses this issue with its education and practice communities of interest, a function expected of accrediting bodies recognized and periodically reviewed by the U.S. Secretary of Education and the Council on Higher Education Accreditation. 

Commission Recommendation E:  That ASPPB reexamine and consider policy on the timing of the EPPP examination for licensure in psychology to assure appropriate timeliness of administration in the sequence of doctoral education and training.

Action taken:  Several actions have been taken, a summary of which follows.

At its 2002 Midwinter Meeting, the Association of State and Provincial Psychology Boards (ASPPB) discussed the timing of the administration of the EPPP component of the licensing examination.  Many licensing jurisdictions require not only the doctoral degree, but also completion of the postdoctoral supervised experience before admitting a candidate to sit for examination, despite the fact that: (a) data clearly indicate that the closer the EPPP is administered to completion of the degree, the better the performance; and (b) the EPPP is a test of the foundational knowledge of professional psychology, not a test of competency to practice.  On this basis, ASPPB president Barbara Van Horne, speaking on behalf of the ASPPB Board of Directors, strongly recommended that state and provincial boards “allow candidates for doctoral level licensure to be admitted to the EPPP following completion of all educational requirements for the doctoral degree.”  It should be noted in addition that all licensing jurisdictions in the U.S., and most of them in Canada, have moved to a computer-based administration of the EPPP for convenience of applicants.

By December 2003, only 17 (of 59) licensing jurisdictions still required completion of the postdoctoral supervised experience prior to admitting a candidate to sit for the EPPP examination.  They were: AK, AZ, CT, DE, HI, IL, ME, MD, MA, MT, NH, NJ, OH, OR, PA, RI, and UT.  Serving at the time as chair of the Association of Psychology Postdoctoral and Internship Centers (APPIC), and subsequently as chair of the Council of Chairs of Training Councils (CCTC), Emil Rodolfa drafted a letter for APPIC and CCTC program directors of doctoral, internship, and postdoctoral programs in professional psychology, and whose programs are in one of these states, to write to their state licensure boards, urging their reconsideration of the timing of the EPPP examination. ASPPB recently provided an update of developments related to the timing of the EPPP examination in different states (Appendix F).

In another development, the Washington State Legislature, based on the recommendation of the Washington State Psychological Association, recently removed the requirement in statute that 1500 of the 3000 total supervised hours required before the granting of licensure be acquired postdoctorally. Currently the statute defers to the Washington State Examining Board of Psychology for “defining the circumstances under which supervised experience shall qualify the candidate for licensure.”  The Washington State Examining Board of Psychology is considering possible rule changes, which govern when supervised experience must be completed prior to licensure, uniform standards for pre- and postdoctoral supervision, standards for practica, and standards for internship sites.

Commission Recommendation F:  Establish an infrastructure to support a national forum on issues of education and their link to the future of our discipline and profession. This forum would provide a venue to convene the leaders of the education constituencies and advance an ongoing dialogue among academic leaders in psychology regarding critical issues of change in education, our discipline, and our society relevant to the teaching of psychology and preparing the next generation of psychologists.

Action taken:  Through leadership of the Board of Educational Affairs and Education Directorate, with support of the Board of Directors and the Council of Representatives, the Education Leadership Conference (ELC) has become an annual forum to achieve the outcomes of this recommendation.  Representatives are invited from APA boards and divisions, state psychological associations, and the many national organizations external to the APA of psychology educators. With the first ELC having been held in 2001 and the most recent in September 2004, and the participation of 125-150 psychologist educators, scientists, and practitioners at each, the following themes have been addressed: re-thinking education in psychology and psychology in education (2001); accountability, assessment, and advocacy related to education in psychology and psychology in education (2003); and applying psychological science to education in psychology (2004). In each of the years, ELC workgroups deliberated over questions related to the theme of the year as pertain to psychology in education (pre-K-12) and education in psychology (pre-college and undergraduate, graduate research academic, and graduate professional education).  An overview of the ELC series with reports of ELC workgroups is accessible through the Education Directorate website homepage http://www.apa.org/ed/.  

Commission Recommendation G:  Build support for practice community “buy-in” to the proposed policy changes on education and training for entry level practice, and build support for education community “buy in” of existing practice advocacy initiatives and to partner with practice advocacy on licensure change initiatives.

Actions taken:  Communication has been maintained between the Education and Practice Directorates, and BEA, BPA, and CAPP about professional education, training, and credentialing issues of mutual interest related to the Commission report.  This includes their respective representation at such annual conferences as the State Leadership Conference (Practice) and Education Leadership Conference (Education); and their invited liaison participation in deliberations of the Council of Credentialing Organizations in Professional Psychology (CCOPP) and the Council of Chairs of training Councils (CCTC).  The longer term issue of licensure legislation or regulation is a much more complex issue that, even were it to be initiated, would require that many of the other initiatives recommended by the Commission to be addressed first.  As noted earlier, some states are making changes in their practices of EPPP administration in line with recommendations of the Commission. 

Commission Recommendation H:  Develop ongoing mechanisms for future conversations and priority discussions between practice and education constituencies to work towards integration of practice and education initiatives and achieving consensus on priorities with regard to advocacy for professional education and training in relation to career development and market place needs for practitioners.

Action taken:  In addition to the ongoing communication between education and practice communities noted in regard to Commission Recommendations G and H, and the regular communication between education and practice public policy offices on legislative and regulatory initiatives, representatives of BEA, BPA, and CAPP met in the past two years to discuss ways in which activities and priorities related to this recommendation might be advanced.  The executive directors for education and practice also meet, with all executive directors on a weekly basis and with one another as needs for particular collaboration arise. Their staff officers likewise communicate regularly on issues or problems of mutual concern and interest.

Commission Recommendation I:  Enhance education advocacy efforts to augment and support practice advocacy in areas of mutual interest, such as changes in state licensing laws.

Action taken:  Similar to what the Practice Directorate has had in place for a number of years, since the time of the Commission’s report, the Education Directorate through its affiliated Public Policy Office for Education has developed a nationwide grass roots advocacy network of educators. Advocacy training workshops have been held in conjunction with annual meetings of psychology educator organizations and at the annual ELC.  An education advocacy breakfast meeting at the annual APA convention also brings many of these colleagues together.  This infrastructure initiative was essential to develop first, before advocacy of specific types or on specific issues could become effective.  At the same time, the Public Policy Office for Education, working with the Education Directorate, has achieved significant accomplishments to advance psychology as a health profession through education and training initiatives at the federal legislative and regulatory levels (Appendix G), keeping the Practice Directorate informed on these so that advocacy efforts for psychology can be coordinated and consistent across domains of interest and responsibility.  Representatives of the Education Directorate and Practice Directorate on several occasions have collaborated in support of colleagues working through their state psychological associations to address legislative and regulatory issues of consequence to the profession of psychology and its education and training structures.

Commission Recommendation J:  Develop an information system for prospective students and others of the public on outcomes of professional education and training, to include: information on program goals and competencies for which training is offered; information on program admissions, attrition, time to degree, student debt, internship placements, licensure outcomes of graduates (and reference to public information on licensure requirement by jurisdiction), and job placement following graduation.

Action taken: The annual publication of Graduate Study in Psychology is the single best source from which prospective graduate students can obtain these types of information. During the past two years the Education Directorate, working collaboratively with the APA Research Office, MIS, and Publications Office, has converted the annual data collection process for this publication to an on-line capability, which also serves as an electronic database for research as needed.  Increased emphasis in this publication has been placed on reporting education outcomes by program and department, a development that is consistent with similar requirements of institutional and professional accrediting bodies in higher education.  Many of the questions raised on a regular basis are addressed also on websites of the Graduate and Postdoctoral Education Office and Program Consultation and Accreditation Office within the Education Directorate, the APA Research Office, and, external to the APA, the Association of Psychology Postdoctoral and Internship Centers (APPIC) and the Association of State and Provincial Psychology Boards (ASPPB).  Links between each of these offices and other sources of information are common. 

  The identification and assessment of these competencies should be done in the context of the foundational and functional competencies identified during the Competencies Conference (2002) and endorsed by the Council of Credentialing Organizations in Professional Psychology (2004).  They are noted as follows. (A) Foundational Competencies: Self-assessment; Scientific Knowledge and Methods; Capacity for Effective Relationships; Adherence to Ethical and Legal Standards; Respect for and Understanding Individual and Cultural Diversity Issues; Ability to Function in Interdisciplinary Systems. (B) Functional Competencies: Assessment, Diagnosis and Case Conceptualization; Intervention; Consultation; Research and Evaluation; Supervision and Teaching; Management and Administration

  Individuals with doctoral degrees in psychology who wish to respecialize may complete the education and training requirements described in this document postdoctorally.