APA Internship Imbalance Issues and CSPP Activities

Transcription

1 Revised 5/27/14 APA Internship Imbalance Issues and CSPP Activities Background Information In the past few years APA has begun to establish performance indicators in certain key areas for accredited programs and has also begun setting thresholds for these indicators. The first performance indicator for which a standard was established was attrition rate, set no more than 7% annually. The most recent threshold associated with the attainment of internship rates states that 50% of the students should be placed in APA accredited internships. A threshold for attainment of licensure may be forthcoming. Historically, CSPP s integrated training model and the model of many other professional schools was for students to participate in two half time internships in community settings while also being engaged in coursework. These half time internships were not generally APA accredited; only full time internships are APA accredited. As the pressure increased for students to obtain APA accredited internships (as well graduate from APA accredited programs), CSPP has ensured its programs students can apply for and participate in APA accredited internships. CSPP programs have also increased their focus on assisting students with obtaining APA accredited internships by providing additional student support, strengthening internship application skills, ensuring students have competitive skills in particular areas, and meet certain requirements (such as having completed dissertation proposals) prior to the application process. There continues to be a significant internship imbalance with far too few APA accredited internships to meet the capacity required given the number of students enrolled in APA accredited programs. Programs not meeting the thresholds established by APA must provide information on their plans and progress as they attempt to meet the thresholds. If a program does not meet the threshold, the program must be able to document how they ensure the quality of the unaccredited internships in which their students are placed. The need to ensure students will be able to obtain APA accredited internships, in addition to accreditation and market pressures related the costs of education, has reduced the number of students in APA accredited programs over the past five to seven years. At some institutions these enrollment reductions have been significant. National Data There have always been a limited number of APA accredited internships in California; students who do not get (or want) APA accredited internships may also apply for APPIC (Association of Psychology Postdoctoral and Internship Centers) approved internships or California CAPIC approved (California Psychology Internship Council) internships. In the past, both APPIC approved and CAPIC approved internships had been very feasible alternatives for students who didn t get an APA accredited internship, wanted to remain in California and/or were in a program curriculum that incorporated half 1

2 time internships. Most students use the APPIC match system to gain APA accredited and APPIC approved internships, but they also may be matched through a CAPIC process in addition to the APPIC process. Statistics for the last three APPIC matches are below, from the APPIC website: 2014 APPIC Match Statistics Combined Results: Phase I and Phase II March 24, COMBINED PHASE I / PHASE II MATCH 2013 MATCH 2014 MATCH Applicants: Positions: Registered for the Match 4,435 4,481 4,335 Withdrew or did not submit ranks Matched 3,152 3,326 3,458 Unmatched Offered in Phase I or Phase II 3,202 3,397 3,534 Withdrew or no ranks in Phase II Filled 3,152 3,326 3,458 Unfilled Compared to the 2012 APPIC Match, the 2014 APPIC Match had: 100 ( 2.3%) fewer registered applicants 332 (+10.4%) additional positions, 237 (+10.0%) of which were APA or CPA accredited 306 (+9.7%) more matched applicants 406 ( 31.6%) fewer unplaced applicants (includes unmatched and withdrawn applicants) Regarding the 4,335 students who registered for the 2014 APPIC Match: 2,587 (59.7%) matched to an accredited position (compared to 53.3% in 2012) 871 (20.1%) matched to a non accredited position (compared to 17.8% in 2012) 877 (20.2%) did not match to a position (includes unmatched and withdrawn applicants) (compared to 28.9% in 2012) CSPP Data Dr. Stephanie Wood, Systemwide Director of the Psychological Services Centers, Dr. Diana Concannon, Systemwide Director of Training, and Dr. Dalia Ducker, Associate Dean for Academic Affairs of CSPP have also been working on this issue. 2

3 Dr. Wood has developed a plan for how CSPP might move all students to APA accredited internships by Her analysis of the number of CSPP students placed in APA accredited and in other internships is below: Number and percentage of placed CSPP internship applicants by type of placement for the most recent 3 year period. CSPP YR PERIOD N % N % N % N % Applied Obtained % % % % APA 49 13% 52 15% 50 18% % CAPIC % % % % APPIC 40 11% 41 12% 32 11% % Other 4 1% 6 2% 13 5% 23 3% +Needed for 50% Needed for 100% from A Plan Outline for Moving to All APA Accredited Internships by 2017 by Stephanie Wood, PhD, MHA She notes that CSPP has enrolled lower entering cohorts over the past few years: 325 students in but only 254 students in , a 22% reduction. She also notes that in California, there are only about 303 APA accredited internship positions. While the number of students at CSPP needing internships has declined due to lower enrollments, Dr. Wood points out that These data indicate that, on average, CSPP must place an additional 116 students in APAaccredited internships per year to meet the current 50% CoA threshold, and place and additional 283 students per year to meet a 100% APA accreditation placement rate per year. (Wood, p. 2) Preliminary (Phase I matching data) for indicate that on a program by program basis (rather than on a total student basis as used above), on average, 37% of the PhD program students obtained APA accredited internships (22 46% range) and 21% of the PsyD programs students obtained APAaccredited internships (range 9 42%). It should be noted that there are more students in the CSPP clinical psychology PsyD programs than the clinical psychology PhD programs. There were increases from the prior year (on a program basis) from 33% on average for the PhD programs (range 25 38%) and 11% on average for the PsyD programs (range 0 27%). National data indicate that PhD programs are much more likely to obtain APA accredited internships than PsyD students: students in practice based programs are at some disadvantage. A review of the literature also indicates that some strategies can make students more successful in gaining an internship: 3

4 Students who have completed their dissertation proposals prior to the application process have an advantage (Callahan, Collins, Jr., and Klonoff, 2010). Programs with greater tuition remissions have a greater percentage of students successfully being matched with APA accredited internship positions (Graham & Kim, 2011). The number of supervised hours, publications and presentations are correlated with match rates (although intervention hours and assessment hours are not) (Callahan, Hogan and Klonoff, 2014). Students report that the level of focus of faculty on assisting students with the internship application process assists students in being successful (Bangen, Kamen, Klonoff, VanderVeen, and Veilleux, 2010). Recommendations for Plans to Address the Issue Dr. Wood s plan outlines the following strategies that she, Dr. Concannon, and Dr. Ducker have been moving forward: Work with students as early as the admissions/application level to inform them of the issues and the need for students to plan for and strategize about the best way to obtain APA accredited internships. Work with students throughout their programs to prepare them to apply for and work to obtain APA accredited internships. Gather additional data on CSPP students competitiveness for APA accredited internship positions to determine how best to make all CSPP students as successful as possible. Provide faculty mentoring and other support for students so they can be effective in the internships process (letters of support, ensuring students are eligible to apply, writing and interviewing skill development). Support faculty in their efforts to mentor and support students through the internship process. Work with local CAPIC internship sites to assist them in becoming APA accredited. Current Activities Clinical psychology program directors and CSPP academic administrators have already been working to change curricular options to promote opportunities to be better prepared for APA accredited internships. In addition, Dr. Wood is submitting a self study for the Oakland Psychological Services Center to become an APA accredited internship and a fully affiliated internship with CSPP, which would add four internship slots. This will be submitted in approximately the next month. Dr. Concannon was able to increase the number of internship slots available this year in the Central California Psychology Internship Centers servicesplacement/fresno community services/gspia/ccpic.php; Dr. Concannon has been working hard over the past several years on the accreditation of the internship and is continuing to seek ways to expand the consortium and the number of positions available. As a Consortium, the several 4

5 different sites involved must all meet APA standards and this consortium structure is more complex than that of standalone internship sites. Dr. Ducker has surveyed the clinical psychology program directors to determine which strategies they are already employing to assist students in gaining APA accredited internships. The survey results indicated, as one example, that all programs discuss essay writing strategies with students and almost all help students with interview preparation/practice, but fewer discuss the specifics of sites/locations and that some sites are easier or more difficult to obtain a position in. Dr. Ducker is working with the programs to identify all the strategies for success and work with programs to help the implement the identified strategies across all programs. Remaining Issues Dr. Wood points out the following issues as needing attention in order to increase the supply of APAaccredited internships sites: Working with existing non accredited internships to develop them into APA accredited internship sites takes time and resources: o The process can be a multi year process since data must be gathered for the self study submission and often that data can take a year or so to develop prior to submission; the application/accreditation process itself can be close to a year in length. o Personnel/infrastructure resources are necessary to identify sites willing to do the work to become APA accredited and to work with the non accredited site over time to assist them in meeting accreditation standards as well as to write the self studies and assist the agencies through the accreditation process. o Since APA accredited sites require significant stipends for students, financial resources must be added by sites which may not have significant funds. Thus, if universities wish to partner with these sites to support accreditation, they may need to provide assistance with administrative costs associated with writing a self study and provide a portion of the student stipend funding, at least for the first few years, to support the sites. The sites would agree to allocate a certain number of internships slots for CSPP students. This is a significant upfront cost, but would be less that covering 100% of the costs of stipends and may be time limited if the site is able to assume the majority of the costs over time. The level of these stipends is also continuing to rise and is required to be consistent with the regional average for other APA accredited internships. o Often the total number of positions at any one internship site is not large; thus, universities need to be prepared to work and partner with multiple sites over several years in order to gain a significant increase in the availability of internship slots for students. All institutions are beginning to feel the increased pressure from APA to ensure accredited internships and are recognizing that the lack of APA accredited positions is not just a professional school problem. As the professional schools, which historically have not all worked in a focused way with their students to gain the internship slots, now engage in more targeted efforts to improve the percentage of their students obtaining APA accredited 5

6 internship, there will be pressure on all schools to increase the availability of APA accredited positions for their students in order to meet APA and their own institutional goals. Dr. Wood, who is President Elect of the National Council of Schools and Programs of Professional Psychology (NCSPP), sees an era of increasing cooperation among graduate psychology education and training associations (e.g., CUDCP, NCSPP) to bring resources and strategies to bear on this problem. 6