Clinical Psych Chapter 1 pt.2

Likewise, expectations for the more independent aspects of graduate training would also reflect the dual emphasis: Graduate students would (under supervision) conduct both clinical work and their own empirical research (thesis and dissertation). Clinical psychology graduate programs would continue to be housed in departments of psychology at universities, and graduates would be awarded the PhD degree. The term scientist-practitioner model was used to label this balanced, two-pronged approach to training (McFall, 2006; Norcross & Sayette, 2022).

For decades, the scientist-practitioner—or the Boulder model, as it is also called—approach to clinical psychology training unquestionably dominated the field (Klonoff, 2011, 2016). In fact, today more programs still subscribe to the Boulder model than to any other. However, as time passed, developments took place that produced a wider range of options in clinical psychology training. In short, the pendulum did not remain stationary near the midpoint between practice and research; instead, it swung toward one extreme and then toward the other.

Leaning Toward Practice: The Practitioner-Scholar (Vail) Model

In 1973, another conference on clinical psychology training was held in Colorado—this time, in the city of Vail (Grus, 2016; Klonoff, 2016). In the years preceding this conference, some discontent had arisen regarding the Boulder or scientist-practitioner model of training. In effect, many current and aspiring clinical psychologists had been asking, “Why do I need such extensive training as a researcher/scientist when my goal is simply to practice?” After all, only a minority of clinical psychologists were entering academia or otherwise conducting research as a primary professional task. Clinical practice was the much more popular career choice (Boneau & Cuca, 1974; McConnell, 1984; Stricker, 2011), and many would-be clinical psychologists sought a doctoral-level degree with less extensive training in research and more extensive training in the development of applied clinical skills like psychotherapy and assessment. Additionally, some within the profession were questioning whether the quality and quantity of practitioners were sufficient to serve the population (Stricker, 2016). So the practitioner-scholar model of training was born, along with a new type of doctoral degree, the PsyD (Foley & McNeil, 2015; Routh, 2015b; Stricker & Lally, 2015). Since the 1970s, clinical psychology graduate programs offering the PsyD degree (rather than the PhD) have proliferated. In fact, from 1988 to 2001 alone, the number of PsyD degrees awarded increased by more than 160% (McFall, 2006). Compared with PhD programs, these programs typically offer more coursework directly related to practice and fewer related to research and statistics (Norcross et al., 1998; Norcross & Sayette, 2022). See the next section of this chapter for a more detailed, point-by-point comparison of PhD and PsyD models of training.

The growth of the PsyD (or practitioner-scholar model, or Vail model, as it is also known) approach to training in clinical psychology has influenced the field tremendously. Currently, about half the doctoral degrees being awarded in the field are PsyD degrees (Norcross et al., 2005; Norcross & Sayette, 2022). The number of PsyD programs is actually much smaller than the number of PhD programs, but the typical PsyD program accepts and graduates a much larger number of students than does the typical PhD program, so the number of people graduating with each degree is about the same (Klonoff, 2011; Norcross & Sayette, 2022; Stricker, 2011).

Comparing PhD Programs With PsyD Programs

Quite a bit of variation exists between PhD programs, just as it does between PsyD programs (Gardner, 2015). However, a few overall trends distinguish one degree from the other. In general, compared with PhD programs, PsyD programs tend to

place less emphasis on research-related aspects of training and more emphasis on clinically relevant aspects of training;

accept and enroll a much larger percentage and number of applicants;

be housed in freestanding, independent (or university-affiliated) “professional schools,” as opposed to departments of psychology in universities;

accept students with lower Graduate Record Examination (GRE) scores and undergraduate grade point averages (GPAs);

offer significantly less funding to enrolled students in the form of graduate assistantships, fellowships, tuition remission, and so on;

accept and enroll a higher percentage of students who have already earned a master’s degree;

have lower rates of success placing their students in APA-accredited predoctoral internships;

produce graduates who score lower on the national licensing exam (EPPP);

graduate students in a briefer time period (about 1.5 years sooner);

graduate students who pursue practice-related careers rather than academic or research-related careers; and

have at least a slightly higher percentage of faculty members who subscribe to psychodynamic approaches, as opposed to cognitive-behavioral approaches.

*GRE scores were reported on the previous GRE scale. Estimated conversions to the current GRE scale are approximately 303 for PsyD and 312 for PhD, based on data provided at https://www.ets.org/s/gre/pdf/concordance_information.pdf

Leaning Toward Science: The Clinical Scientist Model

After the creation of the balanced Boulder model in the late 1940s and the subsequent emergence of the practice-focused Vail model in the 1970s, the more empirically minded members of the clinical psychology profession began a campaign for a strongly research-focused model of training. Indeed, in the 1990s, a movement toward increased empiricism took place among numerous graduate programs and prominent individuals involved in clinical psychology training. In essence, the leaders of this movement argued that science should be the bedrock of clinical psychology. They sought and created a model of training—the clinical scientist model—that emphasized the scientific, research-oriented side of clinical psychology more strongly than did the Boulder model (McFall, 2006; McFall et al., 2015). Unlike those who created the Vail model in the 1970s, the leaders of the clinical scientist movement have not suggested that graduates of their program should receive an entirely different degree—they still award the PhD, just as Boulder model graduate programs do. However, a PhD from a program that follows the clinical scientist model implies a very strong emphasis on the production of scientific research and the use of evidence-based clinical methods (Levenson, 2014; Norcross & Sayette, 2022; Onken Carroll et al., 2014; Shoham et al., 2014).

Two defining events highlight the initial steps of the clinical scientist movement. In 1991, Richard McFall, at the time a professor of psychology at Indiana University, published an article that served as a rallying call for the clinical scientist movement (Treat & Bootzin, 2015). In his “Manifesto for a Science of Clinical Psychology,” McFall (1991) argued that “scientific clinical psychology is the only legitimate and acceptable form of clinical psychology … after all, what is the alternative? … Does anyone seriously believe that a reliance on intuition and other unscientific methods is going to hasten advances in knowledge?” (pp. 76–77).

A few years later, a conference of prominent leaders of select clinical psychology graduate programs took place at Indiana University. The purpose of the conference was to unite in an effort to promote clinical science. From this conference, the Academy of Psychological Clinical Science was founded. McFall served as its president for the first several years of its existence, and as time has passed, an increasing number of graduate programs and internships have become members. Some of these graduate programs have revised the very names of their programs from “clinical psychology” to “clinical science” (or something similar) to reflect the emphasis on science and research. The programs in this academy still represent a minority of all graduate programs in clinical psychology, but among the members are many prominent and influential programs and individuals (Academy of Psychological Clinical Science, 2022; Fowles, 2015; Klonoff, 2016; McFall et al., 2015).

Considering the discrepancies between the three models of training available today—the traditional, middle-of-the-road Boulder model; the Vail model, emphasizing clinical skills; and the clinical scientist model, emphasizing empirical research—the experience of clinical psychology graduate students can vary widely from one program to the next. In fact, it’s no surprise that in the Insider’s Guide to Graduate Programs in Clinical and Counseling Psychology (Norcross & Sayette, 2022), a valuable resource used by many applicants to learn about specific graduate programs in clinical psychology, the first piece of information listed about each program is a self-rating on a 7-point scale from “practice oriented” to “research oriented.” Moreover, it’s no surprise that applicants can find programs at both extremes and everywhere in between. Table 1.2 includes examples of specific graduate programs representing each of the three primary training models (scientist-practitioner, practitioner-scholar, and clinical scientist), including quotes from the programs’ own websites that reflect their approach to training.