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Training and Education in Professional Psychology - Vol 11, Iss 4

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Training and Education in Professional Psychology Training and Education in Professional Psychology is dedicated to enhancing supervision and training provided by psychologists.
Copyright 2017 American Psychological Association
  • New standards of accreditation in health service psychology: Rationale, opportunities, and challenges.
    The intent of this article is to inform the training community about the contextual and conceptual framework that guided development of the Standards of Accreditation (SoA) and to summarize the major changes in accreditation introduced by the SoA. First, the authors address the need for new accreditation standards in light of the evolving landscapes of psychology, higher education, and health care. They then describe the process by which the Commission on Accreditation (CoA) and its communities of interest worked together to develop the SoA and present the general guiding principles and the specific rationale for the most significant changes. Changes in six areas are described in depth, including labeling the profession, level-specific standards, addressing diversity, the discipline-specific knowledge base, defining appropriate competencies, and contingent accreditation. The authors conclude with a discussion of what they envision as the promise of the SoA, including thoughts about the responsibility of the profession (including the CoA and the training and professional communities) to promote and ensure quality training in health service psychology. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Exploring therapeutic alliance training in clinical and counseling psychology graduate programs.
    The therapeutic alliance is widely regarded as an empirically-based element of successful psychotherapy. However, the degree to which training programs incorporate alliance-centered components into their curricula and clinical practica remains unclear. The aims of this study were to explore (a) training programs’ awareness of research that establishes the alliance as a component of evidence-based practice; (b) the extent to which programs incorporate formal, evidence-based alliance training into their pedagogy; (c) what training programs would consider ideal alliance-training practices; and (d) whether there are differences in evidence-based alliance-training practices or perspectives between programs with different terminal degrees. Data derived from a quantitative survey of directors (or their designates; N = 84) of American Psychological Association-accredited clinical (Doctor of Philosophy or Doctor of Psychology) and counseling (Doctor of Philosophy) programs in the United States and Canada. Generally, respondents indicated that their programs were aware of alliance research trends. However, respondents also largely indicated that they do not incorporate systematic, evidence-based alliance training into their programs, despite believing that such systematic elements would contribute to ideal alliance-training practices. There were no statistically significant differences between program degree type in terms of awareness of alliance research, current alliance-training practices, or views on ideal alliance-training practices. We discuss the implications of the present results for training and future research directions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Multicultural social justice group psychotherapy training: Curriculum development and pilot.
    The present study described the implementation and pilot evaluation of a curriculum that sought to more successfully address client presenting concerns and group dynamics that emerged from sociopolitical oppression and inequity. Applied psychology competencies, social justice pedagogy, and a content analysis of 9 graduate-level group psychotherapy syllabi informed the course curriculum development. To advance trainees’ multicultural social justice competencies in group therapy, several learning assessments were employed to target multicultural awareness, knowledge, and skills as well as advocacy, empowerment, and social change. Assessments of learning included self-evaluations, self-reflective journals, reading reactions, seminar discussions, a group curriculum development paper and presentation, and intergroup dialogues. A pilot implementation and evaluation is described. Participants were doctoral students in applied psychology. Participants’ social justice beliefs, attitudes toward social justice actions, and multicultural competencies were evaluated prior to and at the conclusion of the pilot. Further, participants’ written self-evaluations were examined to assess progress toward learning objectives. Participants’ multicultural awareness, knowledge, and skills significantly increased after course completion. Participants’ written evaluations indicated that they made progress toward each of the learning objectives. Implications for research as well as for transferability to graduate coursework are described. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • A randomized-controlled crossover trial of mindfulness for student psychotherapists.
    Although research has documented a number of personal benefits for psychotherapists who practice mindfulness, the existing research examining the effects of psychotherapist mindfulness on client treatment outcomes has been mixed. The purpose of this study was to test whether a brief mindfulness training program for trainee psychotherapists could have a positive impact on psychotherapists’ ratings of their own state and trait mindfulness as well as on psychotherapy session outcomes. In this randomized-controlled crossover trial, 40 graduate student psychotherapists from 2 universities were assigned to either a mindfulness or a control group. Psychotherapists in the mindfulness group received a brief 5-week manualized mindfulness training program; those in the control group received the program after a 5-week no-contact period. Psychotherapists who received the mindfulness training showed improvements in state and trait mindfulness that were significantly greater than the changes seen in the control group. Psychotherapists also reported a significantly higher level of presence in treatment sessions after attending the training compared to the control condition; however, no differences in clients’ ratings of psychotherapist presence or session effectiveness were observed between the 2 conditions. Implications for psychotherapist training and mindfulness practice are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Measuring practice element procedural knowledge: How do trainees PERForm?
    Assessment of intervention competence and adherence to evidence-based practices (EBP) has gained substantial attention in recent years. A variety of methods for measuring procedural knowledge and adherence abound; yet many are resource-intensive, may not be feasible across educational and mental health service delivery systems, and are often associated with a specific treatment manual. This demonstration project assessed the feasibility of using clinical vignette methodology to examine EBP procedural knowledge. Learners across three different samples read a case vignette of a youth with either comorbid depression and disruptive behavior or anxiety and then wrote how they would apply a technique (problem solving or exposure) with that youth. Coding these open-ended responses using the Practice Element Response Form (PERForm) yielded excellent interrater reliabilities for problem solving (intraclass correlation coefficient [ICC] M = .80) and exposure (ICC M = .81). Trainees’ scores increased significantly from pre- to posttraining on the PERForm with medium to very large effect sizes. Results suggest that use of clinical vignette methodology such as that used by the PERForm may be an additional approach to evaluating EBP procedural knowledge that offers the benefits of feasibility, reliability, and sensitivity to training. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • A structured approach to reflective practice training in a clinical practicum.
    Reflective practice is considered to be the key component for achieving greater self-awareness, professional expertise, critical thinking, integration of theory-practice links, and enhanced patient care. While reflective practice is considered a key component in supervision in terms of skill development and increase in clinical competence, it is unknown whether or not reflection is a workable and meaningful training activity that results in a positive outcome. The purpose of this project was to conduct an initial evaluation of the feasibility and acceptability of a reflective practice exercise within a practicum setting. Participants included 22 graduate students (13 females, 9 males) in a Clinical Science doctoral degree program that completed a reflective practice exercise which utilized a series of guiding questions, while receiving training and supervision from a licensed clinical psychologist. Results highlight positive outcomes of the reflective practice in terms of clinician growth and associated client outcomes, following the reflective practice. In addition, the results show that the structured reflective practice is a meaningful exercise as well as an acceptable approach to developing reflective practice as part of clinical practice training and lifelong learning. These findings highlight the potential use of the structured approach to reflective practice in a clinical practicum setting. Recommendations for improving the reflective practice process in a clinical practicum are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • The progressive cascading model improves exposure delivery in trainee therapists learning exposure therapy for obsessive-compulsive disorder.
    Researchers postulate that a lack of training in exposure therapy may underlie the poor dissemination that has been observed. The current study sought to provide support for the progressive cascading model (PCM), which was developed to train novice therapists in exposure-based techniques. The PCM is promising considering its scalability and financial feasibility. Forty-two trainee therapists completed a rotation at a university clinic specializing in obsessive–compulsive disorder where they were trained within the PCM. After training, therapists delivered exposure therapy in a more intense manner with fewer cautious delivery behaviors (e.g., allowing anxiety reduction strategies) and distress reduction behaviors (e.g., reassuring safety). Therapists also had fewer negative beliefs about exposure therapy and reported lower disgust sensitivity post-training. The PCM appears to be a potentially effective training model for teaching exposure-based techniques and warrants additional research. Such a model is timely considering the poor dissemination of exposure therapy and the movement toward competency-based education in graduate school. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Developing alternative training delivery methods to improve psychotherapy implementation in the U.S. Department of Veterans Affairs.
    The Department of Veteran Affairs (VA) has been a recognized leader in evidence-based psychotherapy (EBP) training, with 15 different EBP training programs that address posttraumatic stress disorder (PTSD), depression, chronic pain, insomnia, substance use, motivation for treatment, relationship distress, serious mental illness, and problem-solving skills. VA has a broad impact on the training of mental health professionals in the United States, training over 11,600 unique mental health staff in 1 or more of these EBPs since 2007. Original EBP training delivery methods relied on in-person workshops, followed by consultation with an EBP expert who provided feedback and ratings of audio-recorded sessions. Restrictions on federal government employee travel, in-person conferences, and budgets led to reductions in the number of mental health providers trained in EBPs during recent fiscal years. As a result, alternative training delivery methods were needed for training VA staff. This article describes the process used to select, develop, and pilot test alternative training delivery methods for EBPs. Surveys of key stakeholders and a literature review led us to retain consultation with review of audio-recorded sessions since evidence suggests this is critical to changing clinician behavior. All VA EBP training programs have begun pilot testing blended learning, regional training, or both, depending on local needs. Early results suggest that regional training (train the trainer method) was equivalent to, while blended learning methods showed mixed results relative to, the traditional training method. These alternative training methods may be more sustainable for training psychotherapists in large health care systems or across distances. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Student experiences of remediation in their graduate psychology programs.
    Student competence problems, i.e., behaviors that cause a student or supervisee to fail to meet essential professional standards (Elman & Forrest, 2007), impact many graduate students in applied psychology programs. Students with competence problems are often placed on remediation plans to rectify these problems and facilitate their ability to complete their training successfully. While research has been conducted on other students’ experiences and perspectives of having peers with competence problems, no research to date has investigated the experiences of the students remediated for competence problems. The current study filled the gap in the literature by investigating the lived experiences of 12 graduate students in American Psychological Association (APA)-accredited doctoral-level clinical and counseling psychology programs who were remediated for competence problems. We used a phenomenological approach to glean information on the relationship between remediation and a student’s professional development and development of competence. Results of the study demonstrated 4 themes, with subsumed subthemes: remediation plan details and specifics, experiences with remediators, problem in context, and impact of remediation on trainee. Results indicated some consistency with, as well as unique findings pursuant to, the existing literature base on remediation. In addition, implications of the findings provide the impetus for suggestions for how trainers can implement remediation, including considerations of locus of control and competence, as well as parallels between remediation and therapy process and outcome literature. Recommendations for trainers and additional research implications are offered. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Self-care in clinical psychology graduate training.
    Following a trend in the professional psychology literature, self-care has begun to receive increasing attention at the psychology graduate training level. A limited body of research has supported the value of self-care for the wellbeing of psychology trainees, and has suggested that graduate programs may play an important role in promoting self-care. The present research took a comprehensive approach to studying self-care among a sample of 358 doctoral students recruited from APA-accredited clinical psychology programs. Results demonstrated that self-care is associated with both greater personal wellbeing and better self-reported progress through graduate training, and that self-care can also serve as a buffer against the harmful effects of stress inherent to graduate training in psychology. Two particularly important aspects of self-care for psychology graduate students appeared to be building professional support systems and maintaining awareness of one’s needs and reactions to stressors. Results also indicated that program culture related to student self-care, such that students who perceived greater emphasis on self-care within their programs reported engaging in more self-care. Finally, both quantitative and qualitative results suggested that graduate training programs can better promote self-care among students in several ways. Recommendations for graduate training programs include taking concrete action steps to encourage self-care among students, such as building formal education on self-care into existing coursework, offering targeted workshops or seminars, and encouraging faculty to provide effective models of self-care, with the ultimate goal of building a “culture” that values and promotes self-care as an essential component of training in psychology. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Integrating psychobiography into professional psychology training: Rationale, benefits, and models.
    Psychobiography has played a critical role in the history of psychology, yet training in psychobiographical methods is limited in professional psychology programs. The present article reviews the history of psychobiography and highlights the many benefits of incorporating psychobiography into the health service psychology curriculum. Among the benefits of teaching psychobiography are: anchoring students in their professional identity and history; learning diverse theories of psychology in applied and interesting ways; promoting interdisciplinary learning and ethical awareness; enhancing clinical skill development; promoting methodological pluralism; and enhancing multicultural, social justice, and multilingual competence. Diverse models for incorporating psychobiography in the health service psychology curriculum are presented. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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