Training and Education in Professional Psychology

Passing the torch: Reflections and recommendations to advance Training and Education in Professional Psychology.
As Training and Education in Professional Psychology (TEPP’s) outgoing editorial team ends their term, the authors reflect on the journal’s contributions to health service psychology (HSP) and suggest potential priorities and opportunities as both the journal and the science of education and training continue to mature. TEPP’s aim is to serve as a forum for thoughtful and rigorous conceptual and empirical investigation of current issues in HSP education and training, and for candid self-reflection about strengths, shortcomings, and growth opportunities in HSP education. The authors review the journal’s contributions to this aim through three primary goals established at the beginning of their editorial term: (a) engage the broad training community in sharing its best conceptual and empirical work relevant to education and training across training levels, settings, and focus areas; (b) advance the science of education and training through strong empirical research; and (c) expand emphasis on the sociocultural context in which education and training occurs (Bell et al., 2019). The authors conclude with recommendations to the incoming TEPP editorial team and prospective authors for next steps in advancing HSP education and training. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Development and efficacy of an ethical decision-making tool for training clinical psychologists.
We developed an ethical decision-making tool to assist in training clinical psychologists that had four goals: (a) to mirror the way psychologists naturally think about ethical dilemmas; (b) to facilitate thorough analysis by using a simple, guided checklist format; (c) to provide quick access to intuitively organized explanations and examples of each major domain of ethical challenges and principles; and (d) to facilitate good documentation and record-keeping of the decision-making process. Study 1 surveyed clinical psychologists and asked them to list the top 10–15 ethical considerations they encounter in practice, and then used those categories to help develop the tool. In Study 2, having access to two different versions of the tool significantly improved the quality of analysis of a standardized clinical vignette, particularly for individuals still in training. In Study 3, a streamlined version of the tool significantly improved the quality of graduate trainees’ analysis of the standardized clinical vignette and was faster to use. In Study 4, we demonstrated the efficacy of the tool in helping trainees analyze ethical dilemmas they had actually experienced. In Study 5, faculty at doctoral programs who teach graduate ethics courses provided dilemmas and then graded the responses of trainees who analyzed them either with or without the tool. Analyses completed with the tool received far better grades on average than those completed without the tool. This work is the first that we know of to develop an evidence-based, empirically supported tool for training future psychologists in ethical practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Ethical and diversity considerations of mandatory reporting: Implications for training.
Mandatory reporting, a cornerstone of child protection, is intended to safeguard the welfare of children; however, the existing framework often fails to adequately consider the diverse needs and circumstances of marginalized families. This article highlights the need for greater attention related to reporting cases of suspected child maltreatment and advocates for a paradigm shift in training psychologists, highlighting diversity and multicultural competence as integral components. Drawing on a comprehensive review of literature, we shine a critical light on systemic failures of the child welfare system for marginalized families, including families of color and those living in poverty. When contemplating reporting, we urge trainees to consider how reporting bias might influence accurate reporting and highlight the importance of distinguishing between poverty and neglect. Through the application of a case example, we provide a nuanced discussion of an ethical decision-making process grounded in research that considers psychologists’ legal and ethical responsibilities with particular attention to diversity variables. We conclude the article by providing teaching and training recommendations pursuant to the ethical and legal ramifications of mandatory reporting. The recommendations embrace ethical principles and prioritize diversity in mandatory reporting practices for a more just and equitable approach to child protection. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Getting Racism Out of Our Work (GROW): Design, deployment, and early outcomes for a program to increase psychology supervisor’s multicultural competence.
When psychology clinical supervisors lack the fundamental knowledge and skills required to provide racially and culturally competent supervision, trainee satisfaction, clinical practice, and professional development suffers. Knowledge of key culture and diversity frameworks must be paired with integrated skills and to improve racially and culturally responsive clinical supervisory practices for health service psychology trainees. Organized around Kern’s six-step approach, this article describes the development and pilot implementation of the Getting Racism Out of Our Work core program to provide psychology supervisors with the aforementioned foundational knowledge and skills. Pilot participants reported high levels of satisfaction and applicability of program learning to their supervisory practice. Opportunities to improve the program, such as increasing access to expert consultants and improving accessibility via alternate formats (e.g., asynchronous learning) were noted. Key learnings and future directions are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Development, implementation, and sustainment of multicultural peer-consultation teams in distinct mental health settings: An implementation-focused comparative case study.
Multicultural peer-consultation teams represent one promising approach to supporting mental health providers by providing consultation that is multiculturally conscious and integrates front-and-center concepts related to diversity in identities and lived experiences (i.e., multiculturalism), intersectionality, inclusivity, health equity, antiracism, and anti-oppression. Herein, we take an implementation science-informed approach to describing the development, implementation, and sustainment of multicultural peer-consultation teams in two professional settings—a Veterans Affairs hospital and a psychology department training clinic. We operationalize the core and adaptable components of this model. Last, we reflect on our collective lessons learned and offer recommendations based on our efforts to create teams across mental health care settings. Thus, the present article may function as an implementation blueprint of sorts that others can follow as they consider ways that they can create similar teams at their institutions. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Cultivating cultural consciousness: Identity-based affinity groups among clinical trainees.
The ability to understand one’s and others’ cultural conditioning is essential to developing culturally responsive clinical practice. One means to do this is through ingroup discussion about a shared social identity. This study examines the impact of affinity groups on critical and cultural consciousness among student trainees in a doctoral clinical psychology program. For 6 weeks, 13 participants convened weekly in small identity-related affinity groups, discussing a shared identity using a list of provided prompts. Written reflections of the groups were analyzed, and seven themes emerged: initial apprehension, positive experience, intimacy and safe space, commonality of experience, exploration of intersectionality, group connection and expansiveness, and conscientization of self and other. The groups served as positive, supportive spaces of identity-based enlightenment, with exploration of the interconnectedness of social identities, and deepened insight regarding societal positioning and impact. Implications of the use of affinity groups to develop cultural and critical consciousness within trainees are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Invisible wounds: Testimony of microaggressions from the experiences of clinicians of color in training.
Microaggressions are hurtful interpersonal interactions that pathologize minoritized identities and affect the well-being of people of color (POC) and can contribute to racial trauma. Research thus far has focused on college students and therapy clients. Little research has focused on the experiences of POC who are training as mental health service providers. In a collaborative autoethnography, 10 POC trainees shared their experiences of witnessing or experiencing microaggressions in various professional capacities (e.g., therapist, supervisee, consulting colleague). We identified four primary themes: (a) trainees experience a broad variety of microaggressions across Sue et al.’s (2007) typologies; (b) microaggressions impacted trainees’ emotional well-being; (c) the impact of microaggressions was absorbed in the moment and supervisory support was obtained after; and (d) microaggressions represented opportunities for personal/professional growth and these came at a high cost. Results suggest that POC clinicians’ experiences of microaggressions in a therapy context are ubiquitous and varied. Training programs should prepare all trainees and supervisors to recognize and address microaggressions in the therapy training context. Programs should consider policy and curricular updates that would increase effectiveness in addressing microaggressions. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Mindfulness, self-compassion, gratitude, and burnout in health service psychology trainees: A structural equation model.
Occupational burnout is a growing concern among practicing psychologists but is understudied among psychology doctoral students. There is a need to identify possible protective factors mitigating burnout and the present study examined the interrelationships between mindfulness, self-compassion, gratitude, and burnout in a national sample of health service psychology doctoral trainees (N = 234) using structural equation modeling. Two a priori models were developed and results suggested that mindfulness, self-compassion, and gratitude may each function as important internal resources in mitigating burnout in health service psychology trainees. Mindfulness showed direct positive effects on self-compassion and gratitude and direct negative effects on burnout. Self-compassion and gratitude each also showed direct negative effects on burnout. Mindfulness also showed significant indirect effects on burnout through the partial mediating variables of self-compassion and gratitude. These results can inform researchers examining burnout by further understanding how the aforementioned cognitive factors may account for the differences in burnout. The findings can also be used to inform changes at the organizational level for doctoral training programs and can be used at an individual level as tools for empowering trainees to increase internal cognitive resources that may help them to engage in more sustainable practice. Additional research and practice implications for professional psychologists and limitations are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Specific stressors linked to functional outcomes in psychology doctoral students.
In response to the COVID-19 pandemic and the lack of research on stress levels among psychology doctoral students, this study aimed to investigate the functional outcomes of clinical and counseling psychology doctoral students (N = 889). The study examined the unique effects of various risk factors, including lifetime trauma, recent stressful experiences, COVID-19 stress, financial stress, and general stress, on functional outcomes such as quality of life, depression symptoms, anxiety symptoms, and physical pain. Furthermore, the study explored the effects of gender, racial/ethnic background, and sexual orientation on the relationship between risk factors and outcomes. Multivariate multiple regression analyses were conducted to examine the unique relationships between the risk factors and functional outcomes while controlling for demographic covariates. The findings revealed a considerable proportion of participants reporting diminished quality of life, elevated levels of physical pain, as well as symptoms of depression and anxiety, with 18.33% and 55.56% surpassing the threshold for a probable disorder, respectively. General stress and recent stressful experiences were associated with lower quality of life, increased depression and anxiety symptoms, and pain. Lifetime trauma and COVID-19 stress were linked to more depression and anxiety symptoms and pain, while financial stress was associated with lower quality of life. These findings underscore the critical need to address the concerning levels of stress experienced by psychology doctoral students, as all examined risk factors were associated with one or more of the studied outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Utilizing a university and state collaboration to advance student training and support public mental health care.
This article describes a 20+-year learning collaboration between a clinical psychology program and a state mental health department focused in part on the joint mission of educating and training doctoral students in the development and implementation of data-based decision making in public mental health systems of care. Funded by the state government, the collaboration was designed to assure meaningful contributions to service improvement and to prepare doctoral psychology students for leadership roles in public service. This partnership provided paid graduate assistantships and opportunities for students and others to contribute to accumulated clinical science via practice-based research. We provide a brief contextual overview of events that set the stage for the university/state department team-up; the vision, goals, and structural processes of the collaborative training opportunity; and students’ roles and educational objectives. We then describe outcomes to date including contributions to the system of care and clinical science, placement of students and early-career staff in public service leadership positions, and students’ retrospective perceptions of their learning and development affected by their training experiences in the collaboration. Finally, the authors discuss implications and recommendations for universities that might consider implementing such a partnership. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Existing policies and procedures for training needs among clinical psychology trainees: An institutional policy review.
Students in professional psychology programs undergo 5 or more years of graduate training to prepare for autonomous practice as psychologists, with research, practica, and supervision as core components of these training programs. Many accredited clinical psychology programs utilize a clinical manual or handbook and related documents to share relevant information with students about expectations, training practices, and program policy. However, no research has comprehensively reviewed the extent to which accredited programs clearly outline training processes, expectations, and resources related to research, practica, and supervision. Using a coding system, the present study involved an institutional policy review of clinical psychology handbooks/manuals and related documents for 20 Canadian English graduate programs. Information within documents was coded as either “included,” “partially included,” or “not included.” Fully included items ranged from 10% to 75% for the research domain, 20% to 95% for the practicum domain, and 10% to 85% for the supervision domain. This study highlighted that some available student information may lack the level of detail needed to fully or concretely addressed student training needs. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Exploration of the impact of baseline clinician learner characteristics on motivational interviewing skill improvement following training with a virtual standardized patient.
The aim of this study was to explore the impact of baseline learner characteristics on motivational interviewing (MI) skill acquisition with and without virtual standardized patient (VSP) supplementation. Data from a two-group, randomized trial of 120 volunteer health care professionals recruited from a Department of Veterans Affairs and Department of Defense medical facility were used for this exploratory analysis. Training conditions included a branching storyline VSP, which provided MI skill rehearsal/feedback, and an academic study control. Nine multivariate analysis of variance models were used to examine the effects of baseline characteristics, assigned training condition, and their respective interactions in predicting MI skill improvements from baseline to posttraining. Follow-up between-subjects effects for significant omnibus tests were examined to evaluate the main effects for the baseline characteristics and the interaction effects. A statistically significant interaction was found between training condition and previous MI training, F(3, 99) = 2.77, p = .046; Pillai’s trace = .077; ηp² = .077, on motivational interviewing treatment integrity skill change. This study serves as an initial step in the direction of elucidating, which learners benefit most from simulation-based mental health care training using VSPs. We found that learners with minimal previous MI training benefited more from supplemented training with a VSP rather than traditional academic study alone. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Development and feasibility of a protocol to improve clinical trainees awareness of interpersonal processes using continuous assessment of interpersonal dynamics.
A major foundation for all clinical competencies is the ability to sensitively attend to and understand the moment-to-moment processes occurring between trainees and their clients. The current article reports on the development and feasibility of a training protocol to help clinical trainees become more attuned to moment-to-moment processes during psychotherapy sessions within a practicum training setting. This study uses interpersonal processes as an exemplar of how to use this training framework. This protocol employs a novel methodology called Continuous Assessment of Interpersonal Dynamics in an innovative way by having clinical trainees and client dyads rate both self and others’ moment-to-moment interpersonal behavior across two psychotherapy sessions. Two therapist–client dyads completed this training protocol. Feedback was provided through data visualizations and narrative summaries of the data. Both trainees who participated in the present study reported that the feedback integrating questionnaire and moment-to-moment interpersonal variables was useful in their conceptualization of their clients’ problems, as well as in helping them reflect on their own interpersonal behavior in session. In this article, we combine theory and method to develop a feasible and empirically supported clinical training methodology that is applicable across treatment orientations. All materials to implement this training protocol are available on the Open Science Framework, allowing interested supervisors to integrate this training into their practica (https://osf.io/8f2th/). (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Managing clinical supervision dilemmas: A mixed-methods vignette study.
Clinical supervision plays a pivotal role in training the next generation of health service psychologists. Given the dyadic nature and multiple priorities of supervision, dilemmas are common; however, few data exist on the frequency and types of dilemmas, and more importantly, how they are navigated. Of the limited data that are available on this topic, few encompass the perspectives of both supervisors and supervisees. This study aims to address these gaps by surveying supervisor (N = 29) and supervisee (N = 65) responses to eight vignettes of supervision dilemmas. We use a mixed-methods approach to investigate quantitative ratings of perceived dilemma frequency and harmfulness, and content analysis to identify themes in qualitative responses assessing how participants navigate dilemmas. A supervisor failing to provide adequate critical feedback to a supervisee was perceived by participants as the most frequent and harmful dilemma. Strong consistency in frequency and harmfulness ratings of vignettes was found among supervisors and supervisees. Content analysis revealed four main themes among reported strategies: relational, reflective, direct, and indirect. The majority of strategies reported were direct, involving confrontation and problem solving. However, there were situational and temporal nuances in how participants described they would use strategies. Supervisees reported greater use of indirect strategies involving passivity and avoidance. Overall, our study underscores the potential for a decision-making framework that could help standardize supervision guidelines and recommends that such a framework incorporate an assessment of the severity, frequency, and temporal aspects of each dilemma. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Transitioning to telehealth during COVID-19: Challenges and opportunities for trauma-focused school psychology.
The COVID-19 pandemic has had an unprecedented impact on our society and economy, including devastating impacts on marginalized populations. It has also placed significant demands on health service psychology training programs and their trainees. Almost overnight, trainees had to quickly learn and implement best practices in telehealth, and training programs had to navigate short and long-term challenges, all while ensuring the safety and well-being of trainees, trainers, clients, and our community. The goal of the current project is to describe the challenges and opportunities our trainees and training program encountered when transitioning to telehealth during the early phases of the pandemic, with a specific focus on those trainees completing the stress and trauma track within our school psychology doctoral program. Four total case studies by three trainees at different levels within the stress and trauma track and the program director are presented. We conclude with lessons learned and advice for other health service psychology training programs, especially those that train health service psychologists focused on working with children and youth who have experienced trauma. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

Training and Education in Professional Psychology - Vol 18, Iss 4