Development of a global curriculum for professional psychology: implications of the Combined-Integrated model of doctoral training

This article considers the development of a global training curriculum and qualification in professional psychology, with particular emphasis on the Combined-Integrated (C-I) model. The C-I model exposes professional psychology trainees to two or more of the practice areas (i.e., clinical, counseling, school/educational). The authors argue that the C-I approach is one that is well suited to the development of a global training curriculum due to its emphasis on broadly training psychologists as well as its respect for diversity and integration of various theoretical and professional orientations. A survey of training programs in 16 countries/regions on six continents found significant variation in training, minimal qualifications, and roles of the professional psychologist. The authors recommend that an international group of psychologists develop a regionally flexible, but common, training curriculum and qualification that would include a five- to six-year competency-based qualification. Ways in which the C-I training model may serve to integrate and globalize professional psychology are discussed.     

A history of Combined-Integrated doctoral training in psychology

The history of doctoral training in psychology is reviewed, with special emphasis on the development of training models for applied psychology. Among applied psychology doctoral programs, most label themselves as being one of the three currently recognized practice areas: clinical, counseling, and school psychology; however, since the 1970s, APA also has accredited "combined" programs. The history of the development of the combined model is traced, including information from the programs themselves about the manner in which each evolved. Recently, new interest in the combined category -or Combined-Integrated (C-I) as these programs wish to become known-has emerged, and an organization representing these programs has formed. The C-I model is described, and the potential that the model may serve as a template for the future of professional training in psychology is discussed.     

General practice, primary care, and health service psychology: concepts, competencies, and the Combined-Integrated model

The profession of psychology is being impacted profoundly by broader changes within the national system of health care, as mental and behavioral health services are being recognized as essential components of a comprehensive, preventive, and cost-efficient primary care system. To fully define and embrace this role, the discipline of professional psychology must develop a shared disciplinary identity of health service psychology and a generalized competency-based model for doctoral education and training. This very framework has been adopted by Combined-Integrated (C-I) doctoral programs in professional psychology, which train across the practice areas (clinical, counseling, and school psychology) to provide a general and integrative foundation for their students. Because C-I programs produce general practitioners who are competent to function within a variety of health service settings, this innovative training approach has great potential to educate and train psychologists for a changing health care marketplace.     

What do students want? Perspectives from the front line of doctoral training in professional and Combined-Integrated psychology

Doctoral students in professional psychology face broad challenges, such as changing market demands and increased competition for careers in traditional practice settings. To prepare for these demands, students must decide how much and when to specialize, if at all, predoctorally. Complicating matters, students in single practice area programs (clinical, counseling, or school) may risk becoming insulated within the culture of their practice area, which can limit exposure and understanding of the larger practice field. Despite conditions that may drive potential students away from psychology, little research exists on efforts to address student needs, or on student perspectives of doctoral training in general. One training model that is sensitive to these student needs and concerns is the Combined-Integrated (C-I) model. An exploratory study of C-I student and graduate opinions, experiences, and aspirations revealed that C-I students value breadth of training, diversity of experience, and professional flexibility, and that they experience diverse training opportunities and socialization experiences. Implications of these results vis-à-vis the larger framework of student concerns are examined.     

From the horse's mouth: a case for Combined-Integrated doctoral training in professional psychology

Although new to many members of the psychological community, the notion of a "combined" model of training has been in existence for nearly 30 years (Beutler & Fisher, 1994). The present article is intended to outline the benefits and advantages of the Combined-Integrated (C-I) model. Following a brief discussion of the terms "combined" and "integrated," the advantages of C-I training are discussed across five key themes: (a) the high overlap across traditional practice area training, (b) the advantages of the breadth of training offered, (c) the advantages of C-I training for the professional of psychology, (d) the pragmatic advantages of C-I training to faculty and students, and (e) the benefits of C-I training for salient constituency groups.     

Unified professional psychology: implications for the Combined-Integrated model of doctoral training

The authors outline a new identity for the professional psychologist termed Unified Professional Psychology (UPP). UPP combines recent movements toward a unified psychological science, an independent professional psychology, and Combined-Integrated (C-I) doctoral training programs in psychology. The value in the synthesis of these ideas is that they (a) provide a comprehensive system of thought that defines the science and practice of psychology in a commensurable manner, (b) offer a clear identity for the professional psychologist, and (c) set the stage for a training model that develops competencies that will prepare graduates to serve as leaders and advocates in a wide array of health settings. Issues pertaining to why a new view is needed and how UPP specifies the science-practice relationship are addressed in detail.     

The Consensus Conference and Combined-Integrated model of doctoral training in professional psychology--overview of part 1: nature and scope of the Combined-Integrated model

This special series of articles on the Consensus Conference and Combined-Integrated (C-I) model of doctoral training in professional psychology consists of 13 articles in two successive volumes of the Journal of Clinical Psychology. Six articles are presented in Part 1 (Vol. 60, Issue 9), which collectively describe the "nature and scope" of the C-I model (e.g., historic and definitional issues; the potential advantages of this model; implications for the profession). In Part 2 of this special series (Vol. 60, Issue 10), articles 7 through 12 address the broader implications and potential applications of the C-I model within a range of professional and societal contexts (e.g., for interprofessional collaboration; the health care field; development of a global curriculum; the unified psychology movement; issues of assessment and professional identity; and higher education); article 13 provides a summary of the series as well as a discussion of future directions. As an overview, this paper provides the abstract for each of the articles in Part 1, and describes the various topics of the articles in Part 2. Taken together, the articles in this special series are designed to provide a coherent account of how and why the C-I model is timely and relevant, and therefore warrants serious consideration by the larger education and training community in professional psychology.     

A model and method for "making" a Combined-Integrated psychologist: equilintegration (EI) theory and the beliefs, events, and values inventory (BEVI)

Although the Consensus Conference on Combined and Integrated Doctoral Training in Psychology (e.g., Bailey, 2003) generated much content of relevance to the structure and commitments of Combined-Integrated (C-I) programs, faculty, and students-and Competencies 2002: Future Directions in Education and Credentialing in Professional Psychology (www.appic.org) developed language and guidelines regarding the knowledge areas, skills, and values that students in professional psychology programs should acquire and demonstrate-specific models and methods are necessary to translate these professional guidelines and aspirations into reality. This article offers one such model, Equilintegration (EI) Theory, and method, the Beliefs, Events, and Values Inventory (BEVI), that can be used by faculty, training staff, supervisors, and students in C-I programs to operationalize, assess, and cultivate basic values of education and training from a C-I perspective (e.g., self-awareness, self-assessment, and self-reflection). In addition to this model and method, relevant background information, theory, and research are presented along with attendant implications, hypotheses, and principles.     

Back to our future? The Consensus Conference and Combined-Integrated model of doctoral training in professional psychology

Is it possible and advisable for the profession of psychology to articulate and endorse a common, generalist, and integrative framework for the education and training of its students? At the Consensus Conference on Combined and Integrated Doctoral Training in Psychology, held at James Madison University in Harrisonburg, VA (USA), May 2 to 4, 2003, participants from across the spectrum of education and training in professional psychology ultimately answered "yes." This article, the first in this special series on the Consensus Conference and Combined-Integrated (C-I) model of doctoral training in professional psychology, essentially provides an overview of the conference rationale, participants, goals, proceedings, and results. Because the other 12 articles in this series all reference the Consensus Conference and C-I model, this overview provides a good starting point for understanding what occurred at the conference, what it means to educate and train from a C-I perspective, and what the potential implications of such a model might be for the profession of psychology.     

Beyond consensus: a summary of the special series and future of the Combined-Integrated model

The articles that comprise this Special Series offer a comprehensive examination of the results and implications of the Consensus Conference and Combined-Integrated (C-I) model of doctoral training in professional psychology (see Shealy, Cobb, Crowley, Nelson, & Peterson, 2004). Given the scope of this effort, it may be helpful to provide a summary of the 12 preceding articles. Such a presentation should illustrate the complementarity of the diverse perspectives presented in this series, the essential coherence of this innovative and compelling model of education and training, and its timely relevance for the future of professional psychology. Following a summary of these articles, eight "future topics for discussion" also are presented.     

BOOK REVIEW: Preventing Childhood Disorders,Substance Abuse,and Delinquency

Discusses (a) what roles the specialty of clinical child psychology fulfills and how societal and professional changes have enhanced the need for the specialty, (b) how the field defines itself, (c) how models of training are conceptualized for the specialty, and (d) how some training programs implement specialty training with broad, interdisciplinary components. Clinical child psychology is a professional field of research and practice that, when adequate training is provided, properly deserves a places as a specialty.The dangers of overspecialization and narrowness are more likely present in traditional clinical (adult) psychology than in clinical child psychology, especially when the clinical child training is done in a broadly comprehensive and integrated manner.     

Implementing elements of evidence-based practice into scientist-practitioner training at the University of Nebraska-Lincoln

Evidence-based practice (EBP) has become the predominant model of training and is emerging as a common model of practice for many non-psychology health care professions. Recognizing the relevance of EBP to psychology, the American Psychological Association (APA) developed and endorsed an official policy statement on EBP for the practice of professional psychology. There is now a pressing need to consider ways that EBP can inform scientist-practitioner training. The present article proposes clinical competencies associated with the practice of EBP, and describes initial efforts to implement elements of EBP into training at the University of Nebraska-Lincoln. These efforts have occurred in both the classroom and practicum training experiences, and are geared toward helping students become more effective users of the evidence base through their clinical work. Challenges to the implementation of EBP in clinical psychology training are discussed as well.     

Predictors of doctoral student success in professional psychology: characteristics of students, programs, and universities

In the face of the rising number of doctoral recipients in professional psychology, many have voiced concerns about the quality of nontraditional training programs. Past research suggests that, on a variety of outcomes, graduates from clinical PhD programs outperform graduates from clinical PsyD and, to a lesser extent, counseling PhD programs. We examine an aggregate archival dataset to determine whether student or university characteristics account for the differences in outcomes among programs. The data show meaningful differences in the outcomes of clinical PhD, PsyD, and counseling PhD programs. Furthermore, graduates from research-intensive universities perform better on the psychology licensure exam and are more likely to become American Board of Professional Psychology diplomates. The available data support the notion that the ability to conduct research is an essential component of graduate education. In this light, PsyD programs represent a unique opportunity to train students in the types of evaluation and outcomes assessments used by practicing psychologists. We discuss implications for graduate-level training in professional psychology.     

Coming of age: critical challenges to the future development of pediatric psychology

Described five professional challenges that will affect the future development of pediatric psychology: specialization and professional identity, relationships with other professions, securing resources necessary for effective functioning, the conflict between clinical service delivery and prevention, and development of training models. To meet these challenges, pediatric psychologists need to maintain strong connections with other psychologists, develop new models of collaborative training, practice, and research, emphasize prevention activities, and enhance the scientific basis of pediatric psychology through innovative training programs and support for faculty development.     

Teaching evidence-based practice: implications for psychology

A movement advocating the use of evidence-based practice (EBP) is increasingly influencing health care and the practice of psychology. Thus, teaching evidence-based practice in psychology (EBPP) is critical to the preparation of future health service psychologists. In this article, the authors address common myths associated with EBP, propose core components involved in teaching EBPP, and describe an example of how such training can be incorporated into a professional psychology education and training curriculum.     

Psychologists in Long-Term Care: Overview of Practice and Public Policy: Introduction to the Special Series

With the overall aging of the population and the concomitant need for the provision of mental health care for older adults, professional psychology in long-term care has come of age. Psychologists are now increasingly practicing in such traditional long-term care settings as nursing homes and in less traditional ones such as rehabilitation units, day centers, partial hospitaliza-tion programs, and hospices. The practice of psychology in long-term care is strongly influenced by public policy issues relating to Medicare, such as conditions of reimbursement, the rise of managed Medicare, and the continued disparity between payment for mental health and medical diagnoses. Ceropsychologists must be flexible in the form of their healthcare delivery to continue to provide quality services. The following articles in this special section on long-term care summarize the research on assessment and interventions for long-term care patients, outline the training opportunities available, and provide a decision-making framework for the common professional ethical/legal issues encountered in long-term care settings.     

Current status of doctoral-level training in psychological testing

Training directors of 82 American Psychological Association (APA)-approved doctoral programs in clinical psychology responded to a survey on the current status and recent changes in doctoral training in psychological assessment. Although testing continues to be a major focus of training, a slight decline in emphasis on assessment was noted, most notably with projective techniques. With few exceptions (e.g., NEO-PI, Personality Assessment Inventory), traditional tests were emphasized in coursework and also were considered "essential" for the practicing psychologist. Interestingly, there seems to be increased emphasis on the interview and neuropsychological testing compared to prior surveys of academic settings. Only 29% of the training directors reported that their programs have been significantly affected by managed care, suggesting that most academic programs are somewhat insulated from marketplace pressures. It is recommended that training programs balance their focus on traditional academic values with the realities of the clinical practice arena.