Why Support the Psychological Clinical Science Accreditation System (PCSAS)?
Clinical psychology is in great need of reform. While psychology as a whole, and clinical psychology in particular, are vital scientific disciplines yielding continuing and important research discoveries, the training of clinical psychologists and the accreditation of training programs have regressed. In fact, the accreditation system currently in place is an impediment to more effective mental and behavioral health care.
Over the past 30 years, much of the training of clinical psychologists has shifted from University settings to free-standing, for-profit training programs. These programs are characterized by low admissions standards (low GPA's, low test scores), very high acceptance rates, large class sizes, and poor professor-student ratios. Moreover, most of these programs explicitly endorse training models that devalue scientific research as a basis for determining practice decisions (type of therapy, assessment strategy). Instead, such programs emphasize such factors as personal experience in making treatment decisions. Graduates of these programs tend to earn significantly lower scores on the ASPPB licensing examination than do students trained in University based programs and they rarely produce any research. The large number of students trained by such programs is partly responsible, no doubt, for data showing that clinical psychologists today do not use the most effective treatments for their clients, do not know what those treatments are, and do not use scientific evidence to make treatment decisions. This situation has an incalculable public health cost since highly effective and cost-effective psychological interventions now exist - - but they are not used.
These marginal training programs are routinely accredited by the current accreditation body sponsored by the American Psychological Association. Numerous attempts have been made by University based programs over the past 40 years to reform the current accreditation system, but these have been thwarted by fear of lawsuits and by resistance to strengthening the criteria from nonscientifically based programs.
The status of clinical psychology today resembles that of medicine at the dawn of the 20th century, where many physicians were trained by for-profit programs that did not base their training on science, but instead on personal experience. At that time, neither the public nor employers could identify which physicians were trained in strong, scientifically based programs and which were not. Today patients cannot tell if the clinical psychologist they see will be guided by science, or instead by hunch, personal experience, and nonscientific training. Think of how disturbing it would be if you saw a physician and had no notion as to whether s/he used research evidence to guide treatment and diagnostic decisions. We need to reform the field of clinical psychology so that clinical psychologists use more effective, science based treatments and so that patients and others can tell if the psychologist is scientifically trained.
Medicine was reformed by actions taken by the AMA (e.g., the 1910 Flexner Report) that increased standards for training of physicians: e.g., demanding that training occur in University based programs and that training emphasize science. The Association for Psychological Science (APS) and the Academy of Psychological Clinical Science (the Academy) have supported the recent development of a new accreditation system that is intended to accredit clinical psychology training programs that similarly emphasize science in their training. This body will recognize only training programs that produce strong evidence that they train clinical psychologists who master science based curricula and who both generate new science and use science to guide their treatments.
The PCSAS needs financial support if it is to become a viable accreditation body. It has appointed an Executive Director and is taking steps to achieve Council for Higher Education Accreditation (CHEA) recognition. It has obtained some financial support from the APS, the Academy, and leading universities, but it requires additional financial support to accomplish its mission. The Board of Directors of the PCSAS is requesting the leading universities in North America that house the top science-based clinical psychology training programs to provide financial underwriting support for this new accreditation system. We anticipate that the need for such support will be time-limited, as accreditation/application fees increasingly support the system over the first 5 years.
If you are a strong research University, the PCSAS is appealing to you for support. This request is strongly endorsed by the members of the Academy of Psychological Clinical Science, an association of 60+ premier Clinical Psychology doctoral programs in North America, all housed in leading Universities and Departments of Psychology. (In addition, ten of the top science-oriented internship programs are members of the Academy.) Academy programs are urging their Universities to support PCSAS for the following reasons:
Such support is consistent with the ethos of their Departments of Psychology and their Universities, which both strongly endorse the value of science as the surest route to cumulative progress and high quality education and training. These Universities should support this endeavor because it is the correct and enlightened course of action.
The doctoral training programs in the Academy are the top-rated clinical psychology training programs in the US and Canada. Each of these programs strongly endorses the values of the PCSAS and believes that this new accreditation system will enhance the status of its own program, department, and university. Indeed, it will enhance the status of clinical psychology, in general.
Such recognition will distinguish further the graduates of these doctoral programs and their Universities, and will enhance these graduates' ability to secure high quality, productive, post-graduate positions.
The current accreditation standards promulgated by the American Psychological Association are not designed to recognize or support science based training, and actually force training programs to waste large amounts of time and resources in meeting “checklist” requirements that have little relation to the quality of science based training. The PCSAS system would free programs from meeting accreditation criteria that actually interfere with the optimal training of students.
This system ultimately will enhance the health and welfare of the public. Just as strengthening training standards in medicine markedly enhanced the quality of health care, improved training standards in clinical psychology will enhance health and mental health care dramatically. Evidence based treatments not only are highly effective, but also are cost effective relative to other interventions. Thus, they could help control spiraling health care costs.
This is not a propitious time to seek money. However, the development of the PCSAS started several years ago when the current economic crisis was not apparent. Now that the implementation of the PCSAS has begun, it would be extremely difficult to suspend its development. We are at a unique point in history where a few deeply committed leaders in the field are willing to devote a great deal of time, energy and resources to this endeavor. The leading Universities in North America now have a unique window of opportunity to support this effort, thereby helping to bring about much-needed reforms in the system.
The Board of Directors of PCSAS is asking your University to join with a select group of major Universities in becoming members of the Founders' Circle group by pledging to provide the PCSAS $15,000/year for five years. Universities that choose to join the Founders' Circle will pay no initiation fees, application fees, site visitor expenses, or annual dues to PCSAS during the five years in which they contribute to the Fund. In addition, Founders' Circle Members will be recognized publicly by PCSAS in appreciation for their pioneering support. After this five-year period no further financial support will be requested outside of the normal fees. Please consider this appeal seriously if it is consonant with the ideals of your University. Joining the Founders' Circle has the potential to improve the quality of doctoral education in Clinical Psychology and to enhance dramatically the quality of mental and behavioral health treatment in your State and beyond.