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Eye on Psi Chi: Spring 2015

Applying to Doctoral Programs
in Clinical Psychology:
Buyer Beware

John C. Norcross, PhD, and Christie P. Karpiak, PhD,
University of Scranton (PA)

The experience of applying to clinical psychology doctoral programs resembles, for most students, a maddening whirlwind. Boulder-model PhD or Vail-model PsyD? Which of the 280 doctoral programs in clinical psychology? Applications must be organized, personal statements written, letters of recommendation solicited, GREs taken (and agonized over), and CVs perfected. And the demands of the senior year do not magically pause to make room for all this extra work (Norcross & Sayette, 2014).
The prospect of possibly needing to apply again the following year can appear tantamount to a catastrophe. It is tempting to view acceptance into any doctoral program this year as a better outcome than other options such as waiting another year or considering different degrees. But acting on this sense of urgency could lead to serious trouble in a few years, and usually many thousands of dollars, down the road.
Your anxiety naturally is focused on whether any doctoral programs will welcome your particular combination of strengths and interests. In the midst of the intense concern about your qualifications, it is easy to lose sight of the program’s qualifications.
Undergraduates often are not aware of the importance of applying to programs that will get them to their career destination: a fully trained, licensed clinical psychologist with plentiful career possibilities across the country. That will typically entail attending a doctoral program in clinical psychology that is

accredited by the American Psychological Association (APA), 

sending its students onto APA-accredited internships, and

graduating students who pass the national licensure examination.
So amid the anxiety of just getting into any doctoral program in clinical psychology, please take a few moments to apply to those programs that will get you to your goal. Attend to the compelling data provided by directors of clinical training, APA, and internship and licensing organizations in psychology. Here are the facts.
APA Accreditation
APA accredits doctoral programs in clinical psychology, counseling psychology, school psychology, combined psychology, and emerging areas. Take note that APA does not accredit master’s programs. APA accredits only the doctoral psychology program, not the entire university.
Some webpages contribute to this confusion by highlighting the accreditation of the institution by an educational accrediting body (e.g., the Higher Learning Commission) and making it hard to find information about the doctoral program’s accreditation status. Accepting a spot in a program that lacks APA accreditation can prove risky for your future, and we advise students not to do so unless they have carefully weighed the following five possible implications.
1.
The first implication is the quality of the education you will receive. Accredited doctoral programs must meet stringent requirements. In many cases, a lack of APA accreditation indicates that a program does not meet these basic standards, standards that translate into student experiences in classes and other training venues associated with the program. APA accreditation ensures a modicum of program stability, quality assurance, and professional accountability.
2.
Accredited programs have a formal appeals mechanism to the profession and to APA. This does not apply to students attending nonaccredited programs; you have no recourse in APA.
3.
Graduates of APA-accredited programs are practically guaranteed to meet the educational requirements for state licensure. And the licensure pass rates are, on average, higher for graduates of APA-accredited programs than nonaccredited programs (Templer, Stroup, Mancuso, & Tangen, 2008).
4.
Students from APA-accredited programs find themselves in more advantageous and competitive positions in terms of their internship match rate (Callahan, Collins, & Klonofff, 2010; Graham & Kim, 2011). In fact, starting in 2017, students from nonaccreditedprograms will not even participate in the computerized internship match process until students from APA-accredited programs have completed their matches.
5.
The eventual employment outcomes favor psychologists graduating from accredited programs (Graham & Kim, 2011). The federal government, the Veterans Administration, and many university positions now insist on a doctorate and internship from APA-accredited programs. As we warn our students, “Do you want to spend your entire career explaining and defending why you did not attend an APA-accredited program!?”

APA-Accredited Internships
To receive your doctorate in clinical psychology, you must complete a one-year, full-time or a two-year, half-time internship. In the past, if you were attending an APAaccredited doctoral program, you would rather easily obtain an APA-accredited internship on match day when a computer matches applicants to internship sites in February. But in the present, the proliferating number of doctoral programs, particularly large PsyD programs, has dramatically increased the number of doctoral students seeking APA-accredited internships. The result is an internship imbalance or “crisis” between the rapidly growing number of internship applicants and the slowly growing number of internship spots.
In 2013, 76% of applicants were matched to an APA-accredited internship position on match day. That leaves one-quarter of doctoral psychology students without an accredited internship. About half of the unmatched students completed an unaccredited internship that year, and about half will need to apply next year, delaying their graduation by a year. That’s why it is vital for you to select schools that will maximize the probability of you being in that three-quarters, not in that unfortunate one-quarter.
It is here, the completion of the degree and internship, where the picture is especially bleak for students in unaccredited programs. Students from unaccredited doctoral programs are dramatically less likely than those from accredited programs to gain acceptance into an APA-accredited internship (Norcross, Ellis, & Sayette, 2010). Indeed, students in accredited programs are three times as likely as those from unaccredited programs to get an accredited internship (http://mitch.web.unc.edu/files/2013/10/MatchRates). APA-accredited PhD programs placed 81.5% of their students in accredited internships, and accredited PsyD programs placed 47.3%. By dramatic contrast, only 26.5% of students from unaccredited PhD and 7.6% from unaccredited PsyD programs matched with APA-accredited internships.
Placement rates for specific programs are available from APPIC (www.appic.org/Match/Match-Statistics) and in the Insider’s Guide to Graduate Programs in Clinical and Counseling Psychology (Norcross & Sayette, 2014). In this competitive environment, please check the placement rates for all programs to which you are applying including the accredited ones.
APA and the training community are working to reduce the internship imbalance (Grus, McCutcheon, & Berry, 2011), but it is a complex problem that will not be fixed soon. The upshot is for you, as an applicant, to critically evaluate the internship match rate before you apply and then again after you have received admission offers.
National Licensure Examination
After years of hard work completing a doctoral program and an internship, you naturally expect to pass the national licensure examination in psychology—the Examination for Professional Practice in Psychology (EPPP; www.asppb.net/?page=FAQs). But not everyone passes on the first try or even on subsequent tries.
The accreditation of the doctoral program and internship is a valuable indicator of the quality of the training provided, and it also facilitates documentation of internship training for the licensing board in the state where you wish to practice. The absence of accreditation of either the doctoral training program or the internship will translate into extra hassle, often significant hassle, in preparation to take the licensing exam.
If you attend an APA-accredited program, you stand a 77% probability of passing on any single attempt (www.asppb.net). If you attend a non-APA-accredited program, that chance drops to 65%.
As you select potential doctoral programs, seriously consider the licensure pass rates of their graduates. These statistics are helpfully presented on the website of the Association of State and Provincial Psychology Boards at www.asppb.net. Click on the link for Psychology Licensing Exam Scores by Doctoral Program, and you will find a table of pass rate for each program.
For example, graduates of the University of Alabama’s clinical psychology program have recently passed at a 94% clip. That’s typical of the smaller, more competitive, PhD programs in the scientist-practitioner (Boulder) tradition. Graduates of the less competitive, huge PsyD programs, particularly the for-profit institutions, typically score lower on the EPPP (Graham & Kim, 2011; Templer et al., 2008). Their average licensure pass rates fall in the 55% to 75% range.
One day, while discussing these numbers in class, an undergraduate spontaneously yelled, “Why would anyone even think about applying to a doctoral program where only half the graduates can pass the licensure exam!?” That memorable event led us to formulate the three-quarters rule: Apply only to doctoral programs where three-quarters or more of the students secure an APA-accredited internship and pass the licensure examination on the first try.
In the end, the decision about a doctoral program is more personal than these rules suggest. This constitutes our general advice, but you will need to tailor it to your individual situation and goals. On occasion, a couple of our students have entered doctoral programs with inordinately low internship match rates or depressingly low licensure pass rates, but they did so with their eyes wide open.
That’s precisely our intent in helping you select potential clinical programs: creating well-informed consumers aware of the facts and the tradeoffs. Caveat emptor!
References
Callahan, J. L., Collins, Jr., F. L., & Klonoff, E. A. (2010). An examination of applicant characteristics of successfully matched interns: Is the glass half empty or half full or leaking miserably? Journal of Clinical Psychology, 66, 1–16. doi:10.1002/jclp.20664
Graham, J. M., & Kim, Y. (2011). Predictors of doctoral success in professional psychology: Characteristics of students, programs, and universities. Journal of Clinical Psychology, 67, 350–354. doi:10.1002/jclp.20767
Grus, C. L., McCutcheon, S. R., & Berry, S. L. (2011). Actions by the professional psychology education and training groups to mitigate the internship imbalance. Training and Education in Professional Psychology, 5, 193–201. doi:10.1037/a0026101
Norcross, J. C., Ellis, J. L., & Sayette, M. A. (2010). Getting in and getting money: A comparative analysis of admission standards, acceptance rates, and financial assistance across the research-practice continuum in clinical psychology programs. Training and Education in Professional Psychology, 4, 99–104. doi:10.1037/a0014880
Norcross, J. C., & Sayette, M. A. (2014). Insider’s guide to graduate programs in clinical and counseling psychology (2014/15 edition). New York, NY: Guilford
Templer, D. I., Stroup, K., Mancuso, L. J., & Tangen, K. (2008). Comparative decline of professional school graduates’ performance on the Examination for Professional Practice in Psychology. Psychological Reports, 102, 551–560. doi:10.2466/PR0.102.2.551-560


John C. Norcross, PhD, is Distinguished Professor of Psychology at the University of Scranton, a board-certified clinical psychologist, and coauthor of the Insider’s Guide to Graduate Programs in Clinical and Counseling Psychology. He serves on APA’s Board of Educational Affairs and in the past served on the Item Development Committee for the psychology licensure examination.

Christie P. Karpiak, PhD, is Professor of Psychology at the University of Scranton, an adjunct clinical associate professor of Clinical Sciences at the Commonwealth Medical College, and a licensed psychologist.

Copyright 2015 (Volume 19, Issue 3) by Psi Chi, the International Honor Society in Psychology


 
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