Journal of clinical psychology
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Comment
Some critical observations on twenty-first century graduate education in clinical psychology.
A number of issues raised in the C. R. ⋯ R. Elliott article, "Twenty-First Century Graduate Education in Clinical Psychology: A Four Level Matrix Model" (this issue, pp. 1033-1054), are critically examined: the role of interpersonal and societal factors in understanding the human condition, the desirability of breadth in both undergraduate and graduate education, political and scientific issues in prevention research and application, problems in the use of randomized clinical trials for evaluating psychotherapy, and the efficacy-effectiveness debate in therapy research.
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Placebo and nonplacebo treatments have both positive and negative effects on patient outcomes. To better understand the patterning of treatment effects, three specific interventions will be discussed that are reported to produce more harm than benefit: critical incident stress debriefing, group therapy for adolescents with conduct disorders, and psychotherapy for dissociative identity disorder. In each case, there is an interaction between mechanisms thought to underlie both placebo and specific treatment effects. ⋯ In the three treatments discussed, specific mechanisms interact with nonspecific mechanisms to produce iatrogenic effects. To advance knowledge, it is important both to specify the theory of treatment and its expected outcomes and to put the theory to test. Only with attention to the empirical findings from programmatic research of specific and nonspecific effects and their interaction is it possible to improve the outcomes of treatment beyond the status quo.
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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. ⋯ 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.
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This article provides an overview of issues related to the development and evaluation of competency in psychological assessment. Specifically, we delineate the goals, ideas, and directions identified by the psychological assessment work group in the Competencies Conference: Future Directions in Education and Credentialing in Professional Psychology. This is one of a series of articles published in this issue of the Journal of Clinical Psychology. ⋯ We present a set of eight core competencies that we deemed important for achieving psychological assessment competency and discuss four guidelines for training in the domain of psychological assessment. A variety of methods for evaluating competencies in this domain are suggested, with emphasis on using a collaborative model of evaluation. Recommendations for future directions include strengthening the academic prerequisites for graduate school training; increasing training in culturally sensitive measures; incorporating innovative assessment-related technologies into training; and addressing discontinuities between academic training, internship, and practice environments.
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Review Meta Analysis Historical Article
Computer treatment for common mental health problems.
Perhaps the most complex and controversial role for the computer in clinical practice is as a treatment medium in which the computer effectively replaces the psychotherapist. This article outlines the historical development of computer treatment, from dialogue generators in the 1960s through to the interactive, multimedia programs of the 2000s. ⋯ Next, we review studies of the cost effectiveness of computer treatments. Finally, we outline the implications for research, policy, and practice of this new generation of treatment options.