Speaking of Education
The March 2011 meeting of APA’s Board of Educational Affairs marked a historic step in psychology’s maturation as a U.S. health profession. The board passed a resolution that, while not yet APA policy1 or in widespread practice, will bring psychology in more alignment with other health professions in assuring quality:
“BEA affirms that health service psychologists must be trained in APA/CPA accredited doctoral and APA/CPA accredited internship programs. BEA also affirms that graduation from an APA/CPA accredited doctoral and APA/CPA internship training program must be a prerequisite for licensure for independent practice as health service psychologists.”
Why is this important? The social contract between a profession and the public is that in return for its autonomy, the profession is self-regulating to serve the public interest. While the state may credential individual psychologists to protect the public, the standards for education, training and practice are set by the profession.
With respect to standards for education and training, program accreditation by national psychology serves as the self-regulating quality assurance mechanism. (It is also important to note that program accreditation by the profession is not the same as the regional accreditation process for institutions of higher education.) APA’s Commission on Accreditation is recognized by the U.S. Secretary of Education and the Council for Higher Education Accreditation as the specialized accreditor for professional psychology.
To be eligible for APA accreditation, programs must have as a goal the preparation of psychologists competent for entry to practice. Programs are held accountable for their success in achieving this outcome — and over the past decade we have witnessed an increased emphasis on competency based education and training. Although our discourse has historically been about “models” (e.g., scientist-practitioner, clinical scientist, scholar-practitioner), policymakers and the public are much more concerned about competency in serving the public. Our ability to articulate the research and practice competencies required for psychology as a scientifically based health profession is essential. Of course, tensions and conflicts are intrinsic to any accreditation process and APA’s is not immune. I hear that the APA standards are both too low and too high, too rigid and too loose. There are important perspectives here that deserve attention and debate, but that is not my purpose in highlighting the BEA statement. What BEA has affirmed is the value of our quality assurance mechanism and the importance of its recognition for regulation of our profession. One size may not fit all areas of practice — but this model fits the preparation of health-service psychologists. There is already a norm among other health professions: graduation from a program accredited by the profession is a requirement for licensure.
Psychology is seen as quite unusual by our colleagues in medicine, dentistry and pharmacy, among others. They are surprised to learn that training accredited by the profession is not required by many states for licensure. They are even more alarmed to hear that state regulations often define which courses or experiences should be in a doctoral or internship curriculum — such definitions are seen as the province of a mature self-regulating profession, not the state.
The state steps in when there is a lack of confidence in the self-regulation of the profession. Psychology cannot afford to devolve in this manner. Many excellent, well-intentioned psychologists participate in state licensing boards and while other ways of identifying appropriate education and training may have been necessary in the past, the time has come for psychologists (from academic trainers and field supervisors to state regulators and employers) to accept and rally around the single standard of APA accreditation. If the goal of an APA-accredited program is to prepare psychologists for entry to practice, we need to ensure that the public and the state are confident that our goals are being achieved. That is where we must put our effort. If we fail, we will not only do a disservice to the public, but we will never have parity with other health professions.