In 2006, APA encouraged state psychology boards to acknowledge changes in training practices by dropping the postdoctoral requirement for licensure. How has that shift in APA policy played out over the last five years?
In some ways, say psychologists, the policy change is having the intended effect: Ten additional states — Arizona, Connecticut, Indiana, Kentucky, Maryland, North Dakota, Ohio, Utah, Washington and Wyoming — now allow licensure applicants to substitute supervised training amassed before graduation for the traditional postdoctoral experience and seek licensure immediately upon receiving their doctoral degrees. (Alabama didn't have a postdoc requirement to begin with.)
But the recommendation that states eliminate the postdoctoral requirement has also had unintended consequences. By adding to the heterogeneity of licensing requirements, say some experts, it has restricted psychologists' ability to move to new jurisdictions. And while the change has prompted a push to standardize what counts as appropriate practicum experience, some worry about the state's involvement in setting criteria related to the graduate curriculum. The change has also underscored the importance of documenting and banking credentials, whether you do a postdoc or not (see "Should you bank your credentials?").
An impact on mobility and more
APA's policy change grew out of APA's Commission on Education and Training Leading to Licensure in Psychology in 2001, when education and credentialing organizations came together to review the dramatic changes in professional psychology training over the last 30 years.
When the postdoctoral requirement for licensure was originally recommended, says APA Education Directorate Executive Director Cynthia D. Belar, PhD, students in doctoral programs had minimal clinical training — 400 hours, say — before their "capstone" internship experience. Today's programs put much more emphasis on clinical training, and students amass an unprecedented amount of experience — as much as 2,500 hours — before beginning their internships. Plus, to become APA-accredited, doctoral programs must demonstrate that their curricula prepare students for entry into practice.
"Continuing with the old policy presented a barrier that kept fully trained entry-level psychologists from actually entering practice, even when they were pursuing advanced training opportunities," says Belar. "Moreover, many so-called postdocs were not really organized, sequential training experiences but simply a collection of supervised hours."
Postdoctoral training is still important for psychologists seeking mobility, specialty certification or just continuing professional development, emphasizes Judy E. Hall, PhD, executive officer of the National Register of Health Service Providers in Psychology. "The difference," she says, "is whether one gains that postdoctoral experience with or without a license."
The policy change has worked out well for many early career psychologists, including Owen J. Bargreen, PsyD. Thanks to Washington State's revised law, he was able to launch his Everett, Wash., practice soon after graduating from the California School of Professional Psychology in 2007.
"Because California has a postdoc requirement, I had many colleagues who were doing postdocs while I was getting my practice started," says Bargreen, who plans to spend his career in his home state. "I thought that having one yearlong practicum and two full-time predoctoral internships was enough clinical training to get me started."
But now some are questioning the wisdom of APA's policy shift.
The change was well-intentioned, but solving one problem — at least for students in some states — has brought new difficulties, says APA Recording Secretary Barry Anton, PhD.
Say you decide to take advantage of Washington state's law and skip the postdoc, says Anton. "If you intend to practice in Washington State from the day you get your degree to the day you retire, you're not going to have any problems," he says. "But if you have any intention of going to another jurisdiction, you could have a problem."
Just moving across the border to Oregon could be difficult, Anton points out, since Oregon still requires a postdoc. "To get licensed there, you'd have to do a postdoctoral year — if you could find a way to do that," he says.
Because of these mobility concerns, says Anton, many training directors are urging students to do postdocs even in states that don't require them.
Similarly, the American Psychological Association of Graduate Students (APAGS) suggests that students who opt out of postdocs get — and document — supervised experience even after they're licensed. But even then, warns APAGS Chair-Elect Ali Mattu, you have to realize that some states won't count hours accrued after licensure as fulfilling the postdoc requirement, even if you're supervised.
"If there's any chance you might move after graduation, the only safe option is to do a supervised postdoc," says Mattu. "If moving may be in your future, get your hours and study for the Examination for Professional Practice of Psychology, but hold off on getting licensed until you have satisfied the postdoc requirements."
Even moving between two states that don't require postdocs can be difficult, says Stephen T. DeMers, EdD, executive officer of the Association of State and Provincial Psychology Boards (ASPPB). That's because states often have different requirements when it comes to the kinds of pre-graduation practicum experiences doctoral students can substitute for the postdoc.
In an effort to solve such problems and bring consistency to the field, ASPPB has developed guidelines for practicum experience for licensure — another outgrowth of APA's policy shift.
"Up to that point, licensing boards hadn't really required applicants to show any practicum hours," says DeMers, explaining that ASPPB developed the guidelines with consultation from various education and training groups. "But if you were going to count practicum hours as part of your required hours for supervised experience for licensure, then licensing boards were going to need to have some standards about what practicum experiences were going to be acceptable."
That development worries many in the field, says Belar.
"In the U.S., the social contract between an independent profession and the government is that the profession determines its own education and training requirements," she says, pointing out that licensing requirements for other health professions don't include state rules and regulations regarding specific parts of the curriculum. "The state's involvement in those matters may reflect the public's lack of confidence in the profession's own quality assurance mechanisms — something that could pose significant problems for psychology."
APA's policy shift has also made banking credentials through a service such as ASPPB's Credentials Bank or the National Register of Health Service Providers in Psychology more important than ever, says DeMers.
"Given the inconsistency in licensure requirements, it's all the more reason you need to be able to document what experiences you've had because you don't know where your career's going to take you," he says. "You don't know what you're going to have to document down the road."
Others believe the APA policy change should be reversed. Among them is Emil Rodolfa, PhD, a former ASPPB board member who helped craft the practicum guidelines. He believes the change has done more harm than good.
"If there was ever a time when we could get agreement from everybody about what the standards are and then all change at the same time, then we could do something like this," says Rodolfa, who directs counseling and psychological services at the University of California at Davis. "Until that happens, this is just going to create increasing problems for individuals who want to get licensed."
For Belar, the solution is to work toward consistency in states accepting psychology's standard of education and training for entry into practice — graduation from an APA-accredited doctoral program.
Rebecca A. Clay is a writer in Washington, DC