Speaking of Education

Having passed my 10th anniversary at APA, I have been reflecting on the vision for my own work and how it has evolved over the past 35 years. I began my career as a clinical psychologist working in what we then called medical psychology, having previously benefited from years working as a medical secretary. I was convinced that psychological research and practice had more to contribute to health care, so I spent years developing clinical health psychology programs at doctoral, internship and postdoctoral levels in a university academic health center. As Chief Psychologist at the Los Angeles Kaiser Permanente Medical Center, I learned about health-care delivery systems and the promise of integrated care. Those experiences convinced me the biopsychosocial model was as relevant to the preparation of traditional mental health providers as it was to health psychologists.

So what is my current vision? I see psychology as a hub science for the pursuit of knowledge across scientific disciplines. Psychology practitioners apply knowledge from psychological science to address societal needs in a wide variety of arenas, such as education, industry and the environment. Health is also an important area of psychological research and practice. Health-service psychologists are trained in doctoral programs that are accredited by the profession and have clearly defined learning outcomes. Psychologists' distinctive contributions to health care are recognized and respected by other health professions, policymakers and the public. They have parity with other doctoral health professions. Regulators of practice have confidence in the profession to be self-regulating through rigorous quality-assurance mechanisms: The government provides support for training as a public good.

Also in my vision, psychology graduates who provide health-care services have demonstrated competence in evidence-based practice. Their services are patient centered, culturally sensitive, effective and informed by population-based data. They are skilled in collaboration with other health professionals and are committed to lifelong learning. They are grounded in psychological science and able to integrate knowledge from areas such as biology, genetics and sociology as needed. They stay current with psychological research, and are also able to conduct it, especially practice-based outcomes research and program evaluation. They are informed about health research and the context of health delivery services. They are especially skilled in measurement, and demonstrate capacity for leadership within health-care systems and on health-care teams.

I also have a specific vision for psychologists' education and training. It should provide a seamless transition from undergraduate through postdoctoral, and offer a wealth of opportunities for professional development. With sufficient funding, graduate students could engage in full-time intensive study and be ready to enter practice within five years. Students would have to complete prerequisites and meet high standards to be accepted into graduate programs since not everyone who wants a psychology degree can benefit from doctoral study. Those who meet the standards could begin their work at an advanced level. I also envision that psychology will have put aside its conflicts over professional education and training models to focus on specifying competencies to be achieved, applying our own science in the teaching and learning process and promoting excellence, rather than defining minimum standards. Psychology will coalesce around defining core competencies for those prepared to provide health-care services, and there will be a seamless transition from education and training through licensure and credentialing. Psychology's workforce analysis capacity will also inform us about supply and demand in various areas of practice, and will anticipate societal needs. Graduate education would remain market sensitive, but not market driven, as the integration of science and practice in academia creates new markets for practice.

Of course, there is more work to do for my vision to come true, yet I know others who share parts of it. A working group of members from APA, the Council of Chairs of Graduate Departments of Psychology and the Council of Chairs of Training Councils is developing a blueprint for our future. I look forward to their report in 2012.

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