Since World War II, professional psychologists-in-training have had their choice of one of three core areas accredited by APA: clinical, counseling and school. But APA also accredits a handful of programs that offer training that spans two or three of those areas. In fact, of the 358 APA-accredited doctoral training programs, 11 are accredited to train students in combinations of the three areas.

However, since the first combined program was founded at Vanderbilt University's Peabody College in 1974, these programs have had no outlet to share ideas or pull together--until recently. Last year, the nation's combined and integrated training programs banded together for the first time at APA's 2002 Annual Convention and formed the Consortium of Combined and Integrated Doctoral Programs in Psychology (CCIDPIP). And representatives from the group (pronounced "kid-pip") gathered again at the Consensus Conference on Combined and Integrated Doctoral Training in Psychology, May 2-4, at James Madison University (JMU) in Harrisonburg, Va.

Their three overarching goals in holding the conference--and for the future--were to define what a truly integrated, combined model of training would look like and be called; to clarify the relationship between this model and single practice areas in psychology; and to consider the potential role of the model within the larger health-care field and profession of psychology. In addition to other conference outcomes, participants drafted a mission statement and several guiding principles for combined and integrated doctoral programs in psychology.

"Combined programs have not had a formal voice, even though they're one of the four kinds of doctoral programs accredited by APA," says Craig Shealy, PhD, the consensus conference's chair and director of James Madison University's integrated school, counseling and clinical doctoral program. "It hasn't helped to get the word out to the larger training community about what we do."

CCIDPIP is starting to change that, he notes, by sending representatives or liaisons to such groups as APA's Council of Chairs of Training Councils and the Association of Psychology Postdoctoral and Internship Centers (AAPIC).

The combined model

Combined and integrated programs most frequently combine school psychology training with counseling or clinical, and a few include all three substantive areas. The rationale behind the mix is to bridge sometimes artificial divisions between these core areas, says conference participant Ron Reeve, PhD, head of the human services department at the University of Virginia's Curry School of Education.

In fact, some educators estimate that as much as 80 percent of the content in clinical, counseling and school psychology programs overlaps, says Shealy. Part of that, he says, is because all APA-accredited programs are required to teach a basic set of competencies.

"Combined programs in many ways seize upon these realities," Shealy explains. "We know and appreciate what each of the specialty areas brings to the table--and attempt to produce in our students kind of a gestalt of competencies, attitudes and values that allow them to function across a very wide range of employment settings and professional areas."

That training is a boon to students when they enter the job market, says conference participant Barbara Okun, PhD, clinical training director at Northeastern University's combined school and counseling program.

For one, they're equipped to interact with a wide range of professionals and clients. "They understand different settings, therefore they have more sources for referrals and consultations," she explains.

However, that doesn't mean that CCIDPIP's organizers don't appreciate the value of single-area programs or are trying to establish the model as its own specialty.

"Participants were quite clear that this model of program is not intended as yet another specialty area for doctoral education and training in psychology," says Paul Nelson, PhD, deputy executive director of APA's Education Directorate and a member of the conference's steering committee. "Perhaps as important as anything was their discovery that even within their 'combined' category, their programs are not implemented in an identical manner."

Guiding principles

At the May conference, representatives of the combined and integrated programs mulled over these issues with representatives of the conference's co-sponsors, including the American Psychological Association of Graduate Students, APPIC, CCIDPIP, APA Div. 29 (Psychotherapy), APA's Education Directorate and JMU.

The approximately 30-person group examined the programs' similarities--all have a school psychology component--and differences, such as some covering multiple areas in an additive fashion versus others integrating them. A group of the programs resolved at the conference to continue the comparison of models with a multiprogram self-study in the near future.

Moreover, the conference participants drafted a mission for combined and integrated programs: to produce general practice and health-service psychologists who are competent to function in a variety of professional settings.

"The health-service psychologist piece is crucial," says Shealy, referring to recent legislation that authorizes professionals with the title "health-service psychologist" to receive federal funding from an array of programs. "We want to bring this model in line with what we are known as at a public level and clear up some of the confusion for the public and policy-makers."

In addition to a recommended name change for this type of doctoral program--from "combined doctoral program" to "combined and integrated doctoral program"--perhaps the most tangible outcome of the conference was a draft of principles that guide all combined and integrated programs, including:

  • Provide a unique educational model that affords students a breadth of training that increases their flexibility and marketability and prepares them for a wide variety of settings.

  • Expose students to two or more psychological practice areas, multiple theoretical orientations and the wide parameters of practice.

  • Provide an educational environment that facilitates effective intra- and interprofessional communication, training and scholarship in a manner that is respectful, collaborative and informed.

  • Support prominent student representation, be sensitive to the impact of required training on students and be aware of the interface among training, regulatory and licensing bodies.

The programs also agreed to specify competencies for their students, in part using competencies developed at the 2002 Competencies Conference (see February Monitor).

CCIDPIP plans to continue work on the principles as well as how the programs fit into other issues of the field--such as sequencing, standardizing the number of years to complete training and their interface with specialty training--at their next meeting, which is scheduled for APA's Annual Convention in August.

"We as a field need to look hard at the kinds of employment and professional opportunities we are creating for our students," says Shealy. "And the combined model of training would appear to be responsive to the need to open up the maximum number of employment and professional opportunities."

Further Reading

To attend the CCIDPIP meeting in August, contact Craig Shealy, PhD, at shealycn@jmu.edu. For more information about the consensus conference or combined and integrated programs, visit the CCIDPIP Web site.