The new Standards of Accreditation for Health Service Psychology, which will take effect in 2017, will be used to accredit psychology programs at the doctoral, internship and postdoctoral levels. APA's Council of Representatives overwhelmingly approved the standards at its February meeting.
The standards replace APA's Guidelines and Principles for Accreditation of Programs in Professional Psychologyopens in new window, which were adopted in 1995. Even though amendments were periodically made, the guidelines became outdated as psychology advanced as a discipline and profession, says Debora Bell, PhD, chair of APA's Commission on Accreditation and a psychology professor at the University of Missouri–Columbia.
"We went through extensive phases of public comment about what it means to be a psychologist in health-service psychology and what a psychologist should do," Bell says. During a three-year process, the 32-member commission received more than 1,200 pages of public comments and sought input at training councils, virtual town hall meetings and open forums at three APA Annual Conventions.
The commission used those comments to reach a consensus on nine core areas of competency that psychology programs must meet to be accredited. Those competency areas for students include research; ethical and legal standards; individual and cultural diversity; professional values, attitudes and behaviors; communication and interpersonal skills; assessment; intervention; supervision; consultation; and interprofessional/interdisciplinary skills.
"Most of the competencies that are covered aren't new," Bell says. "It's just a spotlight that we're shining on them."
The Commission on Accreditation will devise implementing regulations with specific definitions for each competency area. Application materials and training sessions will be developed so applicants will be familiar with the new standards, says Jacqueline Wall, PhD, director of APA's Office of Program Consultation and Accreditation. "The commission is working to develop procedures so programs will know the process to apply for program review under the new standards," she says.
Under the current accreditation guidelines, a program can describe how its training meets various goals or objectives, but the same core competency areas aren't necessarily taught in all programs, Bell says. "It made psychology programs very diverse, but it also made it very difficult for people to understand what it means to be a psychologist in health service psychology," she says. "Now the public and licensing boards will know what to expect."
Doctoral and internship programs are encouraged to be unique in the ways they approach the nine competency areas, and they can establish additional objectives for students, Bell says.
The new standards also include a shift in terminology from "professional psychology" to "health service psychology," defined as "the integration of psychological science and practice in order to facilitate human development and functioning." That language helps distinguish psychology as a health-service profession, which has become increasingly important with the passage of the Affordable Care Act and a move toward integrated care, Bell says.
"There are still a lot of laws written and decisions made where it seems like psychological health care is an afterthought," she says.
With the opening of more schools of "professional psychology," it also became confusing about what that term meant in terms of accreditation, Bell says. Professional psychology is more closely associated with PsyD programs, but APA accredits both PhD and PsyD programs in clinical, counseling and school psychology. Nationwide, there are more than 385 APA-accredited psychology doctoral programs, 496 internship programs and 107 postdoctoral programs.
In another important change, the new standards call for additional attention to how training programs make systematic, long-term efforts to attract and retain students and faculty from diverse backgrounds. Programs also must document how they evaluate the strengths and weaknesses of their diversity initiatives and make changes as needed.
A lack of diversity among both doctoral students and faculty is a pressing issue, according to 2013 data from the Commission on Accreditation. Of the more than 25,000 students in accredited U.S. doctoral programs, almost eight out of 10 students were female, and two-thirds were white. Only 7 percent of students were African-American, 7 percent were Asian and 11 percent were Hispanic. Faculty at accredited doctoral programs were fairly evenly split between women and men, but 78 percent were white, 6 percent were Hispanic, 4 percent were African-American and 4 percent were Asian.
The new accreditation standards also include a separate set of three competency levels for postdoctoral training programs because they offer more advanced training.
"The spirit of the new standards is to encourage innovation and best practices," says Steve McCutcheon, PhD, the Commission on Accreditation's associate chair for program review. "We recognize that there is great diversity in terms of educational approaches. We really made an effort to strike a balance between encouraging innovation in training while still providing a framework of basic quality indicators."
The first competency level includes training in integration of science and practice, cultural diversity and ethical issues. The training should focus on advanced practice relevant to the setting, population served and specialty area, says McCutcheon, director of psychology training at the Veterans Affairs Puget Sound Health Care System in Seattle.
The second competency level includes additional educational or training requirements set by the postdoctoral program itself, while the third level requires sufficient training to meet guidelines endorsed by the recognized specialty. For example, postdoctoral programs in clinical neuropsychology would need to comply with the Houston Conference guidelinesopens in new window.
The new accreditation standards also remove a requirement that postdoctoral programs be primarily service-oriented because that unintentionally constrained programs with a substantial focus on clinical research, McCutcheon says. Residencies or fellowships must still have a health-service psychology focus, but there is no specific requirement about how much training must be devoted to research or clinical work.
Overall, the new accreditation standards will provide a clear picture of the core training requirements for accredited psychology training programs across the country, Bell says.
"It will allow a firmer identity and firmer focus on what it means to be a psychologist in health-service psychology," she says.
Brendan L. Smith is a journalist in Washington, D.C.