In “Reimagining Clinical Psychologyopens in new window,” an article in Canadian Psychology/Psychologie Canadienne, Vina M. Goghari calls for clinical psychology to become a socially responsive health care profession exemplified by inclusive science and a diverse and just community—a transformation that would enable the field to provide better health care for all. In this article based on her invited companion paper to her Canadian Psychological Association Award for Distinguished Contributions to Education and Training in Psychology in Canada, Goghari describes her experiences and lessons learned as an educator and presents data and theoretical underpinnings for reimagining the field. She encourages current trainees and professionals to advocate for inclusion and to inspire new generations of students from underrepresented populations to view clinical psychology as a viable professional path.
Benefits of representation and equitable inclusion
Diversity in programs benefits students’ educational experience by contributing additional perspectives, creativity, and innovation, and by paving pathways for belonging and social and restorative justice between different groups. Clients from underserved groups benefit too (Glazer et al., 2014):
- Most patients from historically underrepresented groups are served chiefly by health care professionals from underrepresented groups; communication and cultural differences can limit health care providers’ competency in working with patients whose backgrounds differ from their own.
- Having diverse groups of students training as health care professionals increases the number of students who want to work with underserved populations.
Who is currently in our programs?
Clinical psychology programs should focus more on intersectional identities when recruiting trainees and faculty. In Canada, programs do not collect identity data in a systematic way, which makes assessing representation and progress difficult. What is known is that White women are overrepresented; thus, students from racialized groups are underrepresented (Callahan et al., 2018; Canadian Psychological Association, n.d.). Admissions procedures need to be reformulated to increase objectivity and standardization (Woo et al., 2021).
How are we training?
Inclusive science and knowledge systems. Clinical psychological science is largely rooted in positivist, quantitative, reductionist methods and ways of knowing. But psychologists’ training must encompass a wide array of knowledge traditions and push beyond enumerating Western “great men and great ideas” (Furumoto, 2003) to foreground the histories and contributions of women and individuals from racialized and other underrepresented groups.
Social justice and advocacy. Although most clinical psychology programs focus primarily on individual-level factors such as symptoms and diagnoses, the programs would benefit from focusing on system-level factors, the social locations of clients and professionals, social justice, and advocacy.
The primacy of research over clinical practice. The field needs to train more practicing clinical psychologists. Of the entire global health workforce, only 1% work in mental health, and just 7% of that group are psychologists (Bradley, 2019; Mikail & Nicholson, 2019). Although PsyD programs offer a wholly professional degree to prepare students for a primarily clinical career, Canada has shown very limited enthusiasm for creating PsyD programs, exemplified by its current total of only four accredited programs.
Recommended practices to support social responsiveness in clinical psychology programs
Promising recommendations under the domain of graduate admissions:
- Consider implementing holistic admissions, which include markers less biased by socioeconomic status (e.g., being a multilingual speaker, life experience).
- Specifically, consider clinical aptitude in selection and diversify the markers that address it.
- Limit the sole use of criteria (e.g., GPA, GREs, interviews) that represent conventional notions of “merit”.
- Have faculty from underrepresented groups partake in the adjudication of applications of students from underrepresented groups.
- Avoid “winner takes all” selection processes.
- Avoid selection processes that require students to conform to the norms of the dominant group.
- Collect data and evaluate your admissions processes.
Promising recommendations under the domain of curriculum, teaching, and professional development:
- Practice, and teach, cultural humility and reflexivity.
- Require humanities education.
- Conduct curriculum renewal to include perspectives of Indigenous peoples and other underrepresented groups.
- Teach the assumptions, strengths, and weaknesses of our own models of science and knowledge and teach other traditional models.
- Teach system-level factors: social locations of clients and professionals, social justice advocacy, diversity, and multiculturalism.
- Match students from underrepresented groups with faculty mentors from these groups (from outside program if need be).
- Diversify practicum opportunities.
- Prepare students for a variety of careers.
Promising recommendations under the domain of student and faculty equity and belonging:
- Build underrepresented student and faculty complements together.
- Conduct a program climate review prior to recruiting faculty and students.
- Create entrance awards for students from underrepresented groups.
- Collect (intersectional) identity data on students in the program to compare to admissions applicant data and regional population statistics (cohort size permitting).
- Over select for underrepresented groups in admissions, awards, and other selection processes.
- Honor that all underrepresented groups are different with their own needs for reconciliation.
Conclusion
Clinical psychologists need to cultivate reflexivity and cultural humility and to embrace lifelong reflection and learning. Positing that accreditation panels and professional organizations bear sole responsibility for improving the field’s social responsiveness reveals a failure to realize that those very positions are held by clinical psychologists. Clinical psychologists need to take up those roles, invite individuals from historically disadvantaged groups to meaningfully participate in and productively disrupt the field, and be accountable. Goghari ends her article on a hopeful note, observing that “through transforming ourselves, I have no doubt that we will correspondingly transform our field to become socially responsive.”
This article is in the Clinical Psychology topic area. View more articles in the Clinical Psychology topic area.