Annotated Bibliography PSY 502: Professional Issues in Psych

Annotated Bibliography PSY 502: Professional Issues in Psych

A Sample Answer For the Assignment: Annotated Bibliography PSY 502: Professional Issues in Psych

Title: Annotated Bibliography PSY 502: Professional Issues in Psych

Annotated Bibliography PSY 502: Professional Issues in Psych

As you see in the assignment description of the essay, you are required to cite the text chapter Training and Practice Issues-2.pdf Actions , one supplemental material, and two peer reviewed articles from your own research. Remember to utilize all available library tutorials on how to conduct a literature review and how to find peer reviewed research sources: https://lib.asu.edu/tutorials An annotated bibliography is similar to a reference list, except that each reference includes a brief summary of each article or other source that is included. You must summarize the articles in your own words. You also must be sure to read the entire article and give a summary of the entire article. Do not give into the temptation of reading and summarizing only the abstract of the article. • • Click HERE Links to an external site. for a longer, general explanation of an annotated bibliography and what it should entail. Click HERE Links to an external site. to see how to be sure to properly format your annotated bibliography in APA format, and to see an example annotated bibliography in APA style. Point Breakdown: The required text chapter is included. This source is properly summarized. A full, properly formatted APA-style citation is included: 3 points At least one relevant source from the course supplemental materials is included. This source is properly summarized. A full, properly formatted APA-style citation is included: 3 points At least two relevant articles from peer-reviewed journals are included. These sources are properly summarized. A full, properly formatted APA-style citation is included: 4 points Rubric Annt Bib Annt Bib Criteria This criterion is linked to a Learning Outcometext chapter This criterion is linked to a Learning Outcomesupp material This criterion is linked to a Learning Outcomepeer reviewed articles Total Points: 10 Ratings Pts 3 pts Excellent The required text chapter is included. This source is properly summarized. A full, properly formatted APA-style citation is included. 2.75 pts Very Good Almost all of the criteria for a score of “excellent” are met. 2.5 pts Good Most of the criteria for a score of “excellent” are met. 2.25 pts Fair Required text is included but not properly summarized and/or properly cited. 1.5 pts Poor Citation is missing and source is not properly summarized. 0 pts Missing 3 pts Excellent At least one relevant source from the course supplemental materials is included. This source is properly summarized. A full, properly formatted APA-style citation is included: 2.75 pts Very Good Almost all of the criteria for a score of “excellent” are met. 2.5 pts Good Most of the criteria for a score of “excellent” are met. 2.25 pts Fair A supplemental material is included but not properly summarized and/or properly cited. 1.5 pts Poor Citation is missing and source is not properly summarized. 0 pts Missing 4 pts Excellent Two peer reviewed articles are included. These sources are properly summarized. A full, properly formatted APA-style citation is included for each article. 3.75 pts Very Good Almost all of the criteria for a score of “excellent” are met. 3.5 pts Good Most of the criteria for a score of “excellent” are met. 3.25 pts Fair Articles are included but not properly summarized and/or properly cited. 1.75 pts Poor Citations are missing and sources are not properly summarized. 0 pts Missing 3 pts 3 pts 4 pts � ro Borrower: RAPID:AZS Call #: RC467 .N54 2021 ~ Lending String: Location: C Patron: 0 ro ~ iiiiiiiiiiO …0 .~ !!!!!!!!!!!! ~ ~ Cl) ~ � ~ ~ ~ ~ Volume: Issue: MonthlY ear: Pages: – Article Author: iiiiiiiiiiO iiiiiiiiiiO iiiiiiiiiiO !!!!!!!!!!!! iiiiiiiiiiO iiiiiiiiiiO iiiiiiii !!!!!!!!!!!! ~ ~ Journal Title: Introduction to clinical psychology: bridging science and practice. iiiiiiiiiiO 0 (W) It) U z CO I- ::E “C ~ ..J ns :,:j Shipping Address: NEW: Main Library Fax: This material may be protected by Copyright Law (Title 17 U.S. Code). ~ I Charge Maxcost: Article Title: Training and Practice Issues 0 ~ UMBC Library Stacks Folio On Shelf Imprint: ILL Number: !19074785 1111111111111111111111111111111111111111111111111111111 15 Training and Practice Issues in Clinical Psychology Contents Professional Training [478] Professional Regulation Professional Ethics [486] [490] Professional Independence [497] Professional Multicultural Competence The Future of Clinical Psychology [503] [509] Chapter Preview issues within petence. Based on historical and current forces in models for profes- the field, we also make predictions about where regulation, clinical psychology is heading in the future. This chapter describes professional clinical psychology, sional training, including professional professional independence, and multicultural ethics, com- We hope that the previous chapters have made it obvious that clinical psychologists take professional integrity very seriously. The field has changed significantly over the past 125 years, but the goals of helping people and furthering scientific understanding have remained intact for clinical psychologists worldwide. Relatively recent changes in the field, including the increasing need for mental health services, the proliferation of managed-care systems, expanding possibilities for prescription privileges for clinical psychologists, the focus on multiculturalism and diversity, and the intense focus and debate about evidence-based practice, all suggest that clinical psychology has entered a new era. The field looks very different today than it did just 30 years ago, and we expect it to continue changing over the next 30 years. The story of the changes taking place in clinical psychology has many subplots because the field has been shaped by several overlapping developments. Here, we focus on developments related to five main issues: 1. Professional training. What training does one need to become a clinical psychologist, and what are the options for obtaining it? 2. Professional regulation. What are the mechanisms for ensuring that a clinical psychologist possesses requisite skills and meets at least the minimum requirements to function professionally? 3. Professional ethics. What principles guide clinicians in determining the ethical standards for their profession? How is unethical behavior handled? 4. Professional independence. What is the relationship between clinical psychology and other mental health professions? 5. Professional multicultural competence. How has the field changed with regard to diversity and the need for multicultural competence? 477 478 I Training and Practice Issues in Clinical Psychology Professional Training Section Preview In this section, we discuss the historical and current of the doctor of psychology (Psy.D.) degree, and forces that have affected professional training in the clinical psychology. of A recent internship crisis is also discussed. These include a number establishment of various training models. national conferences on training, the development As described in Chapter 2, the first four decades of the 20th century saw little progress in the creation of advanced training in clinical psychology. For clinicians of that period, experience was not only the best teacher, it was practically the only one. It was not until the late 1940s that clinical psychology found a David Shakow (1901-1981) The Shakow Report set an early standard for clinical psychology training and remains, with surprisingly few exceptions, a standard against which modem clinical programs can be evaluated. (Source: Dipper Historic/ Alamy Stock Photo.) unique opportunity to establish its identity, expand its functions, and elevate its status. During and after Wodd War II, there was a dramatically increased need for mental health professionals (including clinical psychologists) who could work with combat veterans and their families, so when the Veterans Adrninistration and the U.S. Public Health Service announced that they would provide support for the training of graduate students in clinical psychology, clinicians focused their attention on what that training should involve. One of the most influential of these clinicians was Dr. David Shakow, chief psychologist at the W orchester State Hospital in Massachusetts, and leader of an AP A Committee on Training in Clinical Psychology that was charged with formulating a recommended clinical training program. The committee prepared a report entitled “Recommended Graduate Training in Clinical Psychology,” which was accepted by the American Psychological Association in September 1947 and published that same year in the AP A’s main journal, the American Psychologist (American Psychological Association, 1947). Of the many recommendations in the Shakow report, the three most important were that: 1. A clinical psychologist should be trained first and foremost as a psychological scientist, not just as a clinician. 2. Clinical training should be as rigorous as the training for nonclinical areas of psychology. 3. Preparation of the clinical psychologist should be broad and directed toward assessment, research, and therapy. The Shakow report suggested a year-by-year curriculum to achieve these goals in a 4-year time frame. Many of today’s clinical training programs Professional Training are based on that schedule, but it now usually takes about 6 years for students to complete all their training for a Ph.D. in clinical psychology, including the internship (Norcross & Sayette, 2018). The need for extra years arises because most programs require students to complete a master’s thesis (usually in the second year), some require full proficiency in statistics and research methods, and many require courses in specialty areas such as human diversity, substance abuse, health psychology, clinical child psychology, sexual problems, and neuropsychological disorders. The greatest impact of the Shakow report was to prescribe the special mix of scientific and professional preparation that has typified most clinical training programs ever since. This recipe for training-described as the scientist-professional model-was officially endorsed at the first major training conference on clinical psychology, which was held in Boulder, Colorado, in 1949 (Raimy, 1950). The Boulder Conference The Boulder Conference on Training in Clinical Psychology was convened with the financial support of the Veterans Administration and the U.S. Public Health Service, which asked the AP A to name the universities that offered satisfactory training programs, and to develop acceptable programs in universities that did not have them. Because the Boulder participants accepted the recommendations of the Shakow Report for a scientist-professional model of training, Shakow’s plan became known as the Boulder model. Participants at the Boulder Conference further agreed that there should be a mechanism for monitoring, evaluating, and accrediting clinical training programs and internship facilities. As a result, APA formed an Education and Training Board and a Committee on Accreditation that was charged with these tasks. That committee (now called the Commission on Accreditation) published training standards that clinical training programs have to meet in order to be accredited. The 2009 edition of these standards was called Guidelines and Principles for Accreditation of Programs in Professional Psychology (American Psychological Association, I 479 2009), and applied to general training in clinical, counseling, and school psychology. As of 2017, however, the APA Commission on Accreditation began using a new system, called Standards of Accreditation for Health Service Psychology (SoA; American Psychological Society, 2018f). The SoA does not list required courses and specific training experiences, but focuses instead on ensuring that accredited training programs are capable of graduating psychologists whose competencies will enable them to provide high-quality health-care services (Belar,2014). Currently, clinical training sites are visited by an AP A accreditation team about every 5 to 7 years, though the maximum interval can be 10 years. The results of accreditation site visits are published each year in the American Psychologist and can also be found online at the website of the APA Commission on Accreditation (www.apa.org/edJaccredit ation/programs/clinical.aspx). As of 2018, there were 405 active APA -accredited doctoral programs, 244 (60%) of which were in clinical psychology, 76 (19%) in counseling psychology, 70 (17%) in school psychology, and 15 (4%) in combined programs (American Psychological Association, 2018g). There are many other doctoral training programs that operate without APA accreditation, either because the program has not requested a site visit or because approval has not been granted after a visit (see Chapter 16 for more information about the importance of APA accreditation). The Boulder model remains the pivotal point for discussions of clinical psychology training today, but ever since its birth in 1949, some clinicians have not been happy with it. A number of alternative training models have been considered in several subsequent conferences, including the 1955 Stanford Conference (Strother, 1956), the 1958 Miami Conference (Roe et al., 1959), the 1965 Chicago Conference, and two especially important ones at Vail, Colorado in 1973 (Korman, 1976), and at Newark, Delaware in 2011 (Shoham et al., 2014). The Vail Conference With grant support from the National Institute of Mental Health (NIMH), the 1973 Vail Conference 480 I Training and Practice Issues in Clinical Psychology brought together representatives from a wide range of psychological specialties and training orientations, including graduate students and psychologists from various ethnic minority groups. Conference participants concluded that clinical psychological knowledge had advanced to a point that justified going beyond the Boulder model to create training programs with an emphasis on preparing students mainly for clinical practice. The conferees therefore officially recognized practice-oriented training as an acceptable model for departments of psychology that defined their mission as preparing graduate students to deliver clinical services. These “unambiguously professional” programs were to be given status equal to that of their more traditional scientist-professional counterparts. Thus began the new Doctor of Psychology degree, now known as the Psy.D. degree, which we describe later (Stricker, 2011). One of the most controversial of the Vail recommendations was that, like Ph.D.s, people trained at the master’s level should also be considered professional psychologists. The M.A. proposal was short-lived, as the APA voted that the title of psychologist should be reserved for those who have completed a doctoral training program. This policy remains in effect today, but it has come under intense attack as the number of M.A. psychology graduates continues to grow and as many states have allowed master’s-level clinicians to practice independently. Indeed, as described in Chapter 1, master’s-level clinical, counseling, and school psychology programs accept a higher percentage of applicants than doctoral-level programs do. Furthermore, three times as many students graduate with master’s degrees as with Ph.D.s (American Psychological Association, 2016a; Kohout & Wicherski, 2010). the training. of professional psychologists since the Vail conference. There was also a desire to reduce growing tensions between scientists and practitioners over numerous training and organizational issues. The participants passed 67 resolutions, the most important of which was that accredited clinical psychology training programs must expose their graduate students to a standard core of psychological knowledge, including research design and methods; statistics; ethics; assessment; history and systems of psychology; biological, social, and cognitive-affective bases of behavior; and individual differences (Bickman, 1987; see also a special issue of the American Psychologist, December 1987). The Delaware Conference The most recent training-related conference took place at the University of Delaware in October of 2011. It was convened in part because many clinical scientists felt that today’s clinical students are not being sufficiently prepared to address four key areas of clinical science, namely: (a) basic mechanisms of psychopathology; (b) intervention development; (c) efficacy and effectiveness research; and (d) the science of dissemination and implementation (Shoham et al., 2014). As mentioned briefly in Chapter 1, the upshot of the conference has become known as the Delaware Project. Its goals are to generate state-of-thescience training resources and recommendations relevant to knowledge generation across all stages of intervention development, not just to define a single standard model of clinical training. In other words, unlike the results of most other training conferences, the Delaware Project is aspirational rather than prescriptive and regulatory (Onken et al., 2014). You can learn much more about the Delaware Project at its website (www.delawareproject.org) . The Salt Lake City Conference The 6th National Conference on Graduate Education in Psychology was held in 1987, at the University of Utah in Salt Lake City. It was convened for several reasons, including the need to evaluate several changes that had taken place in Clinical Psychology Training Today What does training in clinical psychology look like after all these conferences, discussions, debates, and arguments among clinicians, Professional Training educators, and students? There is no easy answer because training can vary, but we can provide a general summary. First, the scientist-practitioner model has proven to be a tough competitor and is still reflected in more clinical psychology training programs than any other model (Klonoff, 2011). However, in light of conference recommendations, changes in APA accreditation guidelines, and the advent of accreditation offered through the Academy of Psychological Clinical Science (described below), many programs that favor the scientistpractitioner model are struggling to find the best way to train clinical psychologists so that their practical skills are well integrated with a solid foundation of scientific knowledge. Partly in reaction to what he saw as the continued disconnect between science and practice, Richard McFall (1991) wrote a “Manifesto for a Science of Clinical Psychology,” which highlighted the need for all practice to be research based. He argued that “scientific clinical psychology is the only legitimate and acceptable form of clinical Richard McFall His “Manifesto for a Science of Clinical Psychology” led to the founding of the Academy of Psychological Clinical Science. As of 2020, Academy members included 66 doctoral programs and 12 internship sites; you can see the latest list at the APCS website. (Source: With permission from Richard McFall.) I 481 psychology” (p. 76). Three years later, in 1994, McFall and other empirically oriented clinical psychologists formed the Academy of Psychological Clinical Science (APCS). Consistent with its empirical research focus, the Academy is housed within the Association for Psychological Science (APS) rather than the more practiceoriented American Psychological Association. The Academy, which is made up of graduate training programs committed to clinical science, was created in response to concerns that recent developments in health-care reform and licensure and accreditation requirements threaten to erode the role of science and empirical research in the education of clinical psychologists. Academy-accredited programs are committed to training students in interventions and assessment techniques based on empirical research evidence like that summarized in Chapter 7. Many of the faculty in these programs, and in other research-oriented clinical programs, became increasingly concerned by what they saw as a lack of rigor in the APA accreditation system’s standards for what constitutes scientific clinical research. They were also concerned that the long list of requirements that students must fulfill for a program to maintain AP A accreditation made it difficult for students to dedicate as much time to research as would be desirable. As a result, a subset of Academy member departments developed an accreditation system that was both more research-oriented and based more on educational outcomes rather than on meeting certain requirements. The result was the Psychological Clinical Science Accreditation System (PCSAS; Baker, McFall, & Shoham, 2009). The first clinical training program was accredited by PCSAS in 2009 and today there are 39, along with seven more that are being reviewed for accreditation. You can see the latest list at http://pcsas.org/. As of 2020, all of the programs accredited by PCSAS have also maintained their APA or CPA (Canadian Psychological Association) accreditation, but a number of programs have indicated that they may not seek to renew their AP A accreditation when it comes time for a reaccreditation review. Whatever they decide, it is clear that member programs of the Academy, the programs 482 I Training and Practice Issues in Clinical Psychology in the United States, at Adelphi University. Then, in 1970, the first freestanding, non-universitybased professional school of psychology was established as the California School of Professional Psychology (CSPP), with campuses in Los Angeles and San Francisco (Benjamin, 2005). Some practice-oriented programs are still housed in university psychology departments, but many more are to be found in freestanding professional schools of psychology. At some freestanding schools, including the CSPP, students can study for a Ph.D., but most of them offer only the Psy.D. degree. The Psy.D. programs offered at most professional schools provide training that concentrates on the skills necessary for delivering a range of assessment, intervention, and consultation services. In most cases, a master’s thesis is not required, nor is a research-oriented dissertation, although some Dr. Varda Shoham (1948-2014) was a champion of the kind of written, doctoral-level report is usually clinical science model. She worked tirelessly to promote required. Psy.D, graduates are more likely than this model through service in the Society for a Science Ph.D. graduates to be employed in independent of Clinical Psychology, the Academy of Psychological practice, managed care, and other health service Clinical Science, and the Psychological Clinical Science settings (Norcross & Sayette, 2018). Accreditation System. (Source: Supplied with permission by Michael J. Rohrbaugh, PhD) The number of APA -accredited Psy.D. programs continues to grow. As of 2019, there were 93 of them (American Psychological Association, accredited by the PCSAS system, and their faculty 2019b). This is far fewer than the 312 APAare playing critical roles in moving the field of accredited Ph.D. programs, but Psy.D. programs clinical psychology toward a more scientific, enroll far more students than do practice-oriented, evidence-based orientation (McFall, 2012). research-practice, or research-oriented Ph.D. programs (Norcross, Ellis, & Sayette, 2010). Because of these larger enrollments, more students are graduProfessional Schools and the Doctor ating each year from Psy.D. programs than from of Psychology (Psy.D.) Degree Ph.D. programs (Sayette, Norcross, & Dimoff, As suggested by the existence of two different 2011). One reason why Ph.D. programs tend to accreditation systems, the last several decades have fewer students is that, unlike Psy.D. programs, have seen the creation of graduate programs with they tend to provide Significant financial aid to differing philosophies about how to train clinmost or all of those they admit (Norcross, Ellis, & icians (Norcross, Kohout, & Wicherski, 2005). Sayette, 2010). Another reason is that, compared to Some emphasize training in clinical science more Ph.D. programs, Psy.D. programs tend to admit than clinical practice, others take the opposite students with lower mean grade point averages approach, and still others try to balance the two. (GPA) and Graduate Record Exam (GRE) scores As we mentioned in Chapter 2, proposals to (McFall, 2006; Templer, 2005). emphasize practice over research in clinical There is a great deal of heterogeneity among psychology training appeared as early as 1917. Psy.D. training programs (Norcross et al., 2004), However, it was 1951 before the first universityso it is difficult to make general statements about based professional school of psychology appeared them. However, there are a number of troubling Professional Training I 483 thus provides about equal emphasis on research features associated with freestanding Psy.D. proand application to practice. This model is grams that are not as prevalent in university-based common in traditional university Ph.D. proPsy.D. programs. For one thing, the higher acceptgrams and in some professional schools. ance rates and lower admission criteria at free• The practitioner-scholar model, which follows standing schools reflect their status as profitthe Vail conference recommendations and thus making organizations, where, compared to universtresses human-services delivery while placing sities with tighter fiscal controls, it is easier for proportionately less emphasis on scientific mismanagement of funds to occur. Such mismantraining. This model is most commonly seen in agement contributed to the 2019 collapse of Argosy professional schools and many Psy.D. programs. University, one of the largest professional schools of psychology in the United States, many of whose programs had previously been offered through the As you might expect, graduates of the practitionerscholar model spend the least time doing clinical American School of Professional Psychology. research, while graduates of clinical scientist proRegardless of where Psy.D. programs are housed, their students are slightly less likely-91.3 vs. grams spend the most time in that activity (Cherry, 94.7%-than those of Ph.D. programs to be Messenger, & Jacoby, 2000; McFall, 2012). This pattern raises serious concerns among clinical sciaccepted into APA -accredited internship programs entists, who argue that the training provided by (Association of Psychology Postdoctoral and Internships Centers, 2019). Graduates of Psy.D. professional schools does not prepare graduates to properly evaluate the quality of the clinical research programs also tend to score lower than Ph.D. prothey read. These critics point out that clinicians’ gram graduates do on the Examination for Profesability to identify high-quality research designs sional Practice in Psychology, a licensing exam opens the surest path to advancing their knowledge described later in this chapter. Psy.D. graduates and promoting evidence-based clinical services are also less likely to qualify for a specialty diploma (McFall et al., 2015). from the American Board of Professional For their part, advocates of professional school Psychology (also discussed later). In short, gradutraining have concerns about research-oriented ates ofPsy.D. programs, especially those from protraining. They point out, for example, that only grams housed in freestanding professional schools, about half of the faculty who teach graduate stuare less likely overall to have the most distinguished dents in Ph.D. training programs are engaged in career outcomes. So although there are some strong clinical work themselves, even though most of them Psy.D. programs, given their variability, prospective have a license to do so (Himelein & Putnam, 2001; students must be careful to select one whose graduMeyer, 2007). So practice-oriented clinicians worry ates tend to experience good outcomes. that research-oriented programs provide their graduate students with too little appreciation of, Clinical Psychology Training Models or training in, the realities of clinical practice. In short, advocates of the clinical scientist As described in Chapter 1, three main models of model want clinical psychology to develop as a clinical psychology training have emerged from research specialty focused on investigating the conferences such as those held in Boulder and origins, assessment, and treatment of psychoVail (Klonoff, 2011): pathology. Those advocating the practitioner• The clinical scientist model, which grew out of scholar model want the field to develop as an applied profession devoted to clinical service. the Academy of Psychological Clinical Science Ironically, most clinicians think that the approach and places heavy emphasis on scienscientist-practitioner model is a good idea, at tific research. This model is most commonly least in theory (Grus, McCutcheon, & Berry, followed in university settings. • The scientist-practitioner model, which follows 2011). In practice, however, clinical psychologists often fail to integrate science and practice in their the Boulder conference recommendations and 484 I Training and Practice Issues in Clinical Psychology day-to-day work, partly because the incentive systems operating in their workplaces make such integration difficult. For instance, university psychology departments seldom offer support or incentives for clinical faculty who wish to work with clients in a part-time private practice or in a nonprofit clinical setting (Overholser, 2007, 2010), and it is increasingly difficult for clinical psychologists without postdoctoral experience to become licensed while holding an academic position (DiLillo et aI., 2006; Kaslow & Webb, 2011). Conversely, few independent practice clinicians have the time or resources to conduct the kind of research that is published in scholarly journals (Overholser, 2010). These differing reward structures can reinforce attitudes and behaviors that further split the field into practitioners and researchers. So it seems that the Boulder model is a good idea that has been difficult to fully implement (Belar, 2000; Grus, McCutcheon, & Berry, 2011). Evaluating Clinical Psychology Training Philosophical differences aside, what do we know about the comparative clinical effectiveness of graduates from the various training models! Not much. Most of the research comparing different training models focuses on the time students or professionals spend in various activities, where they are employed, how much they publish, or how they view the training they received. There is scant information about whether different training models ultimately lead to different outcomes in treating clients. This situation is unfortunate, because the ultimate goal of clinical psychology training is to produce scientists and practitioners whose work will reduce the burden of mental disorders (Levenson, 2017). We believe that clinical training programs should be evaluated not in terms of specific courses or requirements, but in light of whether they produce clinicians who are competent at performing the professional functions that their work demands. We think that in teaching these technical competencies, training programs should emphasize assessment and treatment methods that have been supported by empirical evidence; they should not offer training in methods or services that have not garnered such support. Indeed, to us, the key elements in training are teaching graduate students how to: (a) evaluate and choose assessment and treatment methods on the basis of high quality research evidence; and (b) directly evaluate the effectiveness of the treatment being provided to each client. Outcome monitoring at the individual client level is especially important when there is minimal applicable research evidence. We believe that if clinical training moves too far from its foundation in psychological science and teaches therapy techniques, assessment methods, and other professional skills without regard for their empirical support, clinical psychologists will become narrowly specialized practitioners for whom research is of only passing interest. If that happens, clinical psychology will become a poorer science and, ultimately, a weaker profession. The Internship Imbalance No matter their location or training model, almost all graduate programs in clinical psychology require their students to complete a full-time, l-year clinical internship. The overwhelming majority of APA-accredited programs require that this internship also be one that is APA-approved. The coordinating entity for matching graduate students to internships in the United States and Canada is APPIC, the Association of Psychology Postdoctoral and Internships Centers. Graduate students submit applications for internships through APPle’s website, usually in November, and in early December applicants are invited for interviews which take place from mid-December to early February. In the second week of February, applicants submit a rank-ordered list of the internships they desire and training directors at the internship sites submit a rank-ordered list of the applicants they prefer. These rankings are processed by a computer that is programmed to match applicants to internship settings in a way that maximizes the desired outcome for both. The results are revealed on a national “match” day, usually in late February. A second round of computerized matching is conducted later to help nonmatched applicants find unfilled internship slots. The internship requirement has been in place for decades, but an internship imbalance arose Professional Training over the past decade as the numbers of graduate students in clinical psychology has grown and the number of internship slots shrank due to funding problems (Hatcher, 2011a, b; McCutcheon, 2011). For example, in 2012, there were 915 applicants who were not matched to any type of internship, and the problem was even worse for the APAI CPA-approved internship settings that are required by most APAICPA-accredited graduate programs. The match rate for internship applicants from those programs was only 53.3 percent in 2012. Because the internship application cycle occurs only once a year, failing to be matched is a serious impediment to nonmatched students’ ability to complete their training. I 485 Various task forces, advocacy groups, and scholarly discussions have addressed what had become the internship crisis (Grus, McCutcheon, & Berry, 201l). As a result, efforts are being made to obtain more federal funds for psychology training, develop more internship slots, decrease the number of students enrolled in graduate programs, and prepare students to be more competitive internship applicants. These efforts seem to have helped, because in 2019, only 3.1 and 6.3 percent of clinical psychology students from Ph.D. and Psy.D. programs, respectively, were not matched (see Match Statistics at appic.org). It will be crucial to keep an eye on these figures in the coming years to ensure that the matching situation continues to improve. In Review I Professional Training Major Clinical Training Conferences Major Recommendations Boulder (1949) Adopt Shakow Report: Training should be for a Ph.D. that emphasizes research and science as central to clinical training. Vail (1973) Practice-oriented training with less emphasis on research is acceptable (supported legitimacy of the Psy.D. degree). Delaware (2011) Training should focus on conducting clinical science as well as on dissemination and implementation of clinical science findings. Clinical Training Models Essential Features Clinical scientist Strong emphasis on scientific research; commonly found in university settings. Scientist practitioner Approximately equal emphasis on research and practice; commonly seen in traditional Ph.D. programs and in some professional schools. Practitioner scholar Strong emphasis on human-services delivery; places less emphasis on scientific training; very common in professional schools and many Psy.D. programs. Test Yourself 1. The training model is advocated for by the Academy of Psychological Clinical Science. 2. The model follows the training recommendations 3. The model follows the recommendations of the Vail conference. of the Boulder conference. You can find the answers in the Answer Key at the end of the book. 486 I Training and Practice Issues in Clinical Psychology Professional Regulation Section Preview This section highlights the reasons for certification the and licensure in clinical psychology and delineates certification A major responsibility of any health-care or human-services profession is to establish standards of competence that members of the profession must meet before they are authorized to practice. The primary purpose of such professional regulation is to protect the public from unauthorized or incompetent practice of psychology by impostors, the untrained, or psychologists who are unable to function at a minimum level of effectiveness. Unlike in other areas of life, caveat emptor (“let the buyer beware”) does not provide adequate protection, because the “buyers” seeking mental health services may not be sufficiently aware of who is qualified to offer those services and who is not. Accordingly, clinical psychology in the United States and Canada has developed an active system of professional regulation. certification. To distinguish between certification and licensure, remember the following rule of thumb: Certification laws dictate who can be called a psychologist, while licensing laws dictate both the title and the services that psychologists may offer. Professional regulation In clinical psychology, establishing standards of competence that must be met in order to be authorized to practice. Certification and Licensure The most important type of regulations are state laws that establish requirements for the practice of psychology and/or restrict the use of the term psychologist to people with certain qualifications. This legislative regulation comes in two kinds of statutes: certification and licensure. Certification laws restrict use of the title psychologist to people who have met requirements specified in the law. Certification protects only the title of psychologist; it does not regulate the practice of psychology. Licensure is a more restrictive type of statute. Licensing laws define the practice of psychology by specifying the services that a psychologist is authorized to offer to the public. The requirements for licensure are usually more comprehensive than for processes required to obtain both. ABPP is also described. Certification Professional regulation through laws that limit the title psychologistto people who have met certain requirements specified in the law. Licensure Professional regulation through laws that define the services that a psychologist is authorized to offer. All 50 states, the District of Columbia, and all Canadian provinces have certification or licensure laws. In many U.S. states, certification and licensure laws are combined in a single statute. Licensing laws are administered by state boards of psychology, which are charged by state legislatures to regulate the practice of psychology. These state boards of psychology perform two major functions: • determining the standards for admission to the profession and administering procedures for selecting and examining candidates, and • regulating professional practice and conducting disciplinary proceedings involving alleged violators of professional standards. The steps involved in becoming licensed differ somewhat from place to place, but there is enough uniformity across most U.S. states to offer a rough sketch of the process (see Table 15.1). Currently, the Association of State and Provincial Psychology Boards (ASPPB) coordinates the activities of the state boards of psychology and attempts to bring about uniformity in standards and procedures. ASPPB has developed a standardized, objective test for use by state boards in examining candidates for Professional Regulation I 487 Table 15.1 So You Want to Be a licensed Psychologist? Imagine you have just completed a doctoral program in clinical psychology and you wish to become a licensed clinical psychologist. Here are the steps that are required in most states. First, you must ask the state board of psychology to review your credentials to determine your eligibility for examination. Their decision will be based on several criteria: 1. Administrative Requirements. You must have reached a certain age and must not have committed any felonies, engaged in treason, or libeled your state governor. These activities are judged to be indicative of poor moral character and may leave you plenty of time to fantasize about licensure while in prison. 2.Education. Most states require a doctoral degree in psychology from an accredited university, meaning one that has been approved by a recognized accrediting agency. However, many states require that you have graduated from an APA-or PCSAS-accredited training program. You will have to provide official graduate and undergraduate transcripts to show that you have met educational requirements. It is not unusual for state boards to request additional documentation to demonstrate that you have the requisite coursework, including syllabi and reading lists. 3. Experience. This requirement usually amounts to multiple years of supervised professional experience in settings approved by the board. In most states, some of the experience must be postdoctoral; letters of reference will be required from your supervisor( s). If, after scrutinizing all of your credentials, the board finds that you are eligible for examination, you will be invited to take one or more examinations. Most states use the EPPP national examination, which until 2020 had been a multiple-choice exam consisting of 225 questions covering general psychology, methodology, applications of psychology, and professional conduct and ethics. The ASPPB now uses an enhanced, two-part version. Part I focuses on content knowledge, whereas Part II focuses on professional skills. The test is available online throughout the year at various websites (see www.asppb.org, where you can also keep up with the latest news about the test). In some states, if you want to practice a specialty such as clinical, school, or industrial psychology, you will be required to take additional tests of your knowledge of content, ethics, laws, and regulations in these areas. The fee for taking the EPPP is $600 per part, for a total of $1200. Fees for having a state board review your credentials range from $50 in Illinois to $733 in Florida; the average is between $200 and $300 (DiLillo et al., 2006; Matthews & Matthews, 2009). The state board may also require that you take and pass an oral examination that covers any and all material relevant to psychology and clinical psychology. If you pass all these tests-congratulations!!! Now you have the right to call yourself a psychologist, practice your specialty, and pay for rather expensive malpractice insurance. No really, congratulations!! If you fail any part of the examination process, you will have a chance to retake that portion. Most boards feel that twice is enough, however; so if you fail again, it might be time to consider another career path. licensure. First established in 1964 and revised frequently since then, this Examination for Professional Practice in Psychology (EPPP) is sometimes called the national exam because all jurisdictions can use it as a part of their examination procedure. Though required for licensing, passing this test does not by itself guarantee competence. There is no firm evidence that EPPP scores are valid for predicting the quality of a candidate’s clinical work (Sharpless & Barber, 2009). In most states, a person must meet all other licensure requirements before being eligible to take the EPPP. EPPP (Examination for Professional Practice in Psychology) A standardized, objective test for use by state boards in evaluating candidates for licensure. These other requirements include having certain kinds of graduate training and clinical internship experiences. In a number of states, only graduates 488 I Training and Practice Issues in Clinical Psychology of APA-accredited doctoral programs may be licensed, which makes a student’s choice about where to go for graduate training particularly important (see Chapter 16). Psychology doctoral graduates in most states must complete postdoctoral supervised activities in order to be eligible for licensure. These activities can include direct clinical practice, research, teaching, consulting, and the like, but in most states the work must consist of 1500 to 4000 hours under the close supervision of a licensed psychologist (Prinstein, 2013). Postdoctoral positions can be AP A-accredited ones, but many psychologists receive their postdoctoral training where they take their first job (Matthews & Matthews, 2009). In most states, too, psychologists are required to keep their license or certification up to date by paying a periodic renewal fee and by documenting their involvement in continuing education (CE). The number of required continuing education hours varies across states; the range is 20 to 40 per 2-year licensing cycle (Neimeyer, Taylor, & Philip, 2010). Many participants report that CE activities gave them new knowledge and increased their effectiveness as practitioners (Neimeyer et al., 2019), but some observers wonder about how valid these reports are and whether state licensing board requirements focus too much on the number of CE hours and not enough on the quality of what’s going on during those hours (Cox & Grus, 2019; Washburn et al., 2019). Reciprocity of Licensure. Because licensing laws vary among states, there is not much reciprocity from one to another. This means that someone licensed as a psychologist in one state cannot automatically transfer that licensure to another state. This situation greatly limits professional mobility for licensed psychologists, whether they are just starting their careers or simply wishing to move to another state later on (Matthews & Matthews, 2009). There are even bigger obstacles to retaining one’s licensure in other countries (Hall & Lunt, 2005). There has been enough concern about the lack of reciprocity among states that, in 2010, the American Psychological Association updated its Model Act for State Licensure of Psychologists (Clay, 2010). Among other things, the revised model licensure act attempts to set consistent standards that would make it easier to move one’s license from state to state. The Model Act suggests that one way of doing that would be for states to stop requiring all professional experience hours to be postdoctoral hours. Instead, states could allow licensure applicants to satisfy the state’s required training hours either in their predoctoral program or through a combination of predoctoral and postdoctoral work (Schaffer, DeMers, & Rodolfa, 2011). The Model Licensing Act is intended to make licensure more manageable and more movable, but in order for it to be of maximum benefit to psychologists wishing to relocate, it will have to be adopted by many, if not all, states (Clay, 2010). To date only 17 states allow applicants to count pre-internship hours towards licensure. The APA, the ASPPB, and the National Register of Health Service Providers in Psychology (known as the National Register) continue to work to increase licensure reciprocity, but it has proven to be a challenging task (Hall & Boucher, 2008). One potentially useful resource for psychology license applicants are “credential banks” that allow applicants to submit their credentials online and then apply for licensure in multiple states if they wish (Matthews & Matthews, 2009). Further, licensed psychologists who have at least 5 years of professional experience, who have no professional disciplinary actions filed against them, and who meet certain other requirements can apply for a Certificate of Professional Qualification in Psychology through ASPPB. This certificate can be useful in seeking licensure in a state other than the one in which the person was originally licensed (Robinson & Habben, 2003). Similarly, certification through the National Register or achieving diplomate (pronounced “DIP-plo-mate”) status through the American Board of Professional Psychology (ABPP; see next section) may give practicing psychologists more mobility across state lines (Hall & Boucher, 2008). A surprisingly large number of graduate students and early career psychologists do not know very much about the licensing processes we have described. For example, one study of nearly 4000 doctoral psychology graduate students found that although 92% of them planned to apply for licensure, 60% of that group had not yet begun looking into licensure requirements (Hall, Wexelbaum, & Boucher, 2007). In addition, over 75% of those wishing to be licensed Professional Regulation were unfamiliar with credentialing organizations such as ASPPB and the National Register (Hall, Wexelbaum, & Boucher, 2007). The same pattern holds true among early career psychologists who were actually seeking licensure! A study of over 1800 such individuals found that less than 10% reported being very familiar with ASPPB and the National Register (Hall & Boucher, 2008). Obviously, greater efforts are needed within the profession to familiarize graduate students and early career psychologists with the facts they need to know about obtaining licensure and improving their chances for professional mobility. I 489 Table 15.2 Diplomas awarded by the American Board of Professional Psychology ABPP Certification Licensed clinical psychologists can seek another type of professional recognition, namely certification by the American Board of Professional Psychology (ABPP). This national organization was founded in 1947 to certify the professional competence of psychologists and to grant them diplomas in one of the 16 specialty-specific areas in psychology listed in Table 15.2. Although it carries no special legal authority, an ABPP diploma is considered more prestigious than licensure. That’s because whereas licensure signifies a minimal level of competence (and is required before seeking a diploma), diplomate status is an endorsement of professional expertise, an indication that the person possesses a masterful knowledge of some specialty field. Accordingly, requirements for the ABPP diploma are more rigorous than for licensure. Depending on the Achieving diplomate status in one of the specialty areas listed here is a sought-after distinction among many professional psychologists. Behavioral and cognitive Clinical Clinical child and adolescent Clinical health Clinical neuropsychology Cognitive and behavioral Counseling Couple and family Forensic Geropsychology Group Organizational and business consulting Police and public safety Psychoanalysis Rehabilitation School specialty area, multiple years of experience are a prerequisite to even take the ABPP examination, which is conducted by a group of diplomates who observe the candidate dealing directly with clinical situations (e.g., giving a test or interacting with a therapy client) and who conduct an oral examination that includes the following related topics: professional knowledge, assessment competence, intervention competence, interpersonal competence with clients, ethical and legal standards and behavior, commitment to the specialty and awareness of current issues, and competence in supervision and consultation (Kaslow, Graves, & Smith, 2012). More information about ABPP diplomate status can be found at www.abpp.org. In Review I Professional Regulation Types of Regulation Description State certification Restricts use of the title psychologist to people who have met requirements of a certification law. Defines practice of psychology; specifies the services psychologists are authorized to offer. State licensure Regulation Agencies Description Association of State and Provincial Psychology Boards (ASPPB) Coordinates activities of state boards of psychology with the aim of bringing about uniformity in standards and procedures. 490 I Training and Practice Issues in Clinical Psychology (cont.) Regulation Agencies Description State boards of psychology Determine standards for licensure or certification and conduct disciplinary hearings in cases of alleged violation of standards. American Board of Professional Psychology (ABPP) A national organization that awards diplomas in specialty areas to particularly well-qualified professional psychologists. Test Yourself 1. The latest version of the EPPP tests both and 2. Professional mobility can be impaired by limits on created by differences in state licensing regulations. 3. In most states, licensed psychologists are required to participate in activities every year in order to retain their licenses. You can find the answers in the Answer Key at the end of the book. Professional Ethics Section Preview We have mentioned the APA Ethical Principles of Psychologists and Code of Conduct in several other chapters. Here we describe how this Ethics Code is organized, how its standards are implemented, Ethical Standards of the American Psychological Association The APA’s Ethical Principles of Psychologists and Code of Conduct, or Ethics Code for short, consists of a Preamble, a set of General Principles, and a large number of specific Ethical Standards (American Psychological Association, 20 lOb, c, 2017). The Preamble and General Principles describe the highest ideals to which psychologists aspire, and provide guidance to psychologists who are evaluating what would be ethically desirable behavior in certain situations. The Preamble provides an overview of the ethics code: Psychologists are committed to increasing scientific and professional knowledge of behavior and people’s understanding of themselves and others and to the use of such knowledge to improve the condition of and how ethical violations are reviewed and acted upon. We also discuss professional malpractice and malpractice litigation. individuals, organizations, and society. Psychologists respect and protect civil and human rights and the central importance of freedom of inquiry and expression in research, teaching, and publication. They strive to help the public in developing informed judgments and choices concerning human behavior. In doing so, they perform many roles, such as researcher, educator, diagnostician, therapist, supervisor, consultant, administrator, social interventionist, and expert witness. This Ethics Code provides a common set of principles and standards upon which psychologists build their professional and scientific work. (American Psychological Association,2017a) The five General Principles of the Code include: • Principle A: Beneficence and Nonmaleficence. The essence of this principle is that psychologists should “do no harm.” Professional Ethics Principle B: Fidelity and Responsibility. This principle states that psychologists must be trustworthy and uphold the highest ethical standards in their professional relationships. o Principle C: Integrity. This principle encourages psychologists to remain accurate, honest, and truthful in their professional work. o Principle D: Justice. This principle focuses on the need to treat all individuals, but especially clients, fairly and justly. • Principle E: Respect for People’s Rights and Dignity. This principle highlights the need for psychologists to treat individuals with the utmost respect for their dignity and individual freedoms. o These General Principles set the tone for psychologists to maintain the highest ethical standards as described in the Code. Unlike the General Principles, the AP A Ethical Standards are legally enforceable. They apply to all members of the APA and may be used by other organizations, such as state boards of psychology and the courts, to judge and sanction the behavior of a psychologist, whether or not the psychologist is an AP A member. The ethical standards are organized under the following ten headings: 1. Resolving Ethical Issues. This section contains standards about how psychologists are to resolve ethical questions or complaints. 2. Competence. The standards in this section state that psychologists must be trained in their specific area of expertise and that they must continue to keep current in their field in order to maintain competence. This section also addresses the issue of when psychologists have personal problems or conflicts that limit their ability to practice in a competent manner. 3. Human Relations. These standards deal with such topics as preventing unfair discrimination, sexual or other harassment, multiple relationships, conflict of interest, providing informed consent, and avoiding termination of clinical services when it is not in the best interest of the client. 4. Privacy and Confidentiality. This section covers psychologists’ obligations to protect I 491 their clients’ rights to confidentiality and privacy. 5. Advertising and Other Public Statements. These standards control the way psychologists publicize their services and how their professional credentials are presented. 6. Record Keeping and Fees. This section provides guidance on documenting professional work, maintaining and disposing of confidential records, setting fees and other financial arrangements, and making and receiving referrals. 7. Education and Training. This section contains several ethical standards that control psychologists’ conduct as they teach and supervise students. 8. Research and Publication. Standards that control psychologists’ research activities are included in this section. They address topics such as receiving approval from an Institutional Review Board before conducting research, obtaining voluntary informed consent from human research participants, debriefing participants, providing publication credit for coauthors, sharing research data, and conducting reviews of scholarly work. 9. Assessment. This section lists rules pertaining to the use and interpretation of tests. 10. Therapy. Here, you will find rules about the structuring, conduct, and termination of therapy. Specific standards prohibit psychologists from having sexual intimacies with current clients, or the relatives and significant others of current clients and from accepting as clients anyone with whom they have had previous sexual intimacies. Psychologists should also not have sexual intimacies with former therapy clients for at least 2 years after the termination of therapy, and even then only if the psychologist can demonstrate that no exploitation of the client has occurred. APA Ethical Standards Legally enforceable statements about what constitutes ethical and unethical behavior by psychologists in ten specific domains. 492 I Training and Practice Issues in Clinical Psychology Implementation of Ethical Standards Most psychologists take great pains to deal with complex and ethically ambiguous situations in accordance with the highest standards of professional conduct. But because many situations involve moral and cultural questions and do not match exactly the terminology used in the AP A Ethics Code, there is often no single, clearly best course of action, no obviously right answer. Consider Table 15.3, for example, which describes situations in which a therapist is in both a professional and a nonprofessional role with a client. Multiple relationships are considered unethical because they can harm the therapeutic relationship, create a conflict of interest, and ultimately harm the client. Do you think that is true in these cases? How do psychologists manage such ethical problems? They begin by always remaining aware of acceptable and unacceptable practices within their area of professional activity. Other steps to minimizing the risk of unethical behavior include establishing proper informed consent procedures, release of information forms, and case documentation systems (Knapp, Bennett, & VandeCreek, 2012). Professionals can also refer to numerous handbooks and casebooks to gain a broader perspective on how other professionals have handled cases similar to the one at hand (e.g. Barnett & Johnson, 2008; Campbell et al., 2010; Knapp, 2012a, b, 2013; Nagy, 2010; Pope & Vasquez, 2016). Consultation with colleagues and professional organizations is also permitted as long as confidentiality can be maintained (or a release of information obtained from clients). Finally, many malpractice insurance companies provide consultation to clinician-policyholders who are seeking clarification on ethical and legal issues. Although taking these steps does not render psychologists immune from malpractice suits or other legal actions, they do reflect a conscientious effort to do the right thing, and documentation of those efforts is likely to be looked upon favorably by professional organizations and courts. Dealing with Ethical Violations When, as fallible human beings, psychologists behave in an ethically questionable manner, they are subject to censure by local, state, and national Table 15.3 Three Examples of Potentially Unethical Behavior • Take a minute and jot down some reasons why, or why not, the psychologist in each of the following cases might be guilty of unethical behavior. Case 1. A therapist has been seeing a 45-year-old man for over a year for problems related to stress and anxiety. The client recently lost his job as an office administrator because the company went bankrupt, and he is looking for work. At the same time, the therapist is in need of an office assistant and records clerk, and she has had a hard time finding someone who meets her high standards. She knows that the client received rave reviews as an office assistant. She hires him to be her records clerk and continues to see him professionally. Case 2. A therapist is treating a 38-year-old woman who has endured the painful breakup of a long-term relationship. The client mentions that she loves dogs and that she finds great comfort in their company. The therapist happens to be an avid dog lover as well, and she raises and breeds border collies as a hobby. The therapist mentions that she has a new litter of puppies that are ready for new homes, and the client purchases one of them from the therapist, Case 3. A cognitive behavior therapist is the only one in his small town who specializes in treating clients with anxiety disorders. A 63-year-old man calls this therapist for help with severe agoraphobia, but he has a limited income and no insurance, so he can afford to pay for only one session. During that session, the therapist learns that the client is an expert carpenter. The therapist offers to treat the client in exchange for carpentry services. The client accepts the offer and builds a set of bookshelves in the den of the therapist’s home. (Adapted from Bersoff 2008.) Professional Ethics organizations whose task it is to deal with violations of ethical practice. Clients or other individuals who believe that a psychologist has been involved in wrongdoing can file a formal complaint with the AP A and/or the state psychology board. Fortunately, the number of such complaints against clinical psychologists is relatively small, but may allege multiple reasons; the vast majority of APA’s nearly 120,000 members never have a formal complaint filed against them (Nagy, 2010). In 2017, only one complaint was deemed serious enough for the AP A Ethics committee to pass it on to the AP A Board of Directors for review. In 2018, the Ethics Committee conducted preliminary investigations of only 11 cases, none of which led to further action (Childress-Beatty, personal email communication, 2019). Formal complaints against psychologists can be made by anybody, including clients and colleagues. The nature of the complaints vary, but as shown in Table 15.4, they typically involve allegations of unprofessional or negligent practice, sexual misconduct, dual relationships with clients, being convicted of a crime, improper record keeping, breach of confidentiality, and fraud-especially as related to inappropriate insurance billing (Knapp, Bennett, & VandeCreek, 2012; Pope & Vasquez, 2016). When a claim of unethical behavior by an AP A member is judged by a state or national disciplinary committee to be true, some form of punishment will be imposed. The most severe AP A sanction is to dismiss the offender from the association and to inform the membership of this action. Unethical conduct can also result in the state psychology board suspending or permanently rescinding the offender’s professional license. Less severe consequences can include censure or censure with probation. As we describe later, clients or others can also seek legal and financial sanctions by filing lawsuits under a state’s professional malpractice laws. Other Ethical Standards The AP A Ethical Principles of Psychologists and Code of Conduct is not the only one that applies I 493 Table 15.4 Top 10 Reasons for Disciplinary Actions Against Psychologists The cases summarized here represent complaints filed against psychologistsfrom 1974 to 2019 that resulted in disciplinary actions (multiple reasons in each case). Reasonfor Disciplinary Action Number Disciplined Unprofessional conduct 1,040 Sexual misconduct 997 Negligence 736 Nonsexual dual relationship 649 Conviction of crime 565 Failure to maintain adequate or accurate records 441 Failure to comply with continuing education or competency requirements 398 Incompetence 368 Improper or inadequate supervision or delegation 315 Substandard or inadequate care 293 Other (the combined total of the 76 remaining reasons) 4,625 Source: ASPPBDisciplinaryData System,https://www .asppb.net/page/DiscStats to the activities of psychologists. Clinical psychologists in particular are responsible for knowing about these other standards. As we have mentioned in other chapters, clinicians must follow numerous general and specialty guidelines when conducting research, performing assessments and psychotherapy, and working with particular categories of clients. Examples include Guidelines for Psychological Practice with Lesbian, Gay, and Bisexual Clients (American Psychological Association, 20l2a), Guidelines for Psychological Practice with Transgender and Gender Nonconforming People (American Psychological Association, 2015a), Guidelines for Assessment of and 494 I Training and Practice Issues in Clinical Psychology Intervention with Persons with Disabilities (American Psychological Association, 2012b), Guidelines for Psychological Practice with Girls and Women (American Psychological Association, 2007b), and Guidelines for Psychological Practice in Health-Care Delivery Systems (American Psychological Association, 2013c). Therapists, especially those working in medical settings or who bill insurance companies for their services, must follow additional rules and regulations. The Health Insurance Portability and Accountability Act (HIPAA) was established by the Department of Health and Human Services in order to protect the confidentiality of information about clients and to deal with other issues regarding insurance reimbursement (Nagy, 2011). Therapists who bill insurance companies also must register for a National Provider Identifier, which is another component of the HIP AA regulations (Munsey, 2007). Regulation Through State Laws The APA’s ethical principles are usually consistent with state laws, but not always, so it is usually best for the psychologist to follow the more stringent of the two (American Psychological Association, 201Ob). For example, whereas the APA ethical standards allow consensual sexual contact between therapists and their former clients 2 years after termination of the therapeutic relationship (as long as no harm can be reasonably expected to be done to the client as a result), many states forbid any sexual contact between therapists and their former clients, ever. Psychologists who live in a state that forbids such contact in perpetuity would be wise to follow the state law rather than to presume that the less stringent AP A ethical code would protect them from criminal prosecution (Pope & Vasquez, 2011). Duty to Warn. In addition to prohibiting certain conduct, some state laws require clinical psychologists to do certain things, even if-under special circumstances-it means violating normal ethical standards. For example, therapists normally keep clients’ information strictly confidential, but what if clients reveal that they plan to harm someone? This was the question raised in the case of Tarasoff vs. Regents of the University of California (reviewed in Nagy, 2010), and the answer has turned out to be yes, at least in some states. Here are the facts of the case: In 1969, Prosenjit Poddar, a student at the University of California-Berkeley, sought therapy through the student mental health services center. During a therapy session, Mr. Poddar told his psychotherapist, Dr. Lawrence Moore, that he intended to kill a young woman, Tatiana Tarasojf, who had apparently rejected his attempts to have a romantic relationship. The therapist informed his superior, Dr. Harvey Powelson, of this threat. The campus police were called and were also asked, in writing, to confine the client. They did so briefly, but then released him after concluding that he was rational, and they believed his promise that he would stay away from the Tarasoffs home. He did not do so. After terminating his relationship with his therapist, Mr. Poddar killed Ms. Tarasoff. He was later convicted of murder. No one had warned the woman or her parents of the threat. In fact, Dr. Powelson had asked the police to return Dr. Moore’s letter and ordered that all copies of the letter and Dr. Moore’s therapy notes be destroyed. Ms. Tarasoffs parents sued the University of California-Berkeley, the psychologists involved in the case, and the campus police to recoverdamagesfor the murder of their daughter. Ultimately, the Supreme Court of California found in favor of the parents. Through this ruling, Ms. Tarasoffs parents helped to change mental health laws throughout the United States. (Ewing & McCann, 2006) In reaching its decision, the court weighed the importance of confidentiality in therapy relationships against society’s interest in protecting itself from dangerous people. The balance was struck in favor of society’s protection. As stated in the Court’s judgment, “The protective privilege ends where the public peril begins.” The Tarasoff decision created a duty to warn the potential victims about clients whom a therapist believes, or should believe, are dangerous. The warning is mandatory in 27 states and Puerto Rico, whereas in 17 other states and the District of Columbia, warnings are permitted but not required. In a few states, duty to warn laws either do not exist or vary by profession (Adi & Professional Ethics Mathbout, 2018; Soulier, Maislen, & Beck, 2010). The rules continue to change, though, such that psychologists who fail to stay up to date about the laws regulating psychology in their state may not fully understand the conditions under which they might be held liable for not warning people who might be the target of a dangerous act by their client. Even in California, where the duty to warn originated, there is now only a duty to act to protect (Weinstock et al., 2014). So, a therapist can still warn the police and the target of a client’s threat, but if doing so is judged to make the client even more dangerous, the therapist can take alternative protective actions. If, as happens now and then, the potential target may be the client’s therapist, or former therapist, making the ethical issues especially complex and difficult (Erickson Cornish et al., 2019). Regardless of the details, therapists face a chilling dilemma in such cases because, as we mention in Chapter 3, it is exceedingly difficult to be sure when a client’s threats are genuine and when they are harmless. Duty to warn A therapist’s obligation or option to notify potential victims about potentially dangerous clients. Regulation Through Malpractice litigation The conduct of clinical psychologists can also be regulated through civil lawsuits brought by clients who allege they have been harmed by the malpractice of those professionals. If a jury agrees with the client’s claim, the clinician may be ordered to pay the client monetary damages to compensate for the harm. Four elements must be I 495 established in order to prove a claim of professional malpractice, namely that: 1. A special professional relationship (I,e., service in exchange for a fee) existed between the client/plaintiff and the clinician/defendant. 2. The clinician was negligent in treating the client. Negligence involves a violation of the standard of care, defined as the treatment that a reasonable practitioner facing circumstances similar to those of the plaintiffs case would be expected to give. 3. The client suffered harm. 4. The clinician’s negligence caused the harm suffered by the client. Fewer than 2% of clinicians will ever be sued for malpractice during their professional careers, a figure that has remained relatively stable for many years and is much lower than for medical specialists in obstetrics, emergency medicine, surgery, or radiology (Knapp, Bennett, & VandeCreek, 2012). At one time, the most common allegation in successful malpractice lawsuits was that the psychologist failed to prevent a client’s suicide (Scott & Resnick, 2006), but that has now changed. Today, successful malpractice lawsuits are most likely to allege that the psychologist provided ineffective treatment, failed to consult with other psychologists to better serve their clients, or did not refer clients to other therapists when they were not able to provide effective services (Pope & Vasquez, 2011; see Table 15.5). Some of the largest damage awards have come in a few instances in which therapists were accused of influencing clients to falsely recall supposedly repressed memories of physical or sexual abuse in childhood. Here is a famous case example: Gary Ramona-once a highly paid executive in the California wine industry-sued family counselor Marche Isabella and psychiatrist Richard Rose for planting false memories of trauma in his 19-year-old daughter, Holly, when she was their patient. Ramona claimed that the therapists told Holly that her bulimia and depression were caused by having been repeatedly raped by him when she was a child. They also told her that the memory of this molestation was so traumatic that she had repressed it for years. According to Ramona, Dr. Rose then gave Holly sodium amytal (a so-called truth serum) to confirm her “recovered memory.” Finally, Isabella was said to have told 496 I Training and Practice Issues in Clinical Psychology Holly’s mother that up to 80% of all bulimics had been sexually abused (a statement for which there is no scientific support). At the trial, the therapists claimed that Holly suffered flashbacks of what seemed to be real sexual abuse. She also became increasingly depressed and bulimic after reporting these frightening images. Holly’s mother, Stephanie, who divorced her husband after Holly’s allegations came to light, testified that she suspected her husband had abused Holly and listed several pieces of supposedly corroborating evidence. Gary Ramona denied ever sexually abusing his daughter. Dr. Elizabeth Loftus, a cognitive psychologist and leading critic of aggressive memory therapy, testified that therapists often either suggest the idea of trauma to their clients or are too uncritical in accepting the validity of trauma reports that occur spontaneously. It appeared that Holly’s memory had been so distorted by her therapists that she no longer knew what the truth was. The jury found that Holly’s therapists had planted false memories in her and, in May 1994, awarded Gary Ramona $500,000. Since then, several other “false memory” cases have been successfully filed against therapists, in Wisconsin, Pennsylvania, Minnesota, and Illinois resulting in multimillion dollar judgments against therapists who had “found” their patients’ lost memories (False Memory Syndrome Foundation, 2016; Heller, 2011; Loftus, 1998). The best way for clinical psychologists and other mental health professionals to decrease their risk of being named in a malpractice lawsuit is to act with the highest level of professional integrity and avoid violating any ethical standards or laws governing mental health treatment (Knapp 2012a, 2012b). This is exactly what the vast majority of clinicians do. Table 15.5 Most Common Sources of Professional Liability Claims Against Psychologists The fact that most malpractice lawsuits involve claims of ineffectivetreatment underscores the need for therapists to be educated about and competent at providing the types of evidence-based practices discussed in Chapters 7 and 9. Source of Alleged Malpractice Percent of Cases Ineffective treatment/failure to consult/failure to refer 29 Failure to diagnose/improper 16 diagnosis Custody dispute 10 Sexual intimacy/sexual harassment and/or sexual misconduct 9 Breach of confidentiality 8 Suicide 4 Supervisory issues, conflict of interest or improper multiple relationships 3 Libel/slander, conflicts in reporting sexual abuse, licensing dispute 2 Abandonment, premises liability, repressed memory, failure to monitor, countersuits resulting from fee disputes, client harmed others including homicide, business disputes, miscellaneous liability claims, discrimination/harassment Source: Adapted from Pope, K. S., & Vasquez,M. J. T. (2011). Ethics in psychotherapy (4th ed.). Hoboken, NJ: Wiley. 1% each and counseling: A practical guide Professional Independence I 491 In Review I Professional Ethics Sources of Ethical Standards or Regulations Content or Role APA Ethics Code A preamble, five general principles, and ten sets of ethical standards. APA Ethics Committee (national) Considers cases in which violation of standards is alleged; decides on punishment if warranted. State psychology boards Consider cases in which violation of standards is alleged; decides on punishment if warranted. APA general and specialty guidelines Provide guidance for conducting research, performing assessments and psychotherapy, and working with particular categories of clients. Health Insurance Portability and Accountability Act (HIPAA) Sets rules and regulations for clinicians in medical settings or who bill insurance companies. State malpractice laws Establish rules by which psychologists accused of professional misconduct are judged in civil damages cases. Test Yourself 1. The of AP A’ s Ethical Principles of Psychologists and Code of Conduct are legally enforceable. 2. The deciding whether it is ethical to reveal a client’s threat against a third party is complicated by the difficulty of 3. Clinicians may consult with other professionals about the ethics of particular cases as long as they can protect their client’s You can find the answers in the Answer Key at the end of the book. Professional Independence Section Preview In this section, we tell the story of how clinical psychologists gained the right to practice psychotherapy independently and the right to receive insurance coverage for mental health services that are comparable to that given for medical services. The story includes the impact of changes in the economics of mental health service delivery and the various ways in which psychologists can earn a living. We conclude the section by describing the controversy over clinicians’ right to prescribe medication. As we mentioned in Chapter 1 and elsewhere, clinical psychologists often consult and collaborate with many other professionals. They work closely with educators, attorneys, religious leaders, social workers, nurses, physicians, and psychologists in other subfields. For the most 498 I Training and Practice Issues in Clinical Psychology part, psychology’s interprofessional relationships are healthy, profitable, and characterized by goodwill. The most obvious sign of this harmony is the frequency of referrals made across groups. Unfortunately, though, interprofessional relationships are not always so cordial. As described in Chapter 2, clinical psychology’s most persistent interprofessional problem has been its wary, often stormy, relationship with the medical profession. Early disputes revolved around the role of psychologists as diagnosticians and treatment providers. More recently, the squabbles have concentrated on psychologists’ eligibility for reimbursement under prepaid mental health plans and on efforts by some psychologists to gain the right to prescribe medication for their clients. Although these controversies are related, we examine them in separate sections so as to clarify the development of each. The Economics of Mental Health Care Having won battles over licensure by the 1950s, and recognition of psychology as an independent profession in the 1970s and 1980s, clinicians turned to struggles involving the economic aspects of mental health care that existed back then. The initial focus of these struggles was whether psychologists should be eligible for insurance reimbursement for their services. Psychologists began lobbying state legislatures to pass freedom-of-choice laws, which mandate that services rendered by qualified mental health professionals licensed to practice in a given state shall be reimbursed by insurance plans covering such services regardless of whether the provider is a physician or a psychologist. By 1983, 40 states covering 90% of the U.S. population had passed freedom-of-choice legislation so that licensed psychologists were reimbursable providers of mental health services (Lambert, 1985). Additional legislation at the federal level promoted recognition of psychologists as independent clinicians. The Rehabilitation Act of 1973 (PL 93-112) provided parity (i.e., equal coverage) for both psychologists and physicians in assessment and treatment services. In 1996, another federal law prevented insurance companies from providing lesser coverage for mental health as opposed to physical health services (Munsey, 2007). Clinical psychologists saw this law as a step in the right direction, but despite its name -the Mental Health Parity Act-there were still a number of limits to parity. It took 12 more years of discussions by policy makers, health-care administrators, psychologists, and other mental health professionals, before Congress passed the more comprehensive Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act. Because its goal is similar to that of the earlier law, this act is also commonly known as the Mental Health Parity Act. It took effect in 2010 (McConnell et al., 2012) and requires insurance companies to provide the same coverage for mental health disorders as they do for physical illnesses (Fritz & Kennedy, 2012). As a result, psychologists and other mental health service providers finally gained professional independence through equality in reimbursement for their work. Parity for mental health services applies to all insurance companies and third-party payers, including those that offer managed-care programs (Gasquoine, 2010). These programs were developed as a means of allocating health services to a group of people in order to provide the most appropriate care while still containing the overall cost of service. Organizations that offer these plans typically provide specific packages of health-care services to subscribers for a fixed, prepaid price. The Mental Health Parity Act applies to all these programs, but it does not allow payment for unlimited mental health services, or services offered by just any licensed professional. So insurance companies and managed-care systems have established insurance panels, which are lists of professionals who have been approved to provide services for reimbursement (Goodheart, 2010). In addition, as with medical procedures, mental health services still require utilization reviews for both privately and publicly funded systems (Clay, 2011b). Thus, like medical doctors, most psychotherapists are bound by certain procedural guidelines (e.g., only a certain number of therapy sessions are preapproved for the cognitive behavioral treatment of depression) Professional Independence and may have to request preapproval before delivering some services. Often the approval for these services is based on their effectiveness, so as mentioned in Chapter 7, utilization reviews constitute yet another reason that so many mental service health providers are focused on learning and using evidence-based practices. Independent Practice As discussed in Chapter 1, the financial rewards available to independent service providers in clinical psychology can be substantial. In 2015, the median annual salary for all doctoral-level clinical psychologists was $80,000, but was $85,000 for those in direct service jobs, and $120,000 for those in private practice (American Psychological Association, 20I7b). As also noted in Chapter 1, the job market for clinical psychologists is expected to grow at faster-than-average rates, by about 14% from 2016-2022 (Bureau of Labor Statistics, 2018). There are three main models for independent practice (Walfish & Barnett, 2009): • Solo practice-The clinician owns the entire practice and is responsible for everything, including renting and decorating office space, purchasing assessment instruments, advertising, billing, and the like; • Group practice-Two or more clinicians join forces and offer services together, usually sharing the costs of the office, office staff, equipment, and the like. Large group practices often hire associates, who either work for a fixed salary or who receive a percentage of the income they generate from their clients; • Mixed-model practice-Two or more clinicians work together, as in a group practice, but they are legally and financially independent. For example, one clinician may simply rent space in the offices of another clinician. In deciding which of these models of independent practice is best, clinicians must consider where their strengths and passions lie. Do they prefer to conduct assessments with young children, provide preventive interventions for at-risk youth, I 499 help couples work through separation and divorce, deal with adult eating disorders, help older adults with end-of-life issues, or what? Which practice model will best allow the pursuit of these interests? Clinicians must also remember that independent practices are small businesses, so in addition to considering the things they are good at and what they enjoy doing, psychologists must also consider whether there is a market for their services and if so, how to succeed in that market (Walfish & Barnett, 2009). Reimbursement rates for clinical services vary widely-depending on whether the fees are coming from public health-care programs (such as Medicare or Medicaid) or from private insurance companies and managed-care programs (such as Blue Cross/Blue Shield or Humana). These rates also depend on geographic region (Gasquoine, 2010), so psychologists must consider the financial feasibility of opening a practice in their area of specialty and in their location. Prescription Privileges Though some aspects of medical and psychological practices have become more integrated, clinical psychologists and the medical profession remain at odds over the prescription privileges movement. This movement would allow specially trained clinical psychologists to prescribe psychotropic medication as well as offer psychotherapy. Prescription privileges movement Efforts to allow specially trained clinical psychologists to prescribe psychotropic medication for their clients. Advocates of prescriptive authority point to several reasons that it should be granted. For one thing, surveys indicate that 98% of psychologists have referred a client to a psychiatrist or physician for psychotropic medication; 75% of them make such referrals on a monthly basis; and approximately one out of three clients of psychologists is taking psychotropic medication (Meyers, 2006). Thus, medication already is a frequent aspect of many clinical psychologists’ practice. Further, many psychologists are 500 I Training and Practice Issues in Clinical Psychology concerned about clients’ inability to gain access to psychiatrists and qualified primary care physicians. Allowing psychologists to prescribe medication, they say, will increase continuity of care and the quality of services available to clients from ethnic or racial minority backgrounds, those of low socioeconomic status, and those living in rural or geographically isolated areas (Linda & McGrath, 2017). In 1996, the APA Council of Representatives voted to support clinical psychologists’ efforts to seek prescriptive authority. An AP A Ad Hoc Task Force on Psychopharmacology suggested that most of the training necessary for obtaining prescription privileges could be conducted at the postdoctoral level. The Council also recommended model legislation to be introduced in states where psychologists are seeking prescriptive authority, as well as a model postdoctoral curriculum (covering neurosciences, pharmacology, physiology, physical and laboratory assessments, and clinical pharmacotherapeutics) to be used in training prescribers (McGrath, 2010). The medical profession is not the only faction opposed to prescription privileges for clinical psychologists; it is a controversial proposal within psychology, too. Although many psychologists support prescription privileges for properly trained clinicians (McGrath & Sammons, 2011), others are worried that existing training for this activity is far less extensive than it is in other health professions and thus might be inadequate to assure client safety (see Figure 15.1). In fact, recent proposals for training psychologists to prescribe have dropped the prerequisite coursework in the biological and physical sciences that had been identified as necessary by the APA’s Ad Hoc Task Force (Robiner, Tumlin, & Tompkins, 2013). Some of those who are alarmed by such changes argue that psychologists who want to prescribe medication should complete formal training as physicians or other medical professionals. Others are concerned that prescription privileges would lead to an increasingly intense focus on the medical and biomedical aspects of behavior, behavior disorder, and treatment, with a consequent loss of clinical psychology’s traditional focus on important psychosocial, environmental, cognitive, and behavioral factors that help to explain and treat disorders (Levine & Schmelkin, 2006). They remind us that “if you give someone a hammer, then everything looks like a nail,” meaning that if psychologists have prescriptive authority, every client’s problems might seem to require drug treatment rather than psychotherapy. Despite strong arguments from inside and outside psychology that prescription privileges for clinicians could be dangerous to clients and detrimental to the profession (Tumlin & Klepac, 2014), as of2020, state legislatures in Iowa, Idaho, Illinois, New Mexico, and Louisiana have passed laws allowing specially trained clinical psychologists to prescribe. Prescriptive authority is also allowed for psychologists in the territory of Guam, in the military, and in the Indian Health Service (American Psychological Association, 20llb). Over half of the other states have considered and rejected prescription privileges bills. Would clinical psychologists in these other states apply for prescriptive authority if it were available? The answer is unclear. One survey suggested that clinical interns and training directors who favor prescriptive authority would seek prescriptive authority (Fagan et al., 2004), but even when it is legal, psychologists may not find it to be attractive. One study found, for example, that only 5% of nurse psychologists chose to seek prescriptive authority and were actually prescribing (Wiggins & Wedding, 2004). And in New Mexico and Louisiana, where psychologists are eligible for prescriptive authority, very few psychologists are seeking the training necessary to attain it (Munsey, 2008; Tompkins & Johnson, 2016). This apparent lack of interest in pursuing prescription privileges greatly undercuts the argument that prescriptive authority will lead to improved access and enhanced patient care. So whether or not prescriptive privileges for psychologists are eventually granted throughout the United States, most professionals agree that those psychologists should proceed cautiously as they consider this important option in their training and practice. I 501 Professional Independence II Practicum o Didactic or didactic plus praeticum D Undergraduate prerequisites 200 180 160 140 f!2 ” 120 iw 100 0 .c; E w (f) 80 60 40 20 a e e ;;; ;; :E ~ 0 a;- u, Q> 0 c jll m a; .c E 0 ‘mm U ~ C. ~ c ~ z- Q; c :2m Q> s: c, Z enen ~ 0 0 0 % 0 f!2 ” >- on ‘”‘” ~ ‘” c» on

 

As we begin this session, I would like to take this opportunity to clarify my expectations for this course:

Please note that GCU Online weeks run from Thursday (Day 1) through Wednesday (Day 7).

 

Course Room Etiquette:

• It is my expectation that all learners will respect the thoughts and ideas presented in the discussions.
• All postings should be presented in a respectful, professional manner. Remember – different points of view add richness and depth to the course!

 

Office Hours:

• My office hours vary so feel free to shoot me an email at [email protected] or my office phone is 602.639.6517 and I will get back to you within one business day or as soon as possible.
• Phone appointments can be scheduled as well. Send me an email and the best time to call you, along with your phone number to make an appointment.
• I welcome all inquiries and questions as we spend this term together. My preference is that everyone utilizes the Questions to Instructor forum. In the event your question is of a personal nature, please feel free to post in the Individual Questions for Instructor forumI will respond to all posts or emails within 24 or sooner.

 

Late Policy and Grading Policy

Discussion questions:

• I do not mark off for late DQ’s.
• I would rather you take the time to read the materials and respond to the DQ’s in a scholarly way, demonstrating your understanding of the materials.
• I will not accept any DQ submissions after day 7, 11:59 PM (AZ Time) of the week.
• Individual written assignments – due by 11:59 PM AZ Time Zone on the due dates indicated for each class deliverable.

Assignments:

• Assignments turned in after their specified due dates are subject to a late penalty of -10%, each day late, of the available credit. Please refer to the student academic handbook and GCU policy.
• Any activity or assignment submitted after the due date will be subject to GCU’s late policy
• Extenuating circumstances may justify exceptions, which are at my sole discretion. If an extenuating circumstance should arise, please contact me privately as soon as possible.
• No assignments can be accepted for grading after midnight on the final day of class.
• All assignments will be graded in accordance with the Assignment Grading Rubrics

Participation

• Participation in each week’s Discussion Board forum accounts for a large percentage of your final grade in this course.
• Please review the Course Syllabus for a comprehensive overview of course deliverables and the value associated with each.
• It is my expectation that each of you will substantially contribute to the course discussion forums and respond to the posts of at least three other learners.
• A substantive post should be at least 200 words. Responses such as “great posts” or “I agree” do notmeet the active engagement expectation.
• Please feel free to draw on personal examples as you develop your responses to the Discussion Questions but you do need to demonstrate your understanding of the materials.
• I do expect outside sources as well as class materials to formulate your post.
• APA format is not necessary for DQ responses, but I do expect a proper citation for references.
• Please use peer-related journals found through the GCU library and/or class materials to formulate your answers. Do not try to “Google” DQ’s as I am looking for class materials and examples from the weekly materials.
• I will not accept responses that are from Wikipedia, Business com, or other popular business websites. You will not receive credit for generic web searches – this does not demonstrate graduate-level research.
• Stay away from the use of personal pronouns when writing.As a graduate student, you are expected to write based on research and gathering of facts. Demonstrating your understanding of the materials is what you will be graded on. You will be marked down for lack of evidence to support your ideas.

Plagiarism

• Plagiarism is the act of claiming credit for another’s work, accomplishments, or ideas without appropriate acknowledgment of the source of the information by including in-text citations and references.
• This course requires the utilization of APA format for all course deliverables as noted in the course syllabus.
• Whether this happens deliberately or inadvertently, whenever plagiarism has occurred, you have committed a Code of Conduct violation.
• Please review your LopesWrite report prior to final submission.
• Every act of plagiarism, no matter the severity, must be reported to the GCU administration (this includes your DQ’s, posts to your peers, and your papers).

Plagiarism includes:

• Representing the ideas, expressions, or materials of another without due credit.
• Paraphrasing or condensing ideas from another person’s work without proper citation and referencing.
• Failing to document direct quotations without proper citation and referencing.
• Depending upon the amount, severity, and frequency of the plagiarism that is committed, students may receive in-class penalties that range from coaching (for a minor omission), -20% grade penalties for resubmission, or zero credit for a specific assignment. University-level penalties may also occur, including suspension or even expulsion from the University.
• If you are at all uncertain about what constitutes plagiarism, you should review the resources available in the Student Success Center. Also, please review the University’s policies about plagiarism which are covered in more detail in the GCU Catalog and the Student Handbook.
• We will be utilizing the GCU APA Style Guide 7th edition located in the Student Success Center > The Writing Center for all course deliverables.

LopesWrite

• All course assignments must be uploaded to the specific Module Assignment Drop Box, and also submitted to LopesWrite every week.
• Please ensure that your assignment is uploaded to both locations under the Assignments DropBox. Detailed instructions for using LopesWrite are located in the Student Success Center.

Assignment Submissions

• Please note that Microsoft Office is the software requirement at GCU.
• I can open Word files or any file that is saved with a .rtf (Rich Text Format) extension. I am unable to open .wps files.
• If you are using a “.wps” word processor, please save your files using the .rtf extension that is available from the drop-down box before uploading your files to the Assignment Drop Box.

Grade of Incomplete

• The final grade of Incomplete is granted at the discretion of the instructor; however, students must meet certain specific criteria before this grade accommodation is even possible to consider.
• The grade of Incomplete is reserved for times when students experience a serious extenuating circumstance or a crisis during the last week of class which prevents the completion of course requirements before the close of the grading period. Students also must pass the course at the time the request is made.
• Please contact me personally if you are having difficulties in meeting course requirements or class deadlines during our time together. In addition, if you are experiencing personal challenges or difficulties, it is best to contact the Academic Counselor so that you can discuss the options that might be available to you, as well as each option’s academic and financial repercussions.

Grade Disputes

• If you have any questions about a grade you have earned on an individual assignment or activity, please get in touch with mepersonally for further clarification.
• While I have made every attempt to grade you fairly, on occasion a misunderstanding may occur, so please allow me the opportunity to learn your perspective if you believe this has occurred. Together, we should be able to resolve grading issues on individual assignments.
• However, after we have discussed individual assignments’ point scores, if you still believe that the final grade you have earned at the end of the course is not commensurate with the quality of work you produced for this class, there is a formal Grade Grievance procedurewhich is outlined in the GCU Catalog and Student Handbook.