Focus on Doctoral Clinical Training:

The State of the Program – 2008

James H. Johnson, PhD, ABPPMarch 28, 2008

Dept. of Clinical and Dept. of Clinical and Health Psychology: An Health Psychology: An

OverviewOverviewMission StatementMission Statement

The Department of Clinical and Health Psychology educates tomorrow’s leaders in Psychology in the scientist-practitioner [and clinical science] tradition, advances psychological science, and improves the health and quality of life of people through excellence in research, education, and health service delivery.

Department of Clinical and Department of Clinical and Health PsychologyHealth Psychology

Doctoral Training in Clinical Psychology

• Models of Training– Scientist-Practitioner (First Accredited in 1953)– Clinical Science (Fall 2007)– Internship Program (First Accredited in 1963)

• Administratively Unique– Only program of its type in country with Scientist-

Practitioner and Clinical Science programs that are physically located in Health Science Center but administratively outside of COM

Department of Clinical and Health Psychology

• Academically Diverse– Areas of Concentration

• Clinical Child/Pediatric Psychology• Clinical Health Psychology• Neuropsychology, Neurorehabilitation, and Clinical

Neuroscience• Emotion, Neuroscience, and Psychopathology• Others as arranged with doctoral committee

(Forensic, Aging )

– Faculty also display diversity in terms of specific areas of expertise and theoretical orientation

“Center of Excellence” ModelClinical Child/Pediatric Area

-specialty plus general training-integrated research/clinical/didactic training

PCITADHD

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Obesity

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“Center of Excellence” Model

Health Psychology Area

-specialty plus general training

-integrated research/clinical/didactic training

Women’sHealth

andInfertility

Epilepsy

Aging

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Dementia

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“Center of Excellence” Model

NNCN Area

-specialty plus general training

-integrated research/clinical/didactic training

Providing Broad & General TrainingWith Opportunities for Specialization

• General Psychology Foundations Core (Focus on broad and general training)

• Clinical Psychology Core• Required research (First year project; dissertation)• Required clinical practica (both core and

advanced)• Advanced electives• Area of Concentration (or Selected Minors)

– Coursework– Advanced specialty practica

• APA-accredited internship

General Program Timetable

Average time to Completion = 6.1 Years

• Year 1…………………• Year 2…………………

• Year 3…………………..

• Year 4…………………..

• Year 5…………………

• Core (Including First Year

Project)

• MS degree, practica, begin AOC, electives

• Complete practica, AOC, qualifying exam

• Apply for internship, dissertation work, finish electives

• Internship

With Cutting Edge Opportunities to Train for

the Future• Recently Developed Course

Offerings– Analysis of Change– Advanced writing seminar– Evidence Based Practice

• Recent Program Initiatives– New opportunities for undergraduate

teaching• Introduction to Clinical Child and Pediatric Psychology• Introduction to Clinical Psychology• Introduction to Health Psychology• Introduction to Clinical Neuropsychology• Psychiatric Disorders

General Program Aims

• Prepare Students to -– Function as a licensed professional psychologist– Practice competently in the areas of

assessment, intervention, and consultation– Take a scholarly evidence-based approach to

clinical activities– Contribute to the advancement of knowledge

through research and creative scholarship– Participate in leadership and advocacy positions

within professional psychology

Focusing on Goals and Competencies

• Goal #1: Prepare students with a broad and general foundation in the science of psychology and a broad and general foundation of coursework representing the underpinnings of the profession of Clinical Psychology

• Competencies Expected: – Develop knowledge reflecting the science base of psychology

(e.g., Cognitive Bases of Behavior, Survey of Social Psychology, Survey of Developmental Psychology, Higher Cortical Functioning, History of Psychology,

– Measurement, Research Design and Statistical Analysis I & II) and– Core/professional areas of Clinical Psychology (e.g., Introduction

to CLP: Professional Issues and Ethics, Clinical Psychological Assessment, Lifespan Psychopathology, Psychological Treatment I)

Focusing on Goals and Competencies

• Goal #2: Prepare students to– 1) independently contribute to the knowledge base of clinical

psychology through original research work and– 2) to use the results of published research to inform clinical practice.

• Competencies Expected:– Competencies in critically evaluating the literature in areas of research

interest;– developing research questions that can be subjected to empirical test,– competencies in experimental design, subject recruitment, statistical

analysis, interpretation of findings, writing up research findings for publication and presentation, and

– developing skills in grant writing.– An additional expectation is the development of competencies in using

empirically based research findings to inform clinical practice activities.

Focusing on Goals and Competencies

• Goal #3: Prepare students with sufficient knowledge and skill-based competencies in clinical activities to allow them to– compete successfully for admission to APA approved internship

placements,– to obtain licensure, and– to have entry level skills for the independent practice of psychology.

• Competencies Expected: – competencies in conducting diagnostic interviews with

children/adolescents/parents and adults,– the administration, scoring, and interpretation of commonly used

evidence-based measures of development, intelligence, achievement, adaptive behavior, and personality/behavioral.

– competencies in the evidence-based treatment (predominately cognitive-behavioral in nature) of children, adolescents and adults displaying a broad range of psychological/behavioral difficulties.

– In addition, students are expected to develop competencies in the consultation with physicians, other health care professionals, and adults and children (and their families) displaying a wide range of health related problems.

Focusing on Goals and Competencies

• Goal #4: Prepare students with knowledge and skills to enable them to make specialty-specific professional contributions through participation in a formally defined clinical research and/or practice area that builds on prior broad and general training in clinical psychology.

• Competencies Expected:– students pursuing specialty training in the above areas will

develop clinical (e.g., assessment, intervention, consultation) and research competencies in working with

• specific age groups (e.g., children and adolescents),• individuals with specific types of problems (e.g., health related

difficulties),• specific clinical approaches (neuropsychological assessment), specific

research foci, • or various combination of these elements.

Focusing on Goals and Competencies

• Goal #5: Prepare students to be cognizant of major sources of individual and group variation and to understand how such diversity affects psychological processes, clinical presentation, and responsiveness to intervention.

• Competencies Expected: – students will be non-discriminating and show respect for

staff, colleagues, and patients from diverse backgrounds,– will be able to appropriately consider diverse patient

backgrounds in the selection administering, and interpretation of assessment measures and

– in the selection and implementation of culturally sensitive approaches to intervention, as is appropriate.

Focusing on Goals and Competencies

• Goal #6: Prepare students to deliver professional services to patients and conduct research in a manner that shows dedication to applicable ethical, professional practice, and legal standards.

• Competencies Expected: – having knowledge of ethical and legal standards for

psychologists,– being able to identify professional ethical and legal dilemmas,– being able to relate ethical dilemmas to potentially relevant

ethical principles, and– demonstrate high standards of ethical/legal behavior in the

provision of clinical activities , research, and professional interactions.

General Program Resources:

Research Training Sites• Research laboratories in the PHHP

research complex• Surge research laboratories• Veterans’ Administration Medical Center• McKnight Brain Institute• Shands Hospital• Other campus & community locations

General Program General Program Resources:Resources:

Clinical Training SitesClinical Training Sites• University of Florida Health Science Center

– Psychology Clinic– Average of 10,726 patient visits per year– Primary clinical training site for program

• Site for most core practicum and advanced practicum rotations

• Shands Hospital– 576-bed tertiary care, 144 intensive care– 500 physicians representing 110 medical specialties

• Primary Care Sites in North Central Florida– Rural primary care clinic (e.g. Dixie County )– Ocala VA Community Based Outpatient Clinic

• Other Settings– Gainesville Veterans’ Affairs Medical Center– NFETC

General Program General Program Resources:Resources:

Collaborations Within the HSCCollaborations Within the HSC

• Anesthesiology• Cardiology• Communicative

Disorders • Dentistry • Endocrinology • Engineering• Exercise and Sport

Science• Family Practice• Genetics• Infectious Disease • Obstetrics and

Gynecology• Oncology

• Orthopedic Surgery• Nephrology• Neurology• Neuroscience• Neurological Surgery• Pediatrics• Physical Therapy • Psychology• Psychiatry• Pulmonary Medicine • Radiology• General Surgery• Transplantation

Medicine

Overview of General Resources:

The People of CHP• 33 Faculty; (tenure track, clinical track,

research track)• 6 affiliate faculty• 12 Support Staff• 83 Graduate Students• 12 Interns• 3 Post-Doctoral Fellows• 100 + “others” – RA’s, work study, etc.

Program Resources:The Faculty

• 33 core faculty active in the training program (along with affiliate faculty)– Dramatic departmental growth during the

past decade• A total of 17 faculty in 1997• Compared to the current core faculty of 33

– Represent broad spectrum of general and specialty interests and areas of expertise

– Numerous national leaders (officers, editors, professional boards)

– Most participate in all departmental missions (teaching, research AND clinical service)

– Serve to model the integration of science and practice

Faculty Productivity: 2006 - 2007

Taught more than 20 didactic courses (in addition to extensive involvement in practicum supervision and research mentoring)

Published 71 peer-reviewed journal articles and 2 books

Authors of 49 journal articles, 17 book chapters, and 1 book “in press”

150 Total Publications in the Past Year – 4.55 per faculty member!!!

Authors of 124 papers presented at national or international conferences

Gave 27 additional presentations to state or local organizations

A Total of 151 Total Presentations – 4.58 per faculty member!!!

Participated in newly awarded grants involving $7.9 million irect costs - Accumulated Total 06–07 Extramural funding = $33,774.449

Two editors of psychology journals: Seventeen faculty serve on Editorial Boards or as Consulting Editors of 37 different psychology-related journals

Eleven core faculty members are currently Specialty Board Certified

Faculty Productivity:2006 – 2007 (Cont.)

• 19 faculty are currently Principal Investigators• Two faculty have currently active T32 awards

– M. Marsiske (Program Director) – Interdisciplinary training program in Physical, Cognitive, and mental health in older adults.

– S. Boggs (Program Director) – Training in treatment outcome research for children.

• A total of 12 faculty received awards for their contributions to the professions during 2006 – 2007 alone (see link to faculty productivity over the past five years on the CHP website)

Faculty as Leaders in the Field

APA Board of Directors (Rozensky)Chair, APA Board of Educational Affairs (Rozensky) Member, APA Council of Representatives (Fennell - Neuropsychology)Member, APA Council of Representatives (Rozensky - Health) Board of Directors, American Board of Clinical Neuropsychology (Bauer, Crosson, Fennell)Board of Directors, American Board of Clinical Child & Adolescent Psychology (Johnson)Board of Directors, the International Neuropsychological Society (Crosson)President, APA Division of Clinical Neuropsychology (Bauer)President, APA Division of Clinical Neuropsychology (Fennell)Member, International Neuropsychological Society Board of Governors (Bauer , Loring)Scientific Advisory Board of the Anxiety Disorders Association of America (Lang)

Note. CHP faculty members played leadership roles in the formal recognition of all of the specialty areas represented in the department

Department Awards

2007 APA Culture of Service in the Psychological Sciences Award

“The support of your department for faculty participation on discipline-related association boards, editing journals, reviewing grant and research proposals, mentoring students and colleagues, service on university committees, and volunteering to provide disaster relief services and management training to those in need is an excellent model for other departments to follow.  It is clear that culture of service is incorporated into the day-to-day activities of your faculty and students.” 

Department/Program Rankings

• 2005 US News and World Report, Clinical Program ranked # 20 overall and # 15 among AAU Public Universities (120 programs)

• In 2007 Ranked # 4 in the nation overall in scholarly productivity (total publications)– Source. Stewart, P.K, Roberts, M.C., and Roy, K. M.

(2007). Scholarly productivity in clinical psychology PhD programs: A normative assessment of publication rates. Clinical Psychology: Science and Practice, 1, 157 – 171.

Program Resources:Students

• 83 doctoral students• Graduate 12-15 Ph.D.’s per year• Outstanding record of getting fellowship

awards (NRSA; University Presidential and Alumni; McKnight awards) as well as others

• Many are student leaders in various psychology organizations (APAGS, FPA, Division 40)

• CHP APAGS

Current Student Demographics2007 – 2008 : All Students

• Gender– 79% female; 21% male

• Ethnic Background– 79% Caucasian; 8% Asian; 6% African American;

2% Hispanic-Latino; 3% Multi-Ethnic; 2% not reported.

• Average time to Complete Program– 6.1 Years

• Student Attrition Rate (Past 7 Years)– 6.4%

Current Graduate Student Fellowship Awards

• 1 Presidential Fellow• 13 Alumni Fellows• 2 McKnight Fellows• 3 NIH National Research Service

Awards• 3 Student Training Awards (T-32)

Last Year’s Class Statistics 2007 - 2008

Completed Applications 378

Size of Incoming Class 15

Receiving Financial Aid 15

Average GPA 3.8

Average GRE Verbal 611

Average GRE Quantitative 675

Average GRE Total 1286

Applicants Interviewing:2008 (Visitation Weekend)

Completed Applications# Interviewing

30350

Average GPA 3.7

Average GRE Verbal 620

Average GRE Quantitative 690

Average GRE Total 1310

Entering Class Fall 2008Total Number of Students = 12

• Child - 3 Students• Health - 4 Students• Neuropsych - 5 StudentsGPA = 3.7 (Range = 3.0 – 3.9); GRE Total = 1282 (Range 1170 – 1350)

Student DemographicsGender

75 % female; 25 % maleEthnic Background

50 % Caucasian; 25 % Hispanic-Latino; 17 % Asian; 8 % African-American

Total Students Reflecting Diversity = 50%

6 Alumni Fellowships; 1 McKnight Fellowship

Program Outcomes: Current Student Research

• During the past 2 years 96% received grades of A-B in research methodology courses

• 98% of students passed MS defense on first try; 98% passed Ph.D. defense on first try

• 100% of qualifying examinations passed during past two years

• 98 % of students received satisfactory research progress evaluations during the last three yearly reviews

• 100% passing grades in writing courses• Between 2002 and 2006 a total of 13 students were awarded

NRSA grants;• 87% of students involved in grant-funded research

Program Research/Academic Outcomes: Alumni

(Last 7 Years)

• 41% of grads in academic/research positions (med center, tenure track, R&D)

• 57 % of graduates have published papers (or chapters (24%) or presented papers (76%) since program completion

• 38% of graduates have multiple publications; 41% have multiple presentations since program completion

• 27% of graduates have been a PI; 24% have been a Co-PI on extramural grants

• 90% belong to national or international organization• 61% of clinician-graduates have published or presented since

graduation• 41% of graduates supervise trainees; 19% supervise other

professionals

Program Outcomes:Integration of Research & Practice

(Current Students)• During 2006 – 2007

– 36% published in peer-reviewed journals (Mean = 2.06); – 69% had a paper of book chapter “in press”– 63% presented at national meetings (Mean 2.43);– 84% published or presented their first year project at national

meeting (based students in program at least three years)– 87% were involved in grant-supported research

• 100% pass rate for qualifying examination during 2006-2007;• 98% of students received satisfactory ratings of clinical

performance• 100% received satisfactory ratings on research performance • Preparation in the integration of theory, research, and

practice received an average rating of 3.9 (1= poor; 5 = excellent) by 38 students completing an anonymous student program review

Integration of Science & Practice: Alumni Data

• 59% of graduates report being involved in clinical work; 86% reported being engaged in research;

• 24% report spending 10% or more of their time in both research and clinical activities

• Adequacy of preparation for integrating theory, research, and practice received a 4.2 rating out of 5 (1 = poor, 5 = excellent) by 45 program graduates completing an anonymous program review.

• Regarding training model identification– 73 % self-identified as scientist-practitioner;– 11% self-identified as a clinical scientist;– 14%, self-identified as a “practitioner”, and – one considered him/herself a “researcher”

Clinically Related Outcomes: Current Students

• All students must achieve passing grades and competent laboratory performance prior to beginning practicum

• 96% of students obtained satisfactory practicum evaluations• All students obtain assessment and therapy experience with

children, adolescents and adults from majority and minority populations

• Students leave for internship with an average of 1950 hours of supervised clinical experience plus additional experience on clinical research assistantships; all students completed core practicum in 4 settings/rotations

• 100% of students in past 7 years have obtained APA-approved internships; all have received average to above average performance ratings

• 1 student terminated for failure to meet academic/professional standards; otherwise no significant violation of ethical or professional practice guidelines

Clinically Related Outcomes:Alumni (Past 7 Years)

• 62% of graduates from last seven years report being currently licensed; no student known to have failed in attempt to obtain license

• No student from last seven years reported having obtained ABPP diploma

• Diverse populations served; over 49% report “frequently” work with minorities, 51% working with lower SES “frequently” or “primarily”

• “Adequacy of training in ethics” received 4.2 rating (out of 5) by 45 graduates completing anonymous program review

• No known ethical complaint lodged against program graduate in this reporting period

Student Awards• During 2006 – 2007 CHP graduate students

were recipients of 26 separate awards.– These included NRSA’s, APS foundation

awards, various student research awards, Society for Pediatric Psychology outstanding student awards, best poster awards, best paper awards, AARP Scholars Program Awards, Psychoneuroimmunology Travel Award, Society of Clinical Psychology Research Grant, Etc. – among others.

Professional Behavior/Ethics: Current Students

• All current students currently hold at least “satisfactory” ratings on this dimension (professional behavior) by research supervisors– all student-initiated research is IRB-approved;

• All current students hold at least “satisfactory” ratings on Ethics by clinical supervisors; all relevant coursework completed prior to practicum; Intro to Clinical Psychology: Professional issues and Ethics is required in the pre-practicum curriculum;

• Of 38 respondents to an anonymous student program review, current student ratings of adequacy of training to deal with ethical issues were 3.9 (scale of 1 – 5; 5 = greater preparedness);

• 79% of students belong to at lest one professional society (66% belong to APA; 61% to a research society);

• 35% of students engage in volunteer University service; 32% engage in community service activities

Professional Behavior/Ethics:Alumni Data

• No graduate of the program is known to have committed a violation of ethical standards;

• Adequacy of training in ethics received a 4.1 (5 = greater preparedness) rating by 45 graduates completing an anonymous alumni program review

• 90% are members of a professional society;• During the past seven years 69% of graduates report

participating in continuing education; average = 29 CEU’s per year.

• 14% of graduates report engaging in pro-bono activities; time in pro-bono activities averaged 5.4 %

Other Program Outcomes: Functioning as Effective

Teachers• One student currently teaching at local

community college;

• 6 - 8 students per year teach undergraduate psychology courses in the department;– 100% have received satisfactory teacher ratings

during the past 2 years.

• 16% of alumni report involvement in formal teaching

Other Program Outcomes: Sensitivity to Issues of Diversity• All students currently carry at least “satisfactory”

clinical ratings on this dimension;• Of 38 respondents to an anonymous student

program review, current student ratings of adequacy of training to deal with issues of diversity were 3.2 (scale of 1 – 5 ( 5 = greater preparedness);

• Adequacy of training in diversity issues” received a 3.7 rating by 45 graduates completing an anonymous alumni program review

Developing an Area of Specialization

• All students declare an area of concentration (AOC) by the end of their second year;

• all students fulfill AOC requirements prior to graduation;– currently 18 students in health psychology,– 23 in child/pediatric, and – 34 students in neuropsychology, – 1 student in emotion neuroscience &

psychopathology

Selected Information:Anonymous Alumni Survey

For the following activities, populations, and problems, please rate how well you believe you were prepared by your graduate education and training (including your internship).

Use a scale from 1 – 5 where 1 = inadequate preparation and 5 = excellent preparation

Overall Ratings:Anonymous Alumni

Questionnaire• Overall• Coursework CHP = 4.2• Coursework (Psychology Dept) = 3.4• Research Mentorship = 4.2• Practica = 4.0• Integration of Research and practice = 4.2• Diversity issues = 3.7• Faculty Role Models = 3.8• Facilities = 4.0

Internship PlacementInternship Placement 100% of Students in past 7 years have obtained APA approved internships

0

10

20

30

40

50

60

70

80

1st 2nd >=3rd

UF APPICRecent Internship Placements:

Boston Internship Consortium Brown University

Columbus Children’s Hospital Children’s Mercy Hospital, KC Children’s Hospital of Philadelphia Columbia University/NY Presbyterian

Duke University Dupont Hospital for Children Emory University Medical Center Harvard/Brockton-West Roxbury VAMC, James A. Haley VAMC, Tampa

Johns Hopkins/Kennedy Krieger InstituteLong Beach VA Healthcare SystemLong Island Jewish/Hillside HospitalMaryland VA Healthcare SystemMedical College of GeorgiaMedical Univ. South CarolinaTulane University Health Science Ctr.University of California, San DiegoUCLA Neuropsychiatric Institute Univ. of Cincinnati Children’s HospitalUniv. Alabama, BirminghamTexas Children’s HospitalUCLA Neuroscience InstituteUNC – Chapel HillUniversity of Chicago Medical CenterWest Haven VAWest Virginia University

2004-2007 Match Statistics

This Year’s Internship This Year’s Internship PlacementsPlacements

•

Clinically Related Outcomes: Clinically Related Outcomes: AlumniAlumni

National Licensure ExamNational Licensure Exam

• 1997 – 2006 : Performance on the Examination for the Professional Practice of Psychology.– Average scores of CHP graduates (N = 82; Mean =

164.7; SD = 13.7) were more than 1 Standard Deviation above the national average (N = 4,355; Mean =156.4; SD = 7.44) on the EPPP

Note. These scores were among the top scores in the nation in comparison to other doctoral level training programs.

So Where do Our Students Go When They Go Away?

Celia Lescano (1998)Brown University Medical School

David Moser (1997)U of Iowa -

Neurosciences

Cheryl McNeil (1989)West Virginia

University

Beth Slomine (1995)John’s Hopkins

Kennedy Krieger

Russell Hoffman (1995), St. Louis

Children’s Hospital

Korey Hood (2003)Harvard Medical

School

Chris Houck (2002)

Brown University Medical School

Jenny Doelling (1989)

Santa Barbara, CA

Private Practice

Bob Swoap (1992) Warren Wilson

College

Sidney Trantham (1999)

Lasell College

Dr. Lisa Sheeber, (1991) Research Scientist, Oregon

Research Institute

Dr. Dan Shapiro (1994), University of Arizona College of Medicine, Health

Psychologist, Author, Speaker

Dr. Chris Loftis (2003), National Health Policy

Forum, Washington, D.C.

Dr. John F. Murray (1998) Private Practice; Sports Psychologist, Speaker

Our Graduates Making a Difference(Click on People for Website)

Dr. Roberta Isleib (1985), Clinical Psychologist;

Mystery Writer

Dr. Bill Kanasky (2003), Litigation Consultant