MIDYEAR MEETING

April 12-14 2007
San Diego, CA

The 2007 ADPTC Mid-year meeting will be held April 12th -14th in parallel with the 2007 APPIC biennial Conference (“Defining and Building Skills in Psychology Training: From Practicum to Practice”) at the Sheraton Marina Hotel in San Diego, California. ADPTC leadership will meet with the APPIC Board on the morning of April 12th. ADPTC will hold its business/committee meetings during the afternoon of April 12th.  Randy Cox and Rob Heffer are working on some initial programming issues for April 13th and 14th.  Randy and his program committee will be solidifying the program over the next month or so. Rick Schulte and Phyllis Terry Friedman have been working on the local arrangements.

ADPTC has reserved rooms for April 11-14 at the rate of $197.88 per day per room, inclusive of taxes ($179/day + 10.545%
taxes).  To receive this rate you MUST make a reservation by:

• Telephoning Kathy Kelly to register (no one else) 619-692-2781
• Identify yourself as the ADPTC group.

SYMPOSIUM AT APA:

Training for Ethical and Multicultural Competencies in the Practicum
Erica Wise, Tony Cellucci, Sonia Banks

Chair:  Erica H. Wise, Ph.D., Discussant:  Robert W. Heffer, Ph.D.,

Symposium Summary
The overall goal of this symposium is to present a model for integrating formal didactic and experiential training for ethical and multicultural competencies into the practicum.  While nobody in our field would argue with the assertion that practicum is the traditional venue for training in the basic clinical competencies of assessment and intervention, our position is that the practicum experience presents a unique opportunity for in-depth understanding of ethical and multicultural concepts and practice.   In the first section, Erica Wise will provide an overview of the proposed model and will review the standards and guidelines within APA that relate to training in ethical and multicultural competencies.  In the second section, Tony Cellucci will present an integrative model for teaching ethics throughout the pre-doctoral program and within the practicum setting.  In the third section, Sonia Banks will challenge us to look beyond the traditional models for inculcating meaningful self-knowledge and multicultural competency that integrates didactic and experiential training.

Presenter:  Erica H. Wise
Practicum training for ethical and multicultural competence
Clinical trainers have an obligation to prepare our graduate students to function ethically and effectively in their myriad future roles as psychologists in an increasingly multicultural society.  Drawing from standards and sources of guidance within the APA, we are proposing a developmental professional training model that promotes the integration of formal didactic training in ethical and multicultural diversity issues into practicum training.  This model is based on the following documents:  The APA Ethics Code (2002), The APA Guidelines and Principles for Accreditation of Programs in Professional Psychology (especially Domains B and D), The ADPTC Practicum Competency Document (2004) and the Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists (APA, 2002).   The unifying concept for training graduate students in both ethical and multicultural competencies is the expectation that trainers will both demonstrate and teach ethical behavior and a high level of sensitivity and respect for individual and cultural diversity.  As role models, our supervision must conform to the provisions of the 2002 APA Ethics Code.  This includes the provision of accurate descriptions of clinical training opportunities that are designed to provide students with requisite skills and competencies (Ethical Standards 7.01 and 7.02), an awareness of the importance of being sensitive to the use of mandated disclosures of personal information (ES 7.04), the importance of providing timely and fair evaluations that are based on actual performance (ES 7.06) and the importance of avoiding exploitative relationships with supervisees (ES 3.05 and 7.07).  In regards to training for multicultural competence, the APA Ethics Code (2002) reminds us in General Principle E that psychologists respect the dignity and rights of all people.  Other sections of the Ethics Code also speak to the ethical imperative of sensitivity to individual and multicultural diversity. The APA Multicultural Guidelines and the ADPTC Practicum Competency Document both emphasize the importance of self-awareness and the extent to which our attitudes and beliefs can influence our perceptions of and interactions with others.  Of particular relevance is Guideline #3 of the APA Multicultural Guidelines which states that “As educators, psychologists are encouraged to employ the constructs of multiculturalism and diversity in psychological education”. Where better for this to occur than in practicum training?

Presenter:  Tony Cellucci
The development of professional ethical competence: One program model
Although ethics is a required component of doctoral training, it is often isolated to a didactic course early in a student?s program. The literature is clear that ethics training must go beyond simple knowledge or recitation of the APA code to include values and ethical reasoning as part of one?s professional identity (Bernard, Murphy, & Little, 1987; Welfel, 1992). Handelsman, Gottlieb and Knapp?s (2005) acculturation metaphor is a useful perspective for thinking about ethical/ professional socialization. This presentation will elaborate on the ethical competencies suggested by ADPTC and argue that they must be integrated and addressed throughout the training program. In particular, the psychology clinic becomes the focal point for students to integrate knowledge of ethical issues with actual practice (Cellucci & Heffer, 2002).

The ADPTC competencies document includes seven items related to ethics: 1) knowledge of the ethics code, professional guidelines, as well as statutes, regulations, and case law; 2) being able to analyze ethical /professional issues across a spectrum of professional activities; 3) understanding ethical dimensions of his/ her own attitudes and practice; 4) seeking appropriate information and consultation; 5) appropriate professional assertiveness related to ethical issues; and 6) evidence of commitment to ethical practice. It is instructive that these competencies reflect not only knowledge and moral reasoning but sensitivity, self-awareness and acting on ethical issues. These competencies can be very useful in formulating program objectives related to this domain.    

This presentation will describe one university model for professional ethical development which is distributed and reinforced throughout a student?s training. This will include first year orientation to the clinic, a description of a standard ethics course that incorporates WebCt as a discussion tool, various activities and methods that can be used by training clinics to reinforce and integrate professional ethical development within practicum, and a capstone ethics/ professional issues seminar prior to internship. The presentation will include specific ideas and exercises for enriching the teaching of ethics. Knowledge survey data for the course will be presented along with case analyses conducted by senior students.

Presenter:  Sonia R. Banks
Practicum and Multicultural Competency: Weaving Multicultural Issues into the Overall Training Agenda
As clinical trainers, we have the ethical challenge to ensure that our practicum students are trained to offer competent care to the multicultural clients we serve. Yet, even with the mounting focus on competency based training, we find that training in the area of multicultural competence often remains perfunctory.  Approaches that seek to integrate the learning of multicultural theory in the classroom with practicum training have met with more success than the basic "read and then do as I say" faculty approach that many supervisors endorse.  Academia is not generally receptive to creating the kind of applied training in cultural competency that we offer in other areas of our discipline.  There is often little program training time or support devoted to the application of innovation and creativity to learning ways to break the barrier of race, culture, gender, orientation and language bias.  Even though we know that many of the current tried and true teaching approaches are not effective, they continue to be widely used in psychology training programs. Creating a new paradigm takes time.  We can teach how to build a model one case at a time, one session at a time, that will serve as an inroad to true multicultural competence.  A model will be presented that allows us to effectively integrate didactic and practicum training and to determine if there is sufficient development occurring for the student related to their understanding of treating a diverse client population.
This presentation will focus on:
1. What needs to be understood at the novice, intermediate and advanced level?
2. How does the supervisor determine if more course-work, field study or role play is needed?
3. What are the barriers to integrating such a progressive approach?
4. Who will benefit if it is not implemented and if it is implemented and why?
5. How can training directors, training practicum directors and supervisors contribute to this paradigm shift?

SYMPOSIUM AT APA:

Incorporating Research and Systematic Data Collection in the Practicum
Eric Sauer, Bonny Forrest, Terry Pace, Bobbi Volmer

Chair: Eric M. Sauer
Symposium Summary
Introduction:  This symposium is one of a 3-topic series of symposia proposed by members of the Association of Directors of Psychology Training Clinics (ADPTC) on topics related to the pre-doctoral practicum in professional psychology. Through email communications with us, David Tolin suggested that these three symposia be reviewed as a group, although submitted separately.  We are requesting acceptance as a series, but are open to acceptance of some, if not all, of the symposia. The other two symposia being submitted are:

Abstract:  This symposium will address a perennial debate in professional psychology.  That is, how can we best train our students to be competent scientist-practitioners?  With their tripart mission of providing psychological research, student training, and services to the public, psychology training clinics (PTCs) are ideally suited to offer students integrative research and practice training experiences.  The current symposium consists of four presentations that will highlight the diverse ways that PTCs may effectively incorporate research and systematic data collection into practicum training.   In the first presentation, Terry Pace, will discuss an ongoing psychotherapy evaluation project that includes multiple dimensions and perspectives. Using the clinical literature as a guide, this practical and integrated approach to outcome evaluation has yielded findings that are useful to treatment planning, client self-evaluation, service evaluation, and helping students learn about the value of evaluation and thinking more scientifically about their applied work.  In the second presentation, Bonny Forrest, who directs multiple training clinics located in a low-income and racially diverse community, will provide an overview of her efforts to help students learn the importance of thinking scientifically about service delivery.  She will highlight research findings from a clinical study on depression and religious coping in a racially diverse sample and demonstrate how alternative research methods employed at these clinics have significantly increased client participation in research.  In the third presentation, Barbara Wollmer, will describe how the utilization of collaborative treatment planning interviews, treatment modality-specific supervision, and close monitoring of client progress have enhanced the depth of students’ understanding of the application of various treatment models.  She will also describe how these same efforts have been effectively applied to a clinical study on problem gamblers.  In the fourth presentation, Eric Sauer, will highlight how practicum courses housed in PTCs can be used to stimulate scientific thinking and provide effective research training. Two areas of focus will include using outcome measurement to inform practice and involving students in clinical research projects..

The University of Oklahoma Counseling Psychology Psychotherapy Evaluation Project
Presenter: Terry M. Pace
The Psychotherapy Evaluation Project at the University of Oklahoma Counseling Psychology Clinic is a program with research, service and training objectives.  Reviews of the literature suggested that a comprehensive approach to outcome assessment in practicum should include multiple dimensions including at least: (a) symptomatic issues, (b) multiple life-
role functioning, (c) general well-being or quality of life, (d) targeted problems or goals, (e) quality of the counselor-
client relationship, (f) client motivation or readiness for change, (g) and general satisfaction with clinic services.  We also concluded that multiple perspectives should be obtained on relevant dimensions, including clients, counselors, parents and supervisors. Our clinic and training program is generalist is scope (i.e., we serve the entire life span, including children, adolescents, adults, couples and families).  We wanted an approach to outcome evaluation that would be integrated and applicable across the range of clients we see.  We sought methods that would be practical and acceptable for clients, counselors, clinic staff and supervisors.  We decided for our needs, that it was better to get consistent data of some breadth and to sacrifice depth. We wanted the evaluation process and results to be useful to counselors and supervisors for treatment planning and useful to the clinic and the training program for overall evaluation.  As a scientist-practitioner program, we expected that this project would help our students learn about the value of evaluation and to think more critically, objectively and scientifically about their applied work.

Likewise, we believed the instruments might assist clients in their own self-evaluation and have a positive impact on their decisions about counseling and motivation for change.  Psychometric data will be presented for our instruments, as well as data on clinic services.  Implications will be discussed regarding outcome and service evaluation and to unique needs of generalist PTCs.

Depression and Religious Coping in a Racially Diverse, Low-Income, Community
Presenter:  Bonny J. Forrest
The Loyola Clinical Centers house seven clinics that serve as the practicum sites for four graduate programs. The city requested that the Clinics be located in a low-income neighborhood.  Since opening, we have encouraged students to engage in dialogues about effectively meeting community members’ needs.  Through conversations at a local food pantry we also understood that depression was a major issue for residents.  Many of the folks we spoke with, did not use the term depression, but spoke instead about feeling blue and about often speaking to a greater power about a problem.   Research shows that although African Americans, persons of limited means, and non-hospitalized persons, are traditionally underrepresented in research on depression, using religious coping methods to reach these participants can increase participation in applied services and studies.

As a scientist-practitioner program, we hoped that this study would help our practicum students learn the importance of critically thinking about service delivery and the needs of their clients. We will present data on the following alternative research methods: (a) inclusion of more relevant incentives for participation, (b) use of a natural community helper, (c) measuring the use of religious coping, and (d) qualitative interviewing.  Some of our findings include:

The two most widely used measures of depression posed significant barriers for use in this population due illiteracy, or blindness;

African Americans reported more somatic complaints and pessimism than Caucasians;

The use of positive religious coping predicted less depression and the use of negative religious coping predicted more depression for African Americans. There was no relationship between religious coping and depression level in Caucasians; and

Depressed individuals were less inclined to volunteer to participate in community research.

Implications will be discussed related to success of alternative methods, outcome and the needs of PTCs in urban community settings.

Development of a Collaborative Treatment Planning Interview and Monitoring Procedures in Practicum
Presenter: Barbara M. Vollmer
Doctoral students often have their pre-doctoral practicum experiences in PTCs.  Although students frequently arrive well equipped with basic skills in reflective listening and intake assessment, they often present with deficits in case conceptualization and treatment planning skills.  Supervisors of beginning students typically find they need to provide a basic framework from which the student can begin to integrate coursework and practicum training.  At the Counseling and Educational Services Clinic at the University of Denver, three procedures have been implemented to help practicum students increase skills in treatment planning and case conceptualization.  First, using the clinical literature as a guide, the Collaborative Treatment Planning Interview (CTPI) was developed to follow the traditional intake.  The main objectives of this interview are to determine the client’s treatment preferences and also to clearly develop the client’s initial goals. The CTPI incorporates questions and approaches suggested by several therapeutic models and also asks clients to state their preferences among several therapeutic modalities. Second, supervisors with expertise in each treatment modality offered in the clinic develop a format and guidelines on how to use the intake and CTPI to write case formulations and a treatment plans. Supervisors have also developed progress notes and an intervention checklist tailored to the different therapeutic modalities to allow monitoring of students’ adherence to the collaborative treatment plan.   Third, all adult clients are systematically administered various evaluation instruments to monitor progress (i.e., a measure of client distress, working alliance inventory, and qualitative interviews).   This presentation will conclude by discussing how these innovative and integrative training methods have been used to conduct a pilot study on problem gamblers and served as an example of systematic data collection in PTCs.

The Development of Scientific Thinking in Practicum
Presenter:  Eric M. Sauer
PTCs are ideal laboratories for teaching students how to think scientifically about applied practice.  This presentation will describe how faculty at the Center for Counseling and Psychological Services at Western Michigan University are helping practicum students integrate science and practice.  One important way that we foster scientific thinking is through systematic outcome assessment.  During practicum, students administer psychometrically sound outcome measures to adult clients at intake and before each counseling session.  As suggested by Ogles, Lambert, and Fields (2002), these standardized data are used to inform clinical practice and can stimulate critical thinking about (a) initial presenting problems or level of severity, (b) critical needs, (c) targets of treatment, (d) client strengths, (e) client progress, and (f) therapy effectiveness.

The second way that we develop scientific thinking is by providing opportunities for practicum students to participate in student-faculty research teams.  For instance, in one of our longitudinal research projects, we are exploring the impact of client and therapist attachment orientations on counseling process and outcome.  Several interesting findings have emerged and students have become quite energized to continue lines of applied inquiry. Beyond providing students with a first-hand experience conducting research in an applied setting, research projects such as these offer other important benefits for our practicum students including faculty mentoring and role-modeling, and positive reinforcement for research-practitioner behaviors and beliefs. These benefits are consistent with previously identified variables that foster positive research training environments (Gelso, 2000; Kahn & Gelso, 1997).

Lastly, I will conclude by sharing my impressions of the successfulness of our attempts to stimulate scientific thinking in practicum students.  Specifically, I will speak about the immediate impacts on our practicum students and then propose some potential long-term effects that similar efforts may have on the next generation of psychologists.

SYMPOSIUM AT APA:

Best Practices for Competent Supervision in Practicum
Brian Lewis, Kim Lassiter, Vic Pantesco, Judy Hyde

Chair:  Brian Lewis, Discussant:  Linda Forrest
Abstract: This symposium is one of a series of three programs being offered by members of the Association of Directors of Psychology Training Clinics (ADPTC) on topics related to the pre-doctoral practicum in professional psychology. As the focus on the practicum has intensified in recent years, so too has the realization that there are challenges unique to this level of training which warrant further consideration. One such challenge involves practicum supervision. In this symposium, four perspectives will be provided on “best practices” in practicum supervision – each addressing a somewhat different area of concern under the general heading. In the first presentation, Kim Lassiter examines the critical role of evaluation in practicum supervision and how this should be tied to practicum competencies. Next, Vic Pantesco will explore the important role of the practicum supervisor in recognizing and responding to the unique needs of problem students as they begin their earliest clinical work. Judy Hyde will then provide an example of a developmental model of practicum supervision currently in use at a university in Australia. This will provide a nice opportunity to broaden the discussion by including a perspective from outside mainstream American psychology. Finally, Brian Lewis will raise the potentially controversial question of whether it is necessary, or even desirable, that the profession consider adopting practicum-specific “guidelines” for supervision. The symposium will end with an open discussion with the audience which will be facilitated by Linda Forrest.

Presentation Title: Evaluation in Practicum Supervision: Suggestions for Best Practices
Presenter: Kim Dudley Lassiter
Abstract: The Association of Directors of Psychology Training Clinics, ADPTC, is a community of experts on pre-doctoral clinical training.  The ADPTC Practicum Competencies Workgroup has produced the Report on Practicum Competencies, which describes a set of core competencies that are the focus of practicum-level training.  Having identified core competencies, ADPTC is now examining competency measurement and how to integrate competencies into evaluation in practicum supervision.

Although supervision practices have been assumed to be similar across professional settings, it appears that the clinical supervision that occurs in practicum/educational settings is distinctive, particularly with respect to technological resources (videotape, observation rooms) and time allotted to the activity.  The suggestions offered here are proposed as best supervision practices for practicum supervision that is directed toward attainment of pre-doctoral clinical competencies.  These guidelines will aid clinical supervisors who have not had the benefit of formal supervision training; will help ensure supervisees’ rights to effective and accurate evaluation; and will facilitate gate-keeping the profession. Best practices in practicum supervision evaluation include: (1) specifying evaluation criteria in a supervision contract with procedures, methods, and timeframes; (2) describing recourse for the supervisee to challenge the evaluation or remediate the deficiencies (due process); (3) differentiating formal from informal evaluation and providing guidelines for each; (4) identifying sources of data and tools for evaluation; (5) making evaluation the norm within the supervisory relationship; and (6) addressing problems early.  Finally, given that lack of timely feedback has become the most common basis of formal ethics complaints regarding supervision, supervisors are encouraged to self-reflect regarding issues that may interfere with their ability to be objective in evaluating a given supervisee and to providing feedback more generally.

Presentation Title:   Best Practices in Practicum Supervision: Focusing on the Problem Student.
Presenter: Victor Pantesco,
Abstract: Within the Association of Directors of Psychology Training Clinics and more broadly across the Council of Chairs of Training Councils, supervision with problematic students absorbs huge amounts of time and emotional energy.  It presents a special category within Best Practices from a few points of view: evaluation procedures, cultural sanctions for addressing problems of a sensitive nature, and professional collegial support for the supervisors.  This presentation will offer first some commentary on selected basic principles within a best practices frame.  Specifically, we will pay attention to a few principles that combine attention to the salient territory of emotions and defense with particular language and strategies for their management in the difficult supervisions.  With these principles and guidelines for both cultural and individual utilization set, particular interventions will be offered and explored within the context of seeking best practice in this challenging subset of supervisees.  Specifically, the following will be emphasized as inclusive and broadly applicable contexts and pathways for
discerning and conducting supervision interventions:
     1. Setting the supervision frame, especially including language and protocol for addressing difficult students
     2. Group peer supervision for supervisors
     3. Tracking supervision session-to-session: a brief documentation tool
     4. Using student evaluations of supervisors to specify themes in supervision
     5. Using the developmental perspective for conceptualizing supervisory intervention with the difficult supervisee.

Presentation Title: Utilizing the Integrated Developmental Model of Supervision in Practicum Training
Presenter: Judy Hyde,
Abstract: Developmental models of supervision are characterized by an understanding that trainees and supervisors progress through a series of stages of increasing development from feeling relatively anxious, insecure, dependent, unknowledgeable and unskilled, through to more confident, secure and autonomous, as knowledge and skills increase; to arrive at high levels of integration, skill, self-awareness, professionalism and independence. These empirically validated models provide a useful framework for conceptualizing the tasks and goals of supervision at the practicum level and beyond.

This presentation will describe the stages of the Integrated Developmental Model of Supervision (Stoltenberg, McNeil, & Delworth, 1998) with a focus on practicum training. The stages of development of practicum students commencing the supervisory process suggest a need for more substantial direction, guidance and instruction in a safe, secure structured environment in the early stages of supervision, and more autonomous, exploratory discussion, with a reduction in the amount of direction, instruction and guidance, as confidence and skills develop. The adaptation of the supervisory style to flexibly meet the needs of practicum students, while accounting for the interaction of the level of complexity of the issues being addressed and the level of development of the student, will be described.

Structures to monitor practicum student development will be given, providing markers to assess development across the domains of self and other awareness (both cognitive and affective), motivation, and autonomy. The impact of these developments on a range of professional activities, from skills acquisition to ethics, will be outlined in light of the requirements for supervision environments to change to augment development and appropriately challenge each developmental level.

The presentation will conclude with a description of how this model is being taught to supervisors and implemented in practicum training at the Rod Power Psychology Clinic in Sydney, Australia. "Integrated Developmental Model of Supervision" and further along confidence and skills develop (not develops).

Presentation Title: Searching for Guidance: Do We Need Practicum-specific Supervision Guidelines?
Chair: Brian L. Lewis, Ph.D.,
Abstract: As the discussion of the pre-doctoral practicum has intensified, questions have arisen regarding the potential need for standards or guidelines in supervision. It is interesting that clear guidelines currently exist for supervision at later levels of professional training (i.e., the internship and post-doctoral levels), but not for the earliest phase of graduate training. The Association of Psychology Postdoctoral and Internship Centers (APPIC), for example, has explicit policies for supervision for any internship or post-doc training program it approves; these include the expectation that the supervisor is licensed and that supervision occurs in an individual format at least 2 hours each week. The American Association of State Psychology Boards (ASPPB) has its own set of recommended guidelines which are used in many jurisdictions to establish supervision requirements for licensure – again focusing exclusively on internship and post-doc training.  The ASPPB guidelines go so far to specify the maximum number of supervisees any one supervisor can oversee (three).

The reason that accepted guidelines for practicum supervision do not exist is because practicum requirements are set by the individual academic programs, and these programs differ in training philosophy and in more mundane concerns like access to resources. The result is considerable variation in supervision practices between doctoral programs, and students are progressing to internship with markedly different experiences (e.g., in the type and intensity of supervision received).

Although there is considerable value in maintaining program autonomy when establishing training requirements, it can also be argued that more consistency is needed in some areas – and practicum supervision expectations might be one of these areas. The purpose of this presentation is to present a case for this thesis in hopes of stimulating further discussion of the topic.