After complaining for years that the existing standards for accrediting graduate psychology programs are flawed, a group of psychological scientists has formed a new accrediting body whose goal is to ensure that therapists, whether or not they have doctoral degrees, are trained in scientifically proven treatments.
“We have made great progress through science to prevent and ameliorate mental-health problems, but proven treatments are not reaching the public,” said Richard M. McFall, executive director of the new group and an emeritus professor of psychology at Indiana University at Bloomington. That, combined with the pressures of managed care, has led to a mental-health crisis in the United States, he said.
For example, he said, empirical research shows that people with obsessive-compulsive disorders will exhibit fewer symptoms after a treatment known as “exposure and response prevention,” in which patients are gradually taught to tolerate the sources of their anxiety without resorting to their compulsive behavior. That therapy is not widely enough understood or offered by clinicians, said Mr. McFall.
Similarly, many psychotherapists “debrief” people with post-traumatic stress disorder, despite research indicating that pressing patients to talk about memories they may not be equipped to cope with could actually worsen their condition (The Chronicle, October 24, 2003).
The new system will be run by the Academy of Psychological Clinical Science, an affiliate of the Association for Psychological Science. While it will focus on certifying programs that advance research, graduates of those programs will be qualified to be licensed as practicing psychologists, said Mr. McFall. They will also be able to train practitioners who do not have Ph.D.'s and who could offer cost-effective care.
A Different Orientation
The much larger American Psychological Association, or APA, has been the dominant accreditor of graduate psychology programs for some 60 years, certifying not only scientific-research programs but also various kinds of programs in clinical psychology, school psychology, and counseling. Because those programs have a range of goals, the APA’s accreditation regulations “are so burdensome, it’s hard to train the next generation of clinical researchers,” said Alan G. Kraut, executive director of the psychological-science group, in an interview last week in Chicago at the group’s annual meeting.
Mr. McFall added that “whereas APA tends to focus on the input side—which courses, how many hours your students have to take, how quickly they graduate—we want to focus on the results of their training: What kinds of jobs are they getting? Where are they publishing their research?” Programs could be accredited by both bodies, he said.
APA officials could not be reached last week for comment. But Robert J. Sternberg, a past president of the association and now dean of arts and sciences at Tufts University, met the news with some disappointment. “To the extent that the APA system has problems, having competition may encourage APA to solve them,” he wrote in an e-mail message.
“On the other hand, I’m afraid this competition may confuse some people, and that is worrisome.” It would have been better, he said, for the two groups to collaborate.
But the new accreditation body did not drop out of the sky. Research psychologists tried to influence APA’s accrediting process in the 1990s, amid vigorous debate over how to ensure the best clinical treatment. The Association for Psychological Science was founded in 1988 by researchers frustrated with their lack of clout in the APA. In 1991, Mr. McFall published a controversial paper, “Manifesto for a Science of Clinical Psychology,” which said the only legitimate form of therapy was one grounded in empirical evidence (The Chronicle, October 24, 2003).
Critics of that view have said that any list of approved practices would be too narrow and would be used by insurance companies to dictate how therapists practice. They also have argued that successful therapy is as much about the patient’s motivation and relationship with the therapist as it is about the methods used.
“This is where medicine was at the beginning of the 1900s,” countered Mr. McFall. “The same arguments were made by physicians in response to the development of standards of practice. Now we take it for granted that doctors are going to prescribe the best, scientifically validated treatments.”
Mr. Kraut said that study after study had shown that when clinical judgment is compared with research, “research comes out ahead.”
The new accrediting group, the Psychological Clinical Science Accreditation System, hopes to begin its first round of reviews this fall.
