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Psychology in the Schools, Vol. 52(10), 2015 View this article online at wileyonlinelibrary.com/journal/pits

2015 Wiley Periodicals, Inc. DOI: 10.1002/pits.21879

ENSURING THE AVAILABILITY AND QUALITY OF SCHOOL PSYCHOLOGY DOCTORAL INTERNSHIPS ABIGAIL M. HARRIS

Fordham University

Currently, only a small percentage of internships accredited by the American Psychological Association (APA) are filled by school psychology interns and only a few of the available APA internship positions are in schools. Program data submitted online to APA indicate that many interns are in sites that meet the guidelines adopted by the Council of Directors of School Psychology Programs (CDSPP). This article compares the APA internship accreditation policies with the CDSPP internship guidelines and draws on several sources of internship and program data to C 2015 analyze the “supply” and “demand” issues for school psychology programs and interns. Wiley Periodicals, Inc.

The persistent and increasing pressure for accredited doctoral programs in psychology to meet uniform training standards raises important questions for school psychology. Specifically, the 2013 resolution approved by the Council of Representatives of the American Psychological Association (APA) that all health service psychologists must be trained in accredited doctoral programs and accredited internships suggests that the only acceptable internships for doctoral school psychology students are those that meet the standards of and successfully obtain accreditation by the APA or Canadian Psychological Association (CPA; APA, 2013b). One question it raises is whether these internships should be the only available option for school psychologists seeking to be licensed health service providers—including those who work in schools. Another question is whether meeting this goal is feasible. This article begins with the first question by considering the alignment between professional standards recognized within school psychology. The latter part of the article uses extant data to consider feasibility by examining the supply (How many APA-accredited internships are available to school psychology interns?) and demand (How many students are matriculated in APA-accredited school psychology programs?) sides of the equation. Also considered is what can be gleaned from these data about the type and quality of accredited and non-accredited internships completed by school psychology trainees. PART I: P ROFESSIONAL S TANDARDS

FOR

D OCTORAL I NTERNSHIPS

Professional standards for school psychology internships have been defined by various groups, including the APA, the Association of Psychology Postdoctoral and Internship Centers (APPIC), the Council of Directors of School Psychology Programs (CDSPP) and the National Association of School Psychologists (NASP). Of these four groups, only the APA accredits internships programs.

Special thanks to Gregory Greenwood, Associate Director for Research, Program Consultation & Accreditation, American Psychological Association, Eric Rossen, Director of Professional Development and Standards, National Association of School Psychologist (NASP), and Mark Swerdlik, Co-Chairperson of the NASP Graduate Education Workgroup for responding graciously and efficiently to data and data analysis requests. Correspondence to: Abigail Harris, Associate Professor, School Psychology Program, Fordham University, 113 West 60th Street, New York, NY 10023. E-mail: [email protected]

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APA Accreditation Standards In the mid-1990s, the APA Commission on Accreditation (CoA; previously known as the Committee on Accreditation) released the Guidelines and Principles for Programs in Professional Psychology (G&P). The updated version of this document includes accreditation criteria for doctoral training programs, internships, and post-doctoral training programs (CoA, 2013b). In addition to the G&P, the APA publishes Implementing Regulations (IR) that define accreditation expectations and requirements with greater specificity (CoA, 2013b). Also, the APA regularly reinforces professional standards by publishing support documents, such as the recently approved guidelines for supervision (Board of Educational Affairs Task Force on Supervision Guidelines, 2014) and the online competency benchmark documents and tools (see http://www.apa.org/ed/graduate/competency.aspx). As of 2013, there were over 370 accredited doctoral programs (including school, counseling, clinical, and combined) and approximately 475 accredited internship programs. To become accredited, doctoral and internship programs must complete a comprehensive self-study and document how they meet the G&P and IR standards. The CoA reviews the self-study and then may approve the doctoral or internship program for a site visit or provide feedback to the program about needed revisions. To become accredited, doctoral and internship programs must complete the site visit and receive a favorable review from the CoA. Access to an accredited internship is generally through the APPIC match process (described later) or by enrollment in a doctoral training program with affiliated accredited internships. Internship agencies that are exclusively affiliated with an accredited doctoral program only admit interns from that university program and, therefore, do not participate in the APPIC match (for more information, see CoA IR C-10; http://www.apa.org/ed/accreditation/about/policies/implementingguidelines.pdf). In February 2015, the APA Council of Representatives approved new Standards of Accreditation for Health Service Psychology (SoA; American Psychological Association, Commission on Accreditation, 2015) to replace the current G&P accreditation guidelines and go into effect January 1, 2017. The new SoA for programs permit the use of non-accredited doctoral internships but require that programs evaluate and document the quality of non–APA-accredited internships (e.g., appropriateness of training activities, frequency and quality of supervision, supervisor credentials, and trainee evaluation procedures). Also, programs must provide evidence regarding competencies attained by interns at these sites and maintain documentation evidence in the student files (APA, CoA, 2015). APPIC Internship Criteria APPIC serves as a clearinghouse for most APA-accredited and many non–APA-accredited internship programs. Although APPIC is not an accrediting body, internship programs or agencies wishing to be listed with the service must affirm that the internship they offer meets specific criteria. Adherence to these criteria is reviewed by APPIC every 3 years (APPIC, 2014). Doctoral trainees seeking internships complete a common application process, and APPIC facilitates a multi-phased matching procedure. Beginning in fall 2017, the only trainees eligible to participate in the APPIC match process will be trainees who are matriculated in APA- or CPA-accredited doctoral programs or in programs that are seeking APA accreditation and have been approved for an initial accreditation site visit (APPIC, 2013b). CDSPP Doctoral Internship Guidelines CDSPP is a professional group that has provided leadership in defining internship standards and guidelines. CDSPP was formed in 1977 as a forum for communication between directors of Psychology in the Schools

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doctoral-level school psychology programs, with the mission to “foster the advancement of doctoral education in school psychology in all its aspects” (CDSPP, 2012). Current membership includes more than 80 accredited and non-accredited doctoral training programs. Critical roles for CDSPP have been (1) promoting the representation of school psychology programs in functions of APA and other organizations that are relevant to doctoral education in school psychology, and (2) advocating for policies and standards that are consistent with high-quality doctoral-level school psychology training. Within this framework, in the early 1980s, a Joint Committee on Internships was formed, with two representatives each from CDSPP, Division 16 of APA, and NASP. The Committee developed internship guidelines that were published along with a directory of doctoral internships in school psychology (Joint Committee on Internships, 1987). Subsequently, these guidelines were revised to be consistent with criteria used to determine eligibility to be listed by the National Register of Health Service Providers in Psychology and approved by the CDSPP membership in 1998 (DiPerna, 2012). Then, in 2011–2012, these guidelines were again revised and updated to more closely reflect APA internship accreditation standards, while recognizing some of the unique training activities and circumstances of school-based internships (CDSPP, 2012). They were approved by the membership in 2012. CDSPP is not an accrediting body; however, many doctoral training programs require that their students complete APA-accredited internships or internships that meet the CDSPP criteria. For non-accredited internships, the doctoral training programs assume responsibility for monitoring compliance. NASP Approval The NASP accreditation process includes both specialist and doctoral training programs and focuses on program responsiveness to NASP standards (NASP, 2010). Approval is awarded to graduate school psychology training programs (not internships). Internship criteria are embedded within the NASP accreditation standards, and training programs must demonstrate that internships meet these standards. Also, as part of the accreditation folio, university training programs must provide data demonstrating the learning and behavioral impact on students/clients of their interns. However, in lieu of submitting a complete accreditation folio, APA-accredited doctoral programs can be approved by submitting documentation of APA accreditation status and copies of program policy documents showing internship requirements consistent with NASP standards that include completion of 1,500 internship hours, with at least 600 hours in a school setting. NASP permits doctoral students to complete exclusively non-school internships if they have completed a schoolbased internship or the equivalent (equivalency is determined by the doctoral program). Although NASP has approved standards for internship that parallel those of other professional groups (Prus, 2009), the NASP accrediting body generally accepts as sufficient the APA standards for doctoral internship as long as the written policies of the doctoral training program are consistent with NASP standards. Comparison of the Professional Standards Tables 1 and 2 provide comparisons of the similarities and differences between current doctoral internship standards or criteria in school psychology as defined by APA, APPIC, and CDSPP. Considerable overlap exists and, often, differences are in the details rather than the overall concept. For example, all three groups require written internship program descriptions but the specific information to be included varies. Similarly, all require that trainees receive copies of due process procedures, that interns are formally evaluated at least two times per year, and that interns receive certificates of successful completion of internship. Again, details vary (e.g., who provides the certificate, the level Psychology in the Schools

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Psychology in the Schools

Require equivalent of 1 year of full-time training to be completed in no fewer than 12 months (or 9–10 months for school psychology internships), or the equivalent of half-time training to be completed within 24 months. (Domain A #4; APPIC # 13; CDSPP #6); APPIC and CDSPP also specify 1,500 hour minimum. Primary training method is experiential/direct contact with service recipients (Domain 3b); at least 25% face-to-face with clients/patients (APPIC # 6); at least 25% face-to-face services to clients, patients, or consultees, such as teachers or other mental health service providers (CDSPP #2) On beginning the internship, the interns receive written information on agency expectations, policies, and procedures related to evaluation (Domain E 4; APPIC #11; CDSPP #3 & 4); they receive a minimum of semiannual written feedback on their performance (Domain E 4; APPIC #15; CDSPP #4) .(Note: CDSPP adds that the supervisor assesses intern performance but the doctoral program is ultimately responsible for evaluation of the intern’s readiness for graduation and entry to profession.) Interns receive information regarding agency policies and due process (Domain A 6 & E 1 & 5; APPIC #12; CDSPP #5) Requires designation of trainee’s status, such as “intern” (IR C-6; APPIC #10; CDSPP #14) Requires a certificate clearly indicating successful completion of doctoral internship issued by internship (Domain E 5; IR C-6(a); APPIC #14); jointly issued by university and internship (CDSPP # 7) The internship program (its goals, objectives, resources, status, expectations, etc.) is described accurately in written materials available to the public and prospective interns (Domain G; APPIC #11; CDSPP # 3) Telesupervision may not account for more than 1 hour (50%) of the weekly minimum individual supervision and not more than 2 hours (50%) of the weekly 4 hours’ total supervision (IR C-28; CDSPP #12). (Note: APPIC does not provide maximum for use—indicating that telecommunication for supervision is permitted in “unusual circumstances” [APPIC #4])

Criteria with Link to Document

Note. Referenced APA criteria (Commission on Accreditation, 2013a, 2013b) are identified by their Domain and/or Implementing Regulation (IR) designations; APPIC references are identified by the numbers used in APPIC Membership Criteria (Association of Psychology Postdoctoral and Internship Centers, 2014); CDSPP references are indicated by the numbers used in the Council of Directors of School Psychology Programs (2012) internship guidelines.

Use of Telesupervision

Public Disclosure

Due Process Intern Title Certificate of Completion

Evaluation Documentation

Face-to-Face Service Delivery

Timing/Duration

Characteristic

Table 1 Commonalities or Alignment between Doctoral Internship Standards in Professional Psychology

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Table 2 Differences between Doctoral Internship Standards in Professional Psychology APA Internship G&P: Includes Domains and Implementing Regulations (IRs)

APPIC Membership Criteria: Doctoral Internship Programs (Revised 2006; Clarified 2011)

Role in Accreditation

The Commission on Accreditation is responsible for accreditation of internship programs

APPIC is not an accrediting body; APA and CPA internships are recognized as meeting APPIC criteria; other programs are reviewed for adherence to APPIC criteria every 3 years “A psychology doctoral internship is an organized training program . . . is designed to provide the intern with a planned, programmed sequence of training experiences. The primary focus and purpose is assuring breadth and quality of training” (APPIC #1) “Internship training is at post-clerkship, post-practicum, and post-externship level and precedes the granting of the doctoral degree” (APPIC #8) “The internship provides training in a range of psychological assessment and intervention activities conducted directly with recipients of psychological services” (APPIC #5)

Goals and objectives of the internship program

“The program has a clearly specified philosophy of training . . . the training model and goals are consistent with its philosophy and objectives” (Domain B) Internship program must be in “developed practice area” (IR C-14) “The program requires all interns demonstrate . . . skills, abilities, proficiencies, competencies and knowledge of . . . . . . theories and methods of assessment and diagnosis and effective intervention (including empirically supported treatments)” (Domain B.4.a; IR C24) “ . . . theories and/or methods of consultation, evaluation, and supervision; . . . strategies of scholarly inquiry . . . issues of cultural and individual diversity” (Domain B)

Minimum number of interns

“The program has an identifiable body of interns . . . completing a doctoral degree in professional psychology” (Domain C 2)

“The internship agency has a minimum of two interns at the predoctoral level of training . . . must be at least half-time” (APPIC # 9)

Supervision frequency

Minimum of two hours weekly of individual supervision with doctoral level licensed psychologist. Two additional hours weekly of individual or group supervision by supervisor(s) appropriately credentialed for their role (Domain B.3, IR C-15-b)

Regularly scheduled individual supervision provided by one or more doctoral level licensed psychologists at a ratio of at least “one hour of supervision for every 20 internship hours” APPIC #4)

CDSPP Internship Guidelines (Ratified November 2012) CDSPP is not an accrediting body; Doctoral programs are responsible for monitoring the quality of non-accredited internships and adherence to guidelines “A school psychology doctoral internship is an organized training program . . . is designed to provide the intern with a planned, programmed sequence of training experiences . . . is the culminating supervised professional practice prior to granting of the doctoral degree . . . consists of range of activities including assessment, evidenced-based intervention, consultation, program development and evaluation, supervision, and research designed to meet the psychological, educational and health needs of the clients. Interns should have experiences with prevention and development of systems supports, as well as with direct intervention for client problems, and should have experiences dealing with cultural and individual diversity” CDSPP #1) “The internship agency has two or more interns engaged in training at the same time. However, agencies having the capacity for only one intern may meet the spirit of this criterion . . . by having regularly scheduled and documented training activities with psychology interns at other sites” (CDSPP # 11) Minimum of two hours weekly of individual supervision with doctoral level licensed psychologist (CDSPP #9) Two additional hours weekly of individual or group supervision conducted by doctoral level psychologist who is licensed or certified by the state to practice as a school psychologist in schools (CDSPP #10) (Continued)


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Table 2 Continued APA Internship G&P: Includes Domains and Implementing Regulations (IRs) Internship supervision

Individual supervision provided by doctoral-level licensed supervisor who is involved in an ongoing supervisory relationship with the intern and has “primary professional clinical responsibility” for the supervision cases (Domain C & IR c-15-b) Supervisors must be doctoral level psychologists who are “appropriately credentialed to practice psychology in the jurisdiction of the internship” (Domain C.1 and IR C-15) Additional hours must be supervised by individuals who are appropriately credentialed for their role/contribution to the program

Professional development/training activities

Must demonstrate sufficient resources to provide training activities consistent with program model/goals

Agreements/financial resources

“The program has the resources required to achieve its training goals . . . support for intern stipends, staff, and training activities” (DomainC3a) “Unfunded internships are strongly discouraged and only permissible in rare and unusual circumstances”; Responsibility for articulating the rationale rests with doctoral and internship program. (IR C-9) Expectation of stipend equity within internship programs including consortia (IR C-9)

School setting requirement

Must include training settings appropriate to the program’s training model (Domain C3e)

APPIC Membership Criteria: Doctoral Internship Programs (Revised 2006; Clarified 2011) There is a “clearly designated doctoral level, licensed staff psychologist who is responsible for the integrity and quality of the training program . . . present at the training facility for a minimum of 20 hours per week” (APPIC # 2) Intern “training staff consists of at least two full-time equivalent doctoral level psychologists” (APPIC #3) “Intern supervision is provided by staff members of the internship agency or by qualified affiliates of that agency who carry clinical responsibility for the cases being supervised. . . . Supervisors must be clearly designated by the agency as clinically responsible for the cases” (APPIC #4 and Clarification) “The internship must provide at least two hours per week of didactic activities such as case conferences, seminars, in-service training or grand rounds” (APPIC # 7)

“The program has the necessary financial resources to achieve its training goals and objectives. Intern stipends shall be reasonable, fair, and stated clearly in advance. Unfunded internship positions are allowable only in unusual and infrequent circumstances . . . Internship positions are equitably funded across the site. Stipends shall be set at a level that is representative and fair in relationship to the geographic location and clinical setting of the training site” (APPIC # 16) Mentions that internship should provide training that meets the requirements for licensure eligibility in the state or jurisdiction (APPIC #13 Clarification)

CDSPP Internship Guidelines (Ratified November 2012) Licensed, doctoral level supervisor employed by agency . . . “responsible for the integrity and quality of the internship program” “The internship agency has at least two psychologists on staff available as supervisors, at least one of which is actively licensed as a psychologist . . . however, agencies such as school districts that have the capacity for only one staff psychologist may meet the spirit of this criterion . . . by entering into consortium agreements” (CDSPP #8)

“The intern has regularly scheduled, supervised, and documented training activities with other doctoral psychology interns.” Agencies having the capacity for only one intern may substitute regularly scheduled and documented training activities with interns from other sites (CDSPP # 11) “Each intern is given a written statement that includes salary, benefits, reimbursable travel, holidays, and other relevant data” (CDSPP #3)

Mentions NASP requirement of a minimum of 600 hours in a school setting but does not explicitly require school hours (CDSPP #6)

Note. Referenced APA criteria (Commission on Accreditation, 2013a, 2013b) are identified by their Domain and/or Implementing Regulation (IR) designations; APPIC references are identified by the numbers used in APPIC Membership Criteria (Association of Psychology Postdoctoral and Internship Centers, 2014); CDSPP references are indicated by the numbers used in the Council of Directors of School Psychology Programs (2012) internship guidelines. Psychology in the Schools

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of detail required in the due process documents) but, for the most part, the differences are relatively minor. Two elements within APA internship accreditation guidelines that are not addressed in the APPIC criteria or adequately covered in the CDSPP Guidelines are Domain D: Cultural and Individual Differences and Diversity and Domain F: Program Self-Assessment and Quality Enhancement. With regard to diversity, the CDSPP guidelines include mention that trainees should have “experiences dealing with cultural and individual diversity,” but neither APPIC nor CDSPP include criteria (parallel to those provided by APA) focused on systematic recruitment/support or coherent training plans related to diversity. Similarly, the CoA emphasizes intern program self-study, whereas neither APPIC nor CDSPP emphasize this requirement. For non-accredited internships, this places the burden on graduate doctoral programs to assess and document how these criteria are met. Intern supervision is a component addressed by all three groups. Both APA and CDSPP guidelines require that interns receive a minimum of 2 hours of weekly individual supervision and an additional 2 hours of individual or group supervision. APPIC stipulates 1 hour of supervision for every 20 internship hours. All three require individual supervision from a clearly designated, doctoral-level licensed psychologist. APA and APPIC explicitly state that supervisors carry clinical responsibility for the services provided by the intern. CDSPP guidelines indicate that supervisors evaluate services provided by the intern, support the intern in the role of psychological service provider, and co-sign reports and documents prepared by the intern. Another important finding is that all three groups have included criteria that accommodate to the unique timing of school-based internships. Although all three groups indicate that a full-time school psychology internship can be completed in no less than a typical school year (APA and CDSPP require a 10-month minimum; APPIC requires a 9–10 month minimum), for APA and APPIC, this is an exception; all other full-time doctoral internships are required to be 12 months in duration. None of the standards specifically require interns to complete hours in a school setting. CDSPP mentions the NASP requirement of 600 school hours, and all three groups emphasize the need for programs and interns to make sure that the internship experience complies with state licensing and certification requirements. One difference in criteria relates to intern stipends. CDSPP guidelines require that interns receive a written statement of salary and benefits, but no mention is made of a minimum. APA and APPIC strongly discourage unfunded internships, and they require programs to justify unfunded internships, although both groups recognize that the amount of stipends reflects local norms and circumstances. A recent article in the NASP Communiqu´e reported that in 2013–2014, 79% of doctoral school psychology interns (including interns from accredited and non-accredited doctoral programs) received stipends. The average annual doctoral stipend was $21,409 (Prus, Colvard & Swerdlik, 2014). Thus, although most doctoral internships include a stipend, some do not. For nonaccredited internship sites seeking to become accredited, stipends and training resources will need to be available and sustainable. Also, doctoral programs that permit students to attend unfunded internships will need to provide justification for this practice as part of maintaining accreditation. Finally, and perhaps central to the potential need for internship guidelines developed by a specialty training council such as CDSPP, is the issue that none of the standards include a requirement that interns develop or hone competencies unique to school psychology or to being a health service provider in a school setting (e.g., classroom observation and intervention skills, knowledge and application of education-specific laws, assessments, diagnoses). In essence, the current CDSPP Guidelines provide a way for internship programs to affirm their commitment to providing quality training parallel to APA accreditation standards and for doctoral programs to evaluate and document the quality of non-accredited internships but they do not go beyond that to define school-specific competencies. Psychology in the Schools

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Doctoral Internships: Quality and Availability PART II: I NTERNSHIP I MBALANCE : S UPPLY

AND

953

D EMAND

Although accredited doctoral training programs in school psychology have always been responsible for ensuring the quality of the internship experiences of their students, the explicit goal of the APA resolution to require APA-accredited internships as criteria for continued program accreditation as well as graduates’ access to licensure provides a strong incentive for programs to focus on placing more students in APA-accredited internships. Currently there are two states, Georgia and Mississippi, where completion of an APA-accredited internship is an eligibility requirement for licensure (Prus et al., 2014). However, the feasibility of all doctoral students from accredited school psychology programs securing APA-accredited internships is the focus of this next section. Numerous published articles have documented the disparity between the number of doctoral students in psychology seeking internships and the number of available positions in APA-accredited internships. There have been two special issues focusing on this topic in the journal Training and Education in Professional Psychology (2007 and 2011), and GradPsych magazine dedicated its March 2012 issue to this topic. Meyerson, Meyerson, Bolson, and Wilson (2013) reported that in 2012, the ratio of the APPIC-listed APA-accredited internships to APPIC applicants was 53%, arguing that university programs could face legal action from unmatched students for failing to provide students with the requirements to graduate. In recent years, considerable efforts and resources have been dedicated to increasing the number of accredited intern positions. For example, in 2012, APA’s Council of Representatives committed up to $3,000,000 for an internship stimulus program (APA, 2013a.), and the number of accredited positions has increased. Nonetheless, the disparity persists, with APPIC reporting an overall match rate of 86% (or 79.8% if those candidates who withdrew are included) in 2014, with only 74.8% of matched applicants securing an accredited internship (Keilin, 2014). Adding to the challenge for school psychology programs is that these numbers do not include doctoral intern applicants who do not participate in the APPIC match because they seek and obtain positions in non-APPIC agencies, such as schools and districts. The next section uses extant data sources to examine the supply and demand sides of the internship imbalance. Research questions focus on identifying the number and kind of APA-accredited internships that are available to school psychology interns and determining the number of students matriculated in APA-accredited school psychology programs who potentially could be required to complete an accredited internship. Also considered is what can be gleaned from the data about the type of accredited and non-accredited internships completed by school psychology trainees. The intent of addressing these questions with current data and analyses is to help inform the decisions that programs and professional associations make as they decide to focus on strategies for creating more APA-accredited internship sites and/or seek other ways of evaluating and monitoring the quality of non-APA-accredited internship sites.

M ETHODS Several data sources were tapped to investigate questions pertinent to the imbalance. One valuable resource for both supply and demand data was the APA Annual Report Online (ARO). All APA-accredited doctoral training programs are required to submit annual updates on every student enrolled in the program. For new students, programs must enter individual demographic and background information. For continuing students, programs are asked to provide annual updates on student progress, including whether the student applied for internship in the previous year. If a student applied for internship, there are additional questions regarding the outcome of the internship application process. Psychology in the Schools

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Similarly, all APA-accredited internship training agencies complete an annual update as well. Agency directors provide specific information about the interns who were selected and trained at the agency the previous year, including the specialty area of each intern. APA provides aggregated data by type of site (e.g., community mental health center, school district or system, consortium). Although program and internship ARO summary reports are available online (see http://www.apa.org/ed/accreditation/programs), additional information was procured by making a formal request to the office of the CoA. With CoA approval, specific 2012 ARO program and internship data were obtained. To examine internship availability, tables listing the number of sites and positions by setting type were obtained and cross-referenced with the specialty areas of the interns filling these positions. To examine the demand side of the equation, program data were used to identify the number of matriculated students who applied and secured accredited and non-accredited internships. Another valuable resource was the data provided by the APPIC website (see http://www. appic.org). Internship sites participating in the APPIC match process provide profiles of their internship training program, including whether the site is APA accredited, the number of available intern positions, and the site’s applicant restrictions or preferences (clinical, counseling, school). Listings available during the summer of 2014 were accessed for this article (Baker & Mendoza-Newman, 2014). In addition, APPIC prepares an annual report detailing the applications received and processed by APPIC, with breakdowns by training specialty and degree types (PhD, PsyD), as well as the associated match rates (APPIC, 2013a). Finally, NASP, in collaboration with the Graduate Education Workgroup, annually surveys graduate programs in school psychology and posts enrollment and internship data for recent years (NASP, n.d.). Summary results of this annual survey were reported by Swerdlik (2014). These data were used to assess the potential demand for doctoral internships, including accredited and currently non-accredited doctoral programs.

R ESULTS Availability of School Psychology Doctoral Internships To understand the internship imbalance as it relates to school psychology, it is useful to consider the available options for prospective interns, especially those who seek experience in a school setting. The availability of school psychology internships was addressed in two different ways. Initially, 2012 APA ARO internship data were used to identify explicitly school or school district sites (APA, 2012b). The data set included 464 accredited internship programs. Of these, six (1%) school district/system sites provided training for 30 interns. There were 38 consortia. Often, consortia include school sites or rotations within the internship program. Although these 38 consortia accounted for the training of 394 interns, only 45 of these intern positions were filled by school psychology interns. The other major resource used to identify potential school psychology internship positions was the 2013–2014 APPIC directory (Baker & Mendoza-Newman, 2014) that listed more than 700 pre-doctoral internship programs (the numbered entries ended at 730; however, approximately 30 entries did not have complete or current information). Within the listing, only 217 programs (138 APA-accredited, seven CPA-accredited, and 72 non-accredited) indicated that they would accept applications from school psychology students. For each of the specialty areas (school, counseling, and clinical), APPIC asks the internship training director to specify “preferred,” “accepted,” or “none” to indicate the program’s willingness to consider applicants from the specialty area. Approximately 500 sites indicated “None” for school psychology. Tables 3 and 4 refer to 217 listed internship sites that accept applications from school Psychology in the Schools

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Table 3 Breakout of Preferences by APPIC Internship Programs That Accept Applications from School Psychology Trainees APA or CPA Accredited

Non-Accredited

School Only Preferred School and Clinical Preferred No Preference Preferred Clinical/ Counseling but Accept School Total

Totals

%

% of APPIC

9

4.1

1.29

9.7

18

8.3

2.57

29 94

20.0 64.8

52 138

24.0 63.6

7.43 19.71

145

100

217

100

31.00

N

%

N

%

1

1.4

8

5.5

4

5.6

14

23 44

31.9 61.1

72

100

N

Note. No Preference includes programs that did not differentiate between specialty areas (i.e., indicated that all specialties were preferred or that all were accepted).

Table 4 Breakout of APPIC Program Specialty Preferences by Total Number of Internship Positions Non-Accredited N School Only Preferred School and Clinical Preferred No Preference Preferred Clinical/Counseling but Accept School Total

APA or CPA Accredited

Total

%

N

%

N

%

3

0.97

51

6.05

54

4.69

10

3.25

112

13.29

122

10.60

98 197

31.82 63.96

184 496

21.83 58.84

282 693

24.50 60.21

308

100.00

843

100.00

1151

100.00

Note. Only includes data for internship programs that accept school psychology applications. No Preference includes programs that did not differentiate between specialty areas (i.e., indicated that all specialties were preferred or that all were accepted).

psychology students. As shown in Table 3, almost two thirds of the sites that do accept school psychology applications nonetheless express a preference for applicants from clinical and/or counseling programs. The “School Only Preferred” group included three consortia and four school districts in Texas. The “School and Clinical Preferred” included a few schools or school districts, some sites serving children with special needs in residential setting, and some agencies providing assessment or therapy services. Notably, there were several therapeutic day schools and a correctional facility school that accepted school psychology applications but preferred applicants from clinical or counseling programs. Finally, two therapeutic day schools in the APPIC listing indicated that they did not accept school psychology applicants. Psychology in the Schools

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Table 4 provides data on the number of internship positions available in the APPIC internship programs that accept school psychology applications. As in Table 3, a majority of the positions were in programs that accept school applicants but prefer clinical or counseling applicants. Only 51 positions were available in APA-accredited sites that specifically indicated a preference for “School” applicants. Another 112 positions were available in accredited sites that indicated a preference for “School and Clinical” applicants. In summary, the pool of APA-accredited internships open to prospective school psychology interns (excluding those from universities with an exclusively affiliated internship program) is very limited, especially for applicants seeking a school-based experience. Although there were more than 20 APPIC internship programs offering some school-based training, preference or even consideration within these programs for applicants from school psychology training programs is not assured. Only about a third of the APPIC sites accept school psychology applicants, and even within this pool, more than 60% of the programs expressed preference for applicants from other specialty areas. Demand for School Psychology Doctoral Internships Analyzing the need or demand for school psychology internships highlights the other side of the imbalance equation. Based on the APA ARO program data for (2012b), there were 70 accredited programs that train school psychologist: 62 school-only programs and 8 programs that combined school psychology training with one of the other specialty areas. According to the program reports to APA, 415 students (327 from school only; 88 from combined) applied for internship for the 2012–2013 academic year. Another source of information about the demand for doctoral internships in school psychology is the NASP Graduate Education Workgroup data base (NASP, 2014). The data base includes 60 of the APA-accredited and 33 non-accredited doctoral school psychology training programs. For the 2013–2014 year, programs reported approximately 346 school psychology interns from APA-accredited programs and an additional 213 doctoral-level school psychology interns from nonaccredited programs. In the short term, this suggests that more than 550 doctoral school psychology internship applicants could be competing for the limited available accredited internships where their competencies are thought to match the needs of the site. In the next couple of years, the disparity will be somewhat less pronounced unless the currently non-accredited doctoral programs seek accreditation and gain approval for an initial site visit. School Psychology and the Internship Match Despite the shortage of accredited internships open to school psychology applicants, of the 415 students from accredited school psychology and combined programs who applied for internship for 2012–2013, 46% obtained APA-accredited internships (APA ARO program data). The percentage from school-only programs was somewhat lower (38%), and applicants from PhD programs fared better (45%) than those from PsyD programs (10%). Not all prospective interns from accredited school psychology and combined programs participate in the APPIC match process. Aside from students in programs with exclusively affiliated internships, there are students who for various reasons choose to seek alternatives outside of the APPIC match process. In 2013, 233 students from school psychology programs and 103 from combined programs registered for the match (Keilin, 2014). These numbers include applicants from non-accredited doctoral programs. Match rates for school psychology and combined program applicants were 69.5% and 81.6%, respectively. In school psychology, the match rate for applicants from PhD programs (74.4%) was significantly higher than the rate for applicants from PsyD programs Psychology in the Schools

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500 450 400 350 300 250 200 150 100 50 0

415

957

399

189 106

81 23 Applied Obtained

APA

CDSPP

APPIC

?

FIGURE 1. 2012 Internship outcomes for trainees from accredited school psychology and combined programs. The category labeled with a question mark is an aggregate of instances in which the programs reported “Other” or the program did not respond.

(36.7%). Combining all match participants (clinical, counseling, school, combined), the match rate was 79.8% (Keilin, 2014). APPIC provides information on the match rates for accredited and non-accredited internships by specialty area. Of the matched applicants in school psychology and combined programs, 82.7% and 79.8%, respectively, matched to accredited internships. The remaining applicants matched to non-accredited internships in the APPIC system. Reviewing the APA ARO program data provides insight into where school psychology internship training occurs. Accredited programs provide individual student data on whether students who applied for internship in the previous year obtained an accredited internship. If the student obtained a non-accredited internship, programs are asked to indicate whether the internship meets CDSPP Guidelines or whether it is one of the non-accredited APPIC internships. Figures 1 and 2 illustrate the match results for applicants from accredited school psychology and combined programs together and then just school psychology programs. The category labeled with a question mark (?) is an aggregate of instances in which the programs reported “Other” or the program did not respond. Of the 313 school psychology applicants who obtained an internship, 189 did not secure an APA-accredited internship. However, 74 of these trainees were in internships that their programs described as meeting CDSPP Guidelines, and 14 were in non-accredited APPIC internships. Results for the aggregate of combined and school-only are comparable. In each case, there are slightly more than 100 interns whose internships are of unspecified characteristics or quality. APA ARO 2012 internship data in Table 5 help clarify the training focus of school psychology interns in APA-accredited internships. Most of the school psychology interns were working within a consortium, consistent with the APPIC findings noted earlier showing a preference by training directors of school-focused consortia for school psychology applications. It is noteworthy that seven (23%) of the interns in the six accredited school district internship programs came from clinical or counseling programs. Also relevant is that 27% of the school psychology interns were in what appear to be “non-school” settings, including 18 students who were interning in medical/hospital settings and 11 in community mental health centers. Psychology in the Schools

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500 450 400 350 300 250 200 150 100 50 0

327

313

124

101

74 14 Applied Obtained

APA

CDSPP

APPIC

?

FIGURE 2. 2012 Internship outcomes for trainees from accredited school psychology programs. The category labeled with a question mark is an aggregate of instances in which the programs reported “Other” or the program did not respond.

Table 5 Substantive Background of Interns as Reported by Internship Program Programs Setting Community Mental Health Center Consortium Correctional Facility General Hospital Health Maintenance Organization Medical Center Medical School Military Medical Center Private General Hospital Private Psychiatric Hospital School District or System State or County Hospital University Counseling Center VA Medical Center Other Total

N 60 38 14 7 2 45 30 11 10 12 6 36 103 74 16 464

Interns School 11 45 0 0 0 13 1 0 3 1 21 0 0 0 13 108

Clinical 225 310 50 29 8 272 153 67 45 57 6 121 173 336 58 1910

Counseling 17 31 8 3 0 15 8 14 3 4 1 6 176 52 5 343

Combined 10 1 0 2 0 8 2 1 1 4 2 5 14 2 8 60

Other 3 7 0 0 0 6 6 1 0 3 0 3 1 2 1 33

Total 266 394 58 34 8 314 170 83 52 69 30 135 364 392 85 2454

Note. Adapted from APA (2012a)

D ISCUSSION

AND I MPLICATIONS

Several important findings emerged in this analysis. It is clear that the number of students matriculated in accredited school psychology programs far exceeds the number of available APA-accredited internships open to school psychology interns. The options are to find ways to increase the number of accredited internship programs with client needs that align with school psychology competencies (and directors of training who value this alignment) and/or to define and adopt procedures for ensuring the quality of non-accredited training sites and experiences. Psychology in the Schools

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Adding accredited school-based programs will be important but not enough. The finding that many APPIC-listed internship training directors—including those at school sites and agencies serving children and families—did not recognize the relevance of school psychology training was informative. One potential implication is that school psychology programs need to consider the expanded skills, such as counseling or therapy, that made the non-school psychology candidates more competitive. Another implication is that the “value added” of school psychology training needs to be better articulated and disseminated to internship programs. Another option for addressing the imbalance is for accredited doctoral programs and highquality non-accredited internship programs to partner in defining and adopting procedures for ensuring the quality of non-accredited internship training experiences. Current NASP accreditation folios require specialist and non-accredited doctoral programs to document the impact on clients of their interns as evidence of intern competencies. In addition, some doctoral programs require a written agreement signed by the university director of training, the internship director and supervising psychologist(s), and the intern prior to the start of the internship. This agreement may include the criteria listed in the CDSPP Guidelines. Procedures and documentation such as these suggest compliance with standards set by APA for accredited internships. In instances where an otherwise high-quality internship does not meet CDSPP Guidelines (e.g., no clear due process procedures or no advertised brochure/internship description), providing easily accessible resources for meeting these requirements might facilitate compliance. However, including procedural safeguards, such as site visits, review of internship products and outcomes, and feedback from interns, supervisors, and clients, could be used to help validate the quality of the experience. An important and related finding is that existing doctoral psychology “standards,” including APA internship accreditation standards, CDSPP guidelines, and APPIC criteria, do not include internship requirements related to the development of specialty-specific knowledge, competencies, and experiences unique to school psychology. Psychologists working in schools need knowledge of education laws, experience collaborating with other school personnel (e.g., teachers, learning specialists, occupational therapists, speech therapists, administrators), skills in psychoeducational and classroom assessment and evidenced-based interventions, and much more. Although CDSPP has recognized and articulated specialty-specific competencies (e.g., Caterino, Hansen, Forman, Harris, & Miller, 2012; Daly, Doll, Schulte, & Fenning, 2011), these taxonomies have not been incorporated into professional standards. As more psychologists from various specialty areas seek positions in schools (see Smith, 2013), the absence of school-specific standards could seriously jeopardize the quality of psychological service delivery in schools. The NASP accreditation and certification guidelines provide some structure for identifying specialty-specific standards. CDSPP could consider creating an addendum to the CDSPP Internship Guidelines that defines school-specific competencies and standards for the related training experiences. In some instances, school psychology trainees enter their doctoral program as credentialed school psychologists. In other instances, doctoral programs permit trainees to document “schoolbased” internship hours apart from a subsequent, more clinically focused, full-time internship. The point of the addendum would be to define doctoral-level school-based training standards and competencies for psychologists seeking to work in schools. Limitations Several important limitations to the results are presented. One limitation is that the reporting years were not always the same. The APA ARO data and the NASP data were from 2012–2013, whereas the APPIC match data were from 2013–2014. In addition, the 2014 APPIC internship site directory (Baker & Mendoza-Newman, 2014) was used to determine the sites’ willingness to Psychology in the Schools

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accept school psychology applicants. Given recent efforts to increase the availability of accredited internships, a decision was made to use the most recent available data from each source. Also, just because a site indicates a willingness to accept applications from school psychology students does not necessarily mean the site has a history of selecting school psychology applicants. Conversely, anecdotal evidence suggests that some sites indicate that they do not accept school psychology applications, but on occasion, they have interviewed and matched with school psychology applicants. Another limitation is that there are likely to be other internship sites that are not in school districts or consortia that include school experiences or competencies not mentioned in the agency description, thus underestimating the potential sites for school psychology interns. Finally, doctoral programs self-report whether the internships of their students conform to CDSPP Guidelines, and the accuracy of this reporting has not been evaluated. Ultimately, it seems likely that a multipronged approach will be needed in resolving the internship imbalance and ensuring the quality of training for psychologists who work in schools. Increasing the availability of APA-accredited internships for school psychology trainees through university partnerships and consortia is one approach. Rigorous monitoring by university programs of internship compliance with CDSPP Guidelines provides an alternative. The success of these efforts may hinge on defining and disseminating standards that reflect the “value added” of school psychology training as a “gold standard” for work in schools. R EFERENCES American Psychological Association. (2012a). Commission on Accreditation (CoA) 2012 annual report online (ARO) internship data. Retrieved from http://www.apa.org/ed/accreditation/about/research/index.aspx American Psychological Association. (2012b). Commission on Accreditation (CoA) 2012 annual report online (ARO) program data. Retrieved from http://www.apa.org/ed/accreditation/about/research/index.aspx American Psychological Association. (2013a, December). Helping to address internship imbalance with grants to support creation of accredited internships. Retrieved from http://www.apa.org/pubs/newsletters/access/2013/12-16/internshipimbalance.aspx American Psychological Association. (2013b, August). Resolution on accreditation for programs that prepare psychologists to provide health services. Retrieved from http://www.apa.org/ed/graduate/accreditation-resolution-programs.aspx American Psychological Association, Commission on Accreditation. (2015). Standards of Accreditation for Health Service Psychology. Retrieved from http://www.apa.org/ed/accreditation/about/policies/standards-of-accreditation.pdf Association of Psychology Postdoctoral and Internship Centers. (2013a). Appendix A: Internship data summaries 2011–2012. Retrieved from http://www.appic.org/Directory/Stats-Other-Directories Association of Psychology Postdoctoral and Internship Centers. (2013b, May). APPIC policy on doctoral program associates. Retrieved from http://www.appic.org/AboutAPPIC/APPICPolicies/DPAPolicy.aspx Association of Psychology Postdoctoral and Internship Centers. (2014). APPIC Membership Criteria: Doctoral Psychology Internship Programs. Retrieved from http://www.appic.org/AboutAPPIC/JoiningAPPIC/MembershipCriteria.aspx Baker, J., & Mendoza-Newman, M. (Eds.). (2014). APPIC Internship and post doctoral programs in professional psychology: Fortieth Edition, 2013–2014. Retrieved from http://www.appic.org/Portals/0/downloads/2013-14_APPIC_Directory.pdf Board of Educational Affairs Task Force on Supervision Guidelines. (2014). Guidelines for clinical supervision in health service psychology. Retrieved from http://www.apa.org/about/policy/guidelines-supervision.pdf Caterino, L., Li, C., Hansen, A., Forman, S., Harris, A., & Miller, G. (2012). Practicum competencies outline: A reference for school psychology doctoral programs. The School Psychologist, 66, 40–51. Commission on Accreditation. (2013b). Guidelines and principles for accreditation of programs in professional psychology (G&P). Washington, DC: APA. Commission on Accreditation. (2013b). Implementing regulations–Section C: IRs related to the guidelines and principles. Washington, DC: APA. Council of Directors of School Psychology Programs. (2012). CDSPP doctoral level internship guidelines. Retrieved from https://sites.google.com/site/cdspphome/2012guidelines Daly, E. J., III., Doll, B., Schulte, A. C., & Fenning, P. (2011). The competencies initiative in American professional psychology: Implications for school psychology preparation. Psychology in the Schools, 48, 872–886. DiPerna, J. C. (2012). Directory of internships for doctoral students in school psychology: 2013–2014. Retrieved from http://www.ed.psu.edu/epcse/school-psychology/internship-directory Psychology in the Schools

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Joint Committee on Internships. (1987). Directory of pre-doctoral internships for students in school psychology. University Park: Pennsylvania State University. Keilin, G. (2014, March). Association of Psychology Postdoctoral and Internship Centers (APPIC) match statistics: Combined results Phase I and II. Retrieved from http://www.appic.org/Match/MatchStatistics/MatchStatistics2014Combined.aspx Meyerson, D. A., Meyerson, L. N., Bolson, A., & Wilson, G. A. (2013). A legal “case” against the internship placement system and a proposal to fix the system and the internship imbalance. Training and Education in Professional Psychology, 7, 174–184. National Association of School Psychologists. (2010). Standards for graduate preparation of school psychologists. Retrieved from http://www.nasponline.org/standards/2010standards.aspx National Association of School Psychologists. (2014). Graduate Education Workgroup data base. Retrieved from http://www.nasponline.org/graduate-education/grad-edu.aspx National Association of School Psychologists. (n.d.). School Psychology Program Information. Retrieved from http://www.nasponline.org/graduate-education/grad-edu.aspx Prus, J. S. (2009). Best practice guidelines for school psychology internships. Retrieved from http://www.nasponline. org/publications/cq/37/8/internship.aspx Prus, J. S., Colvard, H., & Swerdlik, M. E. (2014). The prevalence of paid school psychology internships in the United States. NASP Communiqu´e, 43(3), 28–29. Smith, B. L. (2013). Expanding school-based care. APA Monitor, 44, 45–47. Swerdlik, M. E. (2014, January). 2014 Graduate Education Workgroup update. Paper presented as the 2014 Mid-Winter Meeting of the Council of Directors of School Psychology Programs, Hollywood Beach, FL.


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