A
CONCEPTUAL FRAMEWORK FOR SPECIALIZATION
IN
THE HEALTH SERVICE DOMAIN
OF
PROFESSIONAL PSYCHOLOGY
Council of Credentialing Organizations in Professional Psychology (CCOPP)
January 2004
Over the past six
decades psychology has experienced an exponential growth of scientific
knowledge and professional practice applications. The differentiation of the
profession has resulted in an expanded scope of practice and increased the
desire and need for specialized education and training. How to reflect that
specialization in a way that increases the likelihood of a clear understanding
by the public presents a challenge. Today, practitioners use words like
emphasis, concentration, or specialization in labeling their patterns of
practice. Such labels are typically
based on the practitioner’s education, training and experience. Labeling of psychologists and their practice
patterns relates directly to the history of specialization in professional
psychology and organized structures associated with that effort. Following is a brief introduction to the
complex and rich history of specialization in psychology.
In the 1940’s the first named specialties originated from the need of the US Public Health Service and Veterans Administration Hospitals to identify graduates of qualified training programs in clinical and counseling psychology. At about the same time, the American Psychological Association (APA) recognized the need for an independent practitioner certification function to be apart from itself, as a membership organization. Thus, prompted by APA action, the American Board of Examiners in Professional Psychology, renamed later as the American Board of Professional Psychology (ABPP), was established in 1947 to certify psychologists for independent practice in the near absence of state licensure laws. The broad areas of practice chosen for these practitioners are now known as Clinical, Counseling, and Industrial-Organizational Psychology. In 1968, School Psychology was added. With both training standards and specialty certification of individuals in place, the areas of practice in Clinical, Counseling, Industrial-Organizational, and School Psychology became consensually recognized (de facto) or at least labeled as specialties in professional psychology. However, organized psychology became concerned about the absence of a formal (de jure) process for recognizing specialties.
By the late 1970’s pressures were mounting in professional psychology for establishment of a formal process for specialty recognition, stimulating recommendations from the APA Task Force on Specialty Criteria (1979), the APA Board of Professional Affairs Subcommittee on Specialization (SoS)(1980-86), and the Canadian Psychological Association (CPA)/Council of Provincial Associations of Psychologists (CPAP)(1988). Building upon the criteria and procedures recommended by SoS, ABPP instituted its own specialty identification policies and recognized clinical neuropsychology and forensic psychology in 1984 and 1985, respectively, and subsequently recognized additional specialties.
In 1995, APA designed and implemented a de jure process for the recognition of specialties in professional psychology when it established the Commission for the Recognition of Specialties and Proficiencies in Professional Psychology (CRSPPP). Since that date APA has recognized ten specialties through this process. Although the recognition processes of ABPP and APA have been independent of one another, there is a high degree of overlap between the specialties recognized today by the two organizations. For the list of specialties recognized by each organization, see Appendix A.
Accreditation
Process for Education and Training in Specialties
Building upon the Ann
Arbor Conference on Postdoctoral Residency Training Programs in Professional
Psychology, the Inter-organizational Council for Accreditation of Postdoctoral
Programs in Psychology (IOC) was organized in 1992 and included the major
professional psychology organizations concerned with education, training and
credentialing in the US and Canada. Its
work in collaboration with the APA Committee on Accreditation (CoA) led to a
conceptual framework within which the CoA initiated the accreditation of postdoctoral
training programs in 1999. The IOC also
fostered the recognition of specialties at the postdoctoral level by endorsing
in 1997, at the time it completed its mission and disbanded, the formation of
the Council of Specialties in Professional Psychology (CoS), which continues to
contribute to the development of education and training standards for each
specialty.
At the time CRSPPP was established, APA and other affected groups created an inter-organizational roundtable, now named the Council of Credentialing Organizations in Professional Psychology (CCOPP), to be a forum to promote open lines of communication and reduce policy conflict on issues of specialty and proficiency recognition, accreditation, and credentialing. CCOPP was to do this through sharing expertise and information, initiating policy discussions, and referring relevant analyses to parent bodies for their review and consideration. CCOPP is not itself a policy and decision-making body, independent from its member organizations. Rather, its role is to discuss and analyze from different perspectives issues that may have policy implications. Proposals may then be formulated and forwarded to its member organizations for their independent deliberation and action, as appropriate. The current membership of CCOPP includes the following organizations:
· American Board of Professional Psychology (ABPP);
· APA Committee on Accreditation (CoA);
· College
of Professional Psychology of the APA Practice Organization (CPP);
· APA Commission for the Recognition of Specialties and Proficiencies in Professional Psychology (CRSPPP);
· Association of Psychology Postdoctoral and Internship Centers (APPIC);
· Association of State and Provincial Psychology Boards (ASPPB);
· Canadian Psychological Association (CPA);
· Canadian Register of Health Service Providers in Psychology (CRHSPP);
· (Canadian) Council of Provincial Associations of Psychologists (CPAP);
· Council of Specialties in Professional Psychology (CoSPP), and
· National Register of Health Service Providers in Psychology (NRHSPP).
In order to carry out its task, representatives of the organizations participating in CCOPP determined early in their deliberations the need for a conceptual framework for specialization in professional psychology, something that at that time did not exist. Consequently, CCOPP undertook this challenge, recognizing that any conceptual framework developed for specialization represents a dynamic, evolving, and developmental process subject to change over time. In doing so, CCOPP limited its scope of consideration to health service psychology specialties, as that subset of professional specialties represents the largest single portion of direct service providers in psychology. Moreover, the conceptual framework does not address proficiencies, practice emphases, or other subdivisions of practice in professional psychology.
The conceptual framework is organized around a set of core principles. The principles are not intended to constrain further evolution of specialization, but rather to provide guidance for deliberation about such a process. Set forth in the form of recommendations, the principles are intended to advance coherence and clarity for the education, accreditation, regulation, and credentialing systems in the health service domain of professional psychology. The principles are organized around four basic clusters:
·
Education and Training
·
Specialty Recognition
·
Accreditation and Credentialing
·
Coordination
The principles are based on the following
definitions and assumptions.
Definitions
Discipline: The knowledge, skills,
attitudes, and values of professional psychologists are contained within the
broad discipline named “psychology.”
Realm: The discipline of psychology may be characterized by a number of
realms (e.g., science, education, public interest, practice) which inform each
other. The realm of professional
psychology pertains to the provision of professional services to the public.
Domain: Within the realm of professional
psychology there are different domains or broad areas of practice. The domain of health service psychology
includes the promotion, maintenance, and improvement of health status in the
context of the World Health Organization’s definition of health as “a state of
complete physical, mental, and social well-being and not merely the absence of
disease or infirmity.” Within a domain
may be one or more specialties of professional practice.
Specialty: An area of professional practice requiring didactic and experiential
preparation that provides the basis for competent services with respect to the
distinctive patterns of the following essential parameters of practice: (a)
populations served; (b) psychological, biological, and social problems
targeted; and (c) procedures and techniques used.
Recognized specialty: A
recognized specialty is so designated by a formal process conducted by a national body constituted for that
purpose. Currently there are two bodies that recognize specialties in
professional psychology, the American Board of Professional Psychology and the
American Psychological Association (through the Commission for the Recognition
of Specialties and Proficiencies in Professional Psychology).
Specialty organization: The
organization, composed of representatives of the major constituent bodies
within a specialty, that is constituted with the purpose of identifying the
education, training, credentialing, and practice parameters for purposes of
recognition, accreditation, or credentialing in that specialty.
Specialist: A licensed psychologist who
self-identifies specialty expertise and who practices in one or more specialty
areas based on appropriate didactic and experiential preparation.
Certified specialist: A licensed psychologist who has voluntarily
submitted to a verification of the education, training, and experience required
by a recognized specialty including an examination demonstrating competence in
the specialty.
Competence: The demonstrated capacity to apply
appropriately and effectively domain knowledge, skills, attitudes, and values
acquired in organized sequences of education, training, supervision, and study
based on the foundational and functional competencies that define the realm of
professional psychology.
Foundational
Competencies:
The knowledge, skills, attitudes, and values that are foundational to
professional functions and are based upon the values and science of the
discipline of psychology and the realm of professional practice. Examples of
foundational competencies include but are not limited to: (a) self-assessment
and reflective practice; (b) familiarity with requisite scientific knowledge
and methods; (c) capacity for effective relationships; (d) adherence to ethical
and legal standards; (e) respect for individual and cultural diversity; and (f)
ability to function in interdisciplinary systems.
Functional Competencies: The professional roles and activities that require the integration and application of knowledge, skills, attitudes, and values foundational to the domain of professional practice in which one engages. This category of competencies includes but is not limited to: (a) assessment, diagnosis, and case conceptualization; (b) intervention; (c) consultation; (d) research and evaluation; (e) supervision and teaching; and (f) management and administration.
Specialty-distinctive
Competencies:
The competencies that distinctively characterize a specialty.
Commentary: Specialty-distinctive
competencies result from the combination of foundational and functional
competencies in relation to specific patterns of practice defined by
populations served, problems targeted, and procedures or methods used in the
context of various settings of practice common to a specialty.
For
an elaboration of foundational and functional competencies, see Appendix B.
Assumptions
Underlying the Core Principles
A. The
principles set forth in this document are intended for the domain of health
service psychology within the realm of professional psychology. They may or may not apply to other domains
of professional practice.
B. Psychologists
may choose to focus their professional practice in a particular area. Nothing herein is intended to prevent
licensed, certified, or registered psychologists from practicing in an area for
which they are qualified by education, training, experience and study.
C. Health
service psychologists are defined by a professionally acceptable doctoral
degree in psychology, at least two years of appropriately supervised experience
and training in health service provision, and are required by law to be
licensed, certified, or registered for independent practice and to practice
within their areas of competence as defined by their education, training,
experience, and study.
D. While
recognizing that credentialing as a health service psychologist, or as a
specialist in health service psychology, has been and will continue to be
voluntary, the public uses this information to identify qualified
providers.
E. Professional
psychology has independent, recognized organizations that are responsible for
the formal recognition of specialties, the accreditation of education and
training programs related to recognized specialties, the licensing of
professional practitioners, and the certification of practitioners as health
service psychologists and specialists.
F. Specialty
education and training within the domain of health service psychology may occur
at doctoral and postdoctoral levels.
Core Principles for Specialization
in the Health Service Domain of Professional
Psychology
Education and Training
Principles
Core Principle #1
The
functional competencies essential to
the health service domain and to its specialties are acquired in an organized
and integrated program. They are built
upon and integrated with the foundational
competencies of the realm of
professional psychology acquired through doctoral education and training.
Commentary: Recognized specialties
incorporate all the functional competencies and are not limited to a single
functional competency.
Core Principle #2
Each specialty
organization within the health
service domain defines the doctoral and postdoctoral education, training,
and supervised experience sequence(s) required for completion of realm and domain education and training as well as the acquisition of specialty-distinctive competencies.
Commentary: Specialties in
the health service domain require that in addition to specialty training, the
education and training covering the professional foundation realm and health
service domain competencies are completed.
The sequence and timing of the acquisition of these competencies are
determined by each specialty organization.
Core Principle #3
Each specialty organization within the health service domain is responsible for establishing and reviewing its specialty-specific guidelines for education and training programs, and for continuing professional development.
Commentary: The specialty organization identifies and
modifies the education and supervised training experiences that are necessary
for the preparation, practice, and continuing professional development of its
specialists. The education and training guidelines will be validated
consensually by specialists, educators, trainers, and credentialing bodies in
the specialty. The development of these guidelines will be informed by relevant
stakeholders, e.g., students.
Core Principle #4
Education
and training requirements in the health
service domain and in the broader professional
realm will be reviewed periodically to assess their continuing
effectiveness and relevance.
Specialty Recognition
Principles
Core Principle #5
Specialty preparation extends beyond
foundational preparation and the competency
level required of all psychologists in the health service domain. The
professional literature that undergirds the specialty includes theoretical
foundations and descriptions of specialty-relevant populations, practice
methods, procedures and patterns of practice, and studies of the effectiveness
of specialty services.
Commentary: The specialty knowledge base must be distinguishable from that
which characterizes the scientific and professional foundations of the realm of
professional psychology and from that which characterizes other health service
domain specialties. While there may be
areas of overlap between recognized specialties in some elements of practice,
each specialty demonstrates a distinct pattern of practice.
Core Principle #6
The
specialty organization demonstrates
that the specialty meets a public
need and has identified a sufficient number of practitioners from whom the
public can receive such services.
Continued recognition of a specialty is subject to periodic review.
Commentary: Public need may be demonstrated by incidence, prevalence, and
burden of various conditions that psychologists engaged in the practice of the
specialty address; by numbers of members of the public who have sought services
for these conditions; by the number of specialists being trained, entering
practice, and successfully pursuing their careers; and by such other objective
indices of need as may be presented by petitioners seeking recognition.
Professional education and training programs that prepare psychologists for recognized specialties in the health service domain seek accreditation for the benefit of their students and quality assurance for the public.
Commentary. Relevant accrediting bodies and specialty organizations support the development of accreditation for programs for recognized specialties in the health service psychology domain.
Core Principle #8
Psychologists intending to practice in the health service domain obtain appropriate
recognition that documents their competence
to practice.
Commentary: Such psychologists are required to be licensed, certified, or registered as a psychologist for independent practice. It also serves the profession and the public interest for psychologists to seek voluntary credentials in ways that accurately reflect their areas of practice.
Core Principle #9
The
recognition of specialists involves
credentialing boards and credentialing procedures. These voluntary
credentialing processes include an application with specified standards for
education and training, verification of same, professional peer review, and a
valid and reliable examination process.
Commentary: Any new area of
specialization has an implementation plan for developing the above at the time
of their application for recognition.
The purpose of these processes is to improve the quality of service and
aid in the protection of the public.
Core Principle #10
Specialty organizations, at the time of their
application for recognition of the specialty they represent, develop transition
policies for specialty credentialing of practitioners currently working in the
specialty, but who entered practice before the development of the current
prescribed education and training sequence in that specialty.
Coordination Principles
Core Principle #11
Each
specialty organization develops a
mechanism to facilitate the coordination of credentialing, educational policy
development, and continued recognition for their specialties on a continuing
basis.
Core Principle #12
Specialty
credentialing boards in the health service domain are members of a
multispecialty oversight and coordinating organization that facilitates common
procedural standards and peer review.
An
interspecialty forum coordinates policy, promotes collaboration, and resolves
issues related to education, training, credentialing, and practice in recognized specialties.
Core Principle #14
A
representative interorganizational body that includes organizations that
recognize specialties, that accredit and designate programs, and that
credential and regulate practitioners will facilitate the coordination of
credentialing, regulation, and policy development for specialties in the health service domain.
Commentary: Professional credentialing and regulatory activities may impact
other communities. Therefore, this body
consults with education and training, practice, and other groups as needed to
fulfill its mission.
Conclusions and Next Steps
The Conceptual Framework for
Specialization in the Health Service Domain of Professional Psychology set
forth in this document is the first of its kind. It is organized around a set of definitions, assumptions, and
core principles. CCOPP developed this
conceptual framework within the rich historical context of developments in the
profession of psychology for the purpose of affording common ground on which to
advance psychology as a health profession.
This consensus document was developed and approved by CCOPP for
dissemination. CCOPP recommends that
its constituent organizations and other stakeholders review and adopt the Conceptual Framework as the basis for
the further development of specialization in the health service domain of
professional psychology.
Appendix A: Recognized Specialties of
Professional Psychology
(As of January 2004)
|
Specialty Name |
Recognized by |
Member of CoS 3 |
|
|
ABPP [1] |
APA [2] |
||
|
Behavioral Psychology 4 |
Yes |
Yes |
Yes |
|
Clinical Psychology |
Yes |
Yes |
Yes |
|
Clinical Child Psychology 5 |
Yes |
Yes |
Yes |
|
Clinical Health Psychology |
Yes |
Yes |
Yes |
|
Clinical Neuropsychology |
Yes |
Yes |
Yes |
|
Counseling Psychology |
Yes |
Yes |
Yes |
|
Family Psychology |
Yes |
Yes |
Yes |
|
Forensic Psychology |
Yes |
Yes |
Yes |
|
Group Psychology |
Yes |
No |
Yes |
|
Industrial-Organizational Psychology |
No |
Yes |
No |
|
Organizational Business Consulting |
Yes |
No |
No |
|
Psychoanalysis in Psychology |
Yes |
Yes |
Yes |
|
Rehabilitation Psychology |
Yes |
No |
Yes |
|
School Psychology |
Yes |
Yes |
Yes |
Appendix B: Foundational and Functional
Competencies
Self-Assessment and Reflective Practice: Practice conducted within the boundaries of competencies, commitment to life-long learning, engagement with scholarship, critical thinking and respect for scientifically derived knowledge, and a commitment to the development of the profession.
Familiarity with Scientific Knowledge and Methods: Research methodology, techniques of data collection and analysis, biological bases of behavior, cognitive-affective bases of behavior, life-span human development.
Capacity for Effective Relationships: Capacity to relate effectively and meaningfully with individuals, groups and or communities.
Adherence to Ethical and Legal Standards: Application of ethical concepts and awareness of legal issues regarding professional activities with individuals, groups and organizations.
Respect for Individual and Cultural Diversity: Understanding and sensitivity in working professionally with diverse individuals, groups, and communities who represent various cultural and personal background and characteristics.
Ability to Function in Interdisciplinary Systems: Identification and involvement with one’s colleagues and peers. Knowledge of key issues and concepts in related disciplines and the ability to interact with professionals in them.
Assessment, Diagnosis and Case Conceptualization: Assessment and diagnosis of problems and issues associated with individuals, groups and organizations.
Intervention: Interventions designed to alleviate suffering and to promote health and well being of individuals, groups and organizations.
Consultation: The ability to provide expert guidance or professional assistance in response to a client’s needs or goals.
Research and Evaluation: The generation of research that contributes to the professional knowledge base and evaluates the effectiveness of various professional activities.
Supervision and Teaching: Supervising and training of the professional work of students, trainees, residents, and staff members.
Management and Administration: Managing the practice of health service psychology and related services, and the administration of health organizations, programs and agencies.
[1] American Board of Professional Psychology (http://www.abpp.org/)
[2] American Psychological Association (http://www.apa.org/crsppp/)
3 Council of Specialties in Professional Psychology (http://www.cospp.org/)
4 Name change of specialty approved by ABPP in 2003 is Cognitive and Behavioral Psychology
5 Name of specialty as approved by ABPP in 2003 is Clinical Child and Adolescent Psychology