The key components of a clinical psychology formulation: A consensus study.

OBJECTIVE: Psychological formulation is a key competency for clinical psychologists. However, there is a lack of consensus regarding the key components and processes of formulation that are hypothesized to contribute to poor reliability of formulations. The aim of this study was to develop consensus on the essential components of a formulation to inform training for clinical psychologists and best practice guidelines. METHODS: A Delphi methodology was used. Items were generated from the literature and discussed and refined with a panel of experts (n = 10). In round one, 110 clinical psychologists in the United Kingdom rated the importance of components of formulation via an online questionnaire. Criteria for consensus were applied and statements were rerated in round two if consensus was not achieved. RESULTS: Consensus was achieved on 30 items, with 18 statements regarding components of a formulation and 12 statements regarding formulation process. Items that clinicians agreed upon emphasized the importance of integrating sociocultural, biological, strengths and personal meaning alongside well-established theoretical frameworks. Consensus was not reached on 20 items, including whether a formulation should be parsimonious or adhere to a model. CONCLUSION: Our findings provide mixed evidence regarding consensus on the key components of formulation. There was an agreement that formulation should be client-led and incorporate strengths and sociocultural factors. Further research should explore client perspectives on the key components of formulation and how these compare to the clinicians' perspectives.

Fragilising clients: A positioning analysis of identity construction during clinical psychology trainees' supervision.

CONTEXT: Western mental healthcare system reforms prioritise person-centred care and require clinicians to adjust their professional positions. Realising these reforms will necessitate clinicians-including clinical psychologists-acquiring professional identities that align with them. Learners develop professional identities through socialisation activities: within interactional spaces such as supervision learners come to understand the self (clinician) and, by extension, the other (client). A clinician's understanding of who I am is intertwined with an understanding of who they are. Our study offers a moment-by-moment examination of supervision interactions of clinical psychology trainees to illuminate processes through which the identities of therapists and clients are constructed. AIM: We examined how clinical psychology trainees and supervisors construct identities for themselves and clients in supervision. METHODS: We used positioning analysis to explore identity construction during interactions between supervisors (n = 4) and trainees (n = 12) in a clinical psychology training clinic. Positioning analysis focuses on the linguistic choices participants make as they position themselves (and others) in certain social spaces during everyday interactions. Twelve supervision sessions were audio recorded and transcribed. We found that clients were frequently positioned as fragile and subsequently analysed these sequences (n = 12). RESULTS: Clients' identities were constructed as fragile, which co-occurred with clinical psychologists' claiming positions as responsible for managing their distress. Supervisors played an active role in linguistically positioning clients and trainees in this way. Trainees rarely contested the identities made available to them by supervisors. DISCUSSION AND CONCLUSION: We suggest that linguistically positioning clients as fragile perpetuates paternalistic clinical discourses that do not align with mental healthcare reform priorities. We make visible how this is achieved interactionally through language and influenced by organisational power relations. Intentional efforts are required to support the professional identity construction of clinical psychologists in ways that do not perpetuate paternalism. We offer recommendations for education and clinical practice to support these efforts.

Queridos Residentes, Cuidaos: una Guía Para Sobrevivir a la Psicología Clínica / Dear Trainees, Take Care of Yourselves: A Guide to Surviving Clinical Psychology

La residencia en psicología clínica es un proceso que pondrá al límite la capacidad de adaptación de los residentes,especialmente si no gozan de la supervisión y el soporte institucional adecuados. Conscientes de esta situación, estetrabajo pretende normalizar la complejidad que supone formarse como psicólogo clínico en España, poniendo unénfasis especial en los primeros pasos como residente en el Sistema Nacional de Salud y en los desafíos personalesque ello implica. Asimismo, persigue incrementar la sensibilidad sobre la necesidad de medidas que permitan a losresidentes sobrevivir a la psicología clínica. Por ende, se discute el estado del arte sobre el concepto de autocuidadodentro del campo de la psicología clínica y la psicoterapia desde la perspectiva de que especialistas mejor formadospodrán mejorar el Sistema Nacional de Salud y la atención a la salud mental de los más vulnerables.(AU)

The training system in clinical psychology in Spain is a process that will test the adaptability of trainees to thelimit, especially if they do not have adequate supervision and institutional support. Aware of this issue, this paperaims to normalize the complexity of training as a clinical psychologist in Spain, placing special emphasis on thefirst steps as a trainee in the National Health System and on the personal challenges involved. Moreover, it seeksto increase sensitivity and awareness about the importance of establishing measures that enable trainees to surviveclinical psychology. Therefore, the state of the art on the topic of self-care within the field of clinical psychologyand psychotherapy is discussed from the perspective that better trained specialists will improve the National HealthSystem and mental health care for the most vulnerable people.(AU)

Evaluating training needs in clinical psychology doctoral programs.

OBJECTIVE: Advances in clinical psychology must be accompanied by advances in training. This study assessed training content, quality, and needs during clinical psychology doctoral programs among current or past doctoral students. METHODS: Current or past clinical psychology doctoral students (N = 343) completed an anonymous survey assessing training experiences and needs. A descriptive-focused exploratory factor analysis (EFA) also examined whether common subgroups of academic interests emerged. RESULTS: Most participants reported that they sought training beyond required coursework, primarily in clinical training, cultural competency, and professional development, and reported having taken one or more unhelpful course, including discipline-specific knowledge requirements. Descriptive results from the EFA demonstrated common training areas of interest: diversity topics, biological sciences, clinical practice, and research methods. DISCUSSION: This study demonstrates that trainees and early career psychologists are aware of their nuanced and in some cases, unmet training needs. CONCLUSION: This work foregrounds the need to adapt extant training opportunities to support the next generation of clinical psychologists.

Cultivating a Relevant Supervisory Space: Culturally Expressive and Responsive Model for Supervision in Neuropsychology.

OBJECTIVE: Provision of supervision is an integral component of training in psychology, a view that was solidified in 2014 with the development of the American Psychological Association created Guidelines for Clinical Supervision in Health Service Psychology ( APA, 2014). Current supervisory standards require several components before a relationship is considered supervisory. Among these are assumptions that the supervisory relationship is respectful and collaborative, that feedback is bidirectional, and that it focuses on the development of competency and professional identity by the supervisee. Although clinical and counseling psychology has created supervision models with a variety of different theoretical orientations focused on multiculturalism, neuropsychology as a specialty lacks cohesive, culture-centric, bidirectional supervisory models. METHOD: A systematic review of two electronic databases (PubMed and PsycInfo) was conducted to search for supervision models designed specifically for training in neuropsychology. RESULTS: A new model for supervision in neuropsychology was developed, coined the Culturally Expressive and Responsive (CER) Model for Supervision in Neuropsychology. The model is dynamic, multifaceted, and bidirectional, integrating sociocultural and linguistic considerations throughout the supervisory relationship. CONCLUSIONS: The different facets of the CER Model are discussed, including its place embedded within a larger equitable healthcare model designed to increase healthcare equity. The CER Model highlights the bidirectional supervisory relationship and is designed to be tailored to the developmental level of the learner, encouraging high quality training and evidenced-based practice. Furthermore, the model encourages a process of identity development that is ongoing and emphasizes self-evaluation and cultural humility rather than a static sense of "competence."

Prescriptive authority for psychologists: The next step.

[Correction Notice: An Erratum for this article was reported online in Psychological Services on Jul 11 2022 (see record 2022-79840-001). In the original article, changes were needed to clarify the timeline of state legalizations of prescriptive authority for psychologists (RxP) and the current status of RxP with regard to the Federal Bureau of Prisons (BOP). In the second paragraph of the "RxP From 2011 to Present" section, the citations relating to legalization in Idaho and Iowa were corrected, and the year in the Prescribing Psychologist reference was corrected in the References section and in text citations throughout. Additionally, in the last paragraph of the "RxP From 2011 to Present" section, the text was updated to clarify that at the present time, prescribing psychologists are not able to prescribe for the BOP. All versions of this article have been corrected.] Since the endorsement of prescriptive authority for psychologists (RxP) by the American Psychological Association (APA) in 1995, it has become legal in five states (Idaho, Illinois, Iowa, Louisiana, and New Mexico). The Department of Defense, including the U.S. Air Force, U.S. Army, and U.S. Navy, as well as the Public Health Service, and the Indian Health Service, continue to utilize prescribing psychologists as well. There are now over 200 prescribing psychologists in the United States. Five APA-designated RxP training programs offer a pathway to attain prescription privileges and future board certification when approved. The purpose of this article is to provide information for those with minimal exposure to RxP, updates for those more informed, and recommendations for the next phase of RxP. This article examines scholarship related to RxP as well as newsletter columns, state legislative efforts, current RxP laws, policies, training programs, and critical events in the RxP history. Public access to quality and comprehensive mental health services can be expected to improve as more psychologists complete the necessary RxP training and licensure requirements. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

"Prescriptive authority for psychologists: The next step": Correction.

Reports an error in "Prescriptive authority for psychologists: The next step" by Steven Eric Curtis, Samantha Hoffmann and Maeve O'Leary Sloan (Psychological Services, Advanced Online Publication, May 05, 2022, np). In the original article, changes were needed to clarify the timeline of state legalizations of prescriptive authority for psychologists (RxP) and the current status of RxP with regard to the Federal Bureau of Prisons (BOP). In the second paragraph of the "RxP From 2011 to Present" section, the citations relating to legalization in Idaho and Iowa were corrected, and the year in the Prescribing Psychologist reference was corrected in the References section and in text citations throughout. Additionally, in the last paragraph of the "RxP From 2011 to Present" section, the text was updated to clarify that at the present time, prescribing psychologists are not able to prescribe for the BOP. All versions of this article have been corrected. (The following abstract of the original article appeared in record 2022-58802-001). Since the endorsement of prescriptive authority for psychologists (RxP) by the American Psychological Association (APA) in 1995, it has become legal in five states (Idaho, Illinois, Iowa, Louisiana, and New Mexico). The Department of Defense, including the U.S. Air Force, U.S. Army, and U.S. Navy, as well as the Public Health Service, and the Indian Health Service, continue to utilize prescribing psychologists as well. There are now over 200 prescribing psychologists in the United States. Five APA-designated RxP training programs offer a pathway to attain prescription privileges and future board certification when approved. The purpose of this article is to provide information for those with minimal exposure to RxP, updates for those more informed, and recommendations for the next phase of RxP. This article examines scholarship related to RxP as well as newsletter columns, state legislative efforts, current RxP laws, policies, training programs, and critical events in the RxP history. Public access to quality and comprehensive mental health services can be expected to improve as more psychologists complete the necessary RxP training and licensure requirements. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Preliminary Study of Clinical Psychology Doctoral Students' Training in Food Insecurity Assessment and Resource Provision.

Food insecurity (FI) is common among people with mental illness and is associated with poor health outcomes, suggesting that equipping future psychologists with skills to address FI would be beneficial. We assessed basic FI knowledge and training among clinical psychology doctoral students in the United States and Canada. Graduate students were recruited through psychology listservs and internet postings to complete an online survey about their training experience in FI assessment and resource provision. Students (n=155) reported familiarity with the term FI but not with resources to address it. Less than 10% of students had received any training in FI assessment or resource provision as part of their graduate training, but the majority (over 80%) wished they had received this training. Clinical psychology doctoral students generally do not receive training in FI assessment and resource provision but want this training. Graduate programs should consider adding curricula to address this gap.

Evaluating the Working With Older Adults Scale With Clinical Psychology Doctoral Students.

BACKGROUND AND OBJECTIVES: The ongoing workforce shortage in geropsychology requires continued efforts to understand the factors that influence whether or not students choose to enter this field. The current study builds on prior research by replicating the Working with Older Adults Scale (WOAS) model. Further, the scale was expanded to add professional attitudes, adultist concerns, and number of known professionals in the field of aging. RESEARCH DESIGN AND METHODS: Graduate students in clinical psychology (n = 117) completed the WOAS and new items as part of a larger survey of graduate students in an American Psychological Association-accredited doctoral program. Structural equation modeling was used to first replicate the existing WOAS model and then expanded to include new antecedents in a second model. RESULTS: Results were largely similar to past research validating the WOAS, with the exception that Perceived Behavioral Control was not a significant predictor of Intention in this population. In the expanded model, new items improved the overall model fit and exhibited significant indirect paths to predict intention to work with older adults. DISCUSSION AND IMPLICATIONS: These findings further validate use of the WOAS and expand scholarly understanding of the factors influencing the choice of a career in aging. Individuals positioned to encourage careers in aging may wish to address adultist concerns, explore attitudes about such careers, challenge unhelpful assumptions, and provide greater exposure and access to mentors in the field as part of recruitment efforts.

Growth & change in School Psychology.

School Psychology is an outlet for research on children, youth, educators, and families that has scientific, practice, and policy implications for education and educational systems. In this editorial changes and growth in the journal over the past year pertaining to current and future journal impact, special topics, and editorial leadership are described. Advancements for School Psychology in terms of equity, diversity, and inclusion in the editorial process is reflected upon. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Personal Therapy and Self-Care in the Making of Psychologists.

Psychologists are skilled in assessing, researching, and treating patients' distress, but frequently experience difficulty in applying these talents to themselves. The authors offer 13 research-supported and theoretically neutral self-care strategies catered to psychologists and those in training: valuing the person of the psychologist, refocusing on the rewards, recognizing the hazards, minding the body, nurturing relationships, setting boundaries, restructuring cognitions, sustaining healthy escapes, maintaining mindfulness, creating a flourishing environment, cultivating spirituality and mission, fostering creativity and growth, and profiting from personal therapy. The latter deserves special emphasis in the making of health care psychologists. These strategies are recommended both during training and throughout the career span. Recommendations are offered for enhancing and publicizing systems of self-care throughout the profession.

Increasing access to CBT for psychosis patients: a feasibility, randomised controlled trial evaluating brief, targeted CBT for distressing voices delivered by assistant psychologists (GiVE2).

BACKGROUND: The National Institute for Health and Care Excellence (NICE) recommends that Cognitive Behaviour Therapy for psychosis (CBTp) is offered to all patients with a psychosis diagnosis. However, only a minority of psychosis patients in England and Wales are offered CBTp. This is attributable, in part, to the resource-intensive nature of CBTp. One response to this problem has been the development of CBTp in brief formats that are targeted at a single symptom and the mechanisms that maintain distress. We have developed a brief form of CBTp for distressing voices and reported preliminary evidence for its effectiveness when delivered by highly trained therapists (clinical psychologists). This study will investigate the delivery of this intervention by a cost-effective workforce of assistant psychologists following a brief training and evaluate the acceptability and feasibility of conducting a future, definitive, randomised controlled trial (RCT). METHODS: This is a feasibility study for a pragmatic, three-arm, parallel-group, superiority 1:1:1 RCT comparing a Guided self-help CBT intervention for voices and treatment as usual (GiVE) to Supportive Counselling and treatment as usual (SC) to treatment as usual alone (TAU), recruiting across two sites, with blinded post-treatment and follow-up assessments. A process evaluation will quantitatively and qualitatively explore stakeholder experience. DISCUSSION: Expected outcomes will include an assessment of the feasibility of conducting a definitive RCT, and data to inform the calculation of its sample size. If evidence from a subsequent, fully powered RCT suggests that GiVE is clinically and cost-effective when delivered by briefly trained assistant psychologists, CBTp offered in these less resource-intensive forms has the potential to generate benefits for individual patients (reduced distress, enhanced recovery and enhanced quality of life), service-level patient benefit (increased access to evidence-based psychological therapies) and economic benefits to the NHS (in terms of the reduced use of mental health inpatient services). TRIAL REGISTRATION: Current Controlled Trials, ISRCTN registration number: 16166070. Registered on 5 February 2019.

Introduction to special issue on the history of the future of proactive school psychology: Transcending the past, excelling in the present, and transforming the future.

This Special Issue celebrates the 75th anniversary of the formation of the Division of School Psychology of the American Psychological Association. As part of this milestone celebration, we envisioned a field that could be changed by transcending the past, excelling in the present, and transforming the future. We identified a seminal article written by Conoley and Gutkin (1995) that advocated for the implementation of a systemic, prevention-oriented, ecological framework that would allow school psychology to realize its promise. Conoley, Powers, and Gutkin (2020) provided a synopsis of progress and stagnation in a new paper that served as the nexus from which invited authors were asked to respond, each representing a different aspect of school psychology practice, science, and training. In light of the division anniversary, authors described the historical context of their domain, reflected on the present, and shared recommendations for the future of school psychology. Collectively these contributions discussed school psychology's achievement to date, identify its shortfalls, and offer actionable suggestions for future school psychologists. Transformation is critical now more than ever in light of current health and world concerns and school psychology training and practice issues related to social justice and psychological and educational change. School psychologists are called to become proactive agents of change if we are to help heal our fractured and wounded world. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

How is school psychology doing: Why hasn't school psychology realized its promise?

We take a look back to 1995 when Conoley and Gutkin shared their vision for an adult-focused practice of school psychology with a primary focus on developing health-promoting systems for schoolage children. We then look to the present to what has happened and not happened to substantiate their vision. We found very encouraging developments and continuing challenges in the research targets and practice roles of school psychologists. There is no shortage of evidence-based strategies to improve the school experience of all children. The opportunities offered by, for example, the Multi-Tiered Systems of Support paradigm are promising, but it is unclear whether school psychologists are assuming leadership roles in this work. Furthermore, incorporating postdoctoral specialties is a promising role expansion for school psychologists, but most of the specialties keep the psychologists' focus on individual child assessment and treatment. School psychology is a very large professional tent with room for many approaches to preventing childhood disorders and promoting behavioral and academic success. Graduate education and current practice seem to reflect the traditional test and place roles for psychologists that Conoley and Gutkin hoped to expand beyond 25 years ago. Research efforts and national organization supports are hopeful, however, for a reimagined practice of psychology that makes use of the powerful ecosystems that affect children's well-being. Much work is yet to be done. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

History of the future of proactive school psychology: Historical review at our 75th APA anniversary to transcend the past, excel in the present, and transform the future.

The purpose of this article was to historically review the field of school psychology for the 75th Anniversary of the founding of the Division of School Psychology (DSP) of the APA. Past and present proactive school psychology was evaluated and recommendations for the future were offered in light of historic APA DSP goals. Since its inception, the DSP has worked with APA to protect and expand school psychology as a foundational service area within health service psychology. This article examines the challenges in the field, highlights current issues, and calls for a proactive and transformational future. The article concludes with suggestions from history to adopt current approaches to emulate the transformative vision of proactive school psychology. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

How the history of American Psychological Association Division 16 can shape the future of school psychology: Demonstrating organizational transformation.

Over the past 75 years, the history of Division 16 (School Psychology) has been integral to the science and practice of school psychology. As a constituent body of the American Psychological Association (APA), the division has advocated for role definitions and professional boundaries within APA and has represented the specialty of school psychology within the larger community of psychology. Since the convening of school psychology's Thayer Conference in 1955, the division has remained steadfastly committed to promoting the well-being of children. Toward this end, Division 16 has negotiated entry level debates between APA and the broad specialty of school psychology, sustained partnerships within and among APA and other organizations representing school mental health, elevated the place of technology in the profession of school psychology, and promoted the central importance of cultural competence and diversity within the discipline. The past contributions of Division 16 shape the future of the profession and the division in ways that are consistent with and add to Conoley, Power, and Gutkin's (2020) recommendations for strengthening school psychology's contributions to psychological health promotion and risk reduction in schools. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

School psychology training within a competency framework: Transcending the past, present, and future.

In this special issue, Conoley et al. (2020) repeat the call for a paradigm shift in school psychology graduate education from the individual level to the system level and from secondary and tertiary intervention to primary prevention and implementation science to optimize environments for children's overall health and success. This article describes how school psychology training, as organized by professional standards of practice and credentialing, has evolved to its current status as a recognized specialty of practice within psychology. A review of the history of the accreditation and approval of school psychology programs, as well as the current status of competencies within these standards and procedures are presented. In addition, school psychology as a distinct specialty; various certifications, credentials, and licensure; professional identities; and recent developments in technology, telehealth, and cross-state credentialing are examined. The article includes a summary of how competencies are reflected in the most recent revisions of American Psychological Association accreditation, National Association of School Psychologists approval standards, and credentialing organizations such as Association of State and Provincial Psychology Boards. Finally, we conclude with the assertion that development and adoption of these standards, competencies and professional recognition certifications, which are informed by the current zeitgeist in both health and education more broadly, might propel school psychology to fulfill the promise not yet achieved as outlined by Conoley and colleagues (2020). (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Retrospect and prospect regarding school psychology scholarship: Reflections of Lightner Witmer award winners.

This article provides reflections on several key elements important for establishing and sustaining successful research trajectories and scholarship within the field. Developed by several Lightner Witmer Award recipients, the article highlights several of Lightner Witmer's experiences and pioneering contributions, including the importance of his own mentors, collaborations with interdisciplinary professionals, and his emphasis on the relevance of scientific research programs and the practical implications for helping children. In an effort to move the field forward, we discuss important elements relevant to developing and sustaining successful research programs in school psychology including the importance of mentorship, collaboration, research methodologies, replicability, extramural funding, and dissemination. Throughout, we emphasize the importance of conducting research within the school context, which is consistent with the important influence of ecological systems articulated by Conoley, Powers, and Gutkin (2020), and reflects the hallmark of school psychology scholarship as an applied science. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Past, present, and future of research in school psychology: The biopsychosocial ecological model as an overarching framework.

Conoley, Powers, and Gutkin (2020) called for an increased emphasis on models of psychological service delivery that are primarily indirect, adult-focused, and geared toward systems-level change in the schools. They asserted that research in school psychology should not focus on the problems of individual children and youth but address the "powerful ecosystems" that surround them. Although school- and system-wide interventions are certainly important and can have a positive impact on student outcomes, we contend that biopsychosocial models of human development that integrate the effects of genetics, personal characteristics and behaviors, environments, and broad social contexts are better frameworks for guiding future research in school psychology. In these models, the role of genetics is mediated by the family environment and broader social contexts to influence variability in cognitive, social-emotional, and behavioral domains of psychological functioning. These individual differences then interact with specific situations, leading to outcomes in educationally relevant behaviors, such as achievement, self-esteem, motivation, and peer relations. The focus of research in school psychology, therefore, should not be on "1 size fits all" school-wide interventions but rather on understanding how and why children and youth differ from one another and on translating research on the effects of genes, the environment, and their interplay into effective educational interventions. Research on bullying and victimization in schools is discussed as an example of the importance of taking a biopsychosocial ecological approach to studying complex behavior. (PsycInfo Database Record (c) 2021 APA, all rights reserved).