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from the issue of October 4, 2007
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Psych training program outlined in journal article
BY SARA GILLIAM, UNIVERSITY COMMUNICATIONS
Leaders of the American Psychological Association - as well as the organization's members and practitioners as a group - have recently elected to prioritize evidence-based practice in the training and work of clinical psychologists.
This is positive news for UNL's Clinical Psychology Training Program, which has been a leader in the use of EBP since the early 1990s. In July, professors David DiLillo and Dennis McChargue published an article in the Journal of Clinical Psychology on UNL's unique training program.
"We're among the first programs to really attempt to translate the model of EBP into training and incorporate it into our curriculum and practice," said David DiLillo, director of the clinical program in the psychology department. "We're trying to figure out how to operationalize the components of the model into the training of our students. We're asking, 'What kinds of skills, knowledge, and abilities do they need to be able to practice psychotherapy in evidence-based fashion."
There are three components of EBP.
The first is an emphasis on using relevant research evidence in clinical work.
The second is often called "patient preferences," and refers to the importance of taking into account patients' individual characteristics - ethnic and cultural backgrounds, socio-economic status, religion, gender, and sexual preferences. These characteristics must be considered, since research study results are based on group averages. An ideal approach to treatment involves integration of the best available research with a clinician's understanding of a specific client.
The third component of EBP is clinical expertise. Research directs therapists to particular treatments, and they need to understand what specialized techniques are available, as well as how to alter or modify those for the individual client. This nexus of expertise and clinical judgment is essential, DiLillo said.
The emphasis on EBP within the field of psychology was, in part, a result of changes in the training of medical students. In medical schools, an exaggerated need for accountability was brought on by managed care, which led to the development of evidence-based medicine, DiLillo said. Because clinical psychology is increasingly viewed as a health care profession - in that practitioners are geared toward helping treat clients with specialized psychological disorders - changes in medical training gave rise to consideration of how EBP principles might apply to the treatment of psychological problems and training in clinical psychology. In 2005, the APA adopted a policy encouraging EBP within the field.
"A lot of training programs do things that are very consistent with the EBP model, and when we (UNL clinical professors) examined what we were already doing, we found that we were doing so, as well," DiLillo said. "But at UNL, we've been trying to connect the dots in a more explicit way, to make clear exactly how the model is integrated, and also make changes where more integration is possible."
The psychology department at UNL has long provided students with opportunities that combine service delivery and research; the clinical program is what DiLillo calls a scientist-practitioner program. Graduate students volunteer as therapists and counselors, working alongside faculty who are involved with community agencies. Will Spaulding works with the chronically mentally ill at the Regional Center, Mario Scalora is active in local and national forensic psychology projects, department chair Dave Hansen founded Project SAFE, which works with young victims of sexual abuse, and McChargue works with Houses of Hope, a local substance abuse treatment center.
Students practice their clinical work within those agencies, while using EBP to integrate the latest research into their therapy. This process provides students a chance to utilize the latest research in clinical settings, under the supervision of faculty members with years of specialized experience.
"We provide valuable clinical experience for our grad students, and that also allows us to continually evaluate the effectiveness of interventions. That data, in turn, fuels research programs. In a sense, it's the opposite of an ivory tower approach," DiLillo said.
DiLillo said changes in the program have been the result of a group consensus among the clinical faculty. Faculty members are optimistic that this cutting-edge training will benefit students throughout their careers.
GO TO: ISSUE OF OCTOBER 4
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