Diversity within the field of professional psychology rests heavily on the diversity of the training-toworkforce pipeline. Two major waypoints play a pivotal role in this process, namely admission to (and hence representation within) and retention in doctoral training programs. The present study reports student population data regarding three types of diversity (i.e., race/ethnicity, disability, and gender identification) within doctoral psychology education. Diversity data from the full population of enrolled doctoral students in accredited psychology programs throughout the United States from 2005-2015 were obtained from the American Psychological Association's Office of Program Consultation and Accreditation. Analyses focused on (a) establishing the representation of diverse peoples, according to race/ ethnicity, disability, and gender identification; and (b) identifying the rate of attrition among these groups. Despite no evidence of significant differences in quantitative academic qualifications (i.e., grade point average or graduate record examination scores), Black or African Americans, Hispanic/Latinos, individuals with disabilities, and men were found to be underrepresented relative to the U.S. population at large. These same groups, in addition to Native Hawaiian or Other Pacific Islanders, also evidenced higher attrition from doctoral programs. Professional psychology's training-to-workforce pipeline lacks the diversity of the U.S. population at large, at least with respect to race/ethnicity, disability, and gender identification. Findings suggest processes at the point of admission, more than those involving retention, are most at fault.
A significant innovation in the training of doctoral level professional psychologists, attention to diversity, was implemented nearly 3 decades ago and swept across all accredited programs. Regardless of training model, degree type, or theoretical orientation, attention to diversity became a requirement for program accreditation with the intention of fostering important competencies in the emerging workforce who would be serving an increasingly diverse population during their professional careers. However, to date, whether that is what occurred has not been examined. The current study used archival data to examine the association between client racial/ethnic minority (REM) status and early termination from adult individual psychotherapy (N ϭ 638). Multilevel modeling analyses (MLM) revealed that REM clients were more likely to terminate treatment after 1 session than non-REM clients. However, REM status did not account for the total number of sessions attended, nor was it a significant predictor of symptom change during treatment. The findings suggest that training focused specifically on first session competencies, such as treatment engagement, with REM clients is strongly needed. More broadly, the findings underscore the importance of examining innovations following implementation to determine whether the intended effects are observed or if refinements may be needed. Clinical Impact StatementRacial/ethnic minority (REM) clients terminate psychotherapy after the first session significantly more often than non-REM clients. However, if REM clients are retained beyond that critical first session, neither the length of treatment (i.e., number of sessions) nor overall change in symptom distress across the course of treatment significantly differ from non-REM clients. The findings suggest need for innovation in developing needed skills and competencies to effectively engage REM clients during the very first session.
Although the effectiveness of psychotherapy is now widely recognised (e.g. American Psychological Association, 2013), questions about how much psychotherapy is necessary for client recovery remain. In response to these questions, two contemporary models of the association between the amount of treatment (number of sessions) and amount of change (in symptom distress) have emerged, each with supportive evidence. The first modelthe dose-effect (DE) model-was introduced by Howard and colleagues in the 1980s (Howard, Kopta, Krause, & Orlinsky, 1986). This model suggests that the likelihood of client recovery, when plotted with treatment duration, follows a negatively accelerated curve. That is, with each subsequent session, a greater proportion of clients will have recovered through treatment; however, the greatest gains in likelihood of recovery occur in the initial sessions and diminishing returns are seen as the session number increases. Based on this model, some have suggested that the early sessions of psychotherapy are more potent than later sessions (Baldwin,
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