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Volume 49 Number 2
Edited by Sarah Callahan and Meagan Sweeney
Written by Michelle Abraczinskas, Emily Neger, Katie Knies, Nyssa Snow-Hill, Melanie Morse, and Rebeca Castellanos, University of South Carolina
This paper highlights how we, as a group of students in the clinical-community (CC) psychology program at the University of South Carolina (USC), have taken action to address areas of unmet need as we have progressed through our program. Though the experiences described below are situated at USC, we think the settings created are both applicable and translational to other CC, clinical, and community programs, and want to share our experiences with a wider audience in the hopes that it will be helpful.
Integration of Clinical and Community Psychology
More than 30 years ago, USC, along with other programs across the country, merged the community clinical psychology doctoral programs into a single clinical-community psychology doctoral program, (CC program) so students could have tools to enact social change. Few CC psychology programs remain. Perhaps this is because developing expertise in both clinical and community psychology is difficult to accomplish in a timely and thorough manner. Those students who desire an expertise in both the clinical and community psychology fields may struggle to allocate sufficient time for each discipline and meet program requirements, either feeling caught on a swinging pendulum between the sub disciplines, or surrendering to just one. To compound these difficulties, a thorough search of CC program websites and articles on the topic, revealed that a clear definition of CC integration does not appear to exist.
To address these concerns, students in the CC PhD program formed a CC integration committee in Fall 2014. A series of CC integration forums began for faculty and students to brainstorm integration ideas; faculty also presented personal examples. Students and faculty explored course content and noted those that were well integrated. The committee plans to have students share their personal integration via a variety of mechanisms (e.g. colloquia, symposia).
Creation of the SAB
The CC integration committee collaborates with the Student Advisory Board (SAB), created in Spring 2014 to empower students to make positive programmatic changes. The SAB provides a setting where students can have organized discussions about general training needs and then take action. The SAB is an example of CC integration because it serves as a mesosystem that bi-directionally impacts the systems/organizational level (faculty, clinic) and individual level (student self-efficacy, sense of community). The SAB is a communication pathway between different systems that previously functioned as silos, with a core action focus.
The SAB originally formed as a continuous quality improvement (CQI) mechanism for the innovation Getting to Outcomes (GTO®) in clinical practice at the Psychology Services Center (PSC). This innovation is another example of CC integration, as it impacts individual and systems/organizational level change. The PSC is a community-based treatment center where graduate students in the Psychology Department receive clinical training. In an effort to promote systematic clinical decision-making and practice, the Getting to Outcomes (GTO) framework (Chinman, Imm, & Wandersman, 2004; Wandersman, 2009) was adapted to be used on the individual client level to (1) demystify the therapy process for student therapists, (2) provide a systematic delivery of treatment, and (3) make each step in the therapy process clear to ensure a certain level of quality.
As part of this CQI, focus groups were conducted to gauge students’ usage of the new innovation. Students volunteered to meet on a regular basis to provide input and feedback. The SAB became a setting for such meetings. In addition to CQI, the SAB has grown into an empowering context where students provide input on training and program decisions and a conduit between the students, faculty, and PSC staff.
Though the reason for the creation of the SAB is unique to USC, the broader purpose of the SAB and its function is applicable to other programs. Programs could form student led settings such as the SAB or the CC integration committee as a way to increase student investment, make their voices more heard and collective, and to empower students to become involved in making programmatic changes. If interested, the following tips may be helpful.
Creating a Vision
It may be beneficial to develop the vision during a class, such as a class with a systems level project requirement. The USC SAB was designed within a community psychology practicum class to build the community practice skills of group process and community organizing. Establishing student champions across different cohorts also helps motivate students to attend meetings. Conducting an interest and needs survey through multiple methods (e.g., focus group, survey, one legged interviews) can inform preliminary vision and project ideas.
When beginning, we found it important to work on projects that would likely lead to quick success as a way to celebrate small wins while gaining momentum and excitement. Once these small wins are in place, tackle something more difficult, such as a course curriculum or supervision need. Also, demonstrate taking the advisory board seriously. Meet on a regular basis, take notes, and host professional events that a variety of stakeholders find useful and fun.
We found it vital to garner the support of faculty and staff. Highlight that a SAB can help market the program and meet accreditation or other standards. The SAB at USC helps address clinical training needs and its innovative activities may be a unique draw to the program. In addition, an advisory board can take some of the programmatic change burden off faculty. To build faculty confidence in the SAB, select a realistic, time sensitive task and present the result to faculty. This can help establish a faculty advisory board champion if one does not already exist.
Choosing Meaningful Projects
When we selected change ideas, we acquired student support and interest by focusing on areas identified by the majority of students. We chose to implement peer mentoring to improve sense of community and share information between cohorts. Now in its second year, over 50% of students are participating in the program and they are interfacing with the program earlier in their training. The process and outcome evaluation of the first cohort was presented at the Southeast Eco conference in Fall 2015. Additionally, we created professional development events, such as work/life balance, which at the time was not an area of focus by faculty or other student organizations. We also advocated for curriculum changes and developed an internship preparation training. It is helpful to balance seriousness and fun in project design. We might be working to make changes to externships, while also planning a fun peer mentoring outing.
Once you have begun, it is important for your SAB to maintain momentum. One tip to maintain momentum is to create break out committees dedicated to larger projects with different student leaders in each one. This serves two purposes: it spreads out task responsibility across more members, so that the SAB can accomplish more, and it continues to build champions and further buy-in among committee leaders. Ensure one small win a semester to help keep morale high, especially when trying to target changes that are more difficult. In other words, it is rewarding to set small goals that you can meet to balance out the lofty ones. It is also important be flexible and recognize that projects can be successful yet very different from the original intention based on barriers as well as emerging needs. In our program, the original focus of the peer-mentoring program was peer clinical supervision, but it evolved due to a recognition of the need for more broad mentorship across students’ multiple roles and responsibilities.
Another important component for maintaining momentum is to remain visible. Ways to do this are to hold consistent meetings and a few events a semester and send listserv emails to both faculty and students. Additionally, create a page on social media or add a description to the program website. Finally, make sure change agents and other students know about your accomplishments. This can be done on the website, in an end of the year newsletter, or can be mentioned to faculty at meetings and to students outside the SAB through one legged interviews.
Our new settings helped us increase student voice and change efforts, as well as our connection to the program and each other. Using a systems intervention to improve clinical training and sense of community within our program has naturally provided a connection between clinical and community psychology. This example of CC integration is unique in that it occurs within a department and mainly centers on clinical training. The flexibility allowed in developing community competencies in this way, beginning with a community practicum class, has helped move our definition of clinical-community integration forward and shaped our identities as clinical-community psychologists.
We hope that other Community, CC, and Clinical training programs find the information about the formation of our Student Advisory Board and CC integration committee useful. It is likely that other programs and students have difficulties with CC integration, so it may be helpful to have additional forums to discuss this important issue. If you are interested in learning more about our CC integration committee, SAB, or our peer mentoring program, please do not hesitate to reach out to us.
Chinman, M., Imm, P., & Wandersman, A. (2004). Getting To Outcomes™ 2004. Rand Corporation.
Wandersman, A. (2009). Four keys to success (theory, implementation, evaluation, and resource/system support): High hopes and challenges in participation. American Journal of Community Psychology, 43, 3-21.
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