History of the Council of Clinical Health Psychology Training Programs (CCHPTP)
Shortly after the petition to create the Division of Health Psychology of the American Psychological Association (now named the Society for Health Psychology) was approved in 1978, considerable interest arose regarding this emerging area of science and practice. As psychologists drawn to this extension of the science of psychology into the health care arena sought out professional colleagues with common interests by joining the new division (Division 38), it quickly became apparent that the discipline needed to enumerate the distinctive competencies required for functioning effectively as health psychologists. With funding from the Carnegie Foundation, the MacArthur Foundation, and the Kaiser Family Foundation, the new division planned, organized, and held the National Working Conference on Education and Training in Health Psychology at the Arden House Conference Center in Harriman, NY, in 1983.
The Arden House Conference
An overview of the primary decisions of the 57 participants at the Arden House Conference was provided by Neal Miller (1983). One of the most important decisions was the endorsement of two training options: scientist and scientist-practitioner, now referred to as health psychology and clinical health psychology, respectively. Because health psychologists distinguish themselves from other professions encountered in the modern health care environment through their training in research and program evaluation, a solid foundation in conducting research was required of all who entered the work force as health or clinical health psychologists. From its inception, a professional camaraderie existed between health psychology scientists and those trained to practice clinical health psychology, both members of an APA division that fully embraced both the science and its application. A practitioner model of training that failed to include the acquisition of competencies in conducting research was not considered a viable or desirable model for promoting the science of health psychology, particularly within a health care environment where expertise in research and program evaluation was critical. Additionally, the importance of having both a broad foundation of knowledge of the discipline of psychology and interdisciplinary knowledge from related fields was embraced by meeting participants. Of course, there were distinctive competencies of health psychology discussed as well, including an understanding of how the health care system works, knowledge of various clinical symptoms and pathophysiology, exposure to the mores and vocabulary of the health care setting, and knowledge concerning public health and health policy (for a comprehensive report of the conference proceedings, see Stone et al., 1987).
The Arden House Conference Center in Harriman, NY (1983)
The Working Group on Predoctoral Education/Doctoral Training spent their time at Arden House enumerating the required scientific foundations of both health psychologists and clinical health psychologists during the early stages of graduate training. Their resulting product highlighted the biopsychosocial model that has guided the education of both health and clinical health psychologists since the inception of the specialty area. Not only were core knowledge and skill-based competencies inclusive of the biological, psychological, and social realms of psychology required, but a second tier of knowledge and skill-based competencies were required in the complementary areas of biological, psychological, and social influences on health and disease, the provision of health care, and formation of health policy. Although health and clinical health psychologists-in-training shared content of graduate study with educational programs from other areas of psychology, they also needed to acquire competencies unique to understanding health and disease and working with patients experiencing health care problems that extended beyond the provision of mental health care.
Naturally, the Working Group knew that clinical health psychologists needed an additional set of competencies beyond those acquired by their health psychology peers that enabled them to apply their knowledge of health psychology to work with patients, patient’s families, and members of the health care team to assess and treat the broad range of health problems seen in the health care environment. Much of these practical skills were best acquired while completing practicum experiences, field placements, and internships in health care settings.
Participants of the Arden House Conference devised the blueprints for the fields of health psychology and clinical health psychology that would serve us well for decades. Before leaving Harriman, NY, these influential leaders knew their work was not over. A mechanism was needed to maintain the momentum launched at this meeting to ensure that health and clinical health psychologists-in-training acquired the proper competencies to function in health care settings as they began their careers. In this regard, the meeting participants endorsed the development of the Council of Directors of Health Psychology Training (CDHPT), a non-profit organization charged with the goal of ensuring the educational training models that were established at Arden House had ongoing support. Additionally, this group aimed to advocate for strong educational standards when they inevitably would confront shrinking dollars devoted to educational enterprises and to challenge potential threats aimed at providing sub-standard care for patients seen in health care settings. The Council of Directors of Health Psychology Training was incorporated and comprised of representatives from the leading health and clinical health psychology training programs around the United States (see 1990-91 membership roster [link to CDHPT Membership.1990.pdf]). They met annually during APA Conventions for many years, until falling into a relatively dormant state by the end of the 20th century.
The Tempe Summit on Education and Training in Clinical Health Psychology
Recognizing the importance of maintaining solid educational standards for programs that trained health and clinical health psychologists at the doctoral, internship, and postdoctoral levels, the Education and Training Council of Division 38 approached the Board of Directors of the division in 2007 to request funding to sponsor the Tempe Summit on Education and Training in Clinical Health Psychology (see France, Masters, Belar, Kerns, Klonoff, Larkin, Smith, Suchday, & Thorn, 2008). The primary purpose of this meeting was to revise and update the standards of graduate curricula and training in clinical health psychology and bring the work of Arden House into the 21st century. In particular, because the educational community within the entire science of psychology was making great strides in enumerating the competencies required for the practice of health service psychology (e.g., Fouad, Grus, Hatcher, Kaslow, Hutchings, Madson, Collins, & Crossman, 2009), clinical health psychology needed to be a strong voice in this conversation. The goals of the Tempe Summit were to: “(1) bring interested parties together to begin a dialogue on issues of curriculum and training, and (2) explore the possibility of establishing a standing Council of Clinical Health Psychology Training Directors” (France et al., 2008, p. 575). The Board approved the request and 20 leading educators in health and clinical health psychology training programs were invited to attend the Tempe Summit in March of 2007. During the summit meeting, participants assembled into three groups to review and enumerate the essential competencies associated with the specialty practice of clinical health psychology. One group defined competencies in assessment/diagnosis/case conceptualization and intervention, a second group defined competencies in research/evaluation and consultation, and the final group defined supervision/teaching and management/administration competencies. The complete list of competencies was reported by France et al. (2008).
At the time of the Tempe Summit, the annual meetings of the Council of Directors of Health Psychology Training were no longer occurring and conversations regarding the education of health service psychologists were occurring without representation from health psychology. Recognizing that it was essential that clinical health programs had a voice in these conversations, Tempe Summit participants developed a plan to re-invigorate the existing training council that would serve to represent clinical health psychology at national meetings as well as facilitate regular meetings of educators who trained clinical health psychologists in doctoral, internship, and postdoctoral fellowship programs around the country. To serve this function, the training council was revived and re-incorporated under the new name of the Council of Clinical Health Psychology Training Programs (CCHPTP, acronym pronounced “chip-tip”).
The Council of Clinical Health Psychology Training Programs (CCHPTP)
Just a few months following the Tempe Summit, CCHPTP was incorporated as a non-profit educational agency. Joining with Society for Health Psychology (Division 38 of the APA) and the American Board of Clinical Health Psychology, CCHPTP serves as the critical voice for educational programs in comprising the Clinical Health Psychology Specialty Council. CCHPTP program representatives have met annually since being launched, with programs focusing on various themes relevant to the education and training of clinical health psychologists (see table below).
Table. Themes and Locations of CCHPTP’s midwinter meeting
|2008||New Directions: Competencies in Clinical Health Psychology||San Antonio, TX|
|2009||Assessing Competencies in Clinical Health Psychology||Albuquerque, NM|
|2010||Clinical Health Psychology: Just When Does Specialized Training Begin?||Orlando, FL|
|2011||Training in Integrated Behavioral Health Care in Primary Care Settings: Emerging Roles for Clinical Health Psychologists||Nashville, TN|
|2012||Primary Care Psychology: Is Training in Clinical Health Psychology Necessary?||San Diego, CA|
|2013||Promoting Quality in the Profession of Clinical Health Psychology||Austin, TX|
|2014||The Future of Clinical Health Psychology Training: Opportunities and Challenges||New Orleans, LA|
|2015||Clinical Health Blueprint for the Future of Health Service Psychology||Albuquerque, NM|
|2016||Clinical Health Psychology Training in Inter-Professional Team Based Care||Miami Beach, FL|
2017Program Development and Evaluation in Health Care: Essential Competencies for Clinical Health Psychology
|San Diego, CA|
|2018||Clinical Health Psychology: Cost Offset, Competency, Payer Systems, Outcome Measurement, and Taxonomy Consistency||Nashville, TN|
In the tradition of Arden House and the Tempe Summit, each meeting includes conversations among leaders in the community of educators with the aim of defining and monitoring standards of education and training to ensure high quality and promote best practices, with the overall aim to produce the next generation of clinical health psychologists who are fully competent to accept positions in health care settings around the world. A good number of published works have emanated from these meetings to ensure educators who were not present can keep informed of the latest advances in the education of clinical health psychologists (Kerns, Berry, Frantsve, & Linton, 2009; Larkin, 2009; Larkin, Bridges, Fields, & Vogel, 2016; Larkin & Klonoff, 2014; Masters, France, & Thorn, 2009; Nash & Larkin, 2012; Nash, McKay, Vogel, & Masters, 2012; Nicholas & Stern, 2011).
As seen in the table, many CCHPTP meetings have focused on elaborating on the established competencies that inform educators at all levels of what is expected of an entry level clinical health psychologist. These include those who aim to work in academic health centers, general medical hospitals, and/or specialized medical clinics, as well as those who accept positions in primary care medical practices to integrate behavioral health care into these high volume practice settings. Meetings have focused time and effort on promoting “best practices’ in important areas for training programs at all levels, including inter-professionalism, training in conducting cost-offset research, and clinical supervision.
Based on the foundational work in defining competencies done by CCHPTP, representatives from the Council were invited to participate in the Inter-Organizational Work Group on Competencies for Primary Care Psychology Practice orchestrated by Suzanne Bennett Johnson, president of the American Psychological Association in 2012. The product from this working group was published in the American Psychologist in 2014 (McDaniels et al., 2014). CCHPTP has also been invited to assist the American Board of Clinical Health Psychology as they refine criteria for evaluating candidates for board certification based on the competencies of clinical health psychology largely developed by CCHPTP. Further, the list of competencies developed by CCHPTP will serve as the basis for accreditation criteria used by APA’s Commission on Accreditation for evaluating postdoctoral fellowships with specialties in the area of clinical health psychology.
The CCHPTP Board in Nashville, TN, in 2011. From left to right: Marilyn Stern, Mary Davis (Secretary Treasurer), Anne Hryshko-Mullen, Kevin Masters, Elizabeth Klonoff, Kevin Larkin (Chair), Sharon Berry, Pat Saab, and Justin Nash.
The fundamental training competencies enumerated by CCHPTP have played a central role in the 2010 and 2018 petitions by Clinical Health Psychology Specialty Council to retain clinical health psychology as a specialty by APA’s Commission for the Recognition of Specialties and Proficiencies in Professional Psychology. Through wide adoption of CCHPTP’s work on defining competencies in the area of clinical health psychology, the specialty of health psychology and the entire science of psychology has profited from the important work done by this training council. The work of CCHPTP is an example for other specialty areas who aim to ensure their educational programs are providing the proper classes and experiences for their students to acquire the requisite competencies to enter their chosen fields and conduct their professional work effectively. In this regard, the foundational work that started at Arden House is being carried out through this active training council that ensures that clinical health psychology will maintain its position as a leader in the educational and training community.
Kevin T. Larkin, Ph.D., ABPP - 2018
Fouad, N. A., Grus, C. L., Hatcher, R. L., Kaslow, N. J., Hutchings, P. S., Madson, M. B., Collins, F. L., & Crossman, R. E. (2009). Competency benchmarks: A model for understanding and measuring competence in professional psychology across training levels. Training and education in Professional Psychology, 3(suppl.), S5-S26. DOI: 10.1037/a0015832
France, C. R., Masters, K. S., Belar, C. D., Kerns, R. D., Klonoff, E. A., Larkin, K. T., Smith, T. W., Suchday, S. & Thorn, B. E. (2008). Application of the competency model to clinical health psychology. Professional Psychology: Research and Practice, 39: 573-580. DOI: 10-1037/0735-7028.39.6.573
Kerns, R. D., Berry, S. S., Frantsve, L. M. E., & Linton, J. C. (2009). Life-long competency development in clinical health psychology. Training and Education in Professional Psychology, 3: 212-217. DOI: 10-1037/a0016753
Larkin, K. T. (2009). Variations of doctoral training programs in clinical health psychology: Lessons learned at the box office. Training and Education in Professional Psychology, 3: 202-211. DOI: 10-1037/a0016666
Larkin, K. T., Bridges, A. J., Fields, S. A., & Vogel, M. E. (2016). Acquiring competencies in integrated behavioral health care in doctoral, internship, and post-doctoral programs. Training and Education in Professional Psychology, 10: 14-23. DOI: 10.1037/tep0000099
Larkin, K. T., & Klonoff, E. A. (2014). Specialty competencies in clinical health psychology. New York, NY: Oxford University Press.
Masters, K. S., France, C. R., & Thorn, B. E. (2009). Enhancing preparation among entry-level clinical health psychologists: Recommendations for "best practices" from the first meeting of the Council of Clinical Health Psychology Training Programs (CCHPTP). Training and Education in Professional Psychology, 3: 193-201. DOI: 10.1037/a0016049
McDaniel, S. H., Grus, C. L., Cubic, B. A., Hunter, C. L., Kearney, L. K., Schuman, C. C., Karel, M. J., Kessler, R. S., Larkin, K. T., McCutcheon, S. S., Miller, B. F., Nash, J., Qualls, S. H., Sanders Connolly, K., Stancin, T., Stanton, A. L., Sturm, L., & Bennett Johnson, S. (2014). Competencies for psychology practice in primary care. American Psychologist, 69: 409-429. DOI: 10.1037/a0036072
Miller, N. E. (1983). Some main themes and highlights of the conference. Health Psychology, 2: 11-14. DOI: 10.1037/h0090285
Nash, J. M., & Larkin, K. T. (2012). Geometric models of competency development in specialty areas of professional psychology. Training & Education in Professional Psychology, 6: 37-46. DOI: 10.1037/a0026964
Nash, J. M., McKay, K. M., Vogel, M. E., & Masters, K. S. (2012). Functional and foundational characteristics of psychologists in integrated primary care. Journal of Clinical Psychology in Medical Settings, 19: 93-104. DOI: 10.1007/s10880-011-9290-z
Nicholas, D. R., & Stern, M. (2011). Counseling psychology in clinical health psychology: The impact of specialty perspective. Professional Psychology: Research and Practice, 42: 331-337. DOI: 10.1037/a0024197
Stone, G. C., Weiss, S. M., Matarazzo, J. D., Miller, N. E., Rodin, J., Belar, C. D., Follick, M., J., & Singer, J. E. (Eds.) (1987). Health psychology: A discipline and a profession. London: The University of Chicago Press.