In 2012, the American Psychological Association (APA) endorsed as policy, The Education and Training Guidelines: A Taxonomy for Education and Training in Professional Psychology Health Service Specialties, hereafter referred to as “the Taxonomy.” This Taxonomy was developed in response to confusing inconsistencies across education and training in professional psychology training programs that would describe offerings in their program by a variety of labels, such as “track, emphasis, concentrations,” for either APA and ABPP recognized specialties or other topic areas with no consistent definition of what these terms meant. They could refer to one to three courses, course work and practicum, coursework and research requirements, etc. This inconsistency has made it difficult for trainees at all levels (doctoral, internship, postdoctoral, and post-licensure) to evaluate different programs, as well as for the public to understand psychology education and training. The benefits of using the Taxonomy have been described as akin to truth in advertising, and its adoption would assist those wishing to focus on a particular area of psychotherapy as they investigate different programs.
Professional discussions about these inconsistencies have spanned a number of years including a 1996 APA-endorsed policy on A Taxonomy for Postdoctoral and Continuing Education in Psychology which grew from a national conference (Reich, Sands, & Wiens, 1995); the suggestion by the first APA Educational Leadership Conference in 2001, which recommended “developing a taxonomy of the field that is understandable to the public” (Belar, Nelson, & Wasik, 2003, p. 681); an attempt by the Council of Credentialing Organizations in Professional Psychology (2004) to outline terms and principles for health psychology training; and the 2005 conclusion by the APA Task Force on Quality Assurance of Education and Training for Recognized Proficiencies in Professional Psychology that there was “a need for a clearer taxonomy of terminology in describing the structure of professional psychology, from its education and training foundations, through credentialing and practice representations to the public” (p. 1).
Understanding the Taxonomy
Hence, it is clear that the need for the Taxonomy has been evident for a long time. At this point, a definition of the term taxonomy might be helpful:
A taxonomy is simply the orderly classification or arrangement of a set of related concepts based on their common factors. There is typically a hierarchical structure with clear rules defining components of the taxonomy and how the structure is to be organized. (APA, 2012, p.3; see also Bailey, 1994)
The benefits of clear training nomenclature impact many audiences. It will aid students and potential students and other trainees in being informed consumers by helping them choose programs that fit their needs and career goals. For training programs, the Taxonomy offers clarity in describing their offerings to allow better fit with admitted trainees. The Taxonomy could assist the APA Commission on Accreditation (CoA) by providing clarity for program self-study descriptions of all aspects of their programs and site visits for programs at all accreditation levels: doctoral, internship, and postdoctoral. In particular, the Taxonomy could help a program in describing and defining its program-specific additional competencies pursuant to the new Standards of Accreditation for Health Service Psychology, which state that:
Doctoral programs accredited in health service psychology may require that students attain additional competencies specific to the program. If the program requires additional competencies of its students, it must describe the competencies, how they are consistent with the program’s aims, and the process by which students attain each competency (i.e., the curriculum). Additional competencies must be consistent with the ethics of the profession. (APA, 2015, p. 14)
Similar requirements are outlined for internships (p. 26) and postdoctoral residency programs (p. 38). For licensed psychologists already practicing, the Taxonomy could aid in evaluating the utility of continuing education offerings and how they fit into ongoing professional development and credentialing. Lastly, using the Taxonomy for all levels of training in health service psychology could aid the public in understanding the competencies and skills of their providers and help them choose their psychologists (Rozensky et al., 2015).
The development of the current Taxonomy began with the appointment and funding of a task force by the APA Board of Directors in 2007. This task force was chaired by Drs. Elena Eisman and Lynn Rehm, and included representatives from a comprehensive array of psychologists involved in psychology training and credentialing. When the task force was not funded for a second year to continue its work, the task of completing the Taxonomy was assigned to the APA Commission for the Recognition of Specialties and Proficiencies in Professional Psychology (CRSPPP). The CRSPPP process entailed consultation with multiple constituency groups and a round of public comment from which suggestions were reviewed and incorporated.
The finalized Taxonomy “provides a structure for the consistent labeling of the type, content, and intensity of training and education opportunities available in health service psychology programs” (Rozensky et al., 2015, p. 25). The Taxonomy is summarized in a four by four chart which includes four levels of intensity of training by four levels of training opportunities, i.e., doctoral, internship, postdoctoral, and postlicensure (see Figure 1).
The four levels of intensity from lower to higher are Exposure, Experience, Emphasis, and Major Area of Study. It is intended that these levels of intensity be reserved for specialties that are recognized by APA, ABPP, and CoS (Behavioral & Cognitive, Clinical, Clinical Child, Clinical Health, Clinical Neuropsychology, Counseling, Family, Forensic, Police & Public Safety, Professional Geropsychology, Psychoanalysis, Sleep, School, as well as Industrial-Organizational—recognized by APA). The developers did realize that many programs also offer training in areas that are not recognized specialties (e.g., trauma, multiculturalism, community psychology, biofeedback, substance abuse, neuroscience, feminist psychology) and recommended that such offerings be labeled as a Focus within the program until such areas are more fully developed and recognized.
Major Area of Study.
These would be in areas recognized by APA as specialties, termed substantive practice areas by CoA, and as major rotations by the Association of Psychology Postdoctoral and Internship Centers (APPIC). The new term of Major Area of Study was chosen to remove confusion among the three terms in the previous sentence, and
should be used by programs to describe the highest level of education and training opportunity with respect to the types of knowledge, skills, and attitudes that would be developed and to the intensity and amount of involvement in training to acquire those competencies. This includes expectations for acquisition of knowledge through didactics, practical training and direct service expectations (hours, number of cases, and competencies) and research and scholarly expectations. (APA, 2012, p. 6)
So, for a doctoral program the Major Area of Study would be what CoA considers the program’s traditional substantive professional area (i.e., clinical, counseling, or school). A Major Area of Study for a postdoctoral residency would require 80% of more of training time spent in that specialty area.
A specific definition of this level would follow the guidelines established by the particular specialty according to the level of training (doctoral, internship, postdoctoral, postlicensure). In general,
Emphasis is the level just below major area of study, with distinctly different expectations for the type and intensity of the education and training experience. A programmatic emphasis permits a structured, in-depth opportunity for knowledge acquisition, practical experience, and scientific study in a given specialty area. (APA, 2012, p. 7)
Conceptualized as doing more than merely acquainting a trainee with the speciality,
the experience level falls between emphasis and exposure; the type and intensity of the opportunity for learning that the program offers will be clearly distinct from the other levels, with the specific parameters of knowledge acquisition, practical experience, and scientific study defined by that specialty. (APA, 2012, p. 7)
This “represents an education and training opportunity that is limited in type and intensity. An exposure is identified by the program as a structured learning activity and would be seen as an opportunity to acquaint an individual with that specialty area” (APA, 2012, p. 7).
As stated earlier, this term refers to “opportunities in other training areas” and the idea “that programs strive to provide explicit explanations of the type of training provided in these nonspecialty areas”; its adoption is hoped to “enhance the clarity of communication regarding educational and training opportunities across programs” (APA, 2012, p. 5).
Applying the Taxonomy
These Taxonomy guidelines are aspirational and intended to give guidance to education and training programs. Each recognized specialty area has been charged to develop its own training criteria for each level of intensity by level of training. This task has been coordinated by the Council of Specialties in Professional Psychology (CoS) via the individual Specialty Council members. General guidance in establishing these criteria appear in Figure 1, in which possible types and intensity of training are described in each level.
For example, for a doctoral program the Major Area of Study might be defined as two to three years of didactics, supervised practica, and dissertation or research project; Emphasis might include at least four courses and two practica in a specialty; Experience could be at least one to two courses and practica; and Exposure might be one to two courses. An exemplar for a website describing a particular doctoral program could read: “In our APA-accredited doctoral program at Our University, we offer a Major Area of Study in Clinical Psychology with at least three years of didactic coursework and supervised clinical training in that Major Area of Study, which includes a dissertation or research project. We offer students an Exposure to Clinical Neuropsychology, with one course in that area, and an Experience in Clinical Child Psychology, with two courses and two semesters of supervised practicum in that area. We offer a Focus in personality assessment as part of our advanced practicum, wherein an advanced assessment course and two additional practicum semesters are available” (Rozensky et al., 2015, p. 30). For an internship program, the website might read: “Our internship program is accredited in professional psychology by the APA and offers a Major Area of Study in Counseling Psychology at our University Student Health Center. At least 75% of trainee time will be devoted to training in our Center in direct counseling activities and services. There is an optional Experience in Clinical Health Psychology at our Clinic. This Experience would involve up to 25% of supervised time working with medically ill students and health promotion services” (Rozensky et al., 2015, p. 30). For specific recommendations for a given specialty, inclusive of the various areas of psychotherapy practice, education, and science, the reader is referred to the work of each Specialty Council within CoS in populating exemplars for its specialty training.