Creating a Specialist WebsitePrior to beginning work on this interactive assignment, please read the Neimeyer, et al. (2011) “How Special Are the Specialties? Workplace Settings in Counseling and Cl

Counselling Psychology Quarterly Vol. 24, No. 1, March 2011, 43–53 How special are the specialties? Workplace settings in counseling and clinical psychology in the United States Greg J. Neimeyer a* , Jennifer M. Taylor a, Douglas M. Wear band Aysenur Buyukgoze-Kavas c aDepartment of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL 32611, USA; bPsychology and Community Counseling Clinic, Antioch University Seattle, Seattle, WA 98121, USA; cDepartment of Educational Sciences, Division of Psychological Counseling and Guidance, Middle East Technical University, Ankara, Turkey (Received 1 February 2010; final version received 18 February 2011) How special are the specialties? Although clinical and counseling psychol- ogy each have distinctive origins, past research suggests their potential convergence across time. In a survey of 5666 clinical and counseling psychologists, the similarities and differences between their workplace settings were examined during early-, mid-, and late-career phases to explore the distinctiveness of the two specialties. Overall, clinical and counseling psychologists reported markedly similar workplace settings.

However, some significant differences remained; a greater proportion of counseling psychologists reported working in counseling centers, while a greater proportion of clinical psychologists reported working in medical settings. In addition, during late-career, substantially more counseling and clinical psychologists worked in independent practice contexts than in community mental health centers, medical settings, academia, or university counseling centers. Findings are discussed in relation to the ongoing distinctiveness of the two specialties and the implications of this for training and service in the field of professional psychology.

Keywords:clinical psychology; counseling psychology; workplace settings Introduction Recognized as distinct specialties by the American Psychological Association, clinical and counseling psychology each have distinct histories, intersecting appli- cations, and longstanding concerns regarding their continuing, or diminishing, differences. This article explores these issues and examines the contemporary similarities and differences between these two specialties as reflected in their workplace settings. Workplace settings are examined at early, mid, and late career in order to determine whether differences vary by cohort in a way that might reflect either on their enduring or diminishing differences over time.

Enduring or diminishing differences?

Historically, the specialties of clinical and counseling psychology have developed from different origins and formed distinctly different trajectories as a result *Corresponding author. Email: [email protected] ISSN 0951–5070 print/ISSN 1469–3674 online 2011 Taylor & Francis DOI: 10.1080/09515070.2011.558343 http://www.informaworld.com (Munley, Duncan, McDonnell, & Sauer, 2004). Clinical psychology drew heavily from the mental health movement that emphasized psychological dysfunction, disability, and rehabilitation (McFall, 2006). Its alignment with the medical model, which places a premium on assessment, diagnosis, and treatment within a broad range of hospital and community contexts, reflects a coherent extension of the specialty across time (Tipton, 1983). Counseling psychology, by contrast, derived largely from the vocational guidance movement that emphasized the productive matching of a person to his or her work environment in the interest of optimizing performance and satisfaction (McFall, 2006; Munley et al., 2004). Counseling psychology’s enduring commitment to vocational psychology, personal adjustment, multiculturalism, and social justice (Neimeyer & Diamond, 2001; Tipton, 1983) can be seen as an ongoing testament to the person–environment fit that animated its origins over a century ago (Whiteley, 1980).

These historical differences are reflected in a range of contemporary distinctions between the two specialties, as well (Munley et al., 2004). Longstanding literatures have addressed the enduring distinctions between clinical and counseling psychology training programs in relation to their theoretical commitments (Norcross & Prochaska, 1982; Ogunfowora & Drapeau, 2008) and their training models (Korman, 1974; Norcross, Kohout, & Wicherski, 2005), and have sought to see whether these differences translate into differential internship placements (Brems & Johnson, 1996; Neimeyer & Keilin, 2007; Neimeyer, Rice, & Keilin, 2009; Shivy, Mazzeo, & Sullivan, 2007) or workplace experiences (Owens, Moradi, & Neimeyer, 2008).

Early work concerning their theoretical preferences noted substantial differences between clinical and counseling psychology. Some of the most preferred orientations within the field of counseling psychology, such as Rogerian, humanistic and existen- tial, were among the least preferred orientations within clinical psychology (Norcross & Prochaska, 1982; Watkins, Lopez, Campbell, & Himmell, 1986). By contrast, behavioral and psychodynamic theories have been found to be preferred within clinical training programs (Bechtoldt, Norcross, Wyckoff, Pokrywa, & Campbell, 2001). These theoretical differences have been noted among students and practi- tioners (Cassin, Singer, Dobson, & Altmaier, 2007), as well as among the training directors in these respective specialties (Norcross, Sayette, Mayne, Karg, & Turkson, 1998).

Other work, however, has suggested diminishing differences between the specialties in this regard over time (Zook & Walton, 1989). The majority of students and professionals within both of these specialties recently have been found to identify themselves as eclectic, integrative, or cognitive-behavioral (Bechtoldt et al., 2001), for example, with only modest differences in relation to identification with psychoanalytic, behavioral, or humanistic orientations. The recent work of Ogunfowora and Drapeau (2008) reported no significant differences between the two specialties in relation to any of the theoretical orientations they studied, including humanistic, psychodynamic, behavioral, or biological approaches.

In addition to exploring potential theoretical differences, research on the distinctiveness of clinical and counseling psychology has also noted increasing distinctions in relation to their underlying training models. Historically, both clinical and counseling psychology positioned themselves beneath the scientist–practitioner training model (Norcross, Castle, Sayette, & Mayne, 2004). With its distinctive emphasis on the integration of science and practice, the Boulder Model (1949) 44G.J. Neimeyeret al. dominated the field professional of training within both specialties until the introduction of the Scholar–Practitioner model that arose from the Vail conference (1973). The scholar–practitioner model was introduced as an alternative to the scientist–practitioner model (Korman, 1974), placing primary emphasis on profes- sional training and on the interpretation and application of research, rather than its generation or dissemination.

The scholar–practitioner model of training has proliferated rapidly within clinical psychology, but not within counseling psychology (Norcross et al., 2005). Today, the modal degree conferred in the field of clinical psychology is a Psy.D. degree, which serves as a strong testament to the appeal of the scholar–practitioner model within the field of clinical psychology. By contrast, counseling psychology has retained its longstanding commitment to the scientist–practitioner training model, viewing it as core to its identity as a specialty (Stoltenberg et al., 2000). Unlike clinical psychology, counseling psychology has only two Psy.D. programs, for example, and has regularly reaffirmed its longstanding commitment, the Boulder training model (Meara et al., 1988; Murdock, Alcorn, Heesacker, & Stoltenberg, 1998).

A number of researchers have sought to explore the implications of these differences between clinical and counseling psychology and to determine whether or not they translate into differential outcomes. Taylor and Neimeyer (2009), for example, found qualitative differences in mentoring between clinical and counseling psychology training programs. Students in counseling programs were generally more satisfied and reported higher levels of socioemotional mentoring, but somewhat lower levels of research productivity. Brems and Johnson (1996) studied the internship placements of clinical and counseling students and found that more clinical students were placed in health science centers than were counseling students, whereas more counseling students were placed in university counseling centers, and these findings were supported in a 30-year retrospective of internship placements within the field of counseling psychology in the United States (Neimeyer & Keilin, 2007). The recent work of Neimeyer et al. (2009) extends these findings.

In comparing the internship placements for an entire cohort group of clinical and counseling psychology students, they found differences that mirrored previous findings; against a background of considerable similarity, clinical psychology students nonetheless were significantly more likely to obtain internships in hospital and medical center contexts, whereas counseling psychologists more commonly were placed within counseling center contexts.

Some provisional evidence also supports the idea that these differences may translate into workplace differences, as well. Watkins et al. (1986), for example, found that counseling psychologists were more often employed in counseling centers and academic departments, whereas clinical psychologists were more often found in private practice and medical settings (see also Watkins, Schneider, Cox, & Reinberg, 1987), findings that were largely replicated by the subsequent work of Zook and Walton (1989) and Brems and Johnson (1996). Likewise, Bechtoldt et al. (2001) found that clinical psychologists were more likely to be employed in private practice, hospitals and medical schools, while counseling psychologists were more likely to be employed in counseling centers, differences that have been noted in more recent research, as well (Mogan & Cohen, 2008).

Despite these differences, however, there is longstanding concern that counseling psychology may be losing ground in relation to preserving the distinctiveness of its specialization. The sometimes subtle differences in theoretical orientations withinCounselling Psychology Quarterly45 counseling and clinical, for example, occur against the background of substantial theoretical similarity (Cassin et al., 2007). And, while differences in training models clearly persist, a number of researchers have asked, ‘‘Does the model matter?’’ and some concluded that it may not (cf. Neimeyer et al., 2007; Rodolfa, Kaslow, Stewart, Keilin, & Baker, 2005).

The convergence of the specialties is reflected most clearly, perhaps, in the recognition that most counseling psychology graduates do not emphasize their distinctiveness. Instead, they refer to themselves generically as ‘‘clinical practi- tioners’’ (Watkins et al., 1986), a finding that raises additional concerns about the diminishing distinctiveness of the specialties in the professional marketplace. In fact, Mosher (1980) and Fitzgerald and Osipow (1986) suggest that counseling psychology may either become extinct or simply become absorbed into clinical psychology, most notably because psychologists from both camps are experiencing a convergence in terms of their workplace settings. The purpose of this research was to examine the workplace settings of clinical and counseling psychologists for the evidence of this convergence or of their continuing distinctiveness. By examining these workplace differences within early- mid- and late-career professionals, we hoped to determine whether any differences between the specialties have increased or decreased across the various cohort groups.

Methods Participants In cooperation with the State, Provincial and Territorial Psychological Associations (SPTAs), an Internet survey of psychologists was conducted across North America.

Executive Directors of the Associations were solicited through the Council of Executives of State and Provincial Psychological Associations (CESPPA). Those who agreed to participate were provided with an email to forward to their memberships that described the nature of the study and included a link to the informed consent and survey, which could be completed and submitted online. This survey was part of a larger study that examined broader perceptions of professional development (Neimeyer, Taylor, & Wear, 2009), which included a range of demographic questions, such as the area of one’s degree type (clinical or counseling psychology), workplace setting (Community Mental Health Center, Hospital or Medical Setting, Independent Practice, University Academic Department, University Counseling Center or Mental Health Service, or Other), and the year the highest degree was conferred, among other demographic questions.

A total of 5666 psychologists (clinicaln¼4182; counselingn¼1484) responded to the survey. Fifty-four of the 58 licensing jurisdictions were represented, for a participation rate of 93.1% of the jurisdictions. The overall membership of the SPTAs is approximately 40,000 members, meaning that the current sample represented approximately 14.2% of the total population of the collective member- ships. In all, 58.5% of the participants were women and 41.5% were men. The mean age of participants was 52.7 (SD¼11.79), which closely approximates the mean age of APA members (54.3 years). The majority of the sample reported their ethnicity as White/Caucasian (91.7%), followed by Hispanic (2%), African American (1.7%), Asian (1.2%), two or more races (1.0%), Other (0.8%), American Indian or Alaskan (0.2%), or Native Hawaiian (0.2%); 1.1% declined to report their ethnicities. 46G.J. Neimeyeret al. The percentages of ethnic minorities in the sample closely approximate the percentages of psychologists represented in the membership of APA, where 2.1% are Hispanic, 2% are Asian, 1.8% are African American, and 0.2% are American Indian, and 0.4% are multiracial (Center for Psychology Workforce Analysis and Research, 2007). In terms of workplace setting, the majority of participants described themselves as working in independent practice (56.6%), followed by hospital/medical settings (15.0%), community mental health settings (7.6%), academic settings (6.9%), university counseling center settings (5.0%), or other (8.9%). Participants represented a relatively experienced sample of psychologists, with the median date of licensure being 1989 (SD¼10.97). Approximately 16.4% of participants (n¼926) were considered in their ‘‘early career’’ phase (0–7 years post-highest degree), 39.1% of participants (n¼2210) were considered in their ‘‘mid-career’’ phase (8–20 years post-highest degree), and 44.5% of participants (n¼2518) were considered in their ‘‘late career’’ phase (21 or more years post-highest degree).

Procedures Participants were asked to read the Informed Consent describing the study. After indicating their consent to participate, individuals were linked to the survey.

Participants completed and submitted their surveys online anonymously. The survey included questions regarding specialty (clinical or counseling) and current workplace setting.

Results and discussion Chi-square statistics were conducted to determine if there were significant differences in workplace settings across the career phases of those who graduated from clinical and counseling psychology programs. Pearson Chi-square statistics indicated significant differences between the two specialties in relation to workplace settings in early career, 2(5,N¼907)¼27.77,p50.001, in mid-career 2(5,N¼2175)¼ 65.72,p50.001, and in late career, 2(5,N¼2461)¼67.50,p50.001, phases. These differences emerged against the backdrop of substantial similarities between the workplace profiles of the two specialties, however.

As illustrated in Figure 1, the profiles of workplace settings for clinical and counseling psychologists were generally quite similar at each career stage. For example, within community mental health centers (CMHCs), 13.7% of clinical psychologists and 14.8% of counseling psychologists in the early career phase reported working in this setting. Likewise, in mid-career, 7% of clinical psychologists and 8.3% of counseling psychologists worked in this setting, percentages that diminished somewhat during late career both for the clinical (5.6%) of clinical psychologists work in CMHCs, and counseling psychologists (4.9%).

Unlike CMHC’s, however, more substantial workplace differences occurred in relation to hospital or medical settings, particularly in early career. At early career, nearly one-quarter (24.4%) of clinical psychologists reported working in hospitals or medical settings, compared with 17.7% of the counseling psychologists. At mid- career, the percentages were comparable for clinical (16.8%) and counseling (17.3%).

At late career, both groups showed a substantial decline, though the decline withinCounselling Psychology Quarterly47 clinical psychology (13.2%) was greater than the decline within counseling psychology (9.5%).

For both clinical and counseling psychologists, independent practice was the predominant workplace setting across all stages of the career. However, unlike all other workplace settings, the percentage of clinical and counseling psychologists in independent practice appears to have increased, rather than to have decreased, from early to late career. Nearly twice as many clinical psychologists in late career (66.4%) reported working in independent practices when compared to clinical psychologists working in independent practices in earlier stages of their career (38.7%). Similar findings are observed with counseling psychologists, where 60% of late career counseling psychologists reported working in independent practices, compared with only 35.4% of early career counseling psychologists. It is noteworthy, however, that a higher percentage of clinical psychologists reported working in independent practice settings during each of the three career stages.

Regarding academic setting, similarities between clinical and counseling psy- chologists were again found. In the early career stage 7.7% of the clinical psychologists reported working in an academic setting, compared with 5.7% in mid-career and 6.7% in late-career. For counseling psychologists, the percentage of academic work settings was similarly consistent across early (7%), mid (7.2%), and late (9%) career phases though, as reported by Cassin et al. (2007), a larger percentage of counseling psychologists were employed in academic settings overall (Watkins et al., 1987).

Perhaps, the most striking differences between clinical and counseling psychology occurred in relation to university counseling center settings, where counseling psychologists predominated at each career stage. In each phase, the percentage of counseling psychologists working in counseling center contexts was more than three times that of clinical psychologists. Counseling psychologists in early (16.0%), mid (11.6%), and late (8.2%) phases of their careers were consistently more strongly represented in this work setting compared to clinical psychologists (5.6% in early, 3.2% in mid, and 1.8% in late career), though both groups showed a decline in workplace representation from early to late career. 100 Early Career Clinical 80 90 , Mid-Career, Clinical Late Career, Clinical 60 70 Early Career, Counseling Mid-Career, Counseling 40 50 Late Career, Counseling 20 30 0 10 Hospital or Academic Setting Community Mental Health CenterMedical SettingIndependent PracticeUniversity Counseling Center Figure 1. Workplace differences by specialty across career trajectories.

48G.J. Neimeyeret al. The overall pattern of these results provides qualified support for the distinc- tiveness of clinical and counseling psychology in relation to the workplace settings of the professionals within those fields. Against a backdrop of substantial similarity, the differences that did emerge were consistent with the distinctive values of the respective specialties. Clinical psychologists, for example, were more strongly represented in medical and hospital settings, at least early in their careers, and counseling psychologists were more heavily represented in counseling center settings throughout their careers.

This profile of workplace settings may help inform students who seek graduate training in professional psychology. This could prove valuable given the recent work of Cassin et al. (2007) which suggests that students’ anticipations regarding their future employment may diverge substantially from the actual settings in which graduates find employment. Cassin et al. (2007), for example, found that 33% of counseling psychology graduate students anticipated academic careers, whereas the data from this study indicate that in early career, only 5.7% of counseling psychologists had academic placements. Likewise, only 7.7% of early career clinical psychologists were in academic contexts, compared with 20.1% of the clinical students who anticipated academic careers (Cassin et al., 2007). By contrast, in relation to independent practice, the picture is reversed. Fewer counseling students (24.2%) and clinical students (26.6%) anticipate going into independent practice than are represented in early career, where 35.4% of the counseling psychologists and 38.7% of the clinical psychologists find employment. Thus, this study suggests that students may benefit from gaining a more realistic sense of their workplace probabilities and, perhaps, even utilize this information in their decision making regarding the particular specialty they prefer to pursue. For aspiring graduate students who want to work within a counseling center setting, for example, it may be useful to know that counseling psychologists are disproportionately employed by counseling centers, and this may provide useful information when considering which graduate schools to apply to.

It is important to emphasize, however, that clinical and counseling psychologists are represented in each of the workplace settings included in this study, so employment opportunities are available to both across all of these workplace contexts. Moreover, with few distinctions, the profiles of workplace settings were quite similar for clinical and counseling psychologist across the various cohort groups. Although clear cohort-related shifts occurred, with more professionals in independent practice in late career (cf. Zook & Walton, 1989), these shifts did not appear to vary by specialty. In short, there was no evidence that the differences between clinical and counseling psychology were either substantially greater or lesser in early than in late career. Evidence of stronger late career differences, but diminishing mid and early career differences, might have been consistent with the idea that the differences between the specialties are diminishing across time (Fitzgerald & Osipow, 1986). However, no such evidence was found within this study. To the contrary, the patterns of workplace settings for clinical and counseling psychologists were largely consistent across cohort groups.

Overall, the results of this study provide qualified support for the distinctiveness of clinical and counseling psychology, as reflected in the workplace settings of their practitioners. While substantial differences were the exception, rather than the rule, those differences that did emerge clearly conformed to stipulated differences between the specialties and seemed to endure across cohort groups.Counselling Psychology Quarterly49 It is important to underscore, though, that the examination of workplace settings provides only a global indicator of possible workplace differences. As Owens et al.

(2008) have demonstrated, clinical and counseling psychologists within the same workplace setting can have strikingly different experiences and they fulfill different functions (Tipton, 1983), as well. Within the same setting the duties that are fulfilled and the orientations that are expressed by clinical and counseling psychologists may be markedly different (Osipow, 1980). Zook and Walton (1989), for example, found that while clinical psychologists more often approached their work from a psychodynamic approach, counseling psychologists commonly utilized a humanistic approach toward their work. Importantly, these differences would be masked in this study where only differences in the workplace setting itself were examined, rather than functions and orientations and perspectives expressed within that workplace.

For this reason, the results of this study are best regarded as providing a conservative picture of the differences between the two specialties, leaving it to future work to develop a more detailed picture of the distinctions between the specialties, not only in relation to the places of their employment, but also in relation to the duties, functions, and orientation that each brings to its workplaces.

In addition, it is important to underscore that the cohort differences examined in this study do not necessarily reflect developmental differences. The fact that substantially more clinical and counseling psychologists appear in independent practice contexts during late career, for example, could reflect a movement across the career trajectory away from other workplace settings and toward independent practice. Alternatively, it may simply reflect a cohort effect, with more late-career individuals spending their entire careers in independent practice contexts, while early career individuals have taken positions in more diverse occupational contexts.

Although cohort differences between clinical and counseling psychology were not evident in this sample, it nonetheless remains for future longitudinal efforts to address any genuine developmental differences between the specialties that may have occurred across time.

A final caveat has to do with the rapid internationalization of counseling psychology (Munley et al., 2004; Takooshian, 2003). As the specialty of counseling psychology makes systematic progress toward its international development (Leong & Ponterotto, 2003; Leung, 2003), this development will likely register its effects on workplace settings associated with professionals within this field, as well. A number of researchers and scholars have noted important variations as a function of the cultural adaptation of the specialty to a range of international contexts (Kavas, Taylor, & Neimeyer, 2010; Pelling, 2004; Takooshian, 2003), and these may well be reflected in workplace settings, as well, as the field continues its process of globalization. Indeed, the rapid globalization of the specialty, as well as its quest to embrace cultural diversity and variation, may become a further feature that distinguishes it as a specialty (Neimeyer & Diamond, 2001).

Within the context of these considerations, however, this study provides provisional evidence regarding the continuing differences between clinical and counseling psychology training programs in relation to one of their principal outcomes: the workplace settings of the professionals they train. Future work that clarifies the nature and implications of these differences may contribute to a better understanding of the contemporary distinctions between these specialties. And these distinctions may, in turn, serve as the basis for more informed and effective decision 50G.J. Neimeyeret al. making on the part of students whose career interests may be shaped by the knowledge of the contexts in which they might eventually work.

Notes on contributors Greg J. Neimeyer received his PhD in counseling psychology from the University of Notre Dame. He is professor of psychology in the Department of Psychology at the University of Florida and Director of the Office of Continuing Education and Psychology at the American Psychological Association. A fellow of the American Psychological Association, he is also a member of the Department of Community Health and Family Medicine where he conducts his clinical practice. His areas of research include professional development, epistemology and psychotherapy, constructivism, social influence in clinical contexts, and relationship development and disorder.

Jennifer M. Taylorreceived her MS in counseling psychology from the University of Florida.

She is currently a PhD candidate in the University of Florida counseling psychology program.

Her research focuses on professional development and competencies, continuing education, and mentoring.

Douglas M. Wearreceived his PhD in clinical psychology from the University of Wyoming.

He is the president of Wear & Associates, Inc., executive director of the Washington State Psychological Association, director of Antioch University Seattle Psychology and Community Counseling Clinic, chair of the APA Continuing Education Committee, and past chair of APA Council of Executive Directors of State and Provincial Psychological Associations. His research and professional interests include professional development, supervision, manage- ment, consulting, and coaching.

Aysenur Buyukgoze-Kavasis a research assistant and PhD student at Middle East Technical University, Psychological Counseling and Guidance program. She is part of the Scientific HR Development Program, which aims to train future academicians of Turkey. As a part of this program, she worked as a visiting research scholar at University of Florida, Department of Psychology from February 2009 to October 2009. She is a member of the Turkish Psychological Counseling and Guidance Association and American Psychological Association Division 17. Her major research interests are career decision-making, career indecision, counseling supervision, mentoring and job satisfaction.

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