Some tips to get through the Statement of Equivalence in Clinical Psychology

I have discovered that by looking at the statistics for this blog that the post that gets the most hits is the article about the applying to the British Psychological Society as an Australian clinical psychologist and the Statement of Equivalence in Clinical Psychology (SoE).

Having completed the Statement in January 2002, and coming into contact with plenty of other foreign-trained clinical psychologists in various stages through the SoE, I thought it might be handy to list some tips to increase your SoE success. [hey, I’m assuming if you are reading this that you are either on the SoE or considering it…]

Some tips that may help you successfully complete the Statement of Equivalence:

• choose a Coordinator of Training carefully: this person can play a key role in the completion of the Statement. Optimally you want a Coordinator who 1) has a senior role in the health service, so that they can open doors for you to access placements, and 2) is familiar with the academic standards required, either by supervising previous candidates or being attached to the clinical psychology doctoral course. Ask prospective Coordinators if they have done this before or if they have access to other Coordinators.

• If you can, join a course that supports the SoE process or go to events organised for SoE candidates. For example, two courses I know of in London are the Salomons SoE course and the UCL SoE course. Aside from networking with other SoE candidates and exchanging tips and information, these courses usually provide examples of successful essays and reports so that you can judge the standard required.

• Share past essays and reports with other SoE candidates – the more you see the better you can judge what the assessors grade for. From past experience it also appears that the essay questions are not changed that often, so you may read a successful example of an essay that you are planning to write.

• For the professional practice essays having access to back issues of Clinical Psychology Forum, the house journal of the Division of Clinical Psychology, is essential. In addition the BPS website is also useful, particularly in terms of pointing to UK governmental policy documents (which you refer to in the essays).

• Acceptance: you may never believe that the Statement was a good experience or valuable in terms of your continuing professional development, despite the BPS’s statements to the contrary. In fact, the BPS claims to mandate the SoE only to protect the consumers of psychologists. It is a hoop to jump through.

• In dealing with prospective employers it is important to negotiate for the time and resources required for you to complete the SoE. Some employers are good at striking the balance between your responsibilities and the SoE process, while others will try to exploit you by offering a pay deal for much less than your post usually is paid (while expecting you to hold the same amount of responsibility) or allow no time for SoE within the post. Shop around and be prepared to travel to less desirable parts of the UK to complete the SoE, if you can.

• You will probably never end up believing that your original training was inferior, despite the suggestion embedded in the scrutiny of your clinical qualifications (well, at least according to the BPS). You may live for awhile in the twilight world of being treated like a trainee while also having skills and experience that are highly valued by your employer. In all likelihood these skills are the ones that your original training provided in that below-par excuse-for-a-training-course that you qualified from (& that you probably worked long and hard to get onto). Again, think of hoops…

• In particular, if you are lured by the bright lights of London… think carefully about how much trouble you are willing to go through in order to finish the SoE. To be honest, consider working outside of London to get your Statement (I did) , for the reasons listed above. For example, it has been fairly difficult for SoE candidates in my locality (south London) to get placements near to their permanent job or even in the Trust they work for, due to there being a limited number of supervisors in specialties such as learning disability. It is also important to consider that you are competing against trainees for spots on placements, and that it has been difficult for enough placements to be open to trainees, let alone folks outside of the system like SoE candidates.

Good Luck!!

A monument to pest control

In my home town of Dalby, Queensland there exists a monument in a small park by Myall Creek that has always seemed curious to me: it is a cairn dedicated to the cactoblastis cactorum (a moth originally found in Argentina).

Here are the details about it (from the Dalby Council website):

CACTOBLASTIS MEMORIAL CAIRN

A cairn was erected in Marble Street in 1965 to record the indebtedness of the people of Queensland (and Dalby in particular) to the Cactoblastis Cactorum. This tiny moth saved the Darling Downs from infestation by an introduced plant, the Prickly Pear.

A single, yellow flowering prickly pear was brought to Australia in 1839. By 1925 over 50 million acres of land in Queensland and New South Wales were covered with prickly pear, the greatest example known to man of any noxious plant invasion. The Dalby District was then heavily infested. It was impossible to effectively eradicate the weed either by sprays or cultivation. The land was rendered unusable and drove many from their farms.

The first eggs of the Cactoblastis Cactorum moth were imported from Argentina early in 1925 and were bred in very large numbers and liberated throughout the prickly pear territory. Within 10 years the insect had destroyed all the dense mass of prickly pear.

The cairn is located on Myall Creek as a lasting monument to the Cactoblastis Cactorum and its victory over the prickly pear menace.

For a long while I had wondered whether it was the only monument in the world to an insect, although I have subsequently learnt about the Boll Weevil Monument in the town of Enterprise, Alabama (which is, as you can see from the link, a grander monument than the humble cairn in Dalby).

The prickly pear cactus apparently was orginally brought to Australia with the First Fleet, as host cacti for the cochineal insect, exploited to produce a distinctive red dye (highly prized in Europe in the early 19th century and used, amongst other things, for the the British Red Coats). There was a strong economic imperative for the British Empire to establish an alternative source for cochineal dye at the time of colonisation, as it was produced solely in Mexico (which was under Spanish control). [Incidentally cochineal dye is still used today as a food colouring, E120]

Unfortunately, as the history of Australia has demonstrated several times, using introduced species can be a blessing and a curse, as cactoblastis cactorum is now poised to wreak havoc in Mexico. Following the successful Australian example of biological pest control, the moth has been used around the world to eradicate infestations of cacti on agricultural land, including in the Caribbean, which allows a short hurricane-blown trip to the Mexican shore… where there is plenty of nice, juicy cactus for caterpillars to chew on. The saviour has become the pest.

Psychologists involved in torture: The Guantanamo Experiment

In July 2005 the New Yorker published this article by Jane Mayer, describing the involvement of psychologists in the process of interrogations at the Guantanamo Bay detention centre. It is an alarming read, especially considering the apparent complicity of professional psychologists engaged in what may be considered as the torture of inmates.

The article reports that since 2002, following a period of limited success at gathering intelligence through interrogations, psychologists and psychiatrists have worked as consultants in a “Behavioral Science Consultation Team“, developing psychologically-informed strategies to assist with the productivity of the interrogations. These “psychologically-informed” methods have included “reverse-engineered” components of a program (Survival, Evasion, Resistance and Escape:SERE) designed to help military personel withstand torture if they are captured. The New Yorker article describes a number of the abuses of prisoners at Guantanamo that appear to be applications of the same coercive techniques that SERE candidates are exposed to, such as waterboarding (video), starvation, exposure to extreme temperatures, disruption to sleep patterns, exposure to taped loops of cacophanous sounds, and witnessing the desecration of religious symbols. These coercive techniques are designed to stimulate acute anxiety, which can reduce a person’s capacity for self-regulation (e.g., maintaing silence about secrets is more difficult in interrogations if you are sleep-deprived or coping with intense pain). The article also describes allegations of a psychologist providing consultation to CIA interrogators, suggesting that a prisoner receive “rougher methods” in order to produce the condition of learned helplessness. Finally, there are examples reported of psychologists allegedly using knowledge of prisoners’ mental health histories to assist interrogation methods (e.g., advising on keeping a prisoner in darkness as he had a fear of the dark).

Is the involvement of psychologists in these acts considered unethical by the American Psychological Association’s (APA) Code of Ethics? The APA produced a concensus report (Psychological Ethics & National Security: PENS) designed to clarify the ethical issues in June 2005, however this report has resulted in controversy and dissent within the APA. Prominent members, such as Philip Zimbardo (pdf), have voiced their concerns regarding the process of drafting the concensus report, as well as the recommendations. In July 2006 online magazine Salon described the backlash within the membership of the APA to the PENS report (the APA has responded to this article).

Critically, the PENS report proposes that psychologists not “violate basic principles of human rights”, but then describes that this definition of human rights is determined by the laws of the United States rather than international laws or standards (such as the Geneva Convention). Considering that the Bush Administration has changed the definition of torture, and worked to suspend habeas corpus for detainees, this potentially means that US psychologists operate within an ethical and legal framework that is different from that proscribed by international law. The US definitions of human rights and torture can potentially result in difficult ethical dilemmas for psychologists, as it may be that the abusive treatment of prisoners may never be defined as “torture”.

It appears that the position taken by the APA PENS report has resulted in a preference for the use of psychologists compared to psychiatrists by the US military (reported in the New York Times in June 2006), as the American Psychiatric Association has unequivocally stated that psychiatrists should not be involved in military interrogations.

These are challenging times for professional psychology in the United States, as the political use of an unending “war on terror” results in changes in the legal status of coercive methods, detention without trial, and infringements on human rights. If the ethical framework is also unclear for the role that psychologists may play in interrogations, then it is my belief that we are likely to see more abuses of prisoners along the lines of those that have been reported.