(PS9-13) Characterizing Clinical and Counseling Psychology Graduate Students’ Perceptions of Evidence-based Treatment Utility and Training

Background. Graduate training in evidence-based treatments (EBTs) may be clinical and counseling psychology students’ first exposure to clinical practice and plays a lasting role in attitude development and skill acquisition. However, psychology graduate students are rarely consulted about their experiences learning and using EBTs. Given that provider attitudes, agency, and skills are associated with later EBT use, it is critical to understand graduate students’ training experiences during this formative time period.

Objective. This study used qualitative and quantitative methods to characterize student clinicians’ training experiences and attitudes towards EBTs. Additionally, this study explored the relationships between student clinicians’ EBT training/beliefs and their perceived agency.

Method. 77 psychology doctoral students (M age = 28.1) currently attending APA or PCSAS accredited programs were recruited as part of a larger pilot RCT. Participants rated their perceived agency, the utility of three EBTs (CBT, DBT, ACT), and the EBT focus of their graduate programs. Participants also reported whether they had learned and used each EBT. Three open-ended prompts asked participants to describe: (1) the benefits of EBTs, (2) the limitations of EBTs, and (3) what they wished they had learned about EBTs in their graduate training. Pearson’s correlations were used to examine the associations between student clinicians’ agency, EBT perceptions, and EBT training. Content analysis was used to identify recurring concepts among the data in an iterative process involving two authors.

Results. Participants reported their racial-ethnic backgrounds (7.8% Asian; 9.1% Black or African American; 6.5% Middle Eastern or North African; 80.5% White; 18.2% Hispanic or Latine) and gender identities (11.7% men; 81.8% women; 3.9% gender queer; 2.6% non-binary). Most participants had learned CBT (99%), DBT (86%), and ACT (88%) in their graduate programs. Participants perceived CBT to be most helpful for their patients (M rating = 4.01 out of 5), followed by DBT (M = 3.80) and ACT (M = 3.64). Perceived EBT focus of programs (r = 0.25, p = .030) and perceived utility of CBT (r = 0.29, p = .011) were associated with student clinicians’ agency. However, the total number of EBTs learned/used or perceived utility of DBT/ACT were not associated with student clinicians' agency. Our research team identified the following content categories: mechanisms of change (n = 41), individual differences in treatment response (n = 42), versatility (n = 11), rigidity (n = 12), systemic issues (n = 8), treatment personalization (including adaptations for specific social identities; n = 13), and experiential learning (n = 9). 

Conclusions. Participants viewed EBTs as generally useful for their patients, and greater perceived program focus on EBTs was associated with higher student clinician agency. However, student clinicians also identified important limitations of EBTs and gaps in their clinical training. Considering diverse student perspectives and ideas about EBTs may serve to strengthen graduate clinical psychology curricula and training, with the potential downstream effect of increasing longer-term EBT uptake among postgraduate providers.