1. RESEARCH ISSUES

2.  More complicated and sophisticated research designs and questions are being implemented today.

3.  These research questions tend to look for interactions rather than main effects, for example, under which conditions, with which patients, treated by which therapists, and using which techniques will interventions work best.

4.  the need for newer research designs and methodologies has led to a move toward greater methodological pluralism

5.  Investigating clinical rather than simply statistical significance has also been advanced as a more useful way to make sense of research data

6. Cont’d  The use of effect size and meta-analysis techniques as well as more sophisticated statistical analysis aided by computer technology has increased the utility as well as the complexity of research methodologies and data analysis approaches

7.  Cost containment concerns have also led many new research investigations to incorporate cost-effectiveness or cost-benefit analysis into their design

8.  Recent research has focused on cost-effective, brief, and empirically supported treatment approaches.

9.  Some authors criticize the historically narrow focus of psychological research, stating that “too many psychologists hug the intellectual shoreline and are content to paddle quietly in their own small ponds” (Bevan, 1991, p. 481) and that psychology is “a collection of studies rather than a coherent discipline”

10.  Calls for more creative, risky, and multidisciplinary research has been made by many as well.

11. Practice Issues  Managed Health Care  Prescription Privileges  Medical Staff Privileges  Private Practice  Specialization  Empirically supported treatments

12. Managed Health Care  With the advent of HMOs and PPOs, much of the spiraling health care costs and unnecessary procedures are contained.

13. Cont’d  The HMO and PPO companies determine, along with the professional treating a patient, the most cost-effective and reasonable diagnostic or treatment plan should be followed. Therefore the insurance companies paying for professional health and mental health care services now have an important say in the types of services that can be rendered.

14. Prescription Privileges  The APA, after careful study, has supported efforts to develop a curriculum to adequately train psychologists in psychopharmacology and to lobby state legislative groups to pass laws allowing psychologists to prescribe medications.

15. Medical Staff Privileges  Psychologists in many states have obtained medical staff privileges in order to provide independent inpatient care for their patients. After about 10 years of legislative advocacy and activity, approximately 16% of clinical psychologists have obtained full medical staff privileges in the United States.

16. Private Practice  Private practice trend will quickly reverse itself owing to the rapid changes in the health care delivery and insurance reimbursement systems.

17. Empirically supported treatments  With advances in research and practice, the need for specialization in clinical psychology has become apparent. As clinical psychology has evolved and more information on human behavior has become available, practitioners have endeavored to specialize in areas such as neuropsychology, geropsychology, brief treatments, health psychology, infant psychology, and forensic psychology.

18. Cont’d  Psychologists, it is argued, are excellent candidates to assist in research, teaching, public policy, and clinical practice to improve health promoting behaviors in the population and minimize health-damaging behaviors. Therefore, psychology is now considered not only an independent mental health discipline but also an independent general health care discipline.

19. Training Issues  The types of training models have changed tremendously during the past several decades. Which training models will survive and thrive and which will not has important implications for the future of clinical psychology.