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IV. GENERAL DEPARTMENTAL ACADEMIC DEGREE REQUIREMENTS

CLINICAL DEPARTMENT POLICY AND PROCEDURES FOR ADMINISTERING THE ORAL SPECIALTY COMPREHENSIVE EXAMINATION

PROCEDURES FOR THE CLINICAL ORAL EXAM

1. The student will choose a theoretical orientation and the department administrative assistant, in consultation with the department chair, will assign an Oral Examination Committee to examine the student. The Committee will be comprised of two clinical psychology faculty members who did not supervise the case, who are not serving on the student’s dissertation committee (if known), and who are of the theoretical orientation(s) requested by the student.

2. Students should contact their Oral Examination Committee immediately after the committee is assigned and schedule their examination date well in advance – 3 months prior to the projected exam date is prudent. Students are also responsible for reserving a room and any audiovisual or computer equipment necessary for presenting the case. 

3. The student is required to present as part of the Clinical Oral Examination an audio or video recording of a therapy session with the target client(s). Students are therefore advised during their casework at GSAPP to acquire audio or video recordings of as many therapy clients as possible, to ensure choice of cases to present for clinical orals. In addition, students are advised to negotiate in advance with their practicum supervisors so they can record a session for the purposes of the Clinical Oral Examination. Except in exceptional circumstances, the recording will show the client presented in the case write-up. Any exemption from this requirement must be approved by the committee. In the case of such an exemption, the committee will request one of the following: 1) an audio or video recording of a similar client utilizing the same theoretical orientation, or 2) a verbatim transcription of a session from the target client in instances where a practicum permits audio or video recording but does not permit the recordings to leave the site. Examiners differ in their preferred methods of using the recorded material, so students should check with members of the Oral Examination Committee about their preferences in this regard when the Clinical Oral Examination is scheduled. It is often recommended that the student be prepared to start the playback of the recording at a crucial or relevant juncture in the session that shows an example of the student’s intervention and the client’s response to the intervention. However, the committee is entitled to review any segment of the session it wishes.

4. At least two weeks before the Clinical Oral Examination, the student will provide the Oral Examination Committee with a well-organized, cohesive and defensible write-up of a clinical case. The student should be careful to remove information (name, place of residence, employer and other unique identifiers) that could be used to identify the case, in a manner consistent with HIPAA regulations.

5. Guidelines for Case Write-Up: The write-up should be between 15 to 20 double-spaced pages, not including references. The case must be written up in APA format, must include citations to the scientific literature that contributed to conceptualizing the case (including cultural factors), and should include the following information (specified in the Guidelines for the Psychiatric Evaluation of Adults [APA, 2006]), most of which should be familiar to the student from prior coursework. The written portion of the oral exam should be an independent product and therefore the student should not ask supervisors or advisors to edit or comment on their write-up.

I. BRIEF OVERVIEW OF CLIENT
a. Case context (e.g., treatment setting)
b. Brief demographics
c. Presenting problems
d. Reason for referral

II. ASSESSMENT
a. History of the present illness
b. Psychosocial developmental and family history
c. Mental status examination
d. Description of systematic assessment which can include: structured interviews, questionnaires, observation etc. 
e. DSM-V diagnosis

III. FORMULATION AND TREATMENT PLAN
a. Guiding theory
b. Case formulation
c. Treatment plan

IV. COURSE OF TREATMENT
NOTE: Faculty prefer more pages on treatment course and examples of your clinical decision making and application of therapy strategies and fewer pages on client overview, assessment, and formulation and treatment plan. Please include details and illustrative examples of your specific interventions that match theory and case conceptualization. This could include session-by-session description of treatment interventions or processes or by highlighting examples of interventions that change over different phases of treatment. It will be important for the student to provide specific examples that illustrate, (a) the therapy context that prompted an intervention, (b) the therapist’s choice of a strategy/technique to address the issue, (c) a description of the implementation of that strategy/technique, and (d) the effectiveness of that strategy/technique. The goal is to demonstrate the therapist’s decision-making process, how one implements therapy interventions (or specific technique/strategies), and one’s ability to monitor efficacy of one’s interventions.

V. THERAPY MONITORING
NOTE: The importance of using systematic assessment to quantify client progress and outcome is increasingly viewed as necessary to good practice. Systematic assessment permits the clinician to monitor clinical progress and institute “mid-course” corrections in the target case. It is therefore a requirement for all Clinical Oral Examinations to describe and justify how ongoing progress was regularly assessed using systematic observation and/or measures and how this information was used to modify the case formulation, treatment plan, strategies/techniques used, etc. as therapy proceeded. Systematic observation could include structured interviews, questionnaires, observation, description of therapy processes, idiographic target goals or change indices, etc.

VI. EVALUATION AND DISCUSSION
a. Evaluation of case outcomes based on systematic assessment (note which qualitative and quantitative evaluations were involved)
b. Challenges encountered in working with the case
c. Diversity issues raised by the case and differences between you and the client, including but not limited to race/ethnicity, religious or spiritual orientation, gender-related issues, cognitive or physical challenges, and socio-economic levels
d. Ethical issues raised by this case
e. Description of supervision process and any supervisory issues that arose during treatment; discussion should reference readings or discussions about supervision covered in relevant courses (e.g., “Supervision & Professional Development”)
f. Description of knowledge and experience gained by the student through his/her treatment of the case
g. Description of areas for possible future growth

VII. REFERENCES
a. Citations are to be cited in the style of the latest APA Publication Manual

VIII. TABLES AND FIGURES (Optional)

NOTE: Tables summarizing all the quantitative data collected and figures should be placed at the end of the report

6. Guidelines for Oral Defense: Ordinarily, the clinical oral examination will last between 60 and 90 minutes, so the student and the committee should set aside 90 minutes for the exam. The student should be prepared to offer a brief (5 to15 minute) grand rounds style case summation, that includes identifying information, the presenting problem, diagnosis and impairment, brief history of the problem and past treatment, conceptualization, and a broad overview of your treatment approach, so as to orient everyone to the case. Brevity is important because one of the skills assessed by the Clinical Oral Examination is the ability to succinctly present to colleagues the essentials of a case. This should all be done in a brief “nutshell summary.” Some examiners will ask questions and have you elaborate on aspects of the case after that, and some examiners may waive this presentation. Although students should write up their case within a particular theoretical framework, they should also be prepared to discuss the case in such a way that a faculty member with a different orientation can discuss with them key aspects of the case. Accordingly, the student should be prepared to demonstrate an understanding of the theoretical framework used in the case, and should be prepared as well to articulate an understanding of the case from an alternative theoretical perspective.

Forms for the oral specialty can be obtained at our website: http://gsappweb.rutgers.edu/forms/forms.htm by clicking on the link Clinical Dept. Policy and Procedure for Clinical Orals, and Forms.