Clinical Comprehensive Exam Guidelines

There are two options for the paper/written component of the comprehensive. Regardless of the option chosen, note that the quality of the paper will be judged as well as the content. As this paper is one of the two requirements for formally entering into doctoral candidacy (the other being the oral comprehensive), the quality must be very high. The paper should not resemble a paper handed in as part of a course requirement; often these are content summaries with some integration. The written paper for the comprehensive should demonstrate a higher level of integration and originality of thought than would a course paper. As such, the preparation for this paper will take time and many revisions before it is handed into the committee. Careful proofreading must occur: Note that formatting and referencing must follow the most recent current APA guidelines. Typographical errors, missing words, sentences that do not make sense, reduced margins, etc., will also be taken into account when the committee makes the decision.

1. Oral Examination

The purpose of the oral examination is to provide students with the ability to apply their knowledge of case conceptualization, assessment, treatment, and ethics to a clinical case. Students will choose to be tested on an adult case or a child case. Case descriptions will be written by members of the clinical comprehensive committee and will be available for the student to review a half hour prior to the commencement of the examination. During the one-hour exam, students will be questioned by the four members of the clinical comprehensive committee in turn according to a template of questions created by the committee. Questions will fall into four broad areas: case conceptualization, assessment/clinical intervention, ethical issues, personal issues. Students will be asked to discuss the theoretical and/or empirical issues raised by the case that are relevant to each of these four areas and then to explain their decisions regarding the practical implementation of these issues in the specific case.

Criteria for Pass

A student who successfully passes the oral examination will be able to (a) identify a theory of case conceptualization and accurately apply it to the case, (b) identify the next steps in the assessment process and accurately identify the appropriate assessment measures and/or procedures, (c) provide an exhaustive list of potential diagnoses and identify the appropriate steps for making the differentials, (d) provide an exhaustive list of ethical issues raised by the case and identify the appropriate strategies for addressing these issues, with reference to relevant legislation and Standards of Practice, and (e) show insight in identifying at least a few personal issues raised by the case (e.g., personal biases) and thoughtfully discuss how to address these in practice.

Procedure for Fail

Students who fail the oral examination in May will have the opportunity to re-take it, with a new case, in mid August. Students will be provided with detailed written feedback from the committee members regarding the nature of the weaknesses so as to better prepare for the re-take. Students who fail the second examination in August will be provided with a remediation plan by the committee. This remediation plan may include supplementary coursework, readings, and/or supervised clinical experience. The remediation plan will be completed over the subsequent school year. Students will then have the opportunity for a third re-take the following May. Students who fail the third try will be given a written explanation for the committee’s decision and will not be able to complete the PhD. Note that membership of the clinical comprehensive committee for students’ retakes may change based on administrative turnover from year to year.


2. Paper Requirement

a. Literature Review Option

The purpose of this paper option is to produce a literature and/or theoretical review on a topic in the student’s broad area of study. This topic should not, however, be directly related to the student’s dissertation, and may not form the Introduction section of the student’s dissertation. The scope should be comparable to papers published in Psychological Bulletin or Psychological Review, and students are encouraged to peruse these journals for examples.

The topic should be broad enough that students are able to find a sufficient amount of published papers to support the review. However, it should be focused enough that the paper has depth and students are able to thoughtfully explore the methodological and theoretical issues raised by the topic. The paper should make a contribution; that is, it should not be a simple description of all of the studies that have been conducted on the topic. Instead, it should move the area forward by (a) making a theoretical contribution by, for example, pointing out inconsistencies in the literature and providing suggestions for how future research in this area should resolve them, or providing a theoretical framework to guide future research, or bringing up questions that are important but have yet to be addressed, or (b) making a methodological contribution by, for example, conducting a meta-analysis or other quantitative analysis (e.g., examination of effect sizes) to provide statistical confirmation of an effect.

There is no guideline for number of references or studies to review because that will depend on the topic. Very generally, however, papers of this breadth and depth have at least a few dozen references and focus on at least a dozen core papers in the review. The review should focus on peer-reviewed empirical journal articles, but book chapters and other reviews are helpful in guiding a search for references and providing theoretical background. We also suggest that students do not pick a topic for which there are already a large number of reviews (e.g., what accounts for the sex difference in major depression?). Again, we want the paper to make a unique contribution and be publishable.

We have also been asked about the criterion “recent review.” This does not mean that one cannot include older references. Older references are often very important for providing a historical context to the research question and/or for illustrating how the analysis of the question may have changed over time. The purpose for including this criterion is simply to make sure that the topic is still of current interest in the field. So, if no one has cared about this topic since 1985, then you probably shouldn’t write your comps paper on it!

We strongly encourage students to consult with their supervisor for help in picking a comps paper topic, as he or she is the expert in your area. Once students have picked a topic, we also encourage consultation with members of the comprehensive committee to determine whether the topic meets the criteria for a comps paper and for any questions about the paper’s structure.

Here are a few examples of the sorts of titles that would meet criteria for the lit review option comps paper:

  1. What is the efficacy of adjunctive cognitive therapy for schizophrenia?

    This is good because there’s lots of literature on this topic, it’s not too broad (e.g., not all types of therapy, not for all types of disorders), and one could get into a lot of issues: does it depend on the type/severity/chronicity of schizophrenia? Does it depend on the form cognitive therapy takes? Does it depend on whether family is involved? Etc. One could do a theoretical review or a meta-analysis on this topic.

  2. The personality disorders redefined: categorical versus dimensional models.

    This is a good topic because it’s very current, controversial, and there are lots of empirical papers on the topic, and, again, one could get into a lot of issues: what are the advantages & disadvantages of the categorical DSM approach in relation to the different dimensional approaches? Among the dimensional approaches which is most powerful in explaining the variability maladaptive personality? Which do you recommend for taking the DSM forward?

  3. Primary prevention in the schools: Are children benefiting?

    In this paper one could review the literature on primary prevention programs that have been implemented in schools to help prevent mental illness (or one could go more specific if there’s too much literature on mental illness, in general, and focus on, say, bullying, suicide, self-esteem, etc.). This could even be a meta-analysis. One could then provide an integration and analysis why these programs have not done as well as expected (if they haven’t) and provide recommendations for moving forward.

  4. A cross-cultural analysis of major depressive disorder: Comparison of Asian and Western definitions.

    This is a good topic because you can get into a lot of aspects of the issue: do the two groups present differently. Why might that be? What are the cultural/historical/religious reasons that underlie differences in rates and symptom presentation? Is this changing with China’s rapidly Westernizing culture? What are the implications of this for our understanding of the syndrome of depression very generally and/or for mental health policy in China? There are lots of angles one could take with this.

b. Empirical Paper Option

The purpose of this paper option is to produce an empirical paper on a topic that is not directly related to the student’s dissertation or any other empirical studies that have conducted so far in the student’s graduate career. This paper should also be of publishable quality in a top-tier general journal (e.g., Journal of Abnormal Psychology, Child Development, JPSP) or a secondary topical journal (e.g., Cognitive Therapy and Research, Child Abuse & Neglect, Archives of Sexual Behaviour). Students should target a particular journal when proposing the topic, and students are encouraged to peruse this journal for examples of appropriate topics of study.

This comps option has two important goals. The first is to expose students to a new literature that will hopefully expand understanding of clinical psychology, in general, and students’ specific research focus, in particular. Therefore, for example, if you have been working on the etiology and treatment of sexual dysfunctions, but for your dissertation topic you want to explore the effect of spousal depression in sex therapy outcome, you might want to pursue a data analysis project that explores some different topic related to depression (e.g., with another professor’s data) so that you are able to gain a deeper understanding of the phenomenology and etiology of the disorder. The second goal of this option (although not a requirement) is to expose students to new data analytic methods that they may not have had the opportunity to use, but with which they would like to become familiar. So, for example, if your dissertation topic is going to be a structural equation model of risk factors for bullying, you might want to get your feet wet by pursuing a data analysis project that explores a similar model using a different outcome (e.g., suicidality). 

Students will need to read deeply into the literature supporting the analyses, and will need to conduct analyses that are appropriately complex. We expect students to demonstrate expertise in this new area when writing up the paper. We strongly encourage students to consult with your supervisor for help in picking a paper that does not overlap with their dissertation, but that will be of use in broadening their knowledge base. We also encourage students to consult with the comprehensive committee to determine whether the topic meets the criteria for a comps paper and for any questions about the paper’s structure. Once you have picked a topic, you will contact the faculty member whose data you wish to use to ask permission. We suggest that you come to this person with a fairly well-formed idea (e.g., “I would like to conduct a study for my comps looking at the relation of xxx and yyy to zzz. I see from your website that you are conducting studies in this area. Would you have a dataset that I could use?”). You may then consult with this person (and others) periodically throughout the process for practical guidance regarding, for example, how variables are coded, whether it makes sense to look at a variable in a certain way, etc., but you should be the primary author on the study and paper.

The structure of the empirical paper topics should simply follow that required by the targeted journal. Every journal has a website that provides guidelines to authors in writing their paper. Students should consult this information prior to writing the paper, and are encouraged to read other articles in this journal to get a sense for what the journal is looking for. Again, the comps committee should be consulted with questions regarding the appropriateness of the topic for a fulfillment of the comps requirement.

Important Dates and Guidelines

Proposal due date: Your 1-2 page proposal is due August 31 of your PhD1 year. For the theoretical/lit review option this proposal should briefly describe the main question addressed by the paper and should outline the paper’s structure. It should also clearly indicate the unique contribution your paper will make to the literature and why this is an important contribution. Your proposal should also clearly indicate how your proposed literature review relates to your main area of study. For the empirical paper option this proposal should outline the research question and hypotheses and should clearly indicate the unique contribution your paper will make to the literature and why this is an important contribution. You should also briefly describe the participants, measures, and procedure of the data set on which you will be basing your paper, as well as the data analytic procedures that you will be employing to test your hypotheses. Your proposal should also clearly indicate how your proposed study relates to your main research focus.

Paper due date: THE WRITTEN PAPER IS DUE MAY 1ST of the PhD2 year.

Criteria for Pass/Fail

If a student’s comprehensive paper requires revision, he/she will be given a list of required changes by the committee and will be given the opportunity to revise his/her paper. Students should understand that most papers will undergo at least one revision, similar to what they should expect when submitting their paper to the actual targeted journal. Students will receive their first action letter by June 1st. Their first revision will then be due by July 15th. Students will receive their second action letter by August 15th. Students whose rewrite is still deemed to require major revisions (i.e., more than just minor editorial changes) will be given a second list of required changes by the committee and will be given the opportunity to re-revise the paper. The revision will be due by October 31st of PhD3 at the latest. However, students hoping to apply for internship in PhD3, or apply for grants, should aim to re-submit their first and second revisions as early as possible. The final action letter will be received by November 30th at the latest. Students whose re-revision is still deemed unsatisfactory will be given a written explanation for the committee’s decision and will not be able to complete the PhD.