critical review

Racial and Ethnic Diversity Among Clinical Psychology Doctoral Students Applying for Internship

A. Andrew Dimmick and Jennifer L. Callahan Department of Psychology, University of North Texas

Racial and ethnic diversity constriction in the psychology training-to-workforce pipeline has been broadly identified at the undergraduate, graduate, and licensure levels. Within that context, the present study sought to investigate the rate at which racial and ethnic minority students matched for internship compared to majority non-Hispanic White graduate students. Consistent with prior reports, racial and ethnic minority students were significantly underrepresented in clinical psychology doctoral programs. However, internship match rates did not differ significantly by racial and ethnic minority status. Placed within the larger context of established literature, the findings suggest that internship match is not likely to be a significant contributor to the constriction of racial/ethnic diversity in the training-to-workforce pipeline. As an exception to the problem, other points in the training-to-workforce pipeline that have been identified as points of diversity constriction (e.g., doctoral recruitment and admissions, licensure) may benefit from careful consideration of internship application criteria and/or review processes in formulating constriction remediation plans. Programmatic remediation of underrepresented minorities can lead to several gains for the profession, including improved educational outcomes; improved leadership and critical thinking skills; and increased openness and tolerance for racial, cultural, and value diversity.

Public Significance Statement With declines in representation in the range of 50%–70%, diversity constriction of underrepresented minorities (i.e., Hispanic/Latinx; Black/African American individuals; Native American) is a pernicious problem within clinical psychology for which discipline-level remediation seems appropriate. Points of known constriction, such as doctoral recruitment and admissions and examination for licensure, are encouraged to learn from the more effective methods and processes of internship match to foster greater inclusiveness and equity.

Keywords: race/ethnicity, diversity, clinical psychology, doctoral training, internship

As the population of the United States continues to become increasingly racially and ethnically diverse (U.S. Census Bureau, 2020), the necessity of a more diverse workforce in psychology to

meet the mental health needs of the population has become ever more apparent. A crucial step for increasing racial/ethnic diversity in the workforce of psychology is addressing diversity disparities in the training of future psychologists. Extensive evidence suggests that increased racial/ethnic diversity in higher education leads to student gains, such as positive educational outcomes, critical think- ing skills, personal development, social competence, and openness to diversity (Antonio, 2001; Bowman, 2010; Boylan et al., 2003; Chang, 1999; Denson & Chang, 2009; Flowers & Pascarella, 1999; Gurin et al., 2003; Henderson-King & Kaleta, 2000; Hu & Kuh, 2003; Nishina et al., 2019; Pascarella et al., 1996; Pike, 2002; Taylor, 1998; Terenzini et al., 2001; Umbach & Kuh, 2006; Whitt et al., 2001). Importantly, these positive outcomes from exposure to racial/ethnic diversity in higher education are not limited to the short period a student spends at a higher education institution. Research suggests that White individuals who are exposed to individuals of multicultural backgrounds during their education are more cross-culturally competent when they enter the workforce (Jayakumar, 2008).

Despite the various positive outcomes that accompany increased racial/ethnic diversity, minority underrepresentation in psychology persists as a problem in the psychology training-to-workforce pipeline. A report by the American Psychological Association (APA, 2018b) found that of the 94,643 psychologists working in

This article was published Online First July 22, 2021.

A. Andrew Dimmick https://orcid.org/0000-0002-1975-7869

Jennifer L. Callahan https://orcid.org/0000-0001-9190-3886 A. ANDREW DIMMICK earned his BS in Psychology from Idaho State

University. He is currently a student in the Clinical Psychology doctoral (PhD) program in the Department of Psychology at the University of North Texas (Denton, TX) where he works under the direction of Jennifer L. Callahan. JENNIFER L. CALLAHAN earned her PhD in Clinical Psychology from the

University of Wisconsin-Milwaukee, completed her internship and postdoc- toral training at Yale University, and holds board certification in Clinical Psychology. She is currently Professor and Director of Clinical Training for the Clinical Psychology program in the Department of Psychology at the University of North Texas (Denton, TX) where she directs the Evidence- Based Training and Competencies Research Lab. CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Jennifer L.

Callahan, Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX 76205, United Stated. Email: Jennifer.Callahan@ unt.edu

Training and Education in Professional Psychology

© 2021 American Psychological Association 2022, Vol. 16, No. 4, 412–419 ISSN: 1931-3918 https://doi.org/10.1037/tep0000382

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2016, only 15,143 (16%) identified as racially or ethnically diverse. Concurrently, the proportion of racially/ethnically diverse workers that made up the U.S. workforce at the time was more than double that rate (39%). To understand why workforce diversity is low, the higher education pipeline to the profession must be considered. Beginning with undergraduate majors in psychology, a report

by Luebbe and Ogbaselase (2018) found that the racial/ethnic minority student representation in undergraduate psychology majors was significantly lower than what was expected based on U.S. population census data. Drawing from concurrent census figures (Humes et al., 2011), we would expect 36.3% of U.S. psychology majors to identify as racially or ethnically diverse, in contrast to the smaller 31.9% found by Luebbe and Ogbaselase (2018). These omnibus figures do not fully capture the extent of the problem however. Parsing of diverse students reveals uneven constriction across groups. Representation of Hispanics/Latinx decreased in the diversity pipeline by 23.93% from population diversity to undergraduate psychology student diversity. Diversity constriction of a slightly smaller magnitude was observed in Native American representation with representation of Native Americans decreasing by 11.11%. In contrast, no significant diversity constriction occurred for Black/African American or Asian/Pacific Islander in- dividuals from population representation to undergraduate psychology major representation. Research by Callahan et al. (2018) focused on the doctoral

education years and found evidence of additional diversity constric- tion and even greater underrepresentation of specific racial/ethnic minority groups within accredited doctoral psychology programs. Although no significant diversity constriction occurred among Native American students or Asian/Pacific Islander students, mas- sive constriction was localized to Hispanic/Latinx and Black/ African American individuals. Hispanic/Latinx representation decreased by 34.05% from population diversity to diversity in psychology doctoral programs. Black/African American student representation decreased by 43.81%. With strong constriction in doctoral training, the observation of poor workforce diversity in professional psychology is perhaps not surprising (APA, 2018b; Buchanan & Wiklund, 2020). Unfortunately, past efforts to reme- diate underrepresentation of diversity in the field have been insuffi- cient and largely insubstantial (Borrego, 2018). With few racial/ethnic minorities from underrepresented groups

emerging from the training pipeline, surviving racial/ethnic minori- ties who enter faculty positions suffer as well (Niemann, 2016). When racial/ethnic minority faculty are significantly underrepre- sented and/or characterized as a “token” faculty member, they may be more subject to racial/ethnic stereotypes imposed by faculty members belonging to the racial/ethnic majority. These racial/ethnic minority faculty members are often viewed through the lens of their racial/ethnic identity, instead of as experts and professionals in their specific area of research. Ultimately, the lack of racial/ethnic minority professionals in the psychology workforce fosters a homogenous field and can lead to a reduction in the talents, ideas, and perspectives of the field as a whole (Grapin et al., 2016). An additional side effect of the racial/ethnic diversity constriction

of clinical psychology doctoral students is the racial/ethnic diversity constriction among psychotherapists in the workforce. Racial/ethnic minority psychotherapy clients have been found to show a strong preference for working with a racially/ethnically matching psycho- therapist. They view their racially/ethnically matching therapist as

superior to a nonmatching psychotherapist and have been found to develop a stronger therapeutic alliance with matching psychothera- pists (Cabral & Smith, 2011; Chao et al., 2012). Through the systemic constriction of racial/ethnic diversity from undergraduate psychology students to applicants seeking licensure, the likelihood that a racial/ethnic minority client will be able to receive treatment from a matching therapist is sharply reduced.

While biased admission metrics are of concern (Callahan et al., 2018), an unexplored possibility is that existing homogeneities (e.g., as described by Grapin et al., 2016) may also contribute to sustenance of diversity constriction. Research indicates that certain personality characteristics play a role in admission to graduate psy- chology programs (Appleby et al., 1999) and in matching for intern- ship (Collins et al., 2007; Ginkel et al., 2010). Personality factors such as friendliness, assertiveness, and self-efficacy have been shown to have significant correlations with psychology doctoral students’ like- lihood to match for internship (Callahan et al., 2014). These findings are alarming when examined through the lens of personality differ- ences between racial/ethnic groups. A large meta-analysis of racial/ ethnic differences in personality indicated that small but significant differences exist among the Big Five personality traits (Foldes et al., 2008). As some personality traits are preferred in regards to admission to graduate psychology programs and during the internship match process, racial/ethnic groups with personality traits that do not map onto these preferences risk systematic exclusion from psychology graduate programs and internship match.

Congruent with the previously discussed necessity in identifying and remediating constrictions in the racial/ethnic diversity pipeline, the primary aim of this study was to explore whether or not internship match, a high stakes competitive process in which not all who apply are matched, might be contributing to diversity constriction in the clinical psychology training-to-workforce pipeline. In light of the extant literature pointing to significant constriction at the undergrad- uate, graduate, and licensure levels, it was hypothesized that under- represented clinical psychology racial/ethnic minority students— specifically Black/African American and Hispanic/Latinx—would have a higher ratio of internship site applications to interviews and match for internship at a lower rate than non-HispanicWhite students. A secondary aim of this study was to investigate possible confound- ing variables—various applicant qualifications—for prevalence of underrepresented racial/ethnic minority students at the internship match level. In light of an earlier report finding no significant difference in academic qualifications among those admitted to doctoral training (Callahan et al., 2018), we did not expect under- represented racial/ethnic minority student qualifications for internship—the number of publications on their curriculum vitae (CV), the number of supervision hours, the number of intervention and assessment hours—to significantly differ from those of non- Hispanic White students. However, differences in normative person- ality traits—Openness, Conscientiousness, Extraversion, Agreeable- ness, and Neuroticism—were explored to determine whether personality trait differences between racial/ethnic groups, in the aggregate, might differ in similar ways to those in normative samples.

Method

Participants

To maximize variability in match outcomes, the data set built for the present study pulled data from two previous studies examining

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clinical psychology doctoral student variables and internship match rate at the height of the internship match imbalance (Callahan et al., 2010, 2014). One noteworthy change was made in the combined data set. Five participants were excluded from the combined data set as they did not indicate their racial/ethnic status. Data from 28 participants were removed as they were from the 2011 match year and indicated that they had applied for internship for two or more years. These participants were removed to preclude counting them twice in data analyses. A total of 131 participants were excluded from analyses pertaining to internship match as they did not respond or indicate their match status in the postmatch follow-up survey. Our final sample (N = 568) was majority Female (77.6%) and non-Hispanic White (80.3%; Asian/Pacific Islander, 6.0%; Black/ African American, 4.2%; Hispanic/Latinx, 4.0%; Native American, 0.4%; multiracial, 3.0%; other, 2.1%). The average age of students in our sample was 29.16 (SD = 3.78). They were primarily enrolled in clinical psychology doctoral programs (96.6%) with small pro- portions being enrolled in counseling psychology doctoral programs (0.9%), school psychology doctoral programs (0.2%), or a com- bined program (2.3%). Student data were treated according to the American Psychological Association Ethical Principles of Psychologists and Code of Conduct (2017).

Procedure

Prior to internship match notification day, students in the present study completed a survey regarding their demographic information, internship qualifications, the number of their internship applications and interviews, as well as a personality measure. A subsequent postmatch survey was distributed to all students who completed the original survey to follow-up regarding the students’ match status. A total of 76.9% of the students in the study completed the postmatch survey, with 89.2% of the completers indicating they matched for internship.

Measures

International Personality Item Pool Representation of the NEO-PI-R (IPIP-NEO)

Students completed a version of the IPIP (Goldberg et al., 2006) developed for measuring personality domains included in the NEO Personality Inventory (NEO-PI-R; Costa & McCrae, 1992). The IPIP-NEO is a self-report questionnaire containing 300 questions, each on a 5-point Likert scale. The IPIP-NEO measures personality across the five big personality traits—Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism. Cronbach’s α reli- ability coefficient was calculated for each of the big five personality traits and are as follows: Openness = .64, Conscientiousness = .79, Extraversion = .78, Agreeableness = .77, Neuroticism = .84. It has also shown construct validity with the NEO-PI-R, with significant mean trait correlation (r = .68; Lim & Ployhart, 2006). The five- factor personality model utilized in the IPIP-NEO has been found to fit well across gender and ethnic groups (Ehrhart et al., 2008). Racial and ethnic norms for the IPIP-NEO are not available and use of such norms is discouraged by the inventory developers (Goldberg et al., 2006). The IPIP-NEO was chosen over more common personality measures for a few reasons. The measure is both nonpathologizing and nonclinical, which was important given the nature of the sample.

Additionally, the IPIP-NEO is less commonly used and therefore the students were likely less familiar with it compared to more widely used measures in clinical settings of five-factor personality inven- tories. Recent evidence suggests that the IPIP-NEO is also a more reliable measure of personality than more commonly used person- ality inventories (Hamby et al., 2016).

Results

Hispanic/Latinx and Black/African American clinical psychology doctoral students were significantly underrepresented, χ2(2) = 57.98, p < .001, compared to the representation rates found in the general United States population (Humes et al., 2011). Hispanic/Latinx and Black/African American students were also significantly underrepre- sented, χ2(2) = 36.5, p < .001, in this largely clinical psychology subdiscipline sample as compared to representation in accredited psychology doctoral programs more broadly (Callahan et al., 2018). However, underrepresented Hispanic/Latinx and Black/African American students were not significantly less likely to match for internship than non-Hispanic White students, χ2(3) = 2.73, p = .44. Figure 1 displays this finding within the context of the broader training-to-workforce pipeline. There were also no significant differ- ences in the ratio of applications to interviews, F(2, 380) = .49, p = .62, the number of supervision hours, F(2, 372) = 1.12, p = .33, the number of interventions and assessment hours, F(2, 375) = .80, p = .45, or the number of publications, F(2, 381) = .08, p = .92, as a function of racial/ethnic status.

Personality traits were measured to investigate if trait differences between racial/ethnic groups among those accepted into clinical psychology doctoral programs differed from trait differences found in the population, as well as to examine if trait differences between racial/ethnic groups of those students who matched for internship differ from those found in clinical psychology doctoral programs in general. First, the effect sizes of differences across the big five personality domains by racial group (non-Hispanic White compared with Black/African American, non-Hispanic White compared with Hispanic/Latinx, etc.) were analyzed and compared with differences found in a large meta-analysis by Foldes et al. (2008). Effect size differences can be found in Table 1. Notably, Black/African Amer- ican students in clinical psychology doctoral programs differed from non-Hispanic White students in agreeableness, d = −.07; 95% CI [−.15, .00], and neuroticism, d = −.10; 95% CI [−.19, .00], at different magnitudes, compared to observed differences in agree- ableness (d = .03) and neuroticism (d = .09) found in a normative sample (Foldes et al., 2008). Asian/Pacific Islander students in clinical psychology doctoral programs differed from non-Hispanic White students in conscientiousness, d = .44; 95% CI [−.03, .90], agreeableness, d = .41; 95% CI [−.03, .84], and neuroticism, d = −.78; 95% CI [−1.59, −.04], at different magnitudes, compared to observed differences in conscientiousness (d=−.11), agreeableness (d = −.63), and neuroticism (d = .12) found in normative samples. Finally, Hispanic/Latinx students in clinical psychology doctoral programs differed from non-Hispanic White students in openness, d =−.10; 95% CI [−.20, .01], and conscientiousness, d= .09; 95% CI [−.01, .19], at different magnitudes, compared to observed differ- ences in openness (d = .02) and conscientiousness (d = −.08) found in normative samples.

Next, the effect sizes of personality trait differences by racial group of clinical psychology doctoral students who matched for

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internship were examined and compared to personality trait differ- ences of clinical psychology doctoral students as a whole. Effect size differences can be found in Table 1. Notable differences in the magnitude of trait differences were found between Hispanic/Latinx students and non-Hispanic White students who matched for intern- ship in openness, d = −.02; 95% CI [−.05, .00], and extraversion, d = .01; 95% CI [.00, .02], compared to observed differences in

openness and extraversion found in clinical psychology doctoral students as a whole.

Discussion

The present study investigated constrictions of racial and ethnic diversity in the professional psychology pipeline, specifically at the

Table 1 Differences in Personality Traits by Racial Group Between Clinical Psychology Doctoral Students, Clinical Psychology Doctoral Students Who Matched for Internship, and Normative Samples Found by Foldes et al. (2008)

Racial group comparisona

Differences in normative samples (Foldes et al., 2008)

Differences among students across programs

Differences among students that matched for internship

Mean (M) d d 95% CI d 95% CI

White-Black Openness .10 .33 [−.02, .67] .17 [−.01, .35] Conscientiousness −.07 .13 [−.09, .34] .32 [−.22, .85] Extraversion .16 .41 [−.02, .83] .55 [−.02, 1.12] Agreeableness .03 −.07 [−.15, .00]b −.06 [−.12, 0.00] Neuroticism .09 −.10 [−.19, .00]b −.42 [−.85, .01]

White-Asian/Pacific Islander Openness −.11 −.14 [−.30, .01] −.21 [−.43, .01] Conscientiousness −.11 .44 [−.03, .90]b .43 [−.03, .90] Extraversion .14 .34 [−.02, .70] .21 [−.01, .44] Agreeableness −.63 .41 [−.03, .84]b .47 [−.04, 1.07] Neuroticism .12 −.78 [−1.59, −.04]b −.77 [−1.57, .04]

White-Hispanic/Latinx Openness .02 −.10 [−.20, .01]b −.02 [−.05, .00]c

Conscientiousness −.08 .09 [−.01, .19]b .17 [−.01, .36] Extraversion .02 −.03 [−.08, .02] .01 [.00, .02]c

Agreeableness .05 .27 [−.02, .55] .47 [−.24, .96] Neuroticism −.03 −.41 [−.82, .01] −.41 [−.83, .01]

Note. Bold font indicates statistically significant differences. a White-Native American comparisons were excluded due to insufficient sample size. A correction factor was used in calculating effects size for personality differences among students to account for smaller samples. b 95% Confidence interval does not contain personality effect size difference observed in normative samples. c 95% confidence interval does not contain personality effect size difference observed among students across programs.

Figure 1 Constriction of the Racial and Ethnic Diversity Pipeline in Clinical Psychology

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doctoral and internship match levels within the subdiscipline of clinical psychology. Within this clinical psychology subdiscipline sample, the observed constriction represents significant racial/ethnic minority underrepresentation when compared to (a) the demo- graphics of the United States (Humes et al., 2011) and (b) psychol- ogy doctoral programs as a whole (Callahan et al., 2018). Yet, importantly, racial/ethnic minority students in this sample were as likely to match for internship as the dominant majority (non- Hispanic White students). Regardless of race/ethnicity, successfully matched internship applicants were similarly qualified with respect to the number of supervision hours, intervention and assessment hours, and publications. Personality differences were examined to explore the possibility

that field homogeneity might foster diversity constriction suste- nance. The magnitude of personality differences between racial/ ethnic groups in our sample did somewhat differ from those found in a normative sample (Foldes et al., 2008). Personality trait differ- ences between racial/ethnic groups of students who matched for internship were generally similar to the differences found in clinical psychology doctoral students as a whole. Due to the exploratory nature of this finding, it is unclear whether the differing magnitude of personality traits according to racial group is due to systematic exclusion of racial/ethnic applicants that do not map onto a stereo- typical “White” personality type (i.e., the hypothesis of field homo- geneity), or if the differences are due to another variable entirely. Despite the encouraging finding pertaining to racial/ethnic diver-

sity at internship match, diversity constriction remains a serious problem within clinical psychology. A call for discipline-level remediation seems appropriate. The representation of Hispanics/ Latinx cumulatively decreased 67.74% from undergraduate psy- chology student representation to clinical psychology doctoral student representation. Similarly, a decrease of 65.29% in Black/ African American representation and 50% in Native American representation occurred from undergraduate psychology student diversity to clinical psychology doctoral student diversity. The only racial/ethnic group that was not underrepresented or evidencing constriction was that of Asian/Pacific Islander students, as the representation of Asian/Pacific Islander individuals remained rela- tively stable from population to undergraduate to clinical psychol- ogy doctoral representation. A possible contributor to the significant underrepresentation of

racial/ethnic minority students in our sample could be due to the type of programs sampled in the study. Due to the source data from the original studies from which data were derived from this study, our sample was constrained to students recruited through member programs of the Council of University Directors of Clinical Psychology (CUDCP). Evidence suggests that programs following the clinical-science or scientist–practitioner training models—the two primary training models of CUDCP programs—admit racial/ ethnic minority students at a rate of 22.2%–22.7% (Sayette et al., 2011). Programs that instead follow the practitioner–scholar model of training—a program training model not represented within this sample—accept racial/ethnic minority students at a rate of 42.0%. The acceptance rate of CUDCP programs in the present study (19.7%) closely resembles the acceptance rate of similar programs in past research (22.2%–22.7%). This could explain why the clinical psychology doctoral programs in our study underrepresented racial/ ethnic minority students compared to the results found by Callahan et al. (2018) regarding doctoral psychology programs in general.

This suggests that there may be distinct differences in clinical psychology training models—clinical-science/scientist–practitioner compared to practitioner–scholar—that attract differing rates of racial/ethnic student applicants or differences in training model admission criteria that constricts racial/ethnic program diversity.

The reason racial/ethnic diversity constriction occurs at the clinical psychology doctoral level but not at the internship match level is unknown, but it may be due to different criteria and/or application review processes. One distinct difference between the internship application process and clinical psychology doctoral program application process is the lack of standardized testing. The Graduate Records Examination (GRE) is a common standard- ized test that is used in the admissions process for clinical psychol- ogy doctoral programs, and evidence indicates that racial/ethnic groups do not perform equally well on this exam (The National Center for Fair and Open Testing, 2007), possibly contributing to racial/ethnic diversity constriction (Callahan et al., 2018). The lack of standardized test information on the internship application (Association of Psychology Postdoctoral and Internship Centers (APPIC), n.d.), may encourage more holistic applicant review and weighting of criteria tied to assessment, intervention, supervision, and research metrics (Callahan et al., 2010, 2014).

Extant literature points to recurrence of constriction at a subse- quent point in the training-to-workforce pipeline: the requisite national licensure exam (Sharpless, 2019, 2021; Sharpless & Barber, 2009). Many issues have been raised regarding the Exami- nation for Professional Practice in Psychology (EPPP) and its validity (Callahan et al., 2020, 2021; DeMers, 2009; DiLillo & Tremblay, 2009; Erikson Cornish & Smith, 2009; Ryan & Chan, 1999), but one particularly problematic concern is the role of the EPPP in furthering diversity constriction occurring at the precipice of entering the profession. Research has consistently indicated that fail rates of first-time EPPP test takers differ significantly by racial/ ethnic status, with a much higher rate of failure being found among underrepresented Black/African American (23.33%) and Hispanic/ Latinx (18.60%) applicants as compared to Asian (3.33%) or White (5.75%) applicants (Sharpless, 2019, 2021). Our findings, coupled with research indicating the significant barriers occurring at the undergraduate psychology and licensure levels, help to identify which areas of the training-to-workforce clinical psychology diver- sity pipeline are laudable (i.e., internshipmatch) and which areas are in dire need of improvement (i.e., doctoral recruitment and admis- sions; licensure examination).

The seriousness of constriction in the training-to-workforce pipeline in clinical psychology is exacerbated when taking into consideration the current state of mental health services in the United States. Recent evidence suggests that although the workforce of mental health providers is steadily increasing, it is being far outpaced by the growing need for mental health services (Reinert et al., 2021). In addition to this, the demand for mental health services appears to be highest among racially/ethnically diverse individuals—specifically those who identify as Native American, Black, or multiracial. A report by the American Psychological Association (2018a) of the demand for mental health services between 2015 and 2030 indicates that the need for mental health services will continue to increase, with the largest demands being seen among racial/ethnic minority groups. This increase in the mental health needs of the population emphasizes the necessity to not only train psychologists in multicultural competence, but to

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erode the existing barriers in the diversity pipeline for racially and ethnically diverse students to pursue advanced degrees in psychology.

Limitations

Notwithstanding the important implications of the previously discussed findings, the present study has limitations. Our research suggests that diversity constriction occurs between the undergradu- ate psychology major and clinical psychology doctoral program levels, but the exact point at which constriction occurs is unclear. A possible area of constriction discussed is through the GRE, but it is possible that instead of application criteria excluding racial/ethnic minorities, fewer racial/ethnic minorities apply to clinical psychol- ogy doctoral programs. An additional limitation of our study was the age of the data. The archival data used in this study were combined from two previous studies (Callahan et al., 2010, 2014) pertaining to the 2010 and 2011 internship match. These previous studies occurred during an ideal time to investigate internship match variables: When the rate of unmatched students was highest. This imbalance in matching, while unfortunate, provided a unique opportunity to examine which variables contribute to students matching and receiving their preferred match. Nevertheless, due to the changing nature of the demographics in the United States (U.S.), our findings may not be representative of current clinical psychology doctoral programs. If they are not fully representative, it is likely in the direction of underappreciating the magnitude of underrepresentation. An examination of diversity representation over a 10-year period indicated remarkable stability in prevalence rates of underrepresented minority students in accredited doctoral programs (Callahan & Watkins, 2018) despite the U.S. population demographics changing considerably over the same period (U.S. Census Bureau, 2020). Our study has several directions for future research. Future

research should focus on the clinical psychology doctoral program application process and investigate the extent of racial/ethnic diver- sity constriction that occurs at that level. Research in this area should focus on investigating whether there is a significant difference in the rate of racial/ethnic minority student applications compared to the general population as well as any differences in applicant qualifications—GRE scores, presentations on CV, publications on CV, grade point average (GPA), and so forth—by racial/ethnic status. Due to complications caused by the COVID-19, many clinical psychology doctoral programs excluded GRE score report- ing as an application requirement during the application season tied with fall 2021 admissions. That disruption will provide a novel opportunity to analyze the rate of racial/ethnic minority students’ applications submitted, the rate of racial/ethnic minority students invited to interview, and the rate of racial/ethnic minority students offered admissions compared to previous years when GRE score reporting was a requirement. Programs are encouraged to analyze and report their data transparently.

Conclusions

Evidence suggests that increased racial/ethnic diversity in higher education promotes positive educational, social, and developmental outcomes. Despite these gains, racial/ethnic minority students are underrepresented in clinical psychology doctoral programs

compared to the United States population and psychology doctoral programs in general. The observed diversity constriction does not occur at the doctoral internship match level. Racial/ethnic diversity constriction in the clinical psychology workforce negatively impacts the field, prospective psychotherapy clients, and racial/ethnic minor- ity psychologists in academia. More research is needed to investi- gate what about the clinical psychology doctoral admissions process constricts diversity and at what part of the process diversity con- striction is the most severe.

References

American Psychological Association. (2017). Ethical principles of psychol- ogists and code of conduct (2002, amended effective June 1, 2010, and January 1, 2017). http://www.apa.org/ethics/code/index.html

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418 DIMMICK AND CALLAHAN

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Received December 14, 2020 Revision received May 7, 2021

Accepted May 22, 2021 ▪

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