Clinical Concentration

Doctoral Study in Clinical Psychology Handbook 
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APA Accreditation

ETSU's Clinical Psychology PhD is accredited by the American Psychological Association's Office of Program Consultation and Accreditation. Accreditation was effective as of April 17, 2012.

Questions related to the program's accredited status should be directed to the Commission on Accreditation:

Office of Program Consultation and Accreditation
American Psychological Association
750 1st Street, NE, Washington, DC 20002
Phone: (202) 336-5979 / E-mail:


Program Mission

The mission of this program is to provide doctoral training in Clinical Psychology for rural behavioral health and practice in the context of integrated primary health care.  Our curriculum is a scientist-practitioner model with innovative curricular elements utilizing our collaborative relationship with Quillen College of Medicine and building on its national recognition as a leader in the training of rural 


Family Medicine researchers and practitioners.  We would like to thank our community and academic partners in assisting with the development and implementation of this program, and particularly the Health Resources and Services Administration (HRSA)  for providing grant funds to facilitate this process.  Our program has been developed following American Psychological Association (APA) guidelines, and we will apply for accreditation as soon as allowable under APA rules.  APA does not consider accreditation until there is at 

least one student matriculating in every year of the program, including the internship year.  This means that a program must be active for 3 to 5 years before submission for APA accreditation is possible.  "Award of 'accredited' status is effective on the final day of the site visit preceding the Commission on Accreditation’s (CoA) decision to grant such status. Students who are in the program on that date and subsequently complete the program are considered to be graduates of an accredited program, provided, of course, that the program maintains an accredited status through the date of the students' graduation. Thus, programs are accredited beginning with the site visit, and accreditation is not retroactive."

The primary objective of the articulated master’s/doctoral program in Clinical Psychology at ETSU is to provide training in clinical psychology emphasizing Rural Behavioral Health and Practice in the context of Integrated Primary Healthcare. ETSU, along with the Quillen College of Medicine and Division of Health Sciences has a unique relationship with its surrounding community and region. Because of this relationship the program is unique in what it can offer students in the field of health services psychology.

Family TherapyAgain, the clinical psychology program is guided by the scientist-practitioner model, and it places a strong emphasis on research and interdisciplinary clinical training. Though diverse in respect to methods of inquiry and areas of study, the faculty is of one mind in promoting scientific inquiry as the foundation of clinical psychology.  The program’s philosophy also emphasizes  the respect for and understanding of cultural and individual diversity in policies for recruitment, retention, the development of faculty and students, and the curriculum in field placements.Our students receive traditional classroom and field training in psychological assessment, diagnosis and intervention.  However, our program emphasizes evidence-based intervention and empirically-based assessment and treatment strategies and inter-professional training.  Most importantly, our program is on the cutting edge of training clinical psychologists to work with primary care providers in an integrated rather than segregated fashion. Students participate in classes and field experiences with students and faculty from our medical school, medical residencies, nursing, social work, public health, physical therapy, and pharmacy programs.Thus, our program includes the following competency components not often found in traditional clinical psychology training.

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General Goals and Objectives

Goal #1: Prepare students as independent scientist-practitioners in clinical psychology

Objectives for Goal #1:

1-1. Provide students with a broad and general foundation in psychological science to enable them to understand the history of thought and development, methodological, and theoretical foundations as they inform the current practice of clinical psychology;

1-2. Provide students with the bases to be skilled in research design, methods, execution, and literature evaluation and integration to stay abreast in the field and to make contributions;

1-3. Provide students with theories and methods in diagnostic assessment, formulating and implementing interventions, and evaluating the efficacy of interventions.

Competencies expected for Objective 1-1: Students demonstrate an understanding:

      1-1a. of the history of psychology as a science and systems of psychology as informing the substantive area of clinical psychology;

      1-1b. of the social bases of behavior as informing the substantive area of clinical psychology;

      1-1c. of the cognitive bases of behavior as informing the substantive area of clinical psychology;

      1-1d. of the affective bases of behavior as informing the substantive area of clinical psychology;

      1-1e. of the biological bases of behavior as informing the substantive area of clinical psychology.

Minimum thresholds for 1-1 a-e met by the end of the second matriculation year as evidenced by earning at least a “B” in PSYC 5000 Broad and General Seminar and in PSYC 5018 History and Systems and in PSYC 5707 Adv. Behavioral Neuroscience.

Competencies Expected for objective 1-2: Students demonstrate understanding of and the ability to utilize

      1-2a appropriate research methods and integration of existing theoretical literature;

      1-2b appropriate techniques of data analysis.

Minimum thresholds for 1-2a –b are met by the end of the second matriculation year as evidenced by completion and successful defense of an empirical thesis AND earning at least a “B” in PSYC 5040, Rural Research Methods, PSYC 5210 Statistical Methods and PSYC 5410 Correlation and Multiple Regression AND by the end of the student’s 3rd year through the completion of PSYC 7000, Preliminary Project (see Handbook for description and standards) AND by the end of the 5th year through the completion of the doctoral dissertation.

Competencies expected for 1-3:  Students demonstrate an understanding of methods and are able to apply appropriate methods in practice

      1-3a. of individual differences;

      1-3b. of human development;

      1-3c. of psychopathology and dysfunctional behavior;

      1-3d. of evidence-based methods in assessment and intervention;

      1-3e of the methods of consultation and supervision.

Minimum thresholds for competencies 1-3a-e for demonstration of understanding of theories  are met by the end of the 3rd year as evidenced by earning at least a “B” in PSYC 5825 Psychopathology, PSYC 5870 Interviewing, PSYC 5830 and PSYC 5850 Psychological Assessment I & II, and PSYC 6870 Evidence-Based Interventions; understanding of theories and ability to apply appropriate methods in practice  by passing the Clinical Capstone Project in the second year; AND by the end of the 4th year as reflected in at least a grade of “B” in PSYC 7010 Practicum and PSYC 7910 Externship and achieving minimum acceptable ratings on Practicum Competencies.Goal #2: Prepare students for entry level clinical practice in rural and primary care settings

Objectives for Goal #2:

2-1 Provide students with cultural competence in working with rural populations and community-based practice;

2-2 Provide students with skill development for inter-professional collaboration, communication, and consultation;

2-3 Provide students with knowledge and skill development in models of evidence-based assessment and intervention especially pertinent to primary care settings;

2-4 Provide students with knowledge and skills in professional supervision and peer consultation.

Competencies Expected for Objectives 2-1 to2-4: Students demonstrate

2-1 an understanding of community-based research and practice in rural areas;

2-2 knowledge and skills in inter-professional collaboration and professional consultation;

2-3 knowledge and skills in applying models of evidence-based assessment and intervention especially pertinent to primary care settings;

2-4 applied knowledge of clinical supervision.

Minimum thresholds for competencies 2-1 to 2-4 knowledge and understanding are to be met by the end of the 4th year and are evidenced by earning at least a grade of “B” in PSYC 5040 Rural Research and PSYC 6600 Rural Case-Oriented Learning, PSYC 7000 and 7100 Primary Care Psychology I & II; AND skill are to be met by the end of the 4th year as evidenced by earning at least a grade of “B” in PSYC 7010 Practicum and Seminar and PSYC 7910 Externship AND achieving minimum acceptable ratings on  Practicum Competencies. 

Goal #3: Prepare students for ethical and culturally competent clinical practice

Objectives for Goal #3: Provide students with an understanding of

3-1. the current professional ethics and standards of behavior;

3-2. current federal and state laws on the practice of psychology;

3-3. the literature on individual and cultural differences.

Competencies Expected for Objectives 3-1 to 3-3: Students demonstrate an understanding of and are able to apply in practice

3-1. professional ethics and standards;

3-2. relevant federal and state laws on the practice of psychology;

3-3. cultural diversity and individual differences relevant to all areas of practice.

Minimum Thresholds for 3-1 to 3-3 are to be met by the end of the 2nd year as evidenced by earning at least a grade of “B” in PSYC 5100  Ethical and Legal Practice of Psychology AND passing the cultural diversity component of the Clinical Capstone Project AND passing the Basic Practicum Competencies; AND by the end of the 4th year as evidenced by earning at least a “B” in PSYC 7010 Practicum Seminar in Professional Practice AND PSYC 7910 Externship AND passing the Practicum Competencies  - Professional, Ethical and Diversity sections.

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Experiential Training

Beginning with the second semester in the first program year, Master’s level students shadow psychologists and other health care practitioners participating in multidisciplinary teams in health care settings. In subsequent rotations, students participate in specific clinical activities such as interviewing and case management. Clerkships involve 4-5 hours per week in a primary care setting. Also beginning in the second semester, students are placed in the on-campus training facility, the Behavioral Health and Wellness Clinic (BHWC).  Initially, the students will provide phone coverage, scheduling, and structured intake experiences and observation of advanced students and faculty.  Students provide coverage 4-6 hours per week. The breadth and depth of clinical services in which the student participates will vary from individual to individual and be based on supervisor recommendations.

During the Practicum semesters, students move to more in depth clinical activities including formal assessment, diagnostic interviews, and group, family, and individual intervention. In the fourth program year, doctoral students may participate in the supervision of first year students.  Throughout matriculation, students will provide service in the clinic for 4-6 hours per week. Intensive, 20-hour per week, paid field placements occur in the third and fourth years of the program, with students providing clinical services under the supervision of licensed psychologists and other health care professionals in mental health and primary health care settings in both rural and semi-rural areas.

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Behavioral Health and Wellness Clinic (BHWC)

The BHWC is an outpatient training clinic designed to provide assessment, evaluation, and counseling services in the context of a wide range psychological and health related concerns; behavioral problems, depression, anxiety, stress, ADHD, relationship problems, etc. In addition to clinical-based services, the BHWC is also designed to be a resource for consultation regarding a variety of clinical and non-clinical subjects in psychology; human development, behavioral and cognitive neuroscience, social psychology, statistics, and research design.  The main facility of the BHWC  is on the main ETSU campus.  However, the activities of the BHWC extend well beyond the walls of the center to the greater community and surrounding region.  For example, our students and faculty provide services to through not-for-profit programs, primary care clinics, and school-based programs.

For more information on the BHWC, please click the following link to go to its website:

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Brief Overview of  Integrated Primary Care Models

There is not just one model of integrated primary care, and since our program is empirically based, we assume that our model of training will evolve just as evidence-based practice evolves based on the research.  Primary care/behavioral healthcare integration can be depicted as having five levels (Doherty,  McDaniel, & Baird, 1996). 

Level One: Minimal Collaboration-  is where mental health and other health care professionals work in separate facilities, have separate systems and rarely communicate about cases.  This is the traditional model that is still practiced in most agencies and private practices in the U.S.

Level Two:  Basic Collaboration at a Distance- is where providers have separate systems at separate sites, but communicate about specific patient issues.  Operations, records are separate, and there is no sharing of responsibility or treatment decisions.

Level Three:  Basic Collaboration On-Site- is where mental health/behavioral health professionals and primary care providers share the same site, but have separate systems.  There is more regular communication about shared patients, but  no shared patient care as a team.  Medical physicians have the responsibility and decision-making authority.

Level Four:  Close Collaboration in a Partially Integrated System- is where mental health and other health professionals share the same sites and have some systems in common such as records and scheduling.  There are regular face-to-face interactions about patients, coordinated treatment plans, and a shared appreciation for others’ roles and professional cultures.  Operational discrepancies remain, such as differences in reimbursements. Medical professionals have greater power and influence on the collaborative team.

Level Five:  Close Collaboration in a Fully Integrated System- is where mental and other health care professionals share the same sites, same vision, and same systems in a seamless web of biopsychosocial services. The expectation is of a team offering prevention and treatment where all professional are committed to a systems paradigm and in-depth understanding of each other’s roles and professional cultures with a conscious effort to balance power and responsibility.

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Admission Requirements

Deadline for receipt of application materials is December 1st
Materials should be sent to:
     School of Graduate Studies
     East Tennessee State University
     P.O. Box 70720
     Johnson City, TN 37614-0720
Click for Graduate Application

Applicants to the MA/PhD degree program at ETSU are evaluated once each year only, for admission in the fall semester; applicants for spring admission are not considered. All application information must have been received by December 1st for a candidate to be considered for admission. Students are admitted from two applicant pools, dependent upon level of preparation. All applications are considered with the expectation that the applicant will pursue the PhD. The two applicant pools are as follows:

1. Students holding a baccalaureate degree from a regionally accredited institution will be considered for the MA/PhD program.  Students admitted to the Clinical Psychology PhD program complete the requirements for an MA in Clinical Psychology as part of their PhD requirements. Students seeking a terminal master's degree will not be considered.

2. Students already holding the MA or MS in psychology from a regionally accredited institution may also apply to the MA/PhD program.  The master’s degree must be commensurate with the MA program in Clinical Psychology at ETSU and involve the successful completion of an empirically-based thesis project.  Students possessing a master's degree without an empirically-based thesis will be required to complete an empirically-based thesis before being admitted to doctoral candidacy. For further information see the ETSU Graduate Catalog and the Clinical Concentration Handbook.

The following are required:

1. Completed University application form;

2. A grade point average (GPA) of at least 3.00 on a 4.00 scale in undergraduate and/or graduate level work overall and in Psychology courses;

3. A minimum of 18 semester hours in undergraduate psychology, including courses in quantitative methods, experimental design, personality, history and systems, and abnormal psychology.  Students lacking some of these prerequisite courses, but presenting an exceptional undergraduate record, may be granted graduate admission, but they will be expected to remove all undergraduate deficiencies during their first academic year;

4. GRE scores (Verbal, Quantitative, Written Analysis) are required for application and are taken into account in the admissions process; the GRE Psychology test is NOT required;

5. Letters of recommendation from at least three persons familiar with the applicant's academic background and aptitude for graduate study and future performance as a psychologist;

6. A personal statement of 500-1000 words indicating the applicant's academic experiences, research interests, and career goals.  Prior undergraduate research interests and involvement are weighted heavily as is an interest and commitment to working in a rural and/or primary care setting;

7. A willingness to be interviewed by members of the admission committee, should that be required.

Transfer Credit
Students with graduate credit earned at another institution, upon matriculation at ETSU, may petition to have these credits applied toward their degree requirements at ETSU. While such credits are not automatically transferred and must be approved by the Director of Clinical Training and the School of Graduate Studies, a maximum of 9 semester hours earned elsewhere could be applied.  See the ETSU Graduate Catalog for more details.   For students who have attained a master’s degree elsewhere, a maximum of 48 semester hours may be applied toward the MA/PhD degree requirements.

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 Appendix J: IR C-20 Data on Applications/Admissions/Enrollment/Attrition

Data from Previous Applicants and Accepted Students 

a) Applications and Admissions:

   Applications Cycle Year     
2007-2008 2008-2009 2009-2010 2010-2011 2011-2012 2012-2013  2013-2014 2014-2015
Number of applicants  40 44 43 36 54 72 61 125
Number of incoming students receiving an assistantship that includes a full waiver of tuition 9 6 6 6 6 4 6 6
Scores for Admitted Students            
GRE Verbal                
  Score %ile Score %ile Score %ile Score %ile Score %ile Score %ile Score %ile Score %ile
     Mean 146 31 151 51 160 86 151 56 158 78 155 67 158 78 162 89
     Median 144 26 150 48 162 90 152 61 157 74 155 67 158 78 159 81
GRE Quantitative                      
  Score %ile Score %ile Score %ile Score %ile Score %ile Score %ile Score %ile Score %ile
     Mean 149 49 155 69 151 56 147 40 149 49 152 61 155 60 155 60
     Median 149 49 154 67 152 61 147 40 150 53 152 61 156 64 157 68
GRE Writing                     
  Score %ile Score %ile Score %ile Score %ile Score %ile Score %ile Score %ile Score %ile
     Mean 5.25 89 4.67 77 5.17 88 3.75 33.5 4.5 80 4.5 80 4.5 80 4.5 80
     Median 5.25 89 4.5 72 5.5 96 3.75 33.5 4.5 80 4 56 4.5 80 4.5 80
Undergraduate GPA Mean  3.77  3.27 3.49 3.71 3.76 3.45 3.48 3.46

b) Time to Completion: Program began admitting Students in 2007 with each program year beginning August 14th and ending August 15th of following year

Outcome Year in Which Degrees were Conferred
2007-2008 2008-2009 2009-2010 2010-2011 2011-2012 2012-2013 2013-2014 Total
Total number of students with doctoral degree conferred on transcript 0 0 0 0 1 5 4 10
Mean number of years to complete the program         4 4.8 5.5 5
Median number of years to complete the program         4 5 5.5 5
Time to Degree Ranges N % N % N % N % N $6 N % N % N %
Students in less than 5 years                 1 100 1 20 1 25 3 30
Students in 5 years                     4 80 1 25 5 50
Students in 6 years                         1 25 1 10
Students in 7 years                         1 25 1 10
Students in more than 7 years                                

c) Program Costs: 

Description 2013-2014 1st-year Cohort Cost
Tuition for full-time students (in-state) $3,798.00
Tuition for full-time students (out-of-state) $6,759.00
Tuition per credit hour for part-time students (if applicable) N/A
University/institution fees or costs $677.00
Additional estimated fees or costs to students (e.g., books, travel, etc.) $500.00

Typically, all students receive University support through a graduate assistantship for at least the first two years. The support includes a stipend of $12,000 plus in and out-of-state tuition waivers for the academic year (fall and spring terms). Sources of graduate assistantship support in the remaining two years pre-internship vary, and include community training grants and contracts, teaching assistantships, or faculty grants. To date, 100% of enrolled students have received at least 4 years of graduate assistantship support.

East Tennessee State University Graduate 2011-2012*

Credit Hours

Instate Graduate Maintenance Fee by Credit Hours Program & Service Fee by Credit Hours Total Instate Graduate Maintenance and Prog Serv Fees (Does not include Course Related Fees) Out of State Graduate Maintenance by Credit Hours Program & Service Fee by Credit Hours Total Out of State Graduate Maintenance and Prog Serv Fees (Does not include Course Related Fees)
1 350.00 63.00 413.00 621.00 63.00 1,034.00
2 700.00 126.00 826.00 1,242.00 126.00 2,068.00
3 1,050.00 189.00 1,239.00 1,863.00 189.00 3,102.00
4 1,400.00 252.00 1,652.00 2,484.00 252.00 4,136.00
5 1,750.00 315.00 2,065.00 3,105.00 315.00 5,170.00
6 2,100.00 378.00 2,478.00 3,726.00 378.00 6,204.00
7 2,450.00 441.00 2,891.00 4,347.00 441.00 7,238.00
8 2,800.00 504.00 3,304.00 4,968.00 504.00 8,272.00
9 3,150.00 506.50 3,656.50 5,589.00 506.50 9,245.50
10 3,500.00 506.50 4,006.50 6,210.00 506.50 10,216.50
11 3,570.00 506.50 4,076.50 6,334.00 506.50 10,410.50
12 3,640.00 506.50 4,146.50 6,458.00 506.50 10,604.50
13 3,710.00 506.50 4,216.50 6,582.00 506.50 10,798.50
14 3,780.00 506.50 4,286.50 6,706.00 506.50 10,992.50
15 3,850.00 506.50 4,356.50 6,830.00 506.50 11,186.50
16 3,920.00 506.50 4,426.50 6,954.00 506.50 11,380.50
17 3,990.00 506.50 4,496.50 7,078.00 506.50 11,574.50
18 4,060.00 506.50 4,566.50 7,202.00 506.50 11,768.50
19 4,130.00 506.50 4,636.50 7,326.00 506.50 11,962.50
20 4,200.00 506.50 4,706.50 7,450.00 506.50 12,156.50
21 4,270.00 506.50 4,776.50 7,574.00 506.50 12,350.50
22 4,340.00 506.50 4,846.50 7,698.00 506.50 12,544.50
23 4,410.00 506.50 4,916.50 7,822.00 506.50 12,738.50
  *rates doe not include special course fees

d) Internship: 

Internship Acceptance Rate

Outcome   Year Applied for Internship
2008-2009  2009-2010  2010-2011  2011-2012  2012-2013  2013-2014
N % N % N % N % N % N %
Students who sought or applied for internships* 1    0   3   4   7   3  

Students who obtained internships

1 100     3 100  2 50 6 86 3 100

Students who obtained APA/CPA-accredited internships

1 100     2 67 1 50 3 50 2 67
Students who obtained APPIC member internships that were not APA/CPA-accredited (if applicable)         1 33 1 50 3 50 1 33
Students who obtained other membership organization internships (e.g. CAPIC) that were not APA/CPA-accredited (if applicable)                        

Students who obtained internships conforming to CDSPP guidelines that were not APA/CPA-accredited (if applicable)


Students who obtained other internships that were not APA/CPA-accredited (if applicable)


*This includes students that withdrew from the internship application process

Internship Placement

 Outcome  Year Applied for Internship
2008-2009 2009-2010 2010-2011 2011-2012 2012-2013 2013-2014
N % N % N % N % N % N %
Students who obtained internships 1   0   3   2   6   3  
Students who obtained paid internships 1 100     3 100 2 100 6 100 3 100
Students who obtained half-time internships* (if applicable) 0 0 0   0   0   0   0  

*Should only include students that applied for internship and are included in the number that "sought or applied for internship" from "Internship Placement - Table 1" for each year.

e) Student Attrition Rates:

Variable   Year of First Enrollment
2007-2008 2008-2009 2009-2010 2010-2011 2011-2012 2012-2013 2013-2014  2014-2015
N % N % N % N % N % N % N % N %
Students for whom this is the year of first enrollment (i.e. new students) 9   6   6   6   6   4   6   6  
Students whose doctoral degrees were conferred on their transcripts 4 45 3 50 2 33 1 17 0   0   0   0  
Students still enrolled in program 2 22 1 17 3 50 2 33 6 100 3 75 6 100 6 100
Students no longer enrolled for any reason other than conferral of doctoral degree 3 33 2 33 1 17 3 50 0 0 1 25 0   0  


f) Licensure: 

N/A. The Commission on Accreditation requires calculation of licensure rates based on a denominator of "the total number of program graduates in the past 10 years, minus the number who graduated in the past 2 years." For ETSU this denominator is 0 because all 4 program graduates have graduated within the past 2 years.

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Frequently Asked Questions

Is the program APA-accredited?

Yes. ETSU's doctoral program in Clinical Psychology has been accredited by the APA Commission on Accreditation since Apri1 17, 2012.

How long is the PhD program?

The PhD program is designed as a five-year post-baccalaureate program of study, including a full calendar year of clinical internship. Students admitted to the Clinical Psychology PhD program complete the requirements for an MA in Clinical Psychology en route to PhD completion. Students seeking a terminal master's degree will not be considered. The pre-doctoral clinical internship is a full-time supervised training/employment situation in a formal internship location. The internship is a separate application process and conducted as a 'match' similar to medical school residencies. Internship sites are recognized and or accredited separately from doctoral programs.

The ETSU-based curriculum is four years past the bachelor's. Because there are practical and independent research requirements in addition to structured coursework, it is common for PhD students in clinical psychology program to take longer to graduate than the 5 years of program design.

May I enroll in the program on a part-time basis?

No, the program must be matriculated as a full-time student. Similar to medical school, one cannot complete this type of program on a part-time basis. Thus, it is our intent to support every student who enrolls with graduate assistantships and tuition waivers.

I do not have an undergraduate degree in Psychology. May I still apply?

Yes, students in related undergraduate degree programs are often interested in graduate work in psychology, and are welcome to apply. There are 18 undergraduate hours in psychology that are required, however, to ensure at least some foundation work in psychology has been completed.

Is the program going to be offered online?

There are components of courses that are supported with online material, but the nature of clinical psychology training requires face-to-face training experiences, in our opinion. There is no course that is offered on line, much less the whole program.

I took the GRE years ago. Do I have to take it again?

GRE scores up to five years old may be used in the application. GRE scores older than five years cannot be submitted.

I have a master's degree in a related discipline; will I have to complete the entire program?

If you have an equivalent master's degree in Psychology, you can be admitted post-masters.. However, you should expect to have to take most of the master's courses in the current program; every course taken prior to admission will be compared to our program's courses, and each course must be individually approved by the current course instructor. Practicum courses and courses unique to our program's mission will not be waived. If you have a master's degree in a related discipline such as social work, counseling, or others, you may petition upon acceptance to have up to nine hours of graduate work transferred to this program. If you have already completed a master's thesis, you may petition to have the thesis requirement waived.

I want to do clinical work, but I'm not sure that I want to go all the way to the PhD. May I be admitted for just the master's portion and decide later?

No, there is no longer a terminal master's program in clinical psychology at ETSU, so all applicants must apply to the MA/PhD combined program with the expectation of completing the PhD.

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