APA GUIDELINES

A Taxonomy for Education

and Training in Professional
Psychology Health Service
Specialties and Subspecialties
COMMISSION FOR THE RECOGNITION OF SPECIALTIES AND SUBSPECIALTIES
IN PROFESSIONAL PSYCHOLOGY (CRSSPP)

APPROVED BY APA COUNCIL OF REPRESENTATIVES

AUGUST 2020

APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties A
Copyright © 2020 by the American Psychological Association. This material may be reproduced and distributed without permission provided that
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training in professional psychology health service specialties and subspecialties should be addressed to the American Psychological Association, 750 First
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Suggested bibliographic reference:

American Psychological Association. (2020). Education and training guidelines: A taxonomy for education and training in professional psychology health
service specialties and subspecialties. Retrieved from http://www.apa.org/ed/graduate/specialize/taxonomy.pdf

B APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties
APA GUIDELINES
A Taxonomy for Education
and Training in Professional Psychology
Health Service Specialties and Subspecialties
COMMISSION FOR THE RECOGNITION OF SPECIALTIES AND SUBSPECIALTIES
IN PROFESSIONAL PSYCHOLOGY (CRSSPP)

APPROVED BY APA COUNCIL OF REPRESENTATIVES

AUGUST 2020

Commission for the Recognition of Specialties and Subspecialties CRSSPP Advisory Committee
in Professional Psychology (CRSSPP)
Kevin Arnold, PhD, ABPP
Sarah Ledgerwood, JD (Chair) Brian Stagner, PhD CEO and President
Interim Division Director Clinical Professor Emeritus Center for Cognitive and Behavioral Therapy of
Division of Professional Registration Department of Psychological and Greater Columbus
Missouri Department of Brain Sciences
Commerce & Insurance Texas A&M University Ronald Rozensky, PhD, ABPP
Professor Emeritus
Linda Berg-Cross, PhD, ABPP (Vice-Chair) Adeirdre Stribling Riley, PhD
Department of Clinical & Health Psychology
Professor of Psychology Deputy Chief Psychologist
College of Public Health and Health Professions
Howard University Federal Medical Center (FMC), Butner
University of Florida
Rebecca P. Cameron, PhD Brandi Walker, PhD
Chair and Professor Army Clinical Psychologist/ Behavioral
Department of Psychology Health Officer for 18th APA Staff
California State University, Sacramento Airborne Corps & Womack Army Medical
Center Antoinette Minniti, PhD
Breeda McGrath, PhD
Associate Campus Dean Online Associate Executive Director, Office of CE Sponsor
The Chicago School of Professional Approval
Psychology Education Directorate
Pamela P. Remer, PhD Kristen Knight-Griffin, MPS
Professor Emerita Manager, Office of CE Sponsor Approval
Counseling Psychology Doctoral Program Education Directorate
University of Kentucky
Linda Sobell, PhD, ABPP
President’s Distinguished Professor
Associate Director of Clinical Training
College of Psychology
Nova Southeastern University
Sharon Bowman, PhD, ABPP
Professor and Chair
Counseling Psychology, Social Psychology
and Counseling
Ball State University
P RE FACE
This document is the most recent revision of the document originally entitled Education and
Training Guidelines: A Taxonomy for Education and Training in Professional Psychology Health
Service Specialties, first approved by the American Psychological Association Council of
Representatives in February 2012.
This revision is effective as of August 2020 and supersedes all previous versions.
CON T ENTS

Executive Summary 1

Introduction4

Definition of Taxonomy 4

Process of Developing the Guidelines 4

History of the Taxonomy 4

History and Rationale for the Recognition of Subspecialties 5

Rationale for Sunsetting of Proficiency Recognition 5

Statement of Need 5

Purpose of the Guidelines 6

What These Guidelines Are Not 6

Implementation Steps 7

Feedback7

Education and Training Guidelines: A Taxonomy for Education and Training

in Professional Psychology Health Service Specialties and Subspecialties 9

The Structure of the Taxonomy 10

Broad and General Training and Accreditation 10

A Graphic Presentation of the Guidelines and Taxonomy 11

The Impact of the Guidelines and Its Taxonomy 11

References13

Appendix14

FIGURE A1. Overview of the Taxonomy 14

FIGURE A2. APA-Recognized Specialties 15

FIGURE A3. Stages of Education and Training and Levels of Educational Opportunities 16
 EX E C UT IVE SUMMARY
The purpose of the Education and Training Guidelines: A Taxonomy for Education and Training
in Professional Psychology Health Service Specialties and Subspecialties (hereafter referred to
as guidelines, the Guidelines, or taxonomy), previously titled Education and Training Guidelines:
A Taxonomy for Education and Training in Professional Psychology Health Services Specialties,
is to provide a consistent set of terms and definitions related to education and training
in health service psychology specialties and subspecialties recognized by the American
Psychological Association (APA). The Guidelines also provide a structure for the use of
these terms within the education and training sequences for each of these approved spe-
cialties and subspecialties. The overarching goal of the Guidelines is to facilitate clear and
consistent communication in the use of terminology for training programs, students, pro-
fessional organizations, and members of the public. The Guidelines address the type and
intensity of specialized training opportunities offered by individual education and training
programs at the doctoral, doctoral internship, postdoctoral, and postlicensure stages of
education and training.
These guidelines are intended to be aspirational in nature. The term guidelines, as
used in this document, is consistent with the provisions of APA policy on “Developing
and Evaluating Standards and Guidelines Related to Education and Training in Psychology”
(Section I C[1]) (APA, 2004), as passed by the APA Council of Representatives.
Further, these guidelines reflect mutually agreed-upon definitions as they repre-
sent the profession and extensive cooperative work across organizations related to
the use of the guidelines in describing specialties and subspecialties. This ongoing
work has included constituents who are both within APA (e.g., Office on Early Career
Psychologists, APA Board of Directors, APA Board of Professional Affairs) and outside
of APA (e.g., Association of Psychology Postdoctoral and Internship Centers [APPIC],
American Board of Professional Psychology [ABPP], Council of Specialties in Professional
Psychology [COS]. Importantly, APA’s Commission for the Recognition of Specialties and
Subspecialties in Professional Psychology (CRSSPP), APPIC, ABPP, and COS have already
adopted and integrated shared definitions of specialty and subspecialty. Together, these
groups have conducted several presentations to various publics to educate and encour-
age adoption of the Guidelines (e.g., APA Convention, APPIC conference, the Council of
Clinical Health Psychology Training Programs). The COS, ABPP, APPIC, and CRSSPP have
also sponsored four Specialty Summits that discussed the promulgation and use of the
guidelines across organizations and within each specialty. Most important, each member
specialty of the COS has used the taxonomy to provide education and training guidelines
for their specific specialty (www.cospp.org/education-and-training-taxonomies). Thus,
the guidelines have been used successfully to provide guidance across the education and
training community in health service psychology to utilize consistent educational pro-
gramming terms and definitions when describing their training programs. As a result, the
decision to sunset recognition of proficiencies was made based on thoughtful discussion
and careful consideration vis-à-vis the Interorganizational Summits conducted over the
past 4 years. Specifically, this decision was based on alignment with APA’s strategic plan
to more effectively communicate with the public, create clear and consistent language
within health service psychology, and further the Interorganizational Summit language
and specialty recognition consensus.

APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties 1
The guidelines are predicated on a number of preexisting policies,
fundamental assumptions, and definitions:
1. The use of the term specialty in this taxonomy refers to the
current APA policy specifying that:
A specialty is a defined area of professional psychology practice
characterized by a distinctive configuration of competent
services for specified problems and populations. Practice in
a specialty requires advanced knowledge and skills acquired
through an organized sequence of formal education, training,
and experience in addition to the broad and general education
and core scientific and professional foundations acquired
through an APA or Canadian Psychological Association (CPA)
accredited doctoral program.*,** Specialty training may be
acquired at the doctoral, doctoral internship, postdoctoral, or
postlicensure level as defined by the specialty.
2. The use of the term subspecialty in this document refers to:
A subspecialty is a concentrated area of knowledge, skills, and
attitudes that (a) exists within at least one recognized {par-
ent} specialty; (b) requires additional education, training, and/
or professional experiences; and (c) involves specific (1) prob-
lems, (2) populations, and/or (3) circumscribed approaches.
Subspecialties support specialty education and training by:
• Affirming that each subspecialty is recognized within the
education, training, and practice of the home specialty (or spe-
cialties). The CRSSPP process for the formal recognition of a
subspecialty will always require that a subspecialty first be
recognized and supported within the specialty or specialties
wherein it resides.
• Acknowledging additional, highly focused programmatic edu-
cation and training experiences with clearly defined signature
pedagogies within a given subspecialty, including those that are
targeted to limited problems within the specialty area.
• Acknowledging that subspecialty recognition and development
is deemed essential in creating focused, personalized psycho-
logical interventions by providing the most efficacious treat-
ment in the most efficient and effective possible manner (e.g.,
American Academy of Pediatrics, 2011; Angelino & Lyketsos,
2011; Benore et al., 2017).
• Requiring subspecialties to use and describe the same educa-
tion and training taxonomy that specialties use to define the
programmatic education and training in a subspecialty.
• Allowing the subspecialty to have an identity that is clear to
students, consumers, educators, practicing psychologists, and
other health professionals.
*Except where APA or CPA program accreditation does not exist for that area of professional psychology (APA, 2011b).
**For those training in health service psychology areas, this is in addition to the broad and general education and core scientific and professional foundations acquired through
an APA- or CPA-accredited doctoral program or programs accredited by an accrediting body that is recognized by the U.S. Secretary of Education for the accreditation of
professional psychology education and training in preparation for entry to practice.
2 APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties
3. As of February 2019, APA recognizes 17 specialties: behavioral
and cognitive psychology, clinical child psychology, clinical
health psychology, clinical neuropsychology, clinical psychology,
counseling psychology, couple and family psychology, forensic
psychology, geropsychology, group psychology and group
psychotherapy, industrial-organizational psychology, police
and public safety psychology, psychoanalysis in psychology,
rehabilitation psychology, school psychology, serious mental
illness psychology, and sleep psychology. In addition, there are
three APA-recognized proficiencies: addiction psychology,
sport psychology, and biofeedback and applied
psychophysiology. Currently recognized proficiencies will
remain as such until their date of expiration, at which point the
relevant proficiency groups will accordingly review their status
for potential further recognition with respect to the available
processes established by CRSSPP. Recognized subspecialties
are forthcoming as per the introduction of CRSSPP’s
subspecialty recognition process.
Each of these recognized specialties and subspecialties
is reviewed by the CRSSPP every 7 years for continued
recognition by APA. Specialties are recognized only after an
organized group of psychologists, who carry out research,
practice, and teach in that specialty area, work together to
formally petition APA for new or ongoing recognition. CRSSPP
reviews these requests using 12 predetermined criteria based
directly on APA-approved policy (www.apa.org/about/policy/
principles-recognition.pdf).
The criteria for specialty and subspecialty recognition
include administrative systems and structures, public need,
documentation of the importance of diversity in education and
training, distinctiveness from other specialties, theoretical and
scientific advances, practice parameters, structures and mod-
els of education and training, continuing professional develop-
ment and continuing education, measurement of effectiveness,
quality assurance mechanisms, guidelines for specialty service
delivery, and mechanisms for provider identification and eval-
uation. A specialty must substantially meet these criteria to
be recognized by APA, and specialties are required to address
how they currently utilize or intend to adopt the taxonomy as
part of the petition process.
4. APA recognizes specialties and subspecialties that are related
to the direct provision of health services and those that involve
other aspects of applied professional service (e.g., industri-
al-organizational psychology). The present guidelines relate
only to those specialties and subspecialties in health service
provision. Health service providers are defined as those who
have been duly trained and experienced in the delivery of pre-
ventive, assessment, diagnostic, and therapeutic intervention
services related to the psychological and physical health of
consumers, based on (a) having completed scientific and pro-
fessional training resulting in a doctoral degree in psychology,
 (b) having completed an internship and supervised experience
in health care settings, and (c) having been licensed as psychol-
ogists at the independent practice level (APA, 1996). In the
future, separate guidelines may be developed that describe
education and training in other applied professional specialties
of psychology; however, the current guidelines are not designed
to review those services.
These guidelines presuppose that any doctoral or doctoral
internship program that provides opportunities for specialty
training related to health service provision in health service
psychology is accredited by APA and therefore meets all of the
requirements for broad and general training in health service
psychology. This is consistent with APA’s own definition of
specialties, described previously, that notes that “a specialty
requires advanced knowledge and skills acquired through an
organized sequence of formal education, training, and experi-
ence in addition to the broad and general education and core
scientific and professional foundations.”
5. The present guidelines refer to the educational and training
sequence as having four stages: doctoral education, doctoral
internship, postdoctoral training, and postlicensure learning
opportunities. Thus, although these guidelines outline
recommended terminology that may be applied at any stage of
training, it is the role of each specialty to designate which
stages are appropriate for education and training in that
particular specialty or subspecialty. The COS, an organization
that brings together all specialties to discuss common issues,
was involved in the evolution of these guidelines and has
asserted that it intends to further their development, specialty
by specialty, as well as help with their dissemination. For
example, see links to descriptions of each recognized
specialty’s taxonomy on the COS website (www.cospp.org/
education-and-training-guidelines).
Other organizations have made corresponding changes
to incorporate the taxonomy. For example, APPIC has revised
their online directory to reflect the taxonomic language/cat-
egories such as Major Area of Study and Experience (see www.
appic.org/Directory).
6. Although these guidelines are specific to education and training
in APA-recognized specialties and subspecialties, it is under-
stood that education and training programs may want to inform
students and the public about other educational and training
opportunities with specific populations or in areas of practice
that are not formally recognized by APA as specialties or sub-
specialties. These might include a range of learning opportuni-
ties such as multicultural professional activities, community
psychology, hospital practice, or treatment opportunities with
individuals who are diagnosed with posttraumatic stress disor-
der, traumatic brain injury, diabetes, or autism. These learning
opportunities outside recognized specialties and subspecial-
ties are referred to in the taxonomy as areas of focus.
Because the ongoing utility and fidelity of these guidelines
are dependent on the consistent use of the descriptors Exposure,
Experience, Emphasis, and Major Area of Study, programs are
APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties
strongly encouraged to use these four terms exclusively in
public descriptions of training within APA-recognized spe-
cialties and subspecialties. The term focus should be used to
describe opportunities in other training areas, and programs
should strive to provide explicit explanations of the type of
training provided in these focus areas that are not recognized
specialties or subspecialties. Consistent use of the term focus
for this purpose will enhance the clarity of communication
regarding educational and training opportunities across pro-
grams and provides a consistent nomenclature for describing
these opportunities.
7. These guidelines are not intended to prescribe the training
paths of individual students or specialists, nor is the completion
of a specialty experience at one stage of education and training
meant to imply that training must be completed by an individual
at subsequent stages. Rather, the levels (Exposure, Experience,
Emphasis, Major Area of Study) and stages (doctoral, doctoral
internship, postdoctoral, and postlicensure) in which education
and training opportunities are required for specialization are
defined for the field by the individual specialties themselves,
and specialty councils provide guidance to training programs so
that they may consistently describe their education and training
opportunities. Further, every APA-accredited program offers
training in the General Practice of Psychology and requires at
least one Major Focus of Study in a Specialty area (e.g., school,
counseling, clinical). All students in APA-accredited programs
may have additional specialty training at the graduate level,
depending on their program’s structure. Specialty training at
the doctoral level does not preclude or dictate any specific
specialty training at the other levels (doctoral internship,
postdoctoral, or postlicensure).
8. These guidelines recognize the “general practice of professional
psychology” and acknowledge that any practicing psychologist
can provide a full range of services within the boundaries of his
or her professional competence, as delineated in APA’s Ethical
Principles of Psychologists and Code of Conduct (Standard 2:
Competence; APA, 2002; amended 2010 and 2017; see APA,
2017). Further, these guidelines reflect the general practice of
psychology in APA policy (see, e.g., APA, 2010; APA, 2011a).
This includes the range of competencies in that policy that
include the observation, description, evaluation, interpretation,
and modification of human behavior by the application of
psychological principles, methods, and procedures. These
guidelines acknowledge that these competencies are based on
broad and general training for general practice in health service
psychology and in no way delimit practice. When the general
practice of psychology is noted in this document, this APA
(2011a) policy definition is used.
3
IN TRO D UCTI ON

A Conceptual Framework for Specialization in the Health Service

Definition of Taxonomy
Domain of Professional Psychology. That document proposed defi-
nitions of key terms and provided a series of guiding principles
A taxonomy is simply the orderly classification or arrangement of
related to specialization in the health service domains of psychol-
a set of related concepts based on their common factors. Typically
ogy. The document, after further review, was not recommended
a hierarchical structure with clear rules defines components of
for endorsement as policy by APA.
the taxonomy and how the structure is to be organized (see, e.g.,
In 2005 the APA Task Force on Quality Assurance of
Bailey, 1994). In the current guidelines, the taxonomy reflects four
Education and Training for Recognized Proficiencies in Professional
stages of training in health service psychology (doctoral, doctoral
Psychology concluded that “there appears to be a need for a
internship, postdoctoral, and postlicensure) and, within each
clearer taxonomy of terminology [emphasis added] in describing
stage, four levels of increasing intensity of education and training
the structure of professional psychology, from its education and
opportunities (Exposure, Experience, Emphasis, and Major Area
training foundations, through credentialing and practice represen-
of Study).
tations to the public.” Then, in 2007, the APA Board of Directors
authorized funds to support a 2½-day task force meeting to begin
the development of such a taxonomy.
CRSSPP built upon that task force’s work product, and the
Process of Developing the Guidelines
previously described history, to construct the first version of this
taxonomy in the form of the Education and Training Guidelines,
These guidelines were prepared by APA’s CRSSPP. The guidelines
which were approved as APA policy in February 2012. CRSSPP’s
are based on a consensus developed during the course of several
process that led to those Guidelines involved conversations with
cross-organizational meetings, including ongoing feedback on the
multiple constituency groups and presentations at two APA con-
need for a taxonomy in education and training in health service
ventions during which feedback was solicited and received, and
psychology, as detailed in the next section. Please note that the
then incorporated into several iterations of these guidelines. Then,
transition in these guidelines from use of the term professional
after a round of public comment, additional suggestions were
psychology to health service psychology is aligned with historical
reviewed and incorporated in the guidelines.
developments in the field.
These current guidelines reflect revisions that incorporate
changes in professional psychology, including use of the term
health service psychology, as well as increased attention to diversity
within education and training programs, and introduction of the
History of the Taxonomy
concept of subspecialty within health service psychology. These
guidelines reflect the work of CRSSPP over a 2-year period during
The need for a taxonomy for professional (now health service)
which revisions and updates were reviewed and incorporated in
psychology was raised by individuals, groups, and organizations,
this current version. The addition of a subspecialty definition, con-
both within and outside of APA. A range of groups and organi-
sistent with the field of health service psychology as reflected in
zations such as the APA’s CRSSPP, the COS, and the Council of
work on this topic by ABPP, and the formal removal of proficiency
Credentialing Organizations in Professional Psychology (CCOPP)
are key changes to CRSPPP’s mandate and to the taxonomy.
had a series of explicit discussions about the need for a taxonomy
Since 2015, CRSSPP participated in four interorganizational
to organize and clearly define the multiple terms used to describe
summits hosted by COS in collaboration with ABPP and the
the educational and training opportunities in professional (now
Association of State and Provincial Psychology Boards (ASPPB).
health service) psychology. Historically, each of these groups
The result of those summits included consensus on a single
independently developed their own definitions for key terms to
definition of specialty, as previously noted, which was adopted
remedy this problem, but their diligent efforts often resulted in
by CRSSPP at its fall meeting in 2017. The work of the summits
continued inconsistencies. Rozensky and colleagues (2015, 2017)
(May 2016, December 2016, June 2017, and June 2019) reflects
have provided that historical context.
the investment and commitment across various groups over many
Past efforts to develop a single, consistently used taxonomy
years to sufficiently evolve to meet the needs of the profession.
for professional (now health service) psychology were limited in
Additionally, the recognized need for subspecialty recognition by
scope or not pursued as broad policy of the APA. For example, in
CRSSPP emerged from these summits alongside other interorga-
1996 the APA endorsed a policy—A Taxonomy for Postdoctoral and
nizational work and meetings.
Continuing Education and Training in Psychology—based on the dis-
cussions at the National Conference on Postdoctoral Education
and Training in Psychology in Norman, OK (APA, 1996b). Although
that document remains APA policy, its scope is focused only on
postdoctoral education and training. In 2004 the CCOPP drafted

4 APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties

History and Rationale for the Recognition
of Subspecialties
Since 1996, CRSSPP has been charged by APA with recommend-
ing the recognition of specialties in health service and applied
psychology. Rosenthal et al. (2001) noted that the general public
has little understanding of training and practice of psychology
including at the doctoral level or its range of specialty services.
CRSSPP believes that this paucity of understanding expands
beyond specialty services and includes what would be considered
the subspecialties within APA’s recognized specialties. Thus, clar-
ification is needed to help with APA’s strategic plan that, as one of
its goals and objectives, focuses on helping “evaluate the public’s
understanding of, regard for, and use of psychology” (APA, 2019).
Stein et al. (2009) noted the importance of recognition of
subspecialties in health care (and specifically for psychiatry in
their case), including at the scientific level—that is, recognition of
“significant growth in particular areas, requiring mastery of partic-
ular concepts and methods. At a clinical level, it allows patients
to receive high-quality sub-specialty assessment and intervention
where appropriate. At a health policy level, it ensures that policy-
makers provide appropriate funding for particular services” and
contributes to parity with other healthcare disciplines.
Although Plochg et al. (2009) acknowledged the increasing
subspecialization within organized medicine, they warned of the
need to not fractionate care and acknowledged the population
health care requirements that support integrated, coordinated
care. On the other hand, Block and Palusci (2006) pointed out
that the increased clinical literature in subspecialty areas and the
need for more focused research in such areas are strong argu-
ments for subspecialty recognition.
Also, there is a growing movement toward Patient-Centered
Medical Homes, where each patient’s care is coordinated by an
integrated home specialist through a network of specialists and
subspecialists (American Academy of Family Physicians et al.,
2007). This would then require that psychology be organized in a
similar administrative structure as other health care providers, thus
helping consumers and other providers more easily understand
psychology and psychologists and their specialized contribution
to health care. For example, just as pulmonology is a subspecialty
of internal medicine, so could pain psychology be a subspecialty of
clinical health psychology. This classification system allows for (a)
a clear understanding of the education, training, and competencies
within a recognized psychological specialty or subspecialty; (b)
ease of referral; (c) clear communication across the health service
professions; (d) a coordinated way to propose policy initiatives and
changes; and (e) a profession-wide umbrella to negotiate reim-
bursements under various insurance scenarios. Patient-Centered
Medical Homes will coordinate assessment, care, follow-up, and
reimbursements, so it is essential that psychologists be easily inte-
grated into this health delivery model and use a similar language
and organizational structure as found across health care.
1
APA currently recognizes the following specialties in professional psychology: behavioral and cognitive psychology, clinical psychology, clinical child psychology, clinical health psychology, clinical neuro-
psychology, counseling psychology, couple and family psychology, forensic psychology, geropsychology, group psychology and group psychotherapy, industrial-organizational psychology, police and public
safety psychology, psychoanalysis in psychology, rehabilitation psychology, school psychology, serious mental illness psychology, and sleep psychology.
APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties
CRSSPP believes the time has come to formally recognize
the range of subspecialties actively delivering services in health
service psychology. This action has already been taken by ABPP
since 2008, and it reflects the trajectory of psychology and the
broader health care services environment.
Rationale for Sunsetting of Proficiency
Recognition
Proficiencies have been narrowly defined within APA policy as a
“distinct procedure, technique, or applied skill set used in psycho-
logical assessment, treatment and/or intervention within which
one develops competence” (APA, 2014).
CRSSPP has decided to sunset the concept of proficiency for
several reasons:
1. Even though a large number of “procedures, techniques, or
applied skill set[s]” could apply for recognition, there has been
a paucity of new proficiency applications.
2. More specifically, in 2010 there were seven recognized
proficiencies, and as of January 1, 2020, there are three
recognized APA proficiencies. The three currently recognized
proficiencies will continue with recognition status until the
date for which they were designated to submit a renewal
application.
3. The vast majority of CRSSPP’s expertise, time, policy
development, and actual review activities have focused on
recognition of specialties in health service psychology. In light
of the current landscape for the profession, CRSSPP believes
that focusing on specialty and subspecialty recognition is a
critical service to the field and quality assurance review for
the public.
Statement of Need
This taxonomy serves as a guide to those seeking education
1
and training in a recognized specialty and subspecialty. Such
a taxonomy also provides a structure for the field in general to
facilitate communication concerning how professional psychol-
ogists are educated and trained as health service psychologists
beyond the broad and general training consistent with accredita-
tion standards (APA, 2009b). Before this taxonomy, there were
no consistent definitions or use of terms in the education and
training community to describe training opportunities in areas
recognized as specialties by APA (APA, 2009a, section 90-5;
Rozensky et al., 2015).
5
 For example, Rozensky et al. (2015) discussed how, in
describing training opportunities, education and training depart-
ments and programs often used a range of terms such as area of
study, track, and concentration. These terms could refer to the same
or different amounts of coursework or practica from department
to department or from program to program. Such inconsistency
lead to clarity that would be helpful to students when they seek
graduate education or attempt to later describe the education
and training opportunities in which they participated during their
graduate or postgraduate education.
As further evidence of both the need and timeliness of this
taxonomy, the COS formed a work group in 2010 that included
representatives from COS, ABPP, and APA’s Commission on
Accreditation and CRSSPP to resolve the potential confusion
resulting from the lack of a consistent definition of the term spe-
cialty across these groups. A draft definition was developed and
approved by COS. Then that definition of specialty was recom-
mended by CRSSPP to APA Council of Representative in August
2011 and was accepted as APA Policy at that time. This was a
great stride forward in building a consistent set of definitions in
professional (now health service) psychology and led directly to
the formulation of the current guidelines.
Additionally, in recent years the interorganizational summits
provided multiple opportunities for several groups within and
outside of APA to provide clarity, enhance communication, and
encourage implementation of the taxonomy. These meetings
included COS, APPIC, and ABPP, as well as APA groups such as
CRSSPP, Committee on Early Career Psychologists, BPA, and the
Office of Program Consultation and Accreditation. As a result of
the meetings, COS, APPIC, ABPP, and CRSSPP agreed on a defini-
tion of specialty and, in turn, incorporated this into their respective
materials. For example, APPIC revised their online directory to
reflect the taxonomic language/categories such as Major Area of
Study and Experience (see www.appic.org/Directory); largely with
the support of COS, each specialty has either begun to or fully
developed a taxonomic representation for their group.
Purpose of the Guidelines
By providing both a structure and consistent terminology to
reduce current inconsistencies and enhance communication
within the field, the proposed taxonomy is likely to have a broad
impact. Specifically, the guidelines will have the following effect:
• For students, they will provide a clearer understanding of the
definitions of terms used to describe the type and intensity of
educational and training activities within a specialty or subspe-
cialty provided by doctoral, doctoral internship, and postdoctoral
programs. A clear taxonomy will help students by providing a
structure for consistent “truth in advertising” by programs.
• For those already providing psychological services, the guidelines
will provide clarification of the structure of programs available for
lifelong learning and further professional development.
6 APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties
• For consumers of psychological services and those who make
educational and services policy decisions, the guidelines will
provide a better understanding of the education and training of
psychologists.
It is expected that each APA-recognized specialty and subspe-
cialty will use this taxonomy to describe the recommended type
and intensity of education and training opportunities within each
stage of the education and training sequence within their specialty
or subspecialty. The COS has already been working with all rec-
ognized specialties to provide this information for each stage of
education and training (doctoral, doctoral internship, postdoctoral,
and postlicensure) and for each level of intensity of education
and training opportunities (Exposure, Experience, Emphasis, and
Major Area of Study) within each stage.
What These Guidelines Are Not
• These guidelines are not designed to define specifics of the
training or practice of individual psychologists but rather to
describe programmatic structure and terms only.
• These guidelines are not intended to be a mechanism for defin-
ing the actual content of education and training of professional
psychologists nor limit academic freedom or the general prac-
tice of psychology. The taxonomy is conceptualized as an orga-
nizing construct such that each specialty and subspecialty can
describe its recommended set of educational and training
opportunities within each stage of the education and training.
• Although these guidelines are specific to education and training
in APA-recognized specialties and their subspecialties, it is
understood that education and training programs may want to
inform students and the public about other educational and
training opportunities with specific populations or in areas of
practice that are not formally recognized by APA as specialties
or subspecialties. These might include a range of learning
opportunities such as multicultural professional activities,
community psychology, hospital practice, or treatment oppor-
tunities with individuals who have posttraumatic stress disor-
der, traumatic brain injury, diabetes, or autism. These learning
opportunities should be described in the taxonomy as areas of
focus.
Because the ongoing utility and fidelity of these guidelines are
dependent on the consistent use of the descriptors Exposure,
Experience, Emphasis, and Major Area of Study, education and
training programs are strongly encouraged to use these four
terms exclusively in public descriptions of training within APA-
recognized specialties and subspecialties. It is suggested that the
term focus be used to describe opportunities in other training areas
and that programs strive to provide explicit explanations of the
type of training provided in these nonspecialty areas. Consistent
use of the term focus for this purpose will enhance the clarity of
communication regarding educational and training opportunities
across programs.
• These guidelines and the taxonomy for health service psychol-
ogy are not designed to arbitrate conflicts within the field but,
rather, to provide an organizing framework with common defi-
nitions that can help better illuminate rules to resolve defini-
tional confusion.
• Given that APA recognizes specialties and subspecialties that
are related to the direct provision of health services and those
that involve other aspects of applied professional service (e.g.,
industrial-organizational psychology), the present guidelines
relate only to those specialties and subspecialties in health
service provision.
Feedback
The Guidelines is a “living document.” Accordingly, APA has estab-
lished a systematic plan for periodically reviewing and revising
such documents to reflect developments in the discipline and the
education and training process. Formal reviews will occur every
7 years, which is consistent with APA Association Rule 30-8.3
requiring cyclical review of approved standards and guidelines
within periods not to exceed 10 years. Comments and suggestions
are welcome at any time.
Feedback on the Guidelines may be sent to edmail@apa.org.

Implementation Steps

CRSSPP has been serving as the entity responsible for oversight of

the implementation process for APA. However, implementation
has involved close cooperation with several groups, including the
following:
• COS to establish specialty specific recommendations for each
of the four levels of education and training opportunity pre-
sented in the taxonomy within each stage of education and
training (www.cospp.org),

• COS to help with the dissemination of the completed taxonomy,

• Member organizations represented on the Council of Chairs of

Training Councils, including doctoral training councils and
APPIC, to inform and encourage adoption of the taxonomy,

• APA Boards and Committees to encourage consistent use of

terms and definitions within the Association itself, and

• COS, ABPP, and ASPPB to work with CRSPPP in sponsoring four

Specialty Summits that have worked on promulgating the use of
the taxonomy and ensuring consistency in policy and definitions
across organizations and within the field of professional psy-
chology.
Implementation and dissemination of the Guidelines has occurred
through regularly established meetings between members of
CRSSPP and COS; presentations at national training council meet-
ings and APA annual conventions; four formal Summits held in
Chicago, IL, Chapel Hill, NC, and Washington, DC; written mate-
rials such as pamphlets and submissions to newsletters/journals;
posting of information on the CRSSPP section of the APA website;
and listing of specialty defined taxonomies on the COS website.
Ongoing interaction between CRSSPP and students in
psychology as represented by the American Psychological
Association of Graduate Students has been encouraged
in order to help monitor the impact of the adoption of the
guidelines. This process directly informs the feedback pro-
cess described next and is consistent with the cooperative
and iterative process used to develop the actual guidelines.

APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties 7
A Taxonomy for Education
and Training in
Professional Psychology
Health Service Specialties
and Subspecialties
 EDUCAT IO N AND T R AINING
GU IDEL INES
The taxonomy that forms the basis of the Education and Training Guidelines provides a
structure to organize the interrelationship of terms used to describe the type and intensity
of didactic and health services training opportunities within each stage of the professional
2
psychology education and training sequence. It is expected that each APA-recognized
specialty and subspecialty will use the structure of this taxonomy to organize its descrip-
tion of the expected type and intensity of didactic and training opportunities within each
stage of the education and training sequence for that specialty and subspecialty.
It is hoped that these guidelines, although aspirational in nature, will be used by each
education and training program in professional psychology to consistently describe the
type and intensity of opportunities offered at the doctoral, internship, postdoctoral, or
postlicensure stage in the education and training sequence beyond the broad and general
training expectations currently used in accreditation standards. Thus, the definition of
specialty that forms the basis for the guidelines and the taxonomy is as follows:
A specialty is a defined area of professional psychology practice characterized
by a distinctive configuration of competent services for specified problems and
populations. Practice in a specialty requires advanced knowledge and skills acquired
through an organized sequence of formal education, training, and experience in
addition to the broad and general education and core scientific and professional
foundations acquired through an APA-or CPA-accredited doctoral program.*,**
Specialty training may be acquired either at the doctoral, doctoral internship,
postdoctoral, or postlicensure level as defined by the specialty. (APA Policy, 2011b)
*Except where APA or CPA program accreditation does not exist for that area of profes-
sional psychology.
**For those training in health service psychology areas, this is in addition to the broad and
general education and core scientific and professional foundations acquired through an
APA- or CPA-accredited doctoral program or programs accredited by an accrediting body
that is recognized by the U.S. Secretary of Education for the accreditation of professional
psychology education and training in preparation for entry to practice.

The definition of subspecialty is as follows:

A subspecialty is a concentrated area of knowledge, skills, and attitudes that (a)
has been officially recognized by the parent specialty or specialties; (b) requires
additional education, training, and/or professional experiences; and (c) involves
specific (1) problems, (2) populations, and/or (3) circumscribed approaches within
a recognized specialty; and (4) has been officially recognized by the parent specialty
or specialties according to documented criteria of the specialty or specialties.

2
APA recognizes specialties that both are related to the direct provision of health services and involve other aspects of applied pro-
fessional service (e.g., industrial-organizational psychology). The present guidelines relate only to those specialties in health service
provision. In the future, separate guidelines may be developed that describe education and training in other applied professional
specialties of psychology.

APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties 9
The Structure of the Taxonomy
The taxonomy provides a structure for the consistent labeling of
the type and intensity of education and training opportunities
available in professional psychology programs. Four levels (from
lower to higher intensity: Exposure, Experience, Emphasis, Major
Area of Study) are described within each stage of the education
and training sequence (doctoral, doctoral internship, postdoctoral, or
postlicensure). It is recommended that each education and train-
ing program in health service psychology, regardless of the stage
in the sequence, use these levels of intensity of education and
training to describe learning opportunities for those specialties
offered within its program.
The proposed four levels and the accompanying descriptions
form the key components of the Education and Training Guidelines.
The amounts of didactic and supervised experience presented in
specialties who have established their respective taxonomies are
unique to those specialties; they are shared as various examples
and are not intended to offer specifics for other specialties. Each
recognized specialty and subspecialty is responsible for providing
its own recommendations for these amounts for each level of
intensity within each stage of the education and training sequence.
1. MAJOR AREA OF STUDY. Major Area of Study should be
used by programs to describe the highest level of education
and training opportunity with respect to the types of
knowledge, skills, and attitudes that would be developed and
to the intensity and amount of involvement in training to
acquire those competencies. This includes expectations for
acquisition of knowledge through didactics, practical training
and direct service expectations (hours, number of cases,
and competencies), and research and scholarly expectations.
For example, programs accredited by the APA’s
Commission on Accreditation in a traditional substantive
professional area (i.e., clinical, counseling, or school) would
offer opportunities consistent with a “major area of study” in
the respective area of their programs. Organized sequences
of education and training might be offered in a program in
other recognized specialties as well and might likewise meet
the guidelines for a major area of study within that area.
Although specific details regarding individual programs will
likely vary somewhat, they would be consistent with the rec-
ommendations of that specialty area’s description of major
area of study at a particular stage in the training sequence.
Major Area of Study is used to convey the highest level of
education and training available in that (specialty) area of
study. Postdoctoral education and training in a specialty is
by definition a major area of study requiring 80% or more of
time spent in that specialty area, but it would allow for an
exposure to other specialty areas (with the actual percentage
or other descriptors defined by each specialty).
10 APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties
2. EMPHASIS. Emphasis is the level just below Major Area of
Study, with distinctly different expectations for the type and
intensity of the education and training experience. A
programmatic emphasis permits a structured, in-depth
opportunity for knowledge acquisition, practical experience,
and scientific study in a given specialty or subspecialty area.
Again, a program stating that it offers an emphasis in a
recognized specialty would be expected to follow the guidelines
established by that specialty for this level of education and
training within that program’s stage in the sequence of training
(doctoral, doctoral internship, postlicensure). It should be
noted that at the postdoctoral stage of education and training
it is expected that 80% of a program’s time is within a major
area of study. Further, if a postdoctoral program offers an
exposure in a specialty (up to but not more than 20% of the
time) or two exposure opportunities (of 10% or less each),
then there would be no program emphasis or experience level
within the postdoctoral stage.
3. EXPERIENCE. The experience level falls between Emphasis
and Exposure; the type and intensity of the opportunity for
learning that the program offers will be clearly distinct from
the other levels, with the specific parameters of knowledge
acquisition, practical experience, and scientific study defined
by that specialty. A programmatic “experience” would go
beyond simply acquainting a student with a specialty or
subspecialty but would allow more acquisition of knowledge
and experience than an exposure to that area.
4. EXPOSURE. Exposure represents an education and training
opportunity that is limited in type and intensity. An exposure
is identified by the program as a structured learning activity
and would be seen as an opportunity to acquaint an individual
with that specialty area.
Broad and General Training and Accreditation
This taxonomy affirms the following:
• Broad and general training forms the core of education and
training in health service psychology.
• Programs are themselves accredited by APA.
• Programs clearly show how they integrate their broad general
training with those educational and training activities related to
recognized specialties and subspecialties.
• Programs properly evaluate their students/graduates as being
competent within and across each stage in the education and
training sequence.
A Graphic Presentation of the Guidelines
and Taxonomy
A comprehensive visual representation of the taxonomy is
presented in the appendix, which consists of three figures.
Explanations of what each figure represents and of the relation-
ships among elements in each figure are provided here to guide an
understanding of the graphics.
FIGURE A1 (see p. 14) provides an overview of the discipline of
psychology. The guidelines focus on the steps of training in the
Education and Training box in the center of the figure (doctoral,
doctoral internship, postdoctoral, and postlicensure). This figure
conveys the dynamic interplay of science and practice that informs
education and training; the educational experience prepares those
involved in the practice of psychology and research in the field.
The taxonomy also recognizes both the basic and applied nature
of research in psychology. Within the Area of Practice box, the
relationship between the general practice of psychology and the
recognized specialties and subspecialties in professional psychol-
ogy is noted, and the recognized specialties and subspecialties are
further articulated in Figure 2.
FIGURE A2 (see p. 15) provides direct links to access the APA-
recognized specialties and subspecialties (these will be forthcom-
ing as they are recognized) in professional psychology within the
practice of psychology. The areas of practice include both “health
service psychology” and “other applied services.” Within these
areas of practice are “the general practice of psychology” and the
recognized specialties and subspecialties in professional psychol-
ogy. In the current taxonomy, the term specialty reflects the recently
approved version of the APA policy defining the term (APA, 2020).
FIGURE A3 (see p. 16) presents the constructs that are the focus
of the taxonomy. It details the distinctions between the type and
intensity of education and training activities as a guide to help
programs more consistently label the nature of the programming
they offer. These guidelines and taxonomy describe program-
matic definitions and are not meant to be used to describe the
qualifications or competency of an individual. This taxonomy was
created because the type and intensity of education and training
activities within each stage of the sequence leading to practice
are not defined consistently within the field of psychology or used
consistently across programs. Using this taxonomy and its defini-
tions provides for consistent use of structure and terms.
• Stages of education and training. The taxonomy addresses four
stages in the sequence of education and training in health
service psychology: doctoral programs, doctoral internship
programs, postdoctoral programs, and postlicensure education
and training programs.
• Levels of education and training. Within each of the stages of the
education and training sequence, the taxonomy illustrates an
increasing intensity of education/didactic, research, and
supervised practice (Exposure, Experience, Emphasis, and
Major Area of Study).
APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties
» Thus, these guidelines provide a hierarchical definition of
these education and training activities from lowest to
highest intensity within each stage. Use of the guidelines
allows programs the flexibility to describe their program
accurately and consistently but with the use of now com-
monly accepted terms. The terms, in hierarchical order
(from lowest to highest intensity), are Exposure, Experience,
Emphasis, and Major Area of Study.
» It is expected that each recognized specialty and subspe-
cialty will provide guidance to the field for their special-
ty-specific activities within the increasing levels of education
and training and across the sequence of training as shown
in Figure A3. That is, each specialty will provide a listing of
the didactic, research, and experiential opportunities that
define and distinguish between an exposure, an experience,
an emphasis, and a major area of study at the doctoral, doc-
toral internship, postdoctoral, and postlicensure steps in the
education and training sequence.
• This common use of programmatic descriptors will help educa-
tion and training programs present the content and range of
opportunities in their program in a consistent manner.
• This common use of programmatic descriptors will help stu-
dents compare and contrast programs and use common terms
to describe the education and training opportunities within
their programs.
The Impact of the Guidelines and Its Taxonomy
Clear, consistent communication to enhance “truth in advertis-
ing” for the education and training opportunities in health ser-
vice psychology and training provides many benefits:
• Such program descriptions, with the consistent use of the
terms and structure recommended within the Guidelines, will
continue to clarify the education and training opportunities
for students in health service psychology.
• This will allow programs to use consistent terms when describ-
ing education and training opportunities and will clarify for the
consumer the intensity of training activities in health service
psychology (Exposure, Experience, Emphasis, Major Area of
Study) within each step of education and training (doctoral,
doctoral internship, postdoctoral, postlicensure).
• These guidelines will continue to support the cooperative
work of our education and training community in preparing
the next generation of professional psychologists and will
enhance clear, consistent communication with them.
With the implementation of these guidelines, the following
illustrative examples reflect ways to describe programs in health
service psychology education and training while using agreed
terminology outlined in these guidelines.
11
On the website for an APA-accredited doctoral program,
we might see:

In our doctoral program at Our University, we offer a Major Area

of Study in Clinical Psychology with at least 3 years of didactic
coursework and supervised clinical training in that area of study,
which includes a dissertation or research project. We offer stu-
dents an Exposure to Clinical Neuropsychology with one course
in that area and an Experience in Clinical Child Psychology with
two courses and two semesters of supervised practicum in that
area. We offer a focus in personality assessment as part of our
advanced practicum wherein an advanced assessment course
and two additional practica semesters are available. The opportu-
nity to do a Major Area of Study in the recognized subspecialty of
XYZ is available along with an Emphasis, Experience, or Exposure
to that subspecialty as well.

On the website of an APA-accredited internship program,

we might see:

Our internship program is accredited in health service psychol-

ogy and offers a Major Area of Study in Counseling Psychology
at Our University Student Health Center. At least 80% of trainee
time will be devoted to training in our Center in direct counsel-
ing activities. There is an optional Experience in Clinical Health
Psychology at our Clinic. This Experience would involve up to
20% of supervised time working with medically ill students and
health promotion services.

12 APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties
RE FERE NCES
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13
A PPE N DI X

FIGURE A1
OVERVIEW OF THE TAXONOMY

Psychology

Practice of Education
Research
psychology and Training

Other Applied
Health Service Post-licensure Basic
Services

Postdoctoral Applied

AREA OF PRACTICE:

Specialties Internship
General Practice of
Psychology
Subspecialties

Doctoral

CIRCUMSCRIBED
ACTIVITY: Proficiencies

14 APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties
FIGURE A2
APA-RECOGNIZED SPECIALTIES

REFER TO CURRENT LIST

HEALTH SERVICE OF SPECIALTIES
PSYCHOLOGY on.apa.org/grad-recognized-
specialties

APA-RECOGNIZED SPECIALTIES1

OTHER APPLIED INDUSTRIAL-

SERVICES ORGANIZATIONAL2

Notes:
(1) A specialty is a defined area of professional psychology practice characterized by a distinctive configuration of competent services for specified problems and populations. Practice in a specialty area re-
quires advanced knowledge and skills acquired through an organized sequence of formal education and training in addition to the broad and general education and core scientific and professional foundations
acquired through an APA- or CPA-accredited doctoral program.* Specialty training may be acquire at the doctoral, doctoral internship, postdoctoral or postlicensure level as defined by the specialty (APA,
2011b). *Except where APA or CPA program accreditation does not exist for that area of professional psychology.
(2) APA recognizes specialties that both are related to the direct provision of health service and involve other aspects of applied professional service (e.g., industrial-organizational psychology). The present
guidelines relate only to those specialties in health service provision. In the future, guidelines may be developed that describe education and training in other applied professional specialties of psychology.

APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties 15
FIGURE A3
STAGES OF EDUCATION AND TRAINING AND LEVELS OF EDUCATIONAL OPPORTUNITIES

STAGES OF EDUCATION AND TRAINING

DOCTORAL
DOCTORAL POSTDOCTORAL POSTLICENSURE
INTERNSHIP

MAJOR AREA
LEVELS OF EDUCATION AND TRAINING OPPORTUNITIES

OF STUDY

EMPHASIS

EXPERIENCE

EXPOSURE

Notes:
(1) Completed taxonomies for specialties can be found on the Council of Specialties in Professional Psychology website (www.cospp.org).
(2) This is a guide to be used by education and training programs to describe, using consistent language, the nature of the education and training opportunities in recognized specialties that they provide such
that it is clear to both students and the public. The descriptors provided are not meant to be absolute or standards but to provide guidance to help education and training programs establish clear distinctions.
The Commission for the Recognition of Specialties and Subspecialties in Professional Psychology (CRSSPP), however, recommends the consistent use of these terms across the field to provide consistency.
Each recognized specialty will provide its own recommendations for specific requirements for each level of intensity within each stage of the education and training sequence.
(3) Specialties vary with regard to how or if education and training can be acquired solely at the postlicensure level. For purposes of the taxonomy, an example is provided.
(4) Postdoctoral education and training in a specialty is by definition a major area of study requiring 80% or more of time spent in that specialty area but would allow for an exposure to other specialty areas.
(5) Because the ongoing utility and fidelity of these guidelines are dependent on the consistent use of the descriptors Exposure, Experience, Emphasis, and Major Area of Study, programs are strongly encour-
aged to use these four terms exclusively in public descriptions of training within APA-recognized specialties. It is suggested, then, that the term focus be used to describe opportunities in other training areas
and that programs strive to provide explicit explanations of the type of training provided in these nonspecialty areas.
(6) The taxonomy is NOT designed to define specifics of individual training or practice or to be used to define the qualifications of individuals but to describe programmatic structure such that there is “truth
in advertising” by education and training programs.

16 APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties
18 APA | A Taxonomy for Education and Training in Professional Psychology Health Service Specialties and Subspecialties