New Doctor of Behavioral Health Degree

[smalltownpsych]

I didn't even realize it was an online degree. I hate online education. To me it diminishes the role of great teachers and I personally take as much pride in my teaching skills as I do my therapist skills and I work hard to develop them. Why should I even bother trying to engage students with my enthusiasm when they could just get the information from a website. It amazes me that there is supposedly research to show equivalency in modalities, too.

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[Pragma]

I'm guessing the ppl who sign up for an ONLINE degree are more likely to be from the "research is icky!" crowd.

Yeah I was just thinking more generally about the concept. I agree with you.

 

[bmedclinic]

I would respond to how ridiculous the need for this degree, but I have to go meet with the pain management committee that is comprised of my buddy the ortho surgeon, the old school IM guy, the kooky addiction/OB gyn doc, our new pain management specialist NP, and myself as the representative doctor from the behavioral health department. By the way, if I had obtained a doctorate in behavioral health instead of clinical psychology, I wouldn't even be working here.

Gosh I feel like I know all those characters from my life already. Especially the kooky addiction person. In my case, it was a kooky fam med doc who used to be a anesthesiologist, but liked the pills too much himself so he had to re-specialize after rehab.

BTW, *shocker* that I was working in integrated primary care, I know, I know, WITHOUT a doctorate of behavioral health (how scandalous!) Damn you, bmed, get some legit training like through ASU's online program, rite, rite?

 

[WisNeuro]

Maybe I'm just spoiled in the VA and AMC's where I have been, but we've had mental health practitioners integrated in Prime care for years nod delivering time limited, EBP's in a multidisciplinary setting. I have yet to see this "people in therapy for years" kind of thing. Maybe back in the 50-60's, during the heyday of psychoanalysis, but every hospital system I have trained/worked at emphasizes functional gains, demonstrable goals, and efficiency with regards to time in treatment.

 

[erg923]

Maybe I'm just spoiled in the VA and AMC's where I have been, but we've had mental health practitioners integrated in Prime care for years nod delivering time limited, EBP's in a multidisciplinary setting. I have yet to see this "people in therapy for years" kind of thing. Maybe back in the 50-60's, during the heyday of psychoanalysis, but every hospital system I have trained/worked at emphasizes functional gains, demonstrable goals, and efficiency with regards to time in treatment.

Wise, I would almost guarantee your facility's MHC has some folks who have been there for years....

 

[AcronymAllergy]

To be fair, I'd say there's a time and a place for long-term psychotherapy, although I don't think anyone is arguing against this. And like erg mentioned, even (or perhaps especially...?) the VA isn't immune to having folks who've been in therapy for years on end.

It's just that primary care isn't the place for such services, and as has already been said, psychology has adopted such a model everywhere I've been for as long as I've been either practicing or in training (10 or so years now). Psychology has also become increasingly-focused on outcomes assessments and the prognostic value of psychological assessments; it's why our evals are now par for the course with respect to things like pre-surgical bariatric, organ transplant, DBS, and spinal cord stimulator procedures.

 

[WisNeuro]

Wise, I would almost guarantee your facility's MHC has some folks who have been there for years....

Of course, but they're generally not getting the bulk of that treatment in prime care. I think they do a great job at handling the mild to moderate mental health comorbidities with medical issues and make appropriate referrals for those needing more intensive care. Yes, the VA definitely has frequent fliers, some due to significant longstanding mental health concerns, some due to longstanding secondary gain concerns

 

[Samarian]

For All: Please see the thread in this forum "New Degree Creates Doctor Nurses" and "New Doctorate in Physician Assistant Degree". From a behavioral health standpoint, the new emergence of the Psychiatric Nurse Practitioner may have significant influence in professional training, employment and how care is delivered. The thread above about incomes from the federal occupational data system is telling! ASU-DBH is not alone in the expanding field of effort to improve access and quality of behavioral healthcare - due, it appears, to the lack of the traditional way healthcare has been offered, administered, financed and led. Mental health and behavioral health are much broader than the scope or influence of clinical psychology - the emerging doctorates in many fields and the creation of new ones, proves that. Consider this..... nurse practitioners in general and psychiatric nurse practitioners specifically can prescribe medications as well as deliver various forms of therapy, open their own offices, employ other RN's and practitioners and so forth. They deliver care and are in an increasing abundance in rural and urban settings. In addition, physical therapy, rehabilitation therapy, other medical specialties offer doctorates and I wonder how physicians and psychiatrists feel about that? Oh, gee, can they call themselves "doctor". really, that's your concern? Where is the outrage for getting a doctorate - and not being a physician. What about that pesky MD/DO debate? What about pharmacy doctorates? Are they "doctors". Hummmm? Does anyone think they care what they are called?

I wonder how the medical establishment let nurse practitioners into the health care system with such vast practice scopes in the first place? I am not sure you folks from the VA have noticed, but the rest of us out here in the real world can recognize the importance and contributions to be made through expanded patient access to care and continuing education for practitioners (which is really what the DBH is) as an asset. But if your objection is to people with new doctoral degrees (some in new and emerging fields) are calling themselves, I don't think the emerging professional education system or nomenclature needs to worry much about anything.

 

[WisNeuro]

I wonder how the medical establishment let nurse practitioners into the health care system with such vast practice scopes in the first place? I am not sure you folks from the VA have noticed, but the rest of us out here in the real world can recognize the importance and contributions to be made through expanded patient access to care and continuing education for practitioners

I think you are sorely ignorant of the VA system. Once again, I would urge you to read some outcome and policy literature on the system before deriding it as a healthcare entity. But, from what I've seen so far, empirical data has little to do with your arguments. So, carry on.

 

[Samarian]

One thing I know about this program is that it is definitely NOT supported, affiliated with, or endorsed by the ASU psychology department. I think it was pushed by ASU brass as a money making means-- much like PsyD programs are. I certainly would not want to invest in this program, as it is unclear whether a degree will have any value.

The fact it is not affiliated or endorsed is and an asset. I don't think the DBH leadership need the psychology departments support or approval for anything.

 

[Samarian]

While I realize this is an old thread, I still would like to post some comments just for future readers.

The DBH is a "child" of ASU. This degree has been argued multiple times since they implemented it. The degree is not meant to provide licensing/certification, or to provide additional licensing/certification. I think, at least their original conceptualization of the program, was to provide training into the integration of behavioral health into medicine (integrative behavioral health). The program can be of benefit for knowledge, but being the program is so unknown and lack any true "merit" to it, I doubt having the degree will give you an edge for employment. The program is designed for already licensed (or license eligible) clinicians to further your knowledge. Personally, I would advise against the program. If you already have your masters and license in counseling, I would suggest a doctorate in CES or doctorate in counseling/clinical psychology.

Now, to address some other individuals:
If you complete this degree, you will be able to call yourself a doctor (providing ethical and employer regulations). But, some ethical guidelines forbids you from identifying yourself as doctor unless the degree is directly related to your license, and being this is so new, not sure how some Board will view it. Likewise, I know some employers that will only allow physicians to be called doctor (mostly psychiatric hospitals; in fact, a NP that I know that has two doctorates- DNP and PhD- is not allowed to be addressed as Dr and one of the directors as a PsyD and could not be addressed as Dr). This could be a licensed counselor that has a doctorate in educational leadership cannot be called Dr...., a licensed counselor with a ThD/DMin/etc cannot be called Dr....

I don't understand how this program is being compared to a PsyD program, and the PsyD being called a means for money making.

Absolutely correct! The title and "what you call yourself" is not a universal standard as long as their is no fraud or "intent to deceive for gain". In my state, you cannot call yourself a "doctor" unless you have a degree from an accredited institution (which is much less of a barrier these days, sadly). But you can, and some might say must, correctly and factually, identify your credentials - preferably in writing when the patient fills out forms and reads the information they are given. In this case, as a Doctor of Behavioral Health.

 

[smalltownpsych]

For All: Please see the thread in this forum "New Degree Creates Doctor Nurses" and "New Doctorate in Physician Assistant Degree". From a behavioral health standpoint, the new emergence of the Psychiatric Nurse Practitioner may have significant influence in professional training, employment and how care is delivered. The thread above about incomes from the federal occupational data system is telling! ASU-DBH is not alone in the expanding field of effort to improve access and quality of behavioral healthcare - due, it appears, to the lack of the traditional way healthcare has been offered, administered, financed and led. Mental health and behavioral health are much broader than the scope or influence of clinical psychology - the emerging doctorates in many fields and the creation of new ones, proves that. Consider this..... nurse practitioners in general and psychiatric nurse practitioners specifically can prescribe medications as well as deliver various forms of therapy, open their own offices, employ other RN's and practitioners and so forth. They deliver care and are in an increasing abundance in rural and urban settings. In addition, physical therapy, rehabilitation therapy, other medical specialties offer doctorates and I wonder how physicians and psychiatrists feel about that? Oh, gee, can they call themselves "doctor". really, that's your concern? Where is the outrage for getting a doctorate - and not being a physician. What about that pesky MD/DO debate? What about pharmacy doctorates? Are they "doctors". Hummmm? Does anyone think they care what they are called?

I wonder how the medical establishment let nurse practitioners into the health care system with such vast practice scopes in the first place? I am not sure you folks from the VA have noticed, but the rest of us out here in the real world can recognize the importance and contributions to be made through expanded patient access to care and continuing education for practitioners (which is really what the DBH is) as an asset. But if your objection is to people with new doctoral degrees (some in new and emerging fields) are calling themselves, I don't think the emerging professional education system or nomenclature needs to worry much about anything.

So your argument is that blurring the lines between professions and replacing all these expensive and over-trained doctors with nurse practitioners is a good thing? Then creating new degrees with less oversight so that they can call themselves doctors, too? This is called expanding access?

 

[Samarian]

I guess you'd have to remind yourself of what stimulates behavior change? Is it the intervention that only a scientist/practitioner can master, or the relationship between the patient and provider? Does an on-staff mental health provider in primary care succeed when providing an intervention to a suicidal patient that keeps the patient from needing inpatient care at $5,000 per day for the next 7 days? And instead is provided brief counseling until longer term care is arranged. Does a mental health provider succeed when they can help a newly diagnosed diabetic reduce their anxiety for needles so they can administer their insulin instead heading to the emergency room because of high blood sugar at a cost of $2,000. Does the program succeed if a severely mentally ill patient is referred to and ensured continuity of care to specialty medicine and a therapist for treatment instead of sending them away to follow up on their own? What about a mental health assessment in an exam room that leads to a diagnosis of a substance abuse disorder that the patient was unwilling to discuss with their PCP? Would the PCP care for that information? Or the PCP who just doesn't understand the patient's resistance to medication compliance, could a psychotherapist be useful here? These are all skills anybody with a license to practice psychotherapy should be able to garner are they not? This modality of treatment does not replace longer term counseling and therapy for those that need it, nor does it take a scientist to get good at it. My lack of "common clinical sense" tells me that those that need more intensive treatment shall get it, and I may be influential in destigmatizing mental illness and treatment so the patient actually accepts it. My lack of "clinical common sense" also guides treatment solutions of somatizers, and malingerers which physicians seem to really like for some reason? Your post describes someone that does not understand behavioral health, and is focusing on the treatment of chronic mental illness, in which case you are correct, that brief amount of treatment time is inappropriate, a fact that I thought readers with "clinical common sense" would understand and would not need explaining.

The field of psychology, specifically clinical doctorates is getting hammered by fierce competition from masters level providers (psychology, social work, counselors, LMFT, Nurse Practitioners, etc.) competing to deliver services with their own licenses. Tricare and Medicare are expanding to add LPC's/LMHC, and LMFT to provide clinical mental health services which was reserved primarily by psychologists and social workers, which is in response to the increasing need. Good clinical judgment and therapy can indeed be provided by a master's level license, and is by no means attained only by psychologists.

BTW, the vast majority of mental health providers in primary care and other health care locations will be filled by master's level clinicians under their own licenses, and not by PHD's and DBH's.

You and absolutely correct. The facts, and beloved data of the writers on this thread cannot logically deny those realities. However, we must recognize that some practitioners live in what might best be called a "professional bubble" of doing things the old way - mostly because that is the way THEY did it with little regard or respect for the larger systems and interests in play. The civilian and military federal agencies employing mental health professions still cling to older models - but as the communities and health systems employ and embrace the new models of professional training, that will change as well. SAMSHA embraces integrated care and appears to care less about which licensed professional does it. Nowhere on its website does it say..."only Ph.D psychologists or MD psychiatrists can do this". The DBH includes training in behavioral economics, patient outcome improvement, development of quality measures, system accountability and widening access to care in various models and settings. It just seems weird to me that anyone, especially a mental health professional, would see that as a threat or worthy of condemnation and ridicule. Why would you NOT endorse such improvements... unless, perhaps, you were afraid you could not do them? It is nice to see logic and common sense here instead of defensiveness and retreat into the corner of "show me the data" denial strategies.

 

[WisNeuro]

The civilian and military federal agencies employing mental health professions still cling to older models - but as the communities and health systems employ and embrace the new models of professional training, that will change as well.

The VA was actually way out in front of initiatives such as EBP roll-out and integrating mental health within primary care settings. But, keep going, I'm starting to enjoy the propoganda machine. You're doing a much better job of talking people out of this degree than we ever could.

 

[Samarian]

So your argument is that blurring the lines between professions and replacing all these expensive and over-trained doctors with nurse practitioners is a good thing? Then creating new degrees with less oversight so that they can call themselves doctors, too? This is called expanding access?

I am not sure how to respond to that. Are you aware of what is happening in primary care medicine in terms of the reduction in primary care providers? I am not in a position to judge the quality or integrity of primary care, but I can tell you that there are not enough primary care providers and that advanced clinical nursing education training has significantly expanded into the primary care realm to address that need. Some say that 80% of primary care will be provided by nurse practitioners within the next 10 years. I have no idea if that will happen, nor am I defending it, but the population of nurse owned and operated free standing primary care facilities seem to be very, very significant in my community. Physicians do not seem to mind at all. But that is just my observation. The demand for services has outpaced supplies and as such, the advancement of various forms of training and delivery of services in medicine and behavioral health have emerged - and appear to be thriving. Not sure why that is such a mystery to some, or why it should be resisted.

 

[Samarian]

I think you are sorely ignorant of the VA system. Once again, I would urge you to read some outcome and policy literature on the system before deriding it as a healthcare entity. But, from what I've seen so far, empirical data has little to do with your arguments. So, carry on.

Thank you, I will. I read the newspaper and have access to elements of the federal accountability reports posted in various places in the professional literature. The problems of the VA are no secret.

 

[WisNeuro]

Thank you, I will. I read the newspaper and have access to elements of the federal accountability reports posted in various places in the professional literature. The problems of the VA are no secret.

You may have access to things, but it is obvious that you have not read them. Once again, I would ask how many of those newspaper articles compare the VA to other large healthcare systems? Or how often they talk about the clinical outcomes data, which strongly favor the VA? Or patient satisfaction data, which also strongly favors the VA? The problem is healthcare in the US as a whole, not the VA. The VA has problems like everyone else, they just happen to do a lot more things right than the private sector. But, I guess if that doesn't fit the propaganda narrative, you can continue to pretend the data does not exist.

 

[erg923]

Underlying your whole cheeeleading of this program is the notion that primary care psych is such a unique practice speciality that it requires monumental and drastic changes to ones practice such that unique training program are helpful or nearly required to do it well. This is just complete bull****. Ive been doing this for years now. One needs to be a good psychological practitioner, skilled in evidence based intervention and practice, who works effiecently and communciates well with providers. Knowlege of health psychology and medical terminology helpful. The notion that it requires such a drastic paradigm shift in training is just ridiculous.

 

[erg923]

I am not sure you folks from the VA have noticed, but the rest of us out here in the real world can recognize the importance and contributions to be made through expanded patient access to care and continuing education for practitioners (which is really what the DBH is) as an asset.

Im not really sure what you mean (or how its related to the DBH degree), but the VA has been working hard on increasing access and provides CEUs and CMEs in house for its providers and phyicians at my facility. Im curious why you would feel able to speak to either of these issues when you have no contact with the VA system? How the hell do you know?

 

[Therapist4Chnge]

However, we must recognize that some practitioners live in what might best be called a "professional bubble" of doing things the old way - mostly because that is the way THEY did it with little regard or respect for the larger systems and interests in play.

Many of the posters who have responded to your propaganda ARE intimately involved in "larger systems and interests" and have to deal with multi-disciplinary teams and considerations on a daily basis. I'm in leadership for two (soon to be three) hospital-based multi-disc teams and deal with system level issues and staffing considerations across teams on a daily basis. Your description of…everything, is not what is happening in today's healthcare system.

The civilian and military federal agencies employing mental health professions still cling to older models -

The VA has led some of the more innovative changes in healthcare and EBT, you should definitely read up on those advances (some of which were led/influenced by clinical psychologists).

Samarian, are you a DBH student, licensed clinician, recruiter/ASU employee, etc?

 

[smalltownpsych]

I am not sure how to respond to that. Are you aware of what is happening in primary care medicine in terms of the reduction in primary care providers? I am not in a position to judge the quality or integrity of primary care, but I can tell you that there are not enough primary care providers and that advanced clinical nursing education training has significantly expanded into the primary care realm to address that need. Some say that 80% of primary care will be provided by nurse practitioners within the next 10 years. I have no idea if that will happen, nor am I defending it, but the population of nurse owned and operated free standing primary care facilities seem to be very, very significant in my community. Physicians do not seem to mind at all. But that is just my observation. The demand for services has outpaced supplies and as such, the advancement of various forms of training and delivery of services in medicine and behavioral health have emerged - and appear to be thriving. Not sure why that is such a mystery to some, or why it should be resisted.

Am I aware of what is happening in primary care medicine? I work in a medical setting with MDs, DOs, CRNAs, NPs, and PAs so I would say that is a yes. The physicians that I work with have various levels of concern about mid-level encroachment and opinions about independent practice. To say that physicians don't seem to mind at all is not accurate in the least.

Speaking as a psychologist, I believe that we are very concerned about quality of services that are provided to our patients. Personally, I have worked for various institutions that hire mid-levels and have used my expertise as a psychologist to oversee and ensure that the clinical services are of the highest caliber. My solid experience and training that are at the highest accreditation and licensure standards as a psychologist in research, assessment, outcome measures, program development and design, collaboration with other professionals, assessment and diagnosis, legal and ethical issues, and expertise in psychotherapy are why I was hired for these positions. I feel very strongly about what psychology brings to the table and why someone should hire a Licensed Psychologist. I would not recommend hiring an LPC with a DBH because I see it as an inferior pathway. You can call that professional jealousy, but I have always felt the same way about doctor nurses and I heard about them way before I became a psychologist.

 

[AcronymAllergy]

My initial reaction is that many/most/perhaps all of the skills acquired en route to the DBH seem to be those that licensed psychologists are already capable of providing, with the addition of doctoral-level licensing/care provision. So perhaps rather than creating a new degree path, we might be better served by simply further educating those involved in hiring that psychologists can do these things (which, as smalltownpsych has mentioned, many folks already know).

 

[PsyDr]

Aa: you might want to point out that while they might have some of the skills of psychologists, there are many that are missing (e.g., test administration, interpretation, etc). Don't think you meant anything but, however I would hate for someone to misinterpret and be misled.

As for being stuck in the old ways: 1) for treatments and testing this is inaccurate. Professionals stay up to date on current evidence for diagnosis and treatment. 2) for how professionals are trained, this is also inaccurate. Psychology training standards continue to change and have done so for decades. In neuropsychology, we changed the guidelines for education not too long ago. We recently changed internship. And we did so based off of evidence. Not wish washy anecdotes.

 

[AcronymAllergy]

Aa: you might want to point out that while they might have some of the skills of psychologists, there are many that are missing (e.g., test administration, interpretation, etc). Don't think you meant anything but, however I would hate for someone to misinterpret and be misled.

As for being stuck in the old ways: 1) for treatments and testing this is inaccurate. Professionals stay up to date on current evidence for diagnosis and treatment. 2) for how professionals are trained, this is also inaccurate. Psychology training standards continue to change and have done so for decades. In neuropsychology, we changed the guidelines for education not too long ago. We recently changed internship. And we did so based off of evidence. Not wish washy anecdotes.

Agreed; that's essentially what I meant when I said "doctoral-level care provision." I worded it a bit awkwardly, though, with the intended message being what you've said--psychologists can do most or all of the things mentioned and then some.

 

[Fan_of_Meehl]

[QUOTE="
nurse practitioners in general and psychiatric nurse practitioners specifically can prescribe medications as well as deliver various forms of therapy
[/QUOTE]

Um...no they can't--at least not any form of psychotherapy (beyond generic 'supportive therapy [which secretaries, janitors, and taxi cab drivers can provide as well]') that would pass muster. They may be out there (like four-leaf clovers) but in 20+ years of mental health care experience across multiple inpatient, outpatient, academic, medical school, general hospital etc. contexts I have NEVER come across a general or psychiatric nurse practitioner who did anything (or claimed to do anything) even resembling professional psychotherapeutic services.

 

[Fan_of_Meehl]

I'm guessing the ppl who sign up for an ONLINE degree are more likely to be from the "research is icky!" crowd.

Exactly.

And the 'research is icky!' sentiment in my experience is generally associated with a philosophical approach to treatment characterized by:

1) tendencies to cherry-pick evidence specifically to confirm (rather than honestly surveying evidence that could potentially falsify) one's preliminary diagnoses and clinical hypotheses
1a) unwillingness to measure symptom severity level over the course of treatment to inform case formulation and, generally, just checking to see if their interventions are helping or not
2) a bizarre mentality of superiority based on a pride in one's own ignorance of the research in one's area of practice
3) evasion of peer-review
4) a lack of clinical curiosity
5) intellectual insecurity

So, it's not so much the quality of 'finding stats difficult' or research methodology hard to understand that (as a trait) or the fact that a professional has not had time to read all the latest journal articles that makes him/her a bad psychologist...it's the 1-5 above (and probably many others) that makes for a bad psychologist.

I doubt that the new 'doctor of behavioral health' degree would do as well as currently established doctoral training programs in clinical psychology in properly socializing trainees (and, in truth, current programs aren't doing that well) not to do 1-5 above.

 

[smalltownpsych]

There are already doctors of behavioral health, they are called psychiatrists and psychologists. This online degree is a sham and I would never advise someone to pursue it.

 

[deleted343839]

[T]he new emergence of the Psychiatric Nurse Practitioner may have significant influence in professional training, employment and how care is delivered.

New emergence? Did you time warp back to the 1990s? Psychiatric nurse practitioners are not new. Maybe you're confused by the new Doctor of Nursing Practice (DNP) degree standard that has been proposed. Same core profession, new degree (maybe). As is true of all of the other professions you named that have recently adopted doctoral-level training... all but "behavioral health," of course. What do you behavioral health doctors call yourselves, anyway? (Pro tip: PharmD's prefer the term "clinical pharmacist" and some of them really do care.)

I am not sure you folks from the VA have noticed, but the rest of us out here in the real world can recognize the importance and contributions to be made through expanded patient access to care and continuing education for practitioners (which is really what the DBH is) as an asset.

Out here in the "real world"? Like, not in the trenches with the oldest and sickest patient population in the US? Oh... wait.

I'm in a non-VA medical medical center and no one here knows or cares what a DBH is either. The rule goes like this: if you're a licensed professional, and what you're being asked to do is within your scope of practice, then you get to do it. That goes for our psychiatrists, psychologists, social workers, psychiatric nurse practitioners, and professional counselors. If we need more access to mental health services, we can easily hire another one of the aforementioned as there are far more who want to work in our organization than we can afford to employ. If one of our providers wants to go get a Doctor of Unicorn Therapy, more power to them, but it doesn't change what they are fundamentally hired to do or their qualifications for doing it.

 

[Samarian]

New emergence? Did you time warp back to the 1990s? Psychiatric nurse practitioners are not new. Maybe you're confused by the new Doctor of Nursing Practice (DNP) degree standard that has been proposed. Same core profession, new degree (maybe). As is true of all of the other professions you named that have recently adopted doctoral-level training... all but "behavioral health," of course. What do you behavioral health doctors call yourselves, anyway? (Pro tip: PharmD's prefer the term "clinical pharmacist" and some of them really do care.)



Out here in the "real world"? Like, not in the trenches with the oldest and sickest patient population in the US? Oh... wait.

I'm in a non-VA medical medical center and no one here knows or cares what a DBH is either. The rule goes like this: if you're a licensed professional, and what you're being asked to do is within your scope of practice, then you get to do it. That goes for our psychiatrists, psychologists, social workers, psychiatric nurse practitioners, and professional counselors. If we need more access to mental health services, we can easily hire another one of the aforementioned as there are far more who want to work in our organization than we can afford to employ. If one of our providers wants to go get a Doctor of Unicorn Therapy, more power to them, but it doesn't change what they are fundamentally hired to do or their qualifications for doing it.

Citation: Source: Office of the Actuary, Veteran Population Projections Model (VetPop2011) tables 1L, 3L and 2L

The data on "oldest sickest" is simply not correct. The Veterans population, according to the citation above will drop by 35 % in the next 20-25 years. The average age of the veteran is trending much younger and much higher minority. In addition, those qualified for VA care is 1% or less than the total population of the United States. It is difficult to stay relevant in a demographic atmosphere like that. Agree- I do not think anyone should have any current reason to care about what a DBH is or know what it is intended to do. I don't think anyone knows - but they have a sense "change" is needed and they have crafted a process to address that need (as THEY see it). It is alarmingly like that pesky upstart Psy.D initiative that Nicholas Cummings promoted so many years ago. History DOES repeat itself.

One thing for sure, it is NOT a psychology degree. Second thing for sure is that licensed psychologists are not the only clown in the box licensed and sanctioned to treat mental disorders and behavioral conditions. Third thing for sure is that the tide of advanced training of all types continues to flourish and the practice boundaries of the "mental health professions" are more blurred and illustrated by concentric practice circles than ever before. Textbooks could be written on why that is- as the mental health "professions" appear to be one of the very few occupational "categories" to undergo such massive change in professional training and employment since the 1970's.

In terms of who is a "psychologist" - more and more I am reminded that if it looks like a duck, walks like a duck, well, its a duck. But before you spear me on this sentiment, I am NOT, repeat NOT defending the credibility, usefulness, economics, utilization, future or expansion or drum beating for or about any degree (especially the DBH) or, perhaps more important in this blog, attempting to disarm the psychology industry position of authority or power over the licensing and clinical practice they have traditionally enjoyed. Not in the least. The future has a way of defining and crafting its own destiny, so too with this debate.

You are so very correct about the "rule". Not sure licensure is the best way to assimilate comfort in quality practice - as I have seen such massive incompetence at within each of the categories you cite. You did not mention marital and family therapists,and quite frankly they spook me the most. I do not understand them as a "mental health profession" at all. But that is for another post -or for my interview on the Tonight Show or my article for The Atlantic. I am sure but its seems to me that if we talk about this stuff long enough it will spill over to the patients and (Zeus forbid, social media), and we can confuse them even more than we do now with all our titles, names, licenses and what THEY perceive as bloated egos. The days of defending professional purism without criticism have long passed. Readers note: Not an endorsement, just an observation.

Lastly, I remember the days when psychiatrists, psychologists and social workers were a cooperative, respectful and effective aggregate force working cooperatively for the benefit of the patient. We all got along. Quite well in fact. Cross professional (and quite unproductive in terms of outcome) toxic acrimony about training, self-placed titles and political influence seemed to be non-existent - back then. It was... well... wonderful. Perhaps we all knew our place. But not so much now. Pity.

 

[PsyDr]

so we are clear: you're not going to agree with anything negative about the degree. No one here is supportive of your position. So what is your overall goal here? It's not a productive debate.

 

[erg923]

In terms of who is a "psychologist" - more and more I am reminded that if it looks like a duck, walks like a duck, well, its a duck.

I'm not totally sure what this means, but it may very well be one of the dumbest statements I have ever heard on SDN.

 

[PsyDr]

I'm not totally sure what this means, but it may very well be one of the dumbest statements I have ever heard on SDN.

Dumber than attributing a Samarian statement made on 13:19, 9/20/2015 to an ornithologically naive PsyDr?

 

[smalltownpsych]

I'm not totally sure what this means, but it may very well be one of the dumbest statements I have ever heard on SDN.

Did he just call us quacks?

 

[erg923]

Dumber than attributing a Samarian statement made on 13:19, 9/20/2015 to an ornithologically naive PsyDr?

Dont know how that happened...

 

[ikibah]

HOW IS THIS THREAD STILL GOING.

 

[smalltownpsych]

Duck-ter Freud the very first Doctor of Behavioral Health.

 

[WisNeuro]

HOW IS THIS THREAD STILL GOING.

Because you can never beat a dead horse enough round these parts.

 

[PikminOC]

This is actually a great thread. Thanks for the discussion.

 

[smalltownpsych]

This is actually a great thread. Thanks for the discussion.

I am curious as to your perspective about this type of degree as a psychiatrist?

 

[Samarian]

Nurses get advanced degrees after they receive their license as an RN. Physicians Assistants get doctoral degrees after they get licensed as a PA. MBA's while not licensed, certainly go on for various types of business training and many get advanced or doctoral degrees. Occupational and physical therapists do the same - post licensure. I wonder if they also think that such advanced training is a farce? Where is the research or citations that indicate they get better pay or have more advanced skills that can be proven through a study? Do those that site the DBH as a needless and expensive excursion also condemn that process for themselves when THEY seek additional training or a broadening of their skill sets? The problem here is that "psychologists" want to compare it to some idealized training program that has only limited connection to it. The DBH is NOT a clinical training program and further attempts at trying to define it as such is pointless and comparing it to the training of clinical psychologists amounts to nothing. I simply do not know why anyone would do that. I know psychologists that get training in EMDR, CBT, psychoanalysis, degrees in family therapy, even pharmaceuticals (to be able to prescribe), but I hear no complaints about the "need" or citations for research, income prospects, cost of the training, or complaints about scholastic rigor when it is THEM that seeks such training. Of interest here is why such angst about an obscure little degree? The DBH is no game changer and anyone who thinks its does not grasp the utility and purpose of continuing or professional education post licensure for those who seek it - and furthermore do not much understand the educational concept of lifelong learning and the highly individualized professionally driven needs or interests within it. This little degree is nothing less than a formalized professional development program linked to a current topical interest (Integrated Care), now circulating among us. Actually, I think that definition sounds a great deal in how psychology itself got started. Come on people, things come from things. This is just another thing that came from something else. But I for one do not need to shoot at it, because I do not speak for the needs of others. This thing is not pretending to be anything other than what it is, and the value of it to those who seek it are individual, not professioanal, in terms of its scope. This degree does not further define anything other than what it defines for the bearer. None of us have the right to determine that value for another. Truly we do not.

 

[erg923]

I know psychologists that get training in EMDR, CBT, psychoanalysis, degrees in family therapy, even pharmaceuticals (to be able to prescribe), but I hear no complaints about the "need" or citations for research, income prospects, cost of the training, or complaints about scholastic rigor when it is THEM that seeks such training.

Then you dont read.

This little degree is nothing less than a formalized professional development program linked to a current topical interest (Integrated Care), now circulating among us.

Yes. Then it seems we all finally agree the degree is little more than a piece of paper that denotes the seeking of some "professional development." That is to say, subjectively satisfying but objectively worthless. As we all know how fantastic the literature says CEUs/CMEs (professional development) are at increasing our practice competencies, right?

Worthless to you. Worthless to me. Worthless to patients. Its existence then, reflects poorly on the field. Now, if some university program wants to charge near a hundred grand to do this... and there are people who think this a worthwhile thing, fine. Just don't ask me to respect any of those people. And don't expect me to believe some idiotic notion that the degree is providing some kind of "unique" training that the rest of the psychological training world is so behind on.

 

[clinpsyc87]

I swear to God this thread is a cross between a zombie-horse movie and those joke birthday candles that never blow out

 

[smalltownpsych]

The one thing I can say about this degree is it might be marginally better than an online parapsychology doctorate.

 

[WisNeuro]

The one thing I can say about this degree is it might be marginally better than an online parapsychology doctorate.

Nah, at least with the parapsychology degree, I can counsel ghosts. With the DBH degree I just have a mountain of debt and no new skills.

 

[smalltownpsych]

Nah, at least with the parapsychology degree, I can counsel ghosts. With the DBH degree I just have a mountain of debt and no new skills.

Can you do neuropsych assessments of ghosts, too? ...and would that be neuroparapsychology or paraneuropsychology?

 

[WisNeuro]

Can you do neuropsych assessments of ghosts, too? ...and would that be neuroparapsychology or paraneuropsychology?

Only if you also do a 2 year postdoc in paraneuropsychology. Through the Venkman Institute.

 

[smalltownpsych]

Only if you also do a 2 year postdoc in paraneuropsychology. Through the Venkman Institute.

 

[Therapist4Chnge]

I'm pretty sure if paraneuropsychology became a thing then we'd see another for-profit group pop up and offer online school paraneuropsychology certificates for all of the ghosts that haunt schools that have possible neurologic impairment…besides not having a brain.

 

[smalltownpsych]

I'm pretty sure if paraneuropsychology became a thing then we'd see another for-profit group pop up and offer online school paraneuropsychology certificates for all of the ghosts that haunt schools that have possible neurologic impairment…besides not having a brain.

Makes me wonder if there are ICD-10 codes for post-mortem conditions. Would anancephaly because of a genetic anomaly at birth be a different code than anancephaly due to being incorporeal? They have like 70,000 of them so it should be covered somewhere. Also, are there procedure codes for key parapsychological tasks such as ghost removal, exorcisms, communicating with the dead, administering a WAIS-IV?

 

[Samarian]

Then you dont read.



Yes. Then it seems we all finally agree the degree is little more than a piece of paper that denotes the seeking of some "professional development." That is to say, subjectively satisfying but objectively worthless. As we all know how fantastic the literature says CEUs/CMEs (professional development) are at increasing our practice competencies, right?

Worthless to you. Worthless to me. Worthless to patients. Its existence then, reflects poorly on the field. Now, if some university program wants to charge near a hundred grand to do this... and there are people who think this a worthwhile thing, fine. Just don't ask me to respect any of those people. And don't expect me to believe some idiotic notion that the degree is providing some kind of "unique" training that the rest of the psychological training world is so behind on.

Then its a good thing the ones who get those degrees will not be sad to be absent your respect. That seems like a good thing.