Requirement for psychotherapy

[icalz]

So I'm currently a PGY2 in psychiatry and I've had this question that I've posed to multiple attendings, including program director, with wildly varying answers. My question is, as an MD who is not yet licensed (except for the PIT), can I practice psychotherapy? Or is a physician's license required for this? I'm sure the answer may vary from state to state, and I would be interested in hearing what states might require the MD only and not necessarily the license. If and MD is required to have a physician's license to practice psychotherapy, with no med management involved, why would that be? Thanks for any illumination.

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[nitemagi]

Therapy would probably be considered a medical or psychological intervention. It's illegal to practice medicine without a license, or psychology without a license, I do believe. This may be part of the misunderstanding that therapy is just "talking to people," in which case why would anyone need a license? I presume you're working under your hospital's license, which is fine for doing therapy then (with supervision).

 

[smalltownpsych]

Just cause I have an hour to kill before our medical staff meeting, I'll throw an answer out for this. As a psychiatry resident, you would begin practicing psychotherapy under the supervision of either attendings or senior residents, not sure of the logistics of that and I'm sure it varies from site to site. The main issue is really about competency and scope of practice rather than legality. Without supervised clinical training, no one from any background is assumed to be competent to independently practice psychotherapy regardless of educational background.

 

[nitemagi]

So it looks like Texas has it's own licensing process. I'd go to your PD to discuss what the scope includes, but since ACGME requires developing competency in multiple therapies, I'm guessing the answer is yes (again, with supervision).

 

[smalltownpsych]

So it looks like Texas has it's own licensing process. I'd go to your PD to discuss what the scope includes, but since ACGME requires developing competency in multiple therapies, I'm guessing the answer is yes (again, with supervision).

Also, in Texas the 5th circuit recently ruled that anyone can call themselves a psychologist because psychotherapy is just "talking to people". http://forums.studentdoctor.net/threads/5th-circuit-ruling-about-psychology-license.1191264/
Regardless of that, the OP still wants to follow standard training practices because when a patient dies or kills someone, then the courts have clearly ruled in the past that we are responsible for more than just "talking to people".

 

[PikminOC]

Who is to say those other people won't be responsible for those things also

 

[smalltownpsych]

Who is to say those other people won't be responsible for those things also

You think that courts will hold the life coaches responsible or liable for much of anything? Whatever happened to the "therapists" who did the rebirthing therapy and killed a kid? I worked in the troubled teen industry which was a hotbed of unlicensed therapists with a trail of damaged kids, and a few deaths, and nothing happened to them either.

 

[PikminOC]

http://ktla.com/2016/04/07/4-social...f-8-year-old-gabriel-fernandez-l-a-county-da/
4 Social Workers Charged With Child Abuse in Torture Death of 8-Year-Old Gabriel Fernandez: DA

 

[smalltownpsych]

I just googled the rebirthing thing and saw that the two responsible were sentenced to 16 years for child abuse.
Although the licensed professionals are usually held to a higher standard which is as it should be.