Using PHD/PsyD title in state not licensed in

[Shrink1982]

We will have to agree to disagree. If I have a doctorate, I have the right to refer to myself as Doctor. I would not do this if it is in a filed not related to mental health because I think that is tacky. Calling myself doctor is not misleading at all, whether it be a PsyD or PhD in social work.

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[erg923]

Calling myself doctor is not misleading at all.

Not to you...

 

[Shrink1982]

In what way is it misleading?

 

[erg923]

In what way is it misleading?

Exactly. Ask your clients.

 

[Shrink1982]

You make absolutely no sense. I have patients that call me doctor and I have to correct them. To me, this is nothing more than psychologist privilege. Let's hope after a few years in the profession you aren't so arrogant.

 

[smalltownpsych]

You make absolutely no sense. I have patients that call me doctor and I have to correct them. To me, this is nothing more than psychologist privilege. Let's hope after a few years in the profession you aren't so arrogant.

At our hospital, you would not be allowed to be referred to as doctor. They are very clear that the degree for which you hold licensure is the title that you use at work. We have a nurse practitioner with a DNP and she is not referred to as doctor. I agree with that policy and would always advocate for that to be the case in any place that I would work. In a private practice setting, it's between you and your clients and your licensing board and your own conscience.

 

[erg923]

You make absolutely no sense. I have patients that call me doctor and I have to correct them. To me, this is nothing more than psychologist privilege. Let's hope after a few years in the profession you aren't so arrogant.

I''ll do my best, doctor LCSW.

 

[Shrink1982]

I''ll do my best, doctor LCSW.

You really are a pompous dingus!!

 

[erg923]

n

You really are a pompous dingus!!

There's no need for name calling, Dr LCSW.

I think many well reasoned points were made about various institutional policies that are in place to prevent role confusion for patients. So, no, you dont have the right to call your self doctor just because you hold a doctorate, even if its in a MH field. You can call it "psychologist privledge" or whatever nonsense you like, doesnt matter.

 

[smalltownpsych]

I think he meant Dr. Pompus Dingus

 

[Shooter]

I disagree with you. Many clinical social workers have a PhD. Are you saying they should not be permitted to refer to themselves as "doctor" because they are licensed at the master's level? That makes no sense. Doctor is independent of a license. Now, if they have a doctorate in English, it seems to be in poor taste but I still don't see anything misleading. They are, in fact, a doctor. As long as the clinician makes it clear what their license is (which doesn't necessarily help as patients don't know the scope of practice of an LCSW versus an HSPP versus a psychiatrist). Besides, if you refer to yourself as Dr. Doe, many patients will assume you are a medical doctor. They don't know what degrees psychologists have.

I ALWAYS have and ALWAYS will use LCSW not only because it is required but I am proud of my license. It took a lot of work to get it. In my paperwork, I list I am a licensed clinical social worker and provide the state definition. I list the things I may be able to do for the client and the things I cannot. Which means, I don't do testing and I don't rx meds. There is nothing else that is strictly prohibited (and as I said in an earlier post, I can do testing but choose not to as I would have no idea what I was doing).

People get too hung up on the doctor title. Maybe because this is a forum for students, it is more of an issue but I have not witnessed this kind of arguing in the real world. When I first began reading posts on here a few years ago, I assumed psychologists and clinical social workers got along terribly. It gave me a skewed vision of reality. In the real world, I have not witnessed any of the nonsense that happens on these forums. Professionals respect each other as peers. No one goes around acting pissy because they have a PhD and someone without one is working in a similar position. I work for a large group practice with all mental health professionals and this kind of stuff just doesn't occur. If a master's level therapist gets a PhD (and we have a few) it is celebrated not ridiculed. It is like comparing who's package is bigger than who's......

...or whose ego is bigger than whose

 

[bmedclinic]

I disagree with you. Many clinical social workers have a PhD. Are you saying they should not be permitted to refer to themselves as "doctor" because they are licensed at the master's level? That makes no sense. Doctor is independent of a license. Now, if they have a doctorate in English, it seems to be in poor taste but I still don't see anything misleading. They are, in fact, a doctor. As long as the clinician makes it clear what their license is (which doesn't necessarily help as patients don't know the scope of practice of an LCSW versus an HSPP versus a psychiatrist). Besides, if you refer to yourself as Dr. Doe, many patients will assume you are a medical doctor. They don't know what degrees psychologists have.

For the sake of argument, using your words... if I get a PhD in English (which to me sounds awful, blegh) and then call myself Dr. with my patients, that's misleading. Explain why? Because it's not relevant to my degree? This is where the ambiguity exists, because now you're setting yourself up for the argument that "whatever is relevant is fine." For the sake of our patients, and the ethics of mental health, I'd argue this is a slippery slope best avoided. For that reason, I argue (as I said above) that you use the title related to the license that gives you the ability to practice in your state, and take all available options to clarify this for patients. It's perfectly fine for you to share with your patients that you also have a PsyD in Clinical Psychology, but I think it's misleading to assume that sharing that is akin to me sharing that I roast coffee (hobby level) or that you also have a PhD in English (hobby/ unrelated academic pursuit). I'm glad you're proud of your LCSW, I like LCSW's - and I'm glad you're an LCSW. But you're not operating as doctor in your capacity, so doing anything other than clarifying that You're Dr. Soandso, LCSW is misleading IMO. And it's misleading because you've skirted a chance to clarify your role. And that's not in your patient's best interest (see: Beneficence and Maleficence).

 

[Shooter]

For the sake of argument, using your words... if I get a PhD in English (which to me sounds awful, blegh) and then call myself Dr. with my patients, that's misleading. Explain why? Because it's not relevant to my degree? This is where the ambiguity exists, because now you're setting yourself up for the argument that "whatever is relevant is fine." For the sake of our patients, and the ethics of mental health, I'd argue this is a slippery slope best avoided. For that reason, I argue (as I said above) that you use the title related to the license that gives you the ability to practice in your state, and take all available options to clarify this for patients. It's perfectly fine for you to share with your patients that you also have a PsyD in Clinical Psychology, but I think it's misleading to assume that sharing that is akin to me sharing that I roast coffee (hobby level) or that you also have a PhD in English (hobby/ unrelated academic pursuit). I'm glad you're proud of your LCSW, I like LCSW's - and I'm glad you're an LCSW. But you're not operating as doctor in your capacity, so doing anything other than clarifying that You're Dr. Soandso, LCSW is misleading IMO. And it's misleading because you've skirted a chance to clarify your role. And that's not in your patient's best interest (see: Beneficence and Maleficence).

well said..and without all the previous unnecessary trolls

 

[ClinicalABA]

In many (most?) jurisdictions, our opinions on what we should or shouldn't call ourselves are largely irrelevant- there are actual, enforceable, regulations regarding how you can represent yourself to the public in the capacity of a helping professional. These regulations vary state to state and can be confusing. To be safe, if you are labeling yourself with a credential or degree that is either not directly related to what you are licensed as OR is beyond what is required for the license you have, you need to carefully review all licensure regulations and other state board publications to be sure what you are doing is permitted. It's not always straightforward, and regulations tend to err on the "protect the public from misrepresentation" side of things, so don't go by what you think is fair or ok. Any time a practitioner who is not licensed at the doctoral level (i.e. as a psychologist) represents him or herself to the public as "doctor," there is a very real chance that an enforceable (with fines, sanctions, etc.) rule of the jurisdiction is being violated. I'd call the respective boards in your state just to make sure.

Now for my opinion- reprsenting yourself to the public as "doctor" when you are not licensed at the doctoral level is disingenuous and deceptive. It relies on the potentially neediest as most uninformed participants in the the process to be aware of training standards and degree and licensure requirements to actually determine what you "are." I'd venture to say that my opinion is shared by many licensure boards and ethics codes, and is represented in many regulations and board decision histories.

 

[Shrink1982]

In many (most?) jurisdictions, our opinions on what we should or shouldn't call ourselves are largely irrelevant- there are actual, enforceable, regulations regarding how you can represent yourself to the public in the capacity of a helping professional. These regulations vary state to state and can be confusing. To be safe, if you are labeling yourself with a credential or degree that is either not directly related to what you are licensed as OR is beyond what is required for the license you have, you need to carefully review all licensure regulations and other state board publications to be sure what you are doing is permitted. It's not always straightforward, and regulations tend to err on the "protect the public from misrepresentation" side of things, so don't go by what you think is fair or ok. Any time a practitioner who is not licensed at the doctoral level (i.e. as a psychologist) represents him or herself to the public as "doctor," there is a very real chance that an enforceable (with fines, sanctions, etc.) rule of the jurisdiction is being violated. I'd call the respective boards in your state just to make sure.

Now for my opinion- reprsenting yourself to the public as "doctor" when you are not licensed at the doctoral level is disingenuous and deceptive. It relies on the potentially neediest as most uninformed participants in the the process to be aware of training standards and degree and licensure requirements to actually determine what you "are." I'd venture to say that my opinion is shared by many licensure boards and ethics codes, and is represented in many regulations and board decision histories.

I contacted both my state psychology board and behavioral health board and they both said there is nothing wrong with referring to myself as doctor if I have earned that degree (PsyD). They did stipulate that I should list my license with the PsyD. In order to become a licensed clinical social worker in my state it states, "Have a doctoral degree in social work or a masters in clinical social work approved by the CSWE." So, your point that an LCSW is not licensed at the doctoral level makes no sense. Doctor is an academic title which is not strictly related to a license. As long as the doctorate is related to the license in some way, I don't see the problem. What harm could possibly come. Having a doctorate in psychology or social work or a related filed states that one has additional training at the doctoral level and one has completed a dissertation. How do patients suffer from this? We can go round and round all day but you have failed to mention how an LCSW who decides to get MORE training and complete a dissertation can possibly harm a patient by correctly referring to oneself as doctor. Again, this sounds as if it has more to do with psychologist privilege than anything else. Provide proof that there is potential harm. My state obviously doesn't agree with you.

 

[Shrink1982]

Also, there are clinical social work doctorates (PhD, DSW) that are focused on advanced clinical practice. Why should these individuals be excluded from using the doctor title? how is this "disingenuous and deceptive?" They have a doctorate. It would be disingenuous to represent one as doctor if they did not have a doctorate. It would be deceptive to refer to oneself as doctor if the doctorate were in a field that did not advance the knowledge of the social worker. Having a doctorate tells the public the practitioner has training beyond the masters degree. Why is this a problem? Chicago has a very popular PhD program in clinical social work and there are quite a few PhD clinical social worker who are doctors. No problems from what I have heard.

 

[Shrink1982]

It seems that many of you are looking at things this way: masters level therapist is to psychologist as nurse is to MD. This is not a correct analogy. We are not the nurses of the mental health profession. We practice independently and do not rely on or report to psychologists. Sure, scope of practice is different but that has nothing to do with master's versus doctorate. Psychologists have doctorates and so do psychiatrists but scope of practice is different. I believe you are seeing things from a medical point of view (psychologists are doctors by virtue of their title, not their education). Doctor means "to teach." It is not limited to someone who is in a profession that requires a doctorate. Just because social work does not REQUIRE a doctorate does not mean social workers are excluded from receiving the education and becoming doctors in a social work capacity. This may be your opinion but I don't know of a single professional board that agrees with you.

 

[WisNeuro]

Meh, it'd be more of a personal thing for me. I wouldn't want to willfully pretend to be something I wasn't. But, if that's what makes you feel better about yourself at the end of the day, licensing boards are ok with it, and you're ok with misleading your patients, go nuts.

 

[bmedclinic]

This thread reminds me a lot of this:


Someone really wants to be doctor over thinking about the welfare of their patient first and foremost.

 

[ClinicalABA]

I contacted both my state psychology board and behavioral health board and they both said there is nothing wrong with referring to myself as doctor if I have earned that degree (PsyD).

Good work- It's important to check with the boards within the jurisdiction. Regs and policies can be confusing, and it's always best to clarify with the boards before you potentially commit a punishable error.

In order to become a licensed clinical social worker in my state it states, "Have a doctoral degree in social work or a masters in clinical social work approved by the CSWE."

Then, it would seem to be appropriate and permissible to use the title in your representation to the public.

So, your point that an LCSW is not licensed at the doctoral level makes no sense.

I never made that point?!? My points were, in order of importance:
1- check with your state board on such things if you have any questions on such issue
2- clinicians should be careful in how they represent themselves to the public so as to not potentially take advantage of a vulnerable population

Doctor is an academic title which is not strictly related to a license

This is not exactly true- there are licensure regulations and board decision in my state related to how you can/can't use the term "Doctor" when representing yourself to the public. I'm sure there are similar things in other states.

As long as the doctorate is related to the license in some way, I don't see the problem.

I generally agree with this statement, though I'd add that the degree should be related to the license in a "substantive" way, rather than just tangentially (e.g. a Ph.D. in experimental psych, say, who is licensed as an LMHC should not represent themselves as "doctor" in the context of their clinical work).

Having a doctorate in psychology or social work or a related filed states that one has additional training at the doctoral level and one has completed a dissertation.

There are many "doctorates in psychology" who have not completed a dissertation, but that's a topic for another thread!

How do patients suffer from this? We can go round and round all day but you have failed to mention how an LCSW who decides to get MORE training and complete a dissertation can possibly harm a patient by correctly referring to oneself as doctor. Again, this sounds as if it has more to do with psychologist privilege than anything else. Provide proof that there is potential harm.

The issue of how patients and potential patients are "harmed" by misrepresentation is actually a difficult topic and a good one for further discussion. You do seem to be trying to set up what seems like an overly personal battle with me here, and attributing a lot of things to me that I didn't say directly or didn't intend (for example, I never directly mention any specific license, but you repeatedly attribute to me comments about LCSWs). Please re-read my post. In the first section, I suggest checking with the board because the regs in each jurisdiction differ. I'm glad that you did so, and am happy for you that your doctoral training and degree are directly related to your license and you can appropriately use your degree designation in reference to your clinical work- heck, you did the extra work, presumably have a bigger clinical skill set, and should rightly be able to let potential and current clients know about that. I'm not sure why you're directing all the "psychologist privilege" invective in my direction. Being aggressive in the name of unneeded defensiveness is quite unflattering! I posited that misrepresenting oneself to the public is a kinda crappy thing to do. Do you disagree? If you're not doing that, no need to worry. You checked on it, and it doesn't seem that you are doing so by calling yourself "doctor".

My state obviously doesn't agree with you.

In the last section of my post, clearly label and state my opinion:

"Now for my opinion- representing yourself to the public as "doctor" when you are not licensed at the doctoral level is disingenuous and deceptive."

I'd venture to say that your state most probably agrees with this opinion, and it is reflected in the licensure regulations and board decision. It so happens that in your case, your doctoral training is substantively related to your clinical license, the licensure requirements specifically reference a doctoral degree, and the board says it's ok. I have no problem with that- seems totally appropriate and accurate to call yourself "doctor" in relationship to you licensed clinical work.

 

[Shrink1982]

Meh, it'd be more of a personal thing for me. I wouldn't want to willfully pretend to be something I wasn't. But, if that's what makes you feel better about yourself at the end of the day, licensing boards are ok with it, and you're ok with misleading your patients, go nuts.

How am I "pretending?" This is not a novel idea. Many masters licensed therapists go on to get doctorates and it is becoming more common. Are all these individuals "pretending?" I guess you have insight that the majority of us don't possess. Must be nice to be so enlightened while the rest of us go about our business intentionally deceiving our patients. I guess I should contact all my "pretend" professors and colleagues and let them know they are "pretend" doctors. Can't possibly be a "real doctor" unless one is a psychologist.

 

[Shrink1982]

Licensure exists to ensure minimum standards and protect the public. To use a doctor title without being licensed at the doctoral level does not ensure this checks and balances and has the potential to be misleading. No one is saying that you should not use the title in an academic context. It is the clinical context that matters here. When we present ourselves to patients, we are presenting ourselves as licensed providers. The use of "doctor" with only a Master's-level license can cause confusion and potentially mislead clients into believing that you have a higher license than you actually do.

That is nonsense. Do you really think that patients know what our education entails? A lot of things can be misleading but what does my not being licensed at the doctoral level take away from the clinical encounter? What harm is caused? What is the patient not getting that they would be getting if I was licensed at the doctoral level? If the social work profession started requiring a doctoral degree to become licensed, what would change with my ability to treat my patients? And what is a "higher license?" That is actually quite offensive. A psychologist does not have a higher license. A psychologist has no authority over a masters level therapist. Just because psychology chose to go from a masters to a doctoral in order to get licensed doesn't make it a "higher license." You really do think highly of yourself.

 

[ClinicalABA]

The use of "doctor" with only a Master's-level license can cause confusion and potentially mislead clients into believing that you have a higher license than you actually do.

However, if what he presented elsewhere in this thread is correct, the LCSW licensure standards in his jurisdiction require a "masters or doctorate" and he has checked with the appropriate boards regarding use of the the term "doctor" in his representations to the public. I'd say his use of the term "doctor" is appropriate to his training, related to his licensed work, and sanctioned by the board.

 

[Shrink1982]

At the heart of this lies entitlement. Psychologists have shunned masters level therapists for years. You want so badly to feel special that you truly believe that the doctor title makes you special and you don't want to share that with anyone you believe to be inferior. This has nothing to do with patient care and has everything to do with maintaining some status quo that doesn't even exist. You can't stand the fact that you aren't a physician and therefore need to feel empowered by looking down upon others who have worked quite hard to get where they are at. Your sense of superiority is pathetic. It is interesting because I have had this conversation on my different forums and yet SDN is the ONLY ONE that I got this kind of reaction. Perhaps it is because you are new to the profession or still students yourselves? The reality is state government doesn't agree with you and the federal government doesn't agree with you. I am not sure what branch of the military it is but if you enter with a doctorate in social work you enter as captain. With a masters, you enter as an officer. Seems only some psychologists have problems with doctoral level social workers.

 

[Shrink1982]

However, if what he presented elsewhere in this thread is correct, the LCSW licensure standards in his jurisdiction require a "masters or doctorate" and he has checked with the appropriate boards regarding use of the the term "doctor" in his representations to the public. I'd say his use of the term "doctor" is appropriate to his training, related to his licensed work, and sanctioned by the board.

Yes, what I have stated is correct.

 

[erg923]

Just because psychology chose to go from a masters to a doctoral in order to get licensed doesn't make it a "higher license."

Yes it does. At this point you're just being obstuse about it.

 

[erg923]

At the heart of this lies entitlement. Psychologists have shunned masters level therapists for years.

I think JT has something to profound to say about this topic.

 

[Shrink1982]

FYI: Indiana Statute

IC 25-23.6-5-2 Clinical social worker license requirements

Sec. 2. An individual who applies for a license as a clinical social worker must meet the following requirements: (1) Furnish satisfactory evidence to the board that the individual has received:

(A) a doctoral degree in social work from an eligible postsecondary educational institution that at the time of graduation was accredited by an accrediting agency recognized by the United States Department of Education; or
(B) at least a master's degree in social work from:

(i) an eligible postsecondary educational institution accredited or approved for candidacy by the Council on Social Work Education; or
(ii) a foreign school that has a program of study accredited by the Canadian Association of Schools of Social Work or a program equivalent to a program approved by the Council on Social Work Education by the Foreign Equivalency Determination Service of the Council on Social Work Education. The graduate program under this subdivision must have emphasized direct clinical or client health services as provided under section 3.1 of this chapter.

(2) Meet the clinical social work experience requirements under section 3.5 of this chapter.
(3) Furnish satisfactory evidence to the board that the individual does not have a conviction for a crime that has a direct bearing on the individual's ability to practice competently.
(4) Furnish satisfactory evidence to the board that the individual has not been the subject of a disciplinary action by a licensing or certification agency of another state or jurisdiction on the grounds that the individual was not able to practice as a social worker or clinical social worker without endangering the public.

17

(5) Pass an examination provided by the board.

(6) Pay a fee established by the board.

As added by P.L.186-1990, SEC.9. Amended by P.L.33-1993, SEC.41; P.L.255-1996, SEC.22; P.L.147-1997, SEC.48; P.L.2-2007, SEC.334.

 

[WisNeuro]

How is it not pretending? I'm a doctor, but when someone is having a medical emergency on a plane or whatnot, I don't jump to action. Not my scope of practice. I thin kit's about respecting your patients enough to be honest with them and not willfully misleading your credentials.

 

[Shrink1982]

Yes it does. At this point you're just being obstuse about it.

Talk about obtuse. You are the most arrogant individual I have encountered. I really don't care what you think.

 

[erg923]

I really don't care what you think.

Yes you do.

 

[Shrink1982]

How is it not pretending? I'm a doctor, but when someone is having a medical emergency on a plane or whatnot, I don't jump to action. Not my scope of practice. I thin kit's about respecting your patients enough to be honest with them and not willfully misleading your credentials.

You example makes no sense. I do not profess to act in any way that I am not qualified.

 

[WisNeuro]

Hey, like I said, go nuts and do want you want. It's your opinion. Just don't be surprised when a majority of others don't share your opinion.

 

[ClinicalABA]

The use of "doctor" with only a Master's-level license can cause confusion and potentially mislead clients into believing that you have a higher license than you actually do.

I have to agree with Shrink1982 that the choice of the words "only" and "higher" could be perceived as a little condescending, even if unintended. There is nothing inherently "lesser" about the work performed non-psychologist, independently licensed mental and behavioral health clinicians.

There seems to be three concurrent arguments going on in this thread:

1. Calling yourself a "Doctor" in relationship to how you present your clinical services to the public, when, in fact, your doctoral training is not required of and substantively related to your clinical license is potentially misleading and should be done with caution and within the guidelines set forth for doing so in the jurisdiction in which you are licensed.

-and-

2. Non-psychologist licensed mental and behavioral health clinicians should not call themselves doctor, as it might mislead the public into thinking you are better trained/credentialled than you are

-and-

3. Shrink1982 is not trained/credentialled appropriately to call himself "doctor" in the context of his licensed clinical work.

I would hope that most (all?) of us could see the merits of the first argument. The second one is rather extreme and there are likely varying opinions that one. As to the third argument, if what he says is true, both the licensure regs and the board itself have said its ok for him to refer to himself as "doctor."

 

[Shrink1982]

Didn't you say that you were getting a Psy.D. in psychology? If that's the case, I don't know what that has to do with your social work license or the above regulation (stipulating that a graduate degree in social work is required).

My point is certain individuals have stated clinical social work is a masters license. I am pointing out that this is not necessarily the case.

 

[ClinicalABA]

My point is certain individuals have stated clinical social work is a masters license. I am pointing out that this is not necessarily the case.

It may get a little more complicated if you get a Psy.D. and meet the educational and experience requirements for licensure as psychologist. In my state the board has issued a directive that if meet criteria for being a licensed psychologist but aren't licensed, then using the terms "doctor" or "Psy.D./Ph.D" is viewed as attempt to subvert the licensure regs and would be considered practicing psychology without a license.

 

[Shrink1982]

I have to agree with Shrink1982 that the choice of the words "only" and "higher" could be perceived as a little condescending, even if unintended. There is nothing inherently "lesser" about the work performed non-psychologist, independently licensed mental and behavioral health clinicians.

There seems to be three concurrent arguments going on in this thread:

1. Calling yourself a "Doctor" in relationship to how you present your clinical services to the public, when, in fact, your doctoral training is not required of and substantively related to your clinical license is potentially misleading and should be done with caution and within the guidelines set forth for doing so in the jurisdiction in which you are licensed.

-and-

2. Non-psychologist licensed mental and behavioral health clinicians should not call themselves doctor, as it might mislead the public into thinking you are better trained/credentialled than you are

-and-

3. Shrink1982 is not trained/credentialled appropriately to call himself "doctor" in the context of his licensed clinical work.

I would hope that most (all?) of us could see the merits of the first argument. The second one is rather extreme and there are likely varying opinions that one. As to the third argument, if what he says is true, both the licensure regs and the board itself have said its ok for him to refer to himself as "doctor."

I appreciate you looking at this objectively. Of course, what I say is true. I would not intentionally practice in any way that could jeopardize my license or harm patients. The only reason I seek a doctorate is to gain advanced knowledge that will help me work with my patients. The funny thing is, I would never ask my patients to refer to my as doctor as i find that tacky. However, I will defend that right until I am convinced it would be harmful to do so.

 

[Shrink1982]

It may get a little more complicated if you get a Psy.D. and meet the educational and experience requirements for licensure as psychologist. In my state the board has issued a directive that if meet criteria for being a licensed psychologist but aren't licensed, then using the terms "doctor" or "Psy.D./Ph.D" is viewed as attempt to subvert the licensure regs and would be considered practicing psychology without a license.

I asked the psychology board about this and they said there is no problem with my using the PsyD as I have obtained the degree. They suggested I list my LCSW. I do see how this can be confusing. However, as I have stated multiple times, I am transparent with my patients. They will know I am not a psychologist. I have patients that call me doctor now as they see me in a doctoral type of role but I always correct them. I had one patient who insisted on calling me doctor and I let him do so simply because I wasn't going to argue with him. Many of you assume I am out to mislead patients but that is not my intention. And I think that is what keeps me on here, defending my decision. I realize none of you know me personally but I put honestly and transparency above all else. The therapeutic relationship is quite important and one cannot build and maintain that without honesty and trust.

 

[Shrink1982]

Hey, like I said, go nuts and do want you want. It's your opinion. Just don't be surprised when a majority of others don't share your opinion.

Would love to know who this majority is. The majority of behavioral health providers are clinical social workers and I suspect most would agree with me. As to what psychologists think, doesn't matter.

 

[Shrink1982]

You can mislead without intending to mislead. That's the point I was making. I don't make any assumptions about your intentions.

And you can take steps to avoid misleading.

 

[Shrink1982]

Look, I recognize that having a PsyD will cause SOME to initially think I am a psychologist. However, that will be nipped in the bud during the first ten minutes of our conversation. I had a physician's office call me last week for a referral and when she ended the call she noted she would let the physician know she found a psychologist. This happened without me evening having a PsyD. The first thing I did was explain to her that I am not a psychologist and to ask the physician what services he is seeking for the patient beyond psychotherapy. I explained that I am an LCSW and if testing was needed, this is something I could not provide. She spoke with the physician and called me back saying that I would be fine. Some people really don't know what all the titles mean. It is up to us to correct them when they get it wrong, which is a good amount of the time.

 

[Shrink1982]

Exactly. Which is what I think a lot of people in this thread have been suggesting you think more about. There is no benefit to your patients for you to potentially allow them to think you are operating as a psychologist in the absence of such a license. The only benefit is to you.

NONE of my patients will think I am operating as a psychologist. I always go over my qualifications before we move forward with treatment.

 

[ClinicalABA]

Would love to know who this majority is. The majority of behavioral health providers are clinical social workers and I suspect most would agree with me. As to what psychologists think, doesn't matter.

One of the last times this issue came up on this site was related to this woman: http://www.drkarenruskin.com/- questionable doctoral degree program, really sells the whole "Doctor" title, and self proclaimed expert on a variety of topics. Unfairly or not, this is what often comes to mind when this topic is brought up- someone without appropriate training or licensure, using the "Doctor" label for self-promotion. It's why we are all a little protective of our credentials. Getting eligible and becoming licensed as a psychologist is a very long and expensive process, and it's understandable that we'd be a littler wary of potential "pretenders"!

As an aside, Dr. Karen needs to keep better abreast of licensure changes in her own jurisdiction. As of this past June, the practice of Behavior Analysis is subject to licensure in Massachusetts. In addition to being "America's relationship expert", she also lists herself as a "Behavior Analyst/Interventionist".

 

[Therapist4Chnge]

As long as the doctorate is related to the license in some way, I don't see the problem. What harm could possibly come. Having a doctorate in psychology or social work or a related filed states that one has additional training at the doctoral level and one has completed a dissertation. How do patients suffer from this? We can go round and round all day but you have failed to mention how an LCSW who decides to get MORE training and complete a dissertation can possibly harm a patient by correctly referring to oneself as doctor. Again, this sounds as if it has more to do with psychologist privilege than anything else. Provide proof that there is potential harm. My state obviously doesn't agree with you.

There are few ways this can be problematic, though the first thing I thought of was assessing risk of suicidality/homicidality. You have a doctorally-trained and doctorally-licensed provider (psychologist or psychiatrist) and you have a doctorally-trained and (mid-level) licensed provider. Both may do a S/H risk assessment, but training can vary GREATLY between providers. The former is guaranteed to have doctoral training specific to the licensure and clinical practice of the associated degree, while the latter does not. There are Ph.D.s in Social Work that focus on macro level research, policy, etc…yes those classes and dissertation were at the doctoral level, but how exact does the title and licensure guarantee the same level of training? What can be guaranteed is the minimum level of training for the licensure (i.e. the floor), though not the ceiling. The floor in this case is MS training, which as you have previously pointed out is different than doctoral training.

When evaluating for S/H I want someone who is best trained to do this evaluation. Most states specify training requirements and differentiate by licensure level and not necessarily title for this very reason (amongst other reasons). Yes there are psychologists who have Ph.D.s in I/O, Experimental Psych, etc…but they aren't licensed w/o equitable additional training. Some states allow for licensure at the MS level, though these tend to be psych-assistant positions w. supervision/oversight by a psychologist…so not quite the same scenario.

A second related scenario is someone comes to a clinician for a psychiatric evaluation.
Door #1: Doctor Smith…psychologist
Door #2: Doctor Jones…social worker

Dr. Smith does a clinical interview and administers formal psych testing (e.g. MMPI-2, etc).
Dr. Jones does a clinical interview and administers a couple of self-report questionnaires.

They both provided a "psychiatric eval" and go by the title doctor, but they have different licensures (and scopes of practice)….is the a difference in their evaluations? Which provider is at greater risk for misdiagnosing the case? Is one patient at a greater risk for misleading the evaluator and avoiding hospitalization?

These aren't perfect scenarios, but I think it gets at some of the issues.

 

[deleted343839]

At the heart of this lies entitlement. Psychologists have shunned masters level therapists for years. You want so badly to feel special that you truly believe that the doctor title makes you special and you don't want to share that with anyone you believe to be inferior. This has nothing to do with patient care and has everything to do with maintaining some status quo that doesn't even exist. You can't stand the fact that you aren't a physician and therefore need to feel empowered by looking down upon others who have worked quite hard to get where they are at.

Which psychologists are you talking about? I routinely refer my patients to social workers in the community who are excellent psychotherapists, and I have good working relationships with the social workers in my clinic. I work in a department where most of the other faculty are physicians, and I am thankful every day that I have my job and they have theirs. Admittedly, I was on the fence about med school versus graduate study long ago, but my experience working alongside physicians has validated my decision time and time again.

I suppose if you look hard enough you will find someone who matches the trope you are describing. I suppose I could have soured on the medical profession a long time ago as I have plenty of grist for that particular mill. But I find it more conducive to my well being and professional happiness to cultivate relationships with all kinds of professionals who care for patients, learn what I can from them, and nurture my identity as a psychologist.

You've gotten a lot of opinions here, most of which seem to be well intentioned even if they're not warm and fuzzy. We as psychologists look as these issues through the lens of our own ethics code, and to expect differently of us would be unfair. Why you would pursue a PsyD with no intention of becoming licensed to practice psychology is, quite frankly, beyond my comprehension, but I'm not here to examine your motives. If you are as transparent with your clients, your colleagues, and the general public as you are being here, then you are falling within the letter of the law, but you may still very well be looked upon as a [benign, somewhat confusing] outlier in the professional community.

My only concern is that, despite your transparency, clients who choose to take time out of their day and the money out of their pockets to see you may be vulnerable to a "bait-and-switch" situation once you disclose that the doctorate holder sitting across the room from them is not actually a licensed psychologist, unlike 95+ percent of the other PsyD holders who are in clinical practice. Some people won't care, others will, and some will cut their losses and enter treatment with you even though you're not the type of professional they expected. As others have suggested, it's really on you and your conscience as to whether you can be OK with that.

 

[smalltownpsych]

One of the last times this issue came up on this site was related to this woman: http://www.drkarenruskin.com/- questionable doctoral degree program, really sells the whole "Doctor" title, and self proclaimed expert on a variety of topics. Unfairly or not, this is what often comes to mind when this topic is brought up- someone without appropriate training or licensure, using the "Doctor" label for self-promotion. It's why we are all a little protective of our credentials. Getting eligible and becoming licensed as a psychologist is a very long and expensive process, and it's understandable that we'd be a littler wary of potential "pretenders"!

As an aside, Dr. Karen needs to keep better abreast of licensure changes in her own jurisdiction. As of this past June, the practice of Behavior Analysis is subject to licensure in Massachusetts. In addition to being "America's relationship expert", she also lists herself as a "Behavior Analyst/Interventionist".

What? I thought I was America's relationship expert! My wife likes to tell me I'm not that good at them though whenever she is mad at me.
Figured I would add a bit of tangential levity to the debate. Please resume.

 

[Shrink1982]

One of the last times this issue came up on this site was related to this woman: http://www.drkarenruskin.com/- questionable doctoral degree program, really sells the whole "Doctor" title, and self proclaimed expert on a variety of topics. Unfairly or not, this is what often comes to mind when this topic is brought up- someone without appropriate training or licensure, using the "Doctor" label for self-promotion. It's why we are all a little protective of our credentials. Getting eligible and becoming licensed as a psychologist is a very long and expensive process, and it's understandable that we'd be a littler wary of potential "pretenders"!

As an aside, Dr. Karen needs to keep better abreast of licensure changes in her own jurisdiction. As of this past June, the practice of Behavior Analysis is subject to licensure in Massachusetts. In addition to being "America's relationship expert", she also lists herself as a "Behavior Analyst/Interventionist".

Ok, I'm a patient. I'm on your website that lists you as a Psy.D. in psychology with an LCSW. I don't know what license does what, but it looks like you have a doctorate in psychology so that must mean you're a psychologist (which is what I'm looking for), so I call and set up an appointment with you. Even if you tell me at our first visit that I'm wrong, you have now potentially wasted my time and money, in addition to delayed the start of my treatment if I now need to go look for the type of provider I was wanting to begin with (which I would categorize as a type of harm).

If the use of a title does not benefit your patients by helping them to understand your role and scope of practice, then it may be best (and most transparent) to not use it.

People will assume I am a psychologist whether or not I have a PsyD - happens all the time. Sorry if the individual that cannot read the website and comprehend what it states but if someone doesn't understand the difference between LCSW and having a doctoral degree in psychology, they probably are not all that picky on what type of provider they see.

 

[WisNeuro]

So, because some have assumed so in the past, all will assume so? So, who cares about future patient's possible misinterpretations and possible wasted time? I'm sorry man, but that is a very disrespectful way to treat patients.

 

[Therapist4Chnge]

People will assume I am a psychologist whether or not I have a PsyD - happens all the time. Sorry if the individual that cannot read the website and comprehend what it states but if someone doesn't understand the difference between LCSW and having a doctoral degree in psychology, they probably are not all that picky on what type of provider they see.

…though they still need all of the information presented to them clearly and in a way that they understand so they can make an informed decision about what care they choose to seek. I'm not implying that you don't do this with every patient, I'm merely pointing out that even if they aren't picky that doesn't absolve you from clearly delineating your training, role, etc. Unfortunately there are many clinicians out there that don't make an adequate effort to do this and as a result many of us are touchy when it comes to clearly stating title, scope of practice, etc. I do it with every patient I see because more frequently than not they have no idea what I actually do, my training, nor the purpose of their visit with me.

 

[Shrink1982]

There are few ways this can be problematic, though the first thing I thought of was assessing risk of suicidality/homicidality. You have a doctorally-trained and doctorally-licensed provider (psychologist or psychiatrist) and you have a doctorally-trained and (mid-level) licensed provider. Both may do a S/H risk assessment, but training can vary GREATLY between providers. The former is guaranteed to have doctoral training specific to the licensure and clinical practice of the associated degree, while the latter does not. There are Ph.D.s in Social Work that focus on macro level research, policy, etc…yes those classes and dissertation were at the doctoral level, but how exact does the title and licensure guarantee the same level of training? What can be guaranteed is the minimum level of training for the licensure (i.e. the floor), though not the ceiling. The floor in this case is MS training, which as you have previously pointed out is different than doctoral training.

When evaluating for S/H I want someone who is best trained to do this evaluation. Most states specify training requirements and differentiate by licensure level and not necessarily title for this very reason (amongst other reasons). Yes there are psychologists who have Ph.D.s in I/O, Experimental Psych, etc…but they aren't licensed w/o equitable additional training. Some states allow for licensure at the MS level, though these tend to be psych-assistant positions w. supervision/oversight by a psychologist…so not quite the same scenario.

A second related scenario is someone comes to a clinician for a psychiatric evaluation.
Door #1: Doctor Smith…psychologist
Door #2: Doctor Jones…social worker

Dr. Smith does a clinical interview and administers formal psych testing (e.g. MMPI-2, etc).
Dr. Jones does a clinical interview and administers a couple of self-report questionnaires.

They both provided a "psychiatric eval" and go by the title doctor, but they have different licensures (and scopes of practice)….is the a difference in their evaluations? Which provider is at greater risk for misdiagnosing the case? Is one patient at a greater risk for misleading the evaluator and avoiding hospitalization?

These aren't perfect scenarios, but I think it gets at some of the issues.

I am more than qualified to provide a S/H assessment, so I don't really see what this has to do with the doctor title.
And your second point is lost as well. This could happen whether or not I have a doctorate. And I don't know too many psychologist that utilize an MMPI-2 on a regular basis. I work for a large group practice and the psychologists don't do any psychological testing unless it is an unusual circumstance. I really have totally missed your point.