Assessment Training: MA/MS, Doctoral, and Scope of Practice

[Therapist4Chnge]

I'm in Washington. In order to be licensed here, you have to have about 2 1/2 years post-Masters supervised experience (I think it's 3,000 hours). After that, the licensure opens you up for many positions, including supervision. However, I don't think I can do assessments or testing without a doctorate. Does anyone know differently?

There are some sketchy loopholes out there for MA/MS level people "with proper training" to administer assessments. It varies by state, but people are out there doing it....with mixed results.

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[PsyDr]

a doctorate would:

1) increase the things you could do. this would include assessment, and a wide variety of other professional activities.

2) increase your revenue. MA providers get reimbursed less

3) i would be very wary of any program offering to accept all of your 2 year education. i would imagine they might accept a few hours, but CoA has limits on how many this can be. 3 years is simply unreasonable. 2 years practica, 1 yr internship. dissertation. plus class work. 4 years even sounds like a stretch.

4) i have no idea why a MA level person would want to test. they simply do not have the training for it. practicing outside one's scope of knowledge is a violation of APA ethics. there is no way to bill for it in most states. additionally they are opening themselves up to a wide variety of malpractice suits.

 

[Therapist4Chnge]

4) i have no idea why a MA level person would want to test. they simply do not have the training for it. practicing outside one's scope of knowledge is a violation of APA ethics. there is no way to bill for it in most states. additionally they are opening themselves up to a wide variety of malpractice suits.

I agree....but people are still doing it.

 

[Psych1212]

4) i have no idea why a MA level person would want to test. they simply do not have the training for it. practicing outside one's scope of knowledge is a violation of APA ethics. there is no way to bill for it in most states. additionally they are opening themselves up to a wide variety of malpractice suits.

I agree to an extent, but it depends on the situation.

I have an M.S. in clinical, and when looking for work I stumbled into testing. I was hired by a state agency to administer a standard assessment battery including the WISC, the WRAT, and the MMPI. This is how I have supported myself for the past two years while I waited for my life circumstances to change so that I could apply to grad school. I was trained on the WISC, WRAT, and MMPI in graduate school as part of my Masters, and I was required to undergo agency training before starting work in order to ensure that I was competent. I am also required to accrue 30 hours of CE credits each year related to testing and/or the population I work with.

Every report that I write has to be read and signed by my supervisor, who is a licensed psychologist (and who takes a nice cut off the top j/k).

In my situation, I administer a very specific testing battery time and time again. Not only do I feel qualified to do so, but I feel that I am much more competent in this job as a MS-level clinician than I would be admininstering therapeutic services.

So depending on the situation, I think Masters-level therapists can contribute in areas of testing. But certain precautions need to be taken, and there doesn't seem to be a system of checks and balances in place.

 

[PsyDr]

wait. let me clarify: i believfe that MA level people can be effective PSYCHOMETRICIANS. they are whollly unqualified to interpret data.


you basically had one semester of testing classes. you then obtained a job administering tests. no license test. someone then allows you to interpret these tests. basically there is no quality assurance for the public.

compare to the minimum of 3-4 semesters of assessment classes, followed by a minimum of a year or supervised service in assessment alone before a doctoral candidate, followed by another full 2000 hr internship which has an assessment requirement, followed by a national test. before we can independently do anything. then wrap in a basic component of assessment into every other class.

feeling qualified has nothing to do with being qualified. kruger has something to say about this:

http://www.apa.org/journals/features/psp7761121.pdf


as for your point that you have done something repeatedly: again this is on the job training. taken in its extreme, we could just allow joe blow GED to read a bunch of psych book, buy a few tests and go at it. we require a very specific route for education because it is necessary to understand what you are doing. can you explain why 65 is an important number on the mmpi? how did that number come to be important? what is the false/true positive rates for these instruments? how is a normal curve obtained from the sample? how are those SS derived?

 

[Therapist4Chnge]

My reference was for independent administration of psychological testing. Not too long ago Montana had a proposal (SB 235) that allowed for MA/MS level people to advertise that they can do psychological testing, as they already had a loophole law on the books to allow them to conduct psychological assessments if they were "properly trained." Other states have similar laws on the books for people to conduct assessments.

 

[Psych1212]

wait. let me clarify: i believfe that MA level people can be effective PSYCHOMETRICIANS. they are whollly unqualified to interpret data.


you basically had one semester of testing classes. you then obtained a job administering tests. no license test. someone then allows you to interpret these tests. basically there is no quality assurance for the public.

compare to the minimum of 3-4 semesters of assessment classes, followed by a minimum of a year or supervised service in assessment alone before a doctoral candidate, followed by another full 2000 hr internship which has an assessment requirement, followed by a national test. before we can independently do anything. then wrap in a basic component of assessment into every other class.

feeling qualified has nothing to do with being qualified. kruger has something to say about this:

http://www.apa.org/journals/features/psp7761121.pdf


as for your point that you have done something repeatedly: again this is on the job training. taken in its extreme, we could just allow joe blow GED to read a bunch of psych book, buy a few tests and go at it. we require a very specific route for education because it is necessary to understand what you are doing. can you explain why 65 is an important number on the mmpi? how did that number come to be important? what is the false/true positive rates for these instruments? how is a normal curve obtained from the sample? how are those SS derived?

Actually, I had 3 assessment courses during 3 different semesters....Two required and one elective. I also completed supervised assessments in my practica, although obviously not to the extent of my doctoral counterparts. Additionally, every report is read and signed off on by my supervisor, who is a licensed psychologist. If there is anything he disagrees with or doesn't understand, we discuss it before he signs off. Thankfully for me, the fully licensed psychologists who actually observe my work seem to think I am perfectly capable of doing the job.

While I have my own LLP and my own insurance, his license and supervision are necessary in order for this to occur. That is the state's idea of "quality assurance." Legally, my reports are worthless until an LP signs off on them.

In the eyes of the state, this is a necessary role that needs to be filled. There simply are not enough doctoral level psychologists in the state willing to do testing full time for 35k per year.

I'm not interested in justifying my competency here. I do that with every report and every time that I am evaluated by a supervisor (which is frequently). My intent was to point out that my opinion on the issue has changed over time, as I now believe that Masters level clinicians can contribute in the manner I described above, provided they are in the proper setting and that the necessary precautions are taken.

My reference was for independent administration of psychological testing. Not too long ago Montana had a proposal (SB 235) that allowed for MA/MS level people to advertise that they can do psychological testing, as they already had a loophole law on the books to allow them to conduct psychological assessments if they were "properly trained." Other states have similar laws on the books for people to conduct assessments.

I'd completely agree. Even if your opinion was that I'm completely unqualified to do my job, that would be fine too.

 

[Ollie123]

compare to the minimum of 3-4 semesters of assessment classes, followed by a minimum of a year or supervised service in assessment alone before a doctoral candidate, followed by another full 2000 hr internship which has an assessment requirement, followed by a national test.

Though I absolutely agree with the overall gist of your post, just want to point out that 3-4 classes is definitely not a "minimum" for an APA program. I'll probably be taking 2 since I want to take a neuropsych assessment course, but I could graduate having only taken 1. I don't think this program is out of the ordinary on that front either - many of the programs I looked into only require 1-2 assessment courses.

That said, we obviously spend tons of time outside of classes learning about assessments through supervision, practica, other lectures, etc.

 

[Therapist4Chnge]

Though I absolutely agree with the overall gist of your post, just want to point out that 3-4 classes is definitely not a "minimum" for an APA program. I'll probably be taking 2 since I want to take a neuropsych assessment course, but I could graduate having only taken 1. I don't think this program is out of the ordinary on that front either - many of the programs I looked into only require 1-2 assessment courses.

That said, we obviously spend tons of time outside of classes learning about assessments through supervision, practica, other lectures, etc.

Really?

My program requires 6, and more for neuropsych people. I remember being on internship and some people didn't have that much experience (some intelligence assessment, maybe some experience with the MMPI-2, MCMI, but that was about it), which seems pretty backwards, considering it is an important aspect of our work.

 

[Eruca]

To be sort of blunt, who cares about being able or competent to do assessments if you have to have them supervised (forever) and do all the work for less pay?? I'm a 5th year clinical student, which means I have my Masters. I conduct assessments (WAIS, MMPI, SCID, etc) as part of my practicum. So I guess I'm a masters level clinician doing assessments. I feel relatively competent, with room to learn/grow, but I guess the ultimate goal remains.. I certainly don't want to be trained & feel competent doing something, and not at some point be able to do it independently.

Regarding T4C's above post, although assessment is an important aspect of our training - I also think it really depends on what priority you're going to give it in your professional career. Just because I was trained to do an assessment doesn't mean I will continue to do so. I can do DSM diagnostic assessments with ease, but would refer out for neuropsych. Programs seem to really vary on this issue. Some are extremely assessment heavy, while others are minimally so.

I do agree though, assessment is one of the last bastions of doctoral level clinical work, and I think that is warranted. People seem to accept the medical model without argument, e.g., Nurses don't have the same training as nurse practitioners, and NPs don't have the same training as MDs. If you want full-spectrum independence and diversity of options, you'll have to shell out the time, energy, & money for a doctorate level degree.

 

[Psych1212]

To be sort of blunt, who cares about being able or competent to do assessments if you have to have them supervised (forever) and do all the work for less pay?? I'm a 5th year clinical student, which means I have my Masters. I conduct assessments (WAIS, MMPI, SCID, etc) as part of my practicum. So I guess I'm a masters level clinician doing assessments. I feel relatively competent, with room to learn/grow, but I guess the ultimate goal remains.. I certainly don't want to be trained & feel competent doing something, and not at some point be able to do it independently.

If you want full-spectrum independence and diversity of options, you'll have to shell out the time, energy, & money for a doctorate level degree.

Agreed. I'll be starting my doctoral program in a few months, and I never intended on having to take time off and work. Thankfully, my significant other is finishing up her degree and we can finally relocate.

Coming out of graduate school I was much more conservative regarding this issue. During the past three years working out in the community I learned that there are some instances where masters-level clinicians can do some really good work and make a much needed contribution. I believe that some of these positions involve testing, and I believe that the masters-level clinician can perform them well...provided that they have adequate training and supervision. However, I don't believe in giving someone at my level free reign to simply do any and all testing or to do it independently. The problem that I see is that there is little-to-no effort being made to determine the competency of quite a bit of people doing testing....both with masters and doctoral degrees.


I feel like I may have inadvertently steered the conversation away from the original topic, which involved someone asking for opinions or help make a decision. Your comments above could possibly bring things back around.

In response to the OP, I would definitely considering pursuing the Psy.D. I think that the opportunities and independence that it would provide would be well worth the time and resources spent in order to obtain it. In addition to more diverse opportunities, professional independence, and increased salary, you will simply be better at everything that you do for the rest of your career.

I would focus more on getting into a solid (possibly well-funded) program as opposed to how many credits I could transfer or how much longer it would take. I'd sacrifice that year or two for the superior training and tuition assistance that would continue to benefit me for the rest of my career, not to mention how much better your time in grad school will be if you feel like a good fit for the program.

 

[Ollie123]

Really?

My program requires 6, and more for neuropsych people. I remember being on internship and some people didn't have that much experience (some intelligence assessment, maybe some experience with the MMPI-2, MCMI, but that was about it), which seems pretty backwards, considering it is an important aspect of our work.

Yup, though keep in mind we are a research heavy program that strongly de-emphasizes coursework in general. I think 1-2 is the standard for these programs...like I said pretty much every program I applied to only had 1-2 with maybe a few more optional ones, and these were all very top-notch schools (which is why I got so many rejection letters ). I can't imagine 6 assessment courses...I'll barely make it to 6 adding together courses on assessment, intervention, and clinical seminars.

Admittedly those 1-2 courses are usually quite jam-packed We've been consistently placing very well on internships (Brown, Hopkins, Yale, etc.) so it doesn't seem to be hampering us too much. Realistically, very few graduates will be doing more than a select few assessments necessary for their research line, so I'm not sure it would be all that beneficial for there to be more.

 

[PsyDr]

eruca: this is the most callous, terrible thing i have ever heard on this board. i care. the training requirements are indicated to protect the public from unskilled laborers messing up and giving people incorrect diagnoses. hell, states actually thought this was important enough to create public health laws. so, yeah, i care. i would care if a person misdiagnosed a normal child as autistic, given the high cost of treatment and associated terrible quality of life for the entire family. but perhaps you think it is ok to assign someone to a treatment condition that can take tens of thousands of dollars when no treatment is indicated. ever seen an unsupervised ADOS? i would also care if a person was diagnosed with DAT and it was later discovered to be a tumor. these minimal education requirements are for the good of the public. even the test publishers usually have minimum requirements and they make money by selling to as many as possible.

again, feeling competent has nothing to do with being competent.


ollie: man, the minimum we could do was 3 semesters of classes. 6 if you count the assessment practicum classes.

i ended up taking a lot more.

 

[Ollie123]

ollie: man, the minimum we could do was 3 semesters of classes. 6 if you count the assessment practicum classes.

I always have mixed feelings on the matter. There's a part of me that wants to take every course offered and than 500 more that aren't, and there's a part of me that recognizes that classroom learning is inherently inefficient and can provide a foundation at best, so any classwork is a waste of time relative to what I accomplish left to my own devices and then being closely supervised/consulting with folks.

For now, I've settled on learning the groundwork and what underlies good assessment techniques - its really very similar to research methodology so there is a great deal of overlap. I'll be extremely familiar with the SCID and PAI. Everyone who comes through the school clinic gets a PAI, and at least a few SCID modules are given a large portion of the time anyways, for obvious reasons. Realistically, the SCID is probably the only assessment I'll end up doing regularly (aside from things like the BDI, and suicide assessments if any flags come up), and even the SCID will primarily be a screening tool where I'm only attempting to rule out comorbidity. Anything beyond that I'll have to rely on collaboration or funding to hire folks. I'll have more classes in methodology, statistics, grant writing, and general science than I will on clinical issues. My hope is that if I'm in a good psych department or medical center, I can gather a team to make that happen if it becomes necessary. I'd much rather be in the background writing grants and paying others to do assessments than doing them myself anyways. Though I have to admit despite by research-y nature, interpretation is enjoyable

I assume internship will fill many gaps since most folks on my path will not have huge amounts of clinical experience and the sorts of internships we go to tend to know this and expect to do a fair amount of training (or so I've heard from people anyways), but time will tell.

Anyways, I've side-tracked this enough, I originally was just trying to point out that 4 assessment courses is a LOT more than many schools require, including some of the best in the country (Yale, Minnesota, Washington, UCLA, etc.).

PS - I think Eruca's point was not that its okay to be incompetent, just that if you ARE able to provide competent assessment, it would suck to not receive any benefits from doing so beyond the sheer joy of administering a SCID

 

[Eruca]

eruca: this is the most callous, terrible thing i have ever heard on this board. i care. the training requirements are indicated to protect the public from unskilled laborers messing up and giving people incorrect diagnoses. hell, states actually thought this was important enough to create public health laws. so, yeah, i care. i would care if a person misdiagnosed a normal child as autistic, given the high cost of treatment and associated terrible quality of life for the entire family. but perhaps you think it is ok to assign someone to a treatment condition that can take tens of thousands of dollars when no treatment is indicated. ever seen an unsupervised ADOS? i would also care if a person was diagnosed with DAT and it was later discovered to be a tumor. these minimal education requirements are for the good of the public. even the test publishers usually have minimum requirements and they make money by selling to as many as possible.

Wow, PSYDR. I think you took my comment and projected quite an exaggerated interpretation of that one little line. And I've never had anyone say that something I said was "calloused".. not in my whole life.

I'm sorry if you misunderstood, or if my words misled others. Please go back and read the whole context of my post. Of course I care whether people receive the correct diagnoses. ?? Geez, that is an awful allegation. I actually teach assessment & diagnoses to beginning clinical students, and I preach often about accuracy, conservative diagnosing, and sensitivity to labels.

What I was saying was, why bother getting trained and being competent doing assessments (as one poster did at a masters-level) and then not be able to work with that competence independently? My whole point was that if one wanted to do assessments as part of their career, then they should get their doctorate. I was not saying that competence in assessments does not matter, or who cares about competence. The fact that you got all that from my post baffles me to be honest.

This was the exact line you're referring to - I will bold the 2nd half of the sentence in case you got halfway through and neglected to read the rest. I was not saying 'who cares about competency', I was saying, 'who care's about becoming competent in something you won't actually be able to practice as an independent professional (e.g., with a Masters only).'

To be sort of blunt, who cares about being able or competent to do assessments if you have to have them supervised (forever) and do all the work for less pay??

 

[Eruca]

PS - I think Eruca's point was not that its okay to be incompetent, just that if you ARE able to provide competent assessment, it would suck to not receive any benefits from doing so beyond the sheer joy of administering a SCID

Thank you, Ollie123. That is exactly what I was saying.

 

[PsyDr]

eruca

i read the whole post. your post specifically states "who cares about being able or competent to do assessments if you have to have them supervised (forever)". sounds pretty straightforward to me. i don't believe that i exaggerated any of that. you then personalized it by stating that you did not want to become skilled at something and not be able to do it independently i made no comments about that. you then addressed t4c, which i also did not speak to.

i believe that competence is important whether the person is supervised or not. in your case, you have some doctoral training which gives some evidence of competence. you are then sent to practice under the supervision of someone else to gain further competence. you will eventually have to demonstrate it on your own through licensure procedures. i see all sorts of things from incompetent assessors. some supervised, some not. knowing when to query, or dear god: how to to add, basal and ceiling, etc are all part of competence that supervision cannot fix. formal education is some assurance of competence. there is even a scaffolding approach to competence in assesment. after several semesters and supervised adminstraiton and scoring, you are put in a clinical situaiton which is then supervised. and again until licensed. after all of these procedures are gone through, comptence is guaranteed to the public.

however, from your second post it does sound like you meant something else (i.e., "why bother getting trained if you cant do it independently"). i understand this sentiment and don't significantly disagree. so i apologize for misunderstanding.


psych1212:

my apologies, you have 3 semesters of MA level assessment. i still don't think you are qualified to interpret the data. your state apparently agrees with me. the state feels that there is a public safety concern with interpreting psychological tests. so do the publishers. in order to assuage that fear, a demonstration of competence is made through meeting formal education and standardized test requirements. you have not done so. while i am sure there are other ways to acquisition of knowledge, we must restrict the the practice to those that have demonstrated competence through the formal channels.

as for your idea of the public health need: it doesn't sound like there are a shortage of psychologists, but rather a shortage of money. maybe if your state should pay for the work they need.

 

[futureapppsy2]

While I agree that MA/MS folks are NOT trained to do assessments and hence shouldn't be doing them (though it looks like Montana will pass that bill ), how do you all feel about School Psych EdD/EdS folks being allowed to administer assessments (in school settings, obviously)?

 

[Eruca]

eruca

i read the whole post. your post specifically states "who cares about being able or competent to do assessments if you have to have them supervised (forever)". sounds pretty straightforward to me. i don't believe that i exaggerated any of that.

Very little on this board is "straightforward", we interpret all statements through our own filters, and semantics are rarely black & white in meaning. It seems that based on my original post, at least 1 person interpreted my sentence with my intended meaning, so maybe not so straightforward after all? I appreciate the apology for misunderstanding, and I do wish I had conveyed my sentiment more clearly. However, I also wish we would give each other the benefit of the doubt, or when in question, ask the other to clarify before calling a statement 'the most calloused thing you've heard on this board' and then imply that I don't care about people's lives, money, diagnoses, etc. It saddens me that even psychologists are so quick to judge.

Sorry to take us off task with this post, it's just something I needed to say in regard to that interaction.

 

[Ollie123]

I wouldn't worry too much about going off-task. This entire thread is a result of us going completely off-task in another thread to begin with. How dare you tangent in our tangent!

 

[Psych1212]

psych1212:

my apologies, you have 3 semesters of MA level assessment. i still don't think you are qualified to interpret the data.

And that's fine. Thankfully, the licensed psychologists that supervise me and actually observe my work, as well as the ones that I work side by side with, seem to think I am more than competent and able to do this work.

That's another thing that always surprised me. I entered into a terminal maters program in 2003 that was part of a doctoral program. Some of my friends in the program recently received their doctoral degrees having taken only the same 3 research courses that I took (I chose electives that were aligned with the doctoral program.) as part of the master's program.

your state apparently agrees with me. the state feels that there is a public safety concern with interpreting psychological tests. so do the publishers. in order to assuage that fear, a demonstration of competence is made through meeting formal education and standardized test requirements. you have not done so. while i am sure there are other ways to acquisition of knowledge, we must restrict the the practice to those that have demonstrated competence through the formal channels.

My state licenses me with an LLP and allows me to complete both therapy and assessment under the supervision of a licensed psychologist. This isn't a loophole. They apparently feel that it is sufficient. If enough people feel differently, eventually more restrictions will be placed upon LLPs, and I'm fine with that.

as for your idea of the public health need: it doesn't sound like there are a shortage of psychologists, but rather a shortage of money. maybe if your state should pay for the work they need.

Same difference really. I work in one of the most impoverished areas of the country. Throwing money at an issue isn't an option. I'm sure that any state licensing masters level practitioners wouldn't do so if there was an abundance of fully licensed psychologists willing to do the work for peanuts or if the budget allowed them to pay a salary that could attract LPs. But sadly, that simply isn't reality.

I read it as Ollie stated.

Same here...

I wouldn't worry too much about going off-task. This entire thread is a result of us going completely off-task in another thread to begin with. How dare you tangent in our tangent!

I think that was my fault. But thanks to the magic of moderators, it was all taken care of. (But anyone who had some advice for the OP in that other thread, don't forget to give it.)

 

[PsyDr]

eruca,

what we write is all we have. especially in assessment.

just wait till you get called on the stand. every single sentence you wrote will be called into question.

 

[Eruca]

^ good thing for me this internet message board isn't one of my certified assessment reports, or a court of law. Phew!

(and Ollie123... LOL)

 

[Therapist4Chnge]

just wait till you get called on the stand. every single sentence you wrote will be called into question.

The vast majority of people will not be in this position, but God help them if they are (and they produce sub-standard work), as I've seen seasoned professionals sweat it out up there.

 

[socialcog]

I read it as Ollie stated.

I too.

Assessment training is one of the goals I have entering my program as I received zero hours in assessment during my master's program. However, I did take one introductory to neuropsychological assessment thru UC Berkeley extension--which only reinforced my believe that, speaking for only myself, am in no way qualified to administer assessments nor interpret it's data.

In California, I believe that an MFT is able to legally administer assessments if they are clinically competent to do so. To my knowledge, there is no regulating or supervisory board overseeing that clinician's competence to provide this service. In other words, I get to judge for myself whether or not I am competent to provide this service.

Frighteningly unethical, in my opinion.