Can you practice without a license?

[Carwhisperer]

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Among the many counselors I have seen over the years was a pastor. He had no license to counsel. This is in California. He was in his 80's and money was a little tight so I used to throw him a $20 spot every visit.

Was this illegal? For that matter, what is to stop someone from counseling for pay without a license as long as you don't represent yourself as a licensed counselor?

 

[Therapist4Chnge]

...what is to stop someone from counseling for pay without a license as long as you don't represent yourself as a licensed counselor?

Life Coaching....etc.

 

[wigflip]

You might consider the following issues:

1. Quality of training. (Experience as a client/patient is insufficient.)
2. Ethics.
3. Liability issues.

These three are intertwined in ways that I'm not certain you're fully grasping at this point.

 

[Qwerk]

Legally, maybe. Ethically, no. In several states, unlicensed counselors are allowed to call themselves "counselors" or "therapists" and to practice psychotherapy even if they are not licensed and have no degrees whatsoever, as long as they do not call themselves "licensed," "psychologist," or "social worker," among other restricted terms. Colorado, Minnesota, and Oregon are three states in which this can happen. In some states, unlicensed counselors must register with the state, but in others, there's no requirement. A pastor can also counsel in his or her capacity as a member of the clergy, but may not do so privately in most cases. As Therapist4Change mentioned, there are also titles such as "life coach" and "consultant" that are not regulated. There are other gray areas such as substance abuse counseling in which licensure and/or a particular degree may not be required.

This is a good reason to check the education and licensure of anyone you entrust with your mental health. Even if you feel that they're competent, you have little recourse if they act unethically unless they break the law.

 

[wigflip]

there are also titles such as "life coach" and "consultant" that are not regulated...This is a good reason to check the education and licensure of anyone you entrust with your mental health. Even if you feel that they're competent, you have little recourse if they act unethically unless they break the law.

A client wouldn't have recourse in terms of contacting the state licensing board (since the person is unlicensed), but I'm not certain that a practitioner would be absolved of all liability in civil court, if for example, an unhappy client sought to argue that the practitioner misrepresented him/herself and/or acted beyond the scope of their training/expertise. That is to say, if I were the OP, I'd be cautious about assuming that clients would have no recourse against someone calling themselves a coach or consultant.

 

[Qwerk]

A client wouldn't have recourse in terms of contacting the state licensing board (since the person is unlicensed), but I'm not certain that a practitioner would be absolved of all liability in civil court, if for example, an unhappy client sought to argue that the practitioner misrepresented him/herself and/or acted beyond the scope of their training/expertise. That is to say, if I were the OP, I'd be cautious about assuming that clients would have no recourse against someone calling themselves a coach or consultant.

This is absolutely true -- civil liability might exist if the counselor did not follow state regulations in title, credentials, or scope of practice. That said, if the counselor followed state regulations but committed misconduct that might be cause to strip a licensed professional of his/her license, the client may not be able to get the counselor to stop practicing, even if the client did get a judgment in civil court. There have actually been a few cases in which psychiatrists/psychologists have been stripped of their licenses for misconduct and have continued practicing as psychotherapists without breaking the law.

 

[Psychadelic2012]

The organizations affiliated with life coaches and other paraprofessionals (or whatever you want to call them) can prove to be very careful in educating the professionals they "certify." Rightfully so. It's only ethical. Case in point--I was trained as a hypnotist before actually getting traditional education in the mental health field (I did it backwards). The NGH (certifying organization) is very careful to educate hypnotists about their scope of practice. For example, that they are not "treating" any "disorder" such as anxiety or depression, they are simply helping healthy people with simple habits or problems and are encouraged to give full written disclosure about their training and scope. I respect them for doing that. Do they attract cease and desist orders if they don't practice carefully and in full disclosure? Heck yeah. It is, also, very difficult to draw business if you are not on an insurance panel or employed by an agency, and these certified people are not well-rounded generalists, they tend to specialize in one area or another and they also refer to the licensed people when someone needs a higher level of care. Again, healthy people with specific life circumstances, who pay cash. This isn't going to be a big competition with licensed mental health professionals. If they do well, it's due to marketing and specialization.

 

[BlackSkirtTetra]

The organizations affiliated with life coaches and other paraprofessionals (or whatever you want to call them) can prove to be very careful in educating the professionals they "certify." Rightfully so. It's only ethical. Case in point--I was trained as a hypnotist before actually getting traditional education in the mental health field (I did it backwards). The NGH (certifying organization) is very careful to educate hypnotists about their scope of practice. For example, that they are not "treating" any "disorder" such as anxiety or depression, they are simply helping healthy people with simple habits or problems and are encouraged to give full written disclosure about their training and scope. I respect them for doing that. Do they attract cease and desist orders if they don't practice carefully and in full disclosure? Heck yeah. It is, also, very difficult to draw business if you are not on an insurance panel or employed by an agency, and these certified people are not well-rounded generalists, they tend to specialize in one area or another and they also refer to the licensed people when someone needs a higher level of care. Again, healthy people with specific life circumstances, who pay cash. This isn't going to be a big competition with licensed mental health professionals. If they do well, it's due to marketing and specialization.

What kind of marketing and specialization would even allow them to do well, though?

 

[Isadora]

This is called pastoral counseling. Counseling on mental health matters as it relates to being a member of X religion is within the scope of their practice. Hospital chaplains are an example.

It is not necessarily illegal or unethical provided the pastor did not give medical advice (such as you should pray instead of taking Lexapro because Lexapro will make your liver rot and you will no longer be fit to enter the kingdom of [insert deity here]), failed to refer you to more specialized mental health care - symptoms, need for medication, danger to self or others, pastoral counseling just plain failing, or if there were major boundary issues (have sex with me and you will enter the kingdom of [insert deity here]).

Check with your state licensure laws. If this was through a denominational church, you can also check with their governing body to see whether or not this was okay.

 

[Qwerk]

Here's something I found on the web: an association of unlicensed psychotherapists in Colorado, which has some of the the most liberal psychotherapy regulations of any state. http://www.coloradopsychotherapists.com/about.htm

This strikes me as highly unethical. While I don't think I want to prevent consenting adults from entering therapy with whomever they choose, no matter how untrained, I don't think that these people should be able to use the title "psychotherapist." When most people see this word on someone's business cards, they generally believe that it's a licensed profession with some sort of oversight.

 

[Psychadelic2012]

What kind of marketing and specialization would even allow them to do well, though?

An example would be a specialization in, say, smoking cessation via hypnosis (although there are many specialities that could also be included: weight loss, childbirth/fertility, complementary medical hypnosis). Such specialities all are very narrow and allow the practitioners to follow a curriculum, if you will, of protocols in their practice and they market themselves to the public and other professionals as specializing in that particular area. There are hypnotists who do this well. I won't go into details in order to stay anonymous, but they range from sustainable part-time practices to six-figure mega practices--I know of one in a large city who does complementary medical hypnosis (works with a very specific kind of illness) and markets in hospitals/clinics and to MDs as an alternative adjunct therapy. Said person may also then start a business in training others to do what they do. But here you have people who have created a business and are by no means generalist or even mental health professionals.

 

[BlackSkirtTetra]

It is not necessarily illegal or unethical provided the pastor did not give medical advice (such as you should pray instead of taking Lexapro because Lexapro will make your liver rot and you will no longer be fit to enter the kingdom of [insert deity here]), failed to refer you to more specialized mental health care - symptoms, need for medication, danger to self or others, pastoral counseling just plain failing, or if there were major boundary issues (have sex with me and you will enter the kingdom of [insert deity here]).

I wonder if even this would be considered illegal/unethical in some situations. I spent a summer in Massachusetts and there Medicaid pays for Christian Science practitioners to offer prayer as a primary (and only) source of healthcare, whether mental health or physical health. I can easily see one of their practitioners saying, "You need to pray. Don't take the Lexapro."

But I can't see any of them saying, "You need to have sex with me," because the three that I met were all old ladies.

 

[wigflip]

But I can't see any of them saying, "You need to have sex with me," because the three that I met were all old ladies.

Hey...we old ladies have sex too! 😉