Clinicians licensed at the Master's level presenting themselves as Dr?

[SaraLance]

I've seen this a number of times, and I'm curious if anyone else has as well.

Clinician is licensed at the Master's level (LMFT, LMHC, etc) but uses and introduces themselves as "Dr so and so." And I typically discover that the person has a doctorate in some unrelated field (e.g., education or leadership or something).

Is this not misleading to the public? If you're in a clinical context and introduce yourself as Dr, the layperson will assume (and rightfully so) that you have doctoral level training in this context (whether it's clinical practice, consultation, or something else). While the practice is not as egregious as misrepresenting credentials (e.g., saying they're a licensed psychologist but they're not), I do think it toes an ethical line.

Thoughts?

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[WisNeuro]

I don't think it toes the ethical line, it's over the ethical line. You always make your credentials and role very clear. As part of the informed consent process for evals, I introduce myself as Dr. so and so, a clinical neuropsychologist, yadda yadda. This is one of the problems with the proliferation of diploma mills. Everyone wants to be a doctor without any of the actual expertise or work that it takes to truly be one.

As for seeing this, I haven't seen any of my masters level people do that. I've had patients refer to their masters level therapists as Dr before, during my clinical interview.

 

[Justanothergrad]

I've seen this happen and it leads to confusion. Its totally unethical and unprofessional. There was a LCSW who did that at the VA-he introduced himself as Dr to interns as well.

 

[cara susanna]

In all fairness, sometimes patients call you doctor even when you are very explicit that you are not actually a doctor. Like, I was called "Dr" sometimes as a grad student and psychology intern. I tried to correct them but it didn't always stick.

 

[Justanothergrad]

In all fairness, sometimes patients call you doctor even when you are very explicit that you are not actually a doctor. Like, I was called "Dr" sometimes as a grad student and psychology intern. I tried to correct them but it didn't always stick.

Yeh, that's for sure. I've seen parents encourage their young kids to do it as well to make it more "professional" for them

 

[deleted343839]

I once worked with a nurse practitioner who did this. She had a doctorate in public health.

Another variation on this theme are master’s level clinicians who enroll in online (unaccredited) doctoral programs so they too can be “doctors.”

 

[PsyDr]

I'd be VERY VERY VERY careful here. The AMA tried to get a law passed that made it illegal for anyone other than physicians to call themselves "doctor". It failed, but this line of reasoning could politically open the door again to screw us.

 

[ClinicalABA]

In some jurisdictions this could be considered as practicing psychology without a license, as the address "Dr." in a psychotherapeutic setting is commonly/reasonably construed by the public to mean "doctor in/of psychology." (i seem to recall a board guideline or white paper stating this position). Similarly, in my jurisdiction, a person with a licensable doctoral degree in psychology who is not licensed can not practice pyshcotherapy with a master's level license, as this is seen as attemp to "skirt the reg" and practice psychology without a license. Boards are typically very protective of the public and can be rather humorless regarding such things.

 

[psychrat]

When I was in practicum one of my colleagues would sign his notes with MA, despite that his MA was in another field (education). Our supervisor allowed it, which I thought was odd bc it could be misleading.

 

[foreverbull]

I saw someone online on a webpage identified themselves as a "licensed psychotherapist" even though that's not a real title (in my jurisdiction) and the person was an LCSW. It made me wonder what ethics SW programs follow.

I find this issue to be confusing when it comes to whose ethical principles master's level folks follow. Can anyone shed light on this? APA is clearcut, but does everyone follow APA ethics?

Also, who wants to be the one to notify a clincian you either don't know personally or don't know well that they're misrepresenting themselves and that they need to stop doing it?

 

[WisNeuro]

I saw someone online on a webpage identified themselves as a "licensed psychotherapist" even though that's not a real title (in my jurisdiction) and the person was an LCSW. It made me wonder what ethics SW programs follow.

I find this issue to be confusing when it comes to whose ethical principles master's level folks follow. Can anyone shed light on this? APA is clearcut, but does everyone follow APA ethics?

Also, who wants to be the one to notify a clincian you either don't know personally or don't know well that they're misrepresenting themselves and that they need to stop doing it?

Psychotherapist is not a protected term in any jurisdiction I am familiar with. Presumably, anyone licensed to do therapy of some sort (PhD, PsyD, MSW, LPC, etc) can say that they are a licensed psychotherapist. It's not technically wrong.

 

[Dahresto]

Well, if they earned their PhD in xyz, I don't see it as a problem in referring to them as "Doctor xyz". If they only have their Masters in xyz, but are licensed in their profession, it's questionable for sure, but....ok? Does this impact you in any way, shape or form?

 

[smalltownpsych]

From 2014 code of ethics for American Counseling Association:

Counselors clearly state their highest earned degree in counseling or a closely related field. Counselors do not imply doctoral-level competence when possessing a master’s degree in counseling or a related field by referring to themselves as “Dr.” in a counseling context when their doctorate is not in counseling or a related field. Counselors do not use “ABD” (all but dissertation) or other such terms to imply competency.
https://www.counseling.org/Resources/aca-code-of-ethics.pdf​

This would indicate to me that it is ethical, at least for counselors, to use the doctor title so long as the degree is in a related field such as psychology or counseling and that it is okay to be licensed as a MA level and call yourself doctor.

I don't agree with this myself as I do feel it is misleading and borders on misrepresentation. The hospital that I work at agrees and only allows people who are licensed at a doctoral level to be called doctor regardless of the degree. We have several DNPs who fit this and was considering hiring an LCSW/ Doctor of Parapsychology who would have fit that. The Dr. Parapsychologist actually had the nerve to correct one of the admins when doctor title wasn't used.

 

[CatsFan]

From 2014 code of ethics for American Counseling Association:

Counselors clearly state their highest earned degree in counseling or a closely related field. Counselors do not imply doctoral-level competence when possessing a master’s degree in counseling or a related field by referring to themselves as “Dr.” in a counseling context when their doctorate is not in counseling or a related field. Counselors do not use “ABD” (all but dissertation) or other such terms to imply competency.
https://www.counseling.org/Resources/aca-code-of-ethics.pdf​

This would indicate to me that it is ethical, at least for counselors, to use the doctor title so long as the degree is in a related field such as psychology or counseling and that it is okay to be licensed as a MA level and call yourself doctor.

I don't agree with this myself as I do feel it is misleading and borders on misrepresentation. The hospital that I work at agrees and only allows people who are licensed at a doctoral level to be called doctor regardless of the degree. We have several DNPs who fit this and was considering hiring an LCSW/ Doctor of Parapsychology who would have fit that. The Dr. Parapsychologist actually had the nerve to correct one of the admins when doctor title wasn't used.

Wait but...don't those who have PhD's in psychology refer to themselves as doctor before they're licensed? I'm thinking of people on post-doc, in particular, who may be working on licensure but not officially licensed yet.

 

[foreverbull]

Wait but...don't those who have PhD's in psychology refer to themselves as doctor before they're licensed? I'm thinking of people on post-doc, in particular, who may be working on licensure but not officially licensed yet.

My sup in postdoc told me to refer to myself as "dr." With clients but then to specify that I was an unlicensed clinician being supervised when I introduced myself to new clients. I thought it was the title "psychologist" that was protected and I couldn't use it until licensed, but that I was free to embrace my doctoral status (only after the degree was conferred, as long as I was clear about my lack of licensure with professionals). Not sure if others were told to do the same?

 

[medium rare]

My sup in postdoc told me to refer to myself as "dr." With clients but then to specify that I was an unlicensed clinician being supervised when I introduced myself to new clients. I thought it was the title "psychologist" that was protected and I couldn't use it until licensed, but that I was free to embrace my doctoral status (only after the degree was conferred, as long as I was clear about my lack of licensure with professionals). Not sure if others were told to do the same?

“Dr.” refers to the degree earned, not licensure. If your doctorate is in psychology or a related field, it is (generally) acceptable to introduce yourself as “Dr. So and So” when providing clinical services. However, you should always clarify your title and training regardless of the situation. (And, yes, there are situations where no matter how much you clarify your title/training with patients they will continue to misrepresent you.)

If you are not licensed at a certain level, i.e. ‘psychologist’ and you introduce yourself as such, that is both unethical and illegal - or at least a violation of state statute. If your doctorate is in an unrelated field and you introduce yourself as “Dr.” (i.e. ‘Dr. Laura’), in the clinical context, that is unethical and misleading to the public although not necessarily illegal or a statutory violation.

 

[singasongofjoy]

My sup in postdoc told me to refer to myself as "dr." With clients but then to specify that I was an unlicensed clinician being supervised when I introduced myself to new clients. I thought it was the title "psychologist" that was protected and I couldn't use it until licensed, but that I was free to embrace my doctoral status (only after the degree was conferred, as long as I was clear about my lack of licensure with professionals). Not sure if others were told to do the same?

Same - but then of course if you're not yet licensed (presumably in the process of getting licensed) then during the process of obtaining informed consent you're required (per APA I think?) to make sure they are aware of your credentials/background as well as who your direct supervisor is and how to contact them. So I feel like that makes it pretty explicit that you're not trying to misrepresent yourself.

 

[foreverbull]

Psychotherapist is not a protected term in any jurisdiction I am familiar with. Presumably, anyone licensed to do therapy of some sort (PhD, PsyD, MSW, LPC, etc) can say that they are a licensed psychotherapist. It's not technically wrong.

So just the protected titles are the ones you can't use without that specific license (psychologist, clinical social worker, mft, licensed professional counselor, etc.), it sounds like, whereas you can use the generic term psychotherapist or mental health therapist with any of those licenses.

So in the reverse, if you aren't licensed and/or have no training and call yourself a psychotherapist or mental health therapist, a state board can't do anything about it because it's not protected? Just wanting to clarify.

 

[ClinicalABA]

So just the protected titles are the ones you can't use without that specific license (psychologist, clinical social worker, mft, licensed professional counselor, etc.), it sounds like, whereas you can use the generic term psychotherapist or mental health therapist with any of those licenses.

So in the reverse, if you aren't licensed and/or have no training and call yourself a psychotherapist or mental health therapist, a state board can't do anything about it because it's not protected? Just wanting to clarify.

Regulations will typically prohibit BOTH your referring to yourself using a protected term (e.g., "psychologist" or "mental health counselor") and providing services to the public that are typically associated with the those protected terms. Regardless of what you call yourself, if you start doing CBT for trauma with the general population, you are engaging in the practice of psychology (or social work/mental health counseling) without a license. If you want to bang around calling yourself a psychotherapist and, say, get together and do a general support group, the boards probably aren't going to have a problem with it.

 

[WisNeuro]

What he said. ^

 

[PsyDr]

Regulations will typically prohibit BOTH your referring to yourself using a protected term (e.g., "psychologist" or "mental health counselor") and providing services to the public that are typically associated with the those protected terms. Regardless of what you call yourself, if you start doing CBT for trauma with the general population, you are engaging in the practice of psychology (or social work/mental health counseling) without a license. If you want to bang around calling yourself a psychotherapist and, say, get together and do a general support group, the boards probably aren't going to have a problem with it.

Wanna add some esoterica into the mix?

One of the inventors/pioneers of the vacuum/ aspiration method of surgical abortion was a psychologist. Even designed some of the surgical equipment which remains in use today. Stranger still: his daughter became the voice of Theodore from the chipmunks.

 

[ClinicalABA]

Stranger still: his daughter became the voice of Theodore from the chipmunks.

And for that he and she should forever be damned to the fifth ring of hell!

 

[psych1962]

I've seen this happen and it leads to confusion. Its totally unethical and unprofessional. There was a LCSW who did that at the VA-he introduced himself as Dr to interns as well.

If the social worker has a doctorate, it is not unethical to refer to himself as Dr. A psycholgist is no more a doctor than a social worker with a doctoral degree.

 

[quickpsych]

If the social worker has a doctorate, it is not unethical to refer to himself as Dr. A psycholgist is no more a doctor than a social worker with a doctoral degree.

This is incorrect when you're providing services to a patient and grossly unethical and unprofessional. If I observed a licensed clinical social worker calling themselves Dr. to a patient on an ongoing basis, I would report them to their licensing board. And if they were not licensed but interfacing directly with patients and calling themselves doctor, I would strongly consider bringing this concern to their employer as it could be a legal liability.

That said, having PhD at the end of your name is fine and displaying that is fine. However, a social worker interfacing with patients and introducing themselves or representing themselves as a doctor is absolutely inappropriate. A licensed social worker would be risking their license because both their own licensing boards AND psychologist licensing boards in their jurisdiction could call for suspension of their license.

On the original topic of masters level providers who were grandfathered in with older laws in some jurisdictions as licensed psychologists, they are permitted to refer to themselves as licensed psychologists but they do not call themselves doctor.

BTW the title psychologist in many jurisdictions is a protected term and can not be used unless you are a psychologist (and some state only licensed individuals can use the term) and as far as we know there are no licensing boards that license social workers at the doctoral level. Psychologists are licensed as doctors of psychology , social workers are not licensed as doctors of social work.

You also spelled psychologist wrong.

 

[AcronymAllergy]

If the social worker has a doctorate, it is not unethical to refer to himself as Dr. A psycholgist is no more a doctor than a social worker with a doctoral degree.

The primary difference is the level at which each profession is licensed. Psychologists, like physicians, are licensed at the doctoral level; social workers, like nurse practitioners (at least currently), are licensed at the masters level. Typically when interfacing with patients, the title used reflects the level at which one is licensed to provide patient care.

 

[WisNeuro]

If the social worker has a doctorate, it is not unethical to refer to himself as Dr. A psycholgist is no more a doctor than a social worker with a doctoral degree.

Man, I am curious what got you so heated that you tracked down a 7-year dead thread to make an asinine comment.

 

[psych.meout]

The primary difference is the level at which each profession is licensed. Psychologists, like physicians, are licensed at the doctoral level; social workers, like nurse practitioners (at least currently), are licensed at the masters level. Typically when interfacing with patients, the title used reflects the level at which one is licensed to provide patient care.

Exactly, and doing a "well actually, a psycholgist [sic] is no more a doctor than a social worker with a doctoral degree" misses the point that this is about what laypeople and patients understand and how they use the information to make decisions. They are not expected to know the nuances of someone advertising themselves as a doctor and a licensed mental health provider, but who isn't a psychologist or psychiatrist. The average person doesn't know that there are people who have master's degree with licensure and then go on to get some other degree in which doesn't lead to licensure or in which they were never licensed. The average person is likely going to think someone advertising themselves as a doctor when they are talking to patients, providing mental health services, marketing themselves, etc. is a psychologist or psychiatrist and that's a reasonable assumption for a layperson. The ethical codes and laws restricting this kind of behavior by providers is meant to protect the public from disingenuous providers.

 

[EnPsychlopedia]

If the social worker has a doctorate, it is not unethical to refer to himself as Dr. A psycholgist is no more a doctor than a social worker with a doctoral degree.

Huge disagree in the clinical setting. In clinical settings, one should refer to oneself with the honorific associated with their level of clinical practice. Unless one is practicing at the doctoral level, one does not refer oneself as "Dr." for clinical purposes. Those with doctorate degrees which are not correspondent to some doctoral-level licensure can use the "Dr." honorific as much as they'd like in academic and other non-clinical settings, but clinical settings are where the line should be, in my opinion.

 

[Sanman]

If the social worker has a doctorate, it is not unethical to refer to himself as Dr. A psycholgist is no more a doctor than a social worker with a doctoral degree.

In what context?

I am a minister of the universal life church. I don't walk around the hospital calling myself Minister Sanman because I am not providing religious services there. I can introduce myself as Minister Sanman out at a restaurant and that is fine.

Similarly, a social worker (DSW or not) is not furnishing doctorallly licensed clinical services in the hospital or outpatient setting. So keep it out of the clinical settings. Feel free to call yourself doctor when making dinner reservations.

 

[jdawg2017]

I’m not sure what context this would make sense, but if a social worker in a clinical setting said “Hi I’m [name], your therapist today. I also hold a PhD in macro social work, leadership, etc.” that might be okay… still weird and toeing an ethical line, since the PhD in fields like social work, etc. is not related to the clinical interaction. In fact, I believe in most jurisdictions it’s unethical not to make serious attempts to correct your patient if they refer to you as “Dr.” or “psychologist” when you don’t have that level of expertise.

Doctoral level psychologists have substantially more clinical training relative to master’s level providers before entry into unsupervised clinical practice, full stop. The same difference can be seen between physicians and physician assistants and NPs.

 

[BendDontBreak]

Man, I am curious what got you so heated that you tracked down a 7-year dead thread to make an asinine comment.

LOL, I totally thought this was a new thread until I saw your comment. You ask an intriguing question! (Also... somehow my brain is rejecting the idea that 2018 was SEVEN years ago.)

 

[AcronymAllergy]

LOL, I totally thought this was a new thread until I saw your comment. You ask an intriguing question! (Also... somehow my brain is rejecting the idea that 2018 was SEVEN years ago.)

My brain is particularly bad about doing this with research publication dates. "Oh, this study is pretty recent, it was published in 2015." It's like a mental optical illusion; even typing it out, it still doesn't look that old.

 

[BendDontBreak]

My brain is particularly bad about doing this with research publication dates. "Oh, this study is pretty recent, it was published in 2015." It's like a mental optical illusion; even typing it out, it still doesn't look that old.

YES. I appreciate the validation of this brain glitch!

 

[Dazen]

My brain is particularly bad about doing this with research publication dates. "Oh, this study is pretty recent, it was published in 2015." It's like a mental optical illusion; even typing it out, it still doesn't look that old.

Yup, my 10-year college reunion is this year and it doesn’t seem to compute. Probably doesn’t help that I’m still finishing up grad school so my lifestyle looks remarkably similar in many ways. Felt like much more of an adult in industry.

 

[PsychPsychBaby]

Huge disagree in the clinical setting. In clinical settings, one should refer to oneself with the honorific associated with their level of clinical practice. Unless one is practicing at the doctoral level, one does not refer oneself as "Dr." for clinical purposes. Those with doctorate degrees which are not correspondent to some doctoral-level licensure can use the "Dr." honorific as much as they'd like in academic and other non-clinical settings, but clinical settings are where the line should be, in my opinion.

This is so interesting and helpful, because I myself was getting a little confused as to why someone with a DSW wouldn't be referred to as Dr. in a clinical setting, yet someone with a JD is never called Dr. (I once met someone who was in law school and said she would be a doctor when she graduated and I almost spit out my drink because I have never heard that be the case, but correct me if I'm wrong). I always thought that someone with a DSW or PhD in Social Work would still get the title of Dr. in clinical settings...

 

[AcronymAllergy]

This is so interesting and helpful, because I myself was getting a little confused as to why someone with a DSW wouldn't be referred to as Dr. in a clinical setting, yet someone with a JD is never called Dr. (I once met someone who was in law school and said she would be a doctor when she graduated and I almost spit out my drink because I have never heard that be the case, but correct me if I'm wrong). I always thought that someone with a DSW or PhD in Social Work would still get the title of Dr. in clinical settings...

I've occasionally heard social workers with doctorates refer to themselves as doctors amongst colleagues; not sure if they did so with patients. IMO, it's somewhat misleading. The default in most people's mind, until proven otherwise, is that doctor = physician. When I bring patients back for testing, I usually say some version of, "hi, I'm Dr. AA, a neuropsychologist." Then I go into my speech about why they were referred to me.

IMO, the title to use is the level at which you're licensed. Presents the least confusion, even though there's still often confusion (e.g., psychologist vs. psychiatrist, that psychiatrists are indeed medical doctors, etc.).

Although interesting aside: I'm starting to have more patients saying the equivalent of, "I don't really know the difference between a psychologist and psychiatrist, but I think psychologists can't prescribe medication, right?" Which is more than I used to get.

 

[Therapist4Chnge]

..."hi, I'm Dr. AA, a neuropsychologist." Then I go into my speech about why they were referred to me.

IMO, the title to use is the level at which you're licensed. Presents the least confusion, even though there's still often confusion (e.g., psychologist vs. psychiatrist, that psychiatrists are indeed medical doctors, etc.).

This is the way I taught my fellows. Name, title, and then explain the purpose of the interaction, etc. It is the clearest and most direct approach to ensuring the patient understands what is going on, which is better than many of their other experiences. Often they don't even know the provider's speciality and/or why they are at a particular appointment.

It's also important for other providers to support, as often mid-levels will want to be informal and call everyone by their first names during clinical interactions with patients, which can add to confusion. In the back office I don't care if people use first names, but I always instruct my trainees to start/stay with formal interactions unless specifically told by that person otherwise.

In a clinical setting, it is fully on the clinician to ensure the patient understands who you are, why they are there, and what will go on during the appointment. If someone is licensed as a social worker (example above), then they are only licensed to practice as the masters level, so they should not use the title. If they publish a research article and include the title/degree in that, great....bc that isn't the clinical setting where patients are involved.

 

[ClinicalABA]

The primary difference is the level at which each profession is licensed. Psychologists, like physicians, are licensed at the doctoral level; social workers, like nurse practitioners (at least currently), are licensed at the masters level. Typically when interfacing with patients, the title used reflects the level at which one is licensed to provide patient care.

Yes- and this applies in the other direction too. I provide some services under my MA level certification (BCBA) and licensure (Mass. Licensed Applied Behavior Analyst) billing BCBA codes and am careful about using the doctor title in the settings. It can be especially tricky where I have done the diagnostic eval under my Psych license/billing psych codes, but then go on to do ABA therapy under my ABA license/billing ABA codes.