How are or should clinical skills evaluated for the continuance of licensure?
You have to remember that folks usually have peer supervision whether it is on the student or professional/licensed level. This in and of itself is a way of having your peers/supervisor evaluate you in your work, whatever aspect of it you choose. I was surprised to learn of this from my professor who works in private practice but she says it continues even into retirement.
I've heard that some MD specialties have to be tested from time to time, and perform certain procedures on cadavers for example to remain licensed.
Should there be similar requirements set in place for mental health practitioners?
You can't compare what an MD to a psychologist/therapist. There are more inherent liabilities for an MD then there is for a psychologist/therapist. I would expect them to be held to higher standards because they literally have someone's life in their hands on the surgical table. How would you propose they do this for clinicians? What we do is so subjective whereas MDs have clearcut guidelines for every area of practice. As clinicians there are a variety of modalities that can be used to treat someone whereas in medicine the its often clear what to do.
Do clinicians have to submit a record of some sorts detailing how many ours etc. they have spent over the last year?
Yes, they do. They have to submit/prove that they completed a certain number of units each year. Its often called CEUs-Continuing education Units-lawyers and psychologists do this inaddition to social workers and profesional counselors.
Which brings me to another point, I've heard that their is a certain amount of misdiagnosis taht clinicians engage in to get 3rd party reimbursement. I could see how this could begin to deteriorate the fields credibility. Should practitioners begin to stand up o managed health care, or should there be a massive overhaul to the DSM system of clasification. That is assuming practioners are right all along.
I think I know what you are getting at. Axis II disorders are often NOT/if at all billed to insurance companies because of the dismal outlook for treatment. From what I undertand insurance companies will not reimburse for Axis II treatment. There are some clients who only have an axis II and there are some that have diagnoses on both. The diagnosis given typically is Adjustment disorder if the clinician doesnt want to hurt the clients chances of receiving treatment OR getting insurance or a job down the line.
Ive worked at a CMHA and they are also reluctant to diagnose on the Axis II for similar reasons, however there are times that they did.
I dont think that clinicians are being malicious is writing in Deferred-Axis II and/or Adjustment D/O on Axis I. Until the managed care system changes, this is what we have got to work with. It matters not WHAT we diagnose for but HOW the treatment is carried out.
