Correcting masters level providers

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AbnormalPsych

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Anyone have experience giving feedback to MFTs and LCSWs (that you work closely with) regarding their incorrect interpretations about assessment findings? I have done this occasionally but in a new role I am on a team where I work with them directly as a colleague and in a non-supervisory role. The confidence to which some of their incorrect statements are made and inability to question their scope of practice and training before speaking on such matters is especially concerning.
 
Just out of curiousity, what assessments? I didn’t know MFT could interpret any assessments!
 
It ranges. Big ones are lots of over-interpretation of cognitive (e.g., MoCAs) and symptom screeners for adults as well as a fair amount of mis-interpretation of various kiddo measures. Examples: low average qualitative descriptor on several WISC scales = freak out because this child must be super globally impaired. No understanding of confidence intervals, standard deviations, or how to interpret within domains and a larger battery as a whole.

Edit: to clarify, they aren't interpreting in an "official" documented manner, but they are deinitely integrating their thoughts into treatment plans and referrals.
 
I've given lunch talks aimed at staff (e.g. RN, CNA, OT, PT, SLP, etc) to discuss some basic terminology, particularly info regularly discussed in team mtgs/conferences. This was done in an acute in-patient setting, but it can probably be tweaked for other settings.

While I wanted staff to better understand the info, it was really aimed at the OTs & SLPs bc they were inadvertently spreading bad info and it was negatively impacting clinical care. The issue was most problematic on fellowship where we had younger SLPs recently out of training. I came to figure out OT and SLP wanted their own normed measures, but they didn't understand the basics of psychometrics, let alone appropriate measures for them.

I've seen this pattern in all three hospital systems I've worked, but on fellowship it was the most frustrating bc the politics had a 20+ yr history and I had to fall in line and not rock the boat. Neuropsych/Rehab Psych always went last in team meetings, so we could gently correct or reframe info from earlier and give our recs and move on to the next patient....too passive for me, but it was the best compromise given the politics involved.
 
Everyone with access to the internet is an expert on assessment and diagnostics. I suggest you just keep quiet as the political ramifications of correcting anyone about anything can be very problematic.
 
Maybe phrase the question, "Oh, very interesting. I had different diagnostic impressions from these results. I'm curious to what your thoughts were- maybe we can get together to discuss?" Since you're in a collaborative role, it would make a lot of sense to suggest a case consultation where you could passively "teach" them and give feedback in a way that promotes discussion and learning. I don't think it's a matter of correcting, but a matter of collaborative exploring and teaching. You would be helping the master's level therapist grow and learn by doing this. Also, the ethical ramifications of letting them continue fallaciously interpreting assessments are profound.
 
Maybe phrase the question, "Oh, very interesting. I had different diagnostic impressions from these results. I'm curious to what your thoughts were- maybe we can get together to discuss?" Since you're in a collaborative role, it would make a lot of sense to suggest a case consultation where you could passively "teach" them and give feedback in a way that promotes discussion and learning. I don't think it's a matter of correcting, but a matter of collaborative exploring and teaching. You would be helping the master's level therapist grow and learn by doing this. Also, the ethical ramifications of letting them continue fallaciously interpreting assessments are profound.

I agree, the ethics issues and future patients that could be impacted are concerning. And these are definitely collaborative relationships to maintain and grow and can be good teaching moments to improve the team and their practices.

Even though we are technically colleagues, there are potential political implications given seniority and "standing" of some providers, which always makes these kinds of things interesting. Appreciate the input.
 
As a former master's level clinician, I know I would've easily given deference to a psychologist regarding findings on the MoCa or other such scales. I know arrogant people exist everywhere, but I'm also curious how far a "Oh, really? I was taught X meant Y" would go. I know probably not for all people everywhere, but my impressions of the mid-levels I've encountered is that they're fairly eager to learn.
 
There is yet another ethical question that has not been raised as yet. Some test materials (such as the MMPI, WAIS, etc) are not sold to people without a Ph.D. or PsyD, and a Psychologists license, and it is in fact unethical (and possibly illegal) to expose people without the proper qualifications to these tests unless you are administering them to them, which you are obviously not doing (I hope! 🙂) to master's level colleagues. You *can*, however, reveal the interpreted (by you) results of such tests within the limits of confidentiality, but you cannot give them the raw data, i.e., the individual questions, raw scores, etc. So if you are doing this properly, what they should see is *your* interpretation of the WAIS or MMPI or whatever, not the actual test protocol.

You can have a look at the Pearson catalog and other vendor catalogs to see who is entitled to purchase what, and this should give you a good quick idea of what you ethically can and cannot share with master's level colleagues.
 
Everyone with access to the internet is an expert on assessment and diagnostics. I suggest you just keep quiet as the political ramifications of correcting anyone about anything can be very problematic.

Whaaaaaaaat?!

Isn’t this a tautology? Like, this very statement violates its own principle?
 
Whaaaaaaaat?!

Isn’t this a tautology? Like, this very statement violates its own principle?

Is it possible that the sarcasm escaped your notice ?
 
For what it is worth, our practice has 8 LPCs - and we will only consider hiring an LPC or Psychologist or Psychiatrist - most were trained in psychiatric hospitals and probably half of my clinicians use tests and assessments from Pearson (WISC, etc like you all have mentioned) and have been not only vetted, but trained and performed evaluations under supervision previously with psychiatrists and psychologists both. I understand your issues - I f that when attending CE presentations our staff many times have looked across tables at each other wide-eyed with surprise at some of the things our “peers” in the audience have offered up with absolute confidence.

I am sorry you have to deal with such a delicate task as it seems egos and hurt feelings prevail quite a bit these days!

We find (my co-owner and I) that keeping an extremely tight leash and reign on the “who and how” of those practices has been most effective and we also encourage everyone to “stay in their own lane” - we maintain great working relationships with the neuropsychologists in our area - and prefer to focus on the practice we train in and perfect.

One other observation I have noticed is the profound lack of actual mental health / psychopathology courses that LICSW and MFT programs provide - yet many jobs/agencies hire those individuals anyway as long as they are able to bill a code to insurance - and it is concerning.

Perhaps we are an exception to the rule. Or we are rigorously anxious

Anyone have experience giving feedback to MFTs and LCSWs (that you work closely with) regarding their incorrect interpretations about assessment findings? I have done this occasionally but in a new role I am on a team where I work with them directly as a colleague and in a non-supervisory role. The confidence to which some of their incorrect statements are made and inability to question their scope of practice and training before speaking on such matters is especially concerning.
 
There is yet another ethical question that has not been raised as yet. Some test materials (such as the MMPI, WAIS, etc) are not sold to people without a Ph.D. or PsyD, and a Psychologists license, and it is in fact unethical (and possibly illegal) to expose people without the proper qualifications to these tests unless you are administering them to them, which you are obviously not doing (I hope! 🙂) to master's level colleagues. You *can*, however, reveal the interpreted (by you) results of such tests within the limits of confidentiality, but you cannot give them the raw data, i.e., the individual questions, raw scores, etc. So if you are doing this properly, what they should see is *your* interpretation of the WAIS or MMPI or whatever, not the actual test protocol.

You can have a look at the Pearson catalog and other vendor catalogs to see who is entitled to purchase what, and this should give you a good quick idea of what you ethically can and cannot share with master's level colleagues.

All of the measures you named can be ethically purchased, administered, and interpreted by Master’s level clinicians in several states.
 
I've seen it mentioned on here before: if we rely on test publishers to "protect" the sale and use of more advanced/in-depth assessment measures, we're going to be disappointed. It's not in their best (economic) interests to do so. They may implement low-level requirements, as they have, but they're also going to leave it up to the individual provider to determine if they can ethically use the instruments. And it's also in the best interests of the state boards of master's-level providers to attempt to expand their scopes of practice as much as possible, meaning many of them will say master's-level providers have the training to administer and interpret these instruments.

Whether psychologists agree with all that, and what we do to support or refute it (particularly at the level of the state legislature), is another matter, and relies on us being active participants/advocates in state politics.
 
Do you know of any who are capable?
 
More clearly - that have perhaps had appropriate and satisfactory training that may be outliers?
 
There was a masters level person using neuropsych instruments and providing full evaluations in the area, with lots of misdiagnoses and incorrect interpretations. As the neuro community is pretty close here, word got around. Several of us reported that person to their board. That person no longer provides neuropsych assessments and had to obtain a certain amount of hours of CE credits related to ethics and scope of practice. Based on how badly they screwed up in several reports, they are lucky they were not sued first.
 
Reckless. Ugh. That was certainly the correct thing to do!

There was a masters level person using neuropsych instruments and providing full evaluations in the area, with lots of misdiagnoses and incorrect interpretations. As the neuro community is pretty close here, word got around. Several of us reported that person to their board. That person no longer provides neuropsych assessments and had to obtain a certain amount of hours of CE credits related to ethics and scope of practice. Based on how badly they screwed up in several reports, they are lucky they were not sued first.
 
They are lucky if they still possess a license I surmise.
 
As you can imagine - we (other owner and myself) filter many CV and résumés that we must very carefully question. I remember one applicant letting us know she felt she had unexplainable skills gifted to her - ostensibly not associated with her education.... Hard Pass.
 
The LPC/LPCC board is not as stringent as other boards in this state.
Ah. I see. Sadly that does seem to vary across state lines. As odd as this may sound, I have always enjoyed reading the minutes from various medical, nursing, psychology, counseling, etc. boards in other states (I understand that makes me a very different type of “geek” I have been informed ) and have always been astounded at what it took in some areas to actually LOSE a license in any of the disciplines in one state vs. the hammer coming down for the lifetime of a career in others.
 
More clearly - that have perhaps had appropriate and satisfactory training that may be outliers?

Me personally? No, not that I can recall. I've known multiple MH providers who had little to no formal training in therapy during their master's program, let alone anything related to assessment. That did not stop their state licensing board from saying it's within certain providers' scopes of practice.
 
Incredulous that the state licensing board would give that stamp of approval if (in a perfect world) all disciplines did adhere to those ethical mandates they all claim to rigorously follow and defend. It is hard not to become skeptical and assume money and ego have become the new “ethics”.

I hear my uncle (psychiatrist) lament of the psychologists he worked with (in his state) trying to convince him to support prescriptive privileges for certain psychotropic medications. He always said “if you want to prescribe medication - go to medical school”.

We use 2 well respected and practiced neuropsychologists - it only bolsters the reputation of our LPCs - as our patient population trusts that we have collaborative relationships (and reciprocal referring relationships built on years of quality services) with the best for THEIR NEEDS - and they know exactly what they can expect from our current providers (all LPCs at the moment) - 99.9% counseling in it’s purest form.
 
All of the measures you named can be ethically purchased, administered, and interpreted by Master’s level clinicians in several states.

What’s ethical and what’s legal are two different things.

Having gone through both training to licensure as an LPC and then on to completing graduate school in professional psychology, I wouldn’t have trusted past me to interpret a WAIS let alone do neuropsychology evaluations. MA program that I know about and are CACREP accredited offer very little training beyond a very surface level understanding of CTT and don’t cover cognition at all. I’m not sure someone with this background can ethically be expected to expertly interpret these types of tests at that level of training. Administer sure, but not interpret.


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What’s ethical and what’s legal are two different things.

Having gone through both training to licensure as an LPC and then on to completing graduate school in professional psychology, I wouldn’t have trusted past me to interpret a WAIS let alone do neuropsychology evaluations. MA program that I know about and are CACREP accredited offer very little training beyond a very surface level understanding of CTT and don’t cover cognition at all. I’m not sure someone with this background can ethically be expected to expertly interpret these types of tests at that level of training. Administer sure, but not interpret.


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Yes, they are two different things.

During my Master’s level training I was trained to administer, score, and interpret those measures (and more). Clinicians should work work within their own competencies.
 
Yes, they are two different things.

During my Master’s level training I was trained to administer, score, and interpret those measures (and more). Clinicians should work work within their own competencies.
FWIW....That is not the "typical" training in a counseling program, at least based on my experience previously lecturing in such a program and reviewing training guidelines for one of the state legislatures and their licensing board.
 
Yes, they are two different things.

During my Master’s level training I was trained to administer, score, and interpret those measures (and more). Clinicians should work work within their own competencies.

Sounds like we agree.

Are you a school psychologist? I know Ed.S. folks get trained to do some of this in schools. I was mainly speaking of LPCs/LMFT/LCSWs.


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FWIW....That is not the "typical" training in a counseling program, at least based on my experience previously lecturing in such a program and reviewing training guidelines for one of the state legislatures and their licensing board.

We should overhaul all programs that are not going to provide this sort of training and make sure they offer a May/Jan course for 1 credit hour called

“YOU NEED TO KNOW WHAT YOU DON’T KNOW - #STAY IN OUR OWN LANES: The art of the appropriate referral”

Don’t worry everybody in this whole thread will share in the origin of the course.




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While that is said in jest... I meant every word if it were feasible


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While that is said in jest... I meant every word if it were feasible

I do wish programs did a better job of demonstrating "knowing what you don't know." Otherwise, the scope creep that we see has the potential to harm patients.
 
I do wish programs did a better job of demonstrating "knowing what you don't know." Otherwise, the scope creep that we see has the potential to harm patients.

Well said - and with the focus in the place that so often gets forgotten first!


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There are some broken areas for sure - There was a handful of us in graduate school who were getting clinical mental health masters degrees in order to become licensed professional counselors who got our internship and practicum done at a private psychiatric hospital where the treatment team consisted of psychologists, psychometrists (when needed for caseload overflow), psychiatrists, LPCs and psychiatric nurses. Everyone was part of the treatment team that had one specific function and not ONCE did anyone ever practice above or around each other. Even the psychiatrists would defer to STUDENT IN TRAINING graduate students to assign the appropriate therapy and schedule.

My business partner and I Immediately went to work for my uncle who is a psychiatrist running his office and managing an opiate dependency outpatient clinic from the therapeutic side and maintaining all of the Records and Licensure requirements from the DEA side. Never had an issue there UNTIL - We were able to see some older professionals in the community who had the “licensure credentials” we were supposed to be trying to attain - who were not at all what we wanted to become. Thus “our office” now.

I hope it is encouraging that once the students leave the school - they have to work - and some folks still see the picture the same way you do - and I will tell you right now I would love to hire a neuropsychologist at our office right now…! What is the trend? Are they staying in academia are they working in agencies are they private practice?

Does your national professional organization have a particular stance at all?


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I hope it is encouraging that once the students leave the school - they have to work - and some folks still see the picture the same way you do - and I will tell you right now I would love to hire a neuropsychologist at our office right now…! What is the trend? Are they staying in academia are they working in agencies are they private practice?

Does your national professional organization have a particular stance at all?

Most neuropsychologists are working in primarily clinical settings. Not sure about a trend. Just like other areas, academic jobs are drying up, so if anything, I'd guess even more are going clinical than before.

And, stance on what? Scope creep? We fight legislation at the states level all of the time of midlevels that want to be able to use neuropsych billing codes.
 
Most neuropsychologists are working in primarily clinical settings. Not sure about a trend. Just like other areas, academic jobs are drying up, so if anything, I'd guess even more are going clinical than before.

And, stance on what? Scope creep? We fight legislation at the states level all of the time of midlevels that want to be able to use neuropsych billing codes.

Well, I logically must agree with your pessimism - and I wonder if a suggestion to CACREP to consider looking at regional/state post graduation practice/insurance claim submission vs the actual educational institutions curriculum they are credentialing - for example, if a school is up for renewal - Is there at least a pamphlet?! Lol -

i know what keeps the checks and balances here (Alabama) is the insurance companies. They do not mandate who does the testing and assessments but they sure as hell determine who they reimburse for doing so. Therefore in order for midlevel practitioner to legally and ethically use a code for a test or assessment they must usually use a modifier code showing them practicing as a “psychological tech” and are limited in the hours them can submit - and may even be billing under the psychologist’s NPI many times requiring them to be present or accessible.

So not only do the insurance panels make that a far less financially lucrative option for the clinician (midlevels in that scenario) - it is not worth the headache to the patient. Makes more sense to have the stated clinician perform, bill and interpret - BCBS and Alabama Medicaid (our largest insurers) are basically in lockstep almost with those things.

In more “well to do” areas the cash only approach can muddy the water - but many are having adolescents or children tested or assessed for their schools and now the boards of education are doing their own testing on their own dime and filing the other outcomes almost treating it like anecdotal evidence. Hopefully CACREP would make sure that some sort of oversight would be done JUST due to the massive amounts of billing fraud that already exists!


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We should overhaul all programs that are not going to provide this sort of training and make sure they offer a May/Jan course for 1 credit hour called

“YOU NEED TO KNOW WHAT YOU DON’T KNOW - #STAY IN OUR OWN LANES: The art of the appropriate referral”

Don’t worry everybody in this whole thread will share in the origin of the course.




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Yes!! I think a major issue is providers of ALL levels often don’t know what they don’t know... and overestimate their ethical scope.
 
Sounds like we agree.

Are you a school psychologist? I know Ed.S. folks get trained to do some of this in schools. I was mainly speaking of LPCs/LMFT/LCSWs.


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No, my first degree is in counseling psychology. I have practiced as an LPC and an LPA (Texas). Many states have “Master’s level psychologist” (or a variety of names) licenses for independent practice, including assessment. Those states have different licensure requirements for those providers than for LPC, etc. Usually the same board that manages LP license manages these.

I would definitely arguing that having the degree (PhD or otherwise) and the licensure (LPA, LP, etc.) is not enough to verify a clinician can ethically administer/interpret those measures.
 
FWIW....That is not the "typical" training in a counseling program, at least based on my experience previously lecturing in such a program and reviewing training guidelines for one of the state legislatures and their licensing board.

I believe that varies by region.

My point is there shouldn’t be broad generalizations about what can and cannot be done by various providers. We are all working from our own experiences, that is biased by our own training, state regulations, etc. Saying no Master’s level clinicians are competent to administer and interpret a WAIS is ludicrous. I know that I completed more assessment training in my Master’s than some get in their doctorate. That may be somewhat of an exception but isn’t unheard of. Some students finishing their doctorate have very little supervised assessment experiences. Everyone should learn to work within their own competencies and seek additional training/supervision when necessary.
 
It's one thing to posit in theory, but the actual clinical, ethical, and legal implications are much more problematic. The public shouldn't need to understand the nuances of training differences. Licensing boards need to be MORE strict about scope of practice because scope creep is not only real, but it can be quite harmful. Trying to argue self-policing is as likely as Wall Street and Banks doing it effectively enough to not require oversight.

Assessment using anything more than a screener or self-report measure is asking for trouble. It is one thing to learn to administer these assessments, but it's an entirely different scenario to interpret them. It *should* be limited to doctorally-trained and licensed clinicians. I know the horses are out of the barn, but that doesn't mean it isn't harmful to patients on a daily basis.
 
There are some broken areas for sure - There was a handful of us in graduate school who were getting clinical mental health masters degrees in order to become licensed professional counselors who got our internship and practicum done at a private psychiatric hospital where the treatment team consisted of psychologists, psychometrists (when needed for caseload overflow), psychiatrists, LPCs and psychiatric nurses. Everyone was part of the treatment team that had one specific function and not ONCE did anyone ever practice above or around each other. Even the psychiatrists would defer to STUDENT IN TRAINING graduate students to assign the appropriate therapy and schedule.

My business partner and I Immediately went to work for my uncle who is a psychiatrist running his office and managing an opiate dependency outpatient clinic from the therapeutic side and maintaining all of the Records and Licensure requirements from the DEA side. Never had an issue there UNTIL - We were able to see some older professionals in the community who had the “licensure credentials” we were supposed to be trying to attain - who were not at all what we wanted to become. Thus “our office” now.

I hope it is encouraging that once the students leave the school - they have to work - and some folks still see the picture the same way you do - and I will tell you right now I would love to hire a neuropsychologist at our office right now…! What is the trend? Are they staying in academia are they working in agencies are they private practice?

Does your national professional organization have a particular stance at all?


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The “broken areas” are one reason I returned to school for a doctorate. I saw too many clinicians over the years using the letters behind their name to justify ridiculous, unethical things. Making a statement with a doctorate doesn’t make the statement accurate. You’d be surprised (or maybe you wouldn’t) how many doctoral level providers feel they should never be questioned, even when working well outside their competencies.
 
It's one thing to posit in theory, but the actual clinical, ethical, and legal implications are much more problematic. The public shouldn't need to understand the nuances of training differences. Licensing boards need to be MORE strict about scope of practice because scope creep is not only real, but it can be quite harmful. Trying to argue self-policing is as likely as Wall Street and Banks doing it effectively enough to not require oversight.

Assessment using anything more than a screener or self-report measure is asking for trouble. It is one thing to learn to administer these assessments, but it's an entirely different scenario to interpret them. It *should* be limited to doctorally-trained and licensed clinicians. I know the horses are out of the barn, but that doesn't mean it isn't harmful to patients on a daily basis.

I’m curious what you believe occurs (assessment training wise) at the doctoral level that can’t also occur at the Master’s level?
 
Saying no Master’s level clinicians are competent to administer and interpret a WAIS is ludicrous. I know that I completed more assessment training in my Master’s than some get in their doctorate.

I’m curious what you believe occurs (assessment training wise) at the doctoral level that can’t also occur at the Master’s level?

I'm curious how you think they're comparable. I don't know how to interpret what you said about having more assessment training as a master's student. Assessment is a core competency in doctoral training. Some students go above and beyond their foundational training, but I've never heard of a master's program that provides more training in assessment than a (reputable) doctoral program. Out of curiosity, how many supervised assessment hours did you complete in your master's program? How many integrated assessment reports did you write?

I do agree with you that degree, license, training, scope of practice, and ethical reasoning are all distinct constructs that are not substitutes for one another, and people at all levels practice beyond their competence. State licensure comes with a very low bar for professional practice and of course there is a difference between "legally can" and "ethically should."

Assessment using anything more than a screener or self-report measure is asking for trouble.

And sometimes THAT is asking for trouble too! I can think of several patients who were convinced they had x diagnosis based on some (usually bogus) questionnaire that a counselor recommended.
 
I'm curious how you think they're comparable. I don't know how to interpret what you said about having more assessment training as a master's student. Assessment is a core competency in doctoral training. Some students go above and beyond their foundational training, but I've never heard of a master's program that provides more training in assessment than a (reputable) doctoral program. Out of curiosity, how many supervised assessment hours did you complete in your master's program? How many integrated assessment reports did you write?

I do agree with you that degree, license, training, scope of practice, and ethical reasoning are all distinct constructs that are not substitutes for one another, and people at all levels practice beyond their competence. State licensure comes with a very low bar for professional practice and of course there is a difference between "legally can" and "ethically should."



And sometimes THAT is asking for trouble too! I can think of several patients who were convinced they had x diagnosis based on some (usually bogus) questionnaire that a counselor recommended.

I’d have to look up those numbers. My assessment practicum was a year long and part-time. I believe 15-20 hours per week. I did 1 integrated report per week (and all associated testing), and had a therapy caseload. Near the end (last 2-3 months) I phased out therapy clients and did 2-3 integrated reports per week.

Prior to and concurrent to that practicum I had assessment related courses.

My doctoral program had assessment coursework, but didn’t mandate assessment practicum at that level. I think students had to do 10 integrated reports prior to applying to internship? I can’t recall because I also focused on assessment training and had more than the minimum.

ETA: my Master’s was completed in a state that does not license Master’s level providers to administer/interpret assessment. I didn’t know I would live in a state that allowed it. I sought this training out because I knew as a Master’s level provider I would review assessments from other providers, and I wanted to be able to understand them to best support my clients.

It was an option for practicum that required more elective assessment coursework than our core requirements. There were also therapy-only practicums. I had done one of those and had an assistantship doing therapy, so assessment made sense to me.
 
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I'm curious how you think they're comparable. I don't know how to interpret what you said about having more assessment training as a master's student. Assessment is a core competency in doctoral training. Some students go above and beyond their foundational training, but I've never heard of a master's program that provides more training in assessment than a (reputable) doctoral program. Out of curiosity, how many supervised assessment hours did you complete in your master's program? How many integrated assessment reports did you write?

I do agree with you that degree, license, training, scope of practice, and ethical reasoning are all distinct constructs that are not substitutes for one another, and people at all levels practice beyond their competence. State licensure comes with a very low bar for professional practice and of course there is a difference between "legally can" and "ethically should."



And sometimes THAT is asking for trouble too! I can think of several patients who were convinced they had x diagnosis based on some (usually bogus) questionnaire that a counselor recommended.

I don’t know if they’re comparable, necessarily. I just don’t find it accurate to say that Master’s level programs can’t provide adequate assessment training and all doctoral level programs do. There can be overlap.
 
I don’t know if they’re comparable, necessarily. I just don’t find it accurate to say that Master’s level programs can’t provide adequate assessment training and all doctoral level programs do. There can be overlap.

There can be overlap. Do predoctoral internship applications still count assessment and intervention hours accrued in master's training? If not, they used to. The problem isn't that the training is impossible at the master's level, but rather that there is no consistent standard for master's training. By contrast, all APA-accredited programs provide coursework and supervised experience in psychological assessment. A program cannot be accredited without these features, since assessment is a core competency. We can debate what constitutes "adequate," and some contend that APA's requirements are too lax/minimal, but we know that accredited doctoral programs provide a certain minimum standard of training in assessment.

What you described, i.e.,

My assessment practicum was a year long and part-time. I believe 15-20 hours per week. I did 1 integrated report per week (and all associated testing), and had a therapy caseload. Near the end (last 2-3 months) I phased out therapy clients and did 2-3 integrated reports per week.

...sounds unusual and is probably not the norm. But what do I know? It's difficult to know because master's programs in psychology are not held to any set of consistent standards of clinical training. Even if they were, it doesn't stop a given program from going above and beyond the minimum requirements. That doesn't equate to a higher level of training for licensure purposes, however. To use an imperfect analogy, a physician assistant might acquire a very high level of skill and proficiency in a particular area, but their skill in x area cannot be the basis for an unrestricted medical license. Unlike certification, licensure is fundamentally permissive, and that's why the least restrictive licenses are given to those with the highest and broadest level of training.

My point is that we have some idea of what kinds of minimum competencies go along with an accredited doctoral program, whereas master's level training has not been subject to the same kind of standardization, which makes licensure and scope of practice issues difficult to sort out. APA has decided to get into the business of accrediting master's level psychology programs only very recently, so we will likely see some changes down the road.
 
There can be overlap. Do predoctoral internship applications still count assessment and intervention hours accrued in master's training? If not, they used to. The problem isn't that the training is impossible at the master's level, but rather that there is no consistent standard for master's training. By contrast, all APA-accredited programs provide coursework and supervised experience in psychological assessment. A program cannot be accredited without these features, since assessment is a core competency. We can debate what constitutes "adequate," and some contend that APA's requirements are too lax/minimal, but we know that accredited doctoral programs provide a certain minimum standard of training in assessment.

What you described, i.e.,



...sounds unusual and is probably not the norm. But what do I know? It's difficult to know because master's programs in psychology are not held to any set of consistent standards of clinical training. Even if they were, it doesn't stop a given program from going above and beyond the minimum requirements. That doesn't equate to a higher level of training for licensure purposes, however. To use an imperfect analogy, a physician assistant might acquire a very high level of skill and proficiency in a particular area, but their skill in x area cannot be the basis for an unrestricted medical license. Unlike certification, licensure is fundamentally permissive, and that's why the least restrictive licenses are given to those with the highest and broadest level of training.

My point is that we have some idea of what kinds of minimum competencies go along with an accredited doctoral program, whereas master's level training has not been subject to the same kind of standardization, which makes licensure and scope of practice issues difficult to sort out. APA has decided to get into the business of accrediting master's level psychology programs only very recently, so we will likely see some changes down the road.

I don’t disagree with any of this. Thanks for sharing your thought process. My experience has been that state boards have minimum training standards for the licensure that allows for assessment, those training standards are not consistently present within Master’s level programs.
 
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