Licensure at the Doctorate Becomes Law in Maryland

[Annakei]

Signed by the Governor on May 19, 2009.

Licensure at the Doctorate Becomes Law in Maryland on October 1, 2009

The legislation SB 951/HB 654 http://mlis.state.md.us/2009rs/bills/sb/sb0951e.pdf (click on link to see the whole bill) essentially says that, if you meet all the supervisory experience and hours, and graduate program criteria and requirements, prior to or at the receipt of your doctorate, you would have met eligibility for licensure. Meaning that the post-doc supervisory year would not be necessary. It is no longer mandated. However, for those who have not met all the requirements by that time, post-doc supervision would still be needed and is not eliminated. The language in the bill looks like this:



Health Occupations Article Subtitle 3 Licensing § 18–302 (f) The applicant shall have at least 2 years of professional supervised experience in psychology that is approved by the Board IN ACCORDANCE WITH REGULATIONS ADOPTED BY THE BOARD [At least 1 year of this required experience shall have

occurred after the doctoral degree is awarded.]



As you can see, the bill itself does not specify what the regulations are that have been adopted by the Board. Those regulations are now being revised and promulgated by the Board of Examiners in light of this new piece of legislation. The changes will occur in Title 10, Department of Health and Mental Hygiene, Subtitle 36, Board of Examiners of Psychologists, Chapter 01 Procedures – .04 Professional Supervised Experience Required for Licensure.

http://www.dsd.state.md.us/comar/subtitle_chapters/10_Chapters.htm#Subtitle36



That whole chapter is basically the “how-to” become licensed and what criteria and qualifications are necessary to do so. So as you see, the legislation alone allows for possibility that you might have accumulated the required 3,250 hours of supervised professional experience by the time you receive your doctoral degree. The regulations define how those hours are applied throughout the sequence of your doctoral training, the nature of the supervision, pre-internship and internship experiences, etc.



The other aspect to regulations is the exact process by which a graduate student in a doctoral program, can begin the application process and/or sit for the EPPP and state exams, if and when all the hours are accumulated, i.e., prior to receiving the soctoral degree, or upon receipt of the doctoral degree.



Much work still needs to be done – but it is well in process and MPA will keep everyone informed as each piece is in place.



The Maryland Psychological Association is working to remove barriers to practice for psychologists, to increase training opportunities for those entering the profession, and to ensure that Maryland's neediest citizens have access to the high quality mental health services they need and deserve. By removing unnecessary obstacles to entering the profession all three goals can be achieved. Please educate yourself about this important issue by reading the materials below.

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[psychmama]

This is so encouraging! Maybe other states will begin to change their licensing laws in recognition of the changes in professional psychology programs and training? I have a friend from MD who is on internship now, and I bet she's excited about this!

 

[LM02]

I was recently told that licensure without the postdoc year has been adopted in Alabama, as well (and maybe Ohio?).

The key is that you need to make sure that you have enough hours by the end of internship to be able to do it - if not, you'll still have to accrue the additional hours at the postdoc level. For people coming out of more research-heavy programs, this might be a bit tougher to do predoctorally (but by no means impossible).

 

[Annakei]

Which hours count? All hours obtained during your doctorate (practicum/externsip) or just the year of internship?

 

[psych00]

Which hours count? All hours obtained during your doctorate (practicum/externsip) or just the year of internship?

Hmm...yeah really, if they removed the section saying that at least 1 year has to be after the doctoral degree is awarded, then it seems like the hours you accrue in your program prior to graduating should count...?

Aaaand.....does anyone know if the 3,125 hours of "supervised professional experience" mean face-to-face/intervention & assessment hours, or do they really mean supervised professional experience in general??

 

[KillerDiller]

Hmm...yeah really, if they removed the section saying that at least 1 year has to be after the doctoral degree is awarded, then it seems like the hours you accrue in your program prior to graduating should count...?

I'm confused about this part. Don't most schools require the internship as part of the curriculum before the degree is awarded? I thought my school did, but I could be wrong. Also, what about those who defend their dissertation in the same year as their internship? How would the one year requirement be any different than a post-doc for them?

 

[ADDICTED2STATS]

We are working on this issue in my state. As of next year there will be about a dozen states doing away with the post-doc year. As for hours, it depends on the state, but the key is that hours accrued prior to internship will count (and not just I & A hours). At ASPPB they have been working (through DCTs) to standardize hours across programs in anticipation of this.

My advice: Talk to your state psych association and let them know this is something you want to pursue. Remember, it can be an uphill battle b/c psychologists who are licensed don't see any need to change the law.

 

[Annakei]

We are working on this issue in my state. As of next year there will be about a dozen states doing away with the post-doc year. As for hours, it depends on the state, but the key is that hours accrued prior to internship will count (and not just I & A hours). At ASPPB they have been working (through DCTs) to standardize hours across programs in anticipation of this.

My advice: Talk to your state psych association and let them know this is something you want to pursue. Remember, it can be an uphill battle b/c psychologists who are licensed don't see any need to change the law.

This makes me very happy. I was discussing the issue with colleague and we were saying how silly it is to have to comeplete another year after completing the doctorate to get licensed after just spending 4-7 years training. And, depending on certain variables, you may not be able to get a postdoc right after graduation. So I know that some are essentially in limbo right now because they cannot obtain a postdoc due t several factors. Some of them being that licensed psychologists/CMHCs dont want to hire nonlicensed psychologists because they arent able to be reimbused for their work through insurance panels and Medicaid. Also, paying for supervision is an issue when you're working for next to nothing to get hours for licensure.

I hope that as these states get on board we can post them here for all new and early career psychologists to see.

 

[phillydave]

We are working on this issue in my state. As of next year there will be about a dozen states doing away with the post-doc year. As for hours, it depends on the state, but the key is that hours accrued prior to internship will count (and not just I & A hours). At ASPPB they have been working (through DCTs) to standardize hours across programs in anticipation of this.

My advice: Talk to your state psych association and let them know this is something you want to pursue. Remember, it can be an uphill battle b/c psychologists who are licensed don't see any need to change the law.

Do you have any idea which other states may be going this route? This is indeed good news.

 

[psychmama]

I understand why people want this, but it makes things more difficult with the numerous masters degree practitioners out there.

Further, internship and postdoc are usually supervised more heavily by full-time/near full-time practitioners. Whereas, that's highly variable in graduate school.

Jon- Why does it make things more difficult with Master's level practitioners? As I see it, right now people come out of a doctoral program with something like 1000-2000 supervised hours of clinical training, only to find themselves in the position of being less employable than a master's level therapist. Why? Because many sites refuse to hire unlicensed psychologists (either because they lack manpower to provide supervision, they cannot get paid for non-licensed practitioners, or both). There are not enough post-docs out there to meet the demand of new PsyDs abd PhDs looking to accrue hours for licensure. It's a catch 22 for many.

I think your point about the quality of preinternship training is valid, but I'm guessing there are other ways to address this without punishing those who've had thorough and ample predoctoral training.

 

[lookitssara]

I am totally in favor of doing away with the post-doc year mandate, but I have to mention that masters level clinicians have some difficulty too with this. Most states require at least 2 years of supervised experience after graduation to become licensed...but most jobs require you to be licensed. There are even more hours involved if you want to be eligible for insurance reimbursement. It's not totally apples to oranges!

*I realize doc students go through way more training through school than masters students do...I'm just saying that masters level clinicians still have more hours to do before they are also competitive for hiring.

 

[lamorena]

this is exciting 🙂 i know in my state, a masters level clinician needs 3 years of experience to get an LPC, 2 to get a LCSW, etc. as long as a process that is, i think it makes sense, given the fact that the education is much shorter. i mean, maybe it could be shorter than 3 years for an LPC.. its not a great place to be in, trust me, i have been working toward my LPC and the jobs are SO limited without it. it stinks! but i think there still needs to be something in place in terms of licensure.. not everyone straight out of a master's program is ready to be a therapist.

but doctoral level professionals, on the other hand, are going through intensive training, supervision, practicums, and internships over 4-7 years. doing away with the post doc year is HUGE and i think it makes so much sense.

 

[ADDICTED2STATS]

Lets clarify this just to make sure we're all on the same page. We're not talking about doing away with internship. People will still need to complete their doctorate before they can sit for licensure. The new laws being enacted are just saying once you're Dr. X you can sit for licensure (no more Dr. X + 1 year). The rationale behind this is pretty sound. When the 1 year post-doc requirement started, psychologists were not recieving much clinical training during grad school. The 1 year requirement ensured two years of clinical work (~3000 hours). Now, many people are going on internship with 1,500 + plus and then accruing 2,000 + on internship. We're meeting the same requirements that they did 30 years ago, it's just that we are doing a year sooner. Not to mention the fact that there is no data suggesting that the 1 year postdoc produces superior clinicians. If there were, then I would be all about keeping it.

 

[Therapist4Chnge]

Because the current masters line is a doctorate is a couple of more years of research training. There are, of course, lots of reasons this isn't true. I agree, it makes little sense to allow folks with masters degree to practice and bill and not allow ABIP (all but internship and postdoc) doctoral trained practitioners to practice and bill. I think maybe a provisional license would make more sense, but with requirements to still do internship and postdoc for advanced skills. In other words, no assessment or other tasks that are exclusive to doctorate level activity without postdoc.

Unfortunately this is something that I've heard from a number of sources, and psychologists (and the related organizations) have done little to combat such an uniformed statement. The general public doesn't understand the difference between psychiatry, psychology, and the multitude of mid-level professionals out there.

 

[KillerDiller]

Lets clarify this just to make sure we're all on the same page. We're not talking about doing away with internship. People will still need to complete their doctorate before they can sit for licensure. The new laws being enacted are just saying once you're Dr. X you can sit for licensure (no more Dr. X + 1 year). The rationale behind this is pretty sound. When the 1 year post-doc requirement started, psychologists were not recieving much clinical training during grad school. The 1 year requirement ensured two years of clinical work (~3000 hours). Now, many people are going on internship with 1,500 + plus and then accruing 2,000 + on internship. We're meeting the same requirements that they did 30 years ago, it's just that we are doing a year sooner. Not to mention the fact that there is no data suggesting that the 1 year postdoc produces superior clinicians. If there were, then I would be all about keeping it.

I don't know if you were referring to my comment. I'm not confused about the distinction between internship and post-doc. What I was confused was how the phrase "at least one year of this required experience shall have occurred after the doctoral degree is awarded" eliminated the requirement of a post-doc year. However, I just followed the link and saw that that phrase is crossed out of the proposed legislation even if it is not crossed out of the original post. So that clears that up for me.

Another question I have, however, is whether the 3,000 hours it seems some states are considering refer to total APPIC hours or to clinical contact hours. If it's the latter, it seems there will be plenty of people who do not have 3,000 hours following internship. I mean, even working full time for a full year will not net much over 1,000 hours. I just think such requirments encourage the behavior of all those people who are inflating their hours going into internship.

 

[ClinicalTrainee]

I don't have a strong opinion about this issue personally, but I agree that things are likely to change soon. I believe a few states (Washington and Utah?) do have this rule and it's already created some difficulties for people who try to move across states. If you get a license in one of these states then move to a state with more stringent requirements (supervised post-doctoral hours), you will not be able to get a license there. My understanding is that the state licensing boards and APA are working on this issue, but just something to consider.