PhD/PsyD Should I stay or should I go? - Post-doc hours woes

[quasipostdoc]

Hi all,

Throwaway account but wanted to get feedback on what you'd do in this situation:

After internship didn't have post doc lined up but also didn't have dissertation finished. Got an interview later in fall at a CMH agency , they initially told me no psychologist was there so couldn't provide licensure supervising, then they hired one and informed me they'd proceed with interview process if I was still interested. Wasn't done dissertation yet so hours wouldn't matter yet. So took the job and got to work. Finished dissertation shortly before my employee probationary period ended, got all my health insurance and such lined up. Went to supervisor to see about setting up formal supervision with aforementioned psychologist. Found out this person wasn't yet licensed, they did have a masters level license and a doctorate but were still in process of studying for EPPP and licensing paperwork!

Needless to say I was pretty frustrated. During interview process they sat down with me (HR, hiring manager, management) and told me to my face they had just hired a licensed psychologist after all. Turns out they didn't actually know that licensing requirements for masters level vs doctoral level varied. Most of the staff and clinicians are LPCs and LCSWS so can simply get outside supervision for a fee, PHD and PsyD level in my state aren't allowed to do so.

For the "psychologist's" part they were annoyed that they were being misrepresented but were agreeable to supervising. Of course the hours wouldn't count yet. Then come to find out the psychologist was currently in process of preparing to retake the EPPP. For their part they were transparent with me and have kept me up to date but the CMH agency itself was pretty much "not our problem" to concerns about this. The soon to be psychologist has a lot of experience, we get along well, and I'd have an opportunity alongside them to help further develop an internship program which I'd love to work on.

All this out there the job itself isn't bad, it's opened me up to new clinical experiences I've never had, there's no shortage of hours to be had, it's salaried with full benefits ,own office, have enough autonomy...BUT now I've been sitting around for months with no hours counting I'm stuck on what to do.

At this juncture it'll be at least another 2-3 months until this psychologist is licensed and hours can count and it's been at least 5 months since I was technically license eligible to receive post doc hours that counted.

On one hand I feel like I should have started looking like 3 months ago (and I do have some mentors/supervisors of past I can reach out to see if there's a lead) on other hand I feel stuck because I'm making more than I'd make in most traditional formal post docs, the hours are great, and health insurance not to mention decent vacation/sick time. And yeah part of me is a little bitter that they didn't know what they didn't know and kind of threw up their hands and went "oh well" once this hiring issue was pointed out. But overall the job isn't terrible and grass isn't always greener.

If I look elsewhere am I really going to find something and start something within the next 2-3 months (esp since new post docs are starting now elsewhere and applications for the following year aren't opening for months) and is it just better to suck it up, stick with the tolerable and alright job and just hope it's not much longer of a wait?

Sorry for the long winded post but what would you do? Is it worth it to hang around, take the pay/benefits and just start supervision when this person is licensed or start looking and jump ship to a place that might pay less/might be fee for service but would have one or more licensed psychologists ?


Edit: to clarify I also have a masters in clinical psych as well as doctorate in clinical psych. The agency is mostly LPC and LCSWs . Technically I operate under their licenses because I am license eligible for an LPC (with my masters) although not going for that.

As for the psychologist who isn’t yet licensed they already completed a post doc and also have a separate LCSW license.

Also in my state you don’t need a license , let alone a masters in some cases to do some of the clinical work I do( ie some of the work I do a BS or BA can do) .I am going to seek clarification on the individual therapy however as this is not clear now that I am reading these responses.

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[erg923]

1. Who has been supervising you? You don't have a professional license of any kind, right? Practicing psychology without a licesne can and should be reported to the state board. And this would be ruinness to your career. If I am misinterpreting whats going on here, you need to make it explicit in your post or delete it ASAP! Hint: I did not quote your post for this reason in my response. You're welcome

2. Whats the point of having an unlicensed psychologist "supervise" you?

3. Who is supervising the "unlicensed psychologist" they have working there?

4, I don't understand how an agency can even hire someone without a license without a designed licensed person to sign their notes, bill under, etc? How are they even billing for your (and the other person's) services? This whole thing sounds like a mess.

 

[ClinicalABA]

They lied to you, and now you are in a position where you may be practicing psychology without a license. Find something appropriate (and legal) ASAP. Who in supervising this non-licensed person while they are in limbo?

 

[FreudianSlippers]

Yeah...i'm a little confused too. In California at least, a psychologist trainee must always have a primary supervisor who is a licensed clinical psychologist. Only exception to this is if somebody was registered as a psych assistant they can be partially supervised by a psychiatrist. Like ClinicalABA and Erg asked, do you have any sort of license or are you registered with any board? There's got to be some sort of oversight or somebody could get into big trouble.

 

[AbnormalPsych]

They lied to you, and now you are in a position where you may be practicing psychology without a license. Find something appropriate (and legal) ASAP. Who in supervising this non-licensed person while they are in limbo?

This is not good. You need to leave. And if practicing illegally, stop immediately.

 

[quasipostdoc]

Yeah...i'm a little confused too. In California at least, a psychologist trainee must always have a primary supervisor who is a licensed clinical psychologist. Only exception to this is if somebody was registered as a psych assistant they can be partially supervised by a psychiatrist. Like ClinicalABA and Erg asked, do you have any sort of license or are you registered with any board? There's got to be some sort of oversight or somebody could get into big trouble.

Well said everyone. I edited post above to clarify which hopefully clarified the situation.

In my particular case since I have a masters degree (terminal) as well the supervising is handled by LPCs and LCSWs. Obviously doesn’t count for the license I need at doctoral level but the plan was to have this person take over supervision once they are licensed as a psychologist.

To the person who said they lied , they did and I informed them of this. They were surprised and thought “ABBP” was the “license” psychologists got. So yeah they have enough licensed professionals but some don’t know what they don’t know.

I will be requesting this be researched and am going to request I get pulled from any clinical work that would explicitly need a licensed psychologist to do or supervise ASAP.

Thank you !

 

[erg923]

Well said everyone. I edited post above to clarify which hopefully clarified the situation.

In my particular case since I have a masters degree (terminal) as well the supervising is handled by LPCs and LCSWs. Obviously doesn’t count for the license I need at doctoral level but the plan was to have this person take over supervision once they are licensed as a psychologist.

To the person who said they lied , they did and I informed them of this. They were surprised and thought “ABBP” was the “license” psychologists got. So yeah they have enough licensed professionals but some don’t know what they don’t know.

I will be requesting this be researched and am going to request I get pulled from any clinical work that would explicitly need a licensed psychologist to do or supervise ASAP.

Thank you !

So, you have a license or not?

You cant get an ABPP cert (I assume that what you meant) without a state license.

 

[Mindfulpsych22]

So, you have a license or not?

You cant get an ABPP cert (I assume that what you meant) without a state license.

What I am gathering is that the OP is working as a master’s level trainee/intern (based on their terminal master’s that makes them eligible for licensure at the master’s level) and is being supervised by the licensed LPCs and LCSWs at the site. This sounds like it is being done with the plan to stop functioning as a master’s level trainee and “start” gathering postdoc hours once the PhD staff is licensed as a psychologist. Am I getting this right OP?

 

[quasipostdoc]

So, you have a license or not?

You cant get an ABPP cert (I assume that what you meant) without a state license.

I do not have a license , thus the questions about supervision. I am eligible for both LPC and Psychologist licensure as all degree requirements and clearances are met for both. Including APA accredited program and internship.

I never got my LPC since went back to school shortly after masters and thus was pursuing eventual doctoral level licensing.

This was also disclosed by me during interviews and during hiring.

 

[quasipostdoc]

What I am gathering is that the OP is working as a master’s level trainee/intern (based on their terminal master’s that makes them eligible for licensure at the master’s level) and is being supervised by the licensed LPCs and LCSWs at the site. This sounds like it is being done with the plan to stop functioning as a master’s level trainee and “start” gathering postdoc hours once the PhD staff is licensed as a psychologist. Am I getting this right OP?

Yes this is absolutely correct.

 

[ClinicalABA]

To the person who said they lied , they did and I informed them of this. They were surprised and thought “ABBP” was the “license” psychologists got. So yeah they have enough licensed professionals but some don’t know what they don’t know.

What?!? Are you saying that, when you called them out on this, they told you they thought that the ABBP (did you mean ABPP) meant licensure? That’s really bad, because it means at least one of the following:

1) your employers are covering a lie with another lie
2) your employers don’t confirm the credentials of people they hire

Either way, your employers (or whoever represented them to you) are either lying or frighteningly incompetent. Not be type of place I’d feel comfortable working. You say it’s a CHC, and those are often subject to regular oversight and survey from state oversight agencies. Only the most incompetent would not confirm credential before hiring, so I thinks someone might be doing a little fibbing.

Also, anyone who has a doctoral level clinical degree but practices under a masters license (theirs or their supervisor’s) needs to be very aware of their state regulations of board position papers regarding such clinical behavior. Their may be rules/ guidelines for how you present yourself to the public (including your clients). Things related to how you can reference your degree, whether or not you or others can refer to you as “Dr.”, etc. Basically, you need to be cautious about any behavior that would set you out the public as having doctoral level training/degrees when acting professionally as a masters level clinician.

 

[erg923]

In my view, you are practicing psychology without a license (and without supervision) because the state board is unaware of and has not approved of you being supervised from outside disciplines. The board is likely to find this out when you do go to them to submit appropriate supervision documents. I frankly think you are a bit screwed here? Others are free to disagree.

I am skeptical that a behavioral health organization that hires licensed individuals all the time (and has contractual obligations with CMS) would be so ignorant of the licensing matter.... not to mention so lax in their credential verification processes.

 

[quasipostdoc]

In my view, you are practicing psychology without a license and without supervision because the state boards is unaware of and has not approved of you being supervised from outside disciplines. The board is likely to find this out when you do go to them to submit appropriate supervision documents. I frankly think you a re a bit screwed here? Others are free to disagree.

I’m confused as to how an LPC with the same terminal masters degree I hold is an outside discipline?

Also you can do things like intakes and partial hospitalization groups without a license; in fact in this state there are partial hospitalization programs that only require a bachelors degree in a “related field” and in another state you can be a “registered therapist” without any degree. I disagree with both those type of service delivery options btw for many reasons. Point is there are forms of clinical work that don’t require a license or specific supervision but I agree supervision should be a part of the equation.

However in my situation there are LPCs and my masters degree is eligible for that type of degree and supervision. Why would it matter if I also hold a doctorate ? I’m not disagreeing but am confused how this would matter ? I’m not trying to attempt to count these hours for state board of psychology licensure until a licensed psychologist is on board. So from an agency and billing perspective does it matter? I have a degree that matches requirements for licenses they hold.

To clarify further the person who they thought was a licensed psychologist already isn’t supervising me or signing off on anything currently. An LCSW and LPC are however. But I’m not submitting those hours for licensure as a psychologist because those hours don’t count. There’s a difference between what counts for supervision and what counts for regulations and billing. The state board licensing for LPCs versus Psychologists are surely different governing bodies correct?

One would assume and hope an agency isn’t going to risk its funding by screwing that up.

 

[AbnormalPsych]

I’m confused as to how an LPC with the same terminal masters degree I hold is an outside discipline?

Do they have different licensing boards? LPC and Doctoral level psychology, in your state? If so, they are different.

Also you can do things like intakes and partial hospitalization groups without a license; in fact in this state there are partial hospitalization programs that only require a bachelors degree in a “related field” and in another state you can be a “registered therapist” without any degree.

But since you have a doctoral degree, this doesnt really apply to you. You are held to a higher standard and required to have supervision to engage in clinical work. At both the LPC and doctoral level, actually.

However in my situation there are LPCs and my masters degree is eligible for that type of degree and supervision. Why would it matter if I also hold a doctorate ?

It may or may not. You better get written documentation from the board of psychology in your state that your view on this is correct...Cause in some states, it would not be.

The state board licensing for LPCs versus Psychologists are surely different governing bodies correct?

OMG. You better get familiar with these bodies, and the answer to this question for your state, like yesterday.

One would assume and hope an agency isn’t going to risk its funding by screwing that up.

You know what they say about making assumptions...

Also, they ABBP/ABPP thing and mixing that up for licensure is beyond frigtenging enough to be looking for work elsewhere. Regardless of this other messy situation you find yourself in.

 

[quasipostdoc]

What?!? Are you saying that, when you called them out on this, they told you they thought that the ABBP (did you mean ABPP) meant licensure? That’s really bad, because it means at least one of the following:

1) your employers are covering a lie with another lie
2) your employers don’t confirm the credentials of people they hire

Either way, your employers (or whoever represented them to you) are either lying or frighteningly incompetent. Not be type of place I’d feel comfortable working. You say it’s a CHC, and those are often subject to regular oversight and survey from state oversight agencies. Only the most incompetent would not confirm credential before hiring, so I thinks someone might be doing a little fibbing.

Also, anyone who has a doctoral level clinical degree but practices under a masters license (theirs or their supervisor’s) needs to be very aware of their state regulations of board position papers regarding such clinical behavior. Their may be rules/ guidelines for how you present yourself to the public (including your clients). Things related to how you can reference your degree, whether or not you or others can refer to you as “Dr.”, etc. Basically, you need to be cautious about any behavior that would set you out the public as having doctoral level training/degrees when acting professionally as a masters level clinician.

Yeah well at least one was confused that ABPP wasn’t the license but they came to me to clarify rather than assume.

They do verify credentials and had copies made of all degrees and transcripts. Apparently their stance on my situation is that since I have a terminal masters that is license eligible for at least one of the licenses that some supervisors hold there then I can operate within the constraints of that license.

As for how I can identify myself to clients I simply use my name. I display my degrees and all clearances are available upon request.

Your points make me wonder if these types of agencies can operate differently than say private practices. For example employees don’t hold their own liability insurances and supervision for licensure isn’t required to work there although obviously most have it because they’re trying to get licensed.


My original question is whether it’s worth waiting around for the psychologist to come on board or go hunting for a new place to get my hours.

After reading some of these comments I’m definitely going to look into what I can and can’t do under my current credentials.

 

[PsyDr]

If a malpractice case like this came across my desk, I would hold nothing back. Calling your dept heads, calling your dissertation chair to verify you completed , calling your state psychology board and informing them that you have practiced without a license (just so I can ensure your application is rejected when you apply), calling every malpractice carrier to “ask” about your status and then informing them just so you can never get insured, calling test publishers and “asking” them the same, documenting that you lied about your status at least once even on business cards just to show you’re not to be trusted on the stand, etc

You’re not licensed. You’re definitely not insured. Which means your assets are on the line. If the board finds out about this they could refuse your license application, which you will always have to explain annually to insurance, and any other state application.

 

[quasipostdoc]

Do they have different licensing boards? LPC and Doctoral level psychology, in your state? If so, they are different.



But since you have a doctoral degree, this doesnt really apply to you. You are held to a higher standard and required to have supervision to engage in clinical work. At both the LPC and doctoral level, actually.



It may or may not. You better get written documentation from the board of psychology in your state that your view on this is correct...Cause in some states, it would not be.



OMG. You better get familiar with these bodies, and the answer to this question for your state, like yesterday.



You know what they say about making assumptions...

Also, they ABBP/ABPP thing and mixing that up for licensure is beyond frigtenging enough to be looking for work elsewhere. Regardless of this other messy situation you find yourself in.

Thank you for clarifying these concerns. It prompted me to go and look and yes in my state the board that licenses Social Workers, MFTs, and LPCs is a separate board from the Board of Psychology.

However on your point of higher standards I did find a portion of the state board of psychology standards that may actually preclude me from certain clinical services but I’ll have to get clarification on that.

My place of employment basically is utilizing my masters level training (and they hired me before the doctorate was conferred) to conduct services under licenses issued to supervisors for LPC and LCSW. This is tricky because I know plenty of people working while getting their doctorate and it seems a bit absurd that they’d lose all eligibility , ability to work under relevant supervisors and get hours for the lower licensed degree as soon as they have the higher degree in hand just because a psychologist wasn’t there. So basically if the boards are separate is there an issue ? They aren’t calling me a psychologist nor am I and they aren’t advertising me as such.

I do appreciate you suggesting I check if the state boards are different because a lot of folks assume they aren’t.

 

[quasipostdoc]

If a malpractice case like this came across my desk, I would hold nothing back. Calling your dept heads, calling your dissertation chair to verify you completed , calling your state psychology board and informing them that you have practiced without a license (just so I can ensure your application is rejected when you apply), calling every malpractice carrier to “ask” about your status and then informing them just so you can never get insured, calling test publishers and “asking” them the same, documenting that you lied about your status at least once even on business cards just to show you’re not to be trusted on the stand, etc

You’re not licensed. You’re definitely not insured. Which means your assets are on the line. If the board finds out about this they could refuse your license application, which you will always have to explain annually to insurance, and any other state application.

This sounds quite over the top sorry. I know you’re trying to point out worst case scenario but if this was true then reality would be that burden falls on whoever holds the license the clinician is operating under and that subsequent insurance.

Not sure what verifying what already is done would do here? I’m not saying I disagree here but the counter to any of this worst case scenario at current agency would be , clinician has verifiable degrees and met requirements which meets standards and requirements of the supervisor(s) currently overseeing said clinical work.

And if that ever did happen you can bet your own license that I’d
have a lawyer hired before they could hang up the phone and put that malpractice liability right back on the agency. Of course I’d hope never to need to be in that situation.

If you read my earlier posts and latest comments I hold license eligible degrees at both masters and doctorate. In a state with separate boards for each.

Unless I or the agency is misrepresenting me as a psychologist at this time I’m not sure that’s the issue.

However I do take your point to heart and had no idea the above worst case scenario could exist, but now that I do- next week will be meeting with management to discuss holds on clinical work until I have documentation that the agency is providing the correct and adequate supervision and resources per state regulations for me to conduct those services.

As far as management has told me in past , full time employees are under the agency insurance liability. Officially , as like other CMH centers in the state they operate under the head psychiatrist license; I learned recently that no psychiatrist means no agency.

As much as I sassed in the start of my reply to you, you’re right it’s not worth the hassle and risk without covering all my bases.

And yes as someone else suggested now I will be looking around for a new place to work in the event this current agency cannot provide that documentation .

Thank you.

 

[PsyDr]

You can say it’s over the top. Its not like I came up with that in the fly. It may be the case that I’ve some experience which informs me of what to do.

It only takes one document, business card, letter head, etc that reads “psychologist” to create that problem. You’d have jerks like me happy to read bankers boxes full of documents looking for that information at forensic hourly rates.

Passing liability onto an agency is basically a nonstarter. What happens is they cite your job description, and the state psychology board laws. And then they say you were operating outside of your job description, and are therefore personally liable. You can say “but but but”, which a bored jury won’t care about.

You are risking 5-7 years of effort for a nonsense amount of money relative to that effort and tuition.

 

[quasipostdoc]

You can say it’s over the top. Its not like I came up with that in the fly. It may be the case that I’ve some experience which informs me of what to do.

It only takes one document, business card, letter head, etc that reads “psychologist” to create that problem. You’d have jerks like me happy to read bankers boxes full of documents looking for that information at forensic hourly rates.

Passing liability onto an agency is basically a nonstarter. What happens is they cite your job description, and the state psychology board laws. And then they say you were operating outside of your job description, and are therefore personally liable. You can say “but but but”, which a bored jury won’t care about.

You are risking 5-7 years of effort for a nonsense amount of money relative to that effort and tuition.

Thank you for the prompt reply.

Interesting about citing the job description as it’s documented , how would it work if a supervisor got sued then tried to claim their supervisee was operating outside the job description? Whose liable if someone is operating under your license ? Isn’t it who holds the license?

Additionally if they provide adequate supervision that meets board standards for LPC in a state where that board is separate from Psychology board and I hold applicable degree , is that sufficient as long as it’s clearly defined that im operating under that supervision?

At least for now they refer to
me as a therapist or clinician on any documentation.

In any event you make a solid point.

Given what I now know I’ll be asking to have me taken off clinical work until this can be clarified . If current agency can’t do that and provide documentation they are following applicable regulations needed to ensure my job description is being fulfilled to those standards I’ll be leaving. It’s ashame, overall I like the work and the day to day there but you’re right not worth risking my education and investment over.

 

[PsyDr]

Example: you have sex with a patient. The patient sues. Your employer pulls out the job description and relevant laws and says “well he/she sure as hell wasnt doing that as part of his/her job.”. Then they motion to sever. Now you’re super screwed.

They may in general refer to you as a therapist, but are you 100% sure there not a single document saying they believe otherwise?

 

[Doctor Eliza]

Your points make me wonder if these types of agencies can operate differently than say private practices. For example employees don’t hold their own liability insurances and supervision for licensure isn’t required to work there although obviously most have it because they’re trying to get licensed.

As an aside, I’m a little concerned that you don’t have your own professional liability insurance. When I did my internship at a CMH we were told to get our own insurance. I’m out of that world now, so perhaps someone else can jump in, but it doesn’t sound safe to me.

Sounds like a sticky situation. Good luck to you.

 

[quasipostdoc]

Example: you have sex with a patient. The patient sues. Your employer pulls out the job description and relevant laws and says “well he/she sure as hell wasnt doing that as part of his/her job.”. Then they motion to sever. Now you’re super screwed.

They may in general refer to you as a therapist, but are you 100% sure there not a single document saying they believe otherwise?

That’s a good point.

 

[quasipostdoc]

As an aside, I’m a little concerned that you don’t have your own professional liability insurance. When I did my internship at a CMH we were told to get our own insurance. I’m out of that world now, so perhaps someone else can jump in, but it doesn’t sound safe to me.

Sounds like a sticky situation. Good luck to you.

Thanks yeah I did find that slightly unusual. For internship I did have to carry insurance as well as practicums. Will def look further into this.

 

[AbnormalPsych]

My place of employment basically is utilizing my masters level training (and they hired me before the doctorate was conferred) to conduct services under licenses issued to supervisors for LPC and LCSW. This is tricky because I know plenty of people working while getting their doctorate and it seems a bit absurd that they’d lose all eligibility , ability to work under relevant supervisors and get hours for the lower licensed degree as soon as they have the higher degree in hand just because a psychologist wasn’t there. So basically if the boards are separate is there an issue ? They aren’t calling me a psychologist nor am I and they aren’t advertising me as such.

You are admitting to conducting services UNDER ANOTHER PERSONS LICENSE. This means you are required to have supervision. The other people working you refer to are probably 1) working and getting supervision 2) working in a job that does not require supervision or 3) something else, but hard to say without specifics.

And yes, the boards are separate and think separate. Board of Psychology will not care what you do and claim to the other board. If they think it relates to the functions of a professional psychologist, they may act. Don't put yourself in the cross-hairs on purpose.

FWIW, I always carry my own insurance, even when working for employers who say they will cover me. But, I'm paranoid about protecting myself.

 

[AcronymAllergy]

You are admitting to conducting services UNDER ANOTHER PERSONS LICENSE. This means you are required to have supervision. The other people working you refer to are probably 1) working and getting supervision 2) working in a job that does not require supervision or 3) something else, but hard to say without specifics.

And yes, the boards are separate and think separate. Board of Psychology will not care what you do and claim to the other board. If they think it relates to the functions of a professional psychologist, they may act. Don't put yourself in the cross-hairs on purpose.

FWIW, I always carry my own insurance, even when working for employers who say they will cover me. But, I'm paranoid about protecting myself.

I didn't do this initially, but do now and would recommend it to others, especially with the affordability of insurance. After all, your employer's insurance has your employer's best interests at heart, which won't always necessarily line up with your own best interests.

And I would definitely clarify about providing services that could be viewed as psychological, while possessing the applicable degree, but without a license or supervision. It sounds like part of the initial or early job offer/description was that you'd be receiving supervision by a psychologist (which might be inaccurate, I don't know). That would imply you're providing psychological services. If the job description/duties didn't change once the supervision was not available, I could see how a psychology board might then see that as attempting to practice psychology without a license. But I'm no lawyer.

Overall, for me personally, I'd be looking for a new position with a different agency that has more experience/knowledge working with psychologists in general, and supervised psychologists-to-be specifically. I certainly don't think it's always a bad idea to take a job with a company that has limited experience with psychologists, and to be the one providing education to them about such. But to do that during your first job, when you're still learning the job yourself and are in need of supervision, is less than optimal. If you stick around, I'd encourage you to follow through on your plan to get everything documented in writing.

 

[quasipostdoc]

You are admitting to conducting services UNDER ANOTHER PERSONS LICENSE. This means you are required to have supervision. The other people working you refer to are probably 1) working and getting supervision 2) working in a job that does not require supervision or 3) something else, but hard to say without specifics.

And yes, the boards are separate and think separate. Board of Psychology will not care what you do and claim to the other board. If they think it relates to the functions of a professional psychologist, they may act. Don't put yourself in the cross-hairs on purpose.

FWIW, I always carry my own insurance, even when working for employers who say they will cover me. But, I'm paranoid about protecting myself.

Thanks. So sounds like I should make sure I’m getting adequate supervision for services that require it or cease providing those services until which time such supervision can be provided.

 

[MAClinician]

What?!? Are you saying that, when you called them out on this, they told you they thought that the ABBP (did you mean ABPP) meant licensure? That’s really bad, because it means at least one of the following:

1) your employers are covering a lie with another lie
2) your employers don’t confirm the credentials of people they hire

Either way, your employers (or whoever represented them to you) are either lying or frighteningly incompetent. Not be type of place I’d feel comfortable working. You say it’s a CHC, and those are often subject to regular oversight and survey from state oversight agencies. Only the most incompetent would not confirm credential before hiring, so I thinks someone might be doing a little fibbing.

Also, anyone who has a doctoral level clinical degree but practices under a masters license (theirs or their supervisor’s) needs to be very aware of their state regulations of board position papers regarding such clinical behavior. Their may be rules/ guidelines for how you present yourself to the public (including your clients). Things related to how you can reference your degree, whether or not you or others can refer to you as “Dr.”, etc. Basically, you need to be cautious about any behavior that would set you out the public as having doctoral level training/degrees when acting professionally as a masters level clinician.

Just last year the largest behavioral health provider in MA (so they claimed) got hit with a whistleblower lawsuit and AG charges that claimed fraudulent billing to MassHealth because they had hired individuals who didn’t have the appropriate degree never mind license to be providing clinical services. And they settled by paying back $2 million (a drop in the bucket for what the state claimed was fraudulent billing). So it does happen, very rarely, but it does.

If I were OP, I would be looking for a new job pronto and familiarize myself with state license requirements. I know of some folks who obtained the LMHC first then went back for doctorate. But now they practice only as a psychologist. Also, with all those years of training I would never be doing the work a BA/BS could do. That’s taking advantage of your education by not paying you. The other folks in here have given you good advice so take heed.

 

[PsyDr]

@MAClinician raises a great point. @quasipostdoc if your CMHC bills for you as a psychologist, anyone who figures your identity out can go to a qui tam law firm, and sue the agnecy for triple what was billed under the doctoral title. The standard payout for the whistleblower is 25% of said triple damages, IIRC.

 

[ClinicalABA]

Thanks. So sounds like I should make sure I’m getting adequate supervision for services that require it or cease providing those services until which time such supervision can be provided.

Does your agency have your clients sign a form acknowledging you are a “postdoctoral fellow,” “postdoctoral trainee,” or other appropriate term (consult with your state board), identifying your supervisor for that case, and giving the client a means (e.g. signature line) for consenting to treatment by a such a clinician? If this does not happen before therapy starts, you could have issues (and it’s further evidence that the agency is neither informed or competent enough to protect you and, most importantly, their clients.

I know it can seem like we’re all piling on a little bit here, but I think you’ll find that this group is both protective of trainees and early career psychologists, as well as the field and discipline as a whole. Unfortunately, sounds like you are in a sketchy situation and an important phase of your career.

 

[GrapesOfMath]

Does your agency have your clients sign a form acknowledging you are a “postdoctoral fellow,” “postdoctoral trainee,” or other appropriate term (consult with your state board), identifying your supervisor for that case, and giving the client a means (e.g. signature line) for consenting to treatment by a such a clinician? If this does not happen before therapy starts, you could have issues (and it’s further evidence that the agency is neither informed or competent enough to protect you and, most importantly, their clients.

I know it can seem like we’re all piling on a little bit here, but I think you’ll find that this group is both protective of trainees and early career psychologists, as well as the field and discipline as a whole. Unfortunately, sounds like you are in a sketchy situation and an important phase of your career.

If they are being billed/presented as working under their LPC, then wouldn't the correct protocol be to NOT represent them as a postdoctoral fellow? I feel that having clients sign that form implies that they are working under their PhD degree, for which they are not being supervised. I don't know what the laws are for LPCs/LSWs... if there is a similar form for trainees in those professions, then there should be a form calling them a trainee counselor or whatever the appropriate terminology would be. But if LPCs don't have an equivalent required consent, this may not be necessary at all.

Also from what everyone says here, it sounds like you're fine as long as all billing, clinical documentation, and advertising materials list you as a therapist/counselor/whatever, and not a postdoc, psychology-anything, or "Dr. so-and-so".

If you HAVE been represented as such anywhere, then yes you may be in hot water if you don't fix it quick before anyone catches on. But if that's not the case, then again I think you're fine, albeit wasting your time in terms of getting supervised postdoc hours.

 

[ClinicalABA]

If they are being billed/presented as working under their LPC, then wouldn't the correct protocol be to NOT represent them as a postdoctoral fellow?

You’re right- there should be something identifying them as a trainee at the masters level (not post- doctoral level) if they aren’t independently licensed and are providing supervised services. Either way, clients should be informed of the nature of the trainee status and supervisor should be identified.

 

[ClinicalABA]

Also from what everyone says here, it sounds like you're fine as long as all billing, clinical documentation, and advertising materials list you as a therapist/counselor/whatever, and not a postdoc, psychology-anything, or "Dr. so-and-so".

The prohibited “whatever” can be things you might not think of. For example, in my state (MA), someone with a clinical/counseling doctorate who practices under a masters level credential cannot refer to themselves as a “psychotherapist.” Doing so is considered practicing psychology without a license. Boards can be very conservative and protective of the public. Even displaying your clinical doctoral degree can be problematic, as it gives clients the impression they are receiving doctoral level (e.g. psychology) services, when in fact they are not offered the protections/guarantees of a licensed psychologist, either as their therapist or their therapists supervisor. Proceed cautiously and know your local regulations/board policies.

 

[psychRA]

This sounds quite over the top sorry. I know you’re trying to point out worst case scenario but if this was true then reality would be that burden falls on whoever holds the license the clinician is operating under and that subsequent insurance.
.....
And if that ever did happen you can bet your own license that I’d
have a lawyer hired before they could hang up the phone and put that malpractice liability right back on the agency. Of course I’d hope never to need to be in that situation.

If you read my earlier posts and latest comments I hold license eligible degrees at both masters and doctorate. In a state with separate boards for each.

That scenario is not over the top. At all. A lawyer cannot unilaterally put the liability on the agency just because you believe that the agency should be liable.

You are not a layperson who was hired by this agency and given tasks to do that, unbeknownst to you, are outside your scope of practice. If that were the case, then sure, I'd say the blame could fall squarely on the agency. And as a layperson, you would have no professional license to lose. But you're not a layperson. When you applied to work there, you presumably submitted a CV and a statement or cover letter in which you explained that you're working towards licensure as a psychologist, yes? And you've had the requisite graduate training to understand the process of becoming a licensed psychologist. You've had training on the APA ethics code, including how the ethics code applies to supervision and scope of practice.

In general the person whose license you're operating under bears the responsibility for your clinical practice. But whose license are you actually operating under right now? The person who is "supervising" you may not be an allowable supervisor from a training standpoint. You have a license eligible degree at the masters level, but you're not enrolled in a masters-level training program that has a training agreement with this agency, and you're not working towards licensure at the masters level. The program that granted you your masters is not responsible for you under these circumstances, and the person you're meeting with for supervision may not be responsible for you, either. You're not operating under the almost-psychologist's license because they don't have a license.

You have to understand that this looks really, really bad to anyone who understands the psychology licensure process, and there don't seem to be any mitigating factors in place to clear up the confusion. It doesn't sound like you or the agency have anything in writing that states that, although you were hired with the expectation that you'd be working towards psychology licensure, you are now doing the functions of a masters-level clinician due to a change in circumstances. The agency certainly messed this one up, but ultimately you're the one who is accountable to the BoP.

 

[foreverbull]

This is basically a dead zone for you professionally given how it started out supposedly under the auspices of psychologist supervision but never materialized into that (yet), and you can’t count any hours toward licensure. It’s really unfortunate that your employer/supervisor-to-be put you in this position, but given both their and your unfamiliarity with some of the licensing regulations from both state boards upon working there, you ended up in a really nasty ethical gray area when it comes to training/supervision, credentialing/representation, and billing, etc.

Hopefully it won’t come back to haunt you, and you can escape unscathed (maybe a few extra gray hairs!) but wiser and more cautious when seeking postdoc employment. My advice: get out of there and find an employer who is used to working with postdocs. And make sure you learn your state board regulations for trainees and licensure inside and out.

I'm sure we could get a rowdy debate going as to whether you should omit this from your CV or not. You might have to get creative with your language around this if you leave it on your CV and they ask why you weren't there for very long. The other option is to leave it off entirely and hearken back to your prior clinical work in the interviews.

 

[quasipostdoc]

Thank you again all for your careful insight , care, and feedback on helping me navigate this gray area situation . Definitely a good learning experience and will only help to serve me in continued growth as a future psychologist.

That said i wanted to take a moment to provide follow up on how the issues were addressed and resolved:

Another poster noted it appears said agency is having me operate under my masters level training and thus , applicable in this state, under the separate state board. This turned out to be spot on.

The agency management verified to me in writing that they hired me as a masters level therapist and subsequently under the state board that regulates masters level work. In order for that criteria to be met I had to have had a masters degree in hand at time of hire relevant to the work AND have access to an LPC or LCSW on staff to supervise. Both criteria were met and continue to be met. As well as applicable clearances.

The PsyD was obtained after hire and after I obtained this my roles and services provided did not change. I was and still am providing masters level eligible services.

Neither state board prohibit a doctorate degree holder from operating under the lower degree as long as said operations are consistent with lower degree’s training and state board.

As for what I’m being called. The state board the agency is operating my masters level services under prohibit me from using : LPC, LCSW, MFT and the doctoral level board of psychology prohibits using: post doc, psychology resident, psychology trainee, or psychologist. I can however call myself in the context of my employment there a mental health professional, therapist, clinician, or counselor( but not licensed professional counselor).

The agency in writing and documentation was able to state that per their compliance officers they ensure compliance with applicable state boards and state regulations. I do have a specific supervisor overseeing my work who I do meet with and meets state board requirements. They stated further that state board at masters level work does not require signed consent acknowledgment of status of unlicensed therapists who already hold an applicable degree. The agency does have to provide documentation that they do employ unlicensed therapists operating under applicable licensed supervisors. The agency itself has its own licenses as well to operate as it receives state funding and state insurances. They also in writing stated they hold liability to ensure compliance per their applicable state licenses, state funding , and state insurance contracts. Basically they told me they have to have all this covered and are responsible for doing so.

I was provided a copy of the liability insurance the agency carries as well as written documentation that the policy covers all employees providing clinical services. That said advice noted and will be obtaining my own as applicable.

So that was all a relief to find out.

All that said it’s true none of my current work is applicable or usable for doctoral level work or doctoral level licensure supervision which obviously isn’t ideal for me. But appears the agency is in compliance and I am operating within an applicable state board requirement sufficient role.

So basically it’s all up to code so to speak but it isn’t going to count for my eventual licensure as a psychologist. I’m in essence doing a job as a masters level professional.

Ideally as others said I should be looking for a quick exit but realistically I need a job and health insurance so can’t just up and leave. I would still include this work on my CV as it’s good experience and can with documentation provide relevant licensed supervisor information.

The original plan was that by the time I had my doctorate I’d get set up with a licensed psychologist. Except that this individual didn’t yet get licensed. So yeah that didn’t quite pan out and to be clear they were never made my supervisor nor were they representing themselves as a psychologist. Apparently when they hired me they thought she was already licensed as a psychologist but she told them she was still working on EPPP and board paperwork but by then I was already hired. They had hired this other person as an LCSW that happened to have the same doctorate as me but also had her post doc hours done and was waiting for whatever reason to take EPPP. That should have been researched further on both my end and agency end before I was hired but I did need a job and they did hire me at masters level only at that time .

Overall based on feedback here I’ll be staying for now and operating clearly under masters level work but will also be putting out some searching emails and calls for other opportunities that are a better fit. Yeah the other person is on track to get licensed as a psychologist but the if and when is holding not only them back but by proxy me back.



Thanks again everyone!

 

[foreverbull]

Thanks for the update; it’s helpful information as I’ve never heard of this happening before.

We definitely err on the “better safe than sorry” side in here, and state boards vary in their rules around this tricky issue, so I’m glad you’re able to continue/move on without having to worry about whether you’re in compliance or not. Good luck to you!

 

[ClinicalABA]

Glad things seem to be at least above-board for you and it’s safe to keep your job! This bit still gives me pause and would make me proceed with caution:

Apparently when they hired me they thought she was already licensed as a psychologist but she told them she was still working on EPPP and board paperwork but by then I was already hired.

It’s evidence of deceit, ignorance, or incompetence, all of which put into question anything else they say or do with you. Proceed with caution and find something else ASAP.

 

[LadyHalcyon]

Exactly. On internship my school still paid for mine and on postdoc I paid for my own.

As an aside, I’m a little concerned that you don’t have your own professional liability insurance. When I did my internship at a CMH we were told to get our own insurance. I’m out of that world now, so perhaps someone else can jump in, but it doesn’t sound safe to me.

Sounds like a sticky situation. Good luck to you.