Using PHD/PsyD title in state not licensed in

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ClinicalABA said:
Of course not- nobody has or would argue that. Your training and experience are what (should) give you the competence. The license provides proof of a minimum of training and experience (with implied competency) to clients, employers, funding sources, etc.- nothing more, nothing less.
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Exactly my point for @MamaPhD and @MCParent
 
shooter said:
Wrong. Your license alone does no equal competence.

While you may have a license allowing you to conduct testing, it does not make you competent to perform custody evals, neuro tests, etc. It's an easy way to lose your license (but not your current level of competence).

Competence 101: based on education, training, supervised experience, consultation, study, or professional experience.

Feel free to read previous posts to familiarize w/ all the interesting drama.
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Or, I guess you can intentionally read my post wrong and reply to something I didn't say. :dead:

I'm not saying the license automatically makes you competent to do anything, clearly. I said that you don't get to decide for yourself that you are competent. So the converse of what you chose to read.
 
Sounds like you are retracting your post. You said "you do not get to decide for yourself that you are competent. That's what the purpose of licensing is."

If it's neither me (the psychologist-per 1st post) nor the the license (per your 2nd post)... Then who determines competence Doctor? @MCParent [using attorney's voice]
 
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shooter said:
Sounds like you are retracting your post. You said "you do not get to decide for yourself that you are competent. That's what the purpose of licensing is."

If it's neither me (the psychologist-per 1st post) nor the the license (per your 2nd post)... Then who determines competence Doctor? @MCParent [using attorney's voice]
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Are you being intentionally obtuse?

By the second post I meant that your psych license does not make you competent to practice brain surgery. It is not a blanket competence for everything under the sun.
 
WisNeuro said:
Well, technically, some state license boards outline which specific areas you are competent to practice in based on your training and supervision in those areas.
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Yeps. It goes back to training, supervised experience, and state law. [post #163]
 
WisNeuro said:
Yes, but can you see why some took umbrage to the above quote?
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Yes. I'm on both sides of the fence. It is the ugly truth. Similar offense seemed taken by master-level licensees devalued here.
 
shooter said:
Completed PsyD and had an LPC license w/psychometric privileges for a while. Competent to legally do the same crap every psychologist does out there, except for using the "psychologist' label as it is protected by state law (until my silly 'psychologist' license arrives). The APA ethics code is a torture joke in the courts. State/territory/jurisdictions laws prevail, stay ethical and follow best practices. -Cheers.. 😉
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I have had my own frustrations with licensing laws especially going from one state to the next. Psychologist in one state, no status or ability to work in the other for a period of time. Cross an imaginary line and I can practice and cross back and I cannot. Nevertheless, my frustration was with the unwieldy state laws, not the profession of psychology. I am saddened that someone who is about to get a license to practice psychology would refer to it as silly. I am proud of what we do and our profession. If you don't want the silly license, then don't pay the fees and keep working as an LPC with a PsyD like the rest of them. 😡
 
smalltownpsych said:
I have had my own frustrations with licensing laws especially going from one state to the next. Psychologist in one state, no status or ability to work in the other for a period of time. Cross an imaginary line and I can practice and cross back and I cannot. Nevertheless, my frustration was with the unwieldy state laws, not the profession of psychology. I am saddened that someone who is about to get a license to practice psychology would refer to it as silly. I am proud of what we do and our profession. If you don't want the silly license, then don't pay the fees and keep working as an LPC with a PsyD like the rest of them. 😡
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I share your frustrations with state laws. I vote for one fair national license (like Canada is doing?). My apologies, I didn't mean to frustrate you. I called it "my silly psych license" as I was referring to myself waiting for it to arrive to do the same thing and change the LPC label. It wasn't meant to minimize all licencees out there. I'm sorry for that @smalltownpsych. And hell no... I do want my license!
 
I'd be in favor of a national licensing law, but don't know that it'll ever happen, given the strong states rights history in this respect (e.g., physician licensing). I also don't know that I'd trust APA to be involved in informing legislators about what that law should entail, as they'd likely be the first folks tapped.

At the very least, more uniformity across states would be great. One way to possibly move that forward would be via universal boarding. That way, rather than having a national licensing law, states could essentially just say, "if you're board-certified, bam, you're license-eligible."
 
Canada actually does not have national licensing-- As far as I know it's not even on the table. We *do* have policies that have been put in place to comply with federal laws (e.g., the Mobility Act) that were created to reduce restrictions on moving between provinces for work.
 
shooter said:
Trying to devalue others to save face does not reflect well on your (our) profession.
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Oh please. I am not trying to devalue anyone. However, I think it is worthwhile to point out that the skills of a psychologist and a professional counselor do not entirely overlap. For heaven's sake, that's not a controversial point nor is it "devaluing" LPCs.

For context, let me elaborate on my comment above by summarizing what I did during my work day yesterday:

(1) I provided assessment and intervention to three patients who were referred to me by their physicians to assist in their care;
(2) I resubmitted a research manuscript based on an original study that I designed;
(3) I took a telephone call from a news organization who wanted an expert opinion for a story they were developing;
(4) I met with a colleague to brainstorm ideas for the design of a future clinical trial;
(5) I reviewed a manuscript for a peer-reviewed journal.

Yesterday was one of those days when I had the opportunity to use many of the skills I developed during my doctoral training, which made it easy for me to be piqued by your comment implying functional equivalence between psychologists and LPCs. If you can't see the distinctions between the skill sets of a psychologist and a professional counselor, then perhaps you were shortchanged by your training program. Sure, most psychologists choose only to exercise part of their skill set in their day-to-day work, and there's nothing wrong with that. But don't confuse what you do in practice with the range of skills that doctoral training provides.
 
MamaPhD said:
Oh please. I am not trying to devalue anyone. However, I think it is worthwhile to point out that the skills of a psychologist and a professional counselor do not entirely overlap. For heaven's sake, that's not a controversial point nor is it "devaluing" LPCs.

For context, let me elaborate on my comment above by summarizing what I did during my work day yesterday:

(1) I provided assessment and intervention to three patients who were referred to me by their physicians to assist in their care;
(2) I resubmitted a research manuscript based on an original study that I designed;
(3) I took a telephone call from a news organization who wanted an expert opinion for a story they were developing;
(4) I met with a colleague to brainstorm ideas for the design of a future clinical trial;
(5) I reviewed a manuscript for a peer-reviewed journal.

Yesterday was one of those days when I had the opportunity to use many of the skills I developed during my doctoral training, which made it easy for me to be piqued by your comment implying functional equivalence between psychologists and LPCs. If you can't see the distinctions between the skill sets of a psychologist and a professional counselor, then perhaps you were shortchanged by your training program. Sure, most psychologists choose only to exercise part of their skill set in their day-to-day work, and there's nothing wrong with that. But don't confuse what you do in practice with the range of skills that doctoral training provides.
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Sounds like a good day. Been there, done that before the psychologist license. That's the point on this entire (and super interesting) this forum. @Shrink1982 was brave enough to relive this old, but real monster. Again, it goes back to our training, supervised experience, and state law. [post #163]. APA cannot do anything about it.
 
shooter said:
Sounds like a good day. Been there, done that before the psychologist license. That's the point on this entire (and super interesting) this forum. @Shrink1982 was brave enough to relive this old, but real monster. Again, it goes back to our training, supervised experience, and state law. [post #163]. APA cannot do anything about it.
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I'm fairly skeptical that you have experience designing clinical trials and have been contacted for expert opinion by national news media.
 
AcronymAllergy said:
I'd be in favor of a national licensing law, but don't know that it'll ever happen, given the strong states rights history in this respect (e.g., physician licensing). I also don't know that I'd trust APA to be involved in informing legislators about what that law should entail, as they'd likely be the first folks tapped.

At the very least, more uniformity across states would be great. One way to possibly move that forward would be via universal boarding. That way, rather than having a national licensing law, states could essentially just say, "if you're board-certified, bam, you're license-eligible."
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Yes...that's another good option...50+ states/territories have a soup sandwich and cannot agree in a clear standard to benefit us. But we have 50+ ways to get a psychologist license. Hard to believe psychologists cannot agree on something so important [sarcastic scientific voice].
 
So
WisNeuro said:
I'm fairly skeptical that you have experience designing clinical trials and have been contacted for expert opinion by national news media.
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It's so easy a life coach can do it...the news part
 
shooter said:
Sounds like a good day. Been there, done that before the psychologist license. That's the point on this entire (and super interesting) this forum. @Shrink1982 was brave enough to relive this old, but real monster. Again, it goes back to our training, supervised experience, and state law. [post #163]. APA cannot do anything about it.
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It is not about preventing others from doing what we do. Many of the things that Mama listed can be done by any number of professions. We don't hold the corner on the market for much of anything other than neuropsych testing. That doesn't meant that we can't argue that our unique set of skills does not bring more to the table. When I was hired as a clinical director of a residential treatment facility for adolescents, I looked at the other companies and saw that many of them hired LPCs or LCSWs and the pay was lower than what I was asking for. I was hired because of the title of psychologist; my knowledge of legal and ethical issues, ability to generate, synthesize, and disseminate relevant research; teaching skills; psychotherapy skills; public speaking skills; program development skills; assessment skills; and widest ability to supervise different providers for licensure. Much of what I was bringing to the organization was because of my education and experience as a clinical psychologist. Other people can have some or even all of those same skills, but when you hire a licensed psychologist, there is some assurance that the person has demonstrated competency in these skills.
 
I just noticed that the same point I was making above was already hashed out early on in this thread.
Shrink1982 said:
I have read nothing in state regulations that list administration, teaching, supervision, etc. as being part of a psychologist's scope of practice. Social workers can do these things too.
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WisNeuro said:
I think the point was that this is a standard part of training for a psychologist from a reputable program, but not SOP for a social work program. It's about actually having the background training in it. Also, in some hospital settings (such as the VA for example) you have certain "privileges" in the hospital for which you need to have the documented training to be able to do. This is something that is becoming more and more standardized.
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WisNeuro said:
So, you've designed RCT's and reviewed, designed, and published original research though?
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Yes and more... u don't need a license for that.
 
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Nopes @MamaPhD ..there's just no license requirement for most of that.. While many of you find it self-satisfying to list your cv/ daily workload here, I do not.
 
shooter said:
Nopes @MamaPhD ..there's just no license requirement for most of that.. While many of you find it self-satisfying to list your cv/ daily workload here, I do not.
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Do you like lawsuits?
 
No forensic people here?
 
erg923 said:
You must be single and own nothing then.
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Stalker@erg923. Now, you've been around the block for a while, what is your take on the psychologist licensing drama?
 
Shrink1982 said:
I really don't see the point in continuing this thread as we are never going to agree. I am done.
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I know you're victoriously "done" and all, but I just want to point out that it's not that you disagree with a few people, it's that quite literally almost everyone in this thread disagrees with you. Shouldn't that be alarming and quite a bit scary?
 
Therapist4Chnge said:
There are a few, and more that do it infrequently (like myself). I actually don't mind forensic work, as that is a setting where both training and scope of practice matter greatly.
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Cool, very true. I was wondering about it, cuz many seem unaware of the psycho-legal aspects of licensing. I guess we get scrutinized and become desensitized super early.
 
shooter said:
Yes...that's another good option...50+ states/territories have a soup sandwich and cannot agree in a clear standard to benefit us. But we have 50+ ways to get a psychologist license. Hard to believe psychologists cannot agree on something so important [sarcastic scientific voice].
Click to expand...

At least with the states I've seen, there are probably more similarities than differences. Or at least as many similarities as differences. Most states require something along the lines of, "APA-accredited or equivalent" for graduate and internship training and have similar grandfathering clauses, which is a start. After that, though, you're right--there are too many discrepancies. Postdoc year vs. no, oral exam vs. no, jurisprudence vs. no.

This likely reflects, in part, the significant variability in standards across training programs, and the desire for folks to not want themselves to be disqualified from licensure. What we have to realize is that if we're going to set standards, and if those standards are going to be adequate, we're going to upset some people. That's ok. It's why I make no apologies for supporting ABPP certification in neuropsychology as a universal standard, for example; if you don't meet those criteria (and have graduated within the past decade or so), I generally don't view you as an adequately-trained neuropsychologist.

I do see much more professional interest and activism in my classmates than I have from former well-entrenched supervisors, though, which is a good start.
 
AcronymAllergy said:
At least with the states I've seen, there are probably more similarities than differences. Or at least as many similarities as differences. Most states require something along the lines of, "APA-accredited or equivalent" for graduate and internship training and have similar grandfathering clauses, which is a start. After that, though, you're right--there are too many discrepancies. Postdoc year vs. no, oral exam vs. no, jurisprudence vs. no.

This likely reflects, in part, the significant variability in standards across training programs, and the desire for folks to not want themselves to be disqualified from licensure. What we have to realize is that if we're going to set standards, and if those standards are going to be adequate, we're going to upset some people. That's ok. It's why I make no apologies for supporting ABPP certification in neuropsychology as a universal standard, for example; if you don't meet those criteria (and have graduated within the past decade or so), I generally don't view you as an adequately-trained neuropsychologist.

I do see much more professional interest and activism in my classmates than I have from former well-entrenched supervisors, though, which is a good start.
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I am glad that neuro is moving in the direction of board certification. I would like to see all of us to keep moving in that direction. There are forces in the field that are pulling in the opposite direction and it sounds promising that you are seeing increased professional interest and activism in colleagues. I am involved in my state psychology association for just that reason and I see part of my role on this board to continue to educate students on the need to maintain the high standards that drew me to want to be a psychologist in the first place.
 
AcronymAllergy said:
At least with the states I've seen, there are probably more similarities than differences. Or at least as many similarities as differences. Most states require something along the lines of, "APA-accredited or equivalent" for graduate and internship training and have similar grandfathering clauses, which is a start. After that, though, you're right--there are too many discrepancies. Postdoc year vs. no, oral exam vs. no, jurisprudence vs. no.

This likely reflects, in part, the significant variability in standards across training programs, and the desire for folks to not want themselves to be disqualified from licensure. What we have to realize is that if we're going to set standards, and if those standards are going to be adequate, we're going to upset some people. That's ok. It's why I make no apologies for supporting ABPP certification in neuropsychology as a universal standard, for example; if you don't meet those criteria (and have graduated within the past decade or so), I generally don't view you as an adequately-trained neuropsychologist.

I do see much more professional interest and activism in my classmates than I have from former well-entrenched supervisors, though, which is a good start.
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True. People are too comfty with the status quo. I cannot accept how some peeps are willing to work post-doc with little or no salary. Unfortunately, the field has reinforced that nonsense. 😵
 
It drives me a little crazy that people can be so vague about their credentials. The ACA and AAMFT say that it is okay to use "Dr." in their ethics codes so long as the doctorate is in a "related field" if you are in a clinical setting. Who decides what is related? If someone has a sociology degree, that's a different area of expertise.

When people act like "Who cares, it's all the same!" I question their actual level of understanding of the entire mental health industry.
 
Pragma said:
It drives me a little crazy that people can be so vague about their credentials. The ACA and AAMFT say that it is okay to use "Dr." in their ethics codes so long as the doctorate is in a "related field" if you are in a clinical setting. Who decides what is related? If someone has a sociology degree, that's a different area of expertise.

When people act like "Who cares, it's all the same!" I question their actual level of understanding of the entire mental health industry.
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But, Pragma... It is so much fun (for some) to wail and moan about how every mental/behavioral health pro is the same! And how the fresh-minted are not only equal but BETTER than we "ancients" that have actually been working with a license in the field of Psychology for many years.
 
I really like the below post for multiple reasons, mostly because it illustrates in a non-dismissive way why the two levels of education are different.

I got to thinking about it later though, and I think that part of the problem in this conversation is that sometimes at the masters level, especially in other professions, someone might do any of these given things. For example, it's pretty common to see MSW/MPH and it is not outrageously outside of the scope of education for an MPH to do no.s 2,3,4. I know nursing educators with a masters who do 2,3,4 and 5. To teach nursing, you need a masters, not a PhD.

So while I completely agree that your run of the mill counseling MA or MSW can't do those things, because they were basically trained in 1, it is not unheard of for those items to be done by masters educated individuals. Now, I personally believe that those who hold a PhD still have a greater depth of education and therefore a greater depth of operation. Or at least I hope this is the case 😛

If you look at it, psychology is sorta unique in the medical community. The psychology PhD is one of the few left that claims to train fully both clinical and research and is the gold standard for the field. Maybe Pharmacy once upon a time did this with their PhD, but I think PharmD is pretty much the standard now. Anyway, my point is that I think the reason that psychology is having so much trouble with scope creep and "I can do what you can do" is that because some of the things are doable by masters degrees in other fields. Now again, I'm not really saying they are equal, but it's a perception problem.



MamaPhD said:
Oh please. I am not trying to devalue anyone. However, I think it is worthwhile to point out that the skills of a psychologist and a professional counselor do not entirely overlap. For heaven's sake, that's not a controversial point nor is it "devaluing" LPCs.

For context, let me elaborate on my comment above by summarizing what I did during my work day yesterday:

(1) I provided assessment and intervention to three patients who were referred to me by their physicians to assist in their care;
(2) I resubmitted a research manuscript based on an original study that I designed;
(3) I took a telephone call from a news organization who wanted an expert opinion for a story they were developing;
(4) I met with a colleague to brainstorm ideas for the design of a future clinical trial;
(5) I reviewed a manuscript for a peer-reviewed journal.

Yesterday was one of those days when I had the opportunity to use many of the skills I developed during my doctoral training, which made it easy for me to be piqued by your comment implying functional equivalence between psychologists and LPCs. If you can't see the distinctions between the skill sets of a psychologist and a professional counselor, then perhaps you were shortchanged by your training program. Sure, most psychologists choose only to exercise part of their skill set in their day-to-day work, and there's nothing wrong with that. But don't confuse what you do in practice with the range of skills that doctoral training provides.
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And while I appreciate T4C's post about suicide assessments, I really felt the post came down to "anything you can do, I can do better," which is probably true. But, I think for psychology PhDs to really take their place at the helm of mental health (instead of your mid-levels practicing on the fringes), you are going to have to let go of some tasks. And I'm not strictly suggesting they are the ones T4C mentioned. Does that make sense? I think PhDs are best utilized at their highest level instead of trying to assert their superiority in every single patient interaction. I think this is what quite a few of you have been saying all along, but I feel some of these conversations get bogged down by rehashing that "PhDs do it better" when the conversation should be about "mid-levels are better in this role, and PhDs are better in this role." Yes, PhD providers for everyone all the time with unlimited resources, but most people don't have access that.

I really think your mid-levels, as I myself am wont to do, start to tune out when the conversation turns to "I'm just better at everything." So if you want to school a recalcitrant mid-level, I would suggest leading with something else if you are actually trying to get through to them. You know, just as a suggestion from a mid-level to the PhDs and PsyDs. I get the defending the quality of your role and profession, but IMO so many of these threads "over-correct" and then you lose credibility.
 
Goobernut said:
And while I appreciate T4C's post about suicide assessments, I really felt the post came down to "anything you can do, I can do better," which is probably true.
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I didn't write it to talk about being better. I was trying to make a point that there are different skill sets and not everyone can do eveything, particularly assessment. I can gaurentee that there are many mid-level providers out there who conduct therapy more effectively and with more nuance, and that is fine. It is also important to know limits, that is also what I was getting at w my prior posts.
 
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Goobernut said:
Anyway, my point is that I think the reason that psychology is having so much trouble with scope creep and "I can do what you can do" is that because some of the things are doable by masters degrees in other fields. Now again, I'm not really saying they are equal, but it's a perception problem.
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Well said. And you raise an interesting point by highlighting the skills of professionals who have an MPH or other research degree. I was really focusing on the skills afforded by training in a clinical specialty like counseling, but clearly there are other paths than the PhD to obtain skills in research design, program evaluation, etc. For example, in many fellowships in academic medicine, a common goal is for the physician to obtain an MPH or MS degree to become more competent in research design and evaluation. I'm less accustomed to seeing professional counselors and social workers with second research master's degrees, but I can't argue that's not a unique and useful set of skills.

There are also those who obtain essential skills through non-degree granting education or on-the-job experience. I've had the pleasure of working with a number of research assistants with bachelor's degrees who have become very research-savvy. Once upon a time, the sciences were friendlier toward autodidacts. If you are doing rigorous research that shapes thought, policy, or practice, I don't care what degree you have. But you can understand how someone who spent 8 years in doctoral and postdoctoral training could get a bit irritated at the suggestion that all that training was for naught because, say, an LPC has "been there, done that."

"I can do everything you do" is the complement of "anything you can do, I can do better," no?
 
Therapist4Chnge said:
I didn't write it to talk about being better. I was trying to make a point that there are different skill sets and not everyone can do eveything, particularly assessment. I can gaurentee that there are many mid-level providers out there who conduct therapy more effectively and with more nuance, and that is fine. It is also important to know limits, that is also what I was getting at w my prior posts.
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I'll say I personally understood your purpose, and I pretty much understood where you were coming from, because I've read these posts and your posts off and on over the years. I agree with the discussion of "not representing yourself as more than you are legally allowed to" and generally side with PhDs on the board in this case. I get not everyone can do everything, yet you used examples of functions both groups perform and why PhD's are better at it. I don't feel that your examples showed how "not everyone can do everything" rather you just outlined how PhD's are better trained in the similar (not the same) tasks. I know the difference between what mid-levels call "assessments" and how PhDs/PsyDs are trained more formally and in a whole different way than mid-levels are on "assessments." And you are right, only PhDs should be doing those formal assessments, but again, your example used a task that both groups perform (assessing for suicidality). It's not outside of the scope of practice for a mid-level to interview a patient for suicidality or suicidal ideation. In mid-level practice we would call that "assessment," and I say that even fully understanding the difference of what you call assessment and what mid-levels call assessment greatly differs. Yes, a fully licensed and trained PhD will probably catch something a mid-level can and will miss, but it is not outside of the scope of practice for a mid-level to work with potentially suicidal patients. You see what I mean here with these particular examples? That is why I pointed them out.

I'm frustrated when discussion of mid-level limits enviably heads into "I would only ever refer to a PhD for anything." Again, I'm not pointing this out as a point that T4C made, or that T4C has any fault in this particular conversation, and I honestly don't recall if T4C said that previously. But using that point as an example, can you see how a mid-level reading this thread might not interpret that point the same way as just discussing scope of practice or what their limits are? It is a personal opinion, and one that PhDs or ANYONE is certainly entitled to have. I can see why PhDs feel this way, I can see why MDs might feel the same way about PAs & NPs etc. But making that statement as a PhD implies one feels mid-levels are not only limited in scope but rather they are incapable of performing the smallest task in mental health.

I personally think, of all mid-level relationships, Psychologists have the most difficult one to navigate. Most of your mid-levels are not technically in the same profession. They are "counselors" or "social workers" or "marriage and family therapists" rather than strictly trained in psychology. Mid-levels in mental health have less reason to view psychology PhDs as the "expert." MDs have a strong hold on PAs, and lots of influence on the nursing profession because of their longstanding working relationship. Doctors and nurses really wouldn't be able to function in their roles without the other. I think both professions are aware of this, and that is why the nursing profession continues to pull one of the highest salaries for their level of education (especially below grad school level). In mental health, we don't really have any of that.
 
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