Council Policy Manual: L. Professional Affairs

The APA Policy Manual is a collection of policy actions taken by the APA Council of Representatives. This edition includes actions taken after 1960 and up to but not including August 2001. The texts included in the Manual are the texts of the actual motions passed by Council.

• I. Alcohol and Substance Abuse
  
• II. Autism
  
• III. Changing HC System
  
• IV. Children
  
• V. Consumer Protection - Patient Right
  
• VI. Dementia - Age Related Cognitive Decline
  
• VII. Disaster Response
  
• VIII. DSM
  
• IX. Dual Diagnosis
  
• X. Guideline Development
  
• XI. Health Service Provider
  
• XII. Hospital Privileges
  
• XIII. Hypnosis
  
• XIV. Impaired Psychologists
  
• XV. Independent Science and Profession
  
• XVI. Licensure
  
• XVII. Managed Care
  
• XVIII. Nursing
  
• XIX. Prescription Privileges
  
• XX. Provider Guidelines
  
• XXI. Psychoanalysis
  
• XXII. Public Education
  
• XXIII. Public Service Psychologists
  
• XXIV. Record Keeping
  
• XXV. Serious Mental Illness - Severe Emotional Disturbance
  
• XXVI. School Psychology
  
• XXVII. Title - Doctor
  
• XXVIII. Treatment v. Training
  
• XXIX. Veteran Affairs Psychologists

I. ALCOHOL AND SUBSTANCE ABUSE

1. 1986

The employment of behavioral techniques or drugs which have an aversive effect is among the currently accepted strategies for treating alcoholism. The use of such techniques requires the informed consent of the client or guardian. Such techniques may be appropriate when the client is in serious physical or psychological danger, or is a threat to others. Use of noxious or aversive stimuli must include every reasonable precaution to assure the safety, protection, and physical and emotional integrity of the client.

On Drug and Alcohol Treatment as Sub-issues of 'Substance Abuse'

Alcohol and drug abuse are part of a broad generic syndrome identified as substance abuse. Clinical experience suggests that the likelihood of successful intervention is enhanced if each case is considered individually.

2. February 1992

On the recommendation of the Board of Professional Affairs and the Board of Directors, Council voted to adopt the proposed final APA statement on Alcohol and Substance Abuse. [Appendix L - I.2]

II. AUTISM

1. August 2000

Council voted to endorse the Practice Parameter: Screening and Diagnosis of Autism.

III. CHANGING HEALTH CARE SYSTEM

1. February 1999

Council voted to adopt the following resolution:

WHEREAS the health care system in this country has been dramatically transformed in the last decade from a patient-focused system with an emphasis on the provision of adequate services to a market-driven system increasingly concerned about the cost of providing care to the nation's citizenry;

WHEREAS this transformation has been extremely far-reaching in its influence on all aspects of the health care delivery system and on all communities of interest, including health care professionals and purchasers and consumers of health care services;

WHEREAS all aspects of the profession of psychology are being affected by the changing health care system, including its practices, the education and training of psychologists, related research directions and psychology's objective of promoting human welfare;

THEREFORE BE IT RESOLVED

That APA declares the changing health care system's impact on psychology and the public, with all its resulting challenges and opportunities, to be a matter of the highest priority and concern for the entirety of the Association.

IV. CHILDREN

1. February 1994

Council voted to approve the Guidelines for Child Custody Evaluations in Divorce Proceedings and to adopt the Guidelines as official APA policy. [Appendix L - IV.1]

2. August 1994

On the recommendation of the Board of Directors and the Board of Professional Affairs, Council voted to endorse "Comprehensive and Coordinated Psychological Services for Children: A Call for Service Integration" and to adopt it as APA policy. [Appendix L - IV.2]

3. February 1998

Council voted to adopt the Guidelines for Psychological Evaluations in Child Protection Matters. [Appendix L - IV.3]

V. CONSUMER PROTECTION - PATIENT RIGHTS

1. February 1995

Council voted to approve the following resolution:

WHEREAS a major purpose of the American Psychological Association is to advance psychology as a science and profession as a means of promoting human welfare; and

WHEREAS for almost 50 years the ethical standards of the American Psychological Association have provided extensive safeguards for consumers of mental health services; and

WHEREAS those same standards have been incorporated into state law and regulation to provide additional statutory protection for the consumer; and

WHEREAS these same standards require psychologists to practice only within the boundaries of their competence as determined by demonstrable education, training, and experience; and

WHEREAS there are current efforts to introduce bills in the form of "mental health consumer protection acts" such as those currently being considered by the New Hampshire and Illinois legislatures which purport to protect consumers but on closer inspection contain many provisions that will actually harm consumers and curtail availability of quality services;

NOW THEREFORE the American Psychological Association is opposed to the enactment of legislation that, while seeming to protect the consumer, actually creates a bureaucracy and unnecessary barriers that interfere with consumer access to mental health services and fails to protect consumers.

2. August 1996

Council voted to approve the following substitute motion regarding the Bill of Rights for Patients Undergoing Mental Health Treatment:

Council strongly and in principle endorses and encourages continuing consultation between the leadership of APA and leaders of other professional mental health associations in the formulation of a bill of rights for patients or clients receiving mental health treatment. The Board of Directors will have oversight authority of the bill of rights. [The Principles for the Provision of Mental Health Services and Substance Abuse Treatment Services were subsequently agreed upon.] [Appendix L - V.2]

3. February 1997

Council voted to approve the following motion on the "Follow-up to the Principles for the Provision of Mental Health & Substance Abuse Treatment Services: A Bill of Rights:"

WHEREAS APA has adopted the Principles for the Provision of Mental Health & Substance Abuse Treatment Services: A Bill of Rights and it has come to Council's attention that the procedures and policies of some managed care companies may violate these rights...

THEREFORE be it resolved that APA is committed to identifying and publicizing any abuses by those managed care companies which violate patients rights as well as policies that uphold these rights and to educate consumers about their rights as patients.

VI. DEMENTIA-AGE RELATED COGNITIVE DECLINE

1. February 1998

Council voted to adopt the Guidelines for the Evaluation of Dementia and Age-Related Cognitive Decline prepared by the Presidential Task Force on the Assessment of Age-Consistent Memory Decline and Dementia. [Appendix L - VI.1]

VII. DISASTER RESPONSE

1. August 1997

Council voted to approve designating the Committee for the Advancement of Professional Practice as the appropriate governance entity with responsibility for the Disaster Response Network administered by the Practice Directorate.

VIII. DSM

1. 1980

Compared to its predecessors, and as a generic document, DSM-III represents progress in diagnostic procedure.

However, despite substantive advances in the 'state of the art' of psychopathologic diagnosis, troublesome issues remain. Specifically, some of these issues relate to (1) conceptual obscurity and/or confusion, (2) a questionable broadening of the range and scope of categories classified as mental disorder, (3) use of a 'categorical' rather than 'dimensional' model, and (4) poor applicability to disorders in children. The whole area of diagnostic nomenclature is deserving of further study and research.

The inclusion of several new areas recognizing social and environmental influences on behavior and of a broader empirical data base with consequential increased objectivity and reliability make DSM-III more valuable than the DSM-I and DSM-II for treatment, training, and research.

2. 1985

The welfare of the public is best served when the diagnostic processes are used by mental health specialists trained and qualified in mental health diagnosis and/or diagnostic processes concerning mental states. Additionally, the development of consensus within APA is most likely to occur when, prior to APA's adoption of broad and complex policy positions, formal consultation with appropriate governance units occurs. Finally, be it resolved that APA adopt the policy that useful diagnostic nomenclature must be (a) supported by empirical data, (b) based on broadly representative data, and (c) carefully analyzed.

3. 1986

WHEREAS: The American Psychiatric Association is proposing a revision of the DSM-III with no collaboration and little input from APA and other mental health organizations; and

WHEREAS: The American Psychiatric Association previously utilized the benefits of research supported, in part, by taxpayers funds, some of which was research conducted by psychologists and other behavioral scientists and thus becomes information within the public domain; and

WHEREAS: The American Psychiatric Association has developed three new, controversial diagnoses for a special appendix (Premenstrual Dysphoric Disorder now called Periluteal Phase Disorder, Masochistic Personality Disorder now called Self-Defeating Personality Disorder, and Sadistic Personality Disorder) without presenting any adequate scientific basis and which are potentially dangerous to women;

BE IT THEREFORE RESOLVED: The American Psychological Association is opposed to the inclusion of these diagnoses, even within an appendix section, and urges its members not to use such diagnoses, and

The Executive Officer of the APA is to inform the American Psychiatric Association of this action and broadly disseminate it to all appropriate governmental agencies, other mental health and relevant health organizations, and the general public.

IX. DUAL DIAGNOSIS

1. 1989

WHEREAS, the Association for the Severely Handicapped (TASH) has taken the position that persons diagnosed as having mental retardation plus mental illness ("dual diagnosed") should be so diagnosed only in conjunction with a medical evaluation given by a qualified psychiatrist, and

WHEREAS, the standards for diagnoses of mental illness for persons who also have mental retardation should be as stringent as for persons who are not handicapped, and

WHEREAS, psychologists are prominent in the research on the causes and prevention of both major conditions, are leaders in the area of diagnosis and treatment of both major conditions, and lead in the efforts to increase mental health services for all persons with mental retardation.

THEREFORE BE IT RESOLVED that the American Psychological Association go on record as supporting Division 33 (Mental Retardation) against the efforts of TASH by reaffirming psychology's traditional role in diagnosis, assessment, training and treatment in both the Mental Health and Mental Retardation fields.

X. GUIDELINE DEVELOPMENT

1. February 1995

On the recommendation of the Board of Directors and the Board of Professional Affairs, Council voted to approve the "Criteria for Guideline Development and Review," with the exception of the highlighted text shown in draft 2.3cl of the document. [Appendix L - X.1]

2. August 2000

Council voted to approve the Criteria for Evaluating Treatment Guidelines which replaces the Template for the Developing Guidelines: Interventions for Mental Disorders and Psychosocial Aspects of Physical Disorders. [Appendix L - X.2]

XI. HEALTH SERVICE PROVIDER

1. February 1996

On the recommendation of the Board of Directors, the Board of Professional Affairs, and the Committee for the Advancement of Professional Practice, Council voted to approve the revised Recognition of Health Service Providers as follows:

XII. HOSPITAL PRIVILEGES

1. August 1991

Council voted that the "Guidelines on Hospital Privileges: Credentialing and Bylaws". [Appendix L - XII.1]

XIII. HYPNOSIS

1. August 1986

Be it resolved that the American Psychological Association, in the interest of the public, opposes applications of hypnosis by persons who are not fully trained members or advanced students of health delivery professions and who lack specific, in-depth training in hypnosis. Therefore, be it also resolved that APA opposes the teaching of hypnotic induction techniques or applications of hypnosis that involve treatment or assessment with patients or clients to persons who are not fully trained members or advanced students of a health delivery profession. Be it resolved further that upon passage of this resolution, its text shall be conveyed to the APA Ethics Committee to consider its incorporation in the APA Code of Ethics. We note that the resolution is consistent with the preamble of Principle 1 of the code as well as the Standards of Providers of Psychological Services (Principles and Implications of Standard, 3).

XIV. IMPAIRED PSYCHOLOGISTS

1. February 1989

For almost half a century, psychology has been guided by its own self-developed principles of ethical behavior which are intended to protect uses of psychological knowledge and services. Impairments in the performance of psychologists, induced by mental health problems, substance addiction, and other disturbances, lead to violations of APA's purposes and ethical principles. Prevention programs and early interventions may reduce the incidence and the intensity of impairment. Such actions may best be introduced on the state level. Based on these premises, APA resolves:

to provide information and assistance regarding problems of impaired psychologists to State and Provincial Boards of Examiners, the American Association of State Psychology Boards, and State Psychological Associations;

to provide informational liaison services to the states through its Office of Professional Affairs;

to encourage the APA and Division program committees to give due consideration to impairment in choosing topics;

to advise the editors of the APA Monitor and state and division newsletters of the importance of the educational role in countering impairment;

to facilitate public information programs through the APA Public Information Office. This will include, but not be limited to, developing a directory of impaired psychologists programs; and

to review periodically, psychology's progress in confronting impairment.

XV. INDEPENDENT SCIENCE AND PROFESSION

1. 1965

Council reaffirmed the concept that psychology is an independent science and profession and that in his work the psychologist and his client independently determine the proper application of his work in whatever context he may be functioning.

XVI. LICENSURE

1. February 1992

On the recommendation of Division 18, Council voted to approve the following resolution dealing with the removal of licensure exemptions for psychologists in public health care programs:

Council takes full note of the difficulties each state jurisdiction faces in implementing any proposed changes in statutes governing the practice of psychology. It also recognizes that there are unique circumstances that help shape the practice of psychology in the various states. Nonetheless, and in the hopes of stating more clearly the Association's aspirations for the field's future evolution, it adopts the following resolution:

WHEREAS many states have licensing laws that exempt psychologists from licensure if they provide health care services to clients within state or public agencies, programs and institutions, and

WHEREAS these exemptions in fact or in appearance imply that minimal requirements for competence as indicated by licensure in the profession are not needed when providing health care services to clients within public programs, and

WHEREAS the existence of these exemptions provides a double standard for the care of individuals receiving psychological health care services in public programs, many of whom are poor, of minority backgrounds, and without health insurance or adequate health insurance,

THEREFORE be it resolved:

The APA adopts and promotes policy -

It is further resolved that APA work with state licensing boards and groups such as the National Association of State Mental Health Program Directors and the National Association of Community Mental Health Centers to develop strategies to minimize the impact of implementation of this resolution on underserved populations and to incorporate appropriate exemptions or examinations for those psychologists uniquely qualified to serve divergent and underserved populations.

2. August 1998

Council voted to approve the following APA activities bearing on licensure challenges:

1. Encouragement and assistance to State Psychological Associations (SPAs) and state licensing boards to move to single level doctoral licensure.

2. Active consulting to SPAs in states that have dual level licensure.

3. Encourage the recognition of individuals holding terminal masters degrees in psychology under existing state statutes, provided that such statutes do not recognize, regulate or govern the title or practice of psychology.

4. Convening exploratory meetings focusing on issues involving education, training and credentialing, at the Consolidated meetings with the Board of Directors, Committee for the Advancement of Professional Practice, Board of Professional Affairs, Board of Educational Affairs, American Psychological Association of Graduate Students, the Association of State and Provincial Psychology Boards and other relevant groups.

XVII. MANAGED CARE

1. 1988

WHEREAS, many mental health problems are reflective of profound problems of living, substantial intra-psychic disorganization or serve physical and psychological disruption; and

WHEREAS, some psychological services are specifically focused on the alleviation of the personal distress attendant thereto; and

WHEREAS, managed care or other health care delivery systems should not unduly discriminate against those consumers who need intensive care, against those who need specialty care, and should not systematically endorse short-term or biomedical intervention as the treatment of choice for all patients at the expense of individual needs; and

WHEREAS, managed care delivery programs, by their very nature, frequently impose artificial and/or economic barriers to consumer access to health care services and, as such, are as subject to mismanagement as are traditional funding and delivery systems; and

WHEREAS, many managed health care programs may unfairly exclude those with the greatest need from adequate care and/or otherwise put both consumer and participating professional at substantial economic/psychological risk; and

WHEREAS, it is important that mental health care delivery programs provide appropriate and equally high quality services to all persons in diverse client and underserved populations; and

WHEREAS, providers and patients should be informed of the limitations and restrictions to types and access of psychological services prior to subscribing to a plan (i.e., truth in advertising or explicit statements regarding any financial disincentives to treat and refer patients in need of psychological services),

THEREFORE, BE IT RESOLVED that the American Psychological Association urges consumers, subscribers and psychologists to review carefully the mechanisms, procedures, practices and policies of managed care programs before deciding to participate. Although such programs may offer the potential to expand access to appropriate mental health care, they may also restrict availability of necessary psychological services.

It is further recommended that providers may wish to require as a condition of their participation that such managed health care delivery systems adequately and concretely demonstrate provisions to serve the consumer's interest with sufficient quantity and highest quality of health care based on the available scientific evidence of efficacy.

It is further recommended that consumers, subscribers and psychologists, as a condition of their participation, require that these programs practice truth in advertising regarding the range and duration of psychological services available through the plan and that these programs provide patients access to a diversity of psychological health care competencies based on the available scientific evidence of efficacy.

It is also recommended that providers require that such systems operate in accordance with prevailing standards of care and prevailing scientific knowledge, applicable ethical principles, and that the systems have sufficient economic resources to cover the delivery system's liabilities.

Finally, individual members, state psychological associations and divisions are strongly urged to monitor and inform themselves of the legal and regulatory requirements imposed on managed health care systems and to advocate that such requirements meet the principles enumerated herein.

2. August 1992

Council voted to approve the following resolution:

WHEREAS Government officialdom, representatives of industry and employer groups, and representatives of managed care (MC) and utilization review (UR) companies are increasingly and aggressively promoting managed care as a solution to the nation's health care delivery problem;

AND WHEREAS objective data as to the efficacy of MC and UR approaches to the nation's health problems when adequate quantity and high quality of care are held constant is not extant;

AND WHEREAS degradation in the quantity and quality of care occasions rising concern;

AND WHEREAS the media and the courts (see New Republic, "Managed Care: A Sick Joke"; American Psychiatric News, December 20, 1992; New York Times, "Do They Want My Wife to Die?," April 15, 1992) have documented flagrant abuses by some MC and UR companies;

AND WHEREAS both administration and congressional proposals for health care reform, almost without exception, mandate the establishment of national MC and UR programs exempt from all state mandates as to benefit structure and regulation of service provisions and state controls as to the standards of care;

THEREFORE BE IT RESOLVED:

3. August 1996

Council voted to approve the following motion regarding Managed Care Accessibility and Reimbursement Criteria:

XVIII. NURSING

1. 1987

Council voted to affirm that it is APA policy to work collaboratively with the elected leadership of professional nursing in areas of mutual concern and interest.

XIX. PRESCRIPTION PRIVILEGES

Council voted to adopt the following resolution on prescription privileges for psychologists:

XX. PROVIDER GUIDELINES

1. 1987

Council voted to approve as APA policy the revision of the 1977 Standards for Providers of Psychological Services (renamed General Guidelines for Providers of Psychological Services). [Appendix L - XX.1]

XXI. PSYCHOANALYSIS

1. August 1990

On the recommendation of the Board of Directors and the Board of Professional Affairs, Council voted to approve the following resolution on licensing for psychoanalysts: [The text of the second paragraph of the resolution reflects amendments approved by Council in February 1992.]

"APA has long endorsed the principle of generic education and training for psychology, further recognizing that within any profession there are identifiable and demonstrable specialties.

Thus, from the standpoint of these principles, psychoanalysis is viewed as a set of theories and techniques. In addition, psychoanalysis is viewed as an advanced specialization of a number of professions rather than as an independent profession. Therefore, APA does not recognize psychoanalysis as an independent or licensable profession.

XXII. PUBLIC EDUCATION

1. February 1995

On the recommendation of the Board of Directors, council voted to approve the following motion concerning strategies to promote increased public understanding of the independent practice of psychology including the following actions:

The CEO will direct the development of a plan for a national educational campaign to increase public awareness about psychologists, psychological practice and the value of psychological services, education, training and research in the new health care environment.

XXIII. PUBLIC SERVICE PSYCHOLOGISTS

1. 1956

Psychologists in public programs, whether engaged in service or research, typically seek to work cooperatively with members of other professions with special competencies which they as psychologists do not possess. Such collaboration is most effective when the members of each profession have respect for the special competencies, skills, and responsibilities of each of the other professions represented on the team. Effective collaboration is impeded whenever one profession assumes a hierarchical domination of another or treats another profession as ancillary.

The American Psychological Association believes that psychologists can make their greatest contribution to public service programs only if the administrative structure of the organization enables them to assume full responsibility for their professional activities. By virtue of the standards of selection, professional education and ethical conduct accepted by this association, psychologists are qualified to assume full responsibility for their procedures, techniques, decisions, and actions as psychologists.

XXIV. RECORD KEEPING

1. February 1993

On the recommendation of the Board of Directors and the Board of Professional Affairs, Council voted to approve the Record Keeping Guidelines and to adopt the Guidelines as official APA policy. [Appendix L - XXIV.1]

XXV. SERIOUS MENTAL ILLNESS - Severe Emotional Disturbance

1. February 1999

Council voted to adopt the following resolution:

WHEREAS "Serious mental illness" (SMI) has been defined by the Center for Mental Health Services (CMHS) in accordance with PL 102 321 (1992) to help identify those people who may receive mental health services from states under federal block grants; and that they are people who "have a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified by DSM IV, and that has resulted in functional impairments which substantially interfere with or limit one or more major life activities"; and whereas "severe emotional disturbance" refers to those mental illnesses with similar impact on children and adolescents;

WHEREAS the CMHS definition includes any mental disorders in DSM III or IV with exception of the "T codes, substance use disorders and developmental disorders, unless they co occur with another diagnosable SMI; and that all SMIs have episodic, recurrent or persistent features but vary in terms of severity and disabling effects; and that functional impairment is defined as difficulties that substantially interfere with or limit role functioning in one ore more major life activities including basic daily living skills (e.g., eating, bathing, dressing), instrumental living skills (e.g., managing money, maintaining a household, taking prescribed medication, or functioning in social, family, and vocational/educational contexts) and that adults who would have met the functional impairment criteria during the year without the benefit of treatment or other support services are considered to have a serious mental illness;

WHEREAS the Center for Mental Health Services reports that 5.4 million or 2.7 percent of the adult population have a "severe and persistent" mental illness, such as schizophrenia, bipolar disorder or major depression; and that more than 3 million children and adolescents have a severe emotional disturbance that undermines their present functioning and imperils their future (National Advisory Mental Health Council, 1990);

WHEREAS recovery from serious mental illness, once thought impossible, is being documented in research and demonstrated by the productive lives of an increasing number of recovered and recovering people who are open about their experience (Jamison, 1995; DeSisto, Harding, McCormack, Ashikaga, & Brooks, 1995); and there are many diverse paths through recovery (Bassman, 1997; Frese & Davis, 1997; Harding, Brooks, Ashikaga, Strauss, & Breier, 1987); and no one should be excluded from the possibility of a positive outcome or from services or education which would maximize recovery;

WHEREAS stigma and discrimination are most damaging to recovery and can unjustifiably foreclose opportunities for employment, housing, education, and other services;

WHEREAS the tendency of the lay public as well as some mental health professionals to define individuals as an illness or diagnosis and to use pejorative and dehumanizing terms contribute to the loss of hope, dignity, and self respect;

WHEREAS to be effective facilitators of recovery, it is essential for psychologists to understand how stereotypic and stigmatizing language, attitudes, and behaviors can demean and devalue people with mental illness and have an adverse impart on multiple aspects of functioning, such as self concept, relationships, self esteem, self efficacy, and performance;

WHEREAS the Americans with Disabilities Act (ADA) protects people with mental disabilities and covers psychological training and employment; whereas in selecting applicants to psychology training programs and in hiring psychologists with a mental disability, the issue should be whether individuals can perform the work with reasonable accommodation; and whereas psychology training programs should be careful not to discriminate solely based on the fact or suspicion that students carry a diagnosis of mental illness, but rather to consider their potential to become proficient professionals and their possible future contributions to the field, taking note of the special insight, understanding, and practical experience they bring to their work;

THEREFORE BE IT RESOLVED

Bassman. R. (1997). The mental health system: Experiences from both sides of the locked doors. Professional Psychology: Research & Practice, 28, 238-242.

Bedell, J.R., Hunter, R.H. & Corrigan, P.W. (1997). Current approaches to assessment and treatment of persons with severe mental illness. Professional Psychology: Research & Practice. 28, 217-228.

Coursey, R.D., Alford, J., & Safarjan, W. (1997). Significant advances in understanding and treating serious mental illness. Professional Psychology: Research & Practice, 28, 205-216.

DeSisto, M. J., Harding, C.M., McCormack, R.V., Ashikaga, T., & Brooks, G.W. (1995). The Maine and Vermont three decade studies of serious mental illness. British Journal of Psychiatry, 167, 331-342.

Frese, F.J. & Davis, W.W. (1997). The consumer/survivor movement, recovery, and consumer professionals. Professional Psychology: Research & Practice, 28, 243-245.

Harding, C.M., Brooks, G.W., Ashikaga, T., Strauss, J.S., & Breier, A. (1987). The Vermont longitudinal study of persons with severe mental illness, 1: Methodology, study sample and overall status 32 years later. American Journal of Psychiatry, 144, 718-725.

Jamison, K. R. (1995). An unquiet mind: A memoir of moods and madness. NY: Alfred A. Knopf.

Marsh, D.T., & Johnson, D.L. (1997). The family experience of mental illness: Implications for intervention. Professional Psychology: Research & Practice, 28, 229-237.

National Advisory Mental Health Council. (1990). National plan for research on child and adolescent mental disorders (DHHS Publication No. ADM 90 1683). Washington, DC: US Government Printing Office.

WohIford, P. (1994). National perspectives on clinical training for psychological services. In D.T. Marsh (Ed.), New directions in the psychological treatment of serious mental illness (pp. 3-20). Westport, CT: Praeger.

XXVI. SCHOOL PSYCHOLOGY

1. August 1994

On the recommendation of the Board of Directors, the APA/NASP IOC, and the Board of Professional Affairs, Council voted to endorse the following policy statement and to adopt it as APA policy:

2. February 1995

On the recommendation of the Board of Directors, the APA/NASP IOC, and the Board of Professional Affairs, Council adopted the following guidelines:

These guidelines have no binding effect and do not impose any limitations on the contracting activities of psychologists or school authorities. Decisions in this area are the responsibility of the appropriate educational and licensing authorities.

Rationale

Given the economic recession of the past decade, school districts have sought less expensive approaches to providing psychological services to students in schools. One option frequently explored is the replacement of full time school psychologists employed by the district with psychological services provided by psychologists on a contractual basis. Such contractual services are often part time and sometimes restricted to only those services the district is legally required to provide.

While part time or full time contractual services provided by competent psychologists are reasonable alternatives, such contractual services do raise potential problems. One concern is the appropriate credential that should be obtained by a contractual provider of psychological services to schools.

The APA Model Act for State Licensure of Psychologists (APA, 1987) and most state licensing laws exempt from licensure those individuals who are credentialed as school psychologists by a state department of education and are "employed" by the schools. As contractual service provision has become more common, the question has been raised by both individuals and various state boards of psychology and education as to whether an individual can be hired to provide school psychological services on a contractual basis without a license from a board of psychology. One interpretation has been advanced that contractual services, whether full or part time, still constitute employment by the schools and thus no license is necessary beyond a department of education credential. The alternative interpretation holds that contractual services, whether full or part time, constitute the independent (i.e., autonomous) provision of services. Under the latter interpretation, the individual does not meet the criteria of employment and thus should not be exempted from licensure.

A second concern related to contractual services in school psychology deals with the potential for psychologists to lose their professional autonomy and be hired to perform specific functions rather than function as a professional who delivers comprehensive services. A clear example is a situation where a psychologist is hired to conduct assessments for special education placement where the assessment procedures and parameters are dictated by the contract with no opportunity to alter the process, if necessary. Further, such narrowly prescribed service contracts may impede the provision of comprehensive and integrated services.

The American Psychological Association/National Association of School Psychologists Interorganizational Committee (APA/NASP IOC) has reviewed the issues and concerns associated with the provision of psychological services on a contractual basis. The APA/NASP IOC developed the following policy guidelines dealing with contractual services in school psychology in order to provide guidance to state boards of education and psychology, school administrators, and individual providers of school psychological services on the appropriate credentialing and use of contractual service providers.

Contractual Psychological Services by School Psychologists In Schools

Recognizing that there are school psychologists who provide services to school districts on a part-time basis, and in order to ensure professionalism in services, the APANASP IOC recommends the following as a way to identify those school psychologists who function as employees of a school district. Other psychologists who are not employees are considered to be independent service providers under contract to a school district and therefore must be licensed by a state psychology regulatory board. In doing so, the APAMASP IOC:

• recognizes that school districts employ state education agency credentialed school psychologists and that employment should be defined to include part time employment.

• reaffirms the need for school systems to employ school psychologists, whether employed full or part time, to deliver a comprehensive range of services.

• emphasizes that these public policy recommendations are meant to include, not exclude, existing school psychological personnel.

Within the bounds of state law and statute, any contract for services by a school psychologist with most of the following conditions should constitute employee status of a school psychologist by a school system:

XXVII. TITLE - DOCTOR

1. 1986

That the APA adopt as the standard that it will recommend to the media for the use of 'Dr.' the following: Doctor should be used in references to all individuals who hold doctoral degrees -- M.D, Ph.D., or other --- in any context or format where the title 'doctor' is used for any of them.

XXVIII. TREATMENT v. TRAINING

1. 1978

Where psychotherapy, psychoanalysis, or other forms of psychological treatment or behavior modification are undertaken as a required or credited part of the professional preparation of a psychologist, the cost of such training should not be charged against a health plan by either the trainee or a psychologist/therapist, but where a psychologist or trainee may have a recognized mental disorder and seek professional assistance, the therapy should not be claimed as professional training and should be a reimbursable expense within the limits of the individual's health plan.

XXIX. VETERAN AFFAIRS PSYCHOLOGISTS

1. February 1994

Council approved the following resolution, presented in a new business item, concerning support for Veterans Affairs (VA) psychology:

WHEREAS the Department of Veterans Affairs has a long-standing commitment and history of providing health care to the veterans that have served this country;

WHEREAS VA psychologists have provided a critical service and leadership role in the health care, training, and research mission of the Department of Veterans Affairs; and

WHEREAS health care reform discussions must support the continued role of VA psychologists in serving our nations' veterans;

BE IT RESOLVED that APA establish a high priority to support the continued service to veterans by VA psychologists by (a) presenting the importance of VA psychology's role in veterans' care to the Administration and congressional leaders and policymakers and (b) by opposing attempts to reduce the level of employment of VA psychologists.

Council Policy Manual: Table of Contents | Introduction | A. Elections | B. Awards | C. Membership | D. Human Resources | E. Ethics | F. Board of Directors | G. Divisions and State and Provincial Associations | H. Organization of APA | I. Publications and Communcations | J. Convention Affairs | K. Educational Affairs | L. Professional Affairs | M. Scientific Affairs | N. Public Interest - Part 1 | N. Public Interest - Part 2 | N. Public Interest - Part 3 | N. Public Interest - Part 4 | N. Public Interest - Part 5 | O. Ethnic Minority Affairs | P. International Affairs | Q. Central Office | R. Financial Affairs