Gaining specialty certification

It took about 15 years for Thomas J. Vaughn, PhD, to finally seek out board certification in clinical psychology. "I kept telling myself, 'I'm busy now, but I'm going to do it next year,'" says Vaughn, a private practitioner in Shawnee, Okla. "I just kept doing that year after year."

What finally convinced him were the funny looks from medical colleagues at the clinic where he then worked. Physicians, he points out, get board certified as a matter of course. "Those who don't get looked on with a little suspicion," he says. "I don't think anyone had serious questions about my training or abilities, but they found the fact that I wasn't board certified a little troubling."

Respect isn't the only reason psychologists should consider specialty certification, says Vaughn, editor of Psychology Licensure and Certification: What Students Need to Know (APA, 2006). While APA has no official position on certification, Vaughn and others cite financial incentives, requirements for acceptance on medical staffs and from third-party payers, and the need for consumer protection as factors that make the extra time and expense involved in certification worth it for many psychologists.

And graduate school is not too early to start thinking about certification, they say.

The benefits of certification

You don't need to be board certified to practice psychology. For that, you need only to meet your state's education and licensure requirements.

Less than 5 percent of psychologists who are qualified for board certification actually are, says Christine Maguth Nezu, PhD, president of the American Board of Professional Psychology, one of a handful of organizations that provide specialty certifications.

Some are generalists who don't feel they need certification or practitioners whose practices do just fine without it. (See sidebar for one practitioner's perspective.) Other psychologists don't want to take the time or spend the money for certification.

And, says Nezu, certification didn't always mean what it does now.

Initially, she explains, certification was seen as proof that a psychologist was at the top of the profession. With the burgeoning of psychological knowledge, the meaning of certification has shifted. As specialization has grown, she says, so has the need to assure the public that psychologists who claim to be specialists really do have the training and experience they need to work with special populations or in particular subfields.

ABPP protects consumers by examining and certifying psychologists who can demonstrate competence in one of the 13 specialty areas it recognizes, such as school psychology, clinical neuropsychology and clinical child and adolescent psychology. (APA's Commission for the Recognition of Specialties and Proficiencies in Professional Psychology recognizes all the ABPP specialties except group psychology and rehabilitation psychology.) Certification doesn't just benefit the public, says Nezu, a professor of psychology and medicine at Drexel University in Philadelphia. It can also increase your marketability, she says. Psychologists applying for jobs at the Mayo Clinic in Rochester, Minn., must be board certified or in the certification pipeline, she points out. For psychologists within the Department of Veterans Affairs, certification can bring increases in rank and pay. And, adds Nezu, insurance companies are increasingly requiring that the specialists in their panels be board certified.

More important, she says, certification lifts the profession.

"If we as psychologists are going to insist on equal parity with other professions, such as medicine, law, nursing or dentistry, we need to be able to hold ourselves to that same standard for peer competency evaluation," says Nezu, who is board certified in cognitive and behavioral psychology and clinical psychology. "We haven't done that yet, and that holds back the profession."

How to get started

Getting certified by ABPP is typically a three-step process: submitting your credentials for review, submitting practice samples for peer review and undergoing an oral exam conducted by board-certified psychologists. The clinical neuropsychology and forensic psychology boards also require written tests.

Even though you can't become certified until after you have your doctoral degree from an APA-accredited program, a license and enough experience to have developed a specialty, it's never too early to start thinking about the process, say Nezu and other experts. They offer this advice:

• Start now. At the graduate level, students can start thinking about specialization as soon as they begin their programs, but shouldn't necessarily commit to a specialty pathway, says Catherine Grus, PhD, associate executive director for professional education and training in APA's Education Directorate. "Doctoral training is about expanding your knowledge base, not limiting it," she says.
  
  Students in accredited doctoral programs will get a thorough grounding in general psychological science and practice, says Ted Packard Jr., PhD, a board-certified professor emeritus of educational psychology at the University of Utah. They can then develop specialization via their elective courses, internship and practicum experiences, and postdocs.

• Register with ABPP. ABPP has an early-entry program that allows students to begin the certification process even before they know what specialty area they'll choose. After filling out a two-page application, students can start "banking" their education and training experiences. Instead of scrambling to remember all the details years later, participants simply let ABPP know as they pass each milestone, such as earning a doctorate or getting a license. The early-entry program is also cheaper, with an application fee of just $25 compared with the usual $125. At some universities, psychology students don't even have to pay that; the department picks up the tab as an incentive to encourage eventual certification.

• Seek out mentors. Because so few psychologists are board certified, says Nezu, students may have trouble finding mentors in their departments who can guide them through the process. To help, ABPP's early-entry program gives students access to mentors within its various specialty boards and academies. They can offer advice on the certification process, the specialty itself and job and internship opportunities.
  
  And whether they're certified or not, says Packard, your professors can help you start thinking about the practice samples you'll eventually submit.
  
  These samples are designed to illustrate the depth and breadth of your knowledge and feature cases you have tackled. The samples may include videotapes, case reports, clinical notes, raw data and other materials that demonstrate an applicant's abilities.
  
  "In fact, it's quite common that doctoral qualifying exams will have requirements that are analogous to practice samples," says Packard. While they aren't necessarily called practice samples, he explains, they contain the same basic elements: a comprehensive assessment battery, history of the case and so on.

• Consider other certifications. "Many people define themselves by double or even triple specialties," says Nezu. Others specialize even more narrowly. If you want to demonstrate competence in a more focused skill within a broader specialty area, you might want to seek continuing-education certificates after ABPP certification, says Nezu. A board-certified psychoanalyst might seek additional proficiencies in hypnosis, for example. A forensic psychologist who assesses sex offenders might seek a certificate in the use of penile plethysmographs to determine offenders' levels of arousal when exposed to certain materials. A cognitive-behavioral therapist might want to document specific training in dialectical behavior therapy or behavior analysis.

But be sure the credential is legitimate, warns Packard. "There are a lot of board certifications you can basically buy," he says, explaining that applicants may pay a hefty fee, take a simple test and document seminars they've attended. "You end up with a credential that doesn't really mean very much."

Do some digging to ensure that the certification involves more than a weekend class and test, he says. A legitimate certification process should emphasize peer review, he says.

Still not sure you want to go the specialization and certification route? Consider current market conditions, says Packard.

"The notion of being a general practitioner I don't think is any more valid in psychology than it really is in medicine," he says, citing the explosion of knowledge in the field. "You really don't have any choice but to specialize."