Psychology made significant strides this year in fixing a problem that has been plaguing new doctorates: the requirement in many states that doctoral students complete a one- or two-year supervised postdoctoral period before they can be licensed to practice. The issue is critical to students, who often face a difficult time finding postdoc opportunities and who need to get licensed and start working to begin paying down student loan debt. All but three states require psychology doctoral students who want a license to practice to complete a one- or two-year supervised postdoctoral period. But that requirement dates to a time when students did not accrue significant hours of supervised training in their doctoral programs. Thanks to psychology's advocacy efforts, more states are doing away with the old requirement.
"People are finally figuring out ways to make this happen and getting enough support within their state associations, as well as their licensing boards," says Dan Abrahamson, PhD, assistant executive director for state advocacy in APA's Practice Directorate.
APA has been working on the issue since 2001 when the association's Commission on Education and Training Leading to Licensure in Psychology called for more flexibility in the training sequence. In a report to APA's Council of Representatives, the commission suggested that because of the growth in organized, sequential and well-supervised training practica experiences that students could obtain two years of supervised training (which includes an internship year) before earning a doctorate.
Several states are making progress on the issue, including:
Washington. The state legislature passed more flexible training requirements and the state's psychology board adopted new rules on supervised pre-internship training. The changes allow students who meet the mandated hours of predoctoral training and earn a doctorate to apply for licensure without a postdoc year.
Utah. The state legislature passed legislation this year allowing psychology doctoral students to complete all 4,000 hours of supervised training before the awarding of a doctoral degree. The new law enables students who meet the mandated hours of predoctoral training and earn a doctorate to apply for licensure without a postdoc year.
Connecticut. As part of a two-step process, the state legislature this year removed the requirement for a postdoctoral year. In the second step, the state psychology board, working with the state Department of Public Health, is expected to adopt regulations next year allowing students to accrue the year's worth of supervised training before graduation.
Ohio. The Ohio House passed a bill that allows students who accumulate 1,800 hours of supervised clinical work and a yearlong internship to seek licensure without a postdoctoral year.
To build support for such changes, the APA Practice Organization annually offers five grants of $2,000 each to state, provincial or territorial psychological associations to help fund informational meetings and advocacy.
Defending psychology's role and value
Psychologists were also effective this year in defending psychology's role as a profession that helps address child abuse evaluations and addiction treatment. For example, the Florida Psychological Association fought against a bill that would have allowed only psychiatrists to evaluate whether a child had suffered emotional or psychological injury in child abuse cases, says Connie Galietti, FPA's executive director. It's psychologists, not psychiatrists, who are most often involved in evaluating the mental health toll of child abuse cases in the state's court system, Galietti says.
"This bill would have put victims of child abuse in greater danger," she says. The bill died in committee.
Meanwhile, in Indiana, the Indiana Psychological Association helped to defeat a move to require psychologists, along with other mental health professionals, to be certified to offer addiction treatment. Working with its legislative lobbyist, IPA pointed out that under Indiana's licensing guidelines, psychologists are already held to the standard of treating conditions for which they're trained, says IPA's Tom Barbera, PhD.
The state also made progress in requiring managed health-care companies to include specific language in contracts with health-care treatment providers, including psychologists, on the issue of discounted rates. The bill was necessary because some psychologists who sign up with managed-care companies and agree to treat clients at discounted rates have found that when those companies sell their lists of treatment providers to other insurers, they get too many referrals for clients at the discounted rate.
"They have to be clear about it so that you don't get tricked into taking lower rates," Abrahamson says.
In another state-level victory, the Illinois Psychological Association helped convince the state legislature to add anorexia nervosa and bulimia to the mental health conditions included in the state's mental health parity law. In fact, says Abrahamson, such state-level efforts on parity laid the foundation for the federal mental health parity law enacted by Congress in October, he says.
The states' work drove home the message to Congress that this issue wasn't going to go away, he says.
Looking forward to next year, Abrahamson says psychology will be busy advancing prescriptive authority for psychologists. He expects as many as a dozen states to introduce legislation allowing appropriately trained psychologists to prescribe medications.