First, do no harm

Thanks to the Monitor for addressing the WHO's Mental Health Action Plan and the important issue of globalization in psychology in its January issue. This agenda, the article states, will help to "ensure that all citizens with mental disorders receive the treatment they need."

Perhaps most important, I was relieved to see that the article emphasized human rights, which include improving access to services internationally, but also the Hippocratic tenet that we must never harm those we intend to help. Unfortunately, critiques such as Ethan Watters's compelling yet scathing book "Crazy Like Us" inform us that, in our urgency to expand to new nations, we may actually be imposing our beliefs about problems and the best ways to treat them. After all, even the term "treatment they need" implies judgment that we, as experts, know what is best. However, in making such judgments, we may be breaking down centuries-old, culturally informed and truly effective conceptualizations of distress and coping that are already present in other countries.

Dr. Nadine Kaslow has identified bridging the gap between research and practice as a priority of her APA presidency. This important need is perhaps most evident in developing nations, where much of the work being done is informed by research from developed Western nations. Perhaps social justice in this context is not rushing to provide ill-informed or even harmful services, but instead emphasizing the need for new research that ensures that our practice reflects and builds upon the unique cultural landscapes of the places where we are working.

Brandon A. Knettel
Doctoral candidate in counseling psychology, Lehigh University

The plethora of certification

The February article "Is it time to specialize?" advocates specialty certification for psychologists, citing its "many benefits," including "more and better career opportunities," "greater job security" and "raises the integrity of the field."

There already exists, however, a sine qua non for the practice of professional psychology that denotes, as well as connotes, all of the benefits cited above. It is called a psychologist license, and it is issued by the state or states in which one practices to verify one's training, experience and expertise in the professional practice of psychology and psychotherapy.

The state licensing boards have worked hard to establish national standards for licensing, and many states have established reciprocity. Specialty boards, on the other hand, have no formal oversight by a governmental agency. Most of them are self-appointed "boards" whose intent is to a) monopolize a niche of practice and b) create revenue for those "governing" the board.

The real impact of specialty boards has, in the opinion of many, been the opposite of what the February article suggests. Rather than enhancing professional psychology's image, the growing number of specialty board certifications has diluted the integrity of the state psychologist license, lending the appearance that state licensure is an inadequate or irrelevant qualification.

A wiser strategy for our profession to pursue is to establish national standards for licensure, emphasizing to the public (and ourselves) that state licensure is the relevant qualification for establishing the necessary and appropriate training, experience and expertise for the general practice of psychotherapy.

Charles M. Lepkowsky, PhD
Solvang, Calif.

Please send letters to Sara Martin, Monitor Editor. Letters should be no more than 250 words and may be edited for space and clarity.


The March article "Are e-cigarettes a game changer?" should have said that Herbert Gilbert patented the first e-cigarette in 1963. At the time, his product did not gain recognition. However, his original patent drawings are still used as the roadmap for all e-cigarettes. As the article states, Hon Lik was the first person to manufacture and sell the product successfully.