February 2001
Government Relations
Practice Directorate

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Psychologists’ training and credentialing.

• No other mental health profession requires as high a degree of education and training in mental health as psychology. Accredited doctoral programs in health services psychology, including practica and internships in clinics and hospitals, involve a median of seven years of training beyond an undergraduate degree.
• Licensure is required in all 50 states. Licensure requirements for psychologists are generally uniform across states, authorizing the psychologist to independently diagnose and treat mental and nervous disorders upon completion of both a doctoral degree in psychology (Ph.D., Psy.D. or Ed.D.) and a minimum of two years of supervised experience in direct clinical service. An ethical code has been adopted as a part of all state licensing laws.

Psychologists provide a wide variety of valuable and effective interventions and testing services.

• Psychotherapy offers individuals a treatment approach, which in many cases is equally, if not more, effective than drug therapies. Cognitive and interpersonal psychotherapies, for example, are effective treatments for depression. Alternatives to drug therapies are particularly valuable to elderly populations, who are often suffering from overmedication and numerous side effects of various drugs and drug interactions.
• Psychologists contribute to the care of patients suffering from chronic illnesses through a variety of interventions. For example:
• Psychotherapy, behavioral techniques, and biofeedback help people control high blood pressure and manage chronic pain or headaches.
• Breast cancer patients who participate in group psychotherapy are known to survive longer than those who do not.
• Pre-surgical psychological counseling is associated with fewer complications and a reduction in medication utilization.
• Diabetic adolescents are able to maintain the discipline of diet and insulin treatments through psychotherapy.
• Psychological interventions help cancer patients cope with the side effects of chemotherapy.
• Individual, group, and family psychological interventions are effective for depression, anxiety, and other adjustment issues surrounding chronic illness which affect quality of life.
• Psychologists help patients develop coping strategies and healthy behaviors, which are effective in reducing the factors associated with the development of illness. For instance, psychotherapy and/or behavioral interventions help individuals to change habits to reduce risks for cardiovascular disease, cancer, and HIV.
• Psychology has been in the forefront of the leading psychological and biological research on the mind/body interface, including the diagnosis and treatment of stress disorders, neurological impairments, brain disease and psychosomatic illness.
• Diagnostic tests performed by psychologists are state-of-the-art tools. Increasingly, physicians and other health care professionals turn to psychologists for their diagnostic capabilities. These diagnostic services detect functional impairment and assess the prognosis for improvement or deterioration in functioning. Psychologists apply these results and develop rehabilitative services and treatment.

Psychologists provide services in diverse health care settings and emphasize the least restrictive, most cost-efficient treatment alternatives.

• For many patients, outpatient mental health care, which psychologists typically provide, is equally or more effective than inpatient treatment. For these patients, outpatient treatment is more cost-efficient, less restrictive, and provides greater accessibility, especially for patients in rural areas.
• Physicians and other providers rely on psychologists' services in inpatient hospital and partial hospital settings, and regarding outpatient treatment, 81% of adults say that they would be more inclined to see a physician who works with a psychologist.
• Primary care is an increasingly important component of the health care delivery system. Psychologists in primary care settings serve a crucial function in assessment, treatment planning, and provision of psychological services for patients with a wide variety of health complaints.
• Psychologists work in conjunction with other health care professionals on multidisciplinary treatment teams in settings such as nursing homes and comprehensive outpatient rehabilitation facilities.
• Psychologists are currently recognized as independent providers in federal programs including Medicare, the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), the Veterans Administration, the Federal Employees Health Benefit Plan (FEHBP), HMOs and Medicaid plans.

The provision of psychological services can result in health care cost savings.

• The provision of psychological services to high frequency Medicaid users has been associated with a nearly 40% reduction in their Medicaid utilization.
• Many primary care clinics which include psychologists have shown as much as a 27% reduction in hospital admissions and bed days.
• Actuarial models suggest that every dollar spent on psychological intervention for women with breast cancer may save a health plan between $2.50 and $5.10 in direct treatment costs.

Americans need access to appropriate, high quality psychological treatment.

• 16 of the 20 most common diagnoses by primary care physicians, and 13 of the 15 leading causes of death in the U.S. have substantial behavioral components for which prevention, direct intervention, or rehabilitation services by psychologists can impact the development and the progression of the illness.
• 5 to 10% of Americans can be expected to experience an episode of major depression or dysthymia in a 12-month period. Lifetime prevalence for these disorders may reach 17%. According to a 1990 projection, the economic burden of depressive disorders in the American workplace suggests a total annual cost of $43 billion, with absenteeism alone contributing $12 billion.
• 48% of all Americans between the ages of 15 and 54 experience a psychological disorder during their lifetime. One in four adults in this country suffer a psychological disorder in any given year, and of these individuals, only 28% seek help.
• As many as 75% of all patient visits in primary care practice can be attributed to psychosocial problems that present through physical complaints.