APA Health Service Psychology Workforce Optimization

The United States is experiencing an unprecedented mental health crisis. By 2037, we project a shortage of nearly 80,000 health service psychology (HSP) professionals—leaving us at only 55% adequacy to meet public need. This gap extends across the behavioral health workforce, with similar shortages projected for school counselors, mental health counselors, marriage and family therapists, addiction counselors, and psychiatrists.

Meanwhile, HSP as a profession faces a fragmentation crisis of its own. Nineteen states currently recognize master’s-level HSP professionals, but without national standards or guidance, the result has been an inconsistent patchwork of licensing regulations and professional titles. HSP graduates and employers face confusion about qualifications and scope of practice that vary dramatically from state to state. This fragmentation undermines professional standards, public protection, and the integrity of psychology as a unified discipline.

In 31 states and Washington, DC, individuals with master’s degrees cannot be licensed to practice HSP in their communities. Many of these graduates—22,681 in 2023 alone, compared with just 3,895 doctoral graduates—are forced to seek licensure in other behavioral health professions, taking their psychology training and perspective with them. Psychology hasn’t provided appropriate pathways for a high percentage of psychology graduates interested in behavioral health careers, weakening our professional presence in behavioral health.

APA’s health service psychology workforce optimization initiative represents a mission-driven response to these converging challenges. Rather than allowing the current fragmentation to continue or ceding master’s-level HSP practice to other professions, APA is establishing unified guidance that will strengthen psychology’s impact while meeting urgent societal needs.

This initiative builds on substantial existing infrastructure. Hundreds of institutions currently offer master’s degrees in HSP, with established faculty and training programs. APA’s Commission on Accreditationopens in new window (CoA) approved standards for HSP master’s programsopens in new window in 2021, defining the discipline-specific knowledge and profession-wide competencies that distinguish HSP education from other behavioral health training. The CoA accredited its first HSP master’s program in 2024. Four programs are now currently accredited, and one is under review. With the infrastructure established, CoA is in a stable position to continue moving HSP master’s programs through the accreditation process.

By bringing coherence to this existing landscape, APA positions psychology to lead the behavioral health industry’s evolution. Doctoral HSP psychologists can continue expanding into leadership roles—overseeing program development, evaluating population needs, coordinating provider teams, and leveraging technology innovations—while master’s-level HSP professionals deliver evidence-based health services grounded in psychological science.

APA Council-Approved Operational Principles for Master's-Level Health Service Psychology

In August 2025, APA’s Council of Representatives approved the following operational principles to guide the current and future development of a licensure pathway for master's-level health service psychology (M-HSP) practitioners that is competitive with other master’s-level mental health providers and distinct from doctoral psychologists:

• The title and scope of practice for M-HSP practitioners should meet public health needs and protect and educate the public about this group of providers. 
• Master’s-level practitioners in psychology should have an appropriate title that does not include “psychologist” but establishes its base in psychology.
• M-HSP practitioners should have a scope of practice that ensures they are competitive in the marketplace with other behavioral health master’s level practitioners outside of psychology.
• M-HSP practitioners should be able to provide some services, independently without supervision and within a defined standard appropriate to the master’s level of education, training, and supervision, including psychotherapy and diagnostic intake. 
• M-HSP are included in health service psychology.
• M-HSP are distinct from other mental health practitioners in that they are grounded in psychology science, education and training. 
• The scope of practice of doctoral psychologists is distinct from that of M-HSP in that doctoral psychologists provide a broader range of services as well as conduct complex and comprehensive assessments relative to M-HSP.
• The licensure pathway for M-HSP should be consistent with the scope of practice and not inherently more burdensome than that of other master’s behavioral health professionals.

Professional standards and accreditation

APA has been considering the role of individuals with master’s degrees in psychology for over 75 years, with numerous work groups, task forces, and convenings focused on clinical, counseling, and school psychology—collectively known as health service psychology. In recent years, general agreement has emerged that HSP needs optimization, with value in establishing a unified vision including both doctoral and master’s degree HSP professionals.

The current Standards of Accreditation for doctoral and master’s programs in HSP (PDF, 799KB)opens in new window were approved as APA policy in 2015 and 2021, respectively. These standards articulate comprehensive requirements for HSP programs, including specific competencies that programs must provide opportunities for students to acquire. What distinguishes HSP professionals from other mental and behavioral health clinicians is the unique emphasis on psychological science in both master’s and doctoral education, combined with in-depth knowledge of individual differences and increasing awareness that the answers to complicated societal challenges lie within human behavior.

APA’s CoA accredited its first HSP master’s program in 2024, with additional programs already in the accreditation process.

Licensure and regulation

The Board of Professional Affairs has appointed a task force to revise APA’s Model Licensing Act (PDF, 111KB)opens in new window, last updated in 2010. The task force began work in June 2024 and opened the public comment period on the proposed revisions in January 2026. The proposed revisions include updated requirements and scope of practice for both doctoral and master’s degree professionals in health service psychology.

Currently, 19 states recognize master’s-level HSP professionals, but each has different requirements and steps on the professional pathway. This variability creates confusion for graduates, employers, and the public about training requirements, professional titles, and scope of practice. APA’s Model Licensing Act is not binding to states in enacting their licensing laws, but does reflect current APA policy. It serves as a reference document that states can consult when developing or updating their own psychology licensure laws.

After a period of public comment, the updated act will go to APA’s Council of Representatives for review and voting in February 2027. APA will then work with individual jurisdictions that wish to update their licensing laws to incorporate the new recommendations.

Professional titles and identity

The term “psychologist” will remain exclusively reserved for those with doctoral degrees in psychology. This maintains the established professional nomenclature while creating clear distinctions in the marketplace. The title “licensed practitioner of psychology” will be used for master’s degree health service psychology professionals to convey that psychology represents a distinct body of study and practice to which these professionals belong.

A few states currently use “psychologist” in titles for people with master’s degrees. While APA has no authority to mandate changes in those states, APA’s updated Model Licensing Act recommends reserving the title “psychologist” exclusively for individuals who have earned a doctoral degree in psychology. The act also provides guidance on professional titles for master’s-level HSP professionals that align with emerging national standards while clearly indicating their psychology training and identity.

Scope of practice development

The scope of practice for master’s-level health service psychology professionals outlined in the proposed MLA revisions include independent HSP practice, consistent with other licensed mental and behavioral health professionals holding master’s degrees. This competitive positioning is essential for master’s-level HSP professionals to engage in similar services and compete effectively with other master’s-level behavioral health professionals.

Assessment represents a particularly complex area requiring careful consideration. The scope of practice includes basic assessment capabilities, such as screening assessments for diagnostic purposes. However, the master’s scope of practice does not encompass the full range of psychological assessment, such as the practice of neuropsychology, forensic assessments, child custody and parental fitness evaluations, medical capacity evaluations, medical pre-surgical evaluations, acute medical specialty consultations (inpatient medical hospital, sleep medicine), projective testing, and public safety employment evaluations such as fitness for duty. This distinction reflects the advanced, specialized training required for comprehensive psychological and neuropsychological evaluations.

It’s important to recognize that all mental health professionals currently perform diagnostic assessment because diagnoses are assigned when billing third-party payors and designing treatment plans.

Some members hold the perspective that psychological assessment distinguishes the HSP doctoral profession of psychologists from all other mental health professionals. Others argue that psychological assessment is what distinguishes HSP professionals from other mental health disciplines, regardless of degree level. Many emphasize that psychologists need advanced, specialized training to conduct comprehensive psychological and neuropsychological evaluations, thus this should remain outside the master’s-level scope of practice.

To inform their recommendations, the task force reviewed assessment coursework and training typically provided by programs that offer master’s and doctoral degrees in health service psychology. The task force also examined common practice activities among providers recognized and/or licensed at master’s and doctoral levels in health service psychology and other mental health fields.

School psychology considerations

None of the recommendations alter the current scope of practice for school psychologists credentialed by agencies that regulate practice in public schools. School psychology maintains its own established certification and licensing track, which will remain unchanged by these workforce optimization initiatives.

Workforce integration and leadership

This optimization increases opportunities for doctoral health service psychology psychologists to assume leadership roles in the evolving behavioral health landscape. As health care delivery systems increasingly integrate master’s-level HSP professionals for front-line services, doctoral HSP psychologists are uniquely positioned to lead program development, outcome evaluation, and innovation initiatives. This approach maximizes the unique expertise of each level while expanding psychology’s overall capacity to serve public need.

Market competition and professional impact

Master’s-trained behavioral health professionals already practice in every state through other licensing pathways. Psychology’s health service psychology workforce optimization initiative will create more psychology professionals in the marketplace, but given the documented shortage of behavioral health services and record waiting times, any increased supply addresses unmet need rather than saturating existing markets.

Currently, most graduates from HSP master’s programs are licensed and working as “other” mental health professionals—such as counselors, marriage and family therapists, or clinical social workers. Licensing in other mental health professions is available in all 50 states. By contrast, master’s degree graduates cannot be licensed to practice psychology in the community in 31 states and Washington, DC. This initiative would give students who would otherwise seek master’s-level education in non-psychology behavioral health disciplines a pathway to remain in the psychology profession.

Psychology faculty have long played an essential role in educating, training, and supervising master’s-level mental health providers, particularly in counseling psychology. However, changes to accreditation standards by the Council for Accreditation of Counseling and Related Educational Programs (CACREP) have significantly limited the role of psychology educators in these programs. This shift is part of a broader movement to establish professional counseling as distinct from counseling psychology, which has concerning implications for the academic workforce and for students seeking diverse training perspectives.

While CACREP now accredits nearly 900 master’s programs, the Master’s in Psychology and Counseling Accreditation Council (MPCAC) accredits about 60 psychology programs. These restrictions result in reduced opportunities for academic psychologists and limited licensure pathways for graduates from psychology HSP master’s degree programs. As these trends continue, psychology faces an erosion of its educational and professional presence in master’s-level HSP training.

Based on an initial review by the task force that is updating APA’s Model Licensing Act, states that currently recognize master’s-level HSP professionals show no widespread evidence of negative impacts on doctoral psychologists’ practice opportunities. This preliminary assessment suggests these states demonstrate enhanced capacity by psychology to serve diverse populations and practice settings. The trend in most health care professions involves an increasing workforce of master’s degree professionals working within appropriate scopes of practice to address significant public health needs.

As more states recognize master’s-level psychology professionals, the marketplace may shift away from other mental and behavioral health disciplines toward psychology professionals trained by psychologists. This shift may be particularly pronounced because students with undergraduate degrees in psychology in states with no master’s HSP licensure opportunities tend to enroll in master’s programs in other behavioral health disciplines.

Graduate program sustainability and growth

Currently, many students with undergraduate psychology degrees pursuing advanced studies in behavioral health care choose to enroll in master’s degree programs in other mental and behavioral health disciplines—social work, counseling, marriage and family therapy—because many states offer no master’s psychology degree licensure opportunities. This represents a significant loss of potential psychology-trained professionals to other fields.

The optimization initiative is expected to create more master’s degree health service psychology programs and increase enrollment in existing programs, which will further support doctoral HSP programs at those institutions. Offering both master’s and doctoral programs in health service psychology may help to preserve institutional sustainability by increasing enrollment and tuition revenue and justifying more faculty and more diverse course offerings.

New master’s programs could be developed at universities located in under-resourced areas or at minority-serving institutions, potentially expanding the populations served and increasing the diversity of the workforce. This geographic and demographic expansion aligns with psychology’s commitment to addressing health disparities and serving underserved communities.

Broadening HSP education in a systematic and coordinated way may also offer doctoral educators more opportunities to prepare graduates to leverage their education in innovative ways—to lead HSP and integrated care teams, design innovative approaches to improving care, harness technology to improve lives, and thrive in the changing behavioral health landscape.

Professional association integration and governance

Master’s-level psychology professionals already participate in APA as associate members with established voting privileges. After one year of membership, associate members can nominate candidates for president-elect and vote in the presidential election, and can also nominate candidates for recording secretary, treasurer, and members-at-large on APA’s Board of Directors. However, associate members cannot currently serve as members of APA’s Council of Representatives.

The question of how best to include master’s-level professionals in the professional psychology community, specifically within APA, requires thoughtful consideration of the impact on APA membership, policies, and advocacy voice for the field. However, waiting to adopt a revised Model Licensing Act until such membership and representation decisions are made is not prudent, given that 19 states already recognize master’s-level HSP professionals, and more states are expected to implement such changes soon.

This initiative reflects strategic workforce development priorities and professional responsibility rather than revenue considerations. Revenue from membership dues represents only 3% of APA’s total budget. Even if 20,000 master’s-level HSP professionals joined APA, dues revenue would increase only nominally.

Regulatory consistency and professional standards

APA’s workforce optimization addresses the current regulatory inconsistencies where 19 states recognize master’s-level health service psychology professionals using different approaches. Without national guidance, there is no consistency in regulations, including titles or scope of practice for master’s-trained HSP professionals. This fragmentation undermines professional standards, confuses employers and consumers, and weakens psychology’s professional identity.

The Association of State and Provincial Psychology Boards (ASPPB) has developed its own Model Licensing Act for Psychology Associates and Licensed Practitioners of Psychology, and APA will work with ASPPB to align the respective licensure acts as possible. ASPPB’s Model Act is intended for regulatory bodies and their emphasis on advancing public protection through regulation. However, APA maintains its own Model Licensing Act to provide clarity through policy regarding key issues such as expected scope of practice, training and experience requirements, and title for professionals. APA’s comprehensive approach ensures that HSP professionals can compete effectively while maintaining appropriate professional standards.

Current workforce data and future projections

APA’s Center for Workforce Studies documents the significant gap between the supply of doctoral health service psychologists and demand for their services in the United States, suggesting that an additional 15,000 HSP professionals are needed to meet current demand. This demand would be challenging if not impossible to meet in the foreseeable future through doctoral training alone.

By 2037, the shortage is projected to reach nearly 80,000 fewer HSP professionals than needed, leaving the field at only 55% adequacy. Similar shortages are projected across the behavioral health workforce, including school counselors, mental health counselors, marriage and family therapists, addiction counselors, and psychiatrists.

In 2023, 22,681 students graduated with master’s degrees in health service psychology compared with 3,895 with doctoral degrees. This existing pool of master’s-level graduates represents substantial skilled professionals that psychology is losing to other professions due to inconsistent licensure opportunities.

APA’s health service psychology workforce optimization represents a proactive response to documented societal needs and professional challenges. By establishing unified standards for master’s-level HSP practice, APA will offer guidance that brings coherence to an already existing but fragmented landscape while positioning psychology to lead behavioral health innovation.

The initiative preserves psychology’s scientific foundation and evidence-based practice standards while expanding the profession’s capacity to address urgent mental health needs. It creates clear pathways for HSP graduates at all levels while establishing professional standards that protect both HSP practitioners and the public.

This optimization reflects APA’s organizational mission to benefit society and improve lives through psychological science and practice. As the behavioral health landscape continues evolving, psychology’s unified approach to HSP workforce development ensures the profession remains at the forefront of addressing society’s most pressing mental health challenges.