Psychologists are seeking to modernize the profession

[This article is part of the 2025 Trends Report]

Though psychology has historically been a doctoral-level field, APA’s elected and appointed leaders are creating a blueprint to become a multitiered profession that embraces and guides the training of master’s-level psychology professionals who can help meet the nation’s unprecedented demand for mental health services. The goals are to build consistency for the field, position psychologists to lead in mental and behavioral health, and improve public access to care that is rooted in psychological science.

Psychology is responding to global changes in health care and service delivery that call for a unified vision for the field. This move will also help psychologists remain a distinct and viable part of the mental health workforce as patients seek treatment in a market in which the demand for services far outstrips the mental health provider supply. A recent APA survey of psychologists showed that more than half of respondents reported having no openings for new patients, and 56% reported not maintaining a waitlist (Practitioner Pulse Survey, APA, 2023). The increasing demand for services is such that employment growth in the mental health field is expected to be triple the projection for the typical U.S. jobopens in new window over the next decade, according to a CNN analysis of data from the U.S. Bureau of Labor Statistics.

“Increasing training and licensure of master’s-level psychology professionals elevates the field of psychology by providing opportunities for increased leadership, training, and supervision for psychologists in the health care marketplace,” said Teri Strong, PhD, who leads a private practice in Eugene, Oregon, and serves as chair of APA’s Board of Professional Affairs (BPA).

All states offer licensure for master’s clinicians in social work, counseling, and marriage and family therapy. But only 20 states offer licensure to master’s-level psychology graduates, and the scope of practice, educational requirements, and level of independence varies from state to state. Some states require master’s-level psychology professionals to be supervised throughout their careers, while others grant independence after a certain number of hours or years of supervision. The titles given upon licensure also vary by state, and include licensed psychological associate (LPA), licensed psychological practitioner (LPP), licensed psychological examiner (LPE), and master’s limited license (MLL).

“These master’s-level providers are working in integrated health care systems, community mental health centers, private practice, schools, and other settings,” said Catherine Vieira-Baker, PhD, a psychologist at South Coast Educational Collaborative in Massachusetts and a member of BPA. “APA is trying to ensure that we provide guidance about the requirements for education and licensure for these psychological professionals.”

To support the transition to a multitiered profession, BPA appointed a task force in May 2024 that is revising what is known as the Model Licensure Act (MLA), sample legislation that states can use to implement licensure for psychology professionals. The MLA will include recommendations for master’s-level psychology professionals, including a master’s degree title and scope of practice, educational requirements, and other information to guide state lawmakers and regulatory agencies. In fall 2024, two possible titles—licensed practitioner of psychology and licensed psychological associate—as well as a proposed scope of practice were out for public comment. Over 700 pages of feedback were received and the task force is reviewing, responding, and updating their work and hope to bring a proposal to APA’s Council of Representatives in August 2025.

In July 2024, APA’s BPA and Board of Educational Affairs cleared another major hurdle by detailing the distinct and shared competencies for master’s and doctoral students. This competency framework, which can be used by psychology graduate programs to guide training, will go before APA’s Council of Representatives in February 2025. APA gathered feedback on the framework for 60 days, from August through October 2024.

By leading states and schools in this transition, psychologists will create consistency across the profession, which will help patients and providers alike, said Strong. Focusing on master’s-level credentialing also offers opportunities to increase the diversity of qualified mental health professionals in psychology. “This is a social justice issue,” Strong said. “Getting a doctorate is not available to everyone, and we need a diverse workforce to serve a diverse population.”

States that do not offer licensure to master’s-level psychology professionals run the risk of creating barriers to practice for historically marginalized student populations. “We need to reduce systemic barriers,” said Vieira-Baker. “Not everyone can go directly to a doctoral program after earning an undergraduate degree, and we need to create a pathway for graduates to gain licensure after a master’s degree.”

Helping states develop licensure guidelines for master’s-level psychology professionals could also increase access to high-quality mental health care, especially in parts of the country experiencing provider shortages. “I’m already seeing providers without psychological training who are filling this need, which is lowering the quality of services,” said Matthew Davis, EdS, LPA, who works at Heartstrings Mental Health in London, Kentucky. His concern is that nonpsychology master’s-level providers are offering services such as cognitive behavioral therapy and applied behavior analysis without adequate training. “If the field of psychology does not step up to provide guidance for master’s-level licensure, these other fields will take our place.”

As fields such as social work and counseling have gained more footing in recent years, job applicants with psychology training are facing difficulty finding job postings that accept their training, said Sarah Nolan, MA, LPP, who recently served as the master’s representative for the Kentucky Psychological Association. “I am constantly hearing feedback from members that master’s-level psychology professionals can’t find clinical supervision or are being bypassed for promotions by other disciplines such as social work, counseling, or marriage-family therapists,” said Nolan, who works as a therapist at True North Counseling and Development in Lexington, Kentucky.

Kentucky is one of the states that grants licensure to master’s-level psychology professionals, but until recently these clinicians were required to be under supervision for 5 years before they could be eligible to practice independently—3 more years than the requirement for master’s-level mental health professionals in other fields in Kentucky. In 2024, the Kentucky Board of Examiners of Psychology revised the requirement to 2 years of supervision for master’s-level psychology professionals.

Nolan is seeing a decrease in the number of applicants to master’s programs in psychology departments at schools throughout Kentucky because the path to practice is longer and more complex than for other mental health disciplines. “The more accessible we make the psychology profession to future master’s-level psychology professionals, the more I see our field having a monumental impact across many career fields, including education, clinical practice, industry, and in health care settings,” said Nolan.

In Arkansas, master’s-level psychology professionals are called LPEs, and they have been frustrated for years by the state’s requirement for perpetual supervision by psychologists with no path to independence. The state passed legislation in 2007 that allowed existing LPEs to start practicing independently, but the state stopped offering this licensure to any new master’s-level graduates in 2013. “I had a lot of confidence in the training LPEs received, so it always bothered me that they were perpetually under supervision,” said J. Art Gillaspy, PhD, a professor in the department of psychology and counseling at the University of Central Arkansas. “It felt like their practices were limited.”

The loss of new LPEs in the workforce was felt throughout the state. Positions that were once filled by LPEs were being advertised for psychologists only, but there were not enough psychologists to fill those roles, especially in rural areas. Community mental health agencies sponsored new legislation to reinstate this form of licensure. In 2023, the LPE was reestablished in Arkansas. Supervision is still required for newly licensed LPEs, but legislation is planned for the upcoming legislative session to create a pathway for independence. Gillaspy hopes the consequences of halting the LPE career path will serve as a cautionary tale. “Together, we can get more providers out there who can deliver the quality care people need,” Gillaspy said.

As a leader who oversees 10 emergency departments in Michigan, Jennifer Peltzer-Jones, PsyD, RN, assistant medical director of emergency behavioral health services at Henry Ford Health System in Michigan, confronts the consequences of the mental health provider shortage on a regular basis. Patients frequently seek emergency department care because they cannot find mental health services in the community. “Every day I see people who would benefit from receiving treatment with a mental health provider, and it is distressing knowing that we have a huge cadre of master’s-level professionals who are not being utilized,” she said. “Caseloads are too full, and as we raise up a group of master’s-prepared clinicians, it helps us all.”

As health care delivery systems continue to evolve and incorporate increasing numbers of master’s-degree professionals into care, Strong urges psychologists to educate themselves about the benefits of a multitiered profession, such as more consistency in licensure requirements from state to state and improved access to quality care from professionals with psychology training. “It is time to take a leadership role and put psychology at the forefront of behavioral health,” Strong said. “We need to advocate with state legislatures and regulatory bodies about what this change would look like and why an increase in the number of master’s-level clinicians licensed in the psychology profession will serve the population in need of behavioral health services.”

If APA does not take the lead in developing recommendations, building consistency for the field, and positioning psychologists to lead in mental and behavioral health, the risk is that states will continue to create a variety of different requirements for supervision and scope of practice for master’s-level psychology professionals, and the quality of care may suffer. In states that do not offer licensure to master’s-level psychology professionals, students will need to pursue other fields such as social work, counseling, and marriage and family therapy if they wish to obtain a master’s in a behavioral health field. “My biggest fear is that the voice of psychology will be left behind as legislators make these decisions,” said Vieira-Baker. “We don’t want talented individuals to get credentialed in another field simply because there wasn’t a place for them in the field of psychology.”