Revising the Model Licensing Act to secure the future of psychology

Note: The print version of the Monitor incorrectly stated that APA’s Council of Representatives will vote on the revised Model Licensing Act (MLA) in August 2026. The Council will vote on the MLA revision in February 2027.

The Model Licensing Act (MLA), APA’s recommended guidance to states on what psychology licensure should include for health service psychologists spanning education, supervision, scope of practice, and credential titles, has been revised and will go before APA’s Council of Representatives for a vote in February. The revised document was made available for public comment for 60 days earlier this year, giving APA members and other stakeholders an opportunity to share comments and concerns and propose changes before the vote.

The 2026 revision includes the addition of licensure standards for master’s-level health service psychology providers, with a recommended title of “licensed practitioners of psychology.” The term “psychologist” will continue to be reserved for doctoral-level health service psychology (HSP) providers.

Many states have already created or are considering such licensing pathways to address workforce shortages and other challenges. As part of APA’s broader efforts to optimize the health service psychology workforce, the MLA revisions give psychology a chance to shape how those changes unfold.

The ultimate goal of the MLA revisions is to ensure that the public can access care grounded in psychological science. Nineteen states currently license master’s-level health service psychology professionals. But without guidance from the discipline’s main professional organization, states have developed an inconsistent patchwork of licensing regulations, scopes of practice, and professional titles. For example, some states allow master’s HSP professionals to practice independently after meeting supervision criteria; others require career-long supervision. This fragmentation has caused confusion about qualifications and scope of practice from state to state, making it harder to maintain consistent standards and a clear professional identity for psychology.

“States have and will continue to license master’s-level psychology practitioners to address the mental health needs of their populations,” said Syretta James, PhD, ABPP, the chief behavioral health officer at Armor Health, a leading provider of correctional health care, and co-chair of the APA task force responsible for updating the MLA. “APA weighing in helps maintain quality, safety, and scalability in a rapidly changing mental health landscape.”

Each year, around 23,000 students earn master’s degrees in health service psychology. But 31 states and Washington, D.C., do not offer pathways to licensure in health service psychology for master’s-degree holders, meaning most graduates must seek licensure in other professions, such as counseling or marriage and family therapy.

“Our field now has an opportunity to work with this reality rather than against it,” said James. “It’s time to look within our profession and identify how we’re going to lead this change.”

Psychology is one of several fields facing pressure from health systems to put master’s-level clinicians on the front lines of care. Physician assistants and nurse practitioners, who increasingly take on primary care provider roles, are among those grappling with similar questions about training, supervision, and scope of practice. In 2024, the Centers for Medicare & Medicaid Services moved to reimburse additional master’s-level behavioral health practitioners, reflecting broader recognition of the value these providers can bring to the public.

Meanwhile, the demand for care continues to exceed the size of the workforce. APA’s Center for Workforce Studies continues to predict a substantial shortage of health service psychology professionals over the next decade. With mounting pressures on graduate education, including cuts to grant funding and student loans, simply training more doctoral psychologists is unlikely to be enough to meet future demand.

“There’s not a shortage of work. We know we have a mental health crisis, and we also know that psychology’s master’s-level professionals are well-equipped to meet that need,” said Eric Russ, PhD, a licensed psychologist and organizational consultant based in Louisville, Kentucky, who is executive director of the Kentucky Psychological Association.

Psychologists argue master’s-degree holders with psychology training are better positioned to fill this gap than providers from other fields because of their robust training on evidence-based psychological interventions and assessments.

In Kentucky, master’s-level psychology practitioners have worked alongside psychologists since 1948. Russ points to that successful integration, as well as similar examples in Vermont, Kansas, and other states, as evidence for the model’s feasibility.

“For decades, master’s- and doctoral-level providers have used their clinical training to improve access to evidence-based care,” he said. “Although trained at different levels, a shared grounding in psychological science helps create a coherent professional identity and improves care for folks in Kentucky over what they might otherwise get.”

Evidence from the 19 states where master’s-level practitioners of psychology already operate also suggests they have not posed a competitive threat to psychologists. An initial review by the task force updating the MLA did not find evidence that master’s-level practitioners of psychology negatively affect employment or practice opportunities for doctoral psychologists in states where both levels of practice exist. However, task force members acknowledged that the available data is limited and the subject warrants further study.

If the MLA revisions are adopted by states, psychology would have an opportunity to shape its own master’s profession. Comprehensive psychological evaluations and neuropsychological testing would remain exclusively within the scope of doctoral practice.

This may create advancement opportunities for psychologists. As master’s-level licensed practitioners of psychology take on evidence-based care for common mental health concerns, those with doctoral training may continue to do so, or they may choose to widen the lens and shift into specialty care, leadership roles, or program development and evaluation.

As psychologists complete their training, more may elect to pursue specialties recognized by the Council of Specialties in Professional Psychologyopens in new window, such as forensic psychology, geropsychology, and clinical neuropsychology, as well as those eligible for certification by the American Board of Professional Psychologyopens in new window, including addiction psychology and rehabilitation psychology.

A specialist approach is one potential way to differentiate those with doctoral training, said Jason Washburn, PhD, chief of psychology in the Department of Psychiatry and Behavioral Sciences at the Northwestern Feinberg School of Medicine, and it also makes more sense from a population health perspective. More practicing master’s-level psychology professionals would help meet the growing need among people with common mental health concerns, freeing up psychologists with more specialized expertise to diagnose and treat patients with more complex concerns. This could help build capacity in areas where the field is struggling to meet demand, Russ said. “Unless we find a way to meet that need within our profession, it becomes harder to argue that the current system is working,” he said.

The doctoral degree also uniquely positions psychologists to step into leadership and program evaluation roles, James said, by providing a depth of training in research, statistics, and clinical practice that allows them to ask and answer broader questions about impact.

“The doctoral degree is a reflection of discipline—an immersion in assessment, intervention, and consultation that prepares us to ask better questions and resolve problems on a larger scale,” said James, who leveraged those skills as executive director of Respire Behavioral Health between 2021 and 2025.

Down the line, doctoral programs may further bolster those opportunities by adding training in new areas, such as communication and advocacy strategies that help health service psychologists expand psychology’s impact and share its value with broader audiences, Russ said. Programs can also be more methodical about translating clinical competencies—such as communication, empathy, and problem-solving—into leadership training (Hunt, M. G., et al., Psychological Services, Vol. 21, No. 4, 2024).

Training programs may also incorporate more consulting and leadership skills to prepare health service psychologists for roles in industry, business, and the military, where they already play important roles. They can prepare psychologists to apply their expertise in the technology sector, helping companies build products that draw on psychological science and minimize harm to users, particularly children.

The revised MLA does not bind states to enact licensing in a specific way. Instead, it provides guidance that states can consult if or when they update their psychology licensure statutes, which many do periodically in response to workforce needs, legislative priorities, or changing professional landscapes.

These changes ensure that psychology’s perspective—informed by training standards, scientific evidence, and professional expertise—is available to states considering these issues.

“The world is changing whether or not we step into the debate,” James said. “This move makes sure that psychology has a hand in how this is done, because if we don’t, other people are ready to decide for us.”

The decision ultimately rests with APA’s Council of Representatives, whose vote will reflect member input, public comment, and the needs of a changing workforce.