Mental health clinicians across the United States are identified differently as they are licensed to practice within different scopes. These titles are not just about appropriate designation but represent specific scope and licenses. The more you understand, the more informed you will be when deciding which clinicians to use personally and professionally.
“…it’s especially vital for specialists engaged in work that exposes them, personally or vicariously, to a high incidence of trauma. Known as ‘practice in extremis,’ these specialties require a high level of competence, but they also involve a heightened potential for erosion of competence through the same kinds of emotional and psychological mechanisms that affect public safety personnel (e.g., post-traumatic reactions, vicarious traumatization, compassion fatigue, burnout, empathy failure).”
D. M. Corey, M. J. Cuttler, D. R. Cox, & J. Brower.
(2011). Board certification in police psychology., The Police Chief, 78(8), 100-104.
In this article from his blog, Talking “Shop” 4 Fire and EMS, FSPA Fire Service Member Robert Avsec, a retired fire department battalion chief/paramedic, uses the four levels of fire service hazardous materials response training as a model for helping firefighters and officers–and even clinicians–to understand the different levels of clinicians and their basic scope of practice.
PSYCHIATRISTS
Psychiatrists are physicians who specialize in prevention, diagnosis, and treatment of mental disorders. They work in private practice, hospitals, and clinics. Medical Board of California, www.mbc.ca.gov, (916) 263-2382 or (800) 633-2322.
- Common Services Based on Scope of Practice: Research, Direct Therapy Services, and Prescription Privileges
- Must Earn Doctorate Degree: MD
- Successfully Complete Number of Supervision Hours (for specifics refer to mbc.ca.gov)
- Pass National Examination
- Pass State Examination
PSYCHOLOGISTS
Psychologists work in hospitals, clinics, counseling centers, or private practice. They provide individual, family, or group psychotherapy and design and implement behavior modification programs. Board of Psychology, www.psychology.ca.gov, (866) 503-3221 or (916) 574-7720.
- Common Services Based on Scope of Practice: Research, Psychological Testing- Fitness for Duty/ PreEmployment (among others), Direct Psychological Services, Create, Maintain and Test Effectiveness of Behavioral Health Programs.
- Must Earn Doctorate Degree: PhD or PsyD
- Successfully Complete Number of Supervision Hours (for specifics refer to psychology.ca.gov)
- Research Requirement (many programs require completion of a dissertation-research in the field.)
- Pass National Examination
- Pass State Examination
California Business and Professions Code Section 2903:2903. (a) No person may engage in the practice of psychology, or represent himself or herself to be a psychologist, without a license granted under this chapter, except as otherwise provided in this chapter.
MARRIAGE AND FAMILY THERAPISTS
Marriage and Family Therapists work in clinics, counseling centers, and private practice. They use counseling or psychotherapeutic techniques to assist individuals, couples, and families, and groups with marriage, family and relationship issues. Board of Behavioral Sciences, www.bbs.ca.gov, (916) 574-7830.
- Common Services Based on Scope of Practice: Therapy Services
- Must Earn Masters Degree
- Successfully Complete Number of Supervision Hours (for specifics refer to bbs.ca.gov)
- Pass National Examination
- Pass State Examination
CLINICAL SOCIAL WORKERS
Clinical Social Workers work in health facilities, private practice, and child welfare agencies. They use counseling and psychotherapeutic techniques to assist individuals, couples, families, and groups. They often refer clients to specific resources to improve the quality of life. Board of Behavioral Sciences, www.bbs.ca.gov, (916) 574-7830.
- Common Services Based on Scope of Practice: Therapy Services
- Must Earn Masters Degree
- Successfully Complete Number of Supervision Hours (for specifics refer to bbs.ca.gov)
- Pass National Examination
- Pass State Examination
EDUCATIONAL PSYCHOLOGISTS
Educational Psychologists work in schools or in private practice and provide educational assessment and counseling relating to academic ability, behavior, and other matters, www.bbs.ca.gov, (916) 574-7830.
- Common Services Based on Scope of Practice: Educational Testing & Therapy Services
- Must Earn Masters Degree
- Successfully Complete Number of Supervision Hours (for specifics refer to bbs.ca.gov)
- Pass National Examination
- Pass State Examination
PROFESSIONAL CLINICAL COUNSELORS
Professional Clinical Counselors use counseling interventions and psychotherapeutic techniques to treat cognitive, mental, and emotional issues, including personal growth, adjustment to disability, crisis intervention, and psychosocial and environmental problems, www.bbs.ca.gov, (916) 574-7830.
- Common Services Based on Scope of Practice: Therapy Services
- Must Earn Masters Degree
- Successfully Complete Number of Supervision Hours (for specifics refer to mbc.ca.gov)
- Pass National Examination
- Pass State Examination
Department members should be made aware of both the scopes of practice and competence that the clinician possesses.
- Scope of Practice is what a mental health provider is authorized to do if they have gained the proper competencies to fulfill those functions.
- Scope of Competence is a limiting factor because even with the education, not all providers have the additional training, supervision, and experience to provide specialty care.
- For example: some psychologists are specialized to complete pre-employment screenings (scope of practice) but not all psychologists have that competency (scope of competence.)
Students can work under a mental health clinician’s license with that professional’s approval. However, different licensed clinicians can only supervise those students per the Board of Behavioral Science or Board of Psychology specific guidelines. Psychiatrists and Psychologists can oversee Board of Behavioral Science students because they have a larger scope of practice.
HOW TO DECIDE ON A CLINICIAN
Referral QUESTION + SCOPE OF PRACTICE (Licensed Required for Specific Referral Question) + COMPETENCY within the scope = APPROPRIATENESS of Clinician.
(Don’t forget to consider the connection you feel with them.)
If you don’t know these things about the clinician you are considering, feel free to ask them. It’s good to be an informed consumer.
GOVERNING BODIES
California: Licensed Clinical Social Workers, Licensed Marriage and Family Therapists, Licensed Professional Clinical Counselors, and Licensed Educational Psychologists fall under the jurisdiction of the Board of Behavioral Sciences. Psychologists fall under the authority of the Board of Psychology.
Defer to the unique boards within your states.