Recently, the issue of potential misrepresentation of professional credentials was raised on a regional listserv; with the specific concern that using the term Clinical Psychologist in professional advertising opens up the potential liability of misrepresentation. Today, I had occasion to speak with Daniel O. Taube, J.D., Ph.D. of The Trust. I asked him directly about this issue of legal considerations as well as ethics in marketing of psychologists.
Regulating Diversity of Practice for Consumer Protection*
Psychologists of Many Stripes
In the United Kingdom, there are specialist titles that are also restricted by law, including clinical psychologist, counseling psychologist, educational psychologist, forensic psychologist, health psychologist, occupational psychologist, and sport psychologist. However, in the United States, this competence-within-scope-of-practice issue has garnered little support toward adopting specialty Psychologist licenses. A standardized mechanism for acknowledging specialty competence-within-scope-of-practice already exists in the American Board of Professional Psychology (ABPP).
The ABPP has a separate market in the United States for just this purpose and in service of consumer protection from further public confusion regarding Psychologist – versus Psychiatrist, psychotherapist, Social Worker, MFT, Counselor, etc. – roles and functions. Indeed, my training in counseling psychology (M.A., 1998) was markedly different from my training in clinical psychology (Ph.D., 2008) — they are different disciplines within the same field and, accordingly, have different approaches to training.
Scientists and Practitioners and Scholars (Oh, my!)
To make matters even more confusing, there exist two distinct models of doctoral education and training even within the single discipline of clinical psychology: in the “Boulder Model,” scientist-practitioners earn the traditional Ph.D. (Doctorate of Philosophy) degree, while in the more recent “Vail Model,” practitioner-scholars earn the narrower Psy.D. (Doctorate of Psychology) professional degree. I have trained and supervised, been supervised by, and worked closely with doctoral level clinicians from both training models, and my impression remains that these models do, in fact, engender two somewhat different ways of approaching treatment of maladjustment to the human condition.
Not Just Anyone Can Hang Out their Shingle
Currently, all United States jurisdictions have laws in place that specifically limit the use of the term psychologist to individuals who are licensed by a regulatory body of the state in which they practice. Use of the term “Psychologist” in advertising is regulated as a means of protecting the public from receiving services from unqualified persons who have not met certain minimum requirements and standards.
In most states, including here in Nevada, our state-issued licenses to practice are specifically titled “Psychologist” licenses. There is a single word in bold type on my both my California and Nevada licenses: Psychologist. Technically, this indicates that upon receipt of the license, one may legally present oneself as a Licensed Psychologist.
Nevada Regulation of Psychologist Title
Section 27 of the Nevada Revised Statute (NRS) Chapter 64 provides the definition of a Psychologist in Nevada:
NRS 641.027 “Psychologist” defined. “Psychologist” means a person who:
- Is a graduate of an academic program approved by the Board and is qualified to practice psychology by reason of education, practical training and experience determined by the Board to be satisfactory; and
- Has received from the Board a license to practice psychology.
The customary first step toward becoming a Licensed Psychologist is to obtain a requisite doctoral level degree of Ph.D., Ed.D., or Psy.D. Restriction on the use of the term Psychologist has been a point of particular contention for those holding Ph.D.s in Industrial-Organizational Psychology — an academic and applied field of study for which there is no path to licensure nor specific regulation of practice .
Exceptions and Exempt Settings
The only exception to the restriction on the term Psychologist is in exempt settings, such as my post-doctoral training within the California state government where I was legally considered a Psychologist by virtue of my position of employment despite being initially unlicensed. For professors, academics, and research psychologists who are unlicensed and not service providers but might otherwise be considered psychologists (i.e., social psychologists, cognitive psychologists, industrial-organizational psychologists, human factors psychologists, etc.), Section 390 of NRS Chapter provides similar institutional titular exceptions by virtue of employment under the Scope of Regulation heading:
NRS 641.390 Representation or practice as psychologist without license prohibited; exceptions.
- A person shall not represent himself or herself as a psychologist within the meaning of this chapter or engage in the practice of psychology unless he or she is licensed under the provisions of this chapter, except that any psychological scientist employed by an accredited educational institution or public agency which has set explicit standards may represent himself or herself by the title conferred upon him or her by such institution or agency.
- This section does not grant approval for any person to offer services as a psychologist to any other person as a consultant, and to accept remuneration for such psychological services, other than that of an institutional salary, unless the psychologist has been licensed under the provisions of this chapter.
- This chapter does not prevent the teaching of psychology or psychological research, unless the teaching or research involves the delivery or supervision of direct psychological services to a person. Persons who have earned a doctoral degree in psychology from an accredited educational institution may use the title “psychologist” in conjunction with the activities permitted by this subsection.
Can I be sued for calling myself a Licensed Clinical Psychologist?
Based on my current, best understanding after discussion with Dr. Taub is that the answer to this question is: Unlikely. I have learned that it is rare for a psychology licensing board has disciplined someone for misrepresentation of themselves as a “Licensed Clinical Psychologist” when the title of the license was actually “Licensed Psychologist.” However, if a lawsuit were to be pursued on other grounds, such as malpractice, the inaccurate wording in the accused’s advertising materials would not help their defense.
Apparently, this precise issue has been such a protracted frustration that risk management professionals largely “gave up” on attempts to educate Psychologists about the technicality about 15 years ago. It seems there has been little, if any, actual direct legal consequences associated with the issue, and yet it remains an important consideration in consumer protection.
Recommendations
Irrespective of Ph.D. or Psy.D., referring to oneself as a Clinical Psychologist in the U.S. appears to be perfectly acceptable from a legal and ethical standpoint assuming one has, indeed, been trained, received a doctoral degree in Clinical Psychology, fulfilled all requirements for state licensure, and engages in the practice of Clinical Psychology.
License Title v. Competency-Identity
However, in advertising and marketing for psychologists, it is recommended that the term is distinguished from the state license title. That is, in thinking about one’s ethical advertising and marketing efforts, one will likely do best to consider the use of the term Clinical Psychologist as a description of practice (competency) and associated identity in role – what I have termed competency-identity: how one perceives oneself as a professional based on work function by virtue of education, training, and experience. The technical-legal conundrum only appears to arise when the word Licensed is placed before one’s competency-identity (i.e., “Licensed Clinical Psychologist,” “Licensed Counseling Psychologist,” “Licensed Neuropsychologist,” etc.).
Best Practice Marketing
In addressing this professional marketing issue, the recommendation would seem to involve ethical fidelity through construct expansion – these are dichotomous but related issues for which policy-makers and professionals alike will do well to treat them as such in both governance and practice. One may be a Clinical Psychologist (competency-identity) but – with very few state exceptions (e.g., Ohio) – cannot present ones’ title as Licensed Clinical Psychologist.
A more accurate and best practice is the use of statements such as:
Dr. Ian Pritchard is a Clinical Psychologist providing assessment, treatment, and consultation as a Licensed Psychologist in California (PSY24434) and Nevada (PY0657).”
By honoring the distinction, one avoids the potential legal pitfall.
*Disclaimer: As I am not a licensed attorney, my following conclusions should in no way be considered legal advice, intended or otherwise. Also, the following is not to interpreted as any quotation of Dr. Taube, who was gracious enough to entertain my technical legal question. Rather, what follows in my simple report of my interpretation of the issue and opinions drawn from brief consultation with a bonafide subject-matter expert.
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