When asked to review the state of specialty credentialing for The National Psychologist, we were struck by the multitude of organizations offering professional recognition. We are not strangers to these – just look at the alphabet soup after our names at the end of this article.
The ante and the competition from other mental health professionals in the managed care market have been raised considerably over the past decade, providing a justifiable incentive for psychologists to gather recognitions for their competencies. Many organizations attempt to offer an overwhelmed public additional ways to identify those of us who can do what we say we can and do it well. Of course, a credential is no guarantee, but it can be a solid starting point.
Our colleagues generously supplied us with numerous observations on this somewhat divisive subject of credentialing – a mix of the good, the bad and the ugly. They presented a telling mix of facts (reflecting some lack of awareness of what constitutes a “legitimate” specialty board), and a stronger than expected emotional tenor. Some were (mildly) defensive about the value and legitimacy of the certifications they had and tended to view qualifications that they didn’t have as “unnecessary” or “unrecognized” – but by whom?
Perhaps because of the considerable expansion of the scope of practice for psychologists, we are more concerned than ever about our status and recognition as professionals. Many of us have had to create specialties to stand out among the hordes of psychologists and related professionals churned out each year and “against” the ever increasing powers of lesser or differently trained behavioral specialists, including professional counselors and social workers.
As the “newer kids on the science block,” psychologists struggle with an identity crisis, especially after having made giant steps into the health care market with prescription and hospital privileges. Our historically tenuous relationship with the medical field, and especially psychiatrists, has become even more intense with expanded specialties, for example, as “expert witnesses.”
We no longer have to – nor can we – depend on our traditional “unique” competencies in psychological testing to shine, especially as professional counselors continue to win the rights to administer and interpret these tests. The proliferation of psychotropics has relegated most of psychiatry to a more or less strictly biological treatment of the patient/client. This has left a vast opening for qualified psychologists to step in with a more sound and relevant approach to address human suffering, often referred to as the “biopsychosocial” perspective. We used to call it “holistic.”
To strengthen our presence we must be clear about who we are, what and how we practice. Meeting these objectives is accelerated by credentialing strategies that are recognized as legitimate and reliable. After all, psychological practice is exceptionally broad when compared to other disciplines and many of us are proud of our values of “inclusivity” and “flexibility.” Some of us have reasonable worries about the risk we will become unrecognizable as a unified professional body. We must recognize the increased responsibility to present ourselves honestly to a weary public as members of a coherent profession.
Licensing requirements in the 50 states are stringent and represent a fine model for qualifying professional psychologists. The American Psychological Association (APA), with a membership of over 150,000, continues to represent and guide our profession and to safeguard our diverse range of interests, many of which are identified and represented by the 55 divisions of APA. At present, however, its membership directory includes only two specialty certifications, which may seem to contradict the intention of professional diversity. These are the American Board of Professional Psychologists (ABPP), its thirteen member specialty boards and the American Board of Psychological Hypnosis.
We must wonder why the dozens of other legitimate boards are not included in the APA listings and how to discriminate between legitimate and so-called “vanity” boards to which we are being regularly invited. Additionally, APA offers only two “proficiency” exams often used to qualify specialists in psychopharmacology and substance abuse. There are many professional specialty boards that should be further recognized as legitimate in the behavioral sciences.
Vanity boards are dangerous, as they tend to undermine the credibility of the specialties that they attempt to represent, as well as the legitimate boards. They can be identified by their lack of credentialing criteria. For example, they may “piggy-back” by simply asking that you be credentialed by one or two other “recognized” boards, sign a declaration that you have collected the requisite training and experience, pay the dues and you are in.
All psychologists should be aware enough to distinguish between vanity and legitimate boards and educate colleagues and the public on these matters. We must avoid the temptation to be seduced into easily gained specialty recognition through “vanity” boards which, in the end, can weaken our professional standing.
Legitimate boards have several identifying features. They rarely grandparent members, and if they do, only for short periods and only when there is overwhelming evidence that a psychologist’s training and performance record can hold up against all professional and public doubt and/or resistance.
Legitimate boards require an extended post-graduate training period under the close supervision of a qualified specialist and documented advanced coverage of relevant theory, practice and program issues. An exam (oral and/or written) and/or an extensive work product presentation are required to demonstrate mastery of content and application.
Legitimate boards require the completion of substantial accredited graduate coursework in the specialty area and identification with and participation in the specialty through associations and activities related to the specialty. They require that the specialty be recognized by a bona fide group or association which is nationally recognized as involved in the support, education and development of the specialty. Additionally, continuing education is often required to maintain the specialty recognition.
“Illegitimate” boards should be exposed as “unrecognized” by the major associations and clear and specific deficits of concern should be published and made a part of the national debate. These boards should be encouraged to upgrade their standards or to close down by communicating with these boards within the parameters of professionalism and the law.
In the meantime, psychologists can be more cognizant of the validity and influence of those hard-earned letters after our names. We should shine with our chosen specialties, ensuring the general public that they represent more than “alphabet soup.”
Scott E. Borrelli, Ed.D., ABPP, MP, FICPP, NCC, is a licensed (U.S.A. and Britain) and board certified (ABPP) clinical and counseling psychologist. He is also board certified in clinical psychopharmacology and a qualified medical psychologist. He practices in the United Kingdom (London) and in southern Spain. He is collegiate professor of counseling and psychology with the University of Maryland, European Division.
Jerry Morris, Psy.D., MBA, ABPP, NCSP, CCM, is a licensed clinical psychologist and clinical director of CMHC, Inc., in southwest Missouri. He is board certified in family psychology and school psychology (ABPP), and holds the APA College of Psychology Proficiency in Alcohol and Other Psychoactive Substance Abuse Treatment and has an MBA in management.
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