Professionalism is founded on the concept of benefiting society and the specific persons who receive services under the aegis of a scholarly or learned discipline. Certainly psychologists are dedicated to helping clients and patients improve their psychological health.
Human foibles may lead to faulty professional services that render few benefits and perhaps even inflict harm. Clients with a character or other mental disorder may falsely allege wrongdoing by a psychologist.
In the 1970s, a quest for greater financial revenues and elevated status in the health care professions led mental health practitioners to champion licensing. Psychologists often failed to recognize that, for the government and legal system, the purpose of licensing was to provide safeguards for the service recipients from allegedly unqualified practitioners. Now decades later, every state jurisdiction regulates psychology via its state board of psychology licensing.
Public consumers are assiduously protected. Moreover, the administrative codes, policies and rules applied by licensing agencies are commonly structured to maximize benefits for consumers, with the result at times creating “an uneven playing field.” Defending against a consumer complaint reflects questionable regard for the licensee’s right to Constitutionally protected due process and equal protection.
Unlike in court, which would require that allegations be “definite and certain,” in regulatory processing, it is common for the licensing agency to proceed with an investigation and possible discipline based on ambiguous allegations fostered by a consumer’s negative motives. Some regulatory sources, such as the prosecuting attorneys for a board of psychology, get their promotions and salary increases by “convictions” (i.e., imposing discipline), not by adherence to due process and equal protection.
In my article, “Psychological Safety for Mental Health Practitioners: Suggestions from a Defense Lawyer” (appearing soon in Psychological Injury and the Law), I emphasize that a substantial number of regulatory complaints against mental health practitioners contain false information, reflect wrongful client motives and are unfairly processed either consciously or unconsciously by regulatory agencies in an unfair manner. The psychologist-respondents may believe they have little recourse and are left to suffer negative and undeserved psychological injuries.
For various reasons aligned with confidentiality, unreported information and reluctance by psychologists who have dealt with a licensing complaint, it is impossible to collect reliable data on the number of complaints that were investigated and acted upon in some way by a licensing agency.
In my book, Legal Self-Defense for Mental Health Practitioners (Springer, 2013), I provide various types of information and anecdotes from licensing board actions.
There is strong evidence for believing that the bias toward consumer protection can trigger psychological injury in essentially every respondent-psychologist. (It reminds me of the reality that, when parents divorce, no “child of divorce” escapes psychological impact.)
There is reason to believe that a client complaint, regardless of its validity, elicits high levels of stress/anxiety that can affect physical health, marriage, ability to work effectively and overall career satisfaction. There is often a decrease in future income and there have been some suicides clearly connected to a licensing complaint.
Is there a positive solution?
To avoid high risks of a complaint, a substantial number of psychologists are: (1) avoiding services connected to child custody, abuse or parenting; (2) engaging in careful screening, monitoring and structuring of clients and patients with certain risky diagnoses (e.g., sociopathic, borderline, narcissistic and psychopathic character disorders); (3) not allowing any client debt to occur; (4) keeping more detailed assessment data, treatment plans and process notes, (5) making referral at any signs of unmanageable noncompliance and (6) operating by principles of business law.
Robert Woody, Ph.D., is professor of psychology at the University of Nebraska Omaha, an APA Fellow and member of the APA Council, a Michigan licensed psychologist and a member of the Florida, Michigan and Nebraska Bars. His email is firstname.lastname@example.org.