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Statements of Support from MPA Members Regarding Licensure at the Receipt of the Doctoral Degree Please read these to learn about this important initiative and the views of MPA members. To submit your statement either for or against this initiative for posting on this website please forward it to Dr. Jeffrey Barnett at drjbarnett1@comcast.net
1. Thanks so much for fighting this important fight to allow licensure at the receipt of the doctoral degree. I strongly agree with this change, not because of personal experience, since I seemed to blast my way through my degree so really needed the extra training during my post-doctoral year, but because this is not true of many people who receive their doctorates in psychology. What should matter is the number of hours of training, not whether they were received before or after the degree. Having the degree in hand before receiving some of the necessary supervision hours would assume that some magical thing happens in terms of experience once the degree is held that necessitates additional training hours after that time. That concept is ridiculous to me and has no basis in reality. Feel free to share my statements or not. What's most important is that as many psychologists as possible express their views on this important issue so thanks for pushing us all to do this with your emails.
2. Statement in Favor of Eliminating Required Post Doctorate Year of Supervised Training if Requirements are Fulfilled Prior to Receiving Doctorate Degree
I will be the first in my family to receive a professional degree- the Psy.D. in clinical Psychology. The reason I will receive this degree is because when I saw the requirements and expense it took to enter this career, both pre and post graduation, I closed my eyes and said, “I am going to do it anyway.”
Soon after I graduate, it will be time to repay student loans. At this moment, I have no idea how I will make ends meet paying student loans and maintaining a simple standard of living during my post doctoral year of training which is currently required for licensure. I am a person of color and I also come from a low socioeconomic background. Coupling student loans with survival needs during post doctorate training served as a major deterrent for me when I first considered entering this profession. Although I said, “I am going to do it anyway,” other students of color and/or from low socioeconomic backgrounds may view the required post doc year as an obstacle. An obstacle that is too high to climb in search of a doctorate degree in psychology when student loans await them shortly after internships are complete and dissertations approved.
This post doctorate year potentially stands in a contrary position to the current zeitgeist where APA is working to increase the recruitment and retention of diverse individuals in the profession of psychology. APA’s own research has shown that the number of psychology students of minority status decreases as one ascends the academic ladder: fewer at the doctoral level than the master level and fewer at the master level than the bachelor level. This trend is in opposition to the reality that the general minority population is growing in the U.S. and that psychologists with diverse backgrounds are vital to meeting the needs of a multicultural society. With the post doc year being a year to accumulate supervised clinical hours that most programs now require students to accumulate during their academic and internship year, it is a redundancy that many people of minority and/or low socioeconomic status cannot afford. Therefore, this deterrent to doctoral education in psychology should be re-examined in order to ensure that those who have the potential of contributing important services to this profession and the general population are not discouraged by this boulder in their path.
This is not to say that people of color and low socioeconomic background are unwilling to receive supervised clinical training. I am willing and I do receive this training. I receive it every year that I am in my graduate program. I, and others with backgrounds similar to mine, simply cannot afford this redundant and often times unjustifiable training after graduation. For those who do not want to walk blindly, as I did, into a profession that requires a post-doctoral year that potentially enhances financial hardship, the most obvious solution is to simply pursue other careers. What a loss to the profession of psychology!
Chantal Abukutsa, M.S.
3. STATEMENT BY RANDI E. SCHWARTZ, Ph.D., REGARDING LICENSURE REQUIREMENTS FOR PSYCHOLOGISTS UPON RECEIPT OF A DOCTORAL DEGREE
I would like to offer the following comments on the proposal before you regarding permitting doctoral level psychologists to sit for their licensing examination upon being awarded their degree.
I am in full agreement with the points made by Jeffrey E. Barnett, Psy. D., in his “Statement on Licensure at the Receipt of Doctoral Degree for Psychologists in Maryland.” Rather than repeating this Statement and the conclusions of the 2005 APA Presidential Working Group on this issue, I believe it would be most helpful to describe my own experiences as a currently unlicensed Ph.D. and how, in light my experience, the proposed changes would benefit the citizens of Maryland and preserve the competence and integrity of the psychology profession.
I am a graduate of New York University, where I earned my Ph.D. in Counseling Psychology in 2004. During my Ph.D. program, I completed both a one-year practicum and a one-year long APA approved internship. My internship was an intensive rotation through six departments at one of the largest City Hospitals in New York City, and included extensive individual and group supervision. In addition, while working on my dissertation, I worked at a community psychotherapy clinic in New York for almost three years conducting intake interviews and individual psychotherapy. Prior to and during my doctoral studies, I also worked for ten years as a Master’s level Rehabilitation Counselor and, ultimately, Supervisor at the Rusk Institute of Rehabilitation Medicine. All of this work experience was accomplished prior to the receipt of my Ph.D.
I received my Ph.D. shortly after moving to Maryland. Despite my extensive work history, when I moved to Maryland, I was told by the Board of Examiners that I would need to “clock” 1750 more hours of clinical work before I could even sit for the licensing examination. I was also told that I could not work in Maryland unless I was under the supervision of a licensed psychologist and that I could not refer to myself as a “psychologist” but only, given appropriate supervision, as a “psychology associate.”
As someone who has always had in interest in treating underserved populations in urban settings, I immediately set out to find work. The task was daunting, and I quickly expanded my search to include any work, not just in the setting in which I had hoped to practice. I was able to identify only six clinical post-doctoral positions, for which competition was fierce. I had untold numbers of conversations with potential employers who were very interested in what I could offer patients, but who told me, either verbatim or in effect, “call me when you’re licensed.”
I soon grasped the enormous challenges facing me because of the burdens placed upon employers hiring unlicensed “psychology associates.” These employers did want the additional paperwork and hours that were required to supervise a “psychology associate” and, in addition, were concerned about liability. The biggest problem by far, however, was that potential employers feared, understandably, that my services would not be reimbursable by insurers and Medicare. The current licensing rules thus left these employers and, more importantly, their patients without the benefit of the expertise I had earned through many years of rigorous academic and experiential training. I was particularly frustrated that individuals with Master’s Degrees and far less experience than I had were employed and hired by these organizations because they were licensed.
In at least one instance, the Director of a major rehabilitation facility, with whom I have had contact now for well over two years, has sought through every means possible to employ me to serve his currently underserved hospital population. He is aware of my background and experience and has told me that “I am his perfect psychologist.” Nevertheless, despite many hours both on his part and mine, we have been unable to work out a system that meets the current rules governing “psychology associates” and would enable the Hospital to be reimbursed for my services. Such a situation benefits no one.
After searching for work for more than a year, I was finally lucky enough, at long last, to find a part-time position as a psychology associate at a group practice that does not accept insurance. Given my unlicensed status, I am expected to take a certain percentage of lower fee patients and also pay for weekly supervision and bi-weekly seminars. I consider myself lucky to have fine supervision, a supportive group of colleagues, excellent experience, and, of course, I am clocking hours towards licensure. Despite continuing inquiries by me and interest expressed by potential employers, my unlicensed status continues to mean that these employers will not hire me.
It is also important to note that apart from the my inability to serve patients and the substantial financial burdens I have had to endure, the passing of time means that I suspect I will need to prepare for the licensing examination for much longer than would have been the case had I been able to sit for it upon receipt of my academic degree.
I hope that my story will put in concrete terms the consequences of not allowing doctoral level psychologists in Maryland to sit for the licensing examination upon receipt of their degree.
Randi Schwartz, Ph.D.
4. Statement of Bill Leonard:
Hi Jeff.
5. Statement of Alison Melley:
Jeff: Thank you so much for your work on this extremely important issue. Your report eloquently states the reasons why the regulations should be changed. You also asked for personal experiences. The current post-doc requirements particularly hinder the careers of those of us trying to "balance" family and work. Despite 8 years of graduate training (terminal Masters program and then Ph.D.) - I am not working in the field because it is virtually impossible to do that with no license and three children. As a psychologist
6. Statement by Jonathan Dalton, Ph.D.
Jeff,
Thanks again for taking the lead on this issue. This is one of the most critical issues facing the future of our profession, but one that a lot of already licensed psychologists are unaware of due to the change in the landscape that confronts recent graduates. Below please find my written statement.
I am writing this statement for several reasons. First, I believe that the unnecessary barriers to licensure confronting recent graduates represents one of the most pressing issue facing our profession. Second, I believe that many licensed psychologists are unaware of the dramatic change in the landscape that recent graduates are forced to navigate due to a variety of factors that others have skillfully delineated. Third, I am writing this statement so that others facing the impending "post doc trap" and its requisite series of maddening catch-22's may benefit from my experience.
After defending my dissertation, completing my predoctoral internship, and receiving my Ph.D. in clinical psychology in August 2004, I was relieved to have cleared all of what I thought were the major hurdles to beginning my professional career. I was sadly mistaken. I attempted to secure a postdoctoral position in the Washington D.C. area that would 1) allow me to accrue the necessary supervised hours to enable me to sit for the EPPP; 2) be relevant to my intended career path; and 3) permit me to provide a basic level of financial support to my expectant wife and our soon to arrive child while she was on her scheduled (unpaid) maternity leave. Each of these three criteria were difficult to achieve individually. Together they represented a virtually insurmountable challenge that was only overcome through a combination of dogged persistence, serendipity, and plain luck.
I began my search for such a postdoctoral position several months prior to the completion of my internship at the Kennedy Krieger Institute / Johns Hopkins School of Medicine in Baltimore. I soon realized that I had dramatically underestimated the complexities of the challenge that I would face. I used the usual means of searching for a job: networking, using the MPA and APA classifieds and various listservs, etc. However, as even a casual perusal of these resources will confirm, the available jobs required a license, which required postdoctoral experience, which I could not obtain without a license. Joseph Heller would be proud.
The jobs that I was being offered were similar to what I had done at the very beginning of my training in graduate school (e.g., administering and scoring, but not interpreting psychological assessments, etc.) and represented several steps backward in my clinical training and would not qualify me in any way (that I could discern) in which I was not already qualified. In fact, these jobs were available because they only required a Master’s degree, which meant that I was qualified for them 6 years earlier after receiving my first graduate degree.
I repeatedly spoke with potential employers who delivered the same message in slightly different phrasing. Namely, they would love to hire me because they think I am well-qualified and there is a need for my services. But they could not hire me because as a non-licensed Ph.D. I would be unable to bill for my services. Some recommended that I attempt to obtain an LPC license so I could, in fact, bill for my services. Of course the LPC exam is only offered quarterly, so that wouldn’t have helped my cause in the short-term. The utter ridiculousness of the situation became almost comical one evening when a potential employer stated, in all seriousness, “I’m a little confused. Are you looking for a paid position?” I say almost comical because my wife was 3 months pregnant at that time and I hadn’t worked in 9 weeks.
I must admit that after dedicating virtually my entire twenties to being trained as a psychologist I entertained more than a fleeting thought of leaving the field. I was bewildered by the fact that even after sacrificing 6 years in pursuit of obtaining my Ph.D. in clinical psychology, I still was not employable. But at least I wasn’t alone. I found an archived article in the Monitor from May 2000 (Volume 31, No. 5; http://www.apa.org/monitor/may00/postdoc.html) that both reassured me that my experience was more the norm than the exception and dismayed me that the field had allowed this untenable situation to persist for so long.
Thankfully, I stuck with psychology and came to the conclusion that my three basic criteria for a post doc were sadly unrealistic, and I, like so many of my colleagues, would be forced to settle for two out of three. Whether the post doc was relevant to my career aspirations became secondary. As long as it offered a steady, albeit paltry, income and would give me those precious hours that would enable me to eventually do the work that I wanted so badly to do, I would take it. I decided that I would string together several positions that I was being offered (i.e., working as a consultant to group homes, working as a psychometrist, etc.), sit for the exam, and then do what I really want to do.
I was incredulous when a colleague informed me of another unbelievably quirky roadblock down the road (current students and interns take particular note of this). Most formal postdoctoral positions are 12 months in duration. However, in Maryland one cannot even apply to take the EPPP and state exam until the 12-month anniversary of the start date of the post doc (if your degree has been officially conferred prior to the start date). Of course the state exam is only offered every three months, so most individuals face a 3-4 month lag between the end of their postdocs and when they are licensed, which means, of course, getting reimbursed is again very problematic. To add insult to injury, if one applies for licensure the first day possible and then decides to apply for a psychology associate license so that they may work during this 4-month lag, they will find that their application will be denied because they have already applied for licensure as a psychologist, and the Board of Examiners will not accept concurrent applications. Therefore, they will be explicitly barred from providing psychological services after their post doc has ended and before their license is issued.
In the end I was extremely lucky. After 4 months of searching and holding out for a great post doc I was offered a postdoctoral fellowship at a top-notch academic institution working with internationally renowned supervisors doing work that I love. Amazingly, if they had advertised the position even a week later, I would have already accepted a much less desirable position out of pure necessity. My postdoctoral experience was perhaps the most valuable clinical experience I have had and I believe that I experienced more professional growth during the last 12 months than during any other time in my clinical training. Please understand that I believe that the postdoctoral year is an incredibly important year and should not be abandoned. We simply must remove the barriers to obtaining a quality postdoctoral experience. As I reached the end of my post doc and began looking for where to go next, I naturally dreaded the process given my previous experience. But having extricated myself from the post doc trap, I quickly received offers from my top two choices (neither of which were even looking to hire anyone) and landed my dream job. So for those who follow behind, there is indeed light at that end of that long, winding, unnecessary tunnel.
Please join me in congratulating the MPA Board of Directors in their unanimous approval of the recent MPA motions to remove these unnecessary stumbling blocks placed in front of our colleagues as they leave the staring gate of their careers.
Jonathan Dalton, Ph.D.
7. My name is Kristen Reese and I would like to thank the members of the MPA for the opportunity to speak tonight; however, due to an unavoidable conflict I am unable to attend tonight’s meeting and have asked Ms. Wagner to act as my voice. I do so because I believe the subject of this discussion is incredibly important.
Let me be clear, I strongly support revision of the current post-doctoral hours requirement in Maryland. As has been eloquently stated by Dr. Jeff Barnett, a position supported by the APA Presidential Working Group, the requirement that degreed psychologists attain 1750 supervised hours before the opportunity to sit for licensure is simply outdated in today’s professional market. But my reason for writing is not to simply repeat what opinions have already been offered on this matter. Rather, I would like to share my personal situation as an illustration of the difficulties posed by the current post-doctoral hours requirement.
I earned my Master’s degree in education/psychological services in 1998 from Penn. After practicing clinical work for several years in Louisiana, I returned to school to pursue my doctorate in clinical psychology. Prior to the completion of my doctoral program, I had accumulated approximately 3500 supervised clinical hours, through a combination of carefully researched externships and a year’s internship. As a woman in my early thirties and the mother of two young children, I am now in a position of trying to balance family and work. As addressed in the Working Group’s findings, creating a part-time post-doctoral position is no small feat. Imagine trying to find one that would cover the cost of childcare for both an infant and toddler as well. I was fortunate enough to find an opportunity and am currently working three days a week in an attempt to accrue the postdoctoral hours necessary to sit for licensure. On a practical level, my salary is not enough to cover childcare costs and my family has had to make several sacrifices for me to be able to work the amount that I do just to be able to, at some point, sit for my license. I have justified this by acknowledging that the situation is temporary and that I am working toward a long-term goal.
More importantly, however, on a professional level, I am not in a position where I feel that I am engaged in any meaningful additional experience to my professional development. To clarify, I am conducting psychological assessment in the capacity of a psychometrician that requires only a degree at the Masters level. Because of employment and insurance constraints, I am not permitted to interpret and provide feedback of data – activities that would definitely enhance my professional development. Because I am not licensed, I am unable to perform these functions even under the supervision of a licensed psychologist. As a result, I feel as though I must delay my professional development in order to attain some arbitrary number of hours over and above the confirmed hours I worked before and during my doctoral program.
At the present rate of work, I will complete my hours in another 14 months. The inherent assumption in the current requirements that the accrual of an additional 1750 hours, over the 3500 supervised clinical hours and years of practicing clinical work I have already attained, will somehow increase my competence and better prepare me to practice psychology is, I believe, inaccurate. On the contrary, it is an unnecessary impediment to my ongoing journey to become a competent clinical psychologist. In reality, I will have had a doctorate is psychology for over two years without clear, integrated postdoctoral training experience before I am able to sit for my professional license.
For these reasons, I strongly urge MPA members to support the revision of the outdated postdoctoral hours requirement.
Kristen Reese, Psy.D.
8. Hi Jeff,
9. Hi Dr. Barnett
10. To Whom It May Concern:
11. We are writing in support of the proposed changes regarding licensure at the receipt of doctorate. At the time of graduation, we each had approximately 4,000 hours of supervised clinical work and we believe this is a sufficient amount of supervision in order to take the licensure exam. Furthermore, we believe that training and supervision is a career-long process.
12. Hello Jeff.
About licensure after the doctorate, I won't be able to be at the meeting, but I strongly endorse the concept, for all the reasons APA and others have articulated. Today's doctoral graduates, with a full year's internship and typically lots of experience before internship, are ready to practice, perhaps with a need for some extra/targeted CE and supervision during the first year or two of licensure, which could be required and documented as all other licensees document CE. I typically get calls from every Latino recent licensee in the area - for real! - and several non-Latinos, desperate for employment, or even unpaid work, to accumulate hours toward licensure, and it feels to me like an "eating our young" phenomena, distasteful and not necessary. It is particularly burdensome on minority psychologists, who typically have less economic advantage than others and find the hurdles even harder to jump over.
As always, thanks for all you do for us.
Richard Ruth, Ph.D. Licensed Psychologist
13. Hello
14. Dear Dr. Barnett: This letter is to express my support for altering Maryland’s supervision requirements for licensure in the field of psychology. As a student currently enrolled in a doctoral program, I feel the current requirements ignore the training I am receiving while earning my degree. As a future therapist, I receive extensive supervision via one-to-one meetings, group sessions, video tape review, and peer observation; I receive the same direction regarding psychological assessment. It appears to me that allowing this time to count toward licensure requirements helps ensure that the supervised training we receive involves the practice of psychology. Allowing psychologists to receive their license immediately following graduate school will allow for increased student employability, relieve sites of some liability, and could help underserved clients receive treatment in the few state-run facilities that remain. It is important for The Board to recognize the progress that has been made in psychological training programs; the current requirements are based on further supervision needs that may not apply to today’s graduates. Perhaps a compromise would be to allow immediate licensure, but require one year of supervision by a licensed, established psychologist. This would allow for the benefits of licensure, while assuring continued supervision while in the field.
Thank you for considering all sides of the argument on this issue. I believe The Board has taken a step in the right direction in opening the way for this discussion and, subsequent vote.
Respectfully,
Tanisha S. Bracey, MA
15. As a current Psy.D. student in Loyola's program, I feel strongly prepared for the future. I have been informed that as a third year student, I have already accumulated more clinical and supervision hours than licensed, practicing social workers. Throughout 5 years of training, clinical psychology doctoral students will have accumulated a significant amount of intensely supervised clinical hours. A post-doc year is hard to get, weak in supervision, and sometimes can be met without doing therapy at all. Basically, a year after internship seems redundant and superfluous, especially taking into consideration the financial stress these students are already under.
16. A Statement in Support of Licensure at the Receipt of the Doctoral Degree
As the Early Career Psychologist Liaison to the Maryland Psychological Association’s Board of Directors, I am aware of many of the issues that face new professionals entering psychology. Additionally, as an “Early Career Psychologist,” I was recently navigating through many issues in an attempt to get a position that would allow me to earn the required hours/supervision to achieve my license. Given my recent experiences with the regulations and laws governing the post-doctoral requirements to becoming a Licensed Psychologist in Maryland, I am providing a statement in support of making changes in regulations and law to permit licensure at the receipt of the doctoral degree for psychologists in Maryland.
In my circumstance, in order to reach the currently established requirements, I drove nearly 100 miles a day to a job that provided a clientele and supervision. Much to my dismay however, I worked for a salary that barely paid for the gas required to travel to and from work; this story is too often the rule, not the exception. The current rules requiring many hours of pre-licensed supervised work before one can register for the license examination, increases an already overwhelming, training-related financial hardship. That is, prior to becoming licensed, one is not only unable to command a reasonable salary for an additional year after they have received their degree, but they often must pay for supervisory services, rent office space, and incur other expenses at precisely the same time that they are not paid a reasonable salary. The current rules, therefore, have a tremendous negative impact on the financial wellbeing of individual psychologists in Maryland.
Additionally, there is a negative impact on the facilities that do employ newly degreed psychologists and the populations they serve. If the regulations were too allow well trained people to become licensed when they complete their doctoral degree, the impact of this change could ultimately increase training opportunities for the newly licensed professional, and increase the services available to the public. That is, under the current regulations, facilities that train unlicensed professionals must limit which services these trainees provide because the unlicensed person is usually unable to receive third-party reimbursement for their work; the facilities need the reimbursement money to stay in business. However, if one could become licensed when they received their degree, they would also become eligible to receive third-party reimbursement. Given third party-reimbursement, facilities would be paid and could increase the number of available services provided (i.e, training opportunities), and increases the number of people who could benefit from those services.
Moreover, the current policies are outdated. In our current educational climate, graduate programs are producing internship applicants with extensive clinical training and supervision. Today’s graduates invariably have more extensive and more thorough clinical training compared to those who came into the profession forty years ago, when the current licensure requirements were put forth. The training changes serve to make the pre-licensed requirement of additional supervised clinical hours unnecessary. Given forty years of changes in clinical training, retaining the forty-year-old licensure requirements is paramount to requiring students to type their dissertation on manual typewriters instead of using the computers in their homes.
For all of the reasons presented above, I am clearly stating my support for making regulatory and statutory changes to the current licensure rules. Furthermore, I specifically support the three motions approved in November 2005 by the Maryland Psychological Associations Board of Directors.
Joshua M. Cohen, Ph.D. Licensed Psychologist MPA Board of Directors, Early Career Psychologist Liaison
17.
Jeff,
18. To whom it may concern:
My name is Abigail Skillman and I am currently on internship. I like my job, I like the work I do, I’m well trained, and I want to stay in the field. But right now I don’t know if I can afford to.
I am in the process of applying for post docs, or staff positions, or anything that will pay me enough that I can cover my loan payments that become due upon completion of my internship. Yes, I can go into deferment. Yes, I can request a grace period. But those suggestions are infuriating and insulting to the professional I have become, and speak so poorly about the field I have chosen.
What does the field have to say to its graduates who have earned their doctorates and now can’t find a job that pays enough to support themselves? The field is very clear what it has to say to them. The message is resoundingly: wait a year. The implied promise is that in a year I can sit for licensure and become a fully independent professional. The reality is that I will spend a year accruing 2000 more hours bringing my total to over 6500 supervised hours. I will search, pull strings and scrape up a job and when I do, I will be overwhelmingly grateful that someone is willing to supervise me. I will get paid in the low $20,000 range, which when you remove the six thousand dollars I must make in loan payments each year, I will be struggling to survive on $14,000. And somehow making all this feel even more surreal, my clients will call me Dr. Skillman.
I have faith that I will be able to make a living as a psychologist. I have no delusions of six figure salaries, signing bonuses, or relocation packages. I entered this profession with my eyes open and knew what I was signing up to do. I know I will earn an adequate salary, and, more importantly, I will be able to do work that is enjoyable, significant and fulfilling. And if I hold my breath for another year, I will get there.
When I first learned about this post doc year (during my first year of graduate school), I thought, “Hey it takes five years to get this degree, what’s one more?” But during my first year of graduate school I had no idea about the incredible amount of learning and development that was about to transpire. I also had no idea about the identity transformation I would undergo as I shifted my self concept from student to young professional. I also had no concept of the realities involved in the post doctoral year. My opinion on the post doc year now is, “It takes five years to get this degree, what’s one more?” While the wording is similar the sentiment could not be more dissimilar. What exactly am I going to learn in one more year that will then make me suitable to practice independently? I am learning a tremendous amount on internship. I am committed to learning and growing a tremendous amount my first year working after internship. I am committed to learning that much my second year out, my third year out, and every year thereafter. Licensure will not mean that I have learned what I need to be a competent psychologist. Licensure will simply allow me to be reimbursed fairly for the work I will spend my whole career learning how to do.
Abigail Skillman, M.S. Intern in Clinical Psychology
19. Dr. Barnett, I am writing this letter in support of the proposal to do away with the one-year post-doctoral internship requirement prior to taking the licensure exam. While this law was created in order to supplement the few supervised clinical hours that students received in doctoral programs in decades past, this is no longer necessary today. Doctoral programs have changed their formats so that students are now earning more clinical hours prior to the receipt of their degrees than they were initially expected to earn in pre- and post-doctoral work. Therefore, the removal of the requirement of the post-doctoral year will not diminish the students' training, as it has already been supplemented. In addition, this requirement has had the unfortunate effect of making new graduates unmarketable in many areas of the mental health field. Mental health agencies are frequently not well funded, and they cannot afford to take on post-doctoral individuals who will not bring in payment for their services. Public mental health agencies cannot hire these qualified individuals due to government restrictions. If this proposal is passed, new psychologists will be able to do more diverse and necessary work in our community. Thank you, Stefanie Barr Doctoral Student Loyola College in Maryland
20. I am writing to express my support of the proposal to eliminate the need for Doctoral Psychology students to complete a post-doctoral year before becoming licensed professionals. I unfortunately could not attend the meeting tonight, due to a scheduling conflict; however, I believe that it is important that I show my support on this issue.
Loyola College in Maryland
21. Statement of Christian von Thomsen
Hi Jeff,
Thank you for addressing this important issue. Graduate Student, Loyola College
22. To whom it may concern:
23. To Whom It May Concern,
24. I am a current PsyD student working toward the ultimate goal of becoming licensed in the state of Maryland. I am a supporter of the request to change the supervised clinical experience requirement in order to remove the need to do a "post-doctoral" year of supervised psychological work. When this law was written, there was certainly a need to ensure that students were obtaining a sufficient number of clinical hours-due to the lack of emphasis on clinical work during the academic years. However, doctoral students now have a great deal of time invested in hands-on supervised clinical experience pre-internship. The predoctoral clinical training we receive is closely supervised and monitored by our department, unlike that of many postdoctoral training programs.
25. To whom it may concern,
I am unable to attend Wednesday's meeting, but I would like to write in support of removing the required year of postdoctoral training before licensure in the state of Maryland. Removing this year allow for graduates to become licensed and be reimbursed for services which would help the new practitioner enter the field. The removal would also benefit the under-served populations by allowing new graduates to be hired by the state mental health systems and provide services that would otherwise be provided by counselors and social workers.
This year made sense for training purposes 24 years ago, but today with as many training and supervision hours as graduates have under their belts, the law is hurting everyone concerned for an outdated reason.
Thank you, Kathryn Frisch Doctoral Student, Loyola College
26. Jeff-
I'm very sorry I won't be able to attend Wednesday's meeting about licensure. I wanted to "go on the record" for my support of a change in Maryland regulations and law that would allow individuals to become licensed at the receipt of the doctoral degree.
I think my situation of having a baby post-graduation, but pre-licensure makes a good example of the bind post-graduate/pre-professionals get into. I left my full-time post doc at Springfield Hospital early to have a baby. Because I had not worked there a full year (as most post-docs are time limited), I was not eligible for FMLA leave. I am approximately 175 hours (5 weeks) short of earning the required hours.
So, the options available to complete these hours are either to accept another full time post doc, (which is difficult with a newborn at home) or accept a technician's position to do testing part-time, not my main interest anyway. There are very few formal post-docs offered in Maryland for straight clinical/therapy experiences, as opposed to a specialty like neuropsychology; indeed there are relatively very few formal post-docs in Maryland at all, as compared with the number of doctoral programs and internships. I haven't found any situations to provide therapy, which is what I prefer to do, because third party payors will not reimburse for unlicensed therapists. There are other opportunities for other work having a graduate education in psychology, although it is uncertain which components of which job qualify as license eligible hours. From what I've heard from colleagues, most supervisors in these types of situations are hesitant to "get involved" in determining what aspects of the job qualify, and/or to offer the required weekly supervision, thereby leaving the postdoctoral employee to pay for outside supervision. This compounds the pre-professional's problem because they've been hired at a "not-yet-licensed" salary. The bottom line is, even if I were to find something full time, formal or not, supervised or not, something I'm interested in or not, my pre-licensed salary would not BEGIN to cover daycare. If I was licensed, I could sublease space from someone's practice and see therapy patients part time. As my practice, experience (and child) grow, I could continue to build more hours.
The above information speaks to the logistics problems. More importantly, I think, are issues related to competence, the reason, I suspect, such a long interval between degree and licensure came about in the first place. The experiences I had this past year on my post-doc reinforced my belief that I was already technically "qualified" and well educated to do the work I did there. I didn't learn any more "general fund" psychology this year, although I did gain some specific knowledge relevant to the tracks I worked in (forensics, especially). When I think of the content of the state and national licensure exams, and ask myself if my post experiences will make a difference in my ethical thinking or general psychology knowledge, the answer is no. The value of this past year was that it was helpful and important to have supervision built into my week, mostly for confidence building or for collegial "sharing" of ideas. My competence was never questioned, or a focus of our meetings. I was treated as, and worked as, a full member of the treatment team. If my colleagues, the people I have to work with day after day, accept my competence, it seems to me I'm competent enough to call myself a psychologist. Good luck and please let me know how the discussion goes!
Shawn Costello, Psy.D.
27. Hello Dr. Barnett Doctoral Student, Loyola College in Maryland
28. Jeff,
Michael Bunis Doctoral Student, Loyola College
29. Hi Jeff,
Doctoral Student, Loyola College in Maryland
30. Greetings Dr. Barnett
31. Dear MPA Board of Directors.
As a doctoral student in clinical psychology at Loyola College, I am writing to express my support for removal of the current postdoctoral requirement for licensure in the state of Maryland. I feel that the while this requirement once served a good purpose in ensuring that those entering the profession were adequately trained, it is currently resulting in more harm than good. I was surprised to learn that under current licensure guidelines, it was highly probable that I would not be able to work at a publicly funded institution in Maryland following my graduation in 2010. By allowing these types of restrictions, people who could really benefit from the knowledge of qualified psychologists are being denied a very valuable service. This is disheartening to me because I know I have chosen the field of psychology so that I can help people who really need it the most. Please make the right decision by eliminating the postdoctoral requirement so that my classmates and I are given the opportunities to gain experience, strengthen our skills, and attain our goal of helping others. Thank you for your time and consideration.
Sincerely,
Nina Azhdam Doctoral Student in Clinical Psychology Loyola College in Maryland
32. Hi Jeff. Thanks for letting me express my opinion!
Doctoral Student, UMBC
33. To whom it may concern:
34. Dr. Barnett,
35. Hi Dr. Barnett
I am very grateful for the work you are leading as it so very important for upcoming psychologists. Here is a statement of support. Loyola College
36. I am in support of the recommendation that the licensing exam be made
available at the conclusion of the internship training year. I believe that a student who has completed an APA approved doctoral level program and a year of internship training should be recognized as a competent individual who is able to take the licensing exam and enter the field as a licensed psychologist. Graduate Student, Loyola College
37. Dear Dr. Barnett,
38. Dear Maryland Psychological Association,
I am La Keita Harris, a second year doctoral student in Clinical Psychology at Loyola College in Maryland. I am writing this letter in support of the decision to allow graduate students to sit for the licensing exam and be eligible for licensure after finishing the last year of their respective programs. As we all know, graduate students are graduating with more internship and placement hours than in the past. Therefore, it is only logical and ethical that state laws and regulations move with the current of the ever-changing field of psychology. We are taught that it is unethical to use any older edition of an assessment after a newer edition is created so that we can interpret scores in context of the correct norms. The same situation applies here! Why use an outdated standard and apply it in 2005 when the norms of the profession have changed? Now, the norm is to graduate with more than enough hours to be eligible for licensure so we must change our thinking on this issue. Therefore, it is my proposal that we reconsider this standard that clearly holds us students back from entering the profession of psychology that we so eagerly await.
Please accept this letter and know that I take this matter very seriously as I will be directly affected by it in the near future. Thank you for you time.
Sincerely,
La Keita Harris, M.S. Clinical Psychology Loyola College in Maryland
39. Hi Jeff.
40. Hi Jeff,
I believe eliminating the one year of post doc experience would be a good idea. It is almost impossible to hire a recent graduate under the current regulations. Because they are not licensed, most insurance companies will not panel them. I have tried to negotiate this issue with insurance companies but have not been successful. Hiring a new graduate as a Psychology Associate has become financially impossible. This has been a significant burden to private practices. More established clinicians are less willing to move and want a higher salary. The change would be beneficial. Anyone who wants to maintain their private practice will provide supervision even if the new clinician is licensed if they want to maintain their reputation and insure quality services.
Thanks for your efforts.
Mark Todd, Ph.D.
41. In regards to the Licensure at Doctorate meeting:
42. Here are some of my thoughts regarding the movement to change the law for licensure: Graduate Student Loyola College in Maryland
43. BRAVO to Dr. Jeffrey Barnett and his leading the initiative for psychologists to be able to sit for licensure upon receipt of their doctoral degrees! This is exactly the kind of change our profession needs to remain current and competitive in a cost-driven, licensed-absolutely-required managed health care industry.
I had to move out of Maryland to find a decent post-doc after having a bad experience elsewhere where I did very little work that was related to what I was trained to do. (And I had a lot of clinical experiences while getting my PsyD.) Also, I have heard from the horses' mouth that certain of the post-docs here in Maryland have over 200 applicants for only 3 slots!
Now I am in limbo land, because I don't have my license and the jobs that will hire me without a license are either pretty undesirable and/or very low paying. (I have massive loans to pay off). Also, here in Maryland, I couldn't even submit my materials to sit for the licensing exam until after I finished my post-doc hours. So... It's tough spot. I am sure others out there have similar stories. I believe it is important to do whatever needs to be done to move ahead with this initiative.
Thankfully yours,
Ruth Stine, Psy.D.
44. To Whom It May Concern:
I am writing to express my support of the MPA initiative regarding the issue of licensure at the receipt of the doctoral degree. The postdoctoral year requirement was initiated at a time when clinical externship experiences were not widely available or commonplace within training programs in clinical psychology. However, the emphasis on clinical experiences during graduate training in psychology has increased dramatically since the postdoctoral requirement was put into effect.
In my own case, via my clinical externships alone, I have acquired 1655 hours of pre-doctoral supervised experience. In addition, I completed 1800 hours at an APA-accredited pre-doctoral internship, for a total of 3455 hours of supervised clinical activity that was required by my doctoral program at Loyola College in Maryland for program completion. In addition, through various employment opportunities, I have accumulated 544 hours participating in research, and upwards of 516 hours of testing experience beyond those required within my clinical externships and internships, and I know that many of my peers and colleagues have had similar such experiences outside of the requirements of our doctoral program. Fortunately, all of these training experiences were structured toward learning and professional development. The same cannot be said for the great variation in quality of postdoctoral opportunities that I have explored thus far. There certainly exist certain sites that follow the structure of the internship model, such that they involve didactic components and other learning opportunities. Other sites, however, seem to simply offer supervision but no other opportunities for professional development in the name of furthering our training experiences.
Most basically, with 3455 hours of supervised clinical training as a requirement of my doctoral program, and more than 1000 hours of additional supervised experiences, it is disheartening as an emerging psychology professional, to be aware that, upon the receipt of my doctoral degree and all of the requirements inherent in this accomplishment, that I still have not trained enough to practice independently. The postdoctoral year requirement is archaic and not on course with the prominent training models utilized in clinical psychology programs. I am in strong support of serious consideration of modification of this requirement.
Respectfully Submitted,
Nicole N. Zeitlin, M.S. Psy.D. Candidate, Loyola College
Jeff, Loyola College in Maryland
46. Jeff: Licensed Psychologist MPA Past President
47. I am in favor of changing legislation, in order to allow graduates of doctoral training programs to sit for licensure upon receipt of the doctoral degree. I agree with Dr. Jeffrey Barnett when he says that the need for an additional year of supervised clinical experience has become outdated. As of today, in the fall of my second year at Loyola College, I have amassed approximately 450 hours of clinical experience. If I continued at this pace, I will have over 1200 hours, even before I began my internship year. However, Loyola’s program is a graduated exposure to clinical work, thus this number is a great underestimate of the hours of experience I will obtain in the future. As my externship hour requirements increase and I complete my internship year, there is no doubt that I will have completed at least 3000 hours of clinical experience, when I earn my doctoral degree.
Although, it is helpful to consider the number of hours of clinical experience I am receiving, it is also important to consider the incredible supervision accompanying this experience. The supervision I am currently receiving, and that I expect to receive in the future, is exceptional. I am well aware of the problem that many individuals face in their postdoctoral year(s). With a lack of funding for postdoctoral students, organizations have a difficult time including postdocs on their payroll, let alone sparing the time available to give these individuals, who are not really students anymore, but are not yet full-fledged colleagues, the hours of supervision needed to meet the licensure requirements.
I understand one argument towards delaying licensure is to emphasize the importance of supervision and consultation to early career psychologists. However, I wonder if making individuals who have earned their degree unable to be licensed until they gain additional supervised experience, underscores this point. If the message is the importance of seeking professional consultation and supervision, why treat this class of psychologists differently? Shouldn’t all psychologists continue to maintain strong ties with colleagues and continue to engage in consultation? By requiring an additional year of supervised experience, how can we ensure that the message that is actually being sent is, you must seek appropriate consultation, but only when you are a “student” or “not yet licensed.”
By allowing those who have obtained an appropriate amount of clinical supervised experience to sit for licensure, directly after earning their doctoral degree, we will be allowing this group to do what they have worked so hard to achieve, and what they are qualified to do . . . treat clients! In addition, by decreasing the wait time, which increases the number of clinicians in the field, we will be providing more services to clients and more opportunities for collaboration between therapists. When passing a vote on the ability to sit for licensure at the receipt of the doctoral degree, I hope you will keep in mind the need to change a policy that was once needed, but unfortunately has now hindered the growth of our field.
-Jessica Rothstein Doctoral Student in Clinical Psychology Loyola College in Maryland
48. I strongly support a proposal that would give prospective psychologists the opportunity to become licensed after the completion of the doctoral degree. Other mental health professionals (social workers, counselors etc) are eligible to be licensed, and receive third party reimbursement with far less training and education. As a result, it makes it difficult for prospective psychologists with doctoral degrees to compete with licensed social workers and counselors in the job market. I believe strongly that amending the current licensure requirements would benefit psychologists in the field of mental health.
Pete Johnson Doctoral Student, Loyola College in Maryland
49. A primary goal of the profession of psychology is to serve the underprivileged, yet current Maryland licensing requirements are antithetical to this goal. Issues of supply and demand require students to fulfill educational and internship requirements in urban areas. However, our neediest citizens are not limited to our cities. As a graduate student who commutes a substantial distance in order to become a licensed psychologist, it is distressing that I must leave behind my rural community for an additional, post-doctoral year when my community is already behind in the provision of psychological services. Furthermore, by eliminating the post-doctoral year, new opportunities can be created in rural areas that may help draw more new psychologists, thus increasing the availability of services. It is time for MPA to take a stand and lobby for our state legislators and the Board of Examiners to align psychology’s licensing requirements with other professions.
Sherri Panzone Doctoral Student in Clinical Psychology Loyola College in Maryland
50. Dr. Barnett, I strongly support the efforts of the Maryland Psychology Association to advocate for allowing early career psychologists (ECPs) to be license eligible upon receipt of the doctorate. Training in professional psychology has substantially evolved since the postdoctoral requirement was recommended nearly 40 years ago. Requirements for postdoctoral training were implemented at a time when doctoral students obtained relatively little supervised clinical experience prior to the internship; in contrast, many students today are able to obtain more than two years of quality supervised experience before graduation, rendering the postdoctoral year obsolete and unnecessarily burdensome - particularly in light of the profession’s failure over the past several decades to establish a sufficient number of standardized and appropriately funded postdoctoral training experiences.
Current licensure requirements impose excessive barriers for ECPs, placing us at a significant competitive disadvantage in today’s healthcare market that is increasingly dominated by other behavioral healthcare providers. All other health professions allow new professionals to be licensed upon completion of their terminal degree. The postdoctoral requirement places Psychology in the difficult position of having to explain to health systems, payers, members of other health professions, patients, and other stakeholders why psychologists are ineligible to be legally authorized health service providers when they have completed an advanced doctoral degree and formal internship.
Requiring half of the supervised training experience necessary for licensure to occur after completion of the doctorate prevents ECPs, and the institutions in which they practice, from being reimbursed for the services we provide when such reimbursement could be used to support quality postdoctoral training experiences and advance opportunities for ECPs to work with underserved communities. The postdoctoral requirement also impedes ECPs who need to be licensed for their academic careers—for example, in order to be legally able to supervise students or to function as an appropriate professional model—yet they are forced to accrue the required supervised hours before they launch their academic careers. Unlicensed ECPs also are unable to participate in federal loan repayment programs at clinical sites, of which approximately 150 sites specifically funded for psychologists remain unfilled each year. I know many ECPs are very interested in these opportunities, but after moving for graduate school, then for internship and again for postdoc, many of us are unwilling to move yet again after this long struggle and tremendous cost financially and emotionally for our families and ourselves.
Many of my peers are questioning the value of their education and the profession of psychology, and many of my very bright and talented colleagues have chosen instead to pursue alternative career paths that do not require licensure. I am convinced that the current licensure requirements have become abusive and are pushing many of our best and brightest out of the profession as they wisely choose to pursue other career and business opportunities.
It is imperative that psychologists in all jurisdictions work together to change these outdated statutory and regulatory requirements. The behavioral healthcare needs of our society demand that we work to remove these barriers to entering the profession. Licensure at the receipt of the doctorate will enable ECPs to compete in today’s increasingly competitive and financially strapped healthcare system, and further, it will empower ECPs to provide services to underserved communities and accelerate the elimination of mental health disparities. We must do this to ensure that Psychology retains its status as one of the premier and most respected health professions serving society.
With highest regard and steadfast support to MPA members for being at the forefront of this advocacy effort,
Christopher W. Loftis, Ph.D. Early Career Psychologist Former Chair of the American Psychological Association of Graduate Students
51. As an early career, and newly licensed psychologist in the State of MD, I wholeheartedly favor licensure reform in the state, specifically licensure at the receipt of the doctoral degree. Managing through the licensure process as it is in place at present, was one of the most stressful and complicated processes and thus, I’m in favor of this reform for the following reasons:
Respectfully submitted,
Deborah Hillard, Psy.D. Licensed Psychologist
52. Statement of support: Doctoral Student, UMBC
53. I support the recommendation that the licensing exam be made available upon completion of clinical psychology doctoral programs and that graduates be eligible for licensure at that time. Students who graduate from APA approved doctoral level programs and internship training sites, should be recognized as well prepared and with sufficient experience to enter the professional field as a licensed psychologist. Doctoral Student, Loyola College
54. I would like to express my support for the initiative which proposes allowing students to sit for licensure at the receipt of the doctoral degree. Not only would this benefit students but I believe it would also benefit clients. My career goal is to work with clients who do not have enough access to services at present, specifically those of low socioeconomic status. I believe that I would have a better chance of obtaining a position where I could serve these clients if I could become eligible to sit for licensure when I receive my doctoral degree. This will allow me to receive third-party reimbursement through Medicaid and give me the opportunity to work with clients who I believe are presently
55. I would like to add my support to the proposal that applicants for licensure in psychology in Maryland may be eligible for licensure immediately after receipt of the doctoral degree provided they have met all requirements, including the equivalent of two years of appropriate supervised experience. This change will maintain the current standards while adding flexibility to the timing of supervised experience. It would also put Maryland in line with the majority of other states, which already grant this added flexibility.
S. Michael Plaut, Ph.D.
56. I am currently in my 2nd year of a doctoral program in clinical psychology. Prior to beginning the doctoral program, I had completed my Master’s in clinical psychology at the same college. Between these two programs, I am currently well over five hundred hours of clinically supervised experience in testing and therapy. As a result of these experiences, I am in support of changing the supervised clinical experience requirement in order to remove the need to do a post-doctoral year of supervised psychological work.
Clinical supervision and consultation should not conclude when a psychologist is licensed. Professionals should continue to seek supervision as they grow and progress through the field. These are ideals that we set forth and we should allow people to live up to these expectations.
When this requirement was written, students were entering their internship year with minimal supervised hours, if any at all. This is no longer the standard; this is the exception. Clinical experiences in my own program maintain excellent supervision and monitoring requirements with high expectations of leaving for internship with over 1750 hours of clinically supervised experience. The supervision that is maintained while in training at this level is not necessarily set at the same standard at the post-doctoral level.
In the recent year, this country has seen a call for mental health professionals as we had one of the most horrific hurricane seasons in reported history. This type of community outreach is only one example of the potential voids that newly licensed psychologists could fill. With more psychologists, there is more potential for positive exposure and community work for the profession.
As a professional who works at Johns Hopkins School of Medicine, I am aware of the image that psychologists project to other professions. The message is unclear as to whether or not we feel that our training and educational programs are adequate enough to allow our students to be licensed. There are stipulations that could be maintained including the prospect of still requiring a designated amount of hours of supervision with a psychologist who has been licensed for over “10” years. If we believe that those APA approved programs are producing competent students who graduate with the knowledge, skills, and abilities needed to work in this field, then our actions should be a reflection of that.
Nicole Fromm, M.S. Loyola College in Maryland
57. Dear Jeff,
I, too, support the idea of changing the laws so that psychologists can get licensed at the receipt of the doctoral degree. While there are many reasons I support it, I will share with you one personal experience that I have had each and every year for the last nine years that makes me feel this change is needed. I am a supervisor for the postdoctoral trauma disorders fellows at Sheppard Pratt Health System. These psychology fellows are extremely competitive and well trained, and are seeking advanced training in working with severely traumatized individuals. They work under close supervision and have a great deal to offer some of the most damaged clients in the mental health system. However, because they are not licensed, many patients who would gladly come to them for treatment and psychological testing cannot do so because their insurance plans do not provide reimbursement for unlicensed mental health professionals. Think of what this means! These fellows have often received four or five years of intensive graduate training, and have their Ph.D.'s or Psy.D.'s, yet they are unable to provide treatment that a licensed social worker or other licensed master's level clinician can provide. And they have more training than the licensed master's level clinicians have! So some of the most traumatized, most needy patients are turned away and have to seek out treatment from someone without advanced specialized training in treating trauma disordered patients. I have had to talk to some of these patients, and try to explain to them why they cannot see someone who can help them; it demoralizes them and frustrates me.
There is one other reason that I can personally attest to regarding this proposed change in licensure. After these highly competent postdocs complete their year of training, they always struggle with finding a job due to the fact that so few insurance companies will reimburse for their services. So, for a year they are in "limbo" waiting to sit for licensure, often underutilizing their impressive clinical skills. This situation makes no sense for our clients nor for our profession. I don't see who benefits from the current laws that drag out the licensure process. I see many reasons why it is important to change the laws so that psychologists take the licensure examination upon completion of the doctoral degree.
Thanks for working hard on changing this.
Best wishes,
Bethany Brand, Ph.D.
Associate Professor Psychology Department Towson University 8000 York Rd. Towson MD 21252
58. Concerning the issue of being able to be licensed at the same approximate time that one receives their doctoral degree, I think this is a good idea, assuming that they have received adequate supervision on their clinical skills prior to graduation. The current method makes it much more difficult for people to select the career track that fits their interests and talents.
Philip L. Briley, Ph.D. Licensed Psychologist
59. I absolutely support the initiative to issue licensure at the receipt of the doctoral degree. While all of the points brought up at the open forum are legitimate, the fact that students receiving their doctoral degree will have more hours of supervised clinical experience than individuals had including their post-doctoral year when the requirement went into effect is, in and of itself, significant enough to make a change. If the concern was that the students needed more preparation and experience, it is no longer valid. For the betterment of the population being served and the clinicians serving them, it appears time for a change.
60. Hi Jeff,
61. Hello Jeff. Licensed Psychologist Associate Dean of Arts and Sciences Loyola College in Maryland
62. I am writing to express my support for the issue of licensure at the receipt of the doctoral degree. As I was preparing to receive my doctoral degree in May of 2002, I could recall feeling excited and disappointed at the same time. I was excited to finally complete my training to become a psychologist, but disappointed that I was not yet eligible for the licensure exam. I had accumulated many hours of supervised clinical experience as a student and felt prepared and eager to take the licensure exam. However, according to Maryland law and regulation, I had to accrue an additional 1750 hours of supervised clinical hours and wait at least one year from my graduation date to be considered for the exam.
Midway through my internship year, I began searching for opportunities to work as a psychology associate. I was disappointed as the opportunities were scarce and unappealing. Along with other students from my internship class, we all wondered “what now?” I was very worried that I would have to work in clinical settings that were not of interest to me, just to meet the required hours as indicated by Maryland law and regulation. It was a very desperate and scary time as opportunities for unlicensed clinicians were limited. I can recall another recent doctoral graduate saying “take any position you can get…you just need to get licensed.”
As I was anxiously looking for a clinical position, I determined that a post doctoral internship would make the most sense for me. I would receive specific training in my area of interest while being certain that I would accrue well over the required number of clinical hours to sit for the licensing exam. However, even as a post doctoral intern, not having my license was an obstacle. I could not receive third party reimbursement with certain insurance companies, which really limited my ability to work with certain patients.
When my post-doctoral internship came to an end, I had enough clinical hours but did not meet the one year requirement that Maryland law and regulation required. This put me in an awkward position as I was still not eligible to sit for the licensure exam, yet had accrued enough clinical hours. Once again, I felt stuck and disappointed. I started searching for positions with group practices or clinics, but found that some would not be willing to provide clinical supervision. Although I pursued an opportunity to start a private practice, not having my licensed remained an obstacle. I had to pay for clinical supervision and could not bill for insurance reimbursement with most insurance companies.
Clearly, not being licensed after receiving my doctoral degree was a challenging and stressful experience. A change in Maryland law and regulation that would allow for licensure to occur at the receipt of the doctoral degree would eliminate needless anxiety and allow doctoral students to more easily plan for their careers as psychologists.
Nancy Fiorentino, Psy.D. Licensed Psychologist
63. Hi Jeff,
Licensed Psychologist
64. Hi Jeff.
Licensed Psychologist
65. To Whom It May Concern,
66. Hi Jeff.
67. Hi Jeff.
68. Dear Jeff,
Thanks for your email asking for my input on the recommendations to the Board of Examiners.
The opinions of most graduate students and interns don't necessarily carry great weight for me since those opinions would be self serving. That being said, though I really don't believe graduate psychologists who have the required approved internships should be forced to wait another year to meet licensure qualifications.
Consequently, I support the concept that these individuals should be eligible to take the licensure exam upon completion of all educational and internship requirements, and, if they pass then they deserve to be granted their license without delay.
Having an additional year in a clinical setting seems unreasonable. Their work cannot be reimbursed under most manage care companies and they are already in debt up to their eyeballs. The current system makes them indentured servants to mental health facilities and is both unfair and exploitive. Of course, if I just got my license after having to endure this hardship, I might well oppose letting the next crop off so easy. But since I am getting ready to retire and don't mind the competition, I can lend my support to your recommendation to the Board. Harvey Sweetbaum, Ph.D. Licensed Psychologist
69. Dear Jeff,
I am full support of licensure at the receipt of the doctoral degree. As a practicing psychologist who completed a year-long postdoctoral fellowship, as well as later developed and supervised a postdoctoral training program, I am fully aware of the variety of training opportunities and challenges that a postdoctoral training program before licensure brings. One of the clearest and most significant issues of running a quality postdoctoral training site is funding, as this is difficult to do when fellows cannot be reimbursed for services in many situations. With licensure, I truly believe that quality training programs will increase due to the opportunity for funding through third-party billing.
I am also aware that the training opportunities available to recent graduates vary greatly, and are minimal in many places. By granting licensure, further training and exposure could occur in areas of relevant interest, therefore increasing competence, as well as allowing greater exposure and treatment for underserved populations.
Having been a part of several internship selection committees, it is very clear that training experiences prior to internship and receiving the doctoral degree have increased greatly. Allowing licensure at the receipt of the doctoral degree seems beneficial for both consumers and newly licensed psychologists. I strongly support of this concept.
Chad C. Nelson, Ph.D. Licensed Psychologist
70. I entirely support the initiative to grant licensure eligibility following the receipt of the doctoral degree. Based on my experiences as a masters, doctoral, and intern student I find the training to be comprehensive and reflecting that of a trained professional. Not only is the doctoral student given the clinical experiences which would make him/her appropriate for licensure, but the additional supervision given by trained licenced psychologists aids in the preparation for licensure. Thanks Jeff for getting our voice heard. Gregory Ryan, Psy.D.
71. Dear Dr. Barnett: I was extremely pleased to find the issue concerning the requirement for the
year of supervised post-doc experience as this is a major concern of mine.
I recently completed my Ph.D. and internship and am finding that Maryland,
unlike other states, makes it much more difficult to become licensed. Two
colleagues who I completed internship with are already licensed (i.e., in
Texas and Wisconsin) and as such, are able to apply to jobs requiring
licensure. By contrast, I am in the position of looking for postdocs or Thank you for your efforts in this area. Sincerely, Kim Sanschagrin, J.D., Ph.D.
72. Hi Dr. Barnett: Below is my story about trying to get a post-doc position after internship After completing my internship and Psy.D. in 2003, the jobs I found in the Maryland area that would help me to gain post--doc hours were extremely limited. I ending up taking a psych associate job at a prison, but I was doing very little psychotherapy. In the bulk of my time, I was co-leading a psycho-educational groups. Some of what I was asked to do went against my own beliefs about psychotherapy and professional principles. Needless to say, I only lasted there for a few months and took a non-psych-related job to survive. While I worked my non-psych job, I applied to in-state and out-of-state
post-docs and various other psych. jobs. I was offered a job to do emergency
evaluations of people with mental health problems in emergency rooms, but
the organization did not have a psychologist on staff who could supervise my
work, and therefore the time I worked wouldn't be counted toward licensure. I applied for nearly every post-doc in Maryland and the surrounding area with no luck. (Recently, I spoke to someone at one of the post-doc hospital sites in Maryland, and he told me that the post-doc they offered had over 200 applicants for only 3 slots! Now I don't feel so bad. ) Finally, I landed a post-doc in New York that began the following fall of '04, and that turned out to be a great experience. I am thankful for having had it and I wish there were more like it in our area. My only complaint was the dismally low salary that kept me having to stave off my loan repayments from grad school. After my post-doc in New York was over, I returned to Maryland and applied to the Maryland board for licensure. It has taken several months to get the approval in place and in the meantime, I have been studying for the state and national psychology exams. Without being licensed, my job options are limited in many ways. In the meantime, I have student loans to pay but the psych-related jobs I can get without being licensed would barely cover the minimum payments on them, plus the cost of living for a single person living alone. This has been a trial for me, to get this far and have had it been so difficult. I had no idea going into this profession that it would be like this. After having looked high and low, I realize now that people with master's
degrees and social work degrees with licenses may have more job
opportunities than those of us with our doctoral degrees (but I doubt they
have the debt load or expertise!) It's ironic because in the job interviews
that I have been in for those that will take someone with a masters degree,
I always get the remark, "you have a lot of clinical experience". (And I've
thought to myself, "yes, and I paid for that experience...") But in the Hopefully things will improve after I get licensed, and I guess I will find out because I am not giving up now. I also hope my story will help to change the state laws so that psychologists with several years of pre-doctoral clinical experience who have graduated and finished their internships can apply for licensure after they finish their internship. It would make their lives a lot less difficult and hopefully less expensive. Thank you for your time and consideration. Sincerely, Ruth Stine, Psy.D.
73.
Hi Jeff,
74. Hi Dr. Barnett, It is my opinion that students should be given the opportunity to accrue the practice hours needed for licensure prior to or after the receipt of their doctoral degree. The requirement of post-doctoral hours makes it unnecessarily difficult for early psychologists to obtain licensure. It also makes it difficult for psychologists to establish professional roots in the communities in which they live. I moved to Baltimore, Maryland to attend a graduate program in psychology. After three years here I have made important connections both professionally and personally that lead me to want to stay in Maryland permanently. However I may not be able to do this due to the current requirements for licensure. Not only will I leave Maryland for internship, but it is likely (due to the scarcity of post-doctoral positions) that I will have to move again to do my post-doctorate work in another state. If we are training psychologists every year, only to send them elsewhere to establish their professional careers and identities then we are doing a disservice to Maryland psychology. It is my opinion that psychologists should be able to complete their hours for licensure while attending their graduate programs and internships so that good psychologists who would like to stay in Maryland can have that opportunity. Sarah Johnson, M.S.
75. I am writing to eagerly express my support of licensure reform for psychologists in the state of Maryland. Altering current regulations to allow for licensure upon receipt of the doctoral degree is relevant and clearly supported in evidence cited by Jeffrey Barnett, Psy.D. The initial rationale of the requirement to have one-year of post-doctoral supervised experience is outdated given the amount of clinical experience attained by current doctoral students prior to graduation. As a personal example, I estimate that I had acquired nearly 4000 hours of supervised clinical experience prior to receiving my doctoral degree.
It is clear that this current regulation has become an arbitrary hurdle that hinders both the success of doctoral-level psychologists, as well as access to care by citizens of Maryland. Further evidence to the arbitrary nature of the current regulation is that the hours required during the post-doctoral year can be attained by engaging in professional, but non-clinical, activities such as teaching or research. If the goal of licensure is to ensure a level of clinical competence of professionals in order to protect the welfare of the public, the measure of that competence should clearly be related to hours of clinical experience.
I was fortunate to obtain my required post-doctoral hours as part of a formal two-year fellowship at Johns Hopkins. While this is an institution that is rich with clinical opportunities, I was only able to take advantage of them because my position was funded by research grants. Insurance would not reimburse for my direct services as an unlicensed professional, despite supervision by a licensed psychologist. There is risk to the quality of training for the profession as a whole if some of our best institutions are unable or unwilling to provide training because we cannot “pay for ourselves” by bringing in revenue through our work.
I image that there is a potential fear from governing bodies that allowing licensure upon receipt of the doctoral degree will decrease the likelihood that licensed psychologist will continue to seek out specialized training typically received during the post-doctoral year. My hypothesis is that the opposite would be true. With this proposed change, I foresee more (and better paying) opportunities at many of the well-respected institutions throughout the state of Maryland. This, with no doubt, would only enhance the quality of training and experience that Maryland psychologists have, thus making us better able to provide quality care to citizens in need of our services.
Respectfully,
Licensed Psychologist
76. Jeff, Upon completion of my internship, I opted to not accept a clinical post-doc for three primary reasons: That being said, I am very eager to start practicing. Thse factors have served as a major barrier for me to getting my license at this time. Although I can't wait to get 'out there' and practice, I am amazed how many more hurdles I will continue to have to go through, under current policies, before I can even sit for a licensure exam. I have had friends and colleagues in other helping professions who have had much smoother sailing in much shorter periods of time in terms of receiving training, practicing, and becoming licensed. The barriers I have mentioned, as well as many other barriers, are very frustrating and discouraging for me and others I know who are in a similar position as myself. I can not express to you how pleased I was to learn about these proposed policy changes. These could have a huge impact on my decision and ability to practice in the coming years. Sincerely, Marni Amsellem, Ph.D.
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