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Unlawful practice
case draws attention to licensing issues
(March
2007 Issue)
By Ami Albernaz
The bizarre case of a Mashpee, Mass. woman who for more than a
decade practiced psychology without a license raises the question:
What kinds of regulations are in place to ensure that no one who
is unqualified to practice psychology is doing so?
Tama Judd was sentenced to two years' supervised probation in December
for practicing unlawfully. According to the Attorney General's office,
during the 10 years she practiced, she billed insurance companies
for patients' services. Judd does not hold a doctorate degree as
is required for psychologists in Massachusetts. She was unlicensed
for most of the 10 years, having obtained a license for mental health
counseling in late 2005.
During the time in which Judd worked as a psychologist, the state's
Attorney General's office was responsible for investigating claims
of unlicensed practice. But in the most recent legislative session
in Massachusetts, this responsibility was passed to the Board of
Registration of Psychologists.
The move should strengthen oversight since the board deals directly
with licensing, while the Attorney General's office is busy with
many types of cases, says Elena Eisman, Ed.D., ABPP, executive director
of the Massachusetts Psychological Association.
According to Massachusetts law, any person presenting himself as
a psychologist who is not licensed to practice psychology is subject
to a fine of up to $500, imprisonment of up to three months or both.
To try to ensure the quality of practice, the Massachusetts Psychological
Association has also filed legislation to restrict the use of the
term "psychotherapist" to only those practitioners whose licenses
have psychotherapy within their scope of practice, Eisman adds.
(As of now, anyone can present himself as a psychotherapist).
In New Hampshire, the issue of who can provide psychological services
and under what circumstances is being considered. Currently, people
without a license are prohibited from calling themselves by the
five specified titles - psychologist, pastoral psychotherapist,
clinical social worker, clinical mental health counselor, marriage
or family therapist - that are recognized by the state's Board of
Mental Health Practice. (It is also unlawful for an unlicensed person
to represent himself as a "psychotherapist").
However, an exception to the state's licensing law allows "alternative"
providers to practice "mental health services" without a license
and without registering with the licensing board. A bill now under
discussion would eliminate the category of alternative provider
and require those who now practice under this category to register
with the board. All such future practitioners, meanwhile, would
need to obtain a license, although the new bill does not state whether
the license would need to apply to one of the five specific categories
designated by the Board of Mental Health Practice.
If the license does need to be tied to one of the five categories,
the bill "would be a big step forward," says Sandy Rose, Ph.D.,
president of the New Hampshire Psychological Association. However,
she adds, the requirement that current alternative providers register
with the licensing board "is deceptive, as registration implies
oversight and there remains no regulation of practice for these
providers." Rose and others would like to see the bill amended so
that this group of providers would be subject to the same regulation
to which all other practitioners are bound.
In Maine, meanwhile, complaints of a person practicing psychology
without a license are followed up by a standard investigation process,
says Jeri Betts, administrator of the state's Department of Professional
& Financial Regulation, which encompasses the Office of Licensing
& Registration. If the licensing office receives such a complaint,
the complaint is docketed and investigated and then may be dismissed
or referred to the Attorney General's office. The licensing office
may also send a warning to an unlicensed person who is practicing,
advising him to stop or to apply for a license. For this course
of action, she says, "there has to be solid evidence, not just hearsay."
Addressing unlawful practice depends upon such cases being reported.
"Our oversight begins with the filing of an application [for a license],"
Betts explains. She adds that she does not recall a case in Maine
as extreme as Tama Judd's. "Most often with us, a person might have
failed to renew a license or has come to the state wanting to work
but has failed to get a license, when he or she might be licensed
in another state," she says.
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