Wednesday, May 5, 2010

Who Can Be a Psychologist?

In their article, “An Empirical Survey of Psychological Testing and the Use of the Term Psychological: Turf Battles or Clinical Necessity?” (Dattilio, Frank M.; Tresco, Katy E.; Siegel, Alex Professional Psychology: Research and Practice. 2007 Dec Vol 38(6) 682-689) the authors provide ample evidence to support their argument that state laws attempting to restrict use of the terms “psychology, ” “psychologist,” and “psychological” confuse more than clarify and have proved to be of little benefit to professionals or consumers. The legislatures were correct in attempting to protect the public from individuals claiming to have qualifications they lack. However, laws aimed at preventing fraudulent use of these terms by unqualified professionals have not prevented confusion in the minds of consumers, who regularly confuse psychologist with psychiatrist, and psychologist with psychotherapist of any type.

Many consumers do not appreciate the differences among so-called “mental health professionals” such as psychiatrists, counselors, psychotherapists, psychoanalysts, and psychologists. Statutes restricting use of terms related to psychology accomplish little or nothing to address this problem. The fact that some of these designations overlap increases the confusion: A psychoanalyst might also be a psychologist, a psychiatrist, or a social worker. Even professionals may wrongly assume that a PhD following the name of a professional implies that professional must be a psychologist.

Each of the terms protected under the statutes poses a different problem and calls for its own solution.


Comparison of the terms “psychology” and “psychiatry” helps clarify the problem. Psychiatry is a profession, a medical specialty encompassing the diagnosis and treatment of mental disorders in humans. In contrast, psychology is a science within the broader field of biology; in fact it is one of several sciences that inform the practice of psychiatry. Psychology encompasses the study of normal, as well as pathological, behavior, and it encompasses the study of behavior and functioning of non-human, as well as human, animals. Psychology per se is not a profession at all. Consider common uses of the term: Psychology Today, popular psychology, developmental psychology, The Online Journal of Sport Psychology, psychology 101, psychology department, evolutionary psychology, social psychology, political psychology, and others. Legislation probably cannot eliminate other uses of the term.


The problem with efforts to restrict use of this term to licensed professionals are implicit from the discussion above and from the legitimate use of the term by non-licensed professionals to identify their professions. Not only do school psychologists and industrial psychologists identify themselves as such legitimately, but also scientists who study animal behavior and academics who teach but do not diagnose or treat and thus have no need or qualification for a license. The definition of psychologist should be “one who studies psychology” not “one who practices psychology.”

Psychological (test):

The authors’ focus on psychological testing legitimately arises from the fact that such formal assessment is a major role of psychologists. Psychological treatment (psychotherapy), however, is probably at least as central to the practice of psychology. Most of the same arguments could be made in an illegitimate attempt to prevent professionals who do not hold licenses as psychologists from claiming to provide psychotherapy services. As with “psychology” other common uses of the term “psychological” further blur the boundaries of acceptable use: psychological thriller, psychological aspects, psychological operation, psychological theory, psychological warfare, ad infinitum. The title of a catalog on my desk reads, “The Psychological Corporation.”

The problems with restriction of use of this term in the context of formal assessment arise partly from the lack of a universally accepted operational definition of “psychological testing,” and perhaps of psychological evaluation. The MMPI and the Millon, among others, would seem to be correctly classified as psychological tests regardless of the credentials of the individual who administers the test or interprets the data, but the Draw a Clock test, and the Mini Mental Status Exam would not. The authors also refer to “psychodiagnostic testing,” but do not indicate whether they believe the term should be considered synonymous with “psychological testing.” If any and all measures, instruments, tests, profiles, surveys, symptom inventories, and scales are included, there is no basis for restriction. If only a few, narrowly defined instruments are covered, the validity of the restriction increases, but its usefulness decreases.

The determination of which professional is qualified to administer a given test should depend on training and experience, not on their professional identity. Statutory restriction of the use of the term “psychological testing,” to be feasible, requires an adequate definition. I face a dilemma in completing an application asking whether I perform “psychological testing” as part of a psychiatric forensic examination. I routinely administer the MMPI, but the scoring is performed via computer program by Dr. Butcher. To me the MMPI is clearly a psychological test, but if I answer yes, I risk prosecution for violating Washington law. Conspicuously absent from the discussion, particularly with regard to testing, is any reference to the profession of psychiatry. Attempts to protect the consumer from fraud are legitimate regardless of any assumptions about pecking order. If a social worker cannot legally claim to provide psychological testing a psychiatrist should not be able to either. Efforts to protect the consumer should be limited to restriction of availability of test materials to those qualified to administer them.

The solution is to protect only the term “clinical psychology,” a term that clearly refers to a profession that addresses only humans, their evaluation, and sometimes, if present, treatment of pathological conditions.

•    Laws should not limit use of the term “psychology” at all.
•    Restriction of the term psychologist should be limited to the term “clinical psychologist” and then only when the term is used in an attempt to falsely hold oneself out as a clinical psychologist.
•    Until or unless we can arrive at general agreement on the scope of the term “psychological testing” no statute should limit its use.

Individuals who should be allowed to identify themselves as psychologists include school and industrial psychologists, professors of psychology and those who study animal behavior.


  1. The Director of a Methadone/Counseling Clinic has cards printed with the title of psychotherapist on them. She has a MA in art. What are the ramifications?

  2. Probably depends on state law, but my sense is that there is less restriction on use of psychotherapist than psychologist. I know a highly regarded psychotherapist with a PhD -- in physics.

    Most states probably require certification, registration, or licensure for counselors. Could be that a registered counselor can legal claim to be a psychotherapist.

    Your best bet would be to go the state department of licensing or department of health Web site.

  3. What respect is there out in the clinical world for professional clinical counselors?

    Here in the State of Ohio, professional counselors and professional clinical counselors can administer and score psychological tests in which they received training. PCC's can diagnose and treat mental health disorders and conditions independently and PC's can while under supervision.

    Counselors have received licensure in all 50 states but still seem to be looked down upon by other mental health professions. In all states, individuals who are licensed as counselors need at minimum of a Masters degree plus years of supervised training before earning independent licensure status.

    The counseling profession's lobbying body (ACA) is not nearly as strong as psychiatrists, psychologist, or social workers and I believe leads to counselors being compartmentalized and marginalized by other clinical professions, agencies, State Governments and the Federal Government.

    Counselors have been granted licensure status onset in 1970's and just last year California came on board, as the last state in the union, granting license for counselors.

    So I put my question out there for clinical and non-clinical readers:
    How do other clinical professionals (i.e. psychiatrists, psychologists, social workers, medical physicians)look upon those licensed as professional clinical counselors as fellow colleagues?

  4. Good question, Anon. As I ponder I realize there are several psychotherapists whom I respect and I know they are not psychologists or psychiatrists, but I'm not really certain whether they fall into one of your categories or not. Some of them are LMFT's as well (I think.). So one of your problems is just that the identity is not as clear. When I think of counselors, and this goes way back for me, I think primarily of chemical dependency counselors, then I think of "masters level counselors."

    For the answer to your question, though, it depends so much on the individual rather than the credential. I know counselors I believe to have superior skills, and psychologists I would never refer a patient to.

  5. Professional clinical counselors with a PhD designation provide much the same services as clinical psychologists in Ohio; however, they cannot call themselves "psychologists," even if their education and training is primarily psychological in nature. Psychologists and Psychiatrists have lobbys that are stronger and older than Counselors.
    Clinical Counselors seem to have an identity problem, so why should other professionals recognize them? They need a lobby! Certainly the ACA is not able. It should be easy to do so, if there was a committment to it.

  6. The title of psychologist can only be used by an individual who has a doctoral-level degree in psychology, training, and state license.