Patients are always surprised to learn that there are very few laws governing the practice of medicine. In fact, a physician who is licensed to practice medicine by his state medical board–whatever his specialty–can legally provide counseling for anyone, even if he or she has absolutely no training in psychology at all!
For instance, just because a doctor calls himself a psychiatrist is no guarantee that he is actually competent to practice psychiatry. For example, legally, a proctologist, a medical doctor certified as a specialist only in disorders of the rectum, can label himself as a non-board certified psychiatrist and do adolescent counseling for drug problems or psychotherapy for suicidal patients-all, with no training in psychology.
A urologist, certified only as a specialist in treating urinary disorders, can again identify himself or herself as a psychiatrist, though non board-certified, and still treat a dangerously bipolar patient; and a dermatologist, actually certified as a specialist only in skin disorders could call himself a psychiatrist and treat your child for ADHD-it is all legal and can be done with no training whatever in psychology or mental health treatment.
These three examples may seem ludicrous. But, remember men and women often get their treatments for depression and anxiety without ever checking, or even caring to see if the medical doctor they are consulting is board-certified in psychiatry?
Do not assume that your medical doctor has the right credentials to perform high quality psychological, counseling or psychotherapeutic treatments. After all, even board certification in psychiatry is no guarantee because most board-certified psychiatrists have only 3 years of specialized training in mental health treatment.
Most of their training is in physiology, chemistry, sciences and general medicine. Therefore, they usually prescribe drugs and do little, if any, counseling or psychotherapy.
Screen your possible therapist with the following 3 questions:
1. Are you certified by the American Board of Psychiatry and Neurology?
Make certain that if your doctor labels himself as a psychiatrist that he is certified by the American Board
of Psychiatry and Neurology. If he is, that would mean that he has received specialized professional training in providing mental health treatment.
However, remember that the psychiatrists training often has been centered on physical therapies, like the prescribing of drugs and even the use of shock treatments. Psychiatrists sometimes receive only little training in psychotherapy, counseling or psychological testing.
You know what that means. If you consult a psychiatrist the odds are that you will only walk out with a prescription.
Certainly, there are some psychiatrists who are better-rounded in their training and who do some psychotherapy. Nevertheless, odds are that if your doctor has an MD or DO degree, you will walk out with a prescription as your main or only treatment.
2. Are you certified or licensed by the state Board of Psychology as a clinical psychologist?
While there are many thousands of professionals in
the United States who do some type of counseling or psychotherapy, only a small percentage of these are the elite practitioners who are licensed to practice clinical psychology!
To become a clinical psychologist requires approximately 6 years of specialized college and graduate training in mental health, counseling, psychotherapy and diagnostic testing. This training is obtained during the last two years of college, followed by approximately 3 to 4 years of specialized graduate school after college.
The psychologist has a doctoral degree in psychology-the study of emotions, thinking and behavior. Psychologists then must undergo the equivalent of a one year internship in clinical psychology- no irrelevant courses in proctology or anatomy, just massive amounts of training in psychological treatment, psychotherapy, family therapy, counseling and specialized diagnostic testing.
Only four years of medical school with training in anatomy, obstetrics and other medical sciences in addition to perhaps a few weekend courses or casual reading about psychology, may be the only education that your non-certified psychiatrist may have. This is certainly no substitute for the psychologists rigorous and highly specialized training over many years.
Remember, you are protected when you consult a clinical psychologist. Why? Because any professional who calls himself a clinical psychologist and is licensed to practice clinical psychology independently, has at least 6 to 7 years of college and graduate school training specifically targeted to psychology.
Unless you check the board certification of the medical doctor you are consulting, however, you may not discover that you have been consulting someone who may have little or even no training in mental health and psychological treatment. In fact, you may discover that you have been receiving dangerously inferior forms of psychiatric care, without ever realizing it.
3. Is the state board of psychology or medicine investigating you for any complaints or malpractice suits?
It is true that even great psychiatrists and clinical psychologists do occasionally get sued. However, you can contact your states professional board to learn whether your therapist has demonstrated a pattern of poor care or inappropriate behavior.
Questions that you are commonly told to ask but which are not relevant:
1. To those calling themselves psychiatrists: Are you board certified?
Nearly all medical doctors are certified by one board or another. If a person has an MD or DO degree, just being board certified in anything is not good enough either. The right question to ask is, Are you certified by the American Board of Psychiatry and Neurology?
2. In what state are you licensed to practice psychotherapy and counseling?
Remember states do not specifically license medical doctors to practice psychotherapy and counseling. Absolutely any physician with a valid medical license can legally provide these specialized mental health services-even if they have no psychiatric training at all!
There are no regulations that limit medical doctors to practice within their specialty; not one of the 50
states forbids the practice of psychiatry by non-psychiatrists. The correct question to ask a medical doctor is, Did you complete a
formal residency in psychiatry?
3. If the therapist is not a medical doctor, but a clinical psychologist, you are better protected. All you need to ask is, Are you licensed by the state to practice clinical psychology independently?
If the answer is Yes, unlike physicians who just have the medical license, you automatically know that the therapist with the psychology license is highly qualified and has received the rigorous and specialized training necessary to provide expert psychological services.
Not only can just about any medical doctor get a board certification in something, and not only can any licensed physician render any psychiatric service, trained or not, but remember that any physician with
$500 can join any number of impressive sounding organizations.
Heck, I know of medical doctors who literally create so called societies and academies so that they can call themselves president and use the title as a marketing gimmick! Remember, when screening therapists that the only credentials that really matter are the license to practice clinical psychology or certification by the American Board of Psychiatry and Neurology.
