By the 1980s, the world of psychology had become populated with clinical psychologists. Those doing research, scholarship, and teaching in the field of psychology were now a distinct minority in APA membership. Independent graduate schools that offered Psy.D. degrees now enroll most of those seeking to become psychologists. We also witnessed the emergence of many career options for those wishing to address mental health issues. As I shall note shortly, the field became not just much larger but also much more diversified regarding degree options. Masters degrees were offered in Marriage and Family Therapy and in Clinical Social Work. Soon, as we shall see, there were many other options.
There is one other important point to be made about degree programs and licensing in the United States. A major policy regarding authorization has created many headaches among those trying to regulate the field and those seeking to be certified as practitioners. In the United States, regulation of all professions occurs at the State rather than the National level. Each state has its own regulations and its licensing tests (though national tests are often available). One does not automatically get approved in another state, even with extensive experience of licensed practice in the original state. This provides a major challenge for those who are in transition between states.
While each state established its own regulations, there are some commonalities. Licensing requirements typically include an approved supervised internship and passage of a state-run examination. It is also common for a ghost to hand over the licensing requirements in all states. This ghost concerns the restraint of trade. The original purpose for granting licensing, which was assurance of quality and elimination of “quackery,” has remained at the public level. However, behind the scenes, we find that licensing is being used to control the number of practitioners at any one time in a profession.
It is interesting (and perhaps disturbing) to note that licensing exams (and more generally, the granting of licenses) are often market-driven rather than related primarily to assurance of professional quality. There is a tendency in many licensing domains for there to be lower pass rates on the exam (and lower granting of licenses) when there are many practitioners in the field, than when there is a scarcity of practitioners. There is little data to determine the extent to which this change in levels is common in many other countries; however, this restraining practice is certainly present in many American professions, including psychology.
Professional Recognition of Psychologists
Overall, being addressed as “Doctor” and passing a licensing exam carries significant implications related to expertise, authority, responsibility, and social status. One needs an advanced degree and then licensing if the intention is to work in a medical institution or provide mental health services.
Degrees in Clinical and Nonclinical Fields
If one wishes to work in a medical facility (especially a mental institution) then a doctorate (Ph.D. or Psy.D.) is required. At the Masters Degree level, there is a strong preference (even requirement) that one has obtained a Masters in Social Work (MSW). Increasingly, there is a preference for those who have been awarded an MSW with a clinical emphasis (MCSW). Those psychologists who have been awarded an educational doctorate (Ed.D.) usually need not apply for a job in the mental health field, though they are fully accepted and heavily recruited to provide counselling (and sometimes psychotherapy) services in school systems.
