PhD/PsyD RANT: Arguing with therapists with no research background is like screaming at the ocean and begging the waves to subside

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Curious what "practicing outside of scope" typically means RE: board complaints, as sadly - claiming you are a specialist in XYZ after you took a weekend workshop in voodoo therapy seems normative? I'm guessing this comes up more often in assessment settings.

Just genuinely curious if this is more like "Did PE with limited formal training in it" or "Attempted to do a kidney transplant." Scope seems so poorly defined in most areas of psychology, I can't fathom how far one would need to overstep for actual board action....
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Ollie123 said:
Curious what "practicing outside of scope" typically means RE: board complaints, as sadly - claiming you are a specialist in XYZ after you took a weekend workshop in voodoo therapy seems normative? I'm guessing this comes up more often in assessment settings.

Just genuinely curious if this is more like "Did PE with limited formal training in it" or "Attempted to do a kidney transplant." Scope seems so poorly defined in most areas of psychology, I can't fathom how far one would need to overstep for actual board action....
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We reported a masters level person who was doing neuropsych assessments with no formal training to the board. Other than that, I haven't seen scope come up in a board action.
 
Ollie123 said:
Curious what "practicing outside of scope" typically means RE: board complaints, as sadly - claiming you are a specialist in XYZ after you took a weekend workshop in voodoo therapy seems normative? I'm guessing this comes up more often in assessment settings.

Just genuinely curious if this is more like "Did PE with limited formal training in it" or "Attempted to do a kidney transplant." Scope seems so poorly defined in most areas of psychology, I can't fathom how far one would need to overstep for actual board action....
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I'm thinking of a couple who dips their toes into the custody evaluation domain and makes recommendations that are pretty biased because they've never been adequately trained and did not seek supervision. However, I should also add, that I work with kids, and generally only pay attention to board complaints involving children/families.
 
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As aside - I've seen our board mess up hard a couple of times. One time a psych (complaint filed by ex-husband of client, who psych had brought in for couple work), was using snap chat and doing all sort of boundary violations that clearly indicated a sexual/romantic relationship. But because the wife and psych denied it, they got him for working with BPD without adequate training. Fast forward three months - and another patient from another state files a complaint that they had sex...

The next one was a psych who practiced at her home, and a client shows up and psych is def drunk as all hell. Patient makes a complaint, psych even shows up WEARING SUNGLASSES because fluorescent lights CAUSE MIGRAINES for her. They let her go after asking about how many headaches she has. Fast forward six months and the police get called for a wellness check during a session because the psychologist is so drunk.

But god forbid you don't document that two second phone call.
 
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borne_before said:
As aside - I've seen our board mess up hard a couple of times. One time a psych (complaint filed by ex-husband of client, who psych had brought in for couple work), was using snap chat and doing all sort of boundary violations that clearly indicated a sexual/romantic relationship. But because the wife and psych denied it, they got him for working with BPD without adequate training. Fast forward three months - and another patient from another state files a complaint that they had sex...

The next one was a psych who practiced at her home, and a client shows up and psych is def drunk as all hell. Patient makes a complaint, psych even shows up WEARING SUNGLASSES because fluorescent lights CAUSE MIGRAINES for her. They let her go after asking about how many headaches she has. Fast forward six months and the police get called for a wellness check during a session because the psychologist is so drunk.

But god forbid you don't document that two second phone call.
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As to the first situation, probably more of a CYA thing, unless you have an absolute smoking gun, you're in for a lawsuit. Second one too, without a BAC count, you have no concrete evidence. You either need to have something concrete to go on, or multiple instances in which to point to a preponderance of evidence.
 
Yeah...that's about what I thought.

I wonder if "Working with BPD without adequate training" have ever come up outside of cases where people sleep with patients....
 
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Ollie123 said:
Yeah...that's about what I thought.

I wonder if "Working with BPD without adequate training" have ever come up outside of cases where people sleep with patients....
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Sounds like a great reason to not accept BPD patients if you don't want them.
 
So, as long as I'm DBT-trained, sleeping with patients is okay? (disclaimer: I'm obviously joking)

Ollie123 said:
Yeah...that's about what I thought.

I wonder if "Working with BPD without adequate training" have ever come up outside of cases where people sleep with patients....
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From what I've read and seen, I highly doubt it.
 
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I have never remotely felt tempted to sleep with a patient. Must be finding them in the wrong places.
 
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WisNeuro said:
At that point, just go into sexual surrogacy work
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But then you have to do it with all the patients that need it, not just when you feel like it. Back to to responsibilities...sigh. They made this job seem more fun on TV.
 
Latest issue I’m dealing with: figuring out who the patient is seeing for therapy - patient reports seeing a psychologist, I go look them up it says Christian Psychologist. Took me a while to figure out that they are not in fact a psychologist
 
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tr said:
Er... Don't you work at the VA? Forgive me but the temptations there seemed... minimal
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I work for the VA and in geriatrics, so not really any temptations for me. However, that isn't really funny.
 
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allantois said:
Latest issue I’m dealing with: figuring out who the patient is seeing for therapy - patient reports seeing a psychologist, I go look them up it says Christian Psychologist. Took me a while to figure out that they are not in fact a psychologist
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The term psychologist is protected in many states, if they are not a licensed psychologist, and use that term, they are likely open to legal action.
 
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WisNeuro said:
The term psychologist is protected in many states, if they are not a licensed psychologist, and use that term, they are likely open to legal action.
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If someone is not a licensed psychologist, but calls themselves a psychologist, who will they get in trouble with? I can’t imagine the licensing board since they are not, in fact, licensed.

I have seen an influx of posts in my immigrant community of people coming here and advertising themselves as a “psychologist, therapist, numerologist, coach” (YES all of those terms listed at once!!)

When I ask them where they are licensed and for what, I get told to mind my own business because back in the homeland they practiced for years and were certified as so and so. Don’t have any intentions of being licensed here.

I am left wondering how to respond and why I bothered going to graduate school and going through the licensure process when I could have just been *all the things* without taking the pesky EPPP or crying over dissertation 😂
 
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bluecolourskies said:
If someone is not a licensed psychologist, but calls themselves a psychologist, who will they get in trouble with? I can’t imagine the licensing board since they are not, in fact, licensed.

I have seen an influx of posts in my immigrant community of people coming here and advertising themselves as a “psychologist, therapist, numerologist, coach” (YES all of those terms listed at once!!)

When I ask them where they are licensed and for what, I get told to mind my own business because back in the homeland they practiced for years and were certified as so and so. Don’t have any intentions of being licensed here.

I am left wondering how to respond and why I bothered going to graduate school and going through the licensure process when I could have just been *all the things* without taking the pesky EPPP or crying over dissertation 😂
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Depends on your state statutes, could be your department of human/health services. Your state board will have the appropriate referring info. After reporting, generally they will get a cease and desist for practicing without a license/deception/public welfare/etc. After that they can be subject to fine and/or criminal prosecution.
 
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bluecolourskies said:
If someone is not a licensed psychologist, but calls themselves a psychologist, who will they get in trouble with? I can’t imagine the licensing board since they are not, in fact, licensed.

I have seen an influx of posts in my immigrant community of people coming here and advertising themselves as a “psychologist, therapist, numerologist, coach” (YES all of those terms listed at once!!)

When I ask them where they are licensed and for what, I get told to mind my own business because back in the homeland they practiced for years and were certified as so and so. Don’t have any intentions of being licensed here.

I am left wondering how to respond and why I bothered going to graduate school and going through the licensure process when I could have just been *all the things* without taking the pesky EPPP or crying over dissertation 😂
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"As a licensed psychologist it is my business and I am deciding whether to report you to the state for practicing psychology without a license."
 
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The individual in question is licensed as a counselor
 
The board protects the profession, meaning they may choose to go after people who are pretending to be in the profession.
 
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AbnormalPsych said:
The boards I am familiar with make it clear they protect the public. They don't give a **** about the profession.
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I'd say that ours has its number one priority as protection of the public, but they also highly value integrity of the profession, as they have acted on ethical issues that have not involved any patient harm issues.
 
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WisNeuro said:
No one cares about board complaints, you'll likely get one at some point. You worry about board actions. You generally only get board actions when you royally f up.
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I just found this statement to be true :cryi:. Can't get into specifics, but man, this sucks. Thank god for lawyers, though.
 
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WisNeuro said:
Did you use your own, or the one (likely) included in your liability coverage?
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So, my work has in house council and pays for our liability coverage. They've done a ton of med and nursing board complaints, but never the psych board before. So they are paying for the lawyer I selected (up to 15k). I was willing to throw 5-10g's of my own cash for this one, so it feels good that my work has got my back. The lawyer selected seems to have the best outcomes and is licensed psych and JD. Now we're just in record releasing bureaucracy purgatory with our risk and compliance officers - who want the board to subpoena the records department for records. Apparently the medical boards usually want a records department to send in the records and can't believe the psych board is cool with my lawyer sending in the chart.

I've got a month to get all records and my response to them. But, I've drafted my response, which is being looked at right now, then it'll be a month or two before I go speak at the screening committee. My lawyer thinks the complaint is spurious and has a good chance of getting dismissed at the screening level and he's not very concerned. But, still it sucks. His demeanor changed to much more relaxed when he read the complaint.

Still - didn't think I'd be getting one this early in my career. I've only renewed my license twice. But anyone can make a complaint, and the bar for making one is very low. My lawyer has assured me, that in the type of work I do, assessing kiddos, this won't be my last.

I preemptively went down to .75 fte this month so I can exercise while the kids are at daycare, started with my therapist again, and started my old friend lexapro again. I'm not gonna let this ruin my ability to be a present parent, my health, my career, or my relationships. Or impact the meaning and purpose I get from this job.

What sucks is all the second guessing you do.
 
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borne_before said:
So, my work has council and pays for our liability coverage. They've done a ton of med and nursing board complaints, but never the psych board before. So they are basically paying for the lawyer I selected. I was willing to pay cash for this one. The one selected seems to have the best outcomes and is licensed psych and JD. Now we're just in record releasing bureaucracy purgatory with our risk and compliance officers. I've got a month to get all records and my response to them. But, I've drafted my response, which is being looked at right now, then it'll be a month or two before I go speak at the screening committee. My lawyer thinks the complaint is spurious and has a good chance of getting dismissed at the screening level and he's not very concerned. But, still it sucks. His demeanor changed to much more relaxed when he read the complaint.

Still - didn't think I'd be getting one this early in my career. I've only renewed my license twice. But anyone can make a complaint, and the bar for making one is very low. My lawyer has assured me, that in the type of work I do, assessing kiddos, this won't be my last.

I preemptively went down to .75 fte this month so I can exercise while the kids are at daycare, started with my therapist again, and started my old friend lexapro again. I'm not gonna let this ruin my ability to be a present parent, my health, my career, or my relationships. Or impact the meaning and purpose I get from this job.

What sucks is all the second guessing you do.
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As long as you're following a broadly defined standard of practice, no need to second guess.
 
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WisNeuro said:
As long as you're following a broadly defined standard of practice, no need to second guess.
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Dude, they mailed me the notice on a Friday. I read it as I was gonna go get my kids at home. My heart sank, and I called this lawyer. But that was such a ****ty weekend. But, I got in early on monday, looked over everything and my heart just felt better. I def followed standards and best practices during this assessment.
 
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borne_before said:
Dude, they mailed me the notice on a Friday. I read it as I was gonna go get my kids at home. My heart sank, and I called this lawyer. But that was such a ****ty weekend. But, I got in early on monday, looked over everything and my heart just felt better. I def followed standards and best practices during this assessment.
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All part of the game. This will be a good learning experience for next time as long as everything checks out.
 
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WisNeuro said:
All part of the game. This will be a good learning experience for next time as long as everything checks out.
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It got dismissed. I’m two drinks in and about to take nap before the kids come home!!!
 
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EMDR=exposure therapy=eyeroll
Van der Kolk? Ugh

Masters trained. Not everyone drinks the kool aid.
 
I was gifted the book. It is still in the sealed plastic bag that it came in 2 years later.
 
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psychma said:
I was gifted the book. It is still in the sealed plastic bag that it came in 2 years later.
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Similarly, I tried to read Francine Shapiro's EMDR book...once...couldn't make it past the first two pages of neurobabble.
 
I kind of wish we required psych students to take a pseudo-science class to talk about meta-theory and expose students to the direct stuff our clients use (required Tik Tok exposure to MH stuff, that crappy twitter therapist I hate who does 'trauma' everything, body keeps score, EMDR, etc). Clearly Lilianfeld is the required text. I think most of our students just dont know whats real to clients, or how to discuss with them

It would also probably make the fights between CBT and Humanistic (common v specific) far less robust if they just agreed 'lets get rid of trash'.
 
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psycho1391 said:
Anytime someone asks me if I have read "The Body Keeps The Score", I die a little on the inside.
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I read this. It's not a scientific treatise. It's a distillation of the experiences of one clinician who specializes in trauma.

The underlying point that early life adversity has broad and lasting effects on multiple body systems, including endocrine, metabolic, cardiovascular, etc is very well scientifically established, but perhaps not widely appreciated among the lay public. TBKTS gets this across in a readable way.

The uncritical promotion of poorly established therapies is regrettable, but understandable in the context that we don't actually have any evidence based therapies that acknowledge or address this issue of somatic weathering/allostatic load, so it's unsurprising that woo should spring in to fill the gap.
 
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I definitely think that PE and CPT need better social media presence, especially on TikTok.

I don't like van der Kolk, as you all know, but I do think that The Body Keeps the Score is overall a good and helpful book. It's the stuff he started saying later on that I find to be the issue.
 
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cara susanna said:
I definitely think that PE and CPT need better social media presence, especially on TikTok.

I don't like van der Kolk, as you all know, but I do think that The Body Keeps the Score is overall a good and helpful book. It's the stuff he started saying later on that I find to be the issue.
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My impression of TBKTS from what I know of it is that it can be helpful for people with a good pre-existing knowledge of EBT for trauma but if you don’t have that, it’s easy to read the takeaway as “movement therapy is the only hope for PTSD.” 🤷‍♀️
 
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cara susanna said:
I definitely think that PE and CPT need better social media presence, especially on TikTok.
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100%. Unfortunately the EMDR marketing machine has made it very difficult for those of us still trying to wave the PE and CPT flags :(
 
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tr said:
I read this. It's not a scientific treatise. It's a distillation of the experiences of one clinician who specializes in trauma.

The underlying point that early life adversity has broad and lasting effects on multiple body systems, including endocrine, metabolic, cardiovascular, etc is very well scientifically established, but perhaps not widely appreciated among the lay public. TBKTS gets this across in a readable way.

The uncritical promotion of poorly established therapies is regrettable, but understandable in the context that we don't actually have any evidence based therapies that acknowledge or address this issue of somatic weathering/allostatic load, so it's unsurprising that woo should spring in to fill the gap.
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It has generally been a net positive for my patients. It seems to me that their main takeaway is that traumatic experiences can affect them physically. My read on it was about the same as yours, although to be honest, I really just zipped through it and didn’t read very critically.
 
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