Understanding The Qualifications And Differences Between Professionals
By: Mentor Research Institute
Revised: March 28, 2021
Degree(s). The type of degree or number of degrees a professional has attained indicates their exposure to academic education, their ability to assimilate the relevant body of knowledge and their ability to perform successfully in a academic or research setting. A degree in psychology, counseling, social work or medicine is not by itself a good indicator of professional skill, competence or compassion. An individual with a doctoral degree has been formally exposed to a more advanced and demanding knowledge base than a person with a master's degree. The person with a doctoral degree may have been exposed to a rigorous clinical training internship and residency. However, academic programs vary significantly in terms of the quality of students they graduate. A doctoral degree is not better than a masters degree.
The are people with doctoral degrees that were not related to the area in which they practice. For instance, there are professionals who refer to themselves as Doctor and are licensed but they may be a licensed masters level counselor and hold a Ph.D in English. There is also a difference between a Ph.D and a Psy.D. A Psy.D is a doctorate in the professional practice of psychology. Nearly all Ph.D programs in psychology have a training focus which emphases research and skills necessary to pursue an academic career in psychology, only a few include clinical practice exposure. The distinctions between doctorates and masters degrees alone are insufficient to differentiate the competence of a licensed counselor or therapist. Some programs in counseling, in psychology and in social work are outstanding. Others can be abusive, model callous attitudes, and may actually "weed out" caring and competent people, retaining students primarily on the basis of academic performance or ability to publish research. The level of fame or notoriety achieved by a university may be associated with successful research programs, or success in the distant past, and may not necessarily b related to training for clinicians that will benefit you as a consumer.
License(s). In Oregon, practitioners must be licensed or be supervised by a licensed professional to legally practice psychotherapy, provide consultation or practice counseling or make a mental health related diagnosis. However, there are people who call themselves “counselor” or “therapist” who practice with no license. They may or may not have training. Having a license is the first indicator that a professional has demonstrated competence to practice. However licensure alone is not a reliable predictor that the person is a good practitioner or the right person for you. Licenses are issued by a Licensing Board designated by States where a professional wishes to practice. The fact that a person has a license does not mean the professional is truly competent. It does mean they met the required educational and training requirements, passed a licensing examination, have met the necessary supervision requirements for licensure, and that they are meeting required continuing education requirements.
The fact that a person has lost their license, has been suspended, or sanctioned by their licensing board is an indictor that the professional's competence and judgment have been questionable. Licensing Boards protect the public by denying licensure to people who lack required knowledge and skill, and by sanctioning or removing the status of a license status when professionals have had complaints filled against them sustained through licensing board investigation.
Practicing without a license is not problematic only when the person is supervised by a licensed professional in their process of qualifying for license. In fact it could be to your advantage since those working to qualify for license often charge lower fees.
Your records and your relationship with an unlicensed, or unsupervised therapist are not confidential. That means that your records can be released by the unlicensed counselor or therapist or subpoenaed during legal or administrative proceedings despite any objection you may make.
Training & Certifications. A professional's training or certifications can provide evidence of competence and knowledge within particular areas of practice. Unfortunately, many certifications are little more than marketing tools that create the appearance of competence or special ability. Often only another professional can discern whether or not particular trainings or certifications are meaningful. Many professionals will state they are certified in a certain treatment method, but if you call the particular training institute, you may discover they provide training, but do not give certification. Specific certifications are necessary to conduct court ordered or forensic evaluations. Beyond that, certification is usually no substitute for credible experience and the recommendations of past clients or patients.
Availability. There are four categories of professionals’ availability. Routine means the professional is generally available on a weekly basis. Urgent indicates the professional is generally available within 72 hours. Crisis means the professional or their backup is available to see you within 24 hours. Emergency means you will be seen right away or as soon as reasonably possible. An emergency would generally be seen immediately or within 1 to 8 hours.
Affiliations. Affiliations reflect what organizations or institutes a professional has joined or is involved with. Affiliations alone are not good indictors of professional competence, but can help you identify those professionals who support and participate in activities that demonstrate their professional interests. While many professionals find it offensive as well as an unkind observation about their profession as a whole, there are practitioners who simply join organizations to enhance their resume and to help market their practice. It may help you to feel better about a professional if you ask questions about their interests, involvement and activities within organizations to which they are affiliated.
Fees & Costs. The fees set by a professional in no way indicates their level of competence or the actual demand for their services. It is a fairly common practice for professionals to charge fees that support a very small practice of 5 or 6 clients. Likewise, low fees do not necessarily indicate a professional is not as competent as a professional who charges a much higher fee. Psychotherapy fees can range from $45 per hour to $195 or more per hour in Oregon. Evaluation and expert witness fees generally exceed $100 per hour and can exceed $200 per hour. There has been considerable debate among consumers and within corporate health care as to whether psychotherapy services warrant fees in excess of $90 per hour. Keep in mind that a professional who met 8 patients per day at $90 per hour would bill $720 per day, $3600 a week, and might have gross income of $150,000 to $170,000 per year. (Very few professionals see 8 patients a day, 5 days a week, The typical weekly case load for mental health practitioners is 24-30 sessions. Their business overhead and taxes consume 40 to 60% of their gross income. No matter how many hours they work, you have the right to expect that people who command professional fees are well trained, respectful, professional, licensed, ethical, effective and come well recommended.
Specializations. Many counselors and psychotherapists are in general practice. Some professionals choose to specialize in certain areas and have acquired specialty skills from programs of education and training. To claim a specialization, a professional should have some evidence in the form of a certification or record of continuing education training reported to their licensing Board. A professional who claims a specialization should be able to readily describe their program of training that helped them develop the special skill and experience. It is quite rare that any professional can claim specialization in more than four areas. Specialization is a higher standard than a professional's Focus of Practice & Interest.
For example, working in a hospital does not make a professional a specialist in medical psychology, medical social work, etc.. Having a deep spiritual belief system or spiritual practice does not make them a specialist in spirituality. Keep in mind that professionals with fewer than 10 years of experience will rarely have 4 documented areas of specialization. Keep in mind that a specialization needs to represent a level of skill that one could reasonably defend to a Professional Licensing Board or to a jury in a court of law if they were involved in a court proceeding.
Focus of Practice & Interests. While many professionals may have one or two specialties, they often have experience and training regarding several areas of practice and interests. This information tells you about what a professional does and what kind of work they find interesting. Having a therapist or counselor who is curious and interested in the kind of service you may need can be important. A therapist can be interested in many aspects of mental health and have only a few specializations.
Background & Experience. Knowing where a professional has worked, their background and their experience can help you understand their skills and the talents they bring as an therapist, evaluator or expert. In general, the more rich a professional's background the greater will be his or her ability to recognize a range of problems and potential solutions. Dealing with complex problems, especially crises and emergencies, usually requires the involvement of professionals with credible experience in these areas.
Patient & Client Populations Served. Not all professionals are qualified to treat all populations. In fact, very few professionals are truly able to treat children, and teenagers, and adults, and elders. Work with children and early teens requires consideration of a number of criteria that you should be clear about before your child or young teen enters treatment. For instance, a professional may choose to not work with a child unless the entire family is involved. Others may only work with a child if the family is not involved. This depends on the problem and the professional’s therapeutic orientation.
Therapeutic Orientation & Approach. To some extent, the manner in which a professional will choose to approach a problem can provide information that can help determine whether or not you may benefit from therapy. While there are approaches to treatment that are stereotypic, good therapy does not necessarily belong to any one discipline, or orientation, or approach. If you have benefited from a particular approach in the past, you might consider staying with that approach. And while a different approach may be indicated after a failure to respond, there is still a possibility that you would benefit from another trial of the same approach.
In some decades, psychotherapy techniques can become trendier than a Twitter feed and less therapeutic. Beware of therapy techniques that are revolutionary, miraculous, easy or promise “quick cures” for problems that have existed for a long time.