by Judy E. Hall, Ph.D.
This is a question on the minds of doctoral students, internship and postdoctoral training programs, doctoral programs, licensing boards, state/provincial psychology organizations and the American Psychological Association. In 2000, I participated in the APA Commission on Education and Training Leading to Licensure in Psychology. The 30 person commission recommended that the two year supervised experience requirement leading to licensure be made more flexible. One year of supervised experience could be completed prior to the award of the doctoral degree, in addition to the internship, or up to one year following the receipt of the doctoral degree. The National Register agrees with this principle.
Most of the education and training councils oppose this recommendation. Many graduate students and early career psychologists aggressively support the recommendations. I do not intend to address specific arguments made by either group. The purpose of this column is to point out why the National Register supported the 2001 Commission report in letter to then APA President Norine Johnson, Ph.D., and still does today.
The National Register Response to the Commission Report
Peter Nathan, Ph.D., as Chair of the National Register Board of Directors in 2001, wrote, “When the NR was created in 1973, there was confusion about what a doctoral program in psychology was, there were no internship criteria, and the year of postdoctoral supervised experience was a standard in only a few states. The National Register and APA provided a forum in 1976 and 1977 that led to the development of the designation criteria that identify standards programs must meet to be designated as programs in psychology. The designation criteria are now routinely used by licensure and certification boards to determine eligibility. The National Register implemented the designation of doctoral programs in psychology in 1980 and was joined by ASPPB in 1987. Also, in 1980 the National Register developed the criteria for internship training that formed the basis for subsequent criteria adopted by APPIC and APA. The third criterion of the National Register, that of one year of supervised postdoctoral experience, has been adopted by all but one state as part of the standards for licensure. We recognize that those changes took several years to occur and that other national bodies were involved in promoting those standards. However, it should be noted that the National Register started out in 1973 with a very distinctive standard for definition of a health care provider in psychology.”
Over the next thirty years each state, except one (AL), added a year (or more) of supervised postdoctoral experience to their licensure requirements, essentially bringing their requirements in line with the National Register credentialing requirements and the APA Model Act for State Licensure of Psychologists which followed in 1987.
In considering this issue in 2001, the National Register Board of Directors first underscored the fact that the year of postdoctoral experience is and will remain a requirement for the National Register Health Service Provider in Psychology credential, regardless of whether licensing boards modify their requirements. However, the Board of Directors did see the wisdom in allowing students the opportunity to meet the requirements for licensure at the time that they graduate with their doctoral degree. There were several reasons for this decision. The letter to Dr. Johnson continued as follows: “The Board of Directors believes that the policy proposed by the Commission would enable the discipline to be more in control of its educational and training programs that prepare psychologists to practice independently. Currently, postdoctoral supervised experiences are the least integrated element of our training requirements, are seldom accredited experiences, and are the least likely to occur in an organized setting. Bringing the supervisory requirement under the supervision of academic programs should, over time, correct for such problems. However, for the expected benefits to be realized, doctoral programs will have to improve their oversight and involvement in the various forms of supervised practice experiences in which their students participate.
Dr. Nathan pointed out that there are other reasons to support this APA policy change. First, this brings psychology into conformity with the way many other doctoral-level health care professions prepare their practitioners for licensure. Second, the policy recognizes that the discipline’s educational and training programs continue to improve in quality, and therefore have become more extensive and intensive than they were when the currently accepted model was promulgated.
A Major Challenge: Provide Incentives for Newly Emerging Psychologists to Pursue Postdoctoral Education and Training and Credentialing Opportunities
Washington became the first state to modify its licensure requirements to correspond with the proposed and now effective APA policy. With the pressure being applied from many groups, we presume that a few other states will move in that direction in the relatively near future. This will help early career psychologists get licensed earlier. But we encourage all psychologists to pursue postdoctoral supervised experience. Here are a few reasons.
Change Happens Slowly
In our experiences working with licensing boards, including our efforts to incorporate the National Register credential to expedite mobility, board decisions and regulation/law changes tend to go very slowly. This is not an indictment of licensing boards, it is simply a realization that licensing boards have many challenges and responsibilities. Even if boards decide to un-couple the postdoctoral year, it could be several years before the changes are effective. Regardless of how this trend progresses, we encourage psychologists not to box themselves into any particular state by ignoring postdoctoral supervision requirements that will likely be required for licensure in many states for years to come.
There is Still a Need for Supervised Postdoctoral Experience
Some people described the commission report as getting rid of the postdoctoral year of experience, which is inaccurate. In fact, the 2001 Commission Report made it clear that, “Postdoctoral education and training remains an important part of the continuing professional development and credentialing process for professional psychologists.” Then more recently, the report on this proposed policy to the APA Council of Representatives (C/R) added that, “Postdoctoral education and training is a foundation for practice improvement, advanced competence, and inter-jurisdictional mobility.” The difference is that once licensed, upon the basis of two years of experience acquired before the granting of the degree, the graduate could compete effectively as a licensed psychologist while completing a year of postdoctoral supervised experience.
The National Register Requirements
The National Register does not intend to change its criteria for credentialing as a health care provider in psychology. Consistency in our gold standard is our guarantee to the public and the healthcare environment. The year of postdoctoral supervised experience in health service provision is part of what we verify to state/provincial regulatory bodies when Registrants seek expedited licensure. Now with 40 jurisdictions approving the National Register as a mobility mechanism for licensure and for state health service provider qualification, where that exists, the year of postdoctoral experience is even more important than 30 years ago. The added year of supervised postdoctoral experience gets them the National Register credential, which then leads to mobility and specialty/proficiency credentialing. If all credentialing organizations stand behind the requirement for postdoctoral education and training, the incentives will remain for licensed psychologists to seek further peer review and supervision in postdoctoral health care service provision.
In 2005, APA appointed a Work Group to address the Recommendations of the Commission on Education and Training Leading to Licensure in Psychology. Their recommendation was approved as policy by APA C/R in February, 2006. Now it is up to the states whether they implement this change in licensure requirements. And regardless of any changes, it is up to psychologists and psychological organizations to demonstrate a commitment to continued professional growth by supporting the necessity for postdoctoral education, training and supervised experience.