Let’s talk about your license. Why do you even have one? There are three main reasons why the State of California requires anyone providing mental health services to hold a license.
First, the state wants to eliminate quackery. Licensing ensures that any therapist has adequate professional training and is not just “winging it.”
Second, the state seeks to promote good behavior. It believes that if it maintains leverage over your ability to practice, you will be less likely to stray from the path of righteousness—within your professional life and otherwise.
Third, the state culls “bad therapists” by taking away their license.
All these methods serve the larger goal of protecting the public. And who exactly protects the public against unsavory therapists? That is your licensing board, i.e., the BBS.
In other words, the BBS is not exactly your friend or ally. If you come to the board’s attention, it will scrutinize your conduct and perhaps take away your license and livelihood. If the board finds that you engaged in “unprofessional conduct,” it can require you to jump through a zillion hoops—such as retaking licensing exams, taking or repeating coursework, being supervised, undergoing psychological evaluation, entering a rehabilitation program, submitting to random drug and alcohol testing, etc.—as a condition of continuing to practice.
From the board’s perspective, the license under which you practice is not really “yours.” It is on loan from the state, and conditioned upon good behavior, competence, and adherence to professional rules. For the numerous varieties of “unprofessional conduct” which can get you into trouble with the BBS, see our Law & Ethics CE No. 3, Managing Your Practice under California Law.
And what does your license enable you to do? Well, it’s a pretty big deal. Specifically, as a licensed psychologist, MFT, LCSW, or LPCC, you are expressly allowed to engage in the practice of “psychotherapy.” Licensed educational psychologists (LEPs) are not expressly licensed to conduct “psychotherapy,” but their licensure does extend to “providing psychological counseling for individuals, groups, and families” and “coordinating intervention strategies for management of individual crises”—which are certainly in the same ballpark.
California defines “psychotherapy” as:
- the use of “psychological methods”
- in a professional relationship
- to help a person acquire greater human effectiveness or to modify feelings, conditions, attitudes and behavior which are emotionally, intellectually, or socially ineffectual or maladjustive.
Exactly where is the line separating “psychotherapy” from other methods of helping a person cope with life issues? Suppose a life coach, who has no license whatsoever, begins tracing the roots of a person’s difficulties to childhood, or begins using cognitive-behavioral techniques to help modify a person’s feelings or psychological symptoms. If that is within the context of a “professional relationship” (i.e., they are getting paid), the coach is crossing the line into the unlicensed practice of psychotherapy.
The following are the defining contours of each psychotherapy licensure (except for psychiatrists and psychologists) in California.
- 1. Marriage and Family Therapists (MFTs)
- MFTs can perform psychotherapy with individuals, families, and groups. They can administer psychological tests, but only within the context of an ongoing therapy relationship, and only with appropriate training in that test. (Cal. Atty. Gen. Op. No. 83-810, June 28, 1984.)
- 2. Licensed Clinical Social Workers (LCSWs)
- LCSWs can perform psychotherapy with individuals, families, and groups.
- The issue of whether LCSWs can administer psychological testing is somewhat uncertain. The California Chapter of NASW (National Association of Social Workers) takes the position that the relevant statutory language authorizes LCSWs in California to administer and interpret psychological tests as long as they have the appropriate education and experience in a particular test.
- 3. Professional Clinical Counselors (LPCCs)
LPCCs can perform psychotherapy with individuals.
LPCCs may not assess or treat couples or families unless they have completed additional training. This training requirement can be met by: (1) taking six semester units or nine quarter units specifically focused on marriage and family therapy; or (2) having a named specialization or emphasis area in the qualifying degree in marriage and family therapy, marriage, family, and child counseling, or couple and family therapy. Also, an LPCC must have 500 or more hours of documented supervised experience working directly with couples, families, or children. An LPCC must also complete at least six hours of continuing education that is specific to marriage and family therapy during each two-year license renewal cycle.
LPCCs may use many psychological tests, within the context of an ongoing counseling relationship. They may not, however, use “projective” tests of personality (such as the Rorschach test), individually administered intelligence tests, neuropsychological tests, or a battery of three or more tests to assess psychosis, dementia, amnesia, cognitive impairment, or criminal behavior.
4. Educational Psychologists (LEPs)
LEPs can serve a variety of functions, all of which must pertain to “academic learning processes” or “the educational system.” These include performing educational evaluations, diagnosing psychological disorders relating to academic learning, administering and interpreting psychological tests relating to academic learning, and providing “psychological counseling.”
California law requires that you not only be licensed, but that you communicate the details of your licensure to each client. The following specific rules apply. We strongly advise that, for each one, you provide the information on an informed consent form signed by the client. That way, there is no doubt you communicated the required material.
- Include your full name as filed with the board, your licensure, and your license number on your informed consent form, just as you do on all your marketing materials. For your required disclosures in all advertising, see our Law & Ethics CE No. 3, Managing Your Practice under California Law.
- If you are providing therapy under a fictitious business name, inform the client prior to beginning treatment of the names and licensures of the owners of the practice. (See, e.g., Cal. Bus. & Prof. Code § 4980.46.)
- If you are a trainee, intern, or associate (i.e., not licensed yet), inform each client before beginning treatment that you are unlicensed. Say that you are, for example, an “unlicensed Associate Clinical Social Worker.” Also tell the client that you are providing therapy under supervision, and provide the name and licensure of your supervisor. Tell the client verbally, and put it on your informed consent form as well. (See, e.g., Cal. Bus. & Prof. Code § 4980.44(c).)
- Last, do not forget this simple rule: display your license in a conspicuous place at your primary place of business.
For detailed guidance to complying with California rules, see our Law & Ethics CE No. 3, Managing Your Practice under California Law.
For broader guidance about practicing within your scope of licensure and your scope of competence, see ourLaw & Ethics CE No. 1, Minimizing Legal-Ethical Risk in Psychotherapy