Psychologists, Counselors, and Mind-Body Professionals

Psychologists, Counselors, and Mind-Body Professionals: what's the difference?

And, can a non-licensed person practice emotional release techniques in a state that allows non-licensed health providers to practice?

There are no easy answers, but here are some helpful thoughts.

The few states that current have laws allowing non-licensed healers and therapists to deliver health care services (under certain specified constraints, such as disclosure rules), primarily address the risk of prosecution for unlicensed medical practice; they do not necessarily (or satisfactorily) address the risk of prosecution for unlicensed practice of psychology.

"Psychology" or "psychotherapy" can be defined very broadly by statute so as to encompass just about any kind of counseling, coaching, or other form of professional interaction that addresses 'maladaptive behaviors' or others seeks to increase the 'effectiveness' of behavioral responses, or to deal with the emotions.

Thus, techniques such as "EFT" by non-licensed providers could potentially fall within the ambit of unlicensed practice of psychology.

And despite the statutes aiming to protecting unlicensed practitioners, such providers could still face legal risk.

For those who are interested in potentially upgrading their training in healing modalities offered by the unlicensed, for the non-licensed, a helpful resource is available from U.S. Department of Labor Bureau of Labor Statistics, Occupational Outlook Handbook. It tells us, for example, about the occupational definition of (and requirements for) psychologists and about the same for related professions such as counselors.

Thus:

"Psychologists study the human mind and human behavior. Research psychologists investigate the physical, cognitive, emotional, or social aspects of human behavior. Psychologists in health service provider fields provide mental health care in hospitals, clinics, schools, or private settings. Psychologists employed in applied settings, such as business, industry, government, or nonprofits, provide training, conduct research, design systems, and act as advocates for psychology.

Like other social scientists, psychologists formulate hypotheses and collect data to test their validity. Research methods vary with the topic under study. Psychologists sometimes gather information through controlled laboratory experiments or by administering personality, performance, aptitude, or intelligence tests. Other methods include observation, interviews, questionnaires, clinical studies, and surveys.

Psychologists apply their knowledge to a wide range of endeavors, including health and human services, management, education, law, and sports. In addition to working in a variety of settings, psychologists usually specialize in one of a number of different areas.

Clinical psychologists--who constitute the largest specialty--work most often in counseling centers, independent or group practices, hospitals, or clinics. They help mentally and emotionally disturbed clients adjust to life and may assist medical and surgical patients in dealing with illnesses or injuries. Some clinical psychologists work in physical rehabilitation settings, treating patients with spinal cord injuries, chronic pain or illness, stroke, arthritis, and neurological conditions. Others help people deal with times of personal crisis, such as divorce or the death of a loved one.

Clinical psychologists often interview patients and give diagnostic tests. They may provide individual, family, or group psychotherapy and may design and implement behavior modification programs. Some clinical psychologists collaborate with physicians and other specialists to develop and implement treatment and intervention programs that patients can understand and comply with. Other clinical psychologists work in universities and medical schools, where they train graduate students in the delivery of mental health and behavioral medicine services. Some administer community mental health programs.

Areas of specialization within clinical psychology include health psychology, neuropsychology, and geropsychology. Health psychologists promote good health through health maintenance counseling programs designed to help people achieve goals, such as stopping smoking or losing weight. Neuropsychologists study the relation between the brain and behavior. They often work in stroke and head injury programs. Geropsychologists deal with the special problems faced by the elderly. The emergence and growth of these specialties reflects the increasing participation of psychologists in providing direct services to special patient populations.

Often, clinical psychologists will consult with other medical personnel regarding the best treatment for patients, especially treatment that includes medication. Clinical psychologists generally are not permitted to prescribe medication to treat patients; only psychiatrists and other medical doctors may prescribe certain medications. (See the statement on physicians and surgeons elsewhere in the Handbook.) However, two States--Louisiana and New Mexico--currently allow clinical psychologists to prescribe medication with some limitations, and similar proposals have been made in other States.

Counseling psychologists use various techniques, including interviewing and testing, to advise people on how to deal with problems of everyday living. They work in settings such as university counseling centers, hospitals, and individual or group practices. (See also the statements on counselors and social workers elsewhere in the Handbook.)

School psychologists work with students in elementary and secondary schools. They collaborate with teachers, parents, and school personnel to create safe, healthy, and supportive learning environments for all students; address students' learning and behavior problems; improve classroom management strategies or parenting skills; counter substance abuse; assess students with learning disabilities and gifted and talented students to help determine the best way to educate them; and improve teaching, learning, and socialization strategies. They also may evaluate the effectiveness of academic programs, prevention programs, behavior management procedures, and other services provided in the school setting.

Industrial-organizational psychologists apply psychological principles and research methods to the workplace in the interest of improving productivity and the quality of worklife. They also are involved in research on management and marketing problems. They screen, train and counsel applicants for jobs, as well as perform organizational development and analysis. An industrial psychologist might work with management to reorganize the work setting in order to improve productivity or quality of life in the workplace. Industrial psychologists frequently act as consultants, brought in by management to solve a particular problem.

Developmental psychologists study the physiological, cognitive, and social development that takes place throughout life. Some specialize in behavior during infancy, childhood, and adolescence, or changes that occur during maturity or old age. Developmental psychologists also may study developmental disabilities and their effects. Increasingly, research is developing ways to help elderly people remain independent as long as possible.

Social psychologists examine people's interactions with others and with the social environment. They work in organizational consultation, marketing research, systems design, or other applied psychology fields. Prominent areas of study include group behavior, leadership, attitudes, and perception.

Experimental or research psychologists work in university and private research centers and in business, nonprofit, and governmental organizations. They study the behavior of both human beings and animals, such as rats, monkeys, and pigeons. Prominent areas of study in experimental research include motivation, thought, attention, learning and memory, sensory and perceptual processes, effects of substance abuse, and genetic and neurological factors affecting behavior."

On the other hand, with respect to counselors:

"Counselors assist people with personal, family, educational, mental health, and career decisions and problems. Their duties depend on the individuals they serve and on the settings in which they work.

Educational, vocational, and school counselors provide individuals and groups with career and educational counseling. In school settings--elementary through postsecondary--they usually are called school counselors, and they work with students, including those with academic and social development problems and those with special needs. They advocate for students and work with other individuals and organizations to promote the academic, career, personal, and social development of children and youths. School counselors help students evaluate their abilities, interests, talents, and personality characteristics in order to develop realistic academic and career goals. Counselors use interviews, counseling sessions, interest and aptitude assessment tests, and other methods to evaluate and advise students. They also operate career information centers and career education programs. High school counselors advise students regarding college majors, admission requirements, entrance exams, financial aid, trade or technical schools, and apprenticeship programs. They help students develop job search skills, such as resume writing and interviewing techniques. College career planning and placement counselors assist alumni or students with career development and job-hunting techniques.

Elementary school counselors observe younger children during classroom and play activities and confer with their teachers and parents to evaluate the children's strengths, problems, or special needs. In conjunction with teachers and administrators, they make sure that the curriculum addresses both the academic and the emotional development needs of students. Elementary school counselors do less vocational and academic counseling than do secondary school counselors.

School counselors at all levels help students to understand and deal with social, behavioral, and personal problems. These counselors emphasize preventive and developmental counseling to provide students with the life skills needed to deal with problems before they occur and to enhance students' personal, social, and academic growth. Counselors provide special services, including alcohol and drug prevention programs and conflict resolution classes. They also try to identify cases of domestic abuse and other family problems that can affect a student's development. Counselors interact with students individually, in small groups, or with entire classes. They consult and collaborate with parents, teachers, school administrators, school psychologists, medical professionals, and social workers in order to develop and implement strategies to help students be successful in the education system.

Vocational counselors who provide mainly career counseling outside the school setting are also referred to as employment counselors or career counselors. Their chief focus is helping individuals with career decisions. Vocational counselors explore and evaluate the client's education, training, work history, interests, skills, and personality traits, and arrange for aptitude and achievement tests to assist the client in making career decisions. They also work with individuals to develop their job-search skills, and they assist clients in locating and applying for jobs. In addition, career counselors provide support to persons experiencing job loss, job stress, or other career transition issues.

Rehabilitation counselors help people deal with the personal, social, and vocational effects of disabilities. They counsel people with disabilities resulting from birth defects, illness or disease, accidents, or the stress of daily life. They evaluate the strengths and limitations of individuals, provide personal and vocational counseling, and arrange for medical care, vocational training, and job placement. Rehabilitation counselors interview both individuals with disabilities and their families, evaluate school and medical reports, and confer and plan with physicians, psychologists, occupational therapists, and employers to determine the capabilities and skills of the individual. Conferring with the client, they develop a rehabilitation program that often includes training to help the person develop job skills. Rehabilitation counselors also work toward increasing the client's capacity to live independently.

Mental health counselors work with individuals, families, and groups to address and treat mental and emotional disorders and to promote optimum mental health. They are trained in a variety of therapeutic techniques used to address a wide range of issues, including depression, addiction and substance abuse, suicidal impulses, stress management, problems with self-esteem, issues associated with aging, job and career concerns, educational decisions, issues related to mental and emotional health, and family, parenting, and marital or other relationship problems. Mental health counselors often work closely with other mental health specialists, such as psychiatrists, psychologists, clinical social workers, psychiatric nurses, and school counselors. (Information on physicians and surgeons, psychologists, registered nurses, and social workers appears elsewhere in the Handbook.)

Substance abuse and behavioral disorder counselors help people who have problems with alcohol, drugs, gambling, and eating disorders. They counsel individuals who are addicted to drugs, helping them to identify behaviors and problems related to their addiction. They also conduct programs aimed at preventing addictions from occurring in the first place. These counselors hold sessions designed for individuals, families, or groups.

Marriage and family therapists apply principles, methods, and therapeutic techniques to individuals, families, couples, or organizations in order to resolve emotional conflicts. In doing so, they modify people's perceptions and behaviors, enhance communication and understanding among family members, and help to prevent family and individual crises. Marriage and family therapists also may engage in psychotherapy of a nonmedical nature, make appropriate referrals to psychiatric resources, perform research, and teach courses about human development and interpersonal relationships.

Other counseling specialties include gerontological, multicultural, and genetic counseling. A gerontological counselor provides services to elderly persons and their families when they face changing lifestyles as they grow older. A multicultural counselor helps employers adjust to an increasingly diverse workforce. Genetic counselors provide information and support to families who have members with birth defects or genetic disorders and to families who may be at risk for a variety of inherited conditions. These counselors identify families at risk, investigate the problem that is present in the family, interpret information about the disorder, analyze inheritance patterns and risks of recurrence, and review available options with the family.

... All States require school counselors to hold a State school counseling certification and to have completed at least some graduate course work; most require the completion of a master's degree. Some States require public school counselors to have both counseling and teaching certificates and to have had some teaching experience before receiving certification. For counselors based outside of schools, 48 States and the District of Columbia have some form of counselor licensure that governs their practice of counseling. Requirements typically include the completion of a master's degree in counseling, the accumulation of 2 years or 3,000 hours of supervised clinical experience beyond the master's degree level, the passage of a State-recognized exam, adherence to ethical codes and standards, and the completion of annual continuing education requirements.

Counselors must be aware of educational and training requirements that are often very detailed and that vary by area and by counseling specialty. Prospective counselors should check with State and local governments, employers, and national voluntary certification organizations in order to determine which requirements apply.

As mentioned, a master's degree is typically required to be licensed as a counselor. A bachelor's degree often qualifies a person to work as a counseling aide, rehabilitation aide, or social service worker. Some States require counselors in public employment to have a master's degree; others accept a bachelor's degree with appropriate counseling courses. Counselor education programs in colleges and universities usually are found in departments of education or psychology. Fields of study include college student affairs, elementary or secondary school counseling, education, gerontological counseling, marriage and family counseling, substance abuse counseling, rehabilitation counseling, agency or community counseling, clinical mental health counseling, counseling psychology, career counseling, and related fields. Courses are grouped into eight core areas: Human growth and development, social and cultural diversity, relationships, group work, career development, assessment, research and program evaluation, and professional identity. In an accredited master's degree program, 48 to 60 semester hours of graduate study, including a period of supervised clinical experience in counseling, are required.

Graduate programs in career, community, gerontological, mental health, school, student affairs, and marriage and family counseling are accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP). While completion of a CACREP-accredited program is not necessary to become a counselor, it makes it easier to fulfill the requirements for State licensing. Another organization, the Council on Rehabilitation Education (CORE), accredits graduate programs in rehabilitation counseling. Accredited master's degree programs include a minimum of 2 years of full-time study, including 600 hours of supervised clinical internship experience.

Some counselors elect to be nationally certified by the National Board for Certified Counselors, Inc. (NBCC), which grants the general practice credential "National Certified Counselor." To be certified, a counselor must hold a master's degree with a concentration in counseling from a regionally accredited college or university; must have at least 2 years of supervised field experience in a counseling setting (graduates from counselor education programs accredited by CACREP are exempted); must provide two professional endorsements, one of which must be from a recent supervisor; and must have a passing score on the NBCC's National Counselor Examination for Licensure and Certification (NCE). This national certification is voluntary and is distinct from State licensing. However, in some States, those who pass the national exam are exempted from taking a State certification exam. NBCC also offers specialty certifications in school, clinical mental health, and addiction counseling, which supplement the national certified counselor designation. These specialty certifications require passage of a supplemental exam. To maintain their certification, counselors retake and pass the NCE or complete 100 credit hours of acceptable continuing education every 5 years.

Another organization, the Commission on Rehabilitation Counselor Certification, offers voluntary national certification for rehabilitation counselors. Some employers may require rehabilitation counselors to be nationally certified. To become certified, rehabilitation counselors usually must graduate from an accredited educational program, complete an internship, and pass a written examination. (Certification requirements vary according to an applicant's educational history. Employment experience, for example, is required for those with a counseling degree in a specialty other than rehabilitation.) After meeting these requirements, candidates are designated "Certified Rehabilitation Counselors." To maintain their certification, counselors must successfully retake the certification exam or complete 100 credit hours of acceptable continuing education every 5 years.

Other counseling organizations also offer certification in particular counseling specialties. Usually, becoming certified is voluntary, but having certification may enhance one's job prospects.

Some employers provide training for newly hired counselors. Others may offer time off or provide help with tuition if it is needed to complete a graduate degree. Counselors must participate in graduate studies, workshops, and personal studies to maintain their certificates and licenses.

Persons interested in counseling should have a strong desire to help others and should possess the ability to inspire respect, trust, and confidence. They should be able to work independently or as part of a team. Counselors must follow the code of ethics associated with their respective certifications and licenses.

Prospects for advancement vary by counseling field. School counselors can move to a larger school; become directors or supervisors of counseling, guidance, or pupil personnel services; or, usually with further graduate education, become counselor educators, counseling psychologists, or school administrators. (Psychologists and education administrators are covered elsewhere in the Handbook.) Some counselors choose to work for a State's department of education. For marriage and family therapists, doctoral education in family therapy emphasizes the training of supervisors, teachers, researchers, and clinicians in the discipline.

Counselors can become supervisors or administrators in their agencies. Some counselors move into research, consulting, or college teaching or go into private or group practice."

Information is also provided on working conditions and typical salaries.

Actually, the Department of Labor website is a useful tool for understanding licensing requirements applicable generally to all sorts of health professionals, whether conventional or alternative. For example the DOL writes of chiropractors:

"Chiropractors, also known as doctors of chiropractic or chiropractic physicians, diagnose and treat patients whose health problems are associated with the body's muscular, nervous, and skeletal systems, especially the spine. Chiropractors believe that interference with these systems impairs the body's normal functions and lowers its resistance to disease. They also hold that spinal or vertebral dysfunction alters many important body functions by affecting the nervous system and that skeletal imbalance through joint or articular dysfunction, especially in the spine, can cause pain.

The chiropractic approach to health care is holistic, stressing the patient's overall health and wellness. It recognizes that many factors affect health, including exercise, diet, rest, environment, and heredity. Chiropractors provide natural, drugless, nonsurgical health treatments and rely on the body's inherent recuperative abilities. They also recommend changes in lifestyle--in eating, exercise, and sleeping habits, for example--to their patients. When appropriate, chiropractors consult with and refer patients to other health practitioners.

Like other health practitioners, chiropractors follow a standard routine to secure the information they need for diagnosis and treatment. They take the patient's medical history; conduct physical, neurological, and orthopedic examinations; and may order laboratory tests. X rays and other diagnostic images are important tools because of the chiropractor's emphasis on the spine and its proper function. Chiropractors also employ a postural and spinal analysis common to chiropractic diagnosis.

In cases in which difficulties can be traced to the involvement of musculoskeletal structures, chiropractors manually adjust the spinal column. Some chiropractors use water, light, massage, ultrasound, electric, acupuncture, and heat therapy. They also may apply supports such as straps, tapes, and braces. Chiropractors counsel patients about wellness concepts such as nutrition, exercise, changes in lifestyle, and stress management, but do not prescribe drugs or perform surgery.

Some chiropractors specialize in sports injuries, neurology, orthopedics, pediatrics, nutrition, internal disorders, or diagnostic imaging.

Many chiropractors are solo or group practitioners who also have the administrative responsibilities of running a practice. In larger offices, chiropractors delegate these tasks to office managers and chiropractic assistants. Chiropractors in private practice are responsible for developing a patient base, hiring employees, and keeping records....

Training, Other Qualifications, and Advancement

All States and the District of Columbia regulate the practice of chiropractic and grant licenses to chiropractors who meet the educational and examination requirements established by the State. Chiropractors can practice only in States where they are licensed. Some States have agreements permitting chiropractors licensed in one State to obtain a license in another without further examination, provided that their educational, examination, and practice credentials meet State specifications.

Most State boards require at least 2 years of undergraduate education; an increasing number are requiring a 4-year bachelor's degree. All boards require the completion of a 4-year program at an accredited chiropractic college leading to the Doctor of Chiropractic degree.

For licensure, most State boards recognize either all or part of the four-part test administered by the National Board of Chiropractic Examiners. State examinations may supplement the National Board tests, depending on State requirements. All States except New Jersey require the completion of a specified number of hours of continuing education each year in order to maintain licensure. Chiropractic associations and accredited chiropractic programs and institutions offer continuing education programs.

In 2005, 15 chiropractic programs and 2 chiropractic institutions in the United States were accredited by the Council on Chiropractic Education. Applicants are required to have at least 90 semester hours of undergraduate study leading toward a bachelor's degree, including courses in English, the social sciences or humanities, organic and inorganic chemistry, biology, physics, and psychology. Many applicants have a bachelor's degree, which may eventually become the minimum entry requirement. Several chiropractic colleges offer prechiropractic study, as well as a bachelor's degree program. Recognition of prechiropractic education offered by chiropractic colleges varies among the State boards.

Chiropractic programs require a minimum of 4,200 hours of combined classroom, laboratory, and clinical experience. During the first 2 years, most chiropractic programs emphasize classroom and laboratory work in basic science subjects such as anatomy, physiology, public health, microbiology, pathology, and biochemistry. The last 2 years stress courses in manipulation and spinal adjustment and provide clinical experience in physical and laboratory diagnosis, neurology, orthopedics, geriatrics, physiotherapy, and nutrition. Chiropractic programs and institutions grant the degree of Doctor of Chiropractic.

Chiropractic colleges also offer Postdoctoral training in orthopedics, neurology, sports injuries, nutrition, rehabilitation, radiology, industrial consulting, family practice, pediatrics, and applied chiropractic sciences. Once such training is complete, chiropractors may take specialty exams leading to "diplomate" status in a given specialty. Exams are administered by specialty chiropractic associations.

Chiropractic requires keen observation to detect physical abnormalities. It also takes considerable manual dexterity, but not unusual strength or endurance, to perform adjustments. Chiropractors should be able to work independently and handle responsibility. As in other health-related occupations, empathy, understanding, and the desire to help others are good qualities for dealing effectively with patients.

Newly licensed chiropractors can set up a new practice, purchase an established one, or enter into partnership with an established practitioner. They also may take a salaried position with an established chiropractor, a group practice, or a health care facility."

Interestingly, each such section has a subsection marked "related occupations." So for those contemplating a career in health services, the site is highly useful. For instance, with respect to chiropractic, DOL offers the following (with relevant links):

"Chiropractors treat patients and work to prevent bodily disorders and injuries. So do athletic trainers, massage therapists, occupational therapists, physical therapists, physicians and surgeons, podiatrists, and veterinarians."