Scope of Practice

Scope of practice needs to be updated to ensure that psychologists can use their skills in all relevant settings, such as in integrated care (healthcare settings) and organizations (business, sports teams and organizations). Terms that describe certain principles may also evolve, and our scope of practice should reflect updated professional language.

3. Monitoring interaction with other professions’ scopes of practice

As new professions seek licensure, they may seek to define their own scope of practice. Sometimes these areas may overlap with ours or be subsets of principles developed by psychologists. Legislation defining other professionals should be scrutinized carefully to assess its impact on our profession. Clarifying the boundaries of their practices, and ensuring the wording of our scope of practice reflects new terminology is essential. While other professionals may have interventions and techniques such as psychotherapy or behavioral interventions in common with psychologists does not mean that the entire scope of practice is similar.

• Practice outside scope of practice. Psychologists should take care to practice within the scope of their current license. Additionally, these issues may become cross-profession concerns. Given the overlap across professionals in some activities (i.e., counseling), scope of practice issues can become confusing. Some professionals may not be aware of psychology’s scope of practice, or their own, and may provide services outside their scope of practice. In addition, some professionals may seek out additional training in areas such as testing that are part of psychology’s scope of practice; however, that does not mean that this activity is permitted under their scope of practice and professional license. Individuals who practice outside their scope of practice and provide psychological services without a psychology license should be reported to the Board.

4.

Advocacy and Compliance

Psychology needs to pay attention to ongoing trends in legal and regulatory issues across the healthcare professions. Psychologists should remain alert to the scope of practice of other professionals, as well as proposed licensing acts. As a professional, we must ensure that our ability to practice to the full extent of our training is not impeded by other professionals or our own licensing act.

New Directions

Recently, the American Psychological Association updated its model licensing act that includes a scope of practice. This model act clearly delineates procedures psychologists are able to perform such as supervision and applied behavioral analysis. It also more explicitly addresses healthcare settings and organizations. It also creates new terms to define specialty practices such as applied psychology and health service provider.

“Practice of psychology” is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purposes of (a) preventing, eliminating, evaluating, assessing, or predicting symptomatic, maladaptive, or undesired behavior; (b) evaluating, assessing, and/or facilitating the enhancement of individual, group, and/or organizational effectiveness –including personal effectiveness, adaptive behavior, interpersonal relationships, work and life adjustment, health, and individual, group, and/or organizational performance, or (c) assisting in legal decision-making.

The practice of psychology includes, but is not limited to, (a) psychological testing and the evaluation or assessment of personal characteristics, such as intelligence; personality; cognitive, physical, and/or emotional abilities; skills; interests; aptitudes; and neuropsychological functioning; (b) counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; (c) diagnosis, treatment, and management of mental and emotional disorder or disability, substance use disorders, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; (d) psychoeducational evaluation, therapy, and remediation; (e) consultation with physicians, other health care professionals, and patients regarding all available treatment options, including medication, with respect to provision of care for a specific patient or client; (f) provision of direct services to individuals and/or groups for the purpose of enhancing individual and thereby organizational effectiveness, using psychological principles, methods, and/or procedures to assess and evaluate individuals on personal characteristics for individual development and/or behavior change or for making decisions about the individual, such as selection; and (g) the supervision of any of the above. The practice of psychology shall be construed within the meaning of this definition without regard to whether payment is received for services rendered. a. “Health service provider” (HSP) Psychologists are certified as health service providers if they are duly trained and experienced in the delivery of preventive, assessment, diagnostic, therapeutic intervention and management services relative to the psychological and physical health of consumers based on: 1) having completed scientific and professional training resulting in a doctoral degree in psychology; 2) having completed an internship and supervised experience in health care settings; and 3) having been licensed as psychologists at the independent practice level. b. “General applied psychologist” General applied psychologists provide psychological services outside of the health and mental health field and shall include: 1) the provision of direct services to individuals and groups, using psychological principles, methods, and/or procedures to assess and evaluate individuals on personal abilities and characteristics for individual development, behavior change, and/or for making decisions (e.g., selection, individual development, promotion, reassignment) about the individual, all for the purpose of enhancing individual and/or organizational effectiveness; and 2) the provision of services to organizations that are provided for the benefit of the organization and do not involve direct services to individuals, such as job analysis, attitude/opinion surveys, selection testing (group administration of standardized tests in which responses are mechanically scored and interpreted), selection validation studies, designing performance appraisal systems, training, organization design, advising management on human behavior in organizations, organizational assessment, diagnosis and intervention of organizational problems, and related services.

5. “Applied psychologist” is one who provides services to individuals, groups, and/or organizations. Within this broad category there are two major groupings – those who provide health-related services to individuals and those who provide other services to individuals and/or services to organizations. Although licensure is generic, some of the Board’s Rules and Regulations need to account for variations in relevant training, supervision, and practice.

Compare this to our current scope of practice:

“13:42-1.1 SCOPE OF PRACTICE a) The scope of practice of a licensed psychologist includes, but is not limited to, the use or advertisement of the use of theories, principles, procedures, techniques or devices of psychology, whether or not for a fee or other recompense. Psychological services include, but are not limited to:

1) Psychological assessment of a person or group including, but not limited to: administration or interpretation of psychological tests and devices for the purpose of educational placement, job placement, job suitability, personality evaluation, intelligence, psychodiagnosis, treatment planning and disposition; career and vocational planning and development; personal development; management development; institutional placements; and assessments in connection with legal proceedings and the actions of governmental agencies including, but not limited to, cases involving education, divorce, child custody, disability issues and criminal matters;

2) Psychological intervention or consultation in the form of verbal, behavioral or written interaction to promote optimal development or growth or to ameliorate personality disturbances or maladjustments of an individual or group. Psychological intervention includes, but is not limited to, individual, couples, group and family psychotherapy, and psychological consultation includes consultation to or for private individuals, groups and organizations and to or for governmental agencies, police and any level of the judicial system;

3) Use of psychological principles, which are operating assumptions derived from the theories of psychology that include, but are not limited to: personality, motivation, learning and behavior systems, psychophysiological psychology including biofeedback, neuropsychology, cognitive psychology and psychological measurement; and

4) Use of psychological procedures, which are applications employing the principles of psychology and associated techniques, instruments and devices. These procedures include, but are not limited to, psychological interviews, counseling, psychotherapy, hypnotherapy, biofeedback, and psychological assessments.”

Question

What changes would you make to our current licensing act? What are your thoughts to APA’s model licensing act? Please send your feedback to our Director of Professional Affairs, Judith Glassgold, PsyD, njpadpa@psychologynj.org.

Conclusion

As the field of psychology advances, New Jersey psychologists have to ensure that our scope of practice stays abreast of new developments and trends in psychology, the marketplace, and other professions. This will ensure that our state licenses allow us to provide all the interventions and services that we are trained to provide. This will ensure that there is adequate access to services for patients well as employment opportunities for psychologists. ❖