Psychology Licensure and Practice in Indiana Current Status and New Developments Frederick W. Unverzagt, PhD, HSPP Professor of Psychiatry, Indiana University Department of Psychiatry Linda F Brown, PhD, HSPP Private Practice Promoting Psychology….Supporting Psychologists

Psychology Licensure in Indiana December 7, 2018 Background Statues and rules around professional licensure and practice are promulgated to protect the public Vary by state, evolve over time, best way to stay abreast is to be a member of your state psychological association Interpretation and enforcement of the practice of professional psychology by the Indiana State Psychology Board (SPB) http://www.in.gov/pla/psych.htm

State Psychology Board Psychology Licensure in Indiana December 7, 2018 State Psychology Board Licensure Education/training requirements (graduate program and quantity/quality of clinical service) Application and examination procedures (law exam, EPPP) Defines HSPP which is required for diagnosis and treatment of mental and behavioral disorders Practice Fees, dual relationships, competence, interventions, testing Continuing education Disciplinary action

Licensure: Educational Qualifications Psychology Licensure in Indiana December 7, 2018 Licensure: Educational Qualifications Accredited institution (7 different approving bodies) Doctoral degree in psychology Program - coherent entity, identifiable faculty, integrated sequence of study, student body 75% of doctorate courses are graduate psychology courses 3 years of study with coverage of research design and methodology, statistics, psychometrics, and biological, cognitive-affective, and social bases of behavior Minimum of 1 year residence – taking classes taught by psychologists with other students face-to-face

Supervised Experience Psychology Licensure in Indiana December 7, 2018 Supervised Experience Internship 1 year supervised experience in organized health service training program 1,500 hours within 2 years Approved by the academic doctoral program Organized, integrated series of training and educational experiences At least 2 full-time psychologist supervisors, at least 2 interns in the program per year, 1 director of training

State Jurisprudence Exam Psychology Licensure in Indiana December 7, 2018 State Jurisprudence Exam Format 50 items, multiple choice and true false, two hours to complete Content Title 868, Indiana Code 25-33, Indiana Code 25-1-9, Indiana Code 16-39, Indiana Code 31-33, and Indiana Code 34-30-16 Emphasis placed on conduct and index competency Passing score: 38/50 Retake: must wait 30 days to retake Must pass jurisprudence exam to sit for EPPP

Licensure: EPPP Format Psychology Licensure in Indiana December 7, 2018 Licensure: EPPP Format 225 items (200 test items and 25 developmental items) Multiple choice (4 foils) 4 hour and 15 minute time limit Content: biological, cognitive-affective, and social multi-cultural aspects of behavior; life span development; assessment and diagnosis; treatment and prevention; research methods and statistics; legal-ethical-professional Passing score: 140/200 (70%)*** Cost: $600 plus $79.58 for Prometric “seat” Retake: up to 4 times in 12 months

HSPP Endorsement: Supervised Experience Psychology Licensure in Indiana December 7, 2018 HSPP Endorsement: Supervised Experience Postdoc – “Option 1” 1,600 hours within 1-5 years; 900 hours of which are direct patient contact 1 hour per week face-to-face supervision by HSPP psychologist Trainee cannot pay for supervision Trainee conducts activities in the office or professional setting of the supervisor Supervisor responsible for trainee’s clinical service Teaching and research do not count toward the 900 hours Trainee’s personal therapy doesn’t count toward 1,600 hours

HSPP Endorsement: Supervised Experience Psychology Licensure in Indiana December 7, 2018 HSPP Endorsement: Supervised Experience Model Sequence of Training Act Approved – “Option 2” Allows graduate-level practica training to count toward hours needed for licensure (in replacement of postdoc hours). 3100 hours supervised practice over at least 2 years 1500 hour internship 1600 hours (900 direct patient contact) organized, sequential, experience outside classroom in a clinic. Count starts after master’s and 400 hours of clinical experience

Practice of Psychology Includes: Psychology Licensure in Indiana December 7, 2018 Practice of Psychology Includes: Construction, administration, and interpretation of tests of intellectual and cognitive abilities, aptitudes, skills, interests, attitudes, personality characteristics, perception, emotion, motivation, and opinion Diagnosis and treatment of mental and behavioral disorders Education and vocational planning and guidance Personnel selection and management Arrangement of effective learning environments Resolution of interpersonal and social conflict Techniques used in interviewing, counseling, psychotherapy, and behavior modification Supervision of psychological services Teaching of the practices listed above Planning and conduct of research on human behavior.

Exemptions: Practice of Psychology Psychology Licensure in Indiana December 7, 2018 Exemptions: Practice of Psychology Licensed marriage and family therapist, social worker, mental health counselor, school psychologist Licensed health care professional Cleric Attorney Student/trainee in accredited program under supervision Employee or volunteer of nonprofit organization performing charitable functions Teaching faculty at university Commissioned psychology officer in Armed Services

Privileged Communication Psychology Licensure in Indiana December 7, 2018 Privileged Communication No release of patient information without the expressed consent of the patient or legal representative, except: Within employees of the care group in order to provide service To persons outside the care group to allow continuity of care To arrange payment for services Trials for homicide when disclosure relates directly to the facts or circumstances of the homicide Proceedings to determine mental competency Validity of a will Malpractice actions against the psychologist To health care worker in an a health care emergency

Privileged Communication (cont.) Psychology Licensure in Indiana December 7, 2018 Privileged Communication (cont.) In legal proceedings when the patient’s mental is health entered as evidence Parent or guardian of a minor Guardian of an incompetent person To law enforcement when: committed patient is AWOL, superintendent deems patient a harm to self or others, or if patient in custody and info is limited to medications; and provider determines release would be helpful to patient To Secret Service under certain circumstances Under Court Order (which is different from a subpoena) To deceased person’s personal representative; or if no personal rep exists, the spouse; or if no spouse exists, any responsible family member; to the coroner Department of Child Services if child in an emergency or inquiry

Psychology Licensure in Indiana December 7, 2018 Competence Psychologist shall not render services beyond the scope of competence as determined by training and experience Training is the equivalent of that granted by a doctoral degree in psychology Experience of broad principles and knowledge of the claimed area as judged by qualified peers in that area Must remain current with generally accepted developments and able to apply procedures in a reasonable, effective, efficient, and economical manner Must act within generally accepted ethical principles and maintain awareness of personal limitations

Professional Practice Psychology Licensure in Indiana December 7, 2018 Professional Practice Clinical service only performed within the context of a professional relationship Assessments and recommendations based on information sufficient to substantiate the findings Public advice (lectures, newspaper, radio, internet) requires the highest level of professional judgment; individual assessments are not rendered Computerized scoring services Require specific training Psychologist is responsible for the accuracy of the interpretations Blind interpretations allowed but must be identified as such in report

Professional Practice Psychology Licensure in Indiana December 7, 2018 Professional Practice No dual relationship with patients Discontinue relationship with a patient when objectivity or competency is compromised Prior harmful relationship w/ someone associated with patient Bias against the patient (e.g., age, gender, ethnicity, sexual orientation, language) If harmful relationship becomes apparent psychologist: Notify the patient Assist in referral

Psychological Testing Psychology Licensure in Indiana December 7, 2018 Psychological Testing Domains Intellectual Personality Neuropsychological Can be administered by HSPP or a person supervised by HSPP Must be interpreted by HSPP Competent interpretation requires Academic training in: statistics, test instruction, sampling theory, testing measurement, individual differences, personality theory, abnormal psychology, psychopathology, psychodiagnosis Supervised training and experience in practicum or internship

Sexual Misconduct No sexual intimacies with current patients Psychology Licensure in Indiana December 7, 2018 Sexual Misconduct No sexual intimacies with current patients May not accept a new patient with whom you have had sexual intimacy Sexual intimacies with former patients no sooner than 2 years after termination of professional services; Psychologist bears burden of demonstrating no exploitation

Relationship with the Public Psychology Licensure in Indiana December 7, 2018 Relationship with the Public Payment to a psychologist is based on services delivered, not the referral itself Psychologist shall not offer services to any person receiving similar services from another professional (appropriate collaborative services are not prohibited) No in-person solicitation of business from potential patients Advertisements are regulated No patient testimonials No implied sponsorship by professional associations

Relationship with Other Professionals Psychology Licensure in Indiana December 7, 2018 Relationship with Other Professionals Terminate services when patient is not benefitting and assist with referral if needed Supervising psychologist facilitates professional development of trainees and gives timely evaluations Employees and trainees engage only in activities consistent with their training Unlicensed providers: Receive 1 hour of face-to-face individual supervision per week All notes, reports, and correspondence cosigned Psychologist physically present or available by telephone Written procedures for emergencies

Relationship with Other Professionals Psychology Licensure in Indiana December 7, 2018 Relationship with Other Professionals File a complaint with the AG when you learn of violation of statues or rules by another psychologist – requires written permission of patient involved May not be in a dual relationship with supervisee May not be in a sexual relationship with a student or supervisee

Psychology Licensure in Indiana December 7, 2018 Fees Financial arrangements are made before professional contact begins and clearly understood by patients Fees are reasonable and based on: Difficulty or uniqueness of service and skill required Length of professional relationship Experience and ability of the practitioner No contingency fees No dividing of fees, except in proportion to actual services performed Use of collection agencies is allowed

Record Keeping Clinical records maintained for 7 years Psychology Licensure in Indiana December 7, 2018 Record Keeping Clinical records maintained for 7 years Records should include Identifying data Dates of service Types of service Significant actions taken Records filed within a reasonable time after service completed Records are confidential and only released with patient’s written permission

Continuing Education 40 hours of CE every 2 years Psychology Licensure in Indiana December 7, 2018 Continuing Education 40 hours of CE every 2 years Category I, approved organizations, generally paid programming, at least 20 hours Workshops Conferences Home study (not to exceed 10 hours) Category II, no more than 20 hours count Journal club Colloquial 6 hours in Ethics, at least 3 hours Category I

Closing Practice and Retirement Psychology Licensure in Indiana December 7, 2018 Closing Practice and Retirement Notify all active patients in writing and by publication once a week for 3 weeks in a newspaper Make reasonable arrangements for transfer of records to succeeding practitioner Active patient = consultation within 2 years of practice closure or retirement

Psychology Licensure in Indiana December 7, 2018 Disciplinary Actions Those sanctioned by SPB are responsible for costs of disciplinary proceedings