Science & Pseudoscience Review in Mental Health

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Credentials in Mental Health

We at The Review realize that it is very confusing to many consumers when they see a string of letters separated by periods and commas following the name of a practitioner. What exactly to those letters mean - are they significant or merely window-dressing? Do all those letters stand for various degrees from universities? Why do some practitioners have a rather long string of letters after their name while others have only a very few?

To address those questions, and help you be a better informed consumer, we have broken the topic of credentials in mental health into four categories, offered in what is typically an increasing order of difficulty for the practitioner to achieve within their profession:

Certification: refers to training which is NOT part of a degree program through a university. This level of training is generally considered to be less rigorous than a full degree program but in many cases offers the practitioner a method of obtaining training in a sub-area within their broader professional field.

Degree: refers to training which was part of a structured program from a recognized university. This level of training is generally considered to be potentially the most rigorous (not all programs are the same) and in many fields is seen as the minimum entry level credential for providing services to the consumer. [read more]

License: is a permit to operate or claim some expertise granted by application to the government. In the US each state offers its own licenses across the various mental health professions. Most states have Boards (not to be confused with the Boards listed below) which set standards, examine, and police the professionals seeking a license. Under the laws of many governments certain practices are restricted to those holding the appropriate license.

Boards: are typically associations of professionals within a very specific specialty who band together to set standards for practitioners within that specialty. The rigor and level of requirements for the various boards varies profoundly from those which ask merely for a membership fee (often referred to as vanity boards) to those that require written, electronic, and in-person examinations of the skills of the applicant in order to gain Fellow or Diplomat status under the Board.

Universities: We at The Review are also aware that not all universites are the same. We are aware that there are certain "universities" which do not require attendance or anything resembling traditional coursework (or even any classroom time at all) in order to "award a degree" - even a Doctorate! We provide this information - and links - to better inform consumers and licensing boards that simply because someone has something that looks like a transcript and a fancy certificate on their wall with a seal and some signatures neither necessarily indicates any competence or true academic achievement of any kind. [read more]

It is our position, and that of many of the legitimate professional associations within mental health, that the consumer has every right to know all of the above information as it pertains to any practitioner offering services to the public. Any legitimate professional should willingly answer your questions regarding any claim they have made to status within any of the above areas as it relates to their qualifications to provide services. Any resistance or reluctance to directly answer such questions should bring our watch words to mind immediately: Caveat Emptor!


Degrees within Mental Health

There are range of degrees which lead to some level of practitioner status within mental health. Please understand that not all practitioners within mental health have any college education at all. The Review will endeavour to include as many of these degrees and their professions as possible, however if you are aware of any which are not covered here - please let us know and offer your own suggestions as to how they should be included. If a professional claims a degree (Ph.D., M.D., etc.) but is unwilling to discuss where, when, and with whom they studied - we suggest that you reread our section on Caveat Emptor!

Physicians
The most frequently encountered profession within mental health is the physician. Most people are familiar with their Pediatrician, General Practitioner, or Family Physician. What most do not realize is that the Family Physician is the source of most of the prescriptions for mental health medications (some research indicates upwards of 80-90% of such prescriptions are written by these non-mental health specialists). There are two specialties devoted to treating mental health issues, they are the Psychiatrist and the Neurologist.

M.D. - Doctor of Medicine
The most frequently encountered degree for the physician. The M.D. is an advanced degree which typically requires the person to have obtained a bachelors degree (the standard 4-year university degree) in some science such as biology, chemistry, physics, or other basic science area. M.D.'s are granted by universities which are typically staffed with professionals from a vast array of fields - not merely by other M.D.'s. This is an important distinction from many other degrees because it means that the M.D. has received training at both the basic level (their bachelors degree) and the advanced level (the M.D. itself) from such experts on research and the science of their specialty as microbiologists, organic chemists, pharmacists, and other non-applied scientists. The M.D. typically takes 4 years in the US to obtain and is followed by on-site training in a hospital setting. This training is often referred to as Internship for the first year and Residency for the following years. Residency requirements vary across specialties with 3 or 4 years being common. To be fully licensed as a physician in most states of the US an M.D. must have completed an approved Residency program. So, having been to a Residency, while very important, is not unusual or some particularly special status for a physician.

D.O. - Doctor of Osteopathic Medicine
Though less frequently encountered than the M.D., D.O.'s are considered to be physicians under both Federal and State law. Schools of Osteopathy can be free standing and typically take a more "naturalistic" view of healing. Like the M.D., the D.O. has completed a 4-year university-based degree prior to beginning their training to become a physician. D.O.'s, in order to practice as physicians, must also complete the Internship and Residency requirements.

Psychologists
The term Psychologist can refer to a wide range of people who have had training within the field of psychology. For purposes of this review, we will be confining the descriptions to those degrees designed to equip the recipient to practice some form of mental health service independently. The American Psychological Association, the largest organization of psychologists in the world with nearly 200,000 members and associates, recognizes the Doctorate as the terminal degree required for the practitioner to claim the title "Psychologist". Broadly considered, there are three main types of mental health practitioner who use the title "Psychologist": Clinical, Counseling, and School. Some states offer limited licenses to Masters degree practitioners as "Psychologists" or "Associate Psychologists" or "Psychological Technicians". Clinical Psychologists typically are trained in the widest range of mental health issues of the three types listed with more emphasis on serious mental illness than the other two types of psychologists. Counseling psychologists typically have more training in issues relating to employment and general life events and transitions. Schools allow the use of the title "School Psychologist" to anyone holding that job title within the schools who has a Masters in School Psychology (or higher) and usually require that the person meet the standards of the National Association of School Psychologists (NASP). School Psychologists focus their training on child, adolescent, and family issues and primarily have training in assessment and school-based interventions. There are a variety of degrees which can qualify a person to operate as a psychologist.

ABD - All But Dissertation
This is NOT a degree. This person is not a "Doctor" of any kind and not entitled use that title. It essentially means that they did not finish a program and conveys no sense of why or how far along they were, in whatever program they were in, when they stopped. APA and other professional organizations and universities have policies against the use of this label. Be very wary of ANYONE listing this as a degree or credential!

Ph.D. - Doctor of Philosophy
You will need to ask the Ph.D. in which field and from what type of school they received their degree. The traditional degree obtained by Clinical Psychologists is through Colleges of Arts & Sciences within universities. The Ph.D. is recent years is being offered more frequently by Colleges of Education (which formerly offered primarily the Ed.D.) and free-standing professional schools (which when founded promised to offer only the then new "Psy.D." degree). Typically, in order to obtain a Ph.D., a student must have completed an earned 4-year university degree (the bachelors) prior to entrance into the Ph.D. program. Some Ph.D. programs require a Masters degree prior to admission, but this is the exception in Clinical Psychology programs which typically award the Masters after the completion of certain requirements for the Ph.D. Many Colleges of Education additionally require either the Masters or the Education Specialist (Ed.S.) degree prior to admission to the doctoral program. A course of study averaging 7 years in the US is required to be awarded the Ph.D. from an APA-Approved program. This training includes a wide range of advanced coursework in assessment, research, ethics, biological basis for behavior, developmental, social, cognitive and learning areas of psychology (taught by both practitioners and experimental/research psychologists), as well as supervised practice (a minimum of over 2000 hours before internship), a year-long internship (full time practice within a setting like a hospital, prison, mental health center, or other facility with a range of patients and supervisors), and a dissertation (a large independent supervised original research project).

Ed.D. - Doctor of Education
This is the traditional terminal degree offered by Colleges of Education. School and Counseling psychologists are typically trained in Colleges of Education and until the 1970's routinely received the Ed.D. Counseling and School psychologists from university based programs typically do a large independent supervised research project called a dissertation as the final requirement (following years of advanced coursework and practice supervision) leading to the degree. To practice as a Counseling psychologist in most U.S. states the practitioner must also complete an APA-Approved year of internship training prior to the award of the Ed.D. Some School psychologists also receive a year of such training prior to the award of their doctorate but unlike Clinical and Counseling psychologists this is not a uniform requirement for the School Psychology doctorate.

Psy.D. - Doctor of Psychology
Beginning in the 1960's a movement to train more practitioners in psychology sought to reduce the training in research required to be a doctoral level practitioner in the U.S. and focus more effort on clinical applications. The Psy.D. is the result of that movement. Psy.D.'s are typically awarded by free-standing professional schools (meaning they do not have traditional undergraduate students, a wide array of other scholars like biologists, statisticians, or even basic science/research psychologists specializing in things like developmental, social, organizational, or even learning psychology), however some traditional universities are now offering Psy.D. degrees. There are many differences between the Ph.D. and Ed.D. offered within the traditional university setting and the Psy.D., however the most agreed upon distinction is that the Psy.D. does not include a focus on conducting research. The Dissertation is the hallmark of the Ph.D. and requires a student to demonstrate a mastery of a large body of literature (literature reviews are typically seen as a Masters level accomplishment), a vast array of skills (methodological, administrative, clinical, and interpersonal), and to make an independent contribution to the science of psychology. While some Psy.D.'s claim to have completed a "dissertation" this typically reflects a lack of awareness of what the term traditionally means within traditional Arts & Sciences colleges of research oriented universities. Within most Psy.D. programs the candidate does a "project" which equates to a long (but not fundamentally new kind of) paper as their final requirement for the degree. In addition to coursework typically taught only by other practitioners, and not by researchers or scholars who are not themselves applied practitioners, the Psy.D. must complete the same supervised practice and internship requirements as the Ph.D. and many Ed.D's in order to be licensed in the U.S. and Canada. Additionally, the initial distinction between Ph.D.'s and Psy.D.'s was that the Psy.D. was seen as routinely having completed more practicum experience (hours working directly with patients) is no longer the case and many Ph.D. candidates are seen in internship and residency settings with as many practicum hours as their more "clinically oriented" Psy.D. colleagues.

Other Mental Health Providers

Ed.S. - Education Specialist
The Ed.S. is offered in almost every specialty within education from Administration to Special Education. The degree requirements include the holding of a Masters degree, additional coursework (approximately one year), and occasionally a project. The degree is viewed by most state departments of education in the United States as increasing the recipients ability to supervise others and act as an administrator.

M.A. - Master of Arts
The M.A. is offered to students wishing to specialize in a particular area following the completion of their bachelors (or standard 4-year) degree. The variety of types of M.A.'s is as great as the imagination of the students working towards them. Within mental health there are a vast array of types of M.A.'s from pure research degrees to strictly applied degrees. The masters, all three of the types listed here included, typically takes approximately 1 to 2 years following the completion of the bachelors degree. During that period the student takes courses within a single subject area (psychology, counseling, or biology or English) unlike the bachelors which includes a broad range of coursework in a variety of subject areas. Each masters degree is either "Thesis" or "Non-Thesis" which means one has to complete an original publication quality research project or not in addition to their coursework and practica in order to receive their degree.

M.Ed. - Master of Education
The M.Ed. is awarded by schools or colleges of education and is essentially the equivalent of the M.A. The majority of the practitioner based M.Ed.s are "Non-Thesis" but that is not a strict rule.

M.S. - Master of Science
The M.S. is awarded by many schools for the same work in psychology for which other schools award the M.A. There are some schools which maintain a distinction between the two in which the M.S. goes to non-applied program candidates and the M.A. to the applied or practitioner candidates. In all other respects this degree is essentially the same in general requirements and focus as the M.A.

M.S.W. - Master of Social Work
The M.S.W. is another of the independent practitioner level degrees offered for those wishing a career in mental health. The M.S.W. was initially offered as an advanced degree for those who wanted to provide services to children and families in need of assistance in improving living arrangements and in navigating the public assistance system. Over the years the M.S.W. has broadened and split into several different concentration areas with a very significant percentage of recipients focusing on mental health service delivery (e.g., therapy) to individuals, families, and groups. The degree is typically offered within Schools or even Colleges of Social Work and requires roughly three years to complete.

B.A. - Bachelor of Arts
B.S. - Bachelor of Science
B.S.Ed. - Bachelor of Science in Education
B.S.W. - Bachelor of Social Work


Universities

There are literally thousands of Universities around the world. The vast majority of them are members of some large recognized accreditation authority or are recognized by their national education department or ministry. Most universities offer degrees that require attendance at classes, lectures, seminars, etc. on a campus plus a certain amount of in-person supervision by a faculty member who works (as their primary job) for the university. There are new innovations like Cyber-colleges and other high-tech options for obtaining college courses and even degrees remotely. However, most of these require a student to complete a series of courses (sometimes at their own pace) with assignments, exams, and papers over the course of months and years - just as they would at a traditional campus-based university. Advanced degrees (masters and doctorates) are starting to be awarded in this manner as well.

The problem is that there are certain "universities" which offer "degrees" without the requirements described above designed to actually educate a student. These "universities" often sound great because they offer credit for "life experience". The bottom line on most of these universities is that the student pays a fee (typically in the $1500-5000 range) and submits a résumé and voila - they have a degree! One such institution was featured recently on the U.S. television investigative news program "60 Minutes" after it was closed by the State of Louisiana and the U.S. Federal Government on various charges of fraud. Interestingly, when the Postal Inspectors and FBI agents were going through seized documents they discovered that a rather high percentage of "degree applicants" at this diploma mill were U.S. Federal Government employees - some even in the U.S. Department of Education (DOE). When interviewed the spokesperson for the U.S. DOE declined to comment on how the very U.S. government department charged with dealing with all matters relating to education had accepted such diploma mill degrees as evidence of meeting requirements for jobs, advancement, and pay increases! If even the U.S. Department of Education can be duped by such bogus degrees - Caveat Emptor!

The Review is aware of "professionals" who hold their degrees from such institutions. Many government licensing boards do a wonderful job of screening for such misleading "credentials" but everyone is human. As always, if your mental health professional is reluctant to tell you where, when, and for how long they studied - Caveat Emptor!

There is a new resource for investigating universities and their claims: "The Council for Higher Education Accreditation (CHEA) is the new voice of the nation's colleges and universities on all matters regarding accreditation -- a uniquely American approach to assuring quality and public accountability in institutions and programs through voluntary, non-governmental self-regulation. Established in 1996 as a non-profit organization, CHEA also acts as the national policy center and clearinghouse on accreditation for the entire higher education community." This extensive community includes:

There is also a good guide on how to check out a school at Degree.Net. They provide a step-by-step guide to how to check out a school and offer addresses of accrediting organizations that you may contact.

The following list if from U.S. News Online

Top 10 signs you may be dealing with a diploma mill©

BY MARY LORD

  1. Brochures loaded with misspellings or grammatical errors. Example: seeing "Kodac" on the list of supporting employers.
  2. Inordinate focus on titles and long strings of initials following a faculty member's name. Example: Ph.D., Ed.D., and more and more.
  3. "Administrative offices" housed in rented mailboxes. Numerical signs, like "No. 231," or "Suite 500," can be a giveaway.
  4. Tuition paid on a per-degree basis. (Colleges charge by credit hours, course, or semester.)
  5. Discounts for enrolling in several degree programs at once. Example: Cambridge State University in Shreveport, La., offers $1,000 off for students signing up for a B.A., M.A., and Ph.D.
  6. Credits granted for such everyday experiences as taking yoga, building models, or watching TV. Good programs demand documentation showing how the work corresponds to a college-level course.
  7. Degrees that can be earned in far less time than at a traditional college. Example: Most people need four years to complete a bachelor's degree; Columbia State University–based in Metairie, La., and recently shut down by court order in Louisiana–advertised a 27-day program.
  8. Little or no interaction with professors.
  9. A list of accrediting agencies that sounds a little too impressive. Some schools cite accreditation by organizations not recognized by the U.S. Department of Education, or imply official approval by mentioning of state "registration" or licensing. When in doubt, check with the Council on Higher Education Accreditation, which lists accrediting agencies officially recognized by the U.S. Department of Education.
  10. Overemphasis on affordability and the impact a degree will have on job prospects and self-esteem.

(Also: WORK & HOME - Sheepskin fleecers: When those ivy-clad towers are nothing but a diploma mill BY MARY LORD)

You may also want to check out "DIPSCAM: The Top Ten" which has as its introduction statement:

"This is a listing of America's TOP 10 Diploma Mills RECEIVING A DEGREE FROM ONE OF THESE "SCHOOLS" CAN BE DANGEROUS TO YOUR REPUTATION....... Note: A diploma mill is defined as an institution offering post-secondary degrees which claims an unrecognized accreditation or makes materially false claims as to the acceptance of their degrees."