Julie Miller's Mental Health Blog

“Q” is for Quack

Posted on: June 13, 2010

Quirk.  Qualm.  Quaint.  Quality.  Quick. Quack.

Nothing in the DSM-IV begins with a “Q.”  I can’t even think of a good “Q” word that has much interest (at least for me) in the mental health field.  I won’t do the “queer” thing, or “queen.”

“Quirk” could mean eccentric, and possibly schizoid, but that’s a stretch.

“Qualm” related to fear or doubts could be a topic, but again a stretch.

“Quaint.”  Come on.

“Quality.”  “Quick.”  Nah.

“Quack.”  Ah, now this is something interesting.  Are there quacks in the mental health field?  Why, sure there are.  If a quack is “an untrained person who pretends to be a physician and who dispenses medical advice” (wordnetweb.princeton.edu/perl/webwn), a mental health quack would be an untrained counselor or therapist practicing mental health treatment .  To practice independently in the State of Arizona, a mental health professional must be licensed at the independent level:  LPC (licensed professional counselor, LCSW (licensed clinical social worker), LMFT (licensed marriage and family therapist), or LISAC (licensed independent substance abuse counselor).

An individual with LAC, LMSW, LASAC, or LAMFT after their names are licensed only at an associate level, and must be supervised by a qualified supervisor with an independent license from the State.

In addition, the individual must practice within the scope of their license.  Mental health professionals seem confused about scope of license.  I have witnessed licensed independent substance abuse counselors introducing themselves as Certified Eating Disorder Specialists, and yet they do not practice under the supervision of a qualified clinical supervisor licensed at the independent level.  I have met an individual with a LISAC providing relationship counseling.  I have met an individual with a LISAC providing counseling to children and adults with attachment issues.  None of these individuals are practicing within the scope of their license.

These individuals are conscientious and hard-working, and yet they chose to practice outside the substance abuse field.  Eating disorders and relationship issues, including “codependence,” are not substance abuse issues.  Even problem gambling is not a substance abuse issue.

These individuals may be well-trained and experienced; however, their license restricts them to working with certain issues.  I don’t say this out of a sense of superiority or in an effort to put down someone’s license status.  I have a LISAC, but I also have a LPC, which allows me to work with any issue in which I am trained related to behavioral health issues.

Licensure is in place in the State of Arizona to protect the public.  To protect the public from quacks.  Those practicing outside the scope of their licenses are not quacks, but they have not gone through the training and testing that required of a LPC or LCSW.

When you talk with a counselor or therapist for the first time, always ask for their qualifications.  What is their licensure?  Who is their supervisor, if they are not independently licensed?  What is the scope of their practice?

Oh, and stay away from those TV psychologists – they’re often not licensed anywhere at all!


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