Contemporary Challenges and Controversies

Question 1

Licensing vs. certification

Answer 1

• Licensing restricts the practice of a profession and is typically overseen by state boards; requirements and restrictions can vary
• Certification restricts the use of a name (i.e. “therapist”)

Question 2

Who can provide mental health care at the bachelor’s level?

Answer 2

Substance abuse counselors and pastoral counselors

Question 3

Who can provide mental health care at the master’s level?

Answer 3

Licensed clinical social workers, licensed professional counselors, licensed mental health counselors, and rehabilitation counselors

Question 4

Who can provide mental health care at the doctoral level?

Answer 4

Ph.Ds, Psy.Ds, marriage and family therapists, doctor of education (EdD)

Question 5

What are the allied professions of the mental health workforce?

Answer 5

Physicians/psychiatrists, nurses, nurse practitioners

Question 6

Psy.D

Answer 6

Doctor of psychology; focuses on clinical/professional experience to become a practitioner

Question 7

Ph.D

Answer 7

Doctor of philosophy; focuses on creating knowledge, emphasis on research

Question 8

Current distribution of mental health care workers

Answer 8

• Lack of psychologists; 31:100,000 people in the U.S.
• 56% of Americans with mental illnesses lack access to care

Question 9

Psychotropic medication debate

Answer 9

• The prescription of psychiatric medications has increased in primary care settings
• May lack follow-up or additional psychosocial treatment

Question 10

Current direction of psychotherapy

Answer 10

• Shifted away from long-term therapy
• Emphasis on brief interventions from mental health providers and primary care physicians
• Emphasis on integrated care and medical homes

Question 11

What are some strengths of utilizing technology in psychotherapeutic treatments?

Answer 11

Increased access to treatment in rural and underserved populations and to those with limited mobility or rare conditions

Question 12

What are some weaknesses of utilizing technology in psychotherapeutic treatments?

Answer 12

Protecting patient privacy, blurring of patient-therapist boundaries, professional liabilities when conducting therapy over state lines, the ability to report a person who might not be with you (saftey)

Question 13

What are some controversies when using technology to facilitate treatment?

Answer 13

• Provision of services by for-profit companies
• Chatbots and AI as therapists

Question 14

What are the common scenarios of sexual relationships between providers and patients and are these relationships permitted/justified?

Answer 14

• NEVER justified
• Therapists says the relationship is true love
• Therapist engages in subtle boundary slips and says that “it just got out of hand”
• Therapist incorrectly believes that the therapeutic relationship does not apply out of the office
• Therapist fraudulently presents sexual activity as valid treatment

Question 15

What are some common scenarios when a therapist feels sexually attracted to their client but does not act on it?

Answer 15

• Guilt
• More common that actual sexual relationships
• Therapist needs more training

Question 16

What are some examples of non-sexual touch and how they can have both positive and negative effects?

Answer 16

• Examples: handshake, pat on the shoulder or forearm, hug
• Pros: can be reassuring, caring, comforting
• Cons: can be demeaning, intrusive, frightening

Question 17

Dual relationships in therapy

Answer 17

• Prohibited by the APA
• Ex) financial, social, professional

Question 18

Explain what incidental extra-therapeutic contacts are and how therapists should address this

Answer 18

When a therapist runs into a client outside of the therapy room; addressed in the therapeutic contract that the therapist will not initiate conversation but if the client wants to, they are more than welcome

Question 19

What things should be considered to make therapy accessible for people with disabilities?

Answer 19

• Physical barriers to accessing therapy spaces; not always solved with technology
• Potential barriers to communication
• Lack of training and recognition; can lead to misdiagnosis
• Making spaces accessible to students and trainees with disabilities

Question 20

The law and individual ethics in psychology

Answer 20

• Laws are made through democratic processes, not just for psychologists
• APA ethics code is by psychologists for psychologists and establishes a higher standard of conduct which therapists must adhere to
• The law and the ethics code may be in conflict; responsibility to take all steps available to resolve the conflict and may only adhere to the law in keeping with basic human rights

Question 21

What are the results of the Hoffman Report on the field of psychology?

Answer 21

• Controversy about the role of psychologists in interrogations
• From the Hoffman Report, the APA now bars psychologists from engaging in national security interrogations

Question 22

Explain the Goldwater rule

Answer 22

• Response to a psychiatrist publicly using their role to comment on mental attributes of then-presidential candidate Barry Goldwater
• Discourages diagnosis of public figures without a professional relationship and thorough examination
• Debates over the necessity of personal examination; conclusions are weighted against the type of evidence available