1
Q
Continuing Education requirements
A
- Completion of at least 40 hours of CE credit within the 2-year period immediately preceding the date of application for renewal
- May include attending/presenting a recognized educational seminar; attending/presenting graduate level course; independent study
2
Q
What can cause you to lose your license?
A
- Use of a controlled substance or etoh to an extent that it impairs your ability to work
- Found guilty of any offense (a) reasonably related to the qualifications/duties of a psychologist, (b) essential element is fraud/dishonesty/violence, (c) involving moral turpitude
- Cheating on requirements for licensure (tests/qualifications/etc)
- Obtaining any fee by fraud/deception
- Incompetence, misconduct, negligence, etc in performance of duties
- Violation of (or assisting others to violate) any rules in the guide
- Impersonation of someone else who has a license; allowing someone else to use your license
- Anything that MO doesn’t allow, even if other states do
- Adjudicated insane or incompetent
- Helping someone who is not licensed, to practice
- You didn’t complete everything you needed for licensure
- Failure to display a valid license/certificate
- Violation of professional trust/confidence
- False advertising
- Unethical conduct
3
Q
Outcomes of a complaint to the committee
A
- Claims are unfounded, you’re fine
- Probation (up to 5 years)
- Suspension (up to 3 years)
- Revoke license
4
Q
People exempt from MO Psychology Practice Acts & Rules:
A
- Counselors, etc
- Psychologists working in government, school, or research who were hired BEFORE August 1996
- Other people engaging in activities that are technically defined as “psychology”, as long as they don’t use the word psychologist
* Trainees have to represent themselves accordingly - Employers who use psychological techniques for their own employees (e.g., employment, evaluation) or by employment agencies (e.g. temp service)
- People licensed in a different state practicing temporarily in MO
- Expert testimony
- Teaching, research, IO–as long as it doesn’t involve providing direct psych services to people
- School psychologists
- Doctoral degree in anthropology BEFORE December 1989
5
Q
Rules for temporary practice in MO (for individuals licensed in another state)
A
- Shall not exceed 10 consecutive business days in a 90-day period
- Not more than 15 business days in a 9-month period
6
Q
The State Committee of Psychologists
A
- Consists of 7 psychologists and 1 public member
- Term is 5 years, max 10 years
- Members must: be resident of MO for 1 year; US citizen; licensed in MO for 3 years
- At least 2 must be involved in teaching; 2 involved in clinical care
- Public member must be US citizen, resident of MO for 1 year, registered voter, no hx of being licensed or married to psychologist, no hx of financial interest in psychology
7
Q
Privileged communication
A
Psychologist shall not be examined or be made to testify to any privileged communication without prior consent of the person
8
Q
If a prisoner makes a complaint against a psychologist, what happens re: records
A
- No documentation may appear on file or disciplinary action be taken UNLESS a major rule was violated
- Any case documentation shall be destroyed within 3 months
- No notification to other state boards or national registry UNLESS a major rule was violated
9
Q
Psychological Assistant
A
Person who has received formal approval by the committee as having met the educational & post-degree professional experience requirements but has not yet met examination requirements for licensure as a psychologist (p. 17)
10
Q
Qualified Assistant
A
A person employed by/directly accountable to a licensed psychologist who assists the psychologist in delivery of psych services but is not in the course of pursuing a license in psychology (p. 17)
11
Q
APA designated health service provider delivery areas
A
- Clinical psychology
- Counseling psychology
- School psychology
- Combined scientist-professional psychology doctoral training programs (p. 17-18)
12
Q
Psychological Testing is defined as:
A
- Use of standardized instruments to measure/record human behavior
- Tests require the application of appropriate normative data
13
Q
Psychological tests that are specifically mentioned as being regulated by MO State Committee of Psychologists:
A
- IQ: Wechsler, Stanford-Binet, Kaufman
- NP: Halstead-Reitan, Luria-Nebraska, NEPSY
- Objective mood: MMPI, Million Inventories
- Projective: Rorschach, Holtzman
- Apperception: TAT, CAT, PFT, Tactual Apperception Test
- Drawing: DAP, HTP, Action Family Drawing (p. 18)
14
Q
Maximum time to have provisional license:
A
2 years (1-year initial period, one 1-year renewal) (p. 19)
15
Q
Inactive status requirements
A
- do not need to complete CEs when inactive
- to re-activate, need to submit fee and proof of 40 CE credits within 2-year period immediately prior to date of reactivation
16
Q
How long do you have to inform the Committee of change of address?
A
30 days
17
Q
Requirements for course work in graduate program
A
At least 3 semester-hours or 5 quarter-hours in each:
- Biological bases of behavior (sensation-percep, psychopharm)
- Cognitive-affective bases of behavior (cog, motivation)
- Social bases of behavior (social, group, family systems)
- Individual differences (personality, developmental, etc)
- Scientific method (stats, experimental design, psychometrics) (p. 27)
18
Q
One year’s residency is defined as:
A
- At least 9 hours of weekly f2f instruction, supervision, a/o consultation
- For a min of 1 year
19
Q
Supervised Professional Experience requirements:
A
- At least 1500 hours (within 12-24 months, 20-50 hours/week)
- Meet with supervisor 1 hour/week (primary supervisor 1x/mo)
- Exposure to wide range of professionals, psych services, populations
- 8 hr/mo in-service (seminars, readings, case conf, prof. mtgs)
- Has to be post-doctoral
20
Q
Requirements for National Register (Health Service Provider)
A
- Doctoral degree from APA/CPA accredited program
- 2 years (3,000 hrs) supervised experience (1500 pre-doc; 1500 post-doc)
- Must already hold an active license in a state
21
Q
License by reciprocity
A
- no need to take exams
- ABPP, National Register, licensed in reciprocal state 5 yrs, or Certificate of Professional Qualification (CPQ)
22
Q
Restrictions for practice of a psychological trainee
A
- Psychological trainee shall neither deliver nor be requested to deliver psychological services, but may PARTICIPATE in the delivery of services by a licensed psychologist
- Patient records must document disclosure of trainee’s status and reflect their specific activities (p. 37)
23
Q
Restrictions for practice of Psychological Intern
A
- Intern may deliver psychological services under the immediate supervision of a licensed psychologist
- Records must reflect disclosure of intern status & be signed by psychologist
24
Q
Purpose of internship, residency, psych assistant
A
- Internship: part of the educational process
- Residency: to determine fitness for licensure
- Psych Assistant: for continuity of care
25
Restrictions on practice of Psychological Assistant
- practice under supervision of licensed psychologist
- continuity of patient care is the sole purpose of allowing a psych assistant to deliver psych services--new patients should not be accepted during this brief time period (btwn residency & licensure)
26
Restrictions on practice of Qualified Assistant
- Activities are the full responsibility/liability of licensed psychologist
- MAY NOT diagnose, interpret psychological tests, or perform psychotherapy (p. 37)
27
Aids to interpretation of State Committee Ethical Rules
- Ethical Principles of Psychologists & Code of Conduct (APA)
- Standards of Providers of Psychological Services (APA)
- Specialty Guidelines for Delivery of Psychological Services (APA)
- Code of Conduct (ASPPB)
* *State Committee Ethical Rules trump these if conflict
28
Definition of "client"
- Receiver of psychological services (may be an individual or an organization)
- In case of individuals w/ legal guardians:
- guardian is client for decision making purposes
- individual is client for: issues directly affecting their safety (sexual, multiple relationships); issues agreed as being confidential prior to start of services
29
Confidential information when corporation or other organization is the client
- Rules of confidentiality apply to info pertaining to organization, including personal info about individuals (when obtained in course of contract)
- Info about individuals is subject to confidential control of the org (not the individual) and can be made available to the org
- unless info was not obtained in course of contract
30
Professional relationship
Mutually agreed-upon relationship between psychologist and client for the purpose of client obtaining psychologist's professional expertise
31
Competence (current, new areas)
- Maintain thru CE, consultation, other training
- In new areas: engage in ongoing consultation, education AND inform client
- In emerging areas without recognized standards, "take reasonable steps to ensure competence"
- In emergency, can provide services outside competence if no other options (only till appropriate services are available)
32
Sufficient Professional Information
-When rendering a formal professional opinion about a person (eg in custody hearing), you must have "direct and substantial professional contact with or a formal assessment of" that person
33
What needs to be included in professional records
1. Name and identifying info of client (address, ph#, age, sex)
2. Presenting problem
3. Date/description of each contact
4. Fee arrangement (& discussion w/ client beforehand)
5. Data re: financial transactions
6. Assessment results
7. Nature, type, and goals of any psych interventions
8. Notation/results of formal consults w/ other professionals
9. Notation of referrals given to client
10. Releases signed by client
11. Written informed consent
12. Notation of supervision
34
Documentation requirements (time frames)
- All entries in professional records must be made within 10 days of session
- Records must be maintained for 5 years after last date of service
- Records of supervision must be maintained 5 years after last session
35
Continuity of Care
- Must make arrangements for other professionals to be available during your extended absence
- Must inform client of available emergency services for times you can't be reached (eg after hours, weekends, holidays, vacations)
- Must make provisions for transfer or disposal of all client's records in the case of your death or incapacitation
36
Multiple & Prohibited Relationships
- If you're impaired for any reason (substance, emotional), have to terminate services
- Can't see client if your "objectivity or competency" is impaired b/c of other relationship with client or someone in their lives
- Can't enter into financial or other potentially exploitative relationship with clients for (2) TWO YEARS after
- Can't have sexual relationship with clients for (5) FIVE YEARS after
37
Providing explanation of procedures to clients
- Have to give "truthful, understandable, and reasonably complete account of client's condition to the client/guardian of minor"
- When providing service to someone at request of third party, you have to explain/document nature of relationships w/ all individuals:
- role of psychologist
- who is the client
- probably uses of services/info obtained
- limits to confidentiality
38
Termination of services
- Must provide alternative sources of professional services or assistance when indicated
- Terminate when it is clear that client is not benefitting from the relationship
- Must prepare client appropriately for termination
39
Issues of client welfare
- Providing explanation of procedures
- Termination of services
- Unnecessary services
- Stereotyping
- Multiple relationships
- Solicitation of business by clients
- Make referrals on request of client
- Offering services to clients already receiving services elsewhere
40
Things to include for research (informed consent, general considerations)
- Purpose of procedure
- Voluntary or mandatory
- Freedom to withdraw, protection to do so (e.g. no difference in care)
- Alternatives
- Clarify plans for sharing/using research data
- Who may have access to confidential info (& plans for protecting)
- Any risks or discomfort
- Minimize invasiveness of data gathering
- Permission for recording
- Way to contact you after participation should concerns arise
- Provide them with general results/conclusions (p. 53)
41
Use of deception in research
- Generally not a good idea
- If you're going to do it, have to determine:
- it's justified by value of data
- alternative procedures aren't available
- Have to explain any deceptive aspects at conclusion or earlier
42
Disclosure of confidential information without written informed consent of individual client (p. 53)
- When psychologist judges that disclosure is necessary to protect against a clear and substantial risk of imminent serious harm being inflicted by the client, on the client, or on another person
- Disclose only to appropriate professional workers, public authorities, the potential victim, the family, or both, of the client
- When client is an org, only disclose after failed attempt to have problems corrected within the org
43
Requirements for use of interpreters (re: confidentiality)
- Obtain informed consent of client prior to using interpreter
- Ensure confidentiality & test security are maintained
- Include in report any limitations on data obtained
44
Exceptions to confidentiality
- Risk of harm to client or to others by client
- Court order
- Abuse of children or vulnerable adults
- Interpreters
- Minors/legally dependent clients
- Multiple clients (couples, group)
- Consultation with other professionals
45
When does confidentiality end?
It doesn't--continues after the professional relationship has ceased
46
What info can be provided when advertising professional services
- Name
- Highest relevant academic degree
- Date/type/level of certification/licensure
- diplomate status
- APA membership status
- Address/ph#/office hours
- List of types of services provided
- Fee info
- Policy re: third-party payments
- Languages spoken
47
Public statements concerning services offered shall not contain:
- False, fraudulent, or misleading statements
- Misrepresentation 2/2 omission
- Testimonials from other clients
- Statement creating unjustified expectation of favorable results
- Statement implying unusual, unique, 1 of a kind abilities
- Statement that appeals to client's fears re: not obtaining offered services
- Statement of comparative desirability of offered services
- Direct solicitation of individual clients
48
Remuneration rules
- Don't mislead clients, make expectations clear up front
- Don't charge an excessive fee
- If you work for an institution, don't accept private fees (unless allowed by institution rules)
- Can't get any fee other than for services (BUT unsolicited token gifts are permissible)
- Can't receive commission etc for referral of clients
- Can't sell/promote non-psychology products/services to clients/immediate ex-clients
- Can't bill for services not rendered (BUT can bill for missed appointments not canceled in advance, if that was part of the agreement)
49
Assessment procedures
- Use them competently, stay up-to-date
- Treat assmt results/interpretation as confidential
- Communicate results with adequate interpretive aids
- Include any reservations re: results (normative data, anything else that may affect validity/reliability)
- Protect integrity: do not reproduce or describe in ways that may invalidate measures
- Psychologists developing tests must provide manual w/ development, rationale, purpose, validity/reliability, normative characteristics, special qualifications to administer
50
Psychologists offering assessment procedures or automated interpretation services to other psychologists must include:
Manual with:
- development
- purpose
- application
- normative characteristics
- validity/reliability
- special qualifications
51
Psychologists employing other licensed professionals
- You may employ or utilize the services of another licensed professional in your practice so long as they are acting within the scope of their license
- Don't delegate professional responsibilities to someone who isn't appropriately qualified/credentialed
52
Reporting violations of statutes/rules of the Committee
- If you have knowledge (or believe in good faith) there has been a violation, you should inform the Committee in writing
- When this info is gained from a client, you can report it only with written permission of client
- EXCEPT something that is required reporting (eg CPS)
- If a client asks about reporting something, you have to inform them of standards of practice and how to file a complaint
53
"Accredited program, seminar, or activity" (in reference to CE) can be presented through which types of groups
- Regionally accredited institution of higher education
- American, Regional, State, or Local psychological association
- American Medical Association
- Other professional bodies or groups
54
How long (minutes) is considered 1 credit hour?
50 minutes of instruction (or the equivalent)
55
"Reporting cycle" (in context of CE) is how long?
- every 2-year period
- December 1 - November 30 (eg Dec 2001 - Nov 2003)
- Any CE credits earned after November 30 are applied to next cycle--so make sure you get all 40 before the end of November
56
Continuing Education requirements
- Complete at least 40 CE hours in the immediately preceding 2-year reporting cycle
- min 15 in Category A (formal programs)
- other 25 in either Category A or B (informal programs)
- If you get >40 Cat A in a 2-year cycle, the extra can be carried over to next cycle (max 15 hours)
- If you get licensed in the middle of a reporting period, the CE requirements are pro-rated
(p. 63)
57
Pro-rated CEs if you get licensed in the middle of a reporting cycle:
- Rate of 5 CE hours for every 3 full months between date of licensing and end of reporting cycle
- I am currently in reporting cycle of Dec 1, 2015 - Nov 30, 2017
- I have 21 months left (7 three-month periods left), so I'll need 35 CEs by Nov 30, 2017 (p. 63)
58
CE Reports/Verification
- how long to keep
- documentation includes
- How to verify w/ Committee
- Have to keep full records of completed CEs for 4-5 years after the completion of each reporting cycle
- So I'll have to keep mine from this cycle (15-17) until Nov 30, 2021
- Documentation for each CE should include: course name, proof of accreditation, #CE hours earned, copy of program agenda/outline/etc
- Have to report CEs when you renew at end of cycle (so, e/o year)
- This needs to be sent in by February following end of cycle
- Don't need to submit all details at this time, but keep your records
- If Committee requests documents for proof of compliance, have to provide this w/in 30 days or you're in trouble
59
Category A CE credits
- total needed
- types allowed
- CE credits awarded for each
- Minimum of 15 per reporting cycle
- Formal CE programs by accredited sponsors (# varies)
- Postgrad courses (1 class credit hour = 15 CE)
- Paper/presentation/book
- presentation at professional mtg = 2 CE
- article or chapter = 8 CE
- editing book = 10 CE
- authoring book = 15 CE
- Teaching graduate course
- 5 CE per class
- max 10 CE per reporting cycle
- can only report each class once per cycle
(p. 64)
60
Category B CE credits
- total needed
- types allowed
- CE credits awarded for each
- Max 25 per cycle
- Registered attendance at professional mtgs (3 CE/day)
- Workshops non-accredited (# varies)
- Teaching undergrad course
- 3 CE/class
- 9 max per cycle
- can only report each class once per cycle
- Self-study (max 10/cycle)
61
Experience NOT acceptable for CE credit
- personal psychotherapy
- workshops for personal growth
- service to professional organizations
- providing supervision or case conference
62
Medical records request by patient
- Provide records if patient requests, though you can limit some info if therapeutically best
- Can charge fees for:
- search/copying ($22.82, 53c/page)
- labor costs of outside storage facility ($21.36)
- Postage
- Notary fee ($2)
63
HIV status/test results are confidential except:
- Public employees who need to know to perform duties
- Peace officers, attorney general, prosecuting attorney
- People running a daycare/group home/adoptive or foster parents
- Victims of a sex crime where STI tests were ordered
- Anyone who has tested + (or F+) may request info
(p. 70-71)
64
Other notes about HIV disclosure/confidentiality
- You aren't liable for breaking confidentiality on this if you acted in good faith
- You aren't liable for disclosing HIV+ status to someone with whom that person has had sex
- If you tell any of the allowed people, they can't tell anyone else
- Identity of HIV+ pt participating in research study shall not be disclosed to Dept. of Health
- HIV+ person has to tell their health care providers prior to receiving care
(p. 71)
65
Child Abuse is defined as
- Any physical injury, sexual abuse, or emotional abuse inflicted other than by accidental means
- NOT abuse:
- Spanking (when administered in a reasonable manner)
- Parents refuse tx b/c of religious beliefs (STILL CAN REPORT THIS)
66
Assessment and treatment services for children under ten years old
- purpose
- process/timeline
- program to recognize and treat specific needs of at-risk and abused/neglected children
- includes physical/developmental/mental health screening
- completed w/in 30 days of child's entry into custody
- every 6 months thereafter as long as they are in custody
- If screenings indicate problems, they get a comprehensive eval within 60 days of entry into custody
67
Age limit for "child" as defined by MO laws
68
Family Assessment and Services
- provides prompt assessment of a child who has been reported as a victim of abuse or neglect AND of their family
- provision of community services as needed
69
Reporting child abuse: rules (p. 72-74)
- If you have reason to suspect abuse of a child, have to IMMEDIATELY report to the Division (MO Children's Division of Dept of Social Services)
- You can also report to law enforcement, but still have to report to Division as well
- If 2 ppl jointly have this knowledge, a single report may be made
- You can't get in trouble for making a report in good faith
- Employers must provide immediate access to equipment (phone, computer) and relieve you of other work duties so you can make the report
- You also have to report if the child has died (?)
- People other than mandated reporters can report if they think there's abuse/neglect
- Priests/attorneys do not have to report (?) (p. 74)
70
Reports by hospitals etc TO professional licensing authority RE: disciplinary action of employees
- They have to report any disciplinary action or voluntary resignation b/c of a complaint
- Has to be submitted within 15 days of disciplinary action
71
Age of competency in MO
18 years
72
Age of consent for sex
17
73
Degrees of crime based on victim's age (re: statutory rape)
- Age of consent is 17
- it's second degree sodomy when the other person is 21+
- if defendant is
74
Requirements for renewing license
Submit fee and proof of compliance with CE requirements within 60 days of the registration renewal date
Missouri Jurisprudence
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