Licensing master’s level psychologists could help fill gaps

About 160 million Americans live in areas with mental health professional shortages, with more than 8,000 additional professionals needed to fill the demand, according to the U.S. Health Resources & Services Administration. More states licensing master’s level psychologists could get patients the help they need.

In addition to West Virginia, Kansas, New Mexico, and Kentucky, Vermont is one of only five states that currently license psychologists to operate independently. Approximately 17 other state jurisdictions have a path to licensure for master’s level psychologists to operate under doctorate level supervision.

“Any mental health provider taking new patients is hard to find,” said Lynda Marshall, J.D., executive director of the Vermont Psychological Association. “I think it is harmful to our communities and the state of our profession to be elitist about it, and say ‘no, no, you have to have a doctorate.’”

Vermont currently has 539 doctorate psychologists and 193 master’s psychologists with licenses in good standing. The state’s Office of Professional Regulation shows that master’s psychologists were licensed as early as 1977.

“We offer good access,” said Marshall, noting that Mental Health America ranked Vermont number one for access to mental health care, with the most providers per capita. “People who are seeking mental health care don’t pay attention to the initials. If we didn’t have master’s level psychologists, we’d be in trouble.”

For many mental health professionals, pursuing a doctoral level degree is a dauntingly expensive and time-consuming process. One of the biggest differences between master’s and doctorate level training is the focus on research methods and neuropsychology, said Marshall.

“One thing I sometimes have concerns with is making sure people are practicing in accordance to their training and education,” she said. “But I’ve been involved in mental health administration for 10 years and seen no downside.”

Lynn Bufka, PhD, ABPP, associate chief, Practice Transformation at the American Psychological Association (APA) acknowledged that patients may not understand the differences between, say, a doctoral level psychologist, a master’s level psychologist, a licensed professional counselor, or a licensed therapist. “It could be confusing for consumers.”

About five years ago, in partnership with the Association of State and Provincial Psychology Boards (ASPPB), the APA began discussions to create standards and guidance to accredit psychology master’s programs. The question, said Bufka, is what people can do once they graduate with a master’s degree in psychology.

“There is a distinct value that psychology education brings to the treatment of mental health concerns. But some universities have been hesitant to develop master’s programs,” she said. “If graduates don’t have a career path, that becomes problematic for those programs to continue.”

Because most states do not offer a psychology license option at the master’s level, many at that education level become licensed marriage and family therapists or professional counselors.

In states that do offer any sort of psychology master’s licensure, there is no consistent title for the professionals, said Bufka. And, there are also concerns about billing and insurance coverage for master’s versus doctoral level psychologists.

As more states warm to the idea of licensing master’s level psychologists, people with doctoral degrees in psychology shift more to treating specialty niches or working with more challenging clinical presentations or in settings where they are overseeing a larger number of practitioners, said Bufka.

For now, Bufka said the APA is encouraging members to think about models for the future and how the expertise of different providers can be best used as healthcare evolves.

“I’m a doctoral psychologist myself, and I hope we think about what opportunities this would bring and how we can expand the way we offer services,” she said. “While change can be challenging, there is potential for opportunities, and it would be good for us to get ahead of it as new pathways to practice begin to emerge.”