How Do I Go About Changing a California State Licensing Requirement

July 22, 2022 2:43 PM

I am beginning a second career and getting a masters in Psychology in the state of California. I will complete the program in Spring, 2024. At that time I will be 61 years old.

Before I can get licensed, I will have to complete 3,000 hours of qualifying supervised professional experience.

The more I think about the 3000 hours the more it sounds ageist. I get it for someone in their twenties and thirties. For those who are in their fifties and sixties, it's playing time against time.

I have been working with people for 35 years. Mostly as a yoga teacher. Much of the time in community related environments. A great deal of what is being taught in courses I already know.

What change agent do I approach to discuss this issue. AARP? My state assemblyman or senator? ageism advocate? California Board of Psychology?

Respectfully, no comments about the impossibility or effort it will take make this change.

posted by goalyeehah to Law & Government (16 answers total)

I believe CA has such obscene clinical hours requirements for mental health professionals (LCSWs and MFTs are your allies here) because our whole social service sector depends on their unpaid and low-wage labor. So your efforts to change this may involve changing the entire funding structure of Medi-Cal funded and other public mental health services for the state.
posted by latkes at 2:51 PM on July 22, 2022 [17 favorites]

I'm an LCSW and we are in the same licensure boat. You need to write to Board of Behavioral Sciences, but you will need support from peers to make an impact.

On the social work end, NASW-CA and California Society for Clinical Social Workers are the groups that are easiest to link up with to lobby for things like this--not sure what the exact equivalent would be for psychologists but I know California Association of Marriage & Family Therapists accepts LMFTs, social workers, psychologists, and trainees in all three disciplines, so maybe start with them or their PAC.
posted by assenav at 3:01 PM on July 22, 2022 [1 favorite]

Boards typically make rules, process and policy based on the laws that give them the authority to make said rules, processes and policies. Largely, you have two paths: change the laws governing those specific requirements, or have the board change how the current rules are implemented. The latter is technically easier, but if the board agreed with your position, those rules would have been changed (unless there is a law specifically stating that they cannot or are not permitted to make those changes).

Contacting the individual board members that make up the Psychology board is likely the fastest route to get a rule changed (this is still a very slow process, and they have to agree with you).

Contacting your state representatives to have the laws changed is the next option. (this process is much slower, and again, you need a critical mass of state reps that agree with you to make the changes; it will then take several years for those rules to be implemented).

Getting involved with trade groups and union organizations who can more effectively lobby for such change is a third path, that is not as direct as the prior two, but will probably save more of your sanity. Though, unlike in say, Nursing, mental health professionals are largely non-union and don't have the same level of robustness in these orgs that other medical fields see.

No matter how this process is cut, it is remarkably slow, and will take you longer than 3000 hours to complete (this is not to dissuade you, or say that it is impossible, but to frame the task you are approaching).
posted by furnace.heart at 3:25 PM on July 22, 2022 [3 favorites]

Also, the people that work at/for the state board, are not The Board Members, and have no control over the policies, rules OR laws. They are basically the clerks at the DMV and have to carry out all the policy, rules and process that get made by the Board. They cannot assist with the kinds of things you're looking to change, and trying to do so will make their lives demonstrably harder and they have no power to assist you with this level of change.
posted by furnace.heart at 3:35 PM on July 22, 2022 [3 favorites]

I'm in your age range so I empathize -- but I don't think it's necessarily going to be considered ageist to ask anyone to complete that length of training. Rather I think it would be ageist to say someone our age could not complete it.

I would not want to go a therapist who had less training than other therapists -- even if they had other good life experiences such as being a yoga teacher or working for good causes. The latter could certainly help you be great in your new career, but - as someone on the patient end of things - I hope and expect there is some kind supervised training that comes from analyzing actual therapeutic encounters, and that all therapists with the same degree would have the same amount of it.
posted by ojocaliente at 3:43 PM on July 22, 2022 [47 favorites]

I'm going to push against you as an LCSW - and for this I apologize and I realize it is not answering your question.

The reason you are being asked to complete 3,000 of supervised experience is that your previous experience was not clinical experience. Community work, working as a yoga teacher and working with the public is not Clinical Counseling experience. It just isn't. It is a great base to prepare you for many of the things out there in the world, but it is not individual therapy. It is not giving you the allowance to provide clinical counseling to individuals with varying degrees of behavioral health issues without supervision (if the accreditation you are going for allows you to operate a private practice) and accrediting you to bill for these services as behavioral health services. It is also allowing you to advertise yourself as someone who has met the requirements for licensure.

When you are engaging in this professional work with the associated title, you are working with people who are vulnerable. There is a power differential. You are to be providing evidence-based treatment approaches, evaluating that work and changing interventions as necessary. Doing this with consistency requires significant training and time. Quite frankly I am of the opinion that 3,000 hours is sometimes too little.

You do not have to go far on google (or even through ask) to see people who have had interactions with trained licensed professionals that have been inappropriate, unethical, ignorant, and/or quite frankly full of bias, and discrimination. Working on becoming a counselor is very introspective and seeing your beliefs about yourself and your interactions affect those around you. I really challenge you to think about why your skills specifically are SO good, that you don't need to do the training everyone else does, just because you started this career when you were older? These are people's lives you will be working with as an authority figure with the appropriate experience in the matter. Your actions, your training, your experience, and your education really matters.

Just this week I was in a situation where someone disclosed something incredibly personal about themselves to me. I was the first person they had ever told. How I reacted in that situation set the tone and expectations for ongoing interactions with behavioral health professionals going forward. It was a huge responsibility, and one I take very seriously.

In my career, I've had to do things like advocate with other health professionals about the differences between schizophrenia and depression with psychotic features among many other things. I've had to petition adults, create safety plans, help adult victims escape abuse, and report child abuse from people who I had ongoing clinical relationships with. None of this was easy and none of these things were things I learned through other jobs. These were skills that required ongoing education, ongoing training, and clinical supervision. Even today, over a decade in, I come across situations where I am not sure what my next steps should be as a practitioner, and I am seeking ongoing education and supervision.
posted by AlexiaSky at 5:14 PM on July 22, 2022 [85 favorites]

I'm a psychologist, and the 3000 hour requirement meant basically 2 years of supervised work. One of those years was picked up before I graduated (predoc) in clinical internships that were part of my school's training program. These were basically required classes that consisted of working at a contracted clinic and then meeting in a class with the school's professors to discuss what we were doing at the clinic. The other 1500 hours had to be postdoc.

So the task was to find a job that would allow me to work as a "registered" psychologist, as opposed to a licensed one. This means that the employer had to have a licensed psychologist who was willing to meet with me for supervision at the appropriate frequency (eg 1 hour of supervision for x hours of work), and who would sign the forms attesting to that. This is California btw - your state's licensing laws may differ. At the time when I did it, in addition to jobs, you could work as a "psychological assistant" under someone's license in a private practice mode, although I gather that that's become more difficult to pull off.

I have subsequently worked as the supervisor for a number of unlicensed people who were working at the place I worked and trying to pick up those hours. I was required to take a supervision course and meet with the people and fill out the paperwork, etc. It was pretty straight forward, though I also happened to supervise people who were quite good, and who I had no concerns about. This is all by way of saying it might be possible to find a situation where you are working at a job AND collecting hours.

I did supervise one person who wanted to work without being licensed and she found that she could open a "coaching" practice, which was a field that had no particular credentials or licensing requirements at the time, sort of like being a psychic. She just called herself a coach, and that was that. She did have to be careful in her marketing materials and in how she talked about what she did yo make it clear that she was *not* offering psychological services, not diagnosing, not providing treatment, etc. But she had a niche area and moved her career in that direction.

This doesn't tell you how to change licensing laws, but maybe it opens up some paths that you hadn't considered.
posted by jasper411 at 5:29 PM on July 22, 2022 [8 favorites]

> change the laws governing those specific requirements, or have the board change how the current rules are implemented

Based on having worked on things like this before (not in your specific area), I can say that working both of these avenues at once is often very, very effective. They reinforce each other.

Just for example, you happen to "know" that the idea of passing a bill to change this in the state legislature is impossible right now. A key committee chair opposes it, major heavy-hitter lobbying groups oppose it, there just aren't the votes there to get it done.

But regardless, you find a friendly legislator to introduce the bill you want, they get a hearing, there is some discussion but it doesn't go much further and dies before even passing out of committee.

Well, what has just happened there is that you have gotten the 100% attention of the Board and the bureaucrats and the professional groups in your area, etc. Suddenly your idea has gone from "crazy" to something to be taken seriously.

Say the next year your sponsor reintroduces the bill, and also you find a sponsor in the other chamber (Senate, say) and now it has a hearing in both chambers. After a bunch of discussion and negotiations an amended version (that you HATE because all of your priorities have been negotiated out of it) passes out of committee in one chamber or the other, and then dies right there.

(This would be normal legislative progress, by the way. Typically it takes 4-6 years for an idea to become a passed law - sometimes more like 8-10.)

Suddenly the Board passes a new regulation and reduces the required hours from 3000 to 2000. (Or maybe 2500 or some other number.)

Point is, Boards and agencies like this just hate this type of legislative attention. They would rather be proactive and just handle the matter in some satisfactory way than have the legislature dictate to them.

You've gotten their attention and shown you are serious and committed by getting a bill introduced and discussed and keeping after it for more than a very short while.
posted by flug at 5:55 PM on July 22, 2022 [2 favorites]

I should have waited to let this post simmer in my head before responding, but one last little bit of information and a perspective that may help you relate to, engage with and work towards your goal:

Most folks who have to deal with a licensing board (or most government agencies) as a 'customer' don't often frame the whole operattion the same way that the actual licensing board does. They often view this as them purchasing something, or getting something done in an efficient timeframe. Again, I'd point to the DMV as the most common 'licensing' entity most folks have a basis for interacting with. You pay them and meet the rules, you get to use your license to drive.

Boards simply do not positiong themselves this way; they fundamentally do not operate on these priors. People who sit on licensing boards, and those who work for them, very much view themselves as working on behalf of citizens, not licensees. In fact, they can be almost antagonistic to the licensees, because they are working on behalf of the public. They are not there for you (to issue you a license, to renew you on time, to do anything for you); they are there for citizen safety, and that is very much how they conduct themselves.

Reframing your interactions with the board and the reasons they do what they do in this context, will garner you much better results. You need to tell the board why this is better for the citizens of California, not for the licensees of California; from their perspective, (and likely from their legal charter or whatever gives them the power to make rules and regulations), they're not in this to make your life easy, or even protect you, a licensee.
posted by furnace.heart at 5:59 PM on July 22, 2022 [22 favorites]

Best answer: I’m biased in that I’ve had to deal with the fallout of folks in the mental health field with the mindset: “I went to the school of life, and I don’t really need this bit of the requisite supervised training.” It’s bad, and it makes everyone else look bad. You probably won’t find many sympathetic ears from folks who got licensed just like everyone else.

Yes, some of the training is bullshit. But those hours are there to protect your patients, especially if you go into private practice. Sloppy, prematurely unsupervised work on your end can mean trauma, death, and a lot of collateral damage.

Sadly, the education path just was not built for late entry, but you should have known that timeline before you started your program. You’d be facing the same issue if you chose to be a surgeon. It’s not ageist to require those prelicensure years. On one hand, it creates exclusivity, which stinks for people on the outside. On the other hand, you never had to section someone as a yoga teacher.

I don’t think you are going to get any traction from regs orgs or lic boards because they hate making exceptions, and your situation is not important enough to risk running afoul of insurances, who will look askance at any board that says, “how about we just let this one through?”

Unless your case is one of miscommunication or malicious misrepresentation (ie Phoenix Univ), a board is gonna look you dead in the eye and ask if you didn’t read the regs before entering school.

Find a place you like and a supervisor you respect, and they’ll go by quickly. If you’re in a rush to help people in private practice and you don’t plan to necessarily deal with dx and insurance, coaching is the path you want.
posted by executive_dysfuncti0n at 6:09 PM on July 22, 2022 [33 favorites]

To answer the question, you sue the regulator in question in Federal court (if under the Federal equal protection clause). And then you lose.
posted by snuffleupagus at 7:38 PM on July 22, 2022 [2 favorites]

Best answer: I’m an LCSW and think this is an interesting question, but suggest you take it in a slightly different direction: 3000 hours is, as noted above, two years of supervised work. Even if you find that your coursework contains much you already know, you will encounter situations with real-life clients during your first two years that you absolutely cannot anticipate and won’t know how to handle intuitively. You will need not only the coaching and mentoring but also the legal/liability protection of a fully licensed clinician either signing off on choices you make or making choices when you’re out of your depth. It’s reasonable to compare these two years to something like a medical residency: you can be the top student in your program, but that doesn’t mean you graduate ready to cut people open without working under someone else’s license and insurance. However, you are in an interesting position to advocate about some of the following:

New grads are often hired in community mental health settings with ridiculously low pay and exploitively high caseloads. The low pay is a justice issue because it disproportionately impacts new clinicians from marginalized backgrounds, who are less likely to have the personal/family resources to work for little money while repaying student loans and supporting themselves and their dependents. I think you could absolutely make the case that it’s also a justice issue for older clinicians, who have far fewer years to catch up financially once fully licensed. Further, the way these community mental health clinicians are (often) overworked is an affront to the mental health field and damaging to the health of younger clinicians, but potentially devastating to the health clinicians entering the field later in life.

You could look into advocacy options to improve standards of pay and/or caseloads, or to expand the types of settings where new clinicians can complete their hours. I’d start with your state professional organization (whatever is the equivalent to the state NASW chapter for your discipline) to see what they’re doing for/with older clinicians.
posted by theotherdurassister at 9:34 PM on July 22, 2022 [14 favorites]

Man, these comments have all been really polite and respectful, so yay Metafilter! But honestly, I think you need some serious push back here . . . You're asking a question that kind of demonstrates why you aren't (currently) qualified to be a licensed therapist . . You don't know what you don't know and beyond that, you seem to think you don't need the full training and experience to learn what it is that you don't know to say nothing about then integrating and practicing what it is currently you don't know so that you can actually come to know it.

It might not be your intent but your question and your stance demonstrates a sort of contempt for the field that frankly only therapists would have the fortitude and willingness to tolerate because can you even imagine asking such a question about becoming a medical doctor, a nurse or a plumber? Why are your individual life choices and circumstances more important than protecting the public? From a professional stance, why are your individual life choices and circumstances more important than those of us who completed our training and jumped through all the necessary (sometimes, though certainly not always, arbitrary) hoops? How can you think you can join a profession of peers with that stance?

Anyway, I hope I'm not coming across as harsh or impolite but that's some honest feedback and I think you need to hear it.
posted by flamk at 1:38 AM on July 23, 2022 [34 favorites]

Best answer: Oh, and I wanted to add that I wonder if you might talk to your advisors or professors in your program about your concerns and intentions. I think they might be able to give you some good feedback on why this might or might not be the right battle for you to take on.
posted by flamk at 1:51 AM on July 23, 2022 [3 favorites]

Best answer: I’m biased in that I’ve had to deal with the fallout of folks in the mental health field with the mindset: “I went to the school of life, and I don’t really need this bit of the requisite supervised training.”

I'm one of the patients who suffered enormously from a yes, yoga teacher who thought this (he was also a licensed massage therapist, which was how I got involved with him). It was one of the worst experiences of my life, and I ended up in the psych ER when he realized he was out of his depth and dropped me. I reported him to his massage therapy licensing board (with the encouragement of an excellent licensed therapist). It was complicated because he moved out of state and the new licensing board wouldn't tell me anything, but I note he no longer practices massage therapy. I don't want to be mean, but I can't imagine a world in which being a yoga teacher qualifies you in any way to be a therapist (and I had a year of private lessons with an amazing yoga teacher who was also a licensed social worker while I was dealing with a very serious health crisis - I still don't think of him as anything like a therapist for me).

I would also suggest asking yourself why you don't want to do these hours. Is it the low pay? Is it the feeling that you know enough that you shouldn't have to be closely supervised? I would say the first is legitimate and the second really isn't. Your thinking that being a yoga teacher even enters into this makes me wonder about your understanding of your own limitations, which is very important for a therapist.

I'm a few years older than you and one of the first people to point out ageism when it occurs, but this is not it. Whether the licensing requirements are too onerous in general is a different question and maybe more worth pursuing - as mentioned above, these kind of requirements can be difficult for young people who do not have family wealth. Or just reread the excellent answers from licensed therapists here.
posted by FencingGal at 6:47 AM on July 23, 2022 [31 favorites]

Well I guess this is the question that finally got me to make a Metafilter account, after 10+ years of lurking.

Like others, I’m deeply concerned about your motivations and beliefs that are leading you to ask this, hoping to avoid the full supervision hours. Other folks have given good guidance on why supervision is important, and honestly it doesn’t even prevent you from practicing as a therapist - it’s just a minor additional safety valve (hey new therapist - talk to someone experienced about what you’re doing every week or two, and to make you both accountable we’ll hold them liable for some of what you do.) My wife went to school to be a therapist and was under supervision in California, it was not that arduous/disruptive for her, and only a minor impact on the money she made (vs. a world where no supervision was required. No one gets rich as a therapist though.)

My question to you is - why do you need/want to be a licensed therapist? There are plenty of yoga teacher / energy healer / life coach folks around, and they don’t need any certification or supervision to talk with people about their problems. Why is being licensed important to you? You could go to school and not get licensed, and as long as you call what you do coaching and not therapy, you won’t be breaking any laws (I believe - double-check before doing this!)

Becoming a licensed therapist is like joining a yoga/spiritual lineage. They have requirements and beliefs, and to be part of it you have to (mostly) follow their rules. It’s also your choice whether to join it. I imagine you might bristle at someone trying to join your yoga lineage with minimal training, saying that they had tons of experience from being older, working in the community, and teaching CrossFit for years. That’s what you sound like to therapists and people (like me) who are close to therapists personally and have been in lots of therapy. Would you want to be in years of intense yoga classes with someone who skipped most of the teacher training because they were a CrossFit instructor?
posted by DropTheTable; at 7:24 AM on July 28, 2022