We, the undersigned, support the New York State Education Departments efforts to protect the public from unscrupulous and incompetent practice in the mental health field. We are conscious of the tremendous efforts that have been put into the formulation of Proposed Amendments to the Proposed Regulations for the four, new mental health practitioner groups. We thank you for the opportunity to share our concerns about the Proposed Regulations and to offer our recommendations as articulated below.

THE IMPORTANCE OF ACCEPTED STANDARDS OF CARE AND TRAINING

We emphasize and value the highest standards of training, ethics and practice for the care, treatment, protection and welfare of the public. Members of the psychology community have identified aspects of the regulations that do not appear to be consistent with the accepted standards of training and care in their field. Our general and specific concerns and recommendations are summarized below.

GENERAL CONCERNS REGARDING THE FOUR PRACTITIONER GROUPS

1. Supervisors and faculty members for all four, mental health practitioner groups should include psychologists and other professionals licensed under Articles 131, 131(b), 139, 153, and 154 (physicians, physician assistants, nurses, psychologists and social workers). These professionals shall have appropriate experience and training to supervise and/or teach in their particular areas. Supervisors and faculty licensed under Article 163 should also evidence sufficient training and experience to demonstrate competence in their specific area.

2. Course curricula for all four of the practitioners groups should emphasize the importance of, knowledge of, and sensitivity to diversity issues in patient care and the delivery of mental health services. The curricula, as proposed, simply mention a required course pertaining to culture, and this would be inadequate training.

3. Some provisions should be made to accommodate women or men with young children or other caretaking responsibilities and/or hardship circumstances to have more flexibility in meeting their required supervised experience hours.

SPECIFIC CONCERNS

A summary of concerns for each of the four practitioner groups is delineated below.

MENTAL HEALTH COUNSELING

We have three primary concerns in the area of mental health counseling.

1. First, we are concerned that the proposed curriculum for mental health counselors is not adequate to gain the knowledge level and understanding of syndromes necessary to make differential and co-morbid diagnoses among emotional disturbances, mental disorders, personality disorders, life transition issues, and organically based dysfunctions. Therefore, it is questionable that mental health counselors will have the skills necessary to make correct use of the Diagnostic and Statistical Manual of Mental Disorders. This would expose the public to the dangers of misdiagnosis and misdirected treatment. Therefore, mental health counselors should not be authorized to make psychiatric and psychological diagnoses.

2. Second, we support an amendment that upholds the appointment of appropriately trained and experienced psychologists to teach and train, in addition to supervise, in the colleges, universities, training centers and facilities where mental health counselors will be trained and will receive their counseling experience.

MARRIAGE AND FAMILY THERAPY

To ensure the competence of practitioners trained in marriage and family therapy, we recommend the following:

1. The proposed curriculum needs to have additional coursework devoted to the study of the full range of psychopathology and how neurobiological processes, individual development, and family dynamics mutually influence one another. There also needs to be coursework on the study of multiculturalism and its influence on the organization and functioning of families. Both of these additions are necessary for the training of competency in assessment and diagnosis.

2. We recommend an amendment to the Proposed Regulations that upholds the appointment of appropriately trained and experienced psychologists to teach, train, and supervise in the colleges and universities and in the hospital, clinic, school and other facility settings in which marriage and family therapists will be trained, supervised, and receive their marriage and family therapy experience.

3. We recommend that training programs, accredited by the Department of Education as leading to licensure in Marriage and Family Therapy, employ faculty members who are authorized in the regulations to supervise candidates seeking licensure in Marriage and Family Therapy.

4. We recommend that a private practice setting not be an acceptable setting for obtaining clinical contact hours. A private practice setting does not provide quality training experience.

5. We oppose the licensing of baccalaureate level graduates under any circumstances.

CREATIVE ARTS THERAPISTS

1. First, we are concerned that the proposed curriculum for creative arts therapists does not provide sufficient training in psychopathology to provide the necessary knowledge level and understanding of syndromes for creative arts therapists to make differential and co-morbid diagnoses among emotional disturbances, mental health disorders, life transition issues, developmental disabilities, and organically based dysfunctions. Therefore, it is questionable that creative arts therapists will be adequately able to use the Diagnostic and Statistical Manual of Mental Disorders. This would expose the public to the dangers of misdiagnosis and misdirected treatment. Therefore, we do not believe that creative arts therapists licensed pursuant to Article 163 should be authorized to make psychiatric and psychological diagnoses.

2. Second, we recommend an amendment to the Proposed Regulations that upholds the appointment of appropriately trained and experienced psychologists to teach, train, and supervise in the colleges and universities and in the hospital, clinic, school and other facility settings in which creative arts therapists will be trained and receive their counseling experience.

PSYCHOANALYSIS

Our overriding concern regarding the training and licensing of psychoanalysts is the protection of the public from poorly or inadequately trained psychoanalysts. Because of the depth and intensity of psychoanalytic treatment, this is especially urgent since inadequately trained psychoanalysts may be harmful to their patients. Our concerns are as follows:

1. A strong national consensus exists specifying what constitutes adequate training and supervision in psychoanalysis. This consensus group reflects agreement among a broad range of distinguished and outstanding psychoanalytic institutes and postdoctoral programs throughout the country. It would be unfortunate for New Yorkers if licensure standards for psychoanalysts in New York State were essentially inadequate and very discrepant from established and accepted national norms and standards. These consensus groups have detailed and spelled out in separate letters the standards of adequate training, supervision and practice for the development of a psychoanalyst.

We endorse and support these standards. These nationally accepted standards are not reflected in the Proposed Amendments to the Regulations. The Accreditation Council for Psychoanalytic Education, consisting of psychiatrists, psychologists, and social workers, are involved in petitioning the United States Government Department of Educations Section on Post-Secondary Education to have sole authority to accredit psychoanalytic institutes. Under these guidelines, graduates trained according to the curriculum and experience requirements of Article 163 and the Proposed Amendments would not be recognized as authentic or properly trained psychoanalysts.

2. Another important concern centers on the provision that a masters degree in any subject area is a sufficient prerequisite for acceptance into a psychoanalytic training program as defined in Article 163. We recommend that the prerequisite masters degree be in a mental health field because, in our experience, it would be difficult, if not impossible, for adequate training in psychoanalysis to occur concurrently with training that would be considered prerequisite training in mental health, as the Proposed Regulations permit.

3. The major suggested revisions for the psychoanalytic regulations are detailed in letters from the Consensus Group, with which we concur. These concerns include a minimum of three sessions per week per patient for training and practice; two supervisors over the course of the 300 hours of required supervision; and the requirement that supervisors who are trained in this model should have a minimum of five years of experience following the completion of their training.

We are grateful for all that you are doing to protect the publics right to have competent mental health care, and appreciate the time you have taken to review our recommendations. Thank you for your consideration of our comments, concerns and recommendations.