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Maryland (MD) Psychology Jurisprudence Exam Activities and services - Psych services required for training Board - State board of psychology Number of hours required for licensure - 3250 hours, across 2 years supervised experience (75% by a psychologist, 2 hours for every 20 hours of experience plus other learning activities) Requirement to pass the MD exam - 75% Requirement to pass the EPPI exam - 70% (scaled score 500) recently or 73% before 2002 Two exemptions to being required to have a license in MD - 1 - Interns, fellows, psych associates, students using the appropriate title, only in the training setting 2 - licensed in another state and graned a temporary exemption while they wait to take the exam Why go on inactive status - Leaving state and may return nto practice later How to reactivate license - apply, pay fee, prove CE requirements When do you renew - Every other year, March 31 How soon can you reapply for licensure after it being revoked - 5 years What is Board's mission - ensure a minimum level of training is met Why CE's important - to ensure a minimum in maintaining competence and not harming consumers What are goals of CE's (4 goals, 3 no's) - 1 - maintain professional competency 2- increase professional skills and knowledge 3 - prepare for new roles and responsibilities in practice 4 - expands the science of psych theory, method, or practice NO'S: business meetings, professional committee meetings, presentations/publications for a lay audience What are CE requirements - 40 CE's per 2 years. (Max 20 independent study (APA approved), minimum 3 ethics / law / risk management, minimum 3 cultural competence/diversity, maximum 30 hours for scholarly activities). Goes on cycle ending March 31. Have to keep proof in case of audit. What kind of CE documentation is necessary - Reprints, transcript and course syllabi, test and certificate of completion for independent study or workshops. Keep for 4 years. What CE hours are earned for scholarly activities - Only earned by first 3 authors. Authoring, editing, presenting or revising a publication. 20 hours for a book. 15 for Editor of a book, author of a book chapter, author of a journal article. 15 for service as Editor or Associate Editor of a journal. 15 for service on an editorial board for a journal. 3 hours for each hour of presentation (max 15 hours) for an authorized sponsor. 3 hours for each poster presentation (max 15 hours) for an authorized sponsor. 15 hours for a teaching a new graduate level psychology course What are rules for earning CE at a presentation - Authorized sponsor, defined purpose and content area, qualified presenter, 1 hour or more in lenght, record of attendance, documentation of completion, evaluation form Who is automatically authorized to provide CE in MD - NIH, APA, NASP, NASW, AMA, MD Dept of Health and Mental Hygiene, MD Psych Assoc (approved by APA) Failure to complete CE requirements - - do not complete, or do not comply with audit within 30 days If denied license, can request a hearing - within 30 days, in writing To reactivate license from inactive - Provide proof of 20 CE (10 or fewer independent study) in last year. If more than a year left in the cycle, complete another 20 in that time period. collaborators, employees, 3 - follow rules for animal protection, 4 - comfort, humane treatmen to animals, 5 - make clear nature of participation, costs, obligations, 6 - obtain approvals, 7 - report results accurately 7 standards of professional competence - 1 - limit practice to competence from education training or experience, 2 - acquire special ed and training to address cultural differences, 3 - avoid unfair discrimination, 4 - use intervention and assessment only when appropriate (supported by reliability, validity, outcomes), 5 - maintain competence through CE, 6 - engage in ongoing consultation and seek more training when developing competence in a new area, 7 - document and maintain appropriate records for professional and scientific work 2 indicators of impaired competence - 1 - shall represent qualifications accurately and seek assistance if become aware that competence is impaired; 2 - shall not undertake or continue relationship if there ais possibility that compentence/objectivity could be impaired by: mental emotional physiological pharmacological or personal problems OR present relatinship with client or if there is a conflict of interest or appearance thereof 3 advertising Do's - 1 - represent accurately qualifications, 2 - correct others that misrepresent, 3 - identify paid advertising as such 4 advertising don'ts - 1 - misrepresent affilitation, 2 - claim membership that asserts qualifications, 3 - make public statements that are false, deceptive fraudulent, misleading, partially disclose facts, or create unjustified expectations of favorable results, 4 - solicit endorsements from clients 3 aspects of informed consent (general) - 1 - appropriate language, 2 - vary procedure to ensure capacity to consent, provided all the info, knows it is voluntary, can ask questions 5 - aspects of research consent, make clear - 1 - purpose and nature as well as costs, 2 - risks and consequences, 3 - purpose and nature of eval, treatment, education or training procedure, 4 - right to withdraw, 5 - notification about any observation, taping, filming 6 aspects of therapy, make clear - 1 - reasonable expectation, 2 - nature and purpose of testing, reports, consult, 3 - limits of confidentiality, 4 - fees, billing, collection, 5 - schedules, 6 - termination procedures 5 aspects of fees and payments, make clear - 1 - make advance financial arrangemtns, 2 - inform about collection procedures, 3 - comply with rules on referrals, 4 - make clear any renumeration in providing referrals, 5 - don't sign insurnace statements unless provided the services yourself testing - 9 important things - 1 - only most current versions, 2 - only standardized tests, 3 - not encourage use by untrained, 4 - explain results fully and include factors that affect performance, 5 - avoid misuse of automated reports, 6 - base recommendations on appropriate tests, 7 - don't reproduce materials so as to compromise validity, 8 - supply manual for all tests developed that includes psychometrics, 9 - use appropriate tests for special populations who can you release test results to? - - raw data must be qualified to interpret, unless required by law what are two key aspects of client welfare - 1 - make sure to disclose conflicts of interest, taking confidentiality into account; 2- arrange for emergency coverage when not available what exploitation must be avoided - 1 - exploit or harm; 2 - take actions that violate or diminish rights; 3- exploit trust and dependency; 4 - allow personal, social, religious, organizational, financial, political pressures to lead to misuse of their influence; 5 - enter into non-psych non-professional relationship that is considered exploitative based on (nature, duration, intensity of services; length of relationship; length of time since termination; mental stability of psych and client; circumstances of termination; likelihood of adverse impact) what sexual misconduct must be avoided - 1 - sexual intimacies with current client; 2 - sexual intimacies with former client within 2 years of termination or longer if it might be exploitative (same defininition as earlier); 3 - sexual intimacies with relatives of the client within 2 years of termination; 4- termination so as to engage in sexual intimacies; 5 - sexual behavior in the context of eval, treatment, service; 6 - sexual behavior under the pretext of therapeutic benefit what harrassment must be avoided - 1 - engage in sexual solicitation, advances,verbal or nonverbal sexual conduct in connection with professional role; 2 sexual harrassment of present or former cleints, supervisees, research participants; 3 - create hostile work or educational environment of unwelcome or offensive behaviors 2 ethics in regard to children - 1 - treat minor children or adults with legal guardians only with appropriate authorization; 2 - take special care to protect children. 2 do's for termination - 1 - make referral if in best interest of client; 2 - terminate by notifying in writing, assist in obaining help from another 4 reasons one MUST terminate - if it is clear that the client is not benefitting, multiple relationship develops or is discovered, impaired competency develops, or psychologist is threatened by client or relative 2 reasons to release client records - as permitted or required by law: 1 - patient request; 2 - child abuse reporting 8 ways to protect confidentiality - 1 - maintain confidentiality; 2 - explain limits at beginning of treatment; 3 - safeguard information; 4 - release only as permitted or required by law; 5 - obtain written permission for recording interviews; 6 - avoid invasion of privacy by writing only about data relevant; 7 - treat assessment data as confidential;; 8 - obtain consent before presenting info & disguise information when possible record keeping - include informed consent, presenting problems, diagnosis, fee arrangements, dates and type of service, test data and evaluations, results of consultations what is a psych associate - master's degree or equiv, has applied to the Board, will work under direct supervision of a licensed Psych what type of supervision is required for a psych associate - one-on-one, in person 1 + hours per week for someone with doctorate 2 + hours per week if ABD 3 + hours per week if else (ii) Any service for compensation involving the application of psychological methods or psychological procedures for interviewing, counseling, psychotherapy, behavior modification, or hypnosis; or (iii) Any service for compensation involving the application of psychological methods or psychological procedures for constructing, administering, or interpreting tests of mental abilities, neuropsychological functioning, aptitudes, interests, attitudes, personality characteristics, emotions, or motivations. includes: (i) diagnosis, prevention, treatment, and amelioration of psychological problems, emotional conditions, or mental conditions of individuals or groups; (ii) assist an individual in acquiring greater human effectiveness or to modify feelings, conditions, attitudes, or behavior that is emotionally, intellectually, or socially ineffectual or maladjusted; and (iii) The use of biofeedback instruments what are psychological methods - "psychological methods", "psychological principles", and "psychological procedures" include the body of information that can be derived from a graduate program in psychology, and other education or training recognized by the Board as prerequisites for a license under this title, and that does not amount to the practice of medicine definition of psychologist - "Psychologist" means an individual who practices psychology what does definition of psychologist and psych practice not cover (3 things)? - 1) The right of an individual to practice a health occupation that the individual is licensed, certified, or otherwise authorized to practice under this article; (2) The right of an individual to provide vocational rehabilitation services as authorized under Title 9, Subtitle 6 of the Labor and Employment Article; or (3) The nonprofit activities and services of a bona fide religious organization that is exempt from taxation under § 501 (c) (3) of the Internal Revenue Code. what are 5 exceptions to needing a license? - 1) The activities and services of and the use of an official title by an individual employed by any agency of the federal government, this State, or any political subdivision of this State, or a chartered educational institution while performing the duties of that employment; (except for Department, a county health department, the Baltimore City Health Department, the Department of State Police, or the Department of Public Safety and Correctional Services after July 1, 1985) (2) The education-related services described in regulations adopted by the State Department of Education that are performed by a certified school psychologist: (i) While performing the duties of employment of the certified school psychologist; or (ii) While conducting staff development and training workshops for compensation; (3) The activities and services of a student, intern, resident or fellow while pursuing a supervised course of study in psychology that the Board approves as qualifying training and experience under this title; (4) The activities and services of an individual while performing psychological services under the direct supervision of a licensed psychologist who takes full responsibility for the activities and services performed, if the supervised individual has graduated from an accredited college or university with at least a master's degree based on a program of studies whose content was primarily psychological or a program judged by the Board to be substantially equivalent in subject matter and extent of training to a master's or doctoral degree in psychology, provided that: (i) The supervised individual may not use any title other than "psychology associate"; (ii) The supervised individual has applied to the Board for an exemption under this section; and (iii) The supervised individual has received an exemption under this section within 6 months of application unless the Board grants an extension; and (5) The activities and services of an individual licensed or certified as a psychologist in any state who recently has become a resident of this State and has an application for a license approved by the Board, provided that the individual passes the first scheduled examination for which the applicant is eligible. what is the exception for non-residents? - (1) The Board finds that the circumstances warrant; and (2) The individual: (i) Is not a resident of this State; and (ii) Meets the qualifications, other than residence and examination, for a license. what qualifications are needed for licensure? - (b) Moral character. -- The applicant shall be of good moral character. (c) Age. -- The applicant shall be at least 18 years old. (d) Education. -- The applicant shall have a doctoral degree in psychology as defined in § 18-101(c) of this title. (e) Examination. -- Except as otherwise provided in this subtitle, the applicant shall pass an examination given by the Board under this subtitle. (f) Experience. -- The applicant shall have at least 2 years of professional supervised experience in psychology that is approved by the Board in accordance with regulations adopted by the Board. (g) Residence; place of practice. -- (1) Except as provided in this subsection, an applicant shall reside or practice, or intend to reside or practice, in this State. (2) The Board may issue a license to an applicant who is neither a resident of this State nor practicing in this State if the applicant shows that issuing the license would be in the interest of the citizens or government of this State. (h) Submission of criminal history records check. -- The applicant shall submit to a criminal history records check in accordance with § 18-302.1 of this subtitle. what factors are taken into consideration on criminal history check? - (i) The age at which the crime was committed; (ii) The circumstances surrounding the crime; (iii) The length of time that has passed since the crime; (iv) Subsequent work history; (v) Employment and character references; and (vi) Other evidence that demonstrates whether the applicant poses a threat to the public health or safety. can other professionals use the term psychologists - no, but they can practice elements of pscyh practice that fall within their own practice licensure who serves on the Board - 9 members - 7 psychologists, 2 consumers 2 psychologists engaged in service, 2 in research/teaching/training how long is a term on the Board, and how long can the members serve - 4 year terms, max 2 consecutive terms offense, initial treatment and screening upon admission to a detention center. CANNOT refuse drug abuse or alcohol treatment that parent has consented to can minors 16 or older consent? - Same as an adult for psychological treatment by psychologist, physician, or clinic (but not for counselor, social worker) can we share information about treatment of a minor who consented on his/her own with a parent - Can do so, over objection of minor, but not required to where do we report suspected child abuse or neglect? - Dept of Social Services in county where child lives, within 48 hours, with copy to local State's Attorney if it is abuse (not neglect) AND if working for an agency, give the info to the head of the institution what is sexual abuse? - sexual molestation or expoitation of a child by parent or other person who has temporary or permanent care or custody of child or responsibility of supervision, or by household or family member. Includes incest, rape, sexual offense, sodomy, unnatural or perverted practices what is neglect? - leaving child unattended or failure to give proper care and attention by parent or person who has temporary or permanent care or custody of child, including child health or welfare is harmed or at substantial risk, or mental injury or substantial risk of mental injury what goes into child abuse report? - name, age, address of child, name, home address of parent, whereabouts of child, nature and extent of abuse or neglect, info on previous abuse or neglect, any info on cause or identity of perpetrator who is a mandated report of child abuse / neglect? - educators, human service workers, health practitioners (employees of state agencies have broader role, reporting all abuse regardless of victim's age or perpetrator status (alive or dead) what is a vulnerable adult? - lacks the physical or mental capacity to provide for the adult's daily needs what is neglect of a vulnerable adult? - willfull deprivation of adequate food, clothing essential medical care or habiitative therapy, shelter, or supervision what is self-neglect? - inability to provide self with services that are necessary for physical and mental health, without which impairs or threatens well-being what is abuse of a vulnerable adult? - physical injury as a result of curel or inhumane treatment or as a result of a malicious act what is exploitation of a vulnerable adult? - misuse of funds, property, or person what are exceptions to vulnerable adult title? - abuse in a mental health facility, abuse of intelectually disabled, abuse in a nursing home, abuse in a hospital who is notified in a report of a vulnerable adult? - local department, if in institution, dept. head, by telephone or direct communication or writing, as soon as possible who is mandated to report on vulnerable adults? - health practitioner, human service worker, police what goes in report on vulnerable adult - same as child abuse disclosure of medical record it only allowed if - provided by title or law who can authorize disclosure? - authorization by person of interest (adult patient, adult consenting for another, representative of deceased person, minor if minor consented on own, parent/guardian of minor patient at the discretion of physician, parent/guardian providing consent for minor, attorney for a patient what kind of disclosure is exempted from disclosure rules? - risk management, quality assurance, medical/dental/pharmacy review committee, governed by substance abuse record rules, governed by intellectual disability rules, directory information; child abuse/neglect; elder abuse/neglect what are the parts of a valid authorization? - in writing, dated, signed; name of health care provider; identity of patient; period of time authorization is valid, less than 1 year (except for criminal justice, valid until 30 days after final disposition, or nursing home, valid until revoked); apply only to the medical record of the provider (unless in writing to include record from another provider and that provider has not prohibited redisclosure) workman's comp and disclosure - can disclose information related to workman's comp claim that includes authorization how do you revoke authorization - in writing; efffective on day of receipt; disclosure made prior is not affected how do you document disclosures - medical record should include authorization, any action taken in response; any revocation of authorization how do you handle requests for copies of records - persons of interest have right to a copy, or to see and copy the medical record; can refuse to give it if believe it will be injurious, but then if there is a written request, can make a summary, keep a copy of the summary in the medical record; permit examination and copying by another health professional authorized to treat the individual for the same condition; inform the patient of right to pick a new provider can patients ask to change their medical record - yes, need procedures for this: - does not include deletion. After request, can make the change or refuse to change it (in writing to the patient). if you refuse to change medical record, what do you need to do? - 1. tell patient, in writing, reason for refusal, and procedures established for review of refusal 2. shall permit to insert a statement into medical record from patient about the request, and a statement from you explaining refusal 3. shall write to anyone that was given the record in the past 6 months to explain request for change or actual change in the record payments for costs of copying medical record - (includes medical bill, excludes x-rays) no more than 50 cents per page plus prep fee of $15,