What Does Your Psychology Practice/Licensing Act Reveal That Can Help Your Efforts to Develop a Colleague Assistance Program?

As Chair of the Oklahoma Colleague Assistance program for the Oklahoma Psychological Association, I have been involved in helping establish a colleague assistance program over the past several years.  A critical turning point in my efforts occurred while working clinically with other health care professionals.  I began to examine the practice acts for various disciplines (i.e., medicine, nursing, pharmacy) and this led me to wonder how our psychology practice act compared.  I determined six areas in which we differed significantly from our health professional peers in Oklahoma.  I have posed these in the form of questions below.  Even if you have a formal Colleague Assistance Program (CAP) in your state, it may be useful to review your state’s practice act as it lines up with the workings of your CAP.  It may help to obtain a copy of your state’s psychology practice/licensing act as you read through the list.

  1. Does your practice act contain a reference to practicing with skill and safety that can be compromised by substance abuse and/or a psychiatric condition?  Does your state practice act go further to include medical conditions and neurocognitive conditions which can impair functioning?  Language about impairment is fairly commonplace in practice acts, but knowing how impairment is defined in your practice act is important.
  2. What does your state practice act say about reporting an impaired colleague?  In Oklahoma, there is no explicit mandate in their licensing act for psychologists to report.  Other professions in Oklahoma are explicit about a mandate to report impaired colleagues, and some professionals (e.g., physicians) are required to report across health profession lines.  In some states, like Oregon, there is a requirement to make such reports within a specific time period, 10 days (ORS 676.150, signed into law January 1, 2010).
  3. Related to reporting an impaired colleague, does your state practice act grant civil and criminal immunity if the report is made in good faith?  In our Oklahoma psychology practice act, this is not addressed.
  4. Will your colleague know that you reported her/him to the licensure board? In Oklahoma, the psychologist being reported to the licensure board will receive a copy of the Request for Inquiry (i.e., complaint form) that is sent to the board.  This complaint form contains a description of what is being alleged and the name and contact information of the person making the report.  Other boards in Oklahoma provide statutory protection of the identity of the person filing a complaint.  This of course, lowers the threshold for reporting.
  5. Does your state practice act require you to answer questions upon annual renewal of your license regarding impairment, treatment, or current suitability to practice with skill and safety?  In Oklahoma, this is not addressed in the practice act.  Other health professional boards do include a section in their practice act regarding continued suitability to practice with skill and safety. In addition, the licensee is required to complete an annual attestation about suitability or continued ability to practice with skill and safety, among other questions such as legal problems.
  6. Does your state practice act empower your state licensure board to create or affiliate with an entity that can aid in addressing impairment among psychologists?  In Oklahoma, the ability of our licensure board to affiliate with a program was not explicitly outlined in the practice act or Rules of the Board. An interpretation of the board rules by the State Attorney General’s Office determined that the licensure board had the authority to establish such an affiliation. Consequently, our licensure board moved forward with an agreement that allows psychologists to participate in the state's physician monitoring program. 

Examining our psychology practice act in Oklahoma and comparing it to the practice act of our healthcare professional peers illuminated some stark differences.  When I presented these differences at our annual state psychological association meeting several years ago it created strong momentum to make changes. 

Two specific changes have already occurred.  First, we are currently in our second year of an affiliation agreement with the monitoring program for physicians which is well respected and has been in existence more than 30 years.  For 2016 licensure renewals, psychologists are now required to complete an attestation of continued suitability to practice with skill and safety; however, this requirement has not been added to the practice act to date.  A third change that will require psychologists to report an impaired colleague is currently working its way through the legislative process required to amend our state practice act.  This change also includes immunity from civil and criminal liability if the report is in good faith.  In addition, a psychologist may be able to defer disciplinary action if he/she signs a voluntary agreement to participate in a treatment and monitoring program and successfully complies.  

There are many obstacles to developing a colleague assistance program.  In my experience these boil down to the four L’s: Concerns about Liability, determining who has the Leverage to require providers to get help, Limited financial resources of state psychological associations and limitations imposed by (or lack of awareness of) one’s state Licensure/Practice Act. 

After reading your state licensure act with these six questions in mind, look to the licensure act of your peers in other disciplines and see how they have addressed these issues.  It is also important to note that there may be practice requirements in your state that are not found in your practice act, but in state statutes that apply across healthcare professions.  Nonetheless, you may find that most professions are much further along than psychology.  It was the necessary spark to get us moving in a better direction!  More importantly, it has given us a specific path for making changes to intervene, monitor and support our impaired colleagues in Oklahoma. 

Lastly, I would like to acknowledge that change in our state would not have been possible without the concerted, cooperative efforts by leaders of our state licensure board and state psychological association in Oklahoma.

Julio I. Rojas, Ph.D., is chair of the Oklahoma Colleague Assistance Program for the Oklahoma Psychological Association. He is also a committee member of the Advisory Committee on Colleague Assistance for the American Psychological Association.

The APA Advisory Committee on Colleague Assistance (ACCA) seeks to promote the health and well-being of psychologists by providing resources to help them prevent burnout and to thrive and flourish in their personal and professional lives. It also seeks to help organizations in which psychologists work to promote their well-being. ACCA has a threefold mission:

1. To prevent and ameliorate professional distress and impairment and their consequences among psychologists.
2. To foster and provide resources via linkages to state associations to this end.
3. Thereby, to better protect the public.

ACCA attempts to attain these goals in three ways: By promoting an understanding and acknowledgment of the unique occupational hazards of psychologists’ work, supporting the development and maintenance of state level assistance programming, and encouraging appropriate linkages between state ethics committees, regulatory boards and assistance programs.

By working in these areas, ACCA hopes to serve the interests of the public and the professional community. Resources to help psychologists and their professional organizations can be found on the ACCA web page.

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Comments on "What Does Your Psychology Practice/Licensing Act Reveal That Can Help Your Efforts to Develop a Colleague Assistance Program?"

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Gary Schoener - Tuesday, April 05, 2016

I was a member of the Advisory Committee on the Impaired Psychologist which became the Advisory Committee on Colleague Assistance for its first 13 years. Despite a study ("Psychologists in Distress") which led to an APA book of the same title, very little effort or resources were put to this task. We had a committee of MPA look at these issues & did our own study a quarter of a century ago but were never able to put together a committee. Ironically, every state has a lawyers colleague assistance committee. Psychology,social work, marriage & family therapy all did not. THANKS FOR THIS CONTRIBUTION. Gary Schoener

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