The Board on Professional Standards approved by a majority of 45 to 2 with 3 abstentions the Committee on Non-Medical Clinical Training's recommendations for waivers permitting institutes to train 20 additional non-medical mental health professionals. Carl Davis, Chairman of CNMCT, noted that his committee had processed 35 applications for non-medical training since the December, 1987 meeting, 31 of which were new applications, and 4 renewals. (See page 7 for the 20 approved CNMCT applicants.)
Davis took the opportunity to discuss the Committee's selection process with the Board. He noted that with the number of applicants more than doubling since the last application period ending in December 1987, a new, more efficient procedure for evaluating the individuals was adopted, with each applicant assigned to a primary reviewer for assessment of the application material and summary of it for the committee as a whole. While the whole committee may read each application, they are not responsible to study it in the same depth as the one assigned. Where there are complications, however, additional examiners are appointed.
Davis stressed the safeguards for fairness employed by his committee, with a given committee member being assigned to only one application from a particular institute, and with committee members absenting themselves from discussions on individuals or institutes known to, or connected to, them. The Committee makes it a principle never to reject an application outright or permanently; when an individual cannot be recommended for waiver, a letter is sent to the institute defining the deficiencies in the application, leaving it up to the institute as to whether they want to process the application further with additional information or clarification. He noted, however, that some individuals simply do not qualify for waiver. The Committee had asked that the most qualified, least complicated applications be sent first by the institutes, and that request was honored. Now the Committee is receiving more applications for individuals who have not attained the established standards for excellence.
One issue that creates difficulty in the evaluation process revolves around the degree possessed by the applicant. Heretofore the focus was on the Ph.D. degree in psychology as this was the training closest to the rigor of the medical-psychiatric track. But other forms of training are recognized as potentially appropriate for waiver, such as social work, where the highest relevant degree for the clinician is the master's; the doctorate in social work is usually designed for the researcher, the administrator, or the educator. To receive a master's degree in social work often requires only 18 months of formal education, preparation clearly insufficient and not equal to the standard set by the medical-psychiatric profession. Considerable additional training must be documented in the application of an individual with this background in order to qualify for acceptance. Davis noted that in the group of 35 applicants, 12 held the master's degree in social work or an equivalent degree; only those of
that group who had extensive additional training could be accepted, requiring much documentation by the local institutes and careful assessment by the Committee.
Davis noted as a second problem requests for waiver that violate the minimum standards for training set forth by the Board on Professional Standards. For example, some applicants sought exemption from the rule of tripartite training with overlap of the three categories, in particular applicants who had received partial training in the past but with no waiver, wishing to forego now re-analysis by a training analyst, or to not repeat courses already taken during the previous partial training. Davis emphasized that the institutes would have to address this question and provide reasons and justification for setting aside or modifying the tripartite model for the non-medical applicant, just as it would have to do for the medical applicant.
In response to questions by fellows of the Board as to what additional guidance the Committee requires from the Board to insure that the highest standards be applied in the application process, Davis clarified that the guidance sought for is not in terms of the specific application, but more in the nature of general criteria which must evolve over time. Davis also talked to the issue of providing the Board with more data on those recommended for waiver by the Committee, citing concerns about confidentiality as well as the difficulty of sheer bulk of material included for each individual.
Davis identified several other problems encountered by his committee in their work, but added that on a more positive note, institutes had reported that by engaging in this process for acceptance of the non-medical candidate, all of their acceptance procedures were improved, for medical as well as non-medical individuals. He emphasized that while standards can be eroded if we are not careful, the Committee has been diligent in its search for qualifications, and that the standards of the Board have not been compromised. Davis completed his report by noting that the Gaskill Proposal has provided a beneficial means of increasing the pool of people with excellent clinical skills available for analytic training. Well established procedures for assessment are already in place and the Committee functions smoothly.