To qualify for Health Service Provider certification (HSP), a psychology applicant must complete at least two years of supervised health service experience in a health service setting, one year of which meets the requirements of a health service training program.1 The Board is issuing this policy to clarify its interpretation of these terms, and to describe how it determines whether an applicant’s experience qualifies for HSP certification.
The Board recognizes that the settings in which health services in psychology are provided have expanded and diversified in the last 20 years. Health services today are delivered in settings that have not previously presented themselves to the public as providing such services (e.g., schools). As these settings evolve, the provision of health services is increasingly regarded as essential not only by the program, but also by the community.
- According to Massachusetts law, “health service” is defined as “the delivery of direct, preventive, assessment and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or may be at risk of impairment” (M.G.L. c. 112, §118,).
- Massachusetts law (M.G.L. c.112, , §118) states that “Supervised health service experience” is
-training at a site where health services in psychology are normally provided
-with which the applicant has a formal relationship
-where the applicant is supervised at least one hour for every sixteen hours of training, at least half of which is provided by a psychologist licensed by the board who is a member of the staff of the training site
-at least 25% of the applicant’s time shall be in direct client contact
The regulations of the Board (251 CMR 3.08) stipulate that a “health service setting” is one that “presents itself to the public as providing health services and where clients usually seek health services”.
Therefore, to qualify as supervised health service experience:
- the supervised experience must involve the delivery of health services, and
- the health services must be delivered in a health service setting
- Health Service Setting. The setting must have the following characteristics in order to qualify the training experience for HSP certification. It must
- be a defined entity with programmatic coherence (e.g., clinic, hospital, school counseling center, department, division).
- have a secure place for confidential records.
- teach HIPAA regulations (in addition to FERPA, where relevant)
- provide clinical supervision by qualified licensed professionals who are on-site. The supervisors should have the competencies described in 2 below.
- The health service setting must have a protocol covering emergencies, after-hours coverage, vacation periods, and extended breaks.
- The health service setting must have a referral network for services that are not provided by the health service setting (e.g., medication).
- For facilities in which research is a major component of their mission, the setting must have (i) clients/patients who are not participating in research protocols, (ii) other clinical services not part of the research protocols that are available to all clients/patients (iii) a protocol for ensuring continuity of care for clients who withdraw from research projects.
- In cases where it is not clear whether the training setting qualifies as a health service setting (as defined above), the Board will make a decision based on the following considerations:
- To what extent are the following competencies taught?
- Psychological assessment skills. Comprehensive and integrated assessment from interviews, psychological testing, direct observation. Includes selection of methods and instruments, systematic collection of data, interpretation of the resulting data. Ability to communicate the results to the relevant audience(s) in a manner that is understandable and useful to them.
- Psychological intervention skills. Conducting psychotherapy based on knowledge of theory and research. Includes the whole range of psychotherapeutic intervention (e.g., family therapy, group therapy, cognitive behavior therapy, applied behavior analysis, psychoeducation). Includes case formulation, development of treatment plans, implementation of treatment plans. In child settings, the trainee should have contact with a variety of different family members involved in the child’s care.
- Consultation skills. Includes knowledge of the roles of other professionals, including other health service professionals, and the ability to relate to them in a collegial fashion. Knowledge of the formal and informal organizational structure and the ability to apply that knowledge so that consultations can have maximal impact. Trainees should have significant exposure to other health care professionals.
- Evidence-based practice. Integration of the best available research with clinical skill in all areas of functioning (i.e., psychological assessment, psychotherapeutic intervention, consultation). Application of knowledge from the classroom to clinical situations and problems.
- Relationship/Interpersonal skills. Ability to form and maintain productive relationships with others. Productive relationships are respectful, supportive, professional, and ethical. Ability to understand the role of psychologists in the setting and to maintain appropriate professional boundaries. Ability to work collegially with other professionals and to form positive therapeutic alliances with clients/patients. Ability to work collaboratively with one’s supervisor.
- Does the training involve providing services to a clientele of sufficient number and clinical diversity?
- Is the trainee exposed to clients with psychopathology and a significant level of impairment?
- Does the trainee have the opportunity to work with a variety of clinical problems?
- To what extent are the following competencies taught?
1 A Health Service Training Program is defined as “supervised experience at a site where health services in psychology are normally provided which is part of an organized integrated training program as defined by the rules and regulations of the board” (M.G.L., c. 112, §118).