Legal, Ethical, and Professional Issues in Psychoanalysis and Psychotherapy
Update on Mandatory Continuing Education
Cynthia McLoughlin, Ph.D.
Status of MCE
Legislation and Rules
Last December the Michigan Psychologist, the newsletter of the Michigan Psychological Association, announced that an MCE requirement had been passed into law effective January 1, 2002. There has been much confusion about this announcement, but it is clear at this point that MPA’s report was, at best, premature. There is no MCE requirement for psychologists in Michigan.
The legislation to which the MPA referred in its announcement was a budget bill in which non-binding wording mentioned a legislative “intent” to pass an MCE requirement. (See the end of this article for a web address at which the budget bill can be viewed.)
The Public Health Code currently allows the Board of Psychology (the Licensing Board) to impose MCE requirements only if it has the support of the Department of Consumer and Industry Services (CIS) (the state administrative body that, among many other things, includes the Board of Psychology). CIS officials are appointed by the Governor.
Tom Martin, the director of the Office of Legislative and Policy Affairs for the CIS says that there will be no new MCE requirements under this administration. He noted that Governor Engler has opposed MCE on principle—not only for psychologists, but for all other professions as well. “We don’t believe mandatory CE, the way it’s used in this state and in other states, is particularly helpful in assuring competence or protecting the public, so we’re not going to do it. I have legislation on my desk right now that affects physical therapists. This is legislation we like, but we’re turning it down because it mandates CE.”
When asked about the view of some critics (in this profession and others) that MCE is an essentially empty gesture primarily backed by groups that expect to make money from selling credits—in short, as a “scam.” Martin said, “I’ve used that term myself. You know, you create a cottage industry and some people do very well.”
What “Intent” Language Means
The reasons that MPA lobbied for inclusion of non-binding language supporting MCE for psychologists in the 2001 budget bill are somewhat unclear. In MPA’s first quarter 2002 newsletter, Director of Professional Affairs Judith Kovach, Ph.D., said that the language of the budget bill had given the Department of Consumer and Industry Services the authority to establish MCE rules. This information is contradicted by Tom Martin (and others) who point out that the Public Health Code already gives the CIS the authority (though not the requirement) to establish MCE, therefore no additional legislation is necessary. (This language is found at page 149 of the Occupational Regulations Sections of the Public Health Code, under 333.18233 Renewal of License.)
Dr. Kovach agreed that her statement in the spring issue of the MPA newsletter had not been accurate. She disagreed, however with Martin’s characterization of the inclusion of intent language in the appropriations bill as “meaningless.” “The Appropriations bill passed unanimously,” said Kovach, “and not one legislator objected to the wording on MCE. I wouldn’t agree with the term meaningless when both houses of the legislature unanimously agree.”
Legislative staffers, asked about this assessment, expressed surprise that the MPA would emphasize the margin by which the vote had passed, as most legislation in Lansing is passed unanimously or all but unanimously (the vote on this bill was actually 105 –2) due to compromises reached before the vote. “A vote on a budget bill is not a vote for everything in a budget bill. That’s kind of disingenuous. There were probably about three people in the entire legislature that even knew that language was in there when the vote was taken. We vote on 22 budgets in three days, and there is no way legislators can be aware of every item.” The inclusion of “intent” language (the language used in this bill regarding MCE) would not be a reason for any legislator to vote against a budget bill even if he or she was strongly opposed to the “intent” being stated, said one staffer, “because it literally means nothing.”
Martin said there is “longstanding constitutional precedent” that a statute, such as the Public Health Code, which governs Psychology licensure, cannot be amended through a budget bill. If the legislature had wanted to give the MCE language teeth, Martin said, it could have amended the Public Health Code to require the CIS to promulgate rules, and the CIS would have had no choice but to comply. When asked, Dr. Kovach said that the MPA would have preferred an amendment to the Public Health Code, but knew that that would not be possible under the current administration.
Why the MPA Is Pursuing MCE
The MPA and the Licensing Board (Board of Psychology) continue to support and lobby hard for MCE. They argue that this requirement shows that Michigan psychologists are upholding “the highest standards of practice,” that such measures are necessary to protect the public from incompetent, outdated, or unscrupulous practitioners, and that “more education is better.”
Dr. Kovach acknowledged that there is no evidence that MCE actually does anything to achieve its stated goals. “It’s unfortunate that there is nothing to support the argument of either side in this debate.” Asked why she thought there had been no studies of MCE’s effects on the practice of psychology, she said she believed that “it would be hard to design a study because most states do have MCE requirements. Those that don’t are states that don’t have very many psychologists” (According to an APA survey of state MCE laws, which is available at www.apa.org, the states that do not have MCE requirements, other than Michigan, are Colorado, Connecticut, the District of Columbia, Hawaii, Illinois, New Jersey, New York, North Carolina, and South Dakota, and Virginia.)
Asked on what basis the MPA supports MCE, given that there is no research on its effectiveness, Dr. Kovach said, “We don’t have the data. If it were there, we would want to see it,” but in the absence of research, she said she thought supporters of MCE were relying on their view that “most professionals—not just in psychology but in other professions, believe MCE is effective.” Dr. Kovach said her opinion about the likelihood that MCE would have a positive effect on incompetent or unethical psychologists came in large part from her professional background in substance abuse treatment, in which, she said, “it’s been shown that people who are forced into treatment have equally good recovery rates as those who enter treatment voluntarily. In lieu of other data, I think that says something important about human nature.”
According to Dr. Kovach, the MPA is actively exploring recommendations for what kinds of CE it will recommend that the Licensing Board deem acceptable for fulfilling mandatory CE requirements. She thought it likely that MPA would recommend that all credits must be APA approved. She did not know what kinds of educational activities (beyond attending conferences) would be recommended for inclusion, and said that the MPA has, as yet, taken no official position on the subject. In discussing the possibility that psychologists in Michigan would be allowed to count their self-chosen reading toward fulfilling MCE requirements, Dr. Kovach said, “I’m not a libertarian. I expect monitoring. I do know psychologists who don’t get CE on their own, and it would be easy for them to look on the list of approved books and say they had read one. That seems slipshod to me. I think there needs to be verification.” Asked about the term, “list of approved books,” Kovach said, “I don’t want there to be approved books and banned books, but there are things that try to pass themselves off as psychology that aren’t.”
Dr. Kovach said that the proponents of MCE legislation at this time are the Licensing Board, the Michigan Psychological Association, “people concerned about the APA Ethics Code” (which states that psychologists have an ethical obligation to continue to educate themselves), the Association of State and Provincial Psychology Boards (ASPPB, a private group that is working to standardize licensure requirements, which now vary from state to state), and “members of other health care professions in Michigan that have MCE that have been concerned that the Governor would try to take it away from them.”
Dr. Kovach said she could not specify any actions that have been taken by the ASPPB to promote MCE in Michigan and added that they had not been asked for assistance. She also declined to specify any other health care professions whose members were concerned that this Governor might repeal MCE legislation for them.
A new administration (coming in January) may or may not share Governor Engler’s attitude toward mandatory continuing education. If, after the election, new administrators of the CIS agree to implement MCE for psychologists, the procedure would then be that public hearings would be held to allow for the expression of opinion about what exactly the requirements should be and what kinds of activities would qualify for MCE credit. ™
MCE Information on the Web
The budget bill, Public Act 119, can be found at
APA’s Continuing Professional Education page is at www.apa.org/ce/
A variety of papers on MCE can be found at www.academyprojects.org/mce.htm
APA Approval of CE Sponsors Criteria and Procedures Manual www.apa.org/ce/CPmanual.html
This article was first published in the newsletter of the Michigan Society for Psychoanalytic Psychology in June 2002. It is reprinted here with permission. The author may be contacted through LEAPchair@AcademyProjects.org
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