Battling Shrinks

Mind-bending fray in Florida

Psychotherapy is such an uncertain art, critics say, that anyone with a heartbeat can claim competence in the field.

In Florida, the critics are right: a reporter who flunked psychology in college became a licensed psychologist in Miami, a hamster was officially dubbed "animal psychologist" in Pensacola, and a pet chameleon was licensed as a psychoanalyst and sex therapist in Polk County.

Reason: in its rush to adjourn, the state legislature failed to pass a law extending the life of the board that licenses and regulates psychologists. Since July 1 Florida's counties have issued local licenses to all comers. Bade County alone certified more than 200 psychologists in July, then had doubts and revoked the permits.

One applicant was a woman who simply wanted to hang a license in her bathroom.

Said Malcolm Kahn, president of the Dade County Psychological Association:

"It has created a chaotic situation. People don't know who to turn to for psychological help."

The legislature's failure to act was no accidental lapse but the byproduct of a political deadlock. At issue is the money likely to flow from any national health insurance program. Psychiatrists, who are M.D.s, are not eager to share federal dollars with nonmedical psychologists. Psychologists, in turn, are usually Ph.D.s and generally unenthusiastic about the flow of Government funds to other workers lower on the mental health totem pole: group therapy leaders, marriage counselors and psychiatric social workers.

Much of the energy in the mental health field is now going into jockeying for Government and private reimbursement. In April the American Psychiatric Association hailed as "a terrific triumph" a federal court decision involving clinical psychologists in Virginia. It upheld the Blue Shield's policy that benefits cannot be paid to psychologists directly but only through medical doctors.

In Florida, the issue was psychologists vs. other mental health workers. The house passed a bill that covered the licensing of psychologists and included the certifying of other professionals. But the senate refused to be rushed into passing it. Said State Representative George Sheldon: "The bottom line was not protection of the public but a closed shop." Congress will have the same headache in framing a health insurance program:

in psychotherapy, the link between credentials and performance is notoriously hard to demonstrate. Some studies show that psychiatrists, psychologists and psychiatric social workers do roughly the same work and get similiar results. sb

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