“Scope of Practice” and Psychological Assessments

I’ve previously written a series of blog posts about psychological assessments and evaluations to answer common questions and misconceptions about them. Many people have a vague understanding about what an evaluation is and what it can entail, but there are many nuances to this part of my job that are not common knowledge.

We cannot be expected to know everything about everything, so I will keep blogging common questions I get and hopefully help the public better understand my job.

ethnic female psychotherapist listening to black clients explanation
Photo by Alex Green on Pexels.com

As I have said before, there are hundreds of different kinds of psychological evaluations, and no psychologist is fully qualified to administer every test or answer every referral question. For example, I am not qualified to conduct custody evaluations, forensic assessments, or immigration evaluations.

Unfortunately, I often have to tell people who contact me for an evaluation that the type of assessment they need is outside my scope of practice. That means that I am not qualified to do what they need me to do. Sometimes, they respond with some variation of, “That’s okay! I don’t need someone with a specific qualification. I just need a psychologist. You can still do this assessment.”

I understand how difficult it is to find the right provider to conduct an evaluation, especially since wait lists can be months long, and these requests are often time-sensitive. At the same time, though, please hear me when I say I cannot provide the service you are asking for. I would give the same answer if I was asked to screen someone for cancer or perform surgery – I cannot do things that do not fall under my knowledge, expertise, and scope of practice.

According to the ethics code of the American Psychological Association, Section 2, 2.01, Boundaries of Competence:

Psychologists provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study, or professional experience.

In other words – it is not that I don’t want to help these individuals. I have an ethical obligation to say “No” when something falls outside of my scope of practice.

There are times when bounds of competency are stretched. For example, I practice in multiple rural states, and if I am able to get appropriate training, consultation, and supervision, I can expand my scope to meet a need when the alternative is not getting care. There are other times when this is not an option because I do not feel I can obtain the appropriate qualifications, or because the leg work required is too much.

There are only so many hours in the day and only so many demands I can make on my time and energy. In the past, I have worked to expand my scope of practice based on referrals I got, but at this point, it is a better use of my energy to refer to someone who already has that qualification. My practice has become more niche over the years as I have specialized.

When a psychologist indicates that they cannot do something because it is outside their scope of practice, they are making sure you are getting the right care, competent treatment, and the best support for your needs.

If they indicate that your needs are outside their scope of practice, you can ask them for an appropriate referral. Psychologists who get frequent inquiries for a specific service they cannot provide typically keep a list of providers who can help. For example, while I do not provide custody evaluations, I have a few colleagues in my area whom I trust with referrals. You can ask for a referral if a provider indicates that your needs are outside their scope of practice.

You can also ask your primary care physician for referral information to a provider who performs the type of assessment you need.

Remember – a psychological evaluation is a general term for a type of service, much like there are hundreds of types of “therapy,” theoretical orientations, and interventions. No one provider can provide everything to everyone, but they can help you find the right person to meet your needs.

Published by Dr Marschall

Dr. Amy Marschall received her Psy.D. from the University of Hartford in September 2015. She completed her internship at the National Psychology Training Consortium with specializations in assessment and rural mental health. Currently, she specializes in trauma-informed and neurodiversity-affirming care, and she is certified in telemental health. Dr. Marschall runs a private practice, RMH Therapy, where she provides individual and family therapy as well as psychological assessments across the lifespan. Dr. Amy Marschall is an author and professional speaker.

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