Is it possible for an
individual to become a licensed, practicing, Clinical Psychologist with APA
approval when at one time the individual was under drug therapy for
diagnoses ranging from unipolar depression to paranoid schizophrenia? The
individual stopped drug therapy on the
advice of a government psychiatrist. The individual has been drug free and
mentally "well" for over 7 years now. One more catch: the
individual is still considered mentally ill and incompetent by a government
veteran's organization (actually rated as total and permanent mental
impairment). D
This is a tricky question because there are
different definitions of "impairment" used by the different
agencies involved: the psychotherapy community of which this person either
wishes to join or is already a member, the psychiatrists diagnosing and
dealing with medical issues, and the legal system judging impairment.
However, there are no restrictions on entering or continuing in the
profession as long as one's psychiatric issues do not negatively impact
clients. If they do, there are formal methods within the profession for
resolving these issues: anywhere from mandating an "impaired"
psychologist into treatment to removing the psychologist's license. There
are also informal mechanisms for dealing with this issue, including leaving
therapy, if a dissatisfied client and, for other professionals, refusing to
employ or refer to this therapist. Finally, while the gates are not
completely closed, someone who is severely impaired and not coping well
will have problems getting letters of recommendation and admission to
graduate school, internships and jobs, as well as having difficulty
maintaining supervisors to gain the hours necessary to become licensed.
On a number of levels our field is reticent to mandate perfect psychological health from all of its practitioners. First, we as a field are better at identifying "abnormal" behavior than "normal" behavior. Which of us are optimally functioning?
Another reason is that we all have issues that we need to work on. These issues may even help us excel at what we do -- if we have them under control. For this reason, some theoretical approaches mandate all of its practitioners into therapy. There is a wonderful article in the July/August '97 Family Therapy Networker written by Lauren Slater, describing her own struggles with obsessive-compulsive disorder. She is now the clinical director of her agency. Others have described their successful struggles with schizophrenia, bipolar disorder and unipolar disorder -- including Kay Jamison who has been diagnosed with bipolar disorder and is one of the leading experts on the disorder. A therapist I worked with used her own struggles with panic disorder to help others with similar issues. Many therapists working with clients with a history of child sexual abuse have their own history of abuse.
Having a diagnosis of schizophrenia, PTSD, bipolar disorder, or depression does not make you either a good therapist or bad one. I am more concerned with whether one is currently coping well with one's issues. Many of us have needed to use medication or therapy at one or more points in time to cope well. I want to know what a person's strengths are and what that person has done in order to cope with his or her weaknesses. Is this person aware when he or she is experiencing problems? What is done about these problems? What coping mechanisms are available for these times? JMS
Note: This is a different view than organizations like the military and the Federal Aviation Association take.
