Cummings Graduate Institute

For example, if a Behavior Analyst did tests to diagnose PTSD or ADHD, I’m not convinced as a medical provider I would take their diagnoses at face value! I mean like, what the hell is the opinion of a Behavior Analyst? Do they administer valid, evidenced based tools for assessment? The profession is going to have to do some convincing to the mental health medical professionals that they hold some weight!

 

First you asked for information showing that a clinician can be unlicensed and supervised to be able to practice. I gave you two pieces of real-world evidence from the job market from two different states showing that it is known and done. Then, you acknowledged the fact that this is done, but moved the goalposts to a new marker about definitions.

I then source out a ton of dictionaries, none of which state that a clinician must be licensed which was the original core debate. So then you cite that they mention licensed professions in some of those definitions, which is true. The problem is, you ignore that most list multiple definitions as if two things can't be true at once when they can be and in this case they clearly are. There are some professions where one must be licensed, and others that don't. As the definitions prove, there is an understanding that some professions can or have to be licensed but others don't, neither has any bearing on whether or not the positions we're discussing can carry the title of clinician because we already know for a fact that licensing has no bearing on that in general. But you moved the goalposts yet again...

So now you've moved it to, well people use it for some and not others to differentiate. Fair enough. That still changes nothing because the core fact remains that one in a clinical profession can be and is considered a clinician even without a license.

Jan, to break it down, here is what you're doing wrong: You're arguing that someone licensed in a clinical field is a clinician, but that's obvious and no one is disputing that. Secondly, you're ignoring how the definitions and complementary definitions show us the general understanding is that licensing is not considered a must-have requirement to be considered a clinician, and the odd part about that is you already communicated being aware that licensing is not a requirement, lol.

So, let's do this and end it:

======
Webster
======
cli·ni·cian
(klin-ish'ŭn),
A health professional engaged in the care of patients, as distinguished from one working in other areas of practice.
Farlex Partner Medical Dictionary © Farlex 2012

- We can all agree that there are many health professionals in the care of patients in one capacity or another that are unlicensed.

clinician
[klinish′ən]
a health professional whose practice is based on direct observation and treatment of a patient, as distinguished from other types of health workers, such as laboratory technicians and those employed in research.
Mosby's Medical Dictionary, 9th edition. © 2009, Elsevier.

- We can all agree that there are health professionals whose practice is based on direct observation and treatment of a patient that are unlicensed.

clinician
Any doctor, of any speciality, dealing directly with patients.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005

- ANY Doctor... We can all agree that there are many types of Doctors of many different specialties besides medicine and not all are licensed.

========
Cambridge
========

clinician
noun [ C ] medical specialized UK /klɪˈnɪʃ.ən/ US /klɪˈnɪʃ.ən/
someone, such as a doctor, who has qualifications in an area of very skilled health work

- Look carefully, it says "someone", not specifically a medical Doctor or some sort of licensed Doctor. It then mentions "a Doctor" as an example, and as we all know there are Doctors other than licensed Doctors who hold qualifications in an area of very skilled health work, in fact in mental health it's quite common for a person to be an unlicensed Doctor but be licensed at the Masters level, and some who are not licensed at any level.

=====
Collins
=====

clinician in American
(klɪˈnɪʃən
noun
an expert in or practitioner of clinical medicine, psychology, etc.
Webster’s New World College Dictionary, 4th Edition. Copyright © 2010 by Houghton Mifflin Harcourt. All rights reserved.

- We all know you can be an expert and/or a practitioner in psychology (and other fields) without being licensed if you work under supervision like so many people who hold degrees in mental health fields that don't even qualify for licensure. We know that one has to be licensed to practice clinical medicine but this was never disputed, we're obviously talking about fields where one does NOT have to be licensed.

I won't bother going through the rest of them because it's just a repeat of the same proof.

Any question about my perception of reality is irrelevant.

The original question was whether or not one had to be licensed to be considered/called a clinician. I've provided enough proof that one does not, including those definitions which never mention any such requirement that one be registered, licensed, or certified, and it should also be noted how many of them detail the exact words "other healthcare workers" making it clear that clinicians can come from a wide range of disciplines without specification of being licensed. You even admitted being aware of those being considered clinicians without being licensed.

So that's it, there is nothing else to debate.

 

Maxwell_Smart: First you asked for information showing that a clinician can be unlicensed and supervised to be able to practice. I gave you two pieces of real-world evidence from the job market from two different states showing that it is known and done. Then, you acknowledged the fact that this is done, but moved the goalposts to a new marker about definitions.

Jan: Not a new marker about definitions but professional standards expected from individuals who use the title "Clinician. As I and another poster Copper stated, the title of Clinician generally refers to a licensed individual, of course with exceptions as previously mentioned.

Maxwell: I then source out a ton of dictionaries, none of which state that a clinician must be licensed which was the original core debate. So then you cite that they mention licensed professions in some of those definitions, which is true. The problem is, you ignore that most list multiple definitions as if two things can't be true at once when they can be and in this case they clearly are. There are some professions where one must be licensed, and others that don't. As the definitions prove, there is an understanding that some professions can or have to be licensed but others don't, neither has any bearing on whether or not the positions we're discussing can carry the title of clinician because we already know for a fact that licensing has no bearing on that in general. But you moved the goalposts yet again...

Jan: In fact, I noted the exceptions and agreed with Kismet to a certain extent but with clarification. However, the bottom line is that a Clinician generally infers that the holder of this title is licensed, as I and another poster, Copper, correctly noted.

Maxwell: So now you've moved it to, well people use it for some and not others to differentiate. Fair enough. That still changes nothing because the core fact remains that one in a clinical profession can be and is considered a clinician even without a license.

Jan: Yes, with exceptions, as repeatedly stated.

Maxwell: Jan, to break it down, here is what you're doing wrong: You're arguing that someone licensed in a clinical field is a clinician, but that's obvious and no one is disputing that.

Jan: However, you are "disputing that", because in the vast majority of cases, the title of Clinician in overwhelmingly used to describe professionals who are licensed.

Maxwell: Secondly, you're ignoring how the definitions and complementary definitions show us the general understanding is that licensing is not considered a must-have requirement to be considered a clinician, and the odd part about that is you already communicated being aware that licensing is not a requirement, lol.

Jan: Its obvious that you are not a Clinician thereby basing your opinion on YOUR interpretation of dictionary definitions of the term Clinician. Mine are based on experience and knowledge of the laws, rules and statues pertaining to the use of the title Clinician.

Maxwell: So, let's do this and end it:

======
Webster
======
cli·ni·cian
(klin-ish'ŭn),
A health professional engaged in the care of patients, as distinguished from one working in other areas of practice.
Farlex Partner Medical Dictionary © Farlex 2012

JAN: My reading of the Merriam Webster definition states " A person in the CLINICAL practice of Medicine, Psychiatry and Psychology distinguished from specializing in laboratory or research in theory". This means that these Clinicians are LICENSED!

Maxwell- We can all agree that there are many health professionals in the care of patients in one capacity or another that are unlicensed.

Jan: NO Maxwell, not We agree, but that you feel that you are correct.

Maxwell: clinician
[klinish′ən]
a health professional whose practice is based on direct observation and treatment of a patient, as distinguished from other types of health workers, such as laboratory technicians and those employed in research.
Mosby's Medical Dictionary, 9th edition. © 2009, Elsevier.

- We can all agree that there are health professionals whose practice is based on direct observation and treatment of a patient that are unlicensed.

Jan: Once again, there are exceptions, but the vast majority of Clinicians whose practice is based on direct observation and TREATMENT are licensed!



Maxwell: clinician
Any doctor, of any speciality, dealing directly with patients.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005

- ANY Doctor... We can all agree that there are many types of Doctors of many different specialties besides medicine and not all are licensed.

Jan: You're beating a dead horse. We have discussed this issue ad infinitum but the online Collins definition of Clinician states that "A Clinician is a doctor who specializes in Clinical Work", meaning that they are overwhelmingly licensed.

========
Cambridge
========

Maxwell: clinician
noun [ C ] medical specialized UK /klɪˈnɪʃ.ən/ US /klɪˈnɪʃ.ən/
someone, such as a doctor, who has qualifications in an area of very skilled health work

- Look carefully, it says "someone", not specifically a medical Doctor or some sort of licensed Doctor. It then mentions "a Doctor" as an example, and as we all know there are Doctors other than licensed Doctors who hold qualifications in an area of very skilled health work, in fact in mental health it's quite common for a person to be an unlicensed Doctor but be licensed at the Masters level, and some who are not licensed at any level.

=====
Collins
=====

Maxwell: clinician in American
(klɪˈnɪʃən
noun
an expert in or practitioner of clinical medicine, psychology, etc.
Webster’s New World College Dictionary, 4th Edition. Copyright © 2010 by Houghton Mifflin Harcourt. All rights reserved.

- We all know you can be an expert and/or a practitioner in psychology (and other fields) without being licensed if you work under supervision like so many people who hold degrees in mental health fields that don't even qualify for licensure. We know that one has to be licensed to practice clinical medicine but this was never disputed, we're obviously talking about fields where one does NOT have to be licensed.

Jan: Oye vey!!!!!!

Maxwell: I won't bother going through the rest of them because it's just a repeat of the same proof.

Jan: Thank you!


Maxwell: So that's it, there is nothing else to debate.

Jan: Maxwell, the problem is that you perceived this as a debate when I was hoping for a meaningful discussion. Regardless, best of luck.

 

Am I the only one here who is kind of confused as to what this clinician licensed versus unlicensed argument is about at this point?

 

Nope. What you have been watching here is a pissing contest among three regulars on the forum, one of whom is a moderator, two of whom are agitators, and none of whom know what the hell they’re talking about. Engaging, as usual, in an irrelevant discourse that has nothing to do with the subject of the thread. But they like hearing their own voices and exposing the rest of us to extreme boredom.

But, as you know, I have an RA non-profit Ph.D., and they don’t. None of them. Nada. Zilch. Which makes me smarter than they are, whether they like it or not. And that’s why I continue to laugh at them.

So what’s the truth about clinician? It means whatever the hell you want it to mean. The term has nothing to do with licensure, and anyone is free to use it within the context of their specific field. To wit: A registered nurse is a clinician, an LPN is a clinician, and a nursing assistant is a clinician, all of them within the scope of their specific profession. A psychologist is a clinician, a counselor is a clinician, and a psych tech or psych aide is a clinician, all within the scope of their specific job titles. Anyone who tries to restrict the use of clinician is full of what the French eloquently call merde, Making a mountain out of a molehill and complicating the entire picture.

Now, I’ll go slightly off topic to illustrate the whole, um, clinical picture. One of the many topics I have taught over the years is medical ethics. In fact, of all the courses I have taught at the grad school level – law, counseling, psych, HRD, comparative and pastoral theology, ad infinitum, medical ethics was the most popular course I taught insofar as it was always packed out with students. Go figure…

(For what it’s worth, before the anonymous trolls start trashing my credentials like they usually do, insignificant twits that they are, it happens that the syllabus for one of my medical ethics courses was published by the syllabus repository at Georgetown University. You’ll find it at https://repository.library.georgetown.edu/bitstream/handle/10822/556495/se0298.pdf?sequence=1.)

I always broke the medical ethics field down into two categories: clinical medical ethics and biomedical ethics. That is not a popular breakdown, any more than the way I differentiate diploma mills from degree mills, but it has always worked for me. And I generally taught the clinical end (although I was well versed in the biomedical end as well).

So what’s the difference? Biomedical ethics addresses issues that the average clinician will never have to address: cloning, for example. Clinical medical ethics deals with issues that the average clinician will have to deal with, sometimes on a daily basis, other times on a more infrequent basis. For example, two potential transplant patients but only one available organ that would be physically compatible with either patient: which patient gets the organ? Or, a patient who is diagnosed with stage 4 pancreatic cancer: Should the patient fight like Alex Trebek, or should he or she not bother with aggressive treatment because they’ve got crappy odds of survival?

Some topics in medical ethics can cross into both areas. Stem cell therapy, for example, was once clearly on the bioethics side. But with advances in the use of stem cells to treat Parkinson’s disease, it has crossed over and is now a clinical medical ethics issue, insofar as treatment personnel will be confronted with the stem cell therapy issue in their professional lives. The term treatment personnel, by the way, includes clergy (both pastors and pastoral counselors), and insofar as they are part of a treatment team, that makes them clinicians as well, again within the context of their specific professions.

So, ultimately, who is a clinician? Anyone on a treatment team, regardless of their licensure status or their specific job title, within the context of their specific role on that team. Right down to a hospital housekeeping person, who is presumably trained in the proper clinical use of his or her mop.

So there you have it. The trolls who are arguing about the term clinician are like bullshit philosophers who like to argue about how many angels can dance on the head of a pin. You know, the trolls I like to laugh at because I am better than them, whether they like it or not.

Now, what do you think? Do I really mean it when I say that I’m better than them, or am I just joking? Do I take myself seriously when I trash the trolls, or do I not take myself seriously at all?

Um, guess.

In the meantime, I have spoken. And have said everything I wish to say on this rather boring topic. And since the trolls always like to get the last word in, I shall now let them do so.

 

Abiding by individual State laws is the real issue! Theoretically setup for “patient protection”.

 

Actually, it means nothing of the sort. The fact that you believe it to be true however says something not so nice/smart about you.

 

Steve Levicoff: Nope. What you have been watching here is a pissing contest among three regulars on the forum, one of whom is a moderator, two of whom are agitators, and none of whom know what the hell they’re talking about. Engaging, as usual, in an irrelevant discourse that has nothing to do with the subject of the thread. But they like hearing their own voices and exposing the rest of us to extreme boredom.

JAN: Very interesting. The very negative characteristics you are ascribing to the two posters is an exact description of your antics, which is evidenced in an overwhelming number of your posts including this one!

Levicoff: But, as you know, I have an RA non-profit Ph.D., and they don’t. None of them. Nada. Zilch. Which makes me smarter than they are, whether they like it or not. And that’s why I continue to laugh at them.

JAN: Here we go again. Using this forum to bolster his self-esteem. Nothing more, nothing less.

Levicoff: So what’s the truth about clinician? It means whatever the hell you want it to mean. The term has nothing to do with licensure, and anyone is free to use it within the context of their specific field. To wit: A registered nurse is a clinician, an LPN is a clinician, and a nursing assistant is a clinician, all of them within the scope of their specific profession. A psychologist is a clinician, a counselor is a clinician, and a psych tech or psych aide is a clinician, all within the scope of their specific job titles. Anyone who tries to restrict the use of clinician is full of what the French eloquently call merde, Making a mountain out of a molehill and complicating the entire picture.

JAN: "It means whatever the hell you want it to mean"? Very credible analysis regarding this subject (LOL). And this is the level of critical thinking that Levicoff attempts to pass off as RA doctoral level intellectual processing.

Levicoff: Now, I’ll go slightly off topic to illustrate the whole, um, clinical picture. One of the many topics I have taught over the years is medical ethics. In fact, of all the courses I have taught at the grad school level – law, counseling, psych, HRD, comparative and pastoral theology, ad infinitum, medical ethics was the most popular course I taught insofar as it was always packed out with students. Go figure…

(For what it’s worth, before the anonymous trolls start trashing my credentials like they usually do, insignificant twits that they are, it happens that the syllabus for one of my medical ethics courses was published by the syllabus repository at Georgetown University. You’ll find it at https://repository.library.georgetown.edu/bitstream/handle/10822/556495/se0298.pdf?sequence=1.)

I always broke the medical ethics field down into two categories: clinical medical ethics and biomedical ethics. That is not a popular breakdown, any more than the way I differentiate diploma mills from degree mills, but it has always worked for me. And I generally taught the clinical end (although I was well versed in the biomedical end as well).

So what’s the difference? Biomedical ethics addresses issues that the average clinician will never have to address: cloning, for example. Clinical medical ethics deals with issues that the average clinician will have to deal with, sometimes on a daily basis, other times on a more infrequent basis. For example, two potential transplant patients but only one available organ that would be physically compatible with either patient: which patient gets the organ? Or, a patient who is diagnosed with stage 4 pancreatic cancer: Should the patient fight like Alex Trebek, or should he or she not bother with aggressive treatment because they’ve got crappy odds of survival?

Some topics in medical ethics can cross into both areas. Stem cell therapy, for example, was once clearly on the bioethics side. But with advances in the use of stem cells to treat Parkinson’s disease, it has crossed over and is now a clinical medical ethics issue, insofar as treatment personnel will be confronted with the stem cell therapy issue in their professional lives. The term treatment personnel, by the way, includes clergy (both pastors and pastoral counselors), and insofar as they are part of a treatment team, that makes them clinicians as well, again within the context of their specific professions.

JAN: Here we go again! Levicoff goes off the topic to discuss a totally unrelated subject in order to attempt to demonstrate to posters how his "intellectual prowess" makes him an authority regarding who constitutes a Clinician. Fallacious pedantic posturing beyond anything I have ever observed on this forum.

Levicoff: So, ultimately, who is a clinician? Anyone on a treatment team, regardless of their licensure status or their specific job title, within the context of their specific role on that team. Right down to a hospital housekeeping person, who is presumably trained in the proper clinical use of his or her mop.

JAN: The above statement needs no comment. It speaks for itself. Absolutely Meaningless.

Levicoff: So there you have it. The trolls who are arguing about the term clinician are like bullshit philosophers who like to argue about how many angels can dance on the head of a pin. You know, the trolls I like to laugh at because I am better than them, whether they like it or not.

Now, what do you think? Do I really mean it when I say that I’m better than them, or am I just joking? Do I take myself seriously when I trash the trolls, or do I not take myself seriously at all?

Um, guess.

JAN: Quite frankly, who cares.

Levicoff: In the meantime, I have spoken. And have said everything I wish to say on this rather boring topic. And since the trolls always like to get the last word in, I shall now let them do so.

JAN: Boring doesn't begin to describe the above BS that Levicoff passes off as elucidating this topic. Its outright irrelevant, and self-aggrandizing. Nothing more, nothing less.

 

EXACTLY.

 

The Veterans Administration defines clinician in the code of federal regulations: “Clinician means a Physician, Physician Assistant (PA), Nurse Practitioner (NP), Psychologist, or other independent licensed practitioner.”

https://www.law.cornell.edu/cfr/text/38/70.2

This tells us at a minimum, the use of the title “clinician” is obviously regulated in this circle to those who are “licensed”.
As I pointed out earlier, there are exceptions throughout the USA. It also demonstrates the fact there is varying legislation between different government bodies (Federal, State, Territorial).

 

The thing that bothers me about the DBH is how it appears to my eye to be one of the many attempted back-doors into Clinical Psychology practice. Alongside Pastoral Counseling and countless things like that.

It's going to be a matter of legal fine-print in each state/jurisdiction what licensing requirements and scope of practice for various sorts of mental-health practitioners will be. Along with how they can advertise themselves to prospective patients. So anyone contemplating enrolling in Cummings to become an alternative mental health practitioner will need to familiarize him/herself with the applicable laws.

It's sad in my opinion, since 'Behavioral Health' does suggest a perfectly viable career path that needn't have very much to do with psychology or psychopathology.

I'm a patient/customer/whatever of Kaiser Permanente, the giant HMO where Nicholas Cummings worked for many years. And Kaiser is all over me with preventative-health and healthy-lifestyle tips about diet, exercise and things like that. I believe that Kaiser has a whole department devoted to that. That's what I first thought of when I heard the phrase 'Behavioral Health'.

 

And he doesn't know what any of them have for sure, he doesn't actually know them. He's also confused about his own post. He claims "none of them know they're talking about", then actually agrees 100% with Max's postings--apparently without realizing it--by saying: " So what’s the truth about clinician? It means whatever the hell you want it to mean. The term has nothing to do with licensure, and anyone is free to use it within the context of their specific field." I also find it hilarious that he would call anybody a troll, especially two absolute non-trolls like Jan and Max, when he is the ULTIMATE troll, or maybe he doesn't actually know what trolling means.

Because he is combative all the time, he sees everything outside of him as combat or "pissing contests" as he frequently calls it when things are really just normal debates. Strangely, Jan herself takes the word "debate" as something negative which kind of reveals how she sees these things as a sort of combat as well, the only exception is that at least she is respectful where Levicoff is almost always just a ban-worthy nuisance.

But Max is right and gave the necessary amount of evidence, so I really don't get what angle Jan was going with here. Jan seems like a nice, intelligent person, she just needs to learn when to call it quits because she comes out on the wrong end of these a little too often.

 

I agree! The fact is, behavioral health is not a one or two legged stool. I worked in a University clinic alongside many mental health professionals. They were very good at accurately diagnosing mental health disorders but came to me for the “third leg” of the stool (psychopharmacology). It’s really a collaborative effort and not a stand alone approach to “behavioral health”. The legs being mind, body and spirit.

 

Jan, you were posting a lot about Calsouthern. Have you enrolled for your doctoral program yet? If so, what field?

 

On two different threads, asking Jan about her doctoral program plans/enrollment is like waving a crucifix or Holy Water. She just disappears??

 

Perhaps a PM is more appropriate. Seems more likely one is a target for crucifixion on this forum rather than a civil dialogue.

 

EXACTLY!

Due to the lack of f2f interaction on this and other forums, a number of posters believe that their anonymity allows them to engage in negative, devaluing ad hominem and undermining comments that they wouldn't necessarily employ if relating f2f.

This is the reason that I don't reveal too much personal data due to the "must win or else" mindset of a number of posters that takes on the characteristics of a vendetta.

In fact, a number of years ago I recall an intense, angry verbal exchange on this forum between two posters, one of whom was a faculty member at a distance, online school, the name of which he revealed on this forum. Subsequently, this poster reported that either the poster he was interacting with, or another, contacted his school and made harsh, negative comments about him leading to his demotion after his supervisor reviewed the negative interaction on this forum.

After that experience there was no way that I would reveal ANY identifying information on this or any other online forum.

 

Saying that you are enrolled in a doctoral program in x is too much personal information?

 

Review your follow up response above when I didn't immediately respond to your initial question as to whether I enrolled in CSU's doctoral program. It was sarcastic and hostile, and you didn't provide adequate time for me to respond, as if I'm at your beck and call!

This is the level of mindset that dissuades many posters from posting and engaging in meaningful discussions.

 

My responding to your lack of response took nearly seven hours so hardly a hasty reply. In any case, you are entitled to your thing and seem to enjoy jumping on others. You are also defensively deflecting from the question.

It is your right to not reply (though it has nothing to do with privacy). I am not interested in playing so there is that. Bye.