By Carl RogersA challenge that I wish to raise, especially for clinical and social psychologists, is the radical possibility of sweeping away our procedures for professionalization. I know what heresy that idea is, what terror it strikes in the heart of the person who has struggled to become a “professional.” But I have seen the moves toward certification and licensure, the attempts to exclude charlatans, from a vantage point of many years, and it is my considered judgment that they fail in their aims. I helped the APA to form the ABEPP (American Board of Examiners in Professional Psychology, now named the American Board of Professional Psychology) in 1947 when I was president of the APA. I was ambivalent about the move then. I wish now that I had taken a stand against it.
I am not in any way impugning the motives, the integrity, and the efforts of those who aim toward certification and all that follows from it. I sympathize deeply. I wish there were a way to separate the qualified from the unqualified, the competent worker from the opportunist, the exploiter, and the charlatan. But let’s look at a few facts.
As soon as we set up criteria for certification – whether for clinical psychologists, for NTL group trainers, for marriage counselors, for psychiatrists, for psychoanalysts, or, as I heard the other day, for psychic healers – the first and greatest effect is to freeze the profession in a past image. This is an inevitable result. What can you use for examinations? Obviously, the questions and tests that have been used in the past decade or two. Who is wise enough to be an examiner? Obviously, the person who has ten or twenty years of experience and who therefore started his training fifteen to twenty-five years previously. I know how hard such groups try to update their criteria, but they are always several laps behind. So the certification procedure is always rooted in the rather distant past and defines the profession in those terms.
The second drawback I state sorrowfully: there are as many certified charlatans and exploiters of people as there are uncertified. If you had a good friend badly in need of therapeutic help, and I gave you the name of a therapist who was a Diplomate in Clinical Psychology, with no other information, would you send your friend to him? Of course not. You would want to know what he is like as a person and a therapist, recognizing that there are many with diplomas on their walls who are not fit to do therapy, lead a group, or help a marriage. Certification is not equivalent to competence.
The third drawback is that the urge toward professionalism builds up a rigid bureaucracy. I am not personally aware of such bureaucracy at the national level, but it certainly occurs frequently at the state level. Bureaucratic rules become a substitute for sound judgment. A person is disqualified because he has 150 hours of supervised therapy, while another is approved because he has the required 200. No attention is given to the effectiveness of either therapist, or the quality of his work, or even the quality of the supervision he received. Another person might be disqualified be-cause his excellent psychological thesis was done in a graduate department that is not labeled “psychology.” I won’t multiply the examples. The bureaucrat is beginning to dominate the scene in ways that are all too familiar, setting the profession back enormously.
Then there is the other side of the coin. I think of the “hot-line” workers whom I have been privileged to know in recent years. Over the phone, they handle bad drug trips, incipient suicides, tangled love affairs, family discord, all kinds of personal problems. Most of these workers are college students or those just beyond this level, with minimal intensive “on-the-job” training. And I know that in many of these crisis situations they use a skill and judgment that would make a professional green with envy. They are completely “unqualified,” if we use conventional standards. But they are, by and large, both dedicated and competent.
I think also of my experience in groups, where the so-called naive member often has an inner wisdom in dealing with difficult individuals and situations which far outclasses that of myself or of any other professional facilitator. It is a sobering experience to observe this. Or, when I think of the best leaders I know for dealing with groups of married couples, I think of a man and a woman, neither of whom has even the beginning of satisfactory paper credentials. Very well qualified people exist outside the fence of credentials.
But you may protest, “How are you going to stop the charlatans who exploit persons psychologically, often for great financial gain?” I respect this question, but I would point out that the person whose purpose is to exploit others can do so without calling himself a psychologist. Scientology (from which we might have learned some things, had we been less concerned about credentials) now goes its merry and profitable way as a religion! It is my considered judgment that tight professional standards do not, to more than a minimal degree, shut out the exploiters and the charlatans. If we concentrated on developing and giving outstanding personal help, individuals would come to us, rather than to con artists.
We must face the fact that in dealing with human beings, a certificate does not give much assurance of real qualification. If we were less arrogant, we might also learn much from the “uncertified” individual, who is sometimes unusually adept in the area of human relationships.
I am quite aware that the position I am taking has disadvantages and involves risks. But so does the path to certification and licensure. And I have slowly come to the conclusion that if we did away with “the expert,” “the certified professional,” “the licensed psychologist,” we might open our profession to a breeze of fresh air, a surge of creativity, such as it has not known for years.
In every area – medicine, nursing, teaching, brick-laying, or carpentry – certification has tended to freeze and narrow the profession, has tied it to the past, has discouraged innovation. If we ask ourselves how the American physician acquired the image of being a dollar-seeking reactionary, a member of the tightest union in the country, opposed to all progress and change, and especially opposed to giving health care where it is most needed, there is little doubt that the American Medical Association has slowly, even though unintentionally, built that image in the public mind. Yet the primary initial purpose of the AMA was to certify and license qualified physicians and to protect the public against the quack. It hurts me to see psychology beginning to follow that same path.
The question I am humbly raising, in the face of what I am sure will be great shock and antagonism, is simply this: Can psychology find a new and better way? Is there some more creative method of bringing together those who need help and those who are truly excellent in offering helping relationships?
I do not have a final answer, but I would point to one suggestive principle, first enunciated for me by my colleague Richard Farson (personal communication, 1966): “The population which has the problem possesses the best resources for dealing with the problem.” This has been shown to be true in many areas. Drug addicts, or former drug addicts, are most successful in dealing with individuals who have drug problems; similarly, ex-alcoholics help alcoholics, ex-convicts help prisoners – all of them probably more effectively than professionals. But if we certify or otherwise give these individuals superior status as helpers, their helpfulness declines. They then become “professionals,” with all the exclusiveness and territoriality that mark the professional.
So, though I know it must sound horrendous, I would like to see all the energy we put into certification rules, qualifications, licensure legislation, and written and oral examinations rechanneled into assisting clinical psychologists, social psychologists, and group leaders to become so effective, so devoted to human welfare, that they would be chosen over those who are actually unqualified, whether or not they possess paper credentials.
As a supplement to guide the public, we might set up the equivalent of a Consumer Protective Service. If one complaint comes in about ineffective or unethical behavior, it might well be explained away. But if many complaints come in about an individual’s services to the public, then his name should be made available to the public, with the suggestion “Let the buyer beware.”
Meanwhile, let us develop our learning processes in psychology in such new ways that we are of significantly more service to the public than the “instant gurus,” the developers of new and untried fads, the exploiters who feed on a public obviously hungry to be dependent on someone who claims to have the answer to all human problems. When our own lasting helpfulness is clearly evident, then we will have no need for our elaborate machinery for certifying and licensing.
