Senator SPONG. Thank you, Dr. Levy.

You referred in one part of your statement to the District as a haven for charlatans. Could you give the committee any example of malpractice in the field taking place in the District?

Dr. LEVY. There have been very few cases of malpractice brought to the attention of the District of Columbia Psychological Association. What has been happening is that citizens have been calling the association for information about fully qualified peyschologists. I think it is perhaps too early at the moment to determine the impact of the drift of charlatans into this area. I think, too, that some charlatans, although practicing psychology, may be using an entirely different label for the kind of psychological activity that they engage in.

Senator SPONG. You also made some mention of claims made in advertisements which would be impossible in light of the existing knowledge.

Can you give us any instances of this?

Dr. LEVY. I have not committed any of them to memory.

Some of them are very strange and exotic. Perhaps, my colleague might remember.

Dr. CUMMINGS. I am Dr. Cummings. We have drawn our attention to the question that you are arising here, because it is so important. In the first place, I think many of us have been afraid to speak because we have the fear of being accused of labeling people in this type of thing. There are words and charms used in some of the books, like ads in the Yellow Pages of the Washington Directory under "Psychologists" which use the names, referring to certain positions which have very little to do with the scientific practice of psychology. It is these that Dr. Levy was referring to. One is hard pressed to understand how these can be harnessed. They all claim to be of help to the human behavioral problems and help in the clinical fields, counseling, and what have you. I do have an article here by Sylvia Porter, and I wonder if I might introduce it for the record.

Senator SPONG. Please do.

Dr. CUMMINGS. This is from the Washington Evening Star, Tuesday, April 8, of this year.

I would just like to read to you the first paragraph:

If you are a relative or a friend of one of the five million mentally retarded, you are aware of the heartbreaking research for effective treatment of this widespread and disabling childhood illness. You also must be aware of the extent to which parents of the retarded are tempted by the mental health people, both here and abroad.

And then it goes on here and in a very typically effective manner to spell out what she has in mind here. She uses the psychologists by name as good examples of the educational practice of psychology, but yet noting that because there is no licensing law that a lot of people can sometimes masquerade as psychologists. She says, and I quote her again she has spelled out a list of points which she thinks account for the number of quacks and charlatans in this area, and her final point is that there are no laws.

State laws are grossly inadequate in the regulation of practitioners in this field. There are many people in the United States who have hung up a shingle and they have been unqualified persons. They have hung up a shingle designat ing themselves to be a psychologist, a psychotherapist, or a marriage counsellor.

She goes on from there to further spell it out.

I found it very interesting.

I am afraid that the information we could give you, in answer to your question, would be of that general level, sir.

Senator SPONG. Thank you.

At the opening of the hearing we placed in the record a letter from Mayor Washington.

The committee would like to have your comments on the proposed changes in the bill that the District government has recommended. I realize that you were not here this morning purposely to do that. Do you have a copy of that letter?

Dr. CUMMINGS. We do.

Senator SPONG. We would ask that you address your attention to the suggestions made in the letter and let us have the benefit of your views.

I would like to ask you one or two things. And if you like, you may defer your answer to a later time.

First, you heard me earlier ask Mr. Moyer about the recommendation that charitable agencies and business corporations would be dropped from the list of exempted institutions.

Do you have any comment on that at this time, or would you prefer to wait?

Dr. LEVY. I would like to make some comment for the purpose of understanding, to clarify and clear up in my mind concerning it. It seems to me that he was arguing that in the event that the charitable agency did not have qualified personnel for the selection of professional, competent psychologists, that there might be some possibility of allowing that organization not to come under the rules and regulations of the bill. I think that would be a highly desirable change. Senator SPONG. I would like for you to address yourself to that further in your reply to the general consideration of the letter as a whole.

Your association has looked into the question of what the District government's authority to license psychologists is under its general licensing policy. Do you have a written legal opinion with regard to that, that you could provide for inclusion in the record?

Dr. LEVY. We would be glad to.

Senator SPONG. If you could do that at the same time that you reply as to the letter, it would be appreciated.

(The information requested may be found in the appendix.)

Senator SPONG. Would you say that the most serious problem of malpractice is in connection with psychotherapy, and, if so, why not implement the licensing provisions to apply to those that engage in that activity?

Dr. LEVY. I would like to hold on that question, Mr. Chairman, and develop an answer.

Senator SPONG. All right.

We will submit that question to you.

(The answer may be found in the appendix.)

Senator SPONG. Section 3 (D) defines what is meant by the practice of psychology. There are a lot of things included, such as measuring public opinion and doing research, which I never thought of as being the exclusive property of psychologists.

Off the record.

(Discussion was had outside the record.)

Senator SPONG. As I read the bill, a person would have to have a Ph. D. in psychology to engage in these things. Is that the intent? If not, how do you get around the language that seems to say that?

Dr. LEVY. I would like to ask Dr. Cummings to make a response to that question, Mr. Chairman.

Dr. CUMMINGS. If this is an error on our part, I think it is a very honest one, Senator Spong, because we have tried, at every juncture, to protect the public in the District of Columbia. Psychology is incredibly broad. It has become so over the past 50 to 80 years, as I think the need for it has become more and more known in culture at large. There are so many different ways in which psychologists are functioning.

I think you get a good indication of this by looking at the various divisions that the association is divided into. There are 25 or more different divisions today. There is clinical, counseling, consulting, educational, industrial, and so on and on. It was our feeling that we could serve the purpose of this bill by listing the various ways in which psychologists function, and it was because of this that we did list them.

Now, what we felt we had to do was, at the same time, convey our very sincere wish that would interfere with the general practice of no other business or professional group which is now existing in the culture.

Senator SPONG. Our staff has prepared five or six additional questions. Looking these over, I think that the record would be better if we gave you an opportunity to answer these along with the other matters that we have already asked of you. I will have the staff refer these questions to you, and we will look forward to a reply.

Thank you, gentlemen.

Dr. Little.

(The questions and answers referred to may be found in the appendix.)

STATEMENT OF DR. KENNETH B. LITTLE, EXECUTIVE OFFICER, AMERICAN PSYCHOLOGICAL ASSOCIATION; ACCOMPANIED BY MRS. JUNE HILDRETH, LEGISLATIVE OFFICER

Dr. LITTLE. My name is Kenneth B. Little. I am executive officer of the American Psychological Association.

It has offices here in Washington at 1200 17th Street NW.
I would like to read my statement.

Senator SPONG. Dr. Little, we are very pleased to have you with us this morning.

Dr. LITTLE. Mr. Chairman, my name is Kenneth B. Little. I serve as executive officer of the American Psychological Association, which has its headquarters here in Washington at 1200 17th Street NW.

In this statement, prepared at the invitation of the District of Columbia Psychological Association, the American Psychological Association strongly supports the aims and content of S. 1626 as being in consonance with the association's national policies. My predecessor, Dr. Arthur H. Brayfield, spoke in favor of a similar licensing bill, S. 1864, which was passed unanimously by the Senate in the 90th

Congress. It is my understanding that differences in viewpoint between the District of Columbia Psychological Association and the professional societies representing psychiatrists here in the District prevented final action by the House of Representatives last year, but that the present bill, S. 1626, contains changes that meet the approval of the organized groups representing psychiatrists at the present time.

It is my purpose here to review briefly the history of laws already passed in other jurisdictions to establish standards for the offering of psychological services to the public, and, hopefully, to provide information on why such legislation is necessary and desirable.

The association, with approximately 29,000 members, includes most of the qualified psychologists in the country. Affiliated with the association are psychological associations in the District of Columbia, the Commonwealth of Puerto Rico, the Province of Ontario, and in all States except Alaska-not enough psychologists there yet. Under our bylaws, the territories and Commonwealths of the United States, as well as the Provinces of Canada, are considered to be the equivalent of States.

The first law defining standards for psychologists offering services to the public was adopted in the State of Connecticut in 1945. There are now laws in 40 States and six Canadian Provinces.

An attachment to this statement lists the States and Provinces with laws at the present time, together with the year of adoption.

In 1967, the American Psychological Association adopted a series of policy guidelines for State associations to use should they wish to develop legislation defining and regulating the practice of psychology. Let me summarize, if I may, what our policy statement suggests as basic provisions to be included in a law covering the practice of psychology. First, the qualifications of the psychologist should be set at a realistic level, high enough to assure competence, but not so high as to limit severely the number of eligible psychologists available. Our recommendation is the doctoral degree in psychology and 2 years of supervised experience. Second, the law should not restrict qualified members of other professional groups from doing work of a psychological nature consistent with their training and codes of ethics, nor should it place undue restrictions on the work of psychologists in institutional settings. Third, a code of ethics should be a part of the law or of its regulations. Fourth, adequate provision should be made for the licensing of psychologists already certified or licensed in other jurisdictions with standards no lower; this is frequently called reciprocal endorsement. Fifth, a provision should be included to protect the privileged nature of the psychologist-client relationship. Senate bill 1626 follows the guidelines recommended by our association. Its passage by the Congress will not only give public protection for the citizens of the District, but, in addition, will provide a model for those States still without proper controls. The public has a right to expect help in locating competent psychological services whenever they are needed; a legal definition of who may offer such services is a major contribution in providing necessary safeguards. The American Psychological Association supports legislative efforts to set standards which will insure that substandard services will not be offered to the public.

Almost all of the activities of psychologists touch members of the public in one way or another. Most often the services of psychologists are offered in institutional settings-schools, industry, clinics, hospitals, universities and colleges, and research laboratories. It is not the purpose of the proposed legislation nor of present laws to interfere with the standards established by these institutions. The major objective of the proposed legislation is to insure the professional integrity of the psychological services rendered to the public for a fee. Other testimony before this committee will indicate, for example, the misleading character of the listings under "Psychologists," in yellow pages of the District of Columbia Telephone Directory. We should like to see that situation changed.

Thank you for the opportunity to appear before you today.
Senator SPONG. Thank you, Dr. Little.

(The list of States and Provinces with laws and year of approval referred to follows:)

LIST OF STATES AND PROVINCES WITH LAWS REGULATING THE PRACTICE OF

Alabama (1963)

Alaska (1967)

Arizona (1965)

Arkansas (1955)

California (1957)
Colorado (1961)
Connecticut (1945)
Delaware (1962)
Florida (1961)
Georgia (1951)
Hawaii (1967)
Idaho (1963)

Illinois (1963)

Indiana (1969)

Kansas (1967)

Kentucky (1948)

Louisiana (1964)

Maine (1953)

Maryland (1957)

Michigan (1959)

Minnesota (1951)

Mississippi (1966)

Nebraska (1967)

PYSCHOLOGY

(Year of Approval)

Nevada (1963)

New Hampshire (1957)
New Jersey (1966)
New Mexico (1963)
New York (1956)

North Carolina (1967)
North Dakota (1967)
Oklahoma (1965)
Oregon (1963)

Rhode Island (1969)
South Carolina (1968)
Tennessee (1953)
Texas (1969)

Utah (1959)

Virginia (1946)

Washington (1955)

Wyoming (1965)

Alberta (1960)

Manitoba (1966)

New Brunswick (1967)

Ontario (1960)

Quebec (1962)

Saskatchewan (1962)

Senator SPONG. Are there any other State laws which would employ the same definition of "practice of psychology" as is used in this bill? I know that the Virginia law does not, but I would appreciate your giving us some analysis on this point.

Dr. LITTLE. May I ask Mrs. Hildreth, who is our legislative officer on this, to come up here?

Senator SPONG. Certainly.

Mrs. HILDRETH. I think it is fair to say that as the laws developed over the years there has been a great deal of borrowing from previous definitions, so that I think it is accurate to say now that there are probably 10 or a dozen definitions that are similar or perhaps exactly like the one that is in the proposed S. 1626.

Senator SPONG. There is nothing unique about this.
Mrs. HILDRETH. No.