A few months ago, I was contacted by a young lady on the brink of a psychological breakdown. She was seeking immediate treatment. During our initial meetings it became evident that she had been to therapy over the past few years with various types of psychotherapists who not only didn’t assist her but caused her problem to magnify. The client wasn’t able to pinpoint what the underlying problems were with these various psychotherapists, but she was very vivid in describing the emotional pain she experienced during and after these meetings. As she described the work of her past psychotherapists, I was struck by the mix of deficiencies in her previous treatment including misdiagnoses, boundary violations, and ethical breaches. As a result of these past “treatments” most of our initial work was trying to overcome the trauma my client experienced from these various psychotherapists. Only then were we able to focus on her initial presenting problem.
Over the past few years, a dangerous trend has emerged in the Jewish community here in Israel and in the United States where well-intentioned individuals who have been told in the past that they were “good listeners” decide to pursue a career in mental health counseling. Instead of enrolling in a university and securing a solid education in mental health, they enroll in various types of quasi-academic programs and in a matter of a year or two at best, or several months at worst, end up with a diploma or degree and begin offering psychological services to the masses.
The array of these programs is staggering. They range from a short course or program in CBT or another modality from an “institute” which grants a diploma, to a degree in “emotional therapy”, to an online degree from various universities around the world, or even a master’s degree in something called “clinical sociology”. The common denominator of all these various types of programs is that they lack essential components of real academic training in the complexities of the human mind. Psychologists both in Israel and in the United States have a minimum of seven years of training, four years as an undergraduate student and then at least three years as a graduate student. Beyond courses in brain science, statistics, clinical research methods, developmental psychology, techniques of therapy, theories of therapy, personality theories, psychopathology, assessment, ethics, and law, these programs offer intense training and supervision by seasoned psychologists. Once a degree is granted new psychologists are required to further their education via continuing education and internships, in Israel for at least four years and in the United States for many more years.
The reason the proliferation of these fake psychologists is legally permissible is that although you are not allowed to call yourself a psychologist without actually having a state license in psychology, you are permitted to call yourself a “psychotherapist” without any oversight. Hence, graduates of all these various programs and degrees refer to themselves as “psychotherapist” and are able to treat patients experiencing the most severe mental illness.
Unfortunately, these patients are often unaware that their “psychotherapists” lack systemic training in psychology. In some cases, these therapists intentionally hide their lack of training from their patients. I was even privy to one of these “programs” that had an attached clinic and it was part of the program’s policy to hide from the patients the fact that the “psychotherapists” working in the clinic had no formal training.
I have seen time and time again how individuals seeking treatment from these various “psychotherapists” are misdiagnosed, mistreated, and often experienced severe boundary and ethical violations. For example, I have seen suicide ideation misdiagnosed as “typical teen stuff”. I witnessed cases of “psychotherapists” becoming Facebook friends with their patients and then having relationships with them outside the therapeutic bond. This boundary violation led the patient to develop an unhealthy dependency which furthered the initial psychological problem. I have seen a case of a “psychotherapist” getting so upset at something a patient said in session that she followed the patient out to the parking lot and yelled at her in public. In a most egregious case, one of these “psychotherapists” advised a family in the neighborhood not to pursue a potential dating relationship based on information the “psychotherapist” learned in therapy about the other family. I am in no way suggesting that these types of breeches cannot occur with trained psychologists. However, the likelihood of these types of issues taking place with a trained psychologist is significantly minimized because of the extensive focus on ethics and the law that is an essential part of academic graduate training.
In addition to the damage, individuals who are disappointed or harmed by these “psychotherapists” give up on seeking treatment and often never end up seeing a real psychologist to deal with their problems. Recently, several tragic cases of suicide in the Jewish community involved patients seen by these various types of “psychotherapists”.
Mental illness is a serious problem and causes immense damage to the patients and their families. Over a hundred years of clinical research in mental health has developed clear and scientifically supported treatments for a variety of mental health illnesses. Knowing how to diagnose and treat individuals professionally and ethically requires a level of training equivalent to medical professionals. The wide availability of under-trained “psychotherapists” is a public health danger.
Considering the complexity of mental health training, the average consumer may find it overwhelming when trying to decide where to seek services. This is why state boards in mental health exist. These state organizations review the training of potential mental health professionals and then certify that the training is appropriate. One seeking mental health services should, at a minimum, verify that the psychologist is certified by the state to offer services in a professional and ethical manner.
As a community we must find ways to assist those in need of mental health services. We must raise awareness of the dangers of pseudo-professionals. Furthermore, we should encourage those seeking a career in mental health to avoid short-cuts and pursue authentic education and training in order to truly assist those suffering in professional, ethical, and meaningful ways.