The Ohio Association of Child Caring Agencies’

Testimony on HB 374

Licensing Marriage and Family Therapists

February 19, 2002

Mr. Chairman and members of the committee, my name is Penny Wyman. I am the Executive Director of the Ohio Association of Child Caring Agencies or OACCA. Our members provide a wide range of behavioral health and social services to families and children throughout the state. State regulations and national accreditation bodies require services to be provided by appropriately credentialed individuals, based on the service category. Ohio is currently one of only six states that do not recognize marriage and family therapists as a profession.

I must disclose to you that I am a Licensed Social Worker and serve as Chair of the Professional Standards Committee of the Ohio Counselor and Social Worker Board. I am not here representing the Board today, however, and have no authority to do so.

I am here today as an advocate for families and children, for OACCA’s member agencies and, not least of all, for common sense. Actually, I did not intend to become actively involved with this bill. It was obviously a good idea, we believed that the bill would pass without much fuss. But after reading some of the testimony that was provided to this committee, I felt it was necessary to make sure you had all the facts before casting your votes.

First: There is a shortage of mental health professionals, not a “flood” as Dr. Hayes was quoted.

This is particularly true in areas of our state that do not have academic programs that train these professionals. It is also difficult to find adequate numbers of individuals with independent licenses to provide clinical supervision as required by law and rule. The January, 2001 report of the Ohio Mental Health Commission states, on page 13: “The waiting list for one organization had increased to 98 days. Almost every respondent to the survey reported that waiting lists are growing. Access to care is getting worse – with average waits for psychotherapy and psychiatric evaluation rising to 28 and 60 days, respectively. Increasing caseload sizes are stretching staff capabilities and affecting quality of care.” On page 15, it states: “ A major reason that local mental health systems are not able to meet the needs of their communities is a shortage of adequately trained clinical staff. ... because local public mental health systems do not have enough resources to hire and retain the amount of staff they need to meet access demand. An overall shortage of mental health professionals also contributes to the problem. The need is especially great for child psychiatrists and other clinicians who specialize in serving chilreen, and in rural areas, such as Appalachia.” On page 16: “The average mental healh center psychiatrist manages a caseload of 375 adults. In Ohio, the number is 811.

Second: Strict adherence to “scope of practice” means that all professionals must practice only in those areas in which they have had training, supervised practice, and have passed standardized examinations of their knowledge and skills. There is nothing in this bill or in the

Page 2 OACCA Testimony on HB 374

counselor and social worker licensure law that allows any of these professionals to prescribe medication. That is entirely outside of the scope of practice for anyone who has not received extensive education in physical medicine and all the attendant subject requirements.

Third: The “right tool for the right job” applies to behavioral health services, as well as in other areas of our lives. Sometimes a psychiatrist is best suited to meet a client’s needs: When the mental health problem results from a physical condition or chemical imbalance and medication is needed. When the behavioral health problem results from family dysfunction, social circumstances or situational stress (to name a few), a social worker, counselor or marriage and family therapist is often best suited to meet the needs of a client.

I was disappointed to hear that our behavioral health colleagues understand so little about the special expertise of other disciplines and was alarmed regarding testimony that there was a need to “fix” the mistakes of other, supposedly less qualified, professionals. Social workers and counselors, too, can relate many instances of individuals who were over-medicated when the root of their problems was interfamilial dysfunction and would have been more successfully treated by a professional with skill in family and social systems theory, rather than physical medicine. The client always is the one to suffer when professionals act outside their scopes of practice.

My father says that you should use the right tool for the right job. Sometimes psychiatrists or psychologists are the right tools. Sometimes other professionals, including Marriage and Family Therapists are.

At a time when there is a grave shortage of psychiatrists in Ohio, when there is a growing need for family specific expertise as families come under increasing stressors, and when our county governments are on their financial knees, this bill will increase access to needed services cost-effectively, conserve financial and human resources – allowing psychiatrists to save their time for those who really need that expertise, and allow a qualified profession to be added to those who already are mainstays of Ohio’s behavioral health system Passing HB 374 is fiscally responsible and is in the best interest of Ohioans in need of this specialized expertise.

Thank you for this opportunity to speak with you.