Dr. Shirley Vickery, Chair of the SC Board of Examiners for Psychology, talks with Collins & Lacy professional liability practice group chairperson, Robert Peele. This wide-ranging conversation focuses primarily on legal and ethical considerations for practicing as a psychologist in the State of South Carolina and the role of the South Carolina Labor Licensing and Regulation Board in protecting the interest of the public.
Listen to this episode here and read Robert’s conversation with Dr. Vickery below.
Michael Burney: And welcome to The Legal Bench. I’m Michael Burney, Director of Business Development at Collins and Lacy Law Firm. Licensed and professional have the ethical and legal guidelines for their specialty line of work, and with me today is our attorney Robert Peele and his special guest. Rob has been practicing law in South Carolina for more than ten years and chairs our professional liability practice group at Collins & Lacy in Columbia. Today, Rob’s guest helps us understand professional conduct in a very interesting field.
Robert Peele: I would like to go ahead and introduce and thank Dr. Shirley Vickery for joining us today. Dr. Vickery is the chair of the South Carolina Board of Examiners for Psychology and has been a licensed psychologist since 1988. This is her second time serving on the Board and she has served terms as chair during both of those terms. Dr. Vickery has also served as the President of the South Carolina Psychological Association, and president of the South Carolina Association of School Psychologists. She obtained her Ph.D. in School Psychology from the University of South Carolina and has worked her entire career in this field. Dr. Vickery, thank you for joining us and as chairperson for the Board of Examiners tell us the role the Board takes in your profession.
Dr. Shirley Vickery: Thank you Rob so much for having me and I appreciate the chance to talk about this. You know, the Board of Examiners is really a different kind of organization than a professional organization. We as professionals join professional organizations to gain information in our field, we get continuing education to make professional friendships and relationship with colleagues so that we better our practice. But the Board of Examiners actually comes from a different side. We really are representing the interest of the public in making sure that professionals are appropriately licensed, that their training is fitting to things that they are doing, and that their practice meets the guidelines and specifications of our law and regulations in South Carolina. So, we really take the side of looking at whatever the public is getting good service.
RP: Well that’s great. I know that every profession has several factors which regulate them. What are the aspects for psychologists?
SV: Well, we do have our statute that spells out all the things that psychologists need to know about practice. It actually defines the scope of practice for a psychologist, scope of practice meaning what can a psychologist do, what are those things that psychologists are allowed to do as part of their practice. It defines what the criteria are, what kind of training a psychologist has to have. We have the code of law, the statute, and then the regulations which actually gives us a good bit more information about supervising other people in our profession, what to do about records and psychological records, about things like confidentiality and how do you handle those kind of things. We also have an ethical code that actually our state in our statute and regulations, we have adopted the ethical code of the American Psychological Association, which is the primary organization nationwide that is a professional organization for psychologists that has developed an ethical code. So, there is a fair amount of stuff out there that psychologists need to know about, and you know these are very long wordy documents. They are not things that we can memorize. So, really we ask that people in our profession know where these things are, know how to find them, have a hard copy if they need to have a hard copy, and to just know that these are the sources that tell us what we need to do as practitioners.
RP: Do you psychologists have continuing educational requirements where they are updated on new statutes or ethical issues. How do they learn about changes and the principles, the ethical standards, and the rules and regulations?
SV: Psychologists are required to have continuing education credits and as part of our renewal practice with the Department of Labor, Licensing, and Regulation. Psychologists are required to get 24 continuing education credits every two years. Those credits can be in a couple of different specific areas. There’s actually not in South Carolina, there’s not a requirement that psychologists include ethics as a piece of that. This is a little bit surprising. Some states and jurisdictions do have requirements for specific ethical training every year or every two years. In South Carolina we don’t have that, so actually by attending meetings like our South Carolina Psychological Association, I’ll be going to their meeting in the next couple of weeks and will have a session where we talk to psychologists in this state about changes in our practices and the board and things like that. So really psychologists should be getting involved with their state associations. That’s where they’ll learn those things.
RP: In your experience being on the Board of Examiners for Psychologists, when complaints are made against psychologists is it typically to brand new green psychologists or is it the older ones that are more prone to make mistakes?
SV: This is really an interesting question I think Rob, because it does not tend to be the brand-new psychologists as much as is those of use who are somewhat more experienced, and this is born out of the data nationwide too. I guess it’s related to the fact that we get a little more comfortable and maybe start to drift a little bit from some of the things we’ve learned as we get older. Really people in their 50s are more prone to making practice mistakes than our young folks. Now we do see some errors that younger people make, and sometimes young people make errors because they didn’t know to look in the statute and regs. You know that’s actually one of the things we do as board members when we’re about to license a new psychologist, we do an oral examination with that person. That’s really kind of a different requirement in our field from a lot of fields. But the focus of that oral examination is the statute, regs, and ethical code. I ask them when they do that to bring it, have it in hard copy, mark it up, and look at it while we’re talking, because this is not again something you memorize. It’s something where you should know where to find this stuff in it. But I think part of what goes on with older practitioners are people who are a little bit more experienced is sometimes they just drift a little bit and forget that they need to go back to those basics.
RP: What are some examples of mistakes that are brought to the Board’s attention where a citizen has lodged a complaint against a psychologist. What are some of the more unfortunate examples that you have ever run across?
SV: You know, I’ll start off by sort of saying something else, psychologists are really, in general, a pretty high functioning group in terms of knowing the ethics and understanding how they need to practice. Complaints against psychologists are not as frequent as they are against a number of other professional, so I’m pretty proud of that. It means that along the way we have done good training with psychologists in learning how to practice. But when we find mistakes, we find them in a couple of different areas, I guess. Sometimes it’s competence issues. In other words, did the person really know this area. Should they have been practicing in that area, or are they bleeding over into something they really don’t know anything about. Sometimes it’s something as simple as practicing without a license, and this is a little complicated in mental health related fields, because there are some exceptions. I don’t think this is true in certain other fields like law for instance. People would have to be credentialed the same way whether they were working in a state office building or a private practice. It’s not quite the same for psychologists, because there are exceptions in our statute that allow folks to practice in certain situations without actually having a license, so that confuses some people and knowing the limits of that is something we do run into a fair amount, and that again means that you really didn’t understand the law. We are also seeing, and right now there’s, and I know you guys are aware that telehealth and telepsychology has just changed the whole field during this time in the pandemic, and how does one practice ethically during this time. What specific things do you need to pay attention to with doing therapy in a virtual setting as opposed to a face‑to‑face setting?
RP: Yeah, we kind of see that in our practice of laws. We will get on a Zoom deposition and we aren’t allowed to meet in person with the deponent and it’s different. You can tell people’s body mannerisms, whether they’re being honest and that sort of thing, so I agree that the pandemic has made the virtual part of it a little more complicated.
SV: You know, one of the things that a lot of psychologists participate in doing some kind of or provide a service call, assessments, psychological assessments. And some of the tools that we use for those things are not really designed to be used in a virtual setting. Some of them are, now that we all wear masks everywhere we go and if we’re around anyone else we’re wearing a mask, some of our tools are not designed to be used wearing masks, because you can’t see the person’s facial expressions and you’re not always sure that they are understanding your words correctly. So, you know I’m really interested in what that means for the practice of psychology as move on into the future. How long do we continue to wear a mask? How do we as psychologists interpret our data? Are our licensees being accurate to members of the public when they talk to them about data, when an evaluation has been done under non-standard conditions.
RP: What is unique with the nature of many people psychologists see in their practices?
SV: We rarely see people when they are really doing well. Most of the time when psychologists see someone it’s because there is some stressor or there’s some concern and it can be a very significant thing. Let’s say a family is really concerned about their child whose having lots of problems and behavioral issues within the home or something’s going wrong. Or a person has had a brain injury and needs to figure out how to cope with that. That’s a very stressful event. Or folks who have custody issues, which I’m sure many of your lawyers are familiar with that too, what a stressful time that is. Psychologists get involved in those kinds of situations too.
RP: How do psychologists get away from all of the mental stresses that have to listen to and process on a day-to-day basis?
SV: This is a real challenge for a lot of practitioners and it is important, and we talk to folks about this, as we’re working with them both on the Board and in professional organizations, about the importance of knowing the limits of what you can do, because if you’re working in your field whatever it is and you have folks you’re seeing the entire day, how long can you really go and continue to be available and really engage with that person and do your best. If you allow yourself to see more patients, more clients that you really have the energy and the skill to do, then you could really be creating some difficulties for yourself. Self-care is super important. We expect people to join professional organizations to have colleagues that they talk with and you know one of the best pieces of advice I ever heard in a professional organization one time was, I think it was the president of the American Psychological Association actually said, we all need to have somebody that we trust enough to tell us when we’re really falling apart or we’re really having problems. We need to say to that person please tell me this and I will believe you when you say that.
RP: With all that you’ve shared, what issues do you see with coming from the Board? I know you’ve mentioned practicing without a license, telepsychology, or there any others that are coming up in front of the Board in the past couple of years?
SV What happens with psychologists and a complaint is lodged against them is with our state agency, the Department of Labor, Licensing, and Regulation, that complaint comes into the Board office and then it’s assigned an investigator. This is a really helpful thing to the Board, because we will see the, the Board members will not see exactly who the complaint is against, but will see the kinds of topics that are involved and many times it’s surprising the topics are simple things like just not supplying the records in a timely fashion, or not making it clear what the financial obligations are for the client who is seeing the psychologist. Those things are really pretty easy to work out. There things that we expect the psychologists will be very clear with their clients about, but when those things don’t go well, they do result in complaints, more frequently than you would think.
RP: What is the procedure that a psychologist should follow should they have a complaint lodged against them and what’s the process in investigating the claim?
SV: When a complaint comes in the psychologist will be notified by the Board office. It will not actually be me personally, because I will not know that a complaint is lodged against an individual. None of the board members will know that; it’s all confidential. It does come into the office at LLR and an investigator will be assigned. The psychologist will be notified that a complaint has been lodged against them and they’ll be asked for records. They should supply their records to the Board office because that is one of the places where they really are obligated to share their records, and they should cooperate with the things the investigator asks them to do. The investigation as you can imagine would be different based on what the complaint is about and many times those things are resolved without coming to a hearing before the Board. If the issues aren’t, and I guess I kind of hinted to this a minute ago too, sometimes folks are upset when they see psychologists and especially in situations like custody evaluations. Not everyone is going to get the result from that that they wish for, so we find that some of the complaints lodged against psychologists are not founded and a hearing is not needed. But when a hearing is needed, the hearing normally takes place before the entire Board. That will take a while before it gets to that point, because there is a process of investigation and then some complaints are resolved in some other fashion or are dropped before coming to a hearing.
RP: What are the best strategies for psychologists to stay on the right side of the regulation and ethics part of their governing bodies?
SV: the things I’ve said before really just are the basics. Have that statute and regs some place where you can find it. Be sure that ever so frequently you re-read the sections, especially sections that if you’re a psychologist practicing now you need to know which ones of those things particularly apply to your practice. Things like supervision of other people who work in your practice. Mark that area up and re-read it ever so often so that you’re making sure you’re following the letter of those laws. In addition, join your professional association. The people who do the best in terms of ethical practice are those people who actually make relationships within their professional association. They don’t just go and maybe go out to the beach and have a nice afternoon instead of going to sessions or get their continuing ed, but they invest in the association and make relationships. Have colleagues that they can talk to about things, because really there are not as many psychologists in most areas as there are many other professionals. We have 900 licensed psychologists in South Carolina, but I don’t think most of them actually live here. I think there are a number of folks who are maybe come in and out of the state sometimes and do particular projects. It means that many of us don’t, we really have to look for people to make relationships with, so we have someone to ask advice.
RP: Dr. Vickery, thank you for talking with me today. I really appreciate it. I feel like I’ve learned a lot.
SV: It’s been my pleasure. Thank you so much Rob for giving me this chance.
MB: Well we want to thank Dr. Shirley Vickery for educating us today on the professional conduct for psychologists and Collins & Lacy professional liability attorney Robert Peele for his questions. For more legal information of interest to South Carolina businesses, join us right here for the next episode of The Legal Bench.