The Unintended Consequences of Requiring a Licence to Help

Comments that current proposals for licensure, accreditation, and 3rd-party reimbursement may have several unintended consequences. Until now discussion has focused on the effects of the proposed regulations on the development of psychology as a profession. Recent proposals, however, may have unexpected adverse consequences on 3 other areas as well: the education of professionals within psychology, the delivery of psychological and other helping services, and the self-definition of the consumer of psychological services. Any changes in licensure, accreditation, and reimbursement require compromises of concerns for the profession, for the consumer, and for psychologists' livelihood.

The Differential Usage of Services by Impaired Elderly

Why do some clients use institutional services, while other, with comparable impairment, use community based services? To answer this question, a matching procedure paired clients from the two types of service provision. Sixty-six clients, ages 62 and over, were matched for functional ability as rated on a 6-item ADL scale (Katz, et al., 1970). A discriminant function analysis was performed, with the setting of service provision as the criterion variable. The results indicated that the institutional group was more likely than their community counterparts: (a) to have had previous service contact with other service providers; (b) to have less support available within the community setting from family members or friends; (c) to be more impaired in the areas of mental health and social resources.