(PS13-B44) Caveat Emptor: Mental Health Specialty Certifications and the Public’s Preferences for Clinical Care

Objective: When making decisions about care, mental health consumers may depend upon clinician credentials to judge the level of professional competence. These credentials can include certificates of training which may or may not accurately reflect differential competence, especially given that some are awarded after brief or unstandardized continuing education trainings. To better understand the role of such credentials in mental health consumer choice, the current study was designed to examine preferences for mental health clinicians among potential consumers and factors which may inform these preferences, specifically comparing preferences for doctoral-level mental health clinicians and masters-level clinicians with and without specialty certification for the treatment of generalized anxiety symptoms.  


Methods: Cross-sectional assessment with self-report surveys (clinician preferences, prior mental health diagnosis and treatment, demographic characteristics, anxiety symptoms, mental health literacy and mental health stigma) was administered in two samples to assess replicability of all findings: a college student sample (N=224; 71.9% female; mean age=19.1, SD=1.5) and a sample of adults with chronic pain (N=116; 74.1% female; mean age=43.8, SD=13.8).


Results: We found that across both samples, therapists with a Ph.D. were preferred over those with a Master’s; therapists holding a specialty certification were preferred over those without this credential within each degree level; and certification status trumped degrees such that certified Master’s level clinicians were rated more highly than non-certified PhD-level clinicians. We observed some moderation of these preferences for certified clinicians based on rater characteristics, such that individuals reporting a previous mental health diagnosis had a somewhat lower preference for a certified professional, relative to those with no prior diagnosis reported.


Conclusions: These findings document that certification status carries a magnitude of influence that likely reflects a schism between how the field of clinical psychology conceptualizes itself and how it is seen by its consumers. Given the questionable validity of some specialty mental health certifications as an indicator of competence, it is troubling that this designation holds a significant influence on consumer preference. Implications of our findings for mental health consumers, therapists, and professional organizations are discussed.