Unintended consequences of requiring a license to help.

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Current proposals for licensure, accreditation, and third-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 three 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 our concerns for the profession, for the consumer, and for our own livelihood. Unless we consider the unintended consequences of current proposals, we may undermine the unity of our profession and the public's trust in psychology. All interventions have consequences, and one of the things we should learn to keep in the forefront of our consciousness is that the most important consequences of any intervention almost always turn out to be those consequences that were not intended. (Marcus, 1978, p. 66) For the past several years, psychologists have been debating the effects of licensing, credentialing, and implementation of national health insurance on the development of psychology as a profession (Albee, 1977a; Cummings, 1977; Gross, 1978; Koocher, 19791 Matarazzo, 1977). The discussion has emphasized defining what a psychologist is and determining what training is necessary to produce an individual competent to practice psychology. Two dominant themes have emerged from the discussion: ensuring psychology's place within the third-party reimbursement system and excluding other professions (e.g., social work and marriage and family counseling) from such a system. This article examines important unintended consequences of current efforts to regulate the , practice and training of psychologists. Specifically, we review how present proposals for regulation may influence the development of psychology as a profession. Then we examine how these may Vol. 36, No. 1, 13-21 Copyright 1981 by the American Psychological Association, Inc. 0003-066X/81/3601-0013$00.75 create adverse consequences for the education of professionals, the delivery of professional psychological and other helping services, and the consumers of these services. Within this framework, we show how third-party reimbursement influences psychologists in their efforts to define prac-