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injury, as necessary for the determination of the appropriate course of treatment. Practitioners permitted to make diagnoses in accordance with the APA Diagnostic and Statistical Manual IV (DSM IV), are considered to be licensed to both assess and diagnose. This distinction is significant in obtaining reimbursement from some payers, since many will not pay for treatment without a specific DSM-IV diagnosis.

Diagnosis: For this function, we collected data on whether or not a professional is permitted explicitly to assign a mental health diagnosis to patient/client. If state law permitted a profession to use the DSM IV classification system this was considered to be explicit permission to diagnose, whether or not the word “diagnosis” was included in that profession’s scope of practice.

Treatment Plan: The term “treatment plan” applies to those practitioners who are legally permitted to develop a plan of care/therapy/action for a patient/client to prevent or treat a diagnosed health problem.

Individual/group counseling: Most statutes and/or rules will state whether a practitioner is permitted to provide counseling/therapy services to individuals, families, and/or groups. Counseling is the application of mental health, psychological, or human development principles, through cognitive, affective, behavioral or systemic intervention strategies, that address wellness, personal growth, or career development, as well as pathology (American Counseling Association, no date). A licensure law that permits counseling cannot be construed to permit “psychotherapy” unless explicitly stated. This distinction is significant from a reimbursement perspective, as many third party payers will reimburse for psychotherapy, but not for counseling.

Psychotherapy: The American Medical Association (no date) defines psychotherapy as “The treatment for mental illness and behavioral disturbances in which the clinician establishes a professional contract with the patient and, through definitive therapeutic communication, attempts to alleviate the emotional disturbances, reverse or change maladaptive patterns of behavior, and encourage personality growth and development.” (AMA, no date) As with diagnosis, we collected data on whether or not the ability to engage in psychotherapy with a patient/client is explicitly granted by state law.


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