Supervising an Unlicensed Clinician Who Uses the Wrong Title

Act 52 prohibits practicing psychology without a license and prohibits using the title psychologist or any title that reasonably implies licensure or qualification as a psychologist. Jamie is not licensed in Pennsylvania. Calling her a Psychological Counselor on cards and the website risks holding her out as a psychological provider and blurring the line between supervised support and independent practice. The phrase that she practices under Dr. Okafor's license is especially problematic because a license is personal; it cannot be lent or used as a umbrella for unlicensed practice.

A master's-level unlicensed person may perform limited tasks under appropriate supervision in some settings, but providing weekly individual therapy to 22 clients with minimal oversight is not a limited role. If Jamie is delivering services that meet the definition of the practice of psychology, she may be engaged in unlicensed practice. Dr. Okafor may also face discipline for aiding and abetting unlicensed practice, failing to supervise adequately, and permitting misleading titles. The Board will look at the actual services, not the label on the business card.

The supervision is thin and undocumented: 30 minutes once a month, no note review, no written supervision plan, and no evidence of direct observation or case discussion. Adequate supervision requires a clear contract, defined frequency of individual supervision, review of clinical work, documentation of the supervision, and a mechanism to identify deterioration or risk. The billing is worse. Listing Dr. Okafor as the rendering provider for sessions Jamie performed is a false claim, even if he supervised. Supervision is not the same as rendering the service.

The Board would likely view the combination as unprofessional conduct: misleading titles, false billing, inadequate supervision, and allowing an unlicensed person to function independently. Insurance fraud may also be pursued by other authorities. Dr. Okafor's belief that supervision made everything lawful is not a defense if the arrangement did not meet legal and ethical standards. The Board may consider harm to clients, duration, and whether he cooperated when confronted.

He should stop billing Jamie's sessions under his name and correct any claims already submitted with legal and billing advice. Jamie should stop using the Psychological Counselor title and any implication of licensure; a title that accurately describes her actual credential and role should be used. If Jamie is not lawfully authorized to provide independent therapy, she should not continue seeing clients independently. Dr. Okafor should either place her in a genuinely limited, supervised role with clear boundaries or help her obtain appropriate licensure and practice within another license.

He should create a written supervision plan, increase supervision, review and co-sign notes where appropriate, and document competence and risk assessment. Clients should be informed of the change in a truthful way. He should consult an attorney, consider self-reporting to the Board, and preserve all records. If he simply relabels the position without changing the substance, the Board will see the same problem.