Accountability in Professional
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 Jie Zhong, Mingyi Qian, Ping Yao, and Kevin Xu

Psychology Department of Peking University, Beijing, 100871, P.R. China
 
Reference: Zhong J, Qian M, Yao P, Xu K(2008). Accountability in Professional Psychology: The Improvement in Mainland China. J Hall & E Altmaier (Eds). International Perspectives on Accountability in Professional Psychology. New York: Oxford University Press

   In China, the practice of psychotherapy and psychological counseling is within the area of clinical and counseling psychology. As there is increased need for psychotherapy and counseling for the general population in China, the practice of psychotherapy and counseling is growing, and the number of professionals in this field rapidly increases. High quality professionals are not only in urgent need in the current society, but also are critical to the social prestige and accountability of professional psychology. Although the Chinese Psychological Society (CPS) and Chinese Mental Health Association (CMHA) suggested a need for psychotherapy and counseling practitioners in 1993, the professional movement in clinical and counseling psychology did not take place until 2002. 
 The status quo of accountability for professional psychologists in mainland China is diverse and developing.  The Chinese Ministry of Labor and Social Security Affairs (CMLSS) is in charge of the license of professional psychological counselors. The Chinese Ministry of Health Affairs (CMHA) monitors the qualifications of professional psychotherapists in hospitals and other health care agencies. The CPS controls the quality of professional psychologists and professional training programs. 
 The CMLSS promulgated a state protocol defining the professional criteria for professional psychological counselors in 2001 with revisions in 2002 (CMLSS, 2001; 2002). These national criteria have the following characteristics: 
1. These criteria are dependent on the continuing training program, but not the training programs for master’s or doctoral degrees. Participants who have a junior college degree of two-three years in any major are allowed to enter a continuing training course. 
2. Issuing a license is controlled by professional entrance examination, not based solely on the professional training program. After receiving 60 hours of a continuing training course, participants are allowed to take an exam for an intake counselor license, which is the lowest level of psychological counselors. 
3. Neither professional ethical codes nor quality control for the practicing profession are well structured.

 In 2003, the CMHA established a similar system to certify professional psychotherapists working in hospitals who had passed the required examinations. Typically, the participants who want to take the CMHA required exams for psychotherapist get a degree from a technical secondary school. For example, a nurse, who has a degree from a technical school for training nurses, can apply to take the CMHA examination for certification as a psychotherapist after working in mental health for a few years in a hospital.
 In order to facilitate regular, ordered and healthy development of Chinese clinical and counseling psychology, an urgent task is the development of a professional registration system, which is relatively well-founded and adapted to the Chinese situation. Different from the CMLSS and CMHA, the Clinical and Counseling Psychology Registration System (CCPRS) of CPS is characterized by quality control and voluntary application.  However, it is important to note that the title of professional psychologist in China is not protected by law.

The History of Establishing CCPRS
 Led by the Executive Council of CPS, three different work groups, mainly consisting of CPS Clinical and Counseling Psychology Board members, were established to develop CCPRS. These three workgroups addressed the following: (a) the registration criteria for professional training programs and individual practitioners in clinical and counseling psychology, setting up the criteria for registration, and developing the initial documents for the ethical code; (b) the registration processing workgroup which is responsible for the implementation of registration provisions and auditing the qualifications of the applicants in accordance with the standards; and (c) the professional ethics workgroup which is in charge of implementing and interpreting the professional ethical code, investigating and monitoring the ethical behaviors of the applicants, and guiding the ethical training, consultation, and guidance on ethical issues for professionals, as well as dealing with ethical complaints and regulating unethical behavior. 
 By the authorization of CPS, these three workgroups worked separately with a clear job division and mutual cooperation.  The relevant documents were drafted and finalized based on the preliminary investigation and large amount of preparatory work done by the Clinical and Counseling Psychology Committee of CPS.  For instance, 
members of the CPS Clinical and Counseling Psychology Board conducted preliminary investigations and preparation for the registration system, including researching related to registration systems of different organizations in foreign countries, such as the American Psychological Association, American Counseling Association, British Psychological Society, and Employee Assistance Professionals Association, as well as related systems in Hong Kong and Taiwan province. 
 In 2006 the three work groups met several times and modified the registration documents and code of ethics based upon the previous work and feedback from the Executive Council.  In addition, they evaluated the first group of supervisor candidates and 109 supervisors were accepted in the registration system.
 Two main documents were approved by the Executive Council of CPS in 2007. They are the registration criteria for professional training programs and individual practitioners of clinical and counseling psychology and the code of ethics for counseling and clinical practice.

The Registration Criteria in CCPRS
 The registration criteria include principles and policies and criteria for the following: (a) master’s training programs, (b) doctoral training programs, (c) intern training agencies, (d) clinical and counseling psychologists, (e) supervisors, and (f) the continuing training project. 
 The main principles of this registration system are as follows: First it is non-profit.  Second, it is aimed at quality control: this system seeks to control the quality of the training program, training agency, continuing training projects, and professional practitioners in clinical and counseling psychology in mainland China. Third, it is voluntary: individuals and training programs may apply for registration voluntarily.
 The registration criteria for master and doctoral training program require that the program have a specific training manual which contains the training objectives, the admitting criteria and procedure for the applicants, training process, and quality control of training outcome. There should be a teaching team of registered clinical or counseling psychologists responsible for the training, and there should be a coordinated, well-organized procedure for training. Specifically, the program should contain organized sequence of basic psychology courses and sufficient courses related to the theories and practice in clinical and counseling psychology. Hours of internship and supervision should be strictly prescribed as no less than 100 hours of face to face clinical practice with patients/clients or 100 hours of supervision for a master’s level student and no less than 250 hours of either face to face clinical practice with patients/clients or 200 hours of  supervision for a doctoral level student.
 The registration criteria for the intern training agency require a written declaration or a manual, in which the objectives and content of intern training are described specifically, with the requirements and expectations for the quantity and quality of the tasks that the intern completes also clearly stated. In addition, there are specific requirements in the registration system for the number of registered psychologists and supervisors in the intern agency. 
 To be a registered clinical and counseling psychologist, applicants must comply with the ethical principles, have no malpractice record, be recommended by two registered psychologists, and have no fewer than 150 hours of supervised internship, and fewer than 100 hours of being supervised within 2 years after receipt of the master’s degree. Supervisor applicants must accumulate no fewer than 800 hours of clinical practice, and no fewer than 80 hours of an internship in which the applicant practiced supervision while under supervision. This may occur after being registered as a clinical and counseling psychologist. In addition, they must attend a continuing education program with prescribed content and hours. 
The Professional Ethical Codes in CCPRS
 The content areas for the code of ethics for counseling and clinical practice are as follows: (a) general principles, (b) professional relationships, (c) privacy and confidentiality, (d) professional responsibility, (e) psychological testing and assessment, (f) teaching, training and supervision, (g) research and publication, and (h) resolving ethical issues.
 The general principles include welfare, responsibility, honesty, justice, and respect. Professional relationships involve informed consent, dual and intimate relationships, fee-for-service provisions, not using position for personal gain, and the relationship between colleagues and professionals in related fields. Privacy and confidentiality includes protecting confidentiality and privacy, noting any exemption from confidentiality, and protection of testing data, case records, correspondence, tapes, and videotapes. 
 Professional responsibility includes the requirements for professionals to obtain continuing education and supervision, to practice self-care, to be honest, objective, and accurate when facing the public and the media, and to advocate for themselves and their professional services. Under the principle relating to psychological testing and assessment, psychologists are required to receive proper training, to follow the regulations of test selection, utilization, scoring, interpretation and test development, and not to misuse psychological testing tools. 
 Under teaching, training and supervision, psychologists are required to be honest, serious and responsible, with the goal of improving the student’s professional competency. Psychologists should be aware of the importance of maintaining professional relationships, be honest and fair when evaluating the students, trainees, or supervisees, and not take the advantage of teaching for personal gain.
 Professionals are required to respect the rights of subjects and participants and to report the results honestly in research and publication, with plagiarizing banned. The final chapter provides the framework and procedures for resolving ethical issues and dilemmas, and for making ethical complaints. 
The Current Development of CCPRS
 The work of CCPRS brought attention from the international world, especially from Prof. Schnyder, the Chairman of International Psychotherapy Federation and Prof. Pritz, the Chairman of the World Council of Psychotherapy. They expressed support and then invited members to help draft the ethical code for counseling and clinical psychology practice for the Asian Federation for Psychotherapy (AFP).  Thus, the AFP ethical code was based on the ethical principles of CCPRS. 
 The registration activities for 2006 -2007 include the following: 
1. On June 30th of 2006, 109 registered supervisors who applied voluntarily were approved, following the recommendation from the committee members of the three work groups of CCPRS and the auditing and voting separately by the registration and ethics workgroups. 
2. Moreover, in March of 2007, each registered supervisor recommended three clinical and counseling psychologists as candidates, according to the Interim Procedures for Psychologist Registration. Registration interim procedures emphasize recommending  professionals who have been working in the field of counseling and psychotherapy for many years at a high professional level but without a master’s degree. Psychologist applicants were recommended by two supervisors and will be audited by both the registration and ethical work groups. 
3. By July 1st of 2007, the registration of the first group of applicant psychologists will be finished. Those who qualify will be audited after July 1st of 2007, according to the provisions of the registration criteria and ethical codes. By the end of 2007, the first group of psychologists  will be registered after they successfully pass the three-month ethical auditing.

Further Improvements of CCPRS
 The CPS plans further improvements for CCPRS. A website for the registration system will be developed (http://www.chinacpb.org). The ethical code and the registration criteria, as well as the list of registered psychologists and supervisors, will be placed on the website. Furthermore, the rules and procedures for the registration system will be voted on. The intent is to protect the academic authority and seriousness of the registration system. 
 Training on the ethical principles and on the theory and practice of supervision will be provided to the first group of registered psychologists and supervisors. When possible, teaching staff will also be trained, so that training programs will be designed to comply with the registration system for clinical and counseling psychologists. 
 Following July of 2007, the registration of clinical and counseling psychologists will be publicized in the media to facilitate awareness by both professional and non-professionals. In addition, a registration system will be promoted for related professionals. We will try to make the related government departments aware of the system so as to obtain support.  It is important to ensure that the registration system, including the ethical code, influence relevant national legislation and administrative regulations.
 This registration system, based on a large amount of investigation and scientific research on successful and well-developed professional psychology practice in western countries, is a product of the efforts and wisdom of hundreds of Chinese professionals in clinical and counseling psychology (including those in Hong Kong and Taiwan province). We hope that the registration system will have an impact on the profession, and provide positive and constructive values for improving the quality of professional work, and facilitate healthy and continuing development of the profession in mainland China.
References
Chinese Ministry of Health Affairs (2001). State Professional Criteria of Counselors (protocol). Beijing, Central Broadcast and Television University Press.

Chinese Ministry of Health Affairs (2002). State Professional Criteria of Counselors. Beijing, Central Broadcast and Television University Press.

Chinese Psychological Society, Chinese Mental Health Association (1993). Professional Standards for the Work of Counseling and Psychotherapy of Practitioners in Health Services. Acta Psychological Sinica, 25(2), 223-224.

Chinese Psychological Society (in press). The Registration Criteria for Professional Training Programs and Individual Practitioners of Clinical and Counseling Psychology of Chinese Psychological Society. Acta Psychological Sinica.

Chinese Psychological Society (in press). Code of Ethics for Counseling and Clinical Practice of Chinese Psychological Society. Acta Psychological Sinica.

 

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