Can therapists and alternative practitioners practice without a license in Oregon? In many fields, yes, they can! Are there any rules at all? Yes, there are. I created this Web site to make this information easier to find and understand.
When I started my hypnotherapy practice in Oregon, I found the few online resources scattered and confusing, and this is still the case: No agency takes much of an interest in us. Hence, this Web site.
Oh, and if you’re a licensed practitioner, welcome! Most of the posts on this site will be 100% applicable to you, too, as we discuss topics such as ways to build your practice and give it a compelling, personalized Web presence.
One thing you need to understand about Oregon is that it’s not one of those states where the Legislature is license-happy. As in some other states, the Legislature deliberately keeps things a little loose here, as you’d expect in Oregon.
What Kinds of Things Require a License?
For our purposes, there are licenses for three things:
- Public safety: This is an attempt to keep the death rate down by requiring training and licenses for drivers, surgeons, pharmacists, and so on.
- Restraint of trade: If it’s hard to get a license, the people who already have a license can jack up their prices! They win: everyone else loses. But with a good lobby, all things are possible. These licenses try to pass as public safety licenses, as if the state would run out of room for all the dead bodies if unlicensed people are allowed to practice. But if you look closer, it’s all baloney. A barber has to take three times as many training hours as a policeman, and just as many training hours as a paramedic. Seriously!
- Weird and inexplicable: Hey, cool! A license to be a horse acupuncturist only costs $20!
Admittedly, there are other kinds of licenses, too, but let’s focus on professional licensing and the licensing exemptions that allow those of us in alternative/complementary professions to practice in Oregon with perfect legality in areas like hypnosis, life coaching, fitness coaching, Neurolinguistic Programming (NLP), aromatherapy, guided imagery, somatic experiencing (SE), sensorimotor therapy (SP), mindfulness, Emotional Freedom Technique (EFT), yoga, and all the rest. Also counseling and marriage and family therapy, as we’ll see in a bit.
No License Required in Oregon for Many Activities
What activities and professions are NOT licensed by the state of Oregon? Here are just a few, taken from a much longer list on the licenseinfo.oregon.gov Web site:
- Animal training
- Auto repair
- Dietary Supplements
- Computer programming
- Personal trainers
- … and many more
Clearly, if the Legislature doesn’t think a mechanic needs a license to fix your brakes, they won’t require a license unless the public danger is very high! They’d probably reject many of today’s licenses if they weren’t in place already. So remember:
- Not requiring a license is normal.
- Far from being a loophole, not requiring a license is a deliberate policy of the Legislature.
This can come as a surprise to people who expected that every important occupation required a license, especially when they themselves worked long and hard to obtain their own license. What can I say? The licensing landscape is surprising: no question there. And it’s always been like that.
Licensing Exemptions for Counselors and Alternative Practitioners
Unlicensed counselors, marriage and family therapists, and alternative practitioners are protected by a broad exemption under Oregon law, as discussed in the Oregon Board of Licensed Professional Counselors and Therapists (which I’ll call the “Counseling Board”) on their Who Needs a License? page. These exemptions are designed to cover a wide variety of alternative practitioners as well as people with “Counselor” or “Marriage and Family Therapist” on their business cards.
What kind of person chooses to operate under the license exemption? All kinds of people, including some with very impressive credentials. A fascinating profile by Jenny Westberg, of an internationally renowned (but unlicensed) counselor, was published in the Examiner. You should read the story in full, but here’s the part about the exemption:
“Becky Eklund, the executive director of the Oregon Board of Licensed Professional Counselors & Therapists, explains, ‘There is a phrase in the law that says if someone does not meet the education requirements for licensure, then they can practice without a license.'”
(4)Nothing in ORS 675.715 (Application) to 675.835(Injunctive proceedings) limits or prevents the practice of a persons profession or restricts a person from providing counseling services or services related to marriage and family if the person:
(a)Does not meet the requirements of ORS 675.715 (Application) (1)(b);
The “requirements” basically mean that, to get a license, you need an appropriate Master’s-level degree in Counseling or Marriage and Family Therapy. If you don’t have the right degrees, you don’t need a license to be a counselor or marriage and family therapist! And since the definition of counseling is extremely broad, it covers anything you could consider as “counseling-ish,” including meditation, EFT, guided imagery, NLP, somatic experiencing: you name it. The Oregon Board of Licensed Professional Counselors and Therapists (OBLPCT) recognizes this, calling the “counseling-ish” category “alternative counselors and therapists.”
The exemption is explained on the Counseling Board’s Web site as follows:
The OBLPCT distinguishes between “licensed”, “unlicensed”, “exempt”, and “alternative” counselors and therapists. The Board has authority over licensed and unlicensed counselors and therapists as defined below. The Board has no authority over exempt and alternative providers as defined below….
Unlicensed professional counselors and unlicensed marriage and family therapists are those who qualify for licensure, practice professional counseling or
marriage and family therapy, and have chosen not to become licensed.
Those who may have counseling-related training and provide similar services as licensed counselors and therapists but do not meet the educational requirements to qualify for licensure as an LPC or LMFT. Alternative providers do not assess, diagnose, or treat mental disorders.
We will return to the question of “mental disorders” in a moment, along with the restrictions on wording that you must follow to stay within the rules.
Does Your Practice Fall Under the Educational/Alternative Providers Exemption?
All I’ve found are a few brief statements scattered across their publications, minutes, and a few other places, but in these, as shown above, the Counseling Board acknowledges that the educational exemption is a very broad exemption, covering not only counseling and marriage and family therapy, but also alternative modalities and even emerging modalities.
Since there’s so little outreach (just a few pages), we’re left to guess about the details. Sigh. My personal guess is that modalities are probably in the clear if they meet the conditions below:
- They’re in the counseling, therapy, or alternative space OR are on one of the State’s lists of things that don’t require a license.
- They aren’t something definitely requires a license (like being a physician).
- It isn’t illegal (like using violence against a client’s enemies to achieve catharsis).
- It doesn’t use protected terminology to describe the person or the services (like “psychology” or “doctor” or “Judge of the 9th Circuit Court”).
- It isn’t deliberately deceptive (fraud is fraud, whatever your line of work).
The Educational Exemption: Supporters and Opponents
As you can imagine, the Legislature and alternative/unlicensed practitioners are in favor of the Educational Exemption! According to the Counseling Board’s minutes, so are at least three important Oregon practitioner associations:
On December 13, 2013, Board members Lynne Nesbit, Doug Querin and Scott Christie and staff met with representatives of ORCA, OAMFT and COPACT to discuss options for addressing unlicensed complaints. Representatives of the associations spoke strongly against removing the education exemption from the law.
These three organizations are:
- ORCA, the Oregon Counseling Association,
- OAMFT, the Oregon Association of Marriage & Family Therapy,
- COPACT, the Coalition of Oregon Professional Associations for Counseling and Therapy.
And no wonder! When it comes to “protecting the public,” 85%-90% of the cases taken up by the Counseling and Psychology Boards are against their own licensees and applicants! The rest of us are barely a blip on the radar.
As far as I can tell, there is no longer any organized opposition for the educational exemption. True, many individual license holders would take pleasure in putting all of us out of business tomorrow. But these people are in the minority.
According to Counseling Board Executive Director Ecklund, as quoted in Examiner, the Board once tried to remove the exemption, but the Legislature shot them down:
“The board has supported legislation in the past that would eliminate that education exemption from the law. To date, the proposed legislative changes have not been approved.”
In recent Board minutes, the majority of the Counseling Board members seem to have gotten the message. Both sides of the issue are raised, not just one. The defenders of the exemption see the big picture clearly, so the center of gravity seems to be support, not for banning alternative practitioners, but for creating some kind of open registry under the control of a new Board.
Superstition, Meet Reality
This is not surprising, since being against alternative practitioners is a thankless task! The higher the level of education a consumer has, the more likely they are to turn to complementary or alternative practices (for example, see this Complementary/Alternative Medicine article from the National Institute of Health).
People who oppose complementary or alternative practices always ignore this, claiming, against all the evidence, that our clients are too ignorant, feeble-minded, and insane to know what they’re doing. This bears no relationship to reality. Our average client is an educated, well-informed, and active citizen — A citizen who doesn’t like being talked down to! If you ever want a whole lot of people to walk all over you, just stir up the clients of alternative/exempt practitioners.
Unlicensed/Alternative Practitioners and “Mental Disorders”
Update, April 8, 2015:
It turns out that the Oregon Board of Psychologist Examiners’ position that, broadly, “anyone we don’t like is practicing psychology without a license” is just as unfounded and illegal as it sounds. I consulted with two lawyers on this point specifically, and both came to this same conclusion. See my new post on this topic.
Basically, unless you call yourself a “psychologist” or apply for a license from the Oregon Board of Psychologist Examiners (OBPE), they have no authority over you. All the nonsense that the OBPE says about exempt practitioners not being able use DSM terms, or diagnose mental disorders, or use the word “psychotherapy” is just that — nonsense. They have no authority!
It’s not like the OBPE hasn’t been told. They know. But they’re still prosecuting people anyway.
End of update. Original section continues…
This section is a little long, but it’s important. The rules are non-obvious and need to be followed carefully. Also, keep in mind two things:
- I’m not a lawyer. I’ve consulted with lawyers, but I may still have some of the details wrong.
- The Psychology Board refuses to review this page or to answer my questions (and it’s not like I’m special: they’ll refuse to answer your questions, too! Give it a try: firstname.lastname@example.org, 503-378-4154).
You need to understand the material below and follow the guidelines. Get this wrong, and you may find yourself in a Kafkaesque situation, where the Oregon Board of Psychologist Examiners (OPBE) accuses you, of “representing yourself as a psychologist” or “practicing psychology without a license” when you clearly haven’t. More on that in a bit.
To the best of my understanding, the part quoted previously by the Counseling Board about “assessing, diagnosing, and treating mental disorders” means:
- Unlicensed practitioners don’t get to label people with a diagnosis out of the DSM.
- Unlicensed practitioners don’t get to have their clients fill out diagnostic tests that would result in such labeling.
- Unlicensed practitioners don’t get to use phrases like “treating the disorder” when they talk about “helping the client.”
Note that this is about word usage, labeling, and paperwork. It’s not about therapy. Therapy is allowed!
This can be a difficult concept to wrap your mind around, whether you’re coming at it from the traditional or the alternative perspective.
From the traditional perspective, DSM labels are pervasive, to the point where traditional therapists are sometimes surprised to learn that anyone can do without them. After all, DSM labels are basic vocabulary for communication between the therapist and everyone else: the insurance company, management, other members of the treatment team, anyone doing research or keeping statistics, and so on. But alternative and exempt practitioners generally don’t bill insurance, participate in statistics gathering, etc.
Digression about labeling: Labels have a powerful effect on clients and need to be used carefully. Every time you introduce a new label into the conversation, you reframe their issues. Reframing is a powerful technique, and a negative reframe can easily set your client back. This is more than enough reason to avoid using those weighty and scary DSM names in session.
Labeling and Usage Guidelines for Exempt/Unlicensed Practitioners
You can find guidelines for how to talk about your business (and what words and phrases you must avoid!) in the Psychology Board’s Unlicensed Practice FAQ. You should read the FAQ in full, but the central points are:
1) Question: What does it mean to represent myself as a psychologist?
Answer: Generally, you cannot say that you are a psychologist unless you are a licensed psychologist. To represent oneself as a psychologist means to use a title such as “psychologist” or to say that you provide psychology services. Representation can be verbal or in print form. Examples:
a. “I’m a psychologist” or “I practice psychology”
b. “I’m a psychotherapist” or “I practice psychotherapy”
c. “My profession is psychology”
d. “My treatment orientation is Jungian psychotherapy”
e. “I provide psychological services”
f. “My specialties are depression, anxiety, ADHD…” 1
g. A business named “Frank’s Psychotherapy Clinic”
The footnote under item (f) reads:
A person may not advertise or provide services for a “disorder” listed in the most current revision of the Diagnostic and Statistical Manual of Mental Disorders (e.g., DSMIV-TR). Lay terms such as abuse, overeating, trauma, and addiction, as well as lay terms for depression and anxiety (e.g., grief, moody, fear, worry etc.) are not considered diagnoses and are too general to treat as the specific practice of psychology.
That footnote is the most important part of the FAQ!
Sticks and Stones. These regulations don’t prevent you from doing therapy, just from using certain terms to describe it. It’s the same situation as in the supplement industry: if you sell saw palmetto and claim that it “promotes normal urinary flow,” it’s a supplement, and that’s just fine. If you say it “treats an enlarged prostate,” the same capsule miraculously becomes a drug and you can be prosecuted.
Members of the public can’t tell the difference between these two statements, which means that:
- Because members of the public can’t tell the difference between allowed and forbidden statements, these regulations serve no purpose. What the public needs is clarity.
- You and I can’t tell the difference, either, unless we make a special effort to educate ourselves about the rules, so we can be 100% within the regulations. (Hence this Web site.)
Protecting the public? The State of Oregon claims that, if you use a DSM term (say, “PTSD”), then everyone who reads it will conclude, “You must be a licensed psychologist: that is the only explanation!”
This is ludicrous. Non-psychologists use DSM terms all the time — physicians, psychiatrists, counselors, marriage and family therapists, clinical social workers, nurses, journalists, your aunt Martha. Why would anyone decide that you’re a psychologist, when so many other professions use these same terms? This just doesn’t happen in real life!
The only way to convince a member of the public you’re a psychologist is to use the word “psychologist.” By claiming otherwise, the Oregon Board of Psychologist Examiners’ position is absurd and unreal. But it’s written into the regulations, so let’s all be careful out there.
Overreach. Worse, some licensed practitioners will attempt an extravagant overreach and claim, in effect, “If a client had a trauma (or whatever), they might have some mental disorder or other, and that means we own them. They can see us, but they can’t see you.”
This is wrong on so many levels! Fortunately, the FAQ makes a special effort to clarify this point: The law has no problem with an unlicensed practitioner providing services for a client whose issues can be described in lay terms: terms like “abuse,” “trauma,” “addiction,” or “fear.” This is supported by the Counseling Board’s definition of alternative practitioners, quoted above. (Lay terms make for better communication, better rapport, and better results anyway.)
- Wrong: I can treat your phobia.
- Right: I can help you resolve irrational fears.
- Wrong: I can help you with your ADHD.
- Right: I can help you with focus and concentration.
A Word About Wording
The Board of Psychologist Examiners protects a peculiar selection of words. For example, they insist that, if you use the word “psychotherapy,” you’re deliberately fooling the public into believing that you’re a psychologist. But in the real world, “psychotherapy” is just a generic term meaning, roughly, “talk therapy.” In Colorado, for example, the official term for an unlicensed therapist is a “registered psychotherapist.”
Still, this is written into Oregon law, so avoid this and other “protected terms” when discussing yourself and your services.
Terms to avoid:
- Psychotherapist, psychotherapy
- Psychologist, psychology
- Treat, cure
- Disorder, mental disorder, mental illness
- Current DSM terms and abbreviations like post-traumatic stress disorder or PTSD
- (Possibly, but see below) isolated words from the DSM, like “anxiety” or “depression.”
- Also, don’t lie by claiming licenses, degrees, or titles you don’t have, and don’t claim degrees from unaccredited institutions. Just don’t. And don’t use the word “Doctor” unless you know it’s permissible under Oregon law.
Overreach, part 2. Oregon state regulations say that the actual names of DSM disorders are protected — names like “Generalized Anxiety Disorder” are protected (which is embodied in the regulations). The Unlicensed Practice FAQ also claims that any individual words extracted from a DSM disorder, like “anxiety” or “depression” are protected, too. (By the same logic, they could also claim words like “alcohol,” “eating,” and “social,” which are also words from DSM disorders.) When I called her on it, Becky Ecklund assured me that these words really are protected … somehow? … but made no attempt to justify her opinion.
Dealing with the Oregon Board of Psychologist Examiners (OBPE)
Note: Because I’m about to sound even more exasperated and disapproving than already have, I should preface this section by pointing out that my beef with the Oregon Board of Psychologist Examiners is a narrow complaint about a single issue. It’s an important issue, but it’s just one issue. I don’t have any objection to the existence of the OBPE, and I don’t have any antipathy towards psychologists in general. Quite the contrary: I know that psychology is inherently one of the world’s great professions — “the study of the human mind” — a profession that has made enormous contributions and will continue to do so. Many licensed psychologists are wonderful people by any measure. I wish them every happiness and success, just as soon as they get off my lawn.
The issue comes down to this: the Board should stop prosecuting people for “representing themselves as a psychologist” unless they’re actually doing so! And by “doing so,” I mean representing themselves as a psychologist with sufficient force and clarity that the average member of the public would (a) notice, and (b) conclude, “This guy’s a psychologist.” Because, obviously, no harm can be done unless these criteria have been met.
Since the Board of Psychologist Examiners does so little outreach — five whole pages! — and refuses to answer questions, we don’t know what the rules really are. (Frankly, I don’t think they do, either.) This means that there’s a chance that you will eventually be investigated for violations that harmed no one and would never be noticed by anyone but them, or that they simply made up on the spot.
This is a peculiar strategy! After all, psychology is one of the helping professions. So when they take a “0% helping, 100% punitive” approach, it’s dissonant, even disturbing. It’s like a school shutting down Driver’s Ed courses and setting up speed traps instead.
Here’s my evaluation of the situation, based on the material from the Board’s Web site and elsewhere:
- Expect to win. By my estimate, the Board of Psychologist Examiners eventually dismisses 90% of cases, and often more. And in 2010, the Board won zero out of 69 unlicensed practitioner cases. You may think this makes the Board sound ineffectual and even silly, but winning cases is not their goal.
- But expect to be menaced first. Conning you into shutting down your practice is their goal. The letter they send you will likely be menacing, yet strangely incoherent and lacking in specifics. Expect this tone to be maintained throughout the “investigation.” Don’t be surprised if their “investigator” lies to you or engages in relentless bullying to get you to shut down your practice.
(This apparently is an illegal violation of your civil rights — violation of due process — and leaves the Board open to your Federal lawsuit for both compensatory and punitive damages). Frankly, I see little point in talking to their “investigator” at all. That’s what lawyers are for, as explained below.
- Expect your “violation” to be trivial or nonexistent. In the past, they felt they needed to establish a pretext that people were “practicing psychology,” but listen to this voicemail recording of the OBPE’s “investigator” trying to shut down something that even she admits is a counseling practice, not a psychology practice:
- You have plenty of time. It took the OBPE a whole year to fine someone who wasn’t even there — someone who had already moved out of state before the process even started. (This tells you everything you need to know about the quality of their investigations.) So you have plenty of time. My advice: keep expanding your practice to help cover expenses.
- You can keep practicing. Even when the Board feels so good about revoking a psychologist’s license that they issue a self-congratulatory press release, they don’t get an injunction to actually shut the person down.
- The board has won only 9 actions since 1999 against people you and I would recognize as being unlicensed/alternative practitioners, or 0.6 per year. Not an impressive track record.
- But get a lawyer right away. I’m told that getting a good lawyer is affordable for this kind of action. Be aware that your lawyer will likely say, “Don’t talk to them: leave it to me.” And make sure your lawyer reads this page and the Legal Update for Unlicensed Practitioners page. (Starting from scratch will be needlessly expensive, since the crucial Educational Exemption under ORS 675.825(4)(a) is constructed in a screwy way that’s easy even for lawyers to miss.)
- If you don’t get a lawyer right away, record your phone call. I’m advised that, under Oregon law, you don’t have to tell the person on the other end of the line that you’re making a recording. The OBPE’s “investigator” is so outrageous and self-incriminating that this is an opportunity not to be missed.
- Get a feisty lawyer. You’re dealing with bullies, so you need a lawyer who doesn’t mind confrontation. Some lawyers are defeatist when it comes to this kind of case, so be careful who you hire. I’m impressed by Mike Flinn in Corvallis. He may be able to recommend someone good in your area.
- Don’t turn your back. By my analysis, there is a clear pattern: if you don’t bring a lawyer to the party, the Board of Psychologist Examiners will smell blood and increase the fine. If you have a lawyer, they back off and either dismiss the case or offer a smaller fine.
- This too shall pass. The OBPE tells their lies with great confidence, and most of their victims believe them and shut down their practices without a struggle. But now that the Board has been exposed, fewer people are falling for this, and they’ll soon be forced to stop, one way or another.
- It’s a cost of doing business. Being hassled by the bureaucracy is a cost of doing business. Being 100% legal and ethical gives only partial protection, and we all have to expect to be treated unfairly at some point. I’m told your legal fees are tax-deductible! (And so, god forbid, are fines.)
- You’re in excellent company. Some of the most skillful and influential healers of the modern age were subjected to just this kind of treatment: Milton H. Erickson, the father of modern hypnotherapy, had to defend against an attempt to revoke his medical license in the Fifties, because the licensing board was prejudiced against hypnosis. Louis Pasteur was almost prosecuted for practicing medicine without a license for the first (and successful) use of his rabies vaccine. And good but less famous people are being hassled all the time, too.
- Contact your legislators. Whenever you have trouble with the State of Oregon, contact your legislators. Explain the issue (including links to this page and to my Legislative Update page) and ask them to help. Most legislators take constituent issues seriously, and will do what they can to help. The OBPE is dependent on the Legislature for its budget, Board members have to be confirmed by the State Senate, and the Legislature is responsible for drafting new legislation. Thus, every complaint is a nail in the OBPE’s coffin. This is doubly true since the OBPE is such a tiny, unimportant, and friendless part of the State government. No one is willing to put up with much trouble from them.
- Contact the Governor’s Office. Governor’s Citizens’ Representative Office, 503-378-4582. The governor appoints all Board members and can also remove them at will, and has many investigative resources at her disposal.
Letting Your Clients Know You’re Unlicensed
So much for the licensing boards. Let’s move on to a much simpler topic: communicating clearly with clients.
My clients are generally happy to learn that I’m not a member of the medical/mental-health establishment. Some even say, “good for you,” when learning that I’ve followed an unconventional path. Personally, I’m not the least bit anti-doctor, and neither are my clients. It’s just that, like most educated and intelligent people, we’re also comfortable with some alternative approaches.
I’m convinced that if you make your situation clear, people who like what you’re offering will come to you, and the people who won’t like it will go elsewhere. The net result is that you’ll have the clients you’re best suited for, and your practice will thrive.
How best to ensure that your clients know what they’re looking at? I have multiple disclaimers on my Web site, letting people know that I’m not a doctor, that I don’t have a license, and so on. I have no idea what legal standing a disclaimer might have, but that’s not the point: I want clients to understand where I’m coming from.
Here’s a simple disclaimer, for what it’s worth (I’m no lawyer):
I am a [your modality here] operating under Oregon’s “educational licensing exemption” under ORS 675.825(4)(a), which allows alternative practitioners and counselors to practice legally in Oregon without a license.
As for “letters after your name,” whether degrees or credentials, I think clients care about these even less than licensure. Some of my clients have advanced degrees or are licensed health-care professionals. But they don’t care about the letters after my name: they can tell if I’m a good fit for them from my Web site, because that’s what my Web site is for. A string of letters after my name would have no such effect, regardless of what those letters are.