It sometimes seems like labor abuses are a rite of passage for prelicensed therapists. Recent graduates are often appalled by the unpaid or underpaid positions their colleagues (and sometimes they) willingly take simply to get their hours done. Many wonder whether they will be able to support their families as they progress to licensure.
Therapists also often talk about inadequate supervision, dangerous working conditions, unrealistic and inappropriate demands, and a variety of other serious labor concerns on the road to licensure. Some drop out of the field altogether.
If so many therapists experience labor abuses, then why do the problems persist? There are a number of reasons, but in this post I will address two of them: The therapists who make it to licensure move on, and few prelicensed therapists are willing to take the kinds of actions that would produce meaningful change. If you choose to stand up and fight on these issues, you may be surprised at how much impact you can have.
Get licensed, move on
Like any rite of passage, the struggle to licensure eventually reaches an end. You complete your supervised hours, make it through the licensing exam process, and advance to the next stage of your career. Finally armed with the qualifications necessary to get higher-paying work, many therapists focus their energy on paying off student loan debt, buying a home, or otherwise moving forward. Little time and energy is left to pursue advocacy for prelicensed therapists, especially considering that the newly-licensed therapist may not receive any personal benefit from such work.
Therapists can hardly be blamed for shifting their focus in this way. But it does leave the next group of new graduates vulnerable to the exact same pressures and struggles faced by the last group. Professional associations advocate where they can for the interests of prelicensed therapists, and have made a number of positive changes in California in recent years. Hours of experience for master’s-level licensure have been streamlined, and the “intern” title becomes “associate” for MFTs and PCCs in 2018. But the associations cannot be of much service in areas where the proper policies are already in place. We need therapists in places where the rules are not being followed to demand that those rules be enforced.
Keeping your head down
While those therapists who make it to licensure seek to leave the prelicensed experience behind, those who are still struggling as prelicensed therapists often simply choose not to fight the questionable or even illegal actions of their employers. Here, too, blame is not appropriate: It is entirely understandable why a therapist working toward licensure would focus on gathering hours and preserving professional relationships. Challenging an employer could mean losing one’s job, and make it difficult to get hired into a new one. Many prelicensed therapists have told me of the tough decisions they had to make about calling out unfair or illegal labor practices.
When therapists do challenge troubling practices, though, the results can be groundbreaking. A psychology intern at the University of California San Francisco won a landmark ruling from the California labor board when she challenged the university’s refusal to pay her for most of the hours she worked. Even though the university was not a for-profit business, it was an employer, and the labor board determined that the intern must be paid. Nonprofits and governmental agencies around the state took note.
Unfortunately, we do not yet have a good test case where a prelicensed MFT, PCC, or CSW has challenged an unpaid position. Such positions may be illegal in some instances, but until a therapist challenges them, employers that should be paying their employees by law will continue to enjoy free labor.
What you can do
If you are currently working as a prelicensed therapist and believe that your employer’s practices are questionable, the best start is to get informed. This blog has a number of articles on working as an intern or associate (see here and here). A consultation with an attorney specializing in labor and employment law may well be worth your while. And if you have done these things and believe it is appropriate, a respectful and professional discussion with the employer may be all that is needed to facilitate change. Of course, that discussion can be risky, so again, I do not blame anyone who chooses not to do it. But if you do, and it is unproductive, a formal complaint may be your next step.
The opportunity to help with these issues does not stop once you reach licensure, of course. If you previously worked in an unpaid position, it may be worth investigating whether you are owed back pay, and proceeding accordingly. And while there may not be much personal benefit to you, your willingness to stand up and fight for those behind you will be seen and deeply appreciated.