resources to the Hospital's Psychiatric Residency Training Program, and stimulated a revision of Program organization as outlined below.

For the first two years of training, the clinical base of the Residency Program will be located at Saint Elizabeths Hospital, during which time basic professional skills and knowledge will be provided. The third year of training offers outstanding placements in various appropriate facilities of the Institute.

Training is conducted by a full time teaching staff of ten psychiatrists, plus consultants drawn from the National Institute of Mental Health and the Washington, D.C. psychiatric community.

The First Year Psychiatric Residency Program

In the first year the emphasis will be on clinical evaluation, diagnosis, interviewing, somatic and environmental treatment, disposition and after care of both acute and chronic patients. Experience in child psychiatry and neurology will be included.

First year academic seminars will be closely related to clinical work and include the following:

1. General Clinical Psychiatry.-Psychiatry Training Staff: This includes the discussion of fundamentals of psychiatry and will draw on personnel from the various operating programs of the National Institute of Mental Health (alcoholism, suicide, drug abuse, crime and delinquency, etc.), as well as the training staff of the Hospital.

2. Integrated Psychodynamics.-Edward I. Kushner, M.D., Teaching Analyst, Washington Psychoanalytic Institute.

A course which will introduce dynamic concepts in the frame work of working with patients and include interviewing techniques.

3. Personality Development.-Psychology Training Staff: This will include normal psychological growth and development, as well as other fundamental aspects of psychology.

4. Clinical Neurology.-Harold Stevens, M.D., Professor of Neurology, George Washington University, School of Medicine.

Clinical demonstration of neurologic entities with relevant didactic material. 5. Resident Identity Conference.-Ralph E. Wittenberg, M.D., Director, Psychiatric Residency, Training Program.

Group exploration of attitudes of professional identity.

The Second Year Psychiatric Residency Program

The second year of residency will be located on a long-term treatment unit where each resident will be assigned patients for intensive individual and group psychotherapy. Each resident will treat more than four patients at a time, three times a week; or in lieu of the fourth patient, a small group. Supervision will be provided one hour per week per patient, plus supervision of the administrative care of patients on the unit being treated by other residents. Second year residents are also assigned to the George Washington University Hospital Outpatient Clinic for experience in therapy of neuroses and milder character problems. Individual supervision and a continuous case conference are included.

Second Year Conferences

1. Basic Sciences:

(a) Social Sciences and Psychiatry: Archibald F. Ward, Ph.D., Director Program in Sociology.

(b) Learning Theory and Behavior Modification: Harold Weiner, Ph.D., Director, Operant Conditioning Laboratories.

(c) The Brain and Behavior: Francis N. Waldrop, M.D., Director, Behavioral and Clinical Studies Research Center.

2. Literature of Psychoanalysis.-Edward I. Kushner, M.D., Teaching Analyst, Washington Psychoanalytic Institute.

Review of classic articles relating to clinical work.

3. Psychotherapy.—Oscar Legault, M.D., Teaching Analyst, Washington Psychoanalytic Institute.

Literature and clinical material on theory and practice of individual psy chotherapy.

4. Group Dynamics and Theory.-John Borriello, Ph. D., Psychology Staff. Literature and clinical material on theory and practice of group psychotherapy. 5. Forensic Psychiatry.—Glenn D. Legler, M.D., Training Officer-Psychiatry. Distinguished guests who are experts in various aspects of the field, as well

as Hospital staff from the forensic services discuss legal and psychiatric issues of the offender-group of patients.

6. Community Psychiatry.-Beryce MacLennan, Ph. D., Chief of the Consultation and Community Liaison Section-Mental Health Studies Center and Roger Peele, M.D., Chief of Service, William A. White Division.

Prinicples, literature, and applications of community psychiatry.

7. Child Psychopathology.-Child Psychiatrist.

Review of pathology from infancy through adolescence-National Institute of Mental Health Staff, and guests.

Active clinical rounds and conferences are conducted in treatment areas during both years with outside consultants and training staff.

The Third Year Psychiatric Residency Program

The third year of residency training will be spent largely at the Mental Health Studies Center of the National Institute of Mental Health. The resident will have a varied experience with treatment teams of the Mental Health Studies Center in providing consultation in the community and evaluating and treating outpatients, including adolescents and family groups, marriage problems, etc.

Experience at the Center will include individual supervision, group reviews of video tapes of patient interviews, and seminar discussions with the staff of the Center.

The residents will also be assigned to one of four children's services in the Washington, D.C. area for one day per week experience in child psychiatry. These placements will include appropriate conferences.

Opportunities for elective work in other facilities of the National Institute of Mental Health are planned.

Third Year Conferences

1. Research. Thomas D. Reynolds, M. D., Program Director, Experimental Psychiatry.

Directed towards learning how to approach the psychiatric research literature in a critical way.

2. Special Issues in Psychiatry.-Paul Chodoff, M.D., Teaching Analyst, Washington Psychoanalytic Institute.

Discussions of a variety of topics, such as: private practice, hypnosis, family therapy, etc., with distinguished guests.

3. Psychotherapy.'-Oscar Legault, M.D., Teaching Analyst, Washington Psychoanalytic Institute.

Literature and clinical material on theory and practice of individual psychotherapy.

4. Case Conference.-Harvey Steinberg, M.D., Training Officer-Psychiatry. Group discussion of individual patients in current treatment with residents. 5. Evaluation and Disposition Conference.-William Polk, M.D., Director of Training, Mental Health Studies Center.

Review of the techniques of the evaluative process with clinical examples drawn from patients seen at the Mental Health Studies Center.

PROPOSED AMENDMENTS

[Following are the proposed amendments of the D.C. Medical Society, the MedicoChirurgical Society, D.C., the Washington Psychiatric Society, and the Washington Psychoanalytic Society, as submitted to the Committee]

PROPOSED AMENDED H.R. 10407, SUBMITTED AT THE REQUEST OF SUBCOMMITTEE No. 5, COMMITTEE ON THE DISTRICT OF COLUMBIA, HOUSE OF REPRESENTATIVES, BY THE D.C. MEDICAL SOCIETY, MEDICO-CHIRURGICAL SOCIETY, D.C., WASHINGTON PSYCHIATRIC SOCIETY AND WASHINGTON PSYCHOANALYTIC SOCIETY

A BILL To define and regulate the practice of psychology in the District of Columbia Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That this Act may be cited as the "Practice of Psychology Act."

1 Because present intermediate residents did not have this course, it will be available for third year residents as well.

SEC. 2. The practice of psychology in the District of Columbia is hereby declared to affect the public health, safety, and welfare, and to be subject to regulation and control in the public interest to protect the public from the unauthorized and unqualified practice of psychology, and from unprofessional conduct by persons licensed to practice psychology.

SEC. 3. As used in this Act

(A) "Commissioner" means the Commissioner of the District of Columbia or his authorized agent or agents.

(B) "Person" includes an association, partnership, or corporation, as well as natural persons.

(C) "Accredited college or university" means any college or university which, in the Commissioner's determination, offers either an acceptable full-time resident graduate program of study in psychology leading to the doctoral degree. or a comparable program. In making his determination concerning domestic educational institutions, the Commissioner shall accredit those institutions included in the listings of approved academic institutions published by the United States Office of Education; in determining what foreign educational institutions shall be accredited the Commissioner may take into account the published lists of accrediting agencies and of professional associations.

(D) "The practice of psychology" is the rendering of or offering to render to the public for a fee, monetary or otherwise, any service involving the application of established methods and principles of the science and profession of psychology, except as provided in Sections 5 and 20 of this Act. These principles and methods are concerned with understanding, predicting, and changing behavior, and they include, but are not restricted to, the use of counseling and psychotherapy with groups or individuals having adjustment problems in the areas of work, family, school, and personal relationships; measuring, testing, and assessing aptitudes, skills, public opinion, attitudes, emotions, personality, and intelligence; teaching or lecturing in psychology and doing research on problems relating to human behavior.

(E) For purposes of this Act, references herein to "the practice of counseling and psychotherapy" mean the offering by an individual of services involving the application of the principles and techniques of counseling and psychotherapy, individually and in groups, to individuals with personal complaints and/or symptoms.

SEC. 4. (A) The psychologist who engages in practice shall assist his client in obtaining professional help for all aspects of the client's problem that fall outside of the boundaries of the psychologist's own competence, and in the case of clients for counseling and psychotherapy who are not medical referrals, shall make provision for the diagnosis and treatment of medical problems by an appropriately qualified medical practitioner.

(B) Nothing in this Act shall be construed as permitting the administration or prescription of drugs, surgery, or any manual or mechanical treatment whatsoever, by any person not certified under the Healing Arts Practice Act, District of Columbia, 1928, as amended, nor as permitting a licensee to engage in the practice of the healing art as defined in said Healing Arts Practice Act, except a licensee may engage in the treatment of disease as defined in said Healing Arts Practice Act by means of counseling and psychotherapy, when the primary responsibility for the diagnosis and treatment of the disease devolves upon a physician certified under said Act and there is provision for effective collaboration between the licensee and the physician.

SEC. 5. It shall be unlawful for any person to practice or to offer to practice psychology, or to represent himself to be a psychologist, unless he shall have a valid, unexpired, unrevoked and unsuspended license pursuant to this Act, and for any person to practice, or to offer to practice, or to represent himself to practice counseling and psychotherapy unless he shall have an appropriate valid, unexpired, unrevoked and unsuspended license to do so, endorsed pursuant to section 7 (B), except as hereinafter provided.

(A) Nothing in this Act shall be construed to limit the activites of and use of the title "psychologist" by a person in the employ of any governmental agency, academic institution, charitable agency, research laboratory, or business corporation: Provided. That the services performed by such an employee are a part of his office or position, are provided only within the confines of the organization or offered to like organizations, and are not the practice of counseling and psychotherapy. Persons providing services to the public through governmental or ganizations, such as clinics, who are compensated by their employer rather than

their clients are also exempted under the Act. Persons coming under the exemptions established by this subsection may offer lecture services to the public for a fee but may not offer other psychological services to the public for a fee without having obtained a license.

(B) Nothing in this Act shall be construed to limit the activities of a student intern, or resident in psychology, pursuing a course of study or research with an accredited college, university, or training center: Provided, That such activities are supervised as part of his course of study, and he is designated by such title as "psychology intern," "psychology trainee," or other title clearly indicating trainee status.

(C) Nothing in this Act shall prevent the employment by a person furnishing psychological services for remuneration, of an individual not licensed as a psychologist under the provisions of this Act to assist in the performance of psychological services, other than of counseling and psychotherapy, if such individual works under the supervision of a licensed psychologist who assumes full responsibility for his acts, and if such individual is not in any manner held out to the public as a psychologist.

SEC. 6. (A) The Commissioner shall be responsible for reviewing the applications of persons seeking licensure or certification for the practice of psychology in the District of Columbia, for the granting and renewal of such licenses and certificates, for the preparation and administration of oral and written examinations, and for other matters related to the purposes of this Act.

(B) The Commissioner may appoint a Board of Psychologist Examiners. Each member shall be a citizen of the United States, licensed under the provisions of this Act, who shall either be a resident of the District of Columbia or have worked in the District of Columbia for at least two years preceding appointment to the Board. The initial appointees shall be psychologists eligible for licensure under provisions of this Act.

(C) The Commissioner shall maintain: (1) a record of licenses granted and refused and of licenses revoked or suspended which record shall be available to the public; and (2) a complete record of all hearings conducted pursuant to section 15(B) in connection with the denial, suspension, or revocation of a license. A transcript of an entry in a record of hearing, properly certified, shall be prima facie evidence of the facts therein stated.

SEC. 7. (A) The Commissioner shall grant a license to practice psychology to each applicant who submits satisfactory proof that--

(1) he is of good moral character;

(2) he holds either (a) a doctoral degree in psychology from an accredited college or university and has completed two years of accredited postgraduate experience acceptable to the Commissioner, such two years not to include terms of internship, or (b) a doctoral degree in a field related to psychology from an accredited college or university, plus two years of accredited postgraduate experience: Provided, That his experience and training are considered by the Commissioner to be comparable to the requirements set forth in (2) (a) of this subsection;

(3) he has passed an examination, written or oral or both, the scope and form of which shall be determined by the Commissioner: Provided, That at any given examination session all examinations shall be uniform; and

(4) his application has been accompanied by the necessary fees. (B) The Commissioner shall endorse a license to practice psychology as entitling the licensee additionally to practice counseling and psychotherapy, in the case of each applicant entitled to a license to practice psychology under Section hereof, (1) who in addition shall pass an examination, written or oral, or both, which shall examine specifically with respect to the practice of counseling and psychotherapy, the scope and form of which shall be determined by the Commissioner: PROVIDED, That at any examination session, all such examinations shall be uniform; and (2) the applicant shall have had at least one year's internship and two years of accredited postgraduate experience in counseling and psychotherapy acceptable to the Commissioner.

SECTION. 8. Within one year from and after the effective date of this Act, a license to practice psychology, and one endorsed with respect to counseling and psychotherapy, as appropriate, shall be issued without examination to any applicant who is of good moral character, who either maintains a residence or office, or participates in psychological activities, as determined by the Commissioner, within the District of Columbia, who has submitted an application for license accompanied by the required fee, and who holds

(A) a doctoral degree in psychology from an accredited college or university or other doctoral degree acceptable to the Commissioner, and has completed at least two years of postgraduate experience not including terms of internship; and

(B) a master's degree in psychology from an accredited college or university, or comparable training as determined by the Commissioner, and has engaged in psychological practice acceptable to the Commissioner for seven years after the attainment of his highest degree.

(C) The license shall state whether the licensee may practice counseling and psychotherapy if the training and experience of the applicant is in counseling and psychotherapy as determined by the Commissioner. SEC. 9. The Commissioner may, in his discretion, grant a license with or without an endorsement to practice counseling and psychotherapy, as appropriate without examination, on payment of the required fee, to any person who at the time of application is licensed or certified under the laws of a State or territory of the United States, or of a foreign country or province whose standards, in the opinion of the Commissioner, were substantially equivalent at the date of such certification or licensure, to the requirements of this Act.

SEC. 10. A psychologist who is not licensed under the provisions of this Act. but (1) who is licensed or certified under the laws of a State or territory of the United States or of a foreign country or province whose standards, in the opinion of the Commissioner, were substantially equivalent, at the date of his certification or licensure, to the requirements of this Act or (2) who meets the requirements of subsections (A) (1) and (A) (2) of section 7, and, if he wishes to practice counseling and psychotherapy, subsection (B) (2), and resides in a State or territory of the United States, or in a foreign country or province which does not grant licences or certificates to psychologists, may be employed or invited by a person who is a resident of or maintains a place of work in the District of Columbia to offer professional services in said District for a total of not more than sixty days in any calendar year without holding a license issued under this Act. Upon arrival in the District of Columbia, such a psychologist shall report to the Commissioner with respect to the nature and duration of his professional activities in the District as well as the name of the person who has requested him to render services.

A psychologist claiming exemption under the provisions of this section who offers professional services in the District of Columbia for more than twenty days in any calendar year shall file with the Commissioner evidence of his right to such exemption. Upon proof of that right, to the satisfaction of the Commissioner, the Commissioner shall enter the name of the applicant in a register kept for that purpose and shall issue to the applicant a certificate in evidence of such registration.

SEC. 11. The Commissioner may, in his discretion, waive all or part of the examination required under sections 7(A)(3) or (B)(1) of this Act when the applicant has been certified by a national examining board: PROVIDED. That the examination given by the national examining board was as effective for the testing of professional competence as those required in the District of Columbia. SEC. 12. The District of Columbia Council is authorized to make regulations to carry out the purposes of this Act, including, after public hearing, (A) to fix, increase, or decrease fees to be charged for services performed by the District Government pursuant to the provisions of this Act in such amounts as may, in the judgment of the Council, be reasonably necessary to defray the approximate cost of administering this Act; and (B) to establish standards for the ethical practice of psychology.

SEC. 13. Every person licensed or certified to practice psychology who desires to continue the practice of psychology shall annually pay the required fee for which there will be issued a renewal of licensure or certificate. The Commissioner shall provide a written reminder of the renewal date to every person licensed or registered under this Act, which reminder shall be mailed at least one month in advance. A license or certificate not properly renewed as herein provided shall lapse. The Commissioner shall have the right to reinstate a lapsed license or certificate upon payment of the renewal fee plus a penalty fee. A psychologist who wishes to place his license upon an inactive status may do so by submitting notice thereof to the Commissioner. Such a psychologist may reactivate his license by payment of the renewal fee herein required unless his license has been inactive for a period exceeding five years, in which case he will be required to furnish the Commissioner with evidence as to his com