Group therapy. Background. Involved specialties. Positions of specialty boards ABPN. Procedure 67

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1 Procedure 67 Clinical PRIVILEGE WHITE PAPER Background Group therapy The correct use of the term group therapy refers to psychotherapy services that are provided to designated patient populations whose constituents are dealing with mental problems and emotional obstacles in their lives. Group psychotherapy differs from support groups and self-help groups in that it not only helps people cope with problems, but also provides for change and growth. Group therapy is carried out by clinical health professionals who possess the appropriate licensure, training, and experience; they can have backgrounds in many different areas such as psychiatry, psychology, social work, and various types of counseling. Some of the issues commonly addressed in group psychotherapy sessions include difficulties with interpersonal relationships, medical illness, depression and anxiety, loss, trauma, and personality and addictive disorders. According to the American Group Psychotherapy Association (AGPA), a typical psychotherapy group has around five to 10 members, who are selected by the group therapist based on their ability to be helped by the group experience and serve as learning partners for one another. Different groups use different styles, but in general, sessions last about minutes, during which members express their problems, feelings, ideas, and reactions as freely and honestly as possible in order to better understand themselves and their issues, as well as to become therapeutic helpers for other group members. Involved specialties Psychiatrists, psychologists, advanced practice nurses (psychiatric and mental health), licensed social workers, and mental health workers Positions of specialty boards ABPN The American Board of Psychiatry and Neurology (ABPN) provides board certification in psychiatry. To sit for the certification examination, candidates must have a medical license and have satisfactorily completed one of the following routes of training: Three-year psychiatry residency program: A broad-based clinical year of Accreditation Council for Graduate Medical Education (ACGME) accredited training in internal medicine, family

2 medicine, or pediatrics; or an ACGME-accredited transitional year program that included a minimum of four months of primary care medicine; or an ACGME-accredited residency in a clinical specialty requiring comprehensive and continuous patient care. AND Three full years of postgraduate, specialized residency training in a psychiatry program accredited by the ACGME. Four-year psychiatry residency program: Four years of training in an ACGME-accredited program in psychiatry is acceptable. A psychiatry PGY-1 must include at least four months in internal medicine, family medicine, and/or pediatrics. This training must be in a clinical setting that provides comprehensive and continuous patient care. No more than one month of this requirement may be fulfilled by an emergency medicine rotation, as long as the experience predominantly involves medical evaluation and treatment rather than surgical procedure. Neurology rotations may not be used to fulfill this four-month requirement. The ABPN does not publish specific training requirements for group psychotherapy, but does include group psychotherapy as part of its published content outline for ABIM The American Board of Internal Medicine (ABIM) and the ABPN offer dual certification in internal medicine and psychiatry. A combined residency must include at least five years of coherent education integral to residencies in the two disciplines. At the conclusion of 60 months of training in internal medicine and psychiatry, residents should have had experience and instruction in the prevention, detection, and treatment of acute and chronic medical and psychiatric illness presenting in both inpatient and ambulatory settings. Trainees should be exposed to the psychiatric and medical problems in patients from adolescence to old age and receive training in socioeconomics of illness, the ethical care of patients, and in the team approach to the provision of patient care. The ABIM does not publish specific training requirements for group psychotherapy, but does note that residents must have experience in the evaluation and treatment of couples, families, and groups. AOBNP The American Osteopathic Board of Neurology and Psychiatry (AOBNP) offers certification in the practice of psychiatry, which includes all accepted therapies, assessments, and diagnostic studies. Applicants must be graduates of an 2

3 American Osteopathic Association (AOA) accredited college of osteopathic medicine and must be licensed to practice in the state or territory where practice is conducted. Applicants must successfully complete an AOA-approved internship followed by three years of AOA-approved training in psychiatry. The AOBNP does not publish specific training requirements for group therapy. ABPP/ABGP The American Board of Professional Psychology (ABPP) offers specialty board certification in psychology. Among the specialty boards of ABPP is the American Board of Group Psychology (ABGP). Group psychology is the application and practice of group theory, research, and technique to the assessment and intervention of problems and the enhancement of functioning to individuals, groups, organizations, or systems, according to ABGP. Candidates for certification as specialists in group psychology must hold a doctoral degree from a program in professional psychology accredited by the American Psychological Association (APA) and must be licensed as a psychologist for independent practice at the doctoral level. Applicants must have two years of supervision in group psychology, including 600 hours of supervised group contact. Alternatively, applicants may complete postdoctoral training in group psychology, including an approved internship program and an approved postdoctoral residency program in group psychology or with a group psychology concentration. Graduate and postgraduate courses in group psychology are required of all applicants. Positions of societies, academies, colleges, and associations AGPA According to the AGPA, qualified clinical professionals holding a minimum of a master s degree are eligible to become clinical members of the association. To the AGPA, the term clinical professionals includes psychiatrists, psychologists, social workers, nurses, mental health counselors, marriage and family therapists, pastoral counselors, creative arts therapists, alcohol and drug abuse counselors, and school psychologists. The AGPA also offers certification in group psychotherapy, with the designation certified group psychotherapist (CGP). AGPA defines a CGP as a clinical mental health professional who meets national accepted criteria of education, training, and experience in group psychotherapy. Eligibility for certification requires a graduate degree and the highest clinical licensure available for an individual s discipline in his or her state. If state licensure is not available, membership or certification at the highest clinical level in designated national professional organizations may be used to verify credentials as a clinical mental health 3

4 professional. Additionally, eligibility for certifications requires the following group psychotherapy credentials: Completion of 12 hours of study in group psychotherapy theory and practice that includes the following content areas: Foundations of group psychotherapy The group leader Group dynamics and group process The change process in groups 300 hours of group psychotherapy experience as a leader or coleader accrued during or following clinical graduate training 75 hours of group psychotherapy supervision accrued during or following clinical graduate training The AGPA certification board requires a recertification process every two years that includes: 18 hours of continuing education in group psychotherapy Active state licensure and/or active clinical membership/certification status with designated national professional organizations SGPGP/APA The Society of Group Psychology and Group Psychotherapy (SGPGP) is a division of the APA focused on research, teaching, and practice in group psychology and psychotherapy. SGPGP does not currently publish specific training requirements for group psychotherapy, but is developing national guidelines for doctoral and postdoctoral training. ASGPP The American Society of Group Psychotherapy and Psychodrama (ASGPP) is a membership organization that promotes professional training in group psychotherapy, psychodrama, and sociometry. ASGPP promotes and publishes research in group psychotherapy and related fields, but does not publish specific requirements for training in group therapy. APNA The American Psychiatric Nurses Association (APNA) notes that psychiatric mental health registered nurses assess the mental health needs of individuals, families, groups, and communities. Psychiatric mental health advanced practice registered nurses, who earn master s or doctoral degrees in psychiatric-mental health nursing, assess, diagnose, and treat individuals and families through the administration of psychotherapy. APNA does not publish specific training requirements for group therapy. 4

5 ANCC The American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association, certifies and recognizes nurses in specialty practice areas through its credentialing programs. ANCC offers certification in psychiatric-mental health nursing. To be eligible, applicants must hold a current, active RN license within a state or territory of the United States or the equivalent in another country, have practiced the equivalent of two years full time as an RN, have a minimum of 2,000 hours of clinical practice in psychiatric and mental health nursing within the past three years, and have completed 30 hours of continuing education in psychiatric and mental health nursing within the past three years. ANCC does not publish specific requirements for group therapy. NASW The National Association of Social Workers (NASW) is a membership organization of professional social workers, including social workers in the mental health field. NASW publishes NASW Standards for Social Work Practice in Health Care Settings, which states that social workers in healthcare settings should possess a social work degree from a school accredited by the Council on Social Work Education, and should have additional specialized experience and training from involvement or internship in a healthcare setting. Social workers in leadership roles should be licensed at the advanced practice level. According to this document, social workers may implement intervention and treatment plans that promote patients well-being. Treatment plans may include individual, family, or group counseling and psychoeducational support groups. NASW does not publish specific requirements for training in group therapy. ACGME The ACGME publishes Program Requirements for Graduate Medical Education in Psychiatry, which requires 48 months of residency training in psychiatry, of which 12 months may be completed in a child and adolescent psychiatry program. A required component of training includes exposure to group and other evidence-based psychotherapies. ACGME does not publish specific requirements for group therapy. AOA The AOA and the American College of Osteopathic Neurologists and Psychiatrists jointly publish Basic Standards for Residency Training in General Psychiatry, which requires residents to have 48 months of training that encompasses both adult and child psychiatry as follows: First year: four months of primary care medicine, two months of neurology, no more than six months of psychiatry Three years of general psychiatry or two years of general psychiatry and one year of child/adolescent psychiatry or two years of general psychiatry and one year of geriatric psychiatry 5

6 AOA does not publish a specific requirement for group therapy, but during training, residents must have experience with couples, families, and groups, and must learn techniques for group therapy. Positions of subject matter experts C. Donald Williams, MD, CGP Yakima, Wash. C. Donald Williams, MD, CGP, is a solo psychiatric practitioner in eastern Washington. Dr. Williams is a certified group psychotherapist and shares the views of the AGPA regarding training and certification. The requirements are nontrivial and require a considerable investment of time and effort, he says. Dr. Williams feels that CGP designation is an appropriate credential for group therapists to have; however, he notes that it is unlikely that rural hospitals and other rural employer organizations currently require certification due to the limited number of CGP designated therapists in many areas. He believes that certification requirements will be phased in over time, similar to the history of board certification for medical specialties. Dr. Williams supports the 18-plus credits required every two years to maintain CGP designation. Nina Brown, EdD, LPC, NCC, FAGPA Norfolk, Va. Nina Brown, EdD, LPC, NCC, FAGPA, is a professor and eminent scholar in the Department of Counseling and Human Services at Old Dominion University. Her professional credentials include a doctorate, licensure as a professional counselor (LPC), national counselor certification (NCC), and designation as a fellow by the American Group Psychotherapy Association (FAGPA). Brown says that education and training will vary depending on the types of groups with which therapists will be working. She notes that very different training is required for inpatient groups focused on trauma, for example, versus outpatient groups that might be working on something like interpersonal relationships. Brown says that generally a master s degree is the minimum appropriate educational requirement for a group psychotherapist. Also, while some techniques used for individual therapy do cross over, group therapy demands its own set of skills that require specific training. Brown feels appropriate training can come from many different sources such as the AGPA certification or university integrated training programs, but stresses that training should be targeted to the specific types of groups a therapist will work with. She says it is also important that individuals complete a supervised practicum and have internship or work experience. 6

7 Brown says maintenance of competence can be achieved through group psychotherapy focused continuing education as a component of an individual s normal licensure CE requirements. Positions of accreditation bodies CMS CMS has no formal position concerning the delineation of privileges for group therapy. However, the CMS Conditions of Participation (CoP) define a requirement for a criteria-based privileging process in (c)(6) stating, The bylaws must include criteria for determining the privileges to be granted to individual practitioners and a procedure for applying the criteria to individuals requesting privileges (a)(6) states, The governing body must assure that the medical staff bylaws describe the privileging pro cess. The process articulated in the bylaws, rules or regula tions must include criteria for determining the privileges that may be granted to individual practitioners and a procedure for applying the criteria to individual practitioners that considers: Individual character Individual competence Individual training Individual experience Individual judgment The governing body must ensure that the hospital s bylaws governing medical staff membership or the granting of privileges apply equally to all practitioners in each professional category of practitioners. Specific privileges must reflect activi ties that the majority of prac titioners in that category can perform competently and that the hospital can support. Privileges are not granted for tasks, procedures, or activities that are not conducted within the hospital, regardless of the practitioner s ability to perform them. Each practitioner must be individually evaluated for requested privileges. It can not be assumed that every practitioner can perform every task, activity, or privilege specific to a specialty, nor can it be assumed that the practitioner should be automatically granted the full range of privileges. The individual practitioner s ability to perform each task, activity, or privilege must be individually assessed. CMS also requires that the organization have a process to ensure that practitioners granted privileges are work ing within the scope of those privileges. CMS CoPs include the need for a periodic appraisal of practitioners appointed to the medical staff/granted medical staff privileges ( [a][1]). In the 7

8 absence of a state law that establishes a time frame for the periodic appraisal, CMS recommends that an appraisal be conducted at least every 24 months. The purpose of the periodic appraisal is to determine whether clinical privileges or membership should be continued, discontinued, revised, or otherwise changed. CMS CoPs also include special provisions applying to psychiatric hospitals ( ) that may offer additional guidance when determining privileging criteria. The Joint Commission Note: The following is an excerpt from The Joint Commission Human Resource (HR) Standards. Accredited facilities should refer to the Comprehensive Accreditation Manual for Hospitals for a complete set of HR standards. The Joint Commission has no formal position concerning the scope of practice for group therapy. In its Comprehensive Accreditation Manual for Hospitals, HR standards apply to all staff (employees, contractors, nonemployees who provide services in the healthcare organization. The following Joint Commission EP has particular relevance to understanding the credentialing process for non-privileged practitioners such as the radiology technician. HR , EP 7 states: Before providing care, treatment, and services, the hospital confirms that nonemployees who are brought into the hospital by a licensed independent practitioner [LIP] to provide care, treatment, or services have the same qualifications and competencies required of employed individuals performing the same or similar services at the hospital. Two additional notes further define this EP. The first note states that the confirmation of qualifications and competencies can be accomplished through the hospital s regular process or with the LIP who brought in the individual. The second note specifies that if the care, treatment, and services by the nonemployee are not currently performed by anyone employed by the hospital, leadership must consult appropriate professional hospital guidelines for the required credentials and competencies. The following HR standards are also applicable: The hospital has the necessary staff to support the care, treatment, and services it provides (HR ). The hospital defines staff qualifications specific to their job responsibilities (HR ). The hospital verifies staff qualifications (HR ). EPs 1 5 state that the following is verified and documented in accordance with law, regulation, and hospital policy at the time of hire and when an employee s credentials are renewed, as applicable: 8

9 Current license, certification, or registration Education and experience Criminal background check Health screening The information listed in the previous bullet is used to make decisions regarding staff job responsibilities (HR , EP 6). The hospital determines how staff function within the organization (HR ). EPs 1 2 state that staff who provide care, treatment, or services possess a current license, certification, or registration if required by law and regulation, and practice within the scope of that license, certification, or registration. The hospital provides orientation to staff (HR ). EPs 1 6 state that: The hospital determines the key safety content of orientation provided to staff. The hospital orients its staff to the key safety content before staff provide care, treatment, and services. Completion of this orientation is documented. The hospital orients staff on the following and it is documented: relevant hospitalwide and unit-specific policies and procedures; specific job duties (including those related to infection prevention and control and managing pain); sensitivity to cultural diversity based on job duties and responsibilities; and patient rights, including ethical aspects of care, treatment, and services. Staff participate in ongoing education and training (HR ). EPs 1 13 (note EP 3 and 9 12 do not exist) state that staff participate in ongoing education and training and their participation is documented: To maintain or increase their competency. Whenever staff responsibilities change. Specific to the needs of the patient population served by the hospital. That incorporates the skills of team communication, collaboration, and coordination of care. That includes information about the need to report unanticipated adverse events and how to report the event. On fall reduction activities. Education and training is provided by the hospital that addresses early warning signs of a change in a patient s condition and how to respond to a deteriorating patient, including how and when to contact responsible clinicians. Education is provided to staff and LIPs who may request assistance and those who may respond to those requests. This education and training is documented. Staff are competent to perform their responsibilities (HR ). EPs 1 15 (note 7 14 do not exist) state that the hospital: Defines the competencies it requires of staff who provide care. Uses assessment methods to determine the individual s competence in the skills being assessed. Methods may include test taking, return demonstration, or the use of simulation. Assesses skills utilizing an individual with the educational background, experience, or related knowledge. When a suitable individual cannot be found to 9

10 assess staff competence, the hospital can utilize an outside individual for this task. Alternatively, the hospital may consult the competency guidelines from an appropriate professional organization to make its assessment. Conducts an initial assessment of staff competence as a part of orientation and this assessment is documented. Assesses and documents staff competence once every three years or more frequently as required by hospital policy or in accordance with law or regulation. Takes action when a staff member s competence does not meet expectations. The hospital evaluates staff performance (HR ). EPs 1 3 state that the hospital: Evaluates staff based on performance expectations that reflect their job responsibilities. Evaluates staff performance and documents the evaluation once every three years or more frequently as required by hospital policy or in accordance with law or regulation. Reviews the individual s competencies and performance for nonemployed individuals brought into the facility by an LIP at the same frequency as employees. This can be accomplished either with the LIP or through the hospital s regular process. The Comprehensive Accreditation Manual for Hospitals also states, The hospital collects information regarding each practitioner s current license status, training, experience, competence, and ability to perform the requested privilege (MS ). In the introduction for MS , The Joint Commission states that there must be a reliable and consistent system in place to process applications and verify credentials. The organized medical staff must then review and evaluate the data collected. The resultant privilege recommendations to the governing body are based on the assessment of the data. The Joint Commission introduces MS by stating, The organized medical staff is respon sible for planning and implementing a privileging process. It goes on to state that this process typically includes: Developing and approving a pro cedures list Processing the application Evaluating applicant-specific information Submitting recommendations to the governing body for applicant-specific delineated privileges Notifying the applicant, relevant personnel, and, as required by law, external entities of the privi leging decision Monitoring the use of privileges and quality-of-care issues MS further states, The decision to grant or deny a privilege(s) and/or to renew an existing privilege(s) is an objective, evidence-based process. 10

11 The EPs for standard MS include several requirements as follows: The need for all licensed independent practitioners who provide care, treatment, and services to have a current license, certification, or registration, as required by law and regulation Established criteria as recommended by the organized medical staff and approved by the governing body with specific evaluation of current licensure and/or certification, specific relevant training, evidence of physical ability, professional practice review data from the applicant s current organization, peer and/or faculty recommendation, and a review of the practitioner s performance within the hospital (for renewal of privileges) Consistent application of criteria A clearly defined (documented) procedure for processing clinical privilege requests that is approved by the organized medical staff Documentation and confirmation of the applicant s statement that no health problems exist that would affect his or her ability to perform privileges requested A query of the NPDB for initial privileges, renewal of privileges, and when a new privilege is requested Written peer recommendations that address the practitioner s current medical/clinical knowledge, technical and clinical skills, clinical judgment, interpersonal skills, communication skills, and professionalism A list of specific challenges or concerns that the organized medical staff must evaluate prior to recommending privileges (MS , EP 9) A process to determine whether there is sufficient clinical performance information to make a decision related to privileges A decision (action) on the completed application for privileges that occurs within the time period specified in the organization s medical staff bylaws Information regarding any changes to practitioners clinical privileges, updated as they occur The Joint Commission further states, The organized medical staff reviews and analyzes information regarding each requesting practitioner s current licensure status, training, experience, current competence, and ability to perform the requested privilege (MS ). In the EPs for standard MS , The Joint Commission states that the information review and analysis process is clearly defined and that the decision process must be timely. The organization, based on recommendations by the organized medical staff and approval by the governing body, develops criteria that will be considered in the decision to grant, limit, or deny a request for privileges. The criteria must be consistently applied and directly relate to the quality of care, treatment, and services. Ultimately, the governing body or delegated governing body has the final authority for granting, renewing, or denying clinical privileges. Privileges may not be granted for a period beyond two years. 11

12 Criteria that determine a practitioner s ability to provide patient care, treatment, and services within the scope of the privilege(s) requested are consistently evaluated. The Joint Commission further states, Ongoing professional practice evaluation information is factored into the decision to maintain existing privilege(s), to revise existing privileges, or to revoke an existing privilege prior to or at the time of renewal (MS ). In the EPs for MS , The Joint Commission says there is a clearly defined process facilitating the evaluation of each practitioner s professional practice, in which the type of information collected is determined by individual departments and approved by the organized medical staff. Information resulting from the ongoing professional practice evaluation is used to determine whether to continue, limit, or revoke any existing privilege. HFAP The Healthcare Facilities Accreditation Program (HFAP) has no formal position concerning the delineation of privileges for group therapy. The bylaws must include the criteria for determining the privileges to be granted to the individual practitioners and the procedure for applying the criteria to individuals requesting privileges ( ). Privileges are granted based on the medical staff s review of an individual practitioner s qualifications and its recommendation regarding that individual practitioner to the governing body. It is also required that the organization have a process to ensure that practitioners granted privileges are working within the scope of those privileges. Privileges must be granted within the capabilities of the facility. For example, if an organization is not capable of performing open-heart surgery, no physician should be granted that privilege. In the explanation for standard related to membership selection criteria, HFAP states, Basic criteria listed in the bylaws, or the credentials manual, include the items listed in this standard. (Emphasis is placed on training and competence in the requested privileges.) The bylaws also define the mechanisms by which the clinical departments, if applicable, or the medical staff as a whole establish criteria for specific privilege delineation. Periodic appraisals of the suitability for membership and clinical privileges is required to determine whether the individual practitioner s clinical privileges should be approved, continued, discontinued, revised, or otherwise changed 12

13 ( ). The appraisals are to be conducted at least every 24 months. The medical staff is accountable to the governing body for the quality of medical care provided, and quality assessment and performance improvement ( ) information must be used in the process of evaluating and acting on re-privileging and reappointment requests from members and other credentialed staff. DNV DNV has no formal position concerning the delineation of privileges for group therapy. MS.12 Standard Requirement (SR) #1 states, The medical staff bylaws shall include criteria for determining the privileges to be granted to individual practitioners and a procedure for applying the criteria to those individuals that request privileges. The governing body shall ensure that under no circumstances is medical staff membership or professional privileges in the organization dependent solely upon certification, fellowship, or membership in a specialty body or society. Regarding the Medical Staff Standards related to Clinical Privileges (MS.12), DNV requires specific provisions within the medical staff bylaws for: The consideration of automatic suspension of clinical privileges in the following circumstances: revocation/restriction of licensure; revocation, suspension, or probation of a DEA license; failure to maintain professional liability insurance as specified; and noncompliance with written medical record delinquency/deficiency requirements Immediate and automatic suspension of clinical privileges due to the termination or revocation of the practitioner s Medicare/Medicaid status Fair hearing and appeal The Interpretive Guidelines also state that core privileges for general surgery and surgical subspecialties are acceptable as long as the core is properly defined. DNV also requires a mechanism (outlined in the bylaws) to ensure that all individuals provide services only within the scope of privileges granted (MS.12,SR.4). Clinical privileges (and appointments or reappointments) are for a period as defined by state law or, if permitted by state law, not to exceed three years (MS.12, SR.2). Individual practitioner performance data must be measured, utilized, and evaluated as a part of the decision-making for appointment and reappointment. Although not specifically stated, this would apply to the individual practitioner s respective delineation of privilege requests. 13

14 CRC draft criteria The following draft criteria are intended to serve solely as a starting point for the development of an institution s policy regarding group therapy. Minimum threshold criteria for requesting privileges in group therapy Basic education: MA or MS Minimal formal training: Highest clinical licensure available for an individual s discipline in his or her state and successful completion of a training program that encompasses group psychotherapy, such as certification by the AGPA or the ANCC, or completion of an ACGME- or AOA-accredited residency in psychiatry. Required current experience: Demonstrated current competence and evidence of at least 75 hours of group therapy supervision in the past 12 months or successful completion of appropriate training in group psychotherapy in the past 12 months. References If the applicant is recently trained, a letter of reference should come from the director of the applicant s training program. Alternatively, a letter of reference may come from the applicable department chair and/or clinical service chief at the facility where the applicant most recently practiced. Reappointment Reappointment should be based on unbiased, objective results of care according to a hospital s quality assurance mechanism. Applicants must demonstrate current competence and evidence of 150 hours of group therapy supervision in the past 24 months based on the results of ongoing professional practice evaluations and outcomes. In addition, a minimum of 18 hours of continuing education related to group therapy should be required. For more information Accreditation Council for Graduate Medical Education 515 North State Street, Suite 2000 Chicago, IL Telephone: Fax: Website: 14

15 American Board of Internal Medicine 510 Walnut Street, Suite 1700 Philadelphia, PA Telephone: Website: American Board of Medical Specialties 222 North LaSalle Street, Suite 1500 Chicago, IL Telephone: Website: American Board of Professional Psychology/ American Board of Group Psychology 600 Market Street, Suite 300 Chapel Hill, NC Telephone: Fax: Website: American Board of Psychiatry and Neurology 2150 E. Lake Cook Road, Suite 900 Buffalo Grove, IL Telephone: Website: American Group Psychotherapy Association 25 East 21st Street, 6th floor New York, NY Telephone: Website: American Nurses Credentialing Center 8515 Georgia Avenue, Suite 400 Silver Spring, MD Telephone: Website: American Osteopathic Association 142 East Ontario Street Chicago, IL Telephone: Website: 15

16 American Osteopathic Board of Neurology and Psychiatry 2730 S. Val Vista Drive, #146 Gilbert, AZ Telephone: Website: neurology-psychiatry-certification.aspx American Psychiatric Nurses Association 1555 Wilson Boulevard, Suite 530 Arlington, VA Telephone: Fax: Website: American Psychological Association 750 First Street, NE Washington, DC Telephone: Website: American Society of Group Psychotherapy and Psychodrama 301 N. Harrison Street, Suite 508 Princeton, NJ Telephone: Fax: Website: Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD Telephone: Website: DNV Healthcare, Inc. 400 Techne Center Drive, Suite 350 Milford, OH Website: Healthcare Facilities Accreditation Program 142 E. Ontario Street Chicago, IL Telephone: Website: 16

17 The Joint Commission One Renaissance Boulevard Oakbrook Terrace, IL Telephone: Fax: Website: National Association of Social Workers 750 First Street NE, Suite 700 Washington, DC Telephone: Website: Society of Group Psychology and Group Psychotherapy 750 First Street NE Washington, DC Telephone: Website: Editorial Advisory Board Clinical Privilege White Papers Associate Editorial Director: Erin Callahan, Managing Editor: Julie McCoy, William J. Carbone Chief Executive Officer American Board of Physician Specialties Atlanta, Ga. Darrell L. Cass, MD, FACS, FAAP Codirector, Center for Fetal Surgery Texas Children s Hospital Houston, Texas Jack Cox, MD Senior Vice President/Chief Quality Officer Hoag Memorial Hospital Presbyterian Newport Beach, Calif. Stephen H. Hochschuler, MD Cofounder and Chair Texas Back Institute Phoenix, Ariz. Bruce Lindsay, MD Professor of Medicine Director, Cardiac Electrophysiology Washington University School of Medicine St. Louis, Mo. Sally J. Pelletier, CPCS, CPMSM Director of Credentialing Services The Greeley Company, a division of HCPro, Inc. Danvers, Mass. Beverly Pybus Senior Consultant The Greeley Company, a division of HCPro, Inc. Danvers, Mass. Richard A. Sheff, MD Chair and Executive Director The Greeley Company, a division of HCPro, Inc. Danvers, Mass. The information contained in this document is general. It has been designed and is intended for use by hospitals and their credentials committees in developing their own local approaches and policies for various credentialing issues. This information, including the materials, opinions, and draft criteria set forth herein, should not be adopted for use without careful consideration, discussion, additional research by physicians and counsel in local settings, and adaptation to local needs. The Credentialing Resource Center does not provide legal or clinical advice; for such advice, the counsel of competent individuals in these fields must be obtained. Reproduction in any form outside the recipient s institution is forbidden without prior written permission. Copyright 2012 HCPro, Inc., Danvers, MA