At Telehealth Certification Institute, we often hear the following questions:

• What is the difference between a certification, credential, certificate, accreditation, or license?
• Which of these is the best for me to show my qualification, and which is a better predictor of competence?  
• Does my state allow me to provide telemental health services?
• Are the Continuing Education (CE) hours you provide accepted in my state?

First of all, the reason why someone would care whether or not a clinician has one of these credentials is because it helps to assess whether or not that clinician is likely to be competent in a specialty area. The term credential is used broadly to include all professional qualifications: certifications, certificates, accreditations, degrees, licenses, or to refer to a specific credential. The definitions of all of these terms vary according to who is defining them.

Let’s first start with licensure.  Licensure is provided by a legal body that regulates the law of a certain jurisdiction.  Looking at the United States of America, for example, each of the 50 states has the authority to prohibit people from providing a particular service or using a particular title if they decide to do so. And one of the legal justifications for that is to protect the public. A professional license can either be a practice act and/or a title act. This means it prevents people from either providing a service (practice act) or using a protected professional title (title act) in a given jurisdiction without having authorization from the government. Licensing boards regulate licensure laws, provide authorization to professionals to practice, set standards for the practice, investigate complaints about licensees, and place sanctions on professionals’ licenses if needed. 

An accreditation is provided by one organization to another. So there are different types of accreditations, and these terms are defined differently by different people. There are organizations that will accredit degree programs at universities,  verifying that the program meets certain qualifications and standards set by the accrediting organization. In regards to telehealth, an organization can sometimes be accredited for telehealth services by an accrediting organization.  This is so people can assess whether or not a telehealth program is likely to be competent in providing telehealth services. An accrediting organization reviews all of the policies and procedures of a telehealth organization and conducts an onsite audit to assess the competency of their telehealth practice. An annual review process will follow to make sure that the telehealth organization is still meeting those standards. We provide accreditation to organizations upon request.

There are three main types of certifications: legal certifications provided by legal bodies (similar to licensure), certifications provided by professional associations, and certifications provided by training organizations.   Certifications aim to recognize a clinician's competence in a specialty area and, in some cases, aim to ensure that competence is maintained. Professional associations can provide the highest standard of certification by following certain procedures: First, the association becomes accredited as a certifying body by a third-party accreditation organization. They then establish boards of experts, one to create the requirements and standards for the certification and another to create the certification exam, for which clinicians are proctored or monitored on-site. The association also approves training programs from third-party institutes, sets application requirements for clinicians (often including a professional license to practice), and requires them to maintain their certification. Lastly, the association will investigate complaints brought against clinicians who hold their certification. In contrast, other independent organizations (not professional associations) may provide a “certification” for completing their training. This type of certification is rightfully called a training certificate.

A credential in a specialty area of practice is similar to a professional certification in that it often requires other credentials, such as a professional license, to qualify for it and for it to be renewed, but usually without the third accreditation.

A certificate for a specialty generally indicates that a professional has completed a particular training program. Certificate training programs are usually comprehensive programs that cover the essential competencies necessary to meet the standards for practice in that specialty area. Examples of organizations which accredit credentialing organizations are:

• The American National Standards Institute (ANSI)
• The Institute for Credentialing Excellence (ICE)

Which credential is best to hold, and which is a better predictor of competence?  

The title of a particular credential or qualification is not necessarily a good indicator of a telemental health provider’s competence. There is no study that statistically measures this. What is more important is what the clinician needed to accomplish or learn to achieve that credential and to maintain it.

Factors to consider are:

• Are there qualification requirements to achieve the credential? Such as earning a graduate degree, years of supervision, or holding a professional license or certification from a legal body.
• What is the course work required to earn the credential (topics covered)?
• Is an examination required for the credential?
• Does the training provider specialize in telemental health?  This is important because it is a rapidly evolving field requiring true dedication and specialization on the part of an instructor.
• When was the last time the training was updated?
• Is there live interaction in the training or credentialing process?
• Do credential holders have access to an instructor for questions?
• Is there a live assessment for competency?
• Is there an evaluation of the credential holder’s policies and procedures for telemental health?
• Is there a third party accrediting the provider of the credential or the credential itself?  Is the accrediting body familiar with telehealth. 

After a careful and ongoing review of all of the codes of ethics, practice guidelines, and professional literature, we at Telehealth Certification Institute created our TeleMental Health Training Certificate (THTC) Program.  The THTC program covers all of the essential competencies of telemental health.  We take pride in many aspects of our program:

• It is very practical. Our participants can confidently implement what they have learned.
• We regularly update our courses.
• We maintain our THTC program on a FULL-TIME basis.
• Our alumni have access to ask our expert instructor, Raymond Barrett, questions on the training content.
• We offer different training formats to meet the learning needs of our participants.
• We have examinations with the online self-study version of the program, which effectively measures competency.
• Our live webinar version of the program allows clinicians to practice their skills and receive direct feedback.
• Our Telemental Health Starter Bundle offers the THTC training program, a TeleMental Health Provider Workbook (containing sample clinical forms, guided worksheet for creating a telehealth program, and sample policies and procedures), and a one-hour consultation with our expert telehealth consultant, Raymond Barrett

For organizations who desire a custom process for evaluating their telehealth program or clinicians, we provide:

• Customize telehealth training to meet the specific use case of the organization.
• Customize a telehealth examination.
• Audit the organization’s workflow, policies, and procedures.
• Provide live training for staff.
• Provide live assessment of the competency of their clinical staff and learning plans for improvement.

Does my state allow me to provide telemental health services?

Professional certifications, credentials, certificates, and accreditations often get confused with licensure and certifications provided by state governments in the United States.  Individual states can create a professional license certification that regulates whether an individual can provide a service or use a title in their state. It is normally within the scope of practice of a behavioral health provider’s license to provide telemental health services to clients/patients who are located in that state. States often create telehealth rules and regulations which may specify which means of communication are allowed for telemental health services and might require that clinicians receive a specific amount of continuing education in telemental health.  Note that state governments often use several different terms for telemental health, telehealth, teletherapy, etc.  

Similar to a legal license or certification to practice, a professional credential in telemental health helps in assessing whether or not a telemental health provider is likely to be competent in providing those services.  However, state governments generally do not concern themselves with whether or not a professional holds a credential from a private organization. States do, however, require that clinicians only practice within their boundaries of competence, and some require approved training and application for specialty areas such as telemental health.  

Are the Continuing Education (CE) hours accepted in my state?

Most of the licensing boards require that clinicians earn a specified amount of continuing education every renewal period for their license or legal certification.  It is important to review the specifics of these requirements on you state board’s website.  You can then view the CE information for each of Telehealth Certification Institute’s course offerings under “CE Hours” on each course page.