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Licensure

Applying for the Psychoanalytic License or Certification

Listed by state to date

New York State

New Jersey

Vermont

Download the New York State psychoanalyst license application forms here: http://www.op.nysed.gov/prof/mhp/psyanllic.htm

This link takes you to Psychoanalysis Application Forms, with instructions and links for each form. Under the Mental Health Practitioners sidebar on the left, scroll down for the Psychoanalysis tab.

Download License Requirements and Application Forms.

Psychoanalyst Application Packet has all the instructions and forms in one pdf. Read through carefully to decide which path best fits your education and clinical experience. Print out each form.

Form 1-Application for Licensure: Send to New York State with your photo and a check for $345.00. Also fill out Form 4 with the names of 3 colleagues or supervisors (these will be endorsers) and send to the state with Form 1. If you work with children also send the certificate of completion of the child abuse course. If you do not work with children, send the certificate of exemption to the state.

Form 2-Certification of Psychoanalytic Study: Complete Section I and send entire form to your institute.

Form 2A-Certification of Graduate Study: You will need at least two copies of this form. Complete Section I of each copy and send one entire copy to your graduate school and one to the institute from which you graduated.

Form 4-Applicant Experience and Endorsement Record: Complete form and send to the Office of Professions (address at bottom of form).

Form 4B-Certification of Supervised Experience: List 3 colleagues or supervisors (endorsers) who can verify that you have been in practice full-time for 7 years or the equivalent.

Child Abuse Certificate of Exemption Form: Fill out and send to NYS if you do not work with children.

Forms that must be notarized can be taken to your bank. There should be no fee.

For more information, contact the state at 518-474-3817 or op4info@mail.nysed.gov.

PATAKI SIGNS PSYCHOANALYTIC LICENSING BILL

Please be advised that a psychoanalyst who has a current certification from the State of New Jersey is entitled to call herself/himself a “New Jersey State Certified Psychoanalyst.” However, a psychoanalyst is not required to have a New Jersey state certification in order to practice psychoanalysis in New Jersey.

Certification is not licensure. New Jersey State Certified Psychoanalysts should advise their clients to contact their own insurance provider(s) to determine what, if any, psychoanalytic services are covered.

Download the New Jersey Certification as a Psychoanalyst forms here: http://www.njconsumeraffairs.gov/psya/Pages/applications.aspx

Click here to see laws and regulations: http://www.njconsumeraffairs.gov/psya/Pages/regulations.aspx

Tips for NJ License Applicants:

  1. Read the entire application before you apply and make sure you have filled out every section and answered every question before you submit it to the Board.
  2. After you complete the application, find a Notary Public to notarize your signature on the application. Most bank branches have a Notary Public who can assist you, usually for a small fee.
  3. Include the correct application filing fee with your application. The amount of the nonrefundable filing fee can be found on the first page of the application. Send only a check or money order, made payable to the “State of New Jersey.” If you submit a money order, fill out all sections including your name, and save the receipt portion for your records. If you are submitting a check, make sure your name is clearly printed on the check.
  4. If you are required to submit official transcripts or examination results, arrange for the school or examination entity to send the documents directly to the Board. The Board cannot accept copies of these documents or other required documents sent by the applicants themselves. If you are required to submit proof that you are licensed in a state other than New Jersey, contact that out-of-state licensing board and request that it send a license verification letter directly to the New Jersey Board. The submission of a copy of your out-of-state license does not meet the requirements for license verification.
  5. For those applicants who are required to undergo a Criminal History Background Check: Schedule an appointment to have your fingerprints digitally recorded as soon as you receive the fingerprinting instruction sheet and the preprinted form from the Board. To save time, you can schedule an appointment to be fingerprinted at the next available appointment anywhere in New Jersey, instead of the next available appointment closest to your home. There are 17 fingerprinting locations throughout New Jersey and some are busier than others.
  6. If you have been arrested or convicted of a crime, you must submit a detailed letter of explanation, all of the relevant police reports, reference letters and, if applicable, judgments of conviction, sentencing orders, termination of probation orders and evidence of rehabilitation. Contact the court clerk and any attorneys involved to request the file regarding your arrest or conviction.
  7. Make sure you submit a passport-style photograph of your face and shoulders. Fullsized photographs, photographs with other people, full-body photographs, photocopies of photographs, scanned photographs or photocopies of your passport will not be accepted. Sign your full name and print your first and last name on the reverse side of the photograph in case it becomes detached from your application.
  8. When responding to the question on the application concerning “student loan default,” please note that according to the U.S. Department of Education, “default means you failed to make your payments on your student loan as scheduled according to the terms of your promissory note, the binding legal document you signed at the time you took out your loan.” If you just graduated and have not yet made any scheduled payments, you are most likely not in default.
  9. Include a copy of your marriage certificate, divorce decree or court order if you have ever changed your name.
  10. Notify the Board promptly of any new address or change of address after you have submitted your license application.

Psychoanalysts in the state of Vermont are governed by the “advisor” model of regulation, created by the legislature. Two licensed members of the profession are appointed by the secretary of state to advise the director of the Office of Professional Regulation (OPR) on matters relating to the profession. Their mission is public protection. The director and the advisors carry out this mission by: ensuring that applicants are qualified for licensure; setting standards for the profession by proposing statutes and adopting administrative rules; and, with the assistance of OPR staff, investigating complaints of unprofessional conduct, taking disciplinary action against a licensee when necessary to protect the public. Our website provides links to the laws governing this profession, as well as resources for applicants, licensees, consumers, and employers.

For more information, please click here: https://www.sec.state.vt.us/professional-regulation/list-of-professions/psychoanalysts.aspx

For forms and FAQs, please click here: https://www.sec.state.vt.us/professional-regulation/list-of-professions/psychoanalysts/forms-applications.aspx