Knowledge base

Behavioral health workforce licensure in Oklahoma

Nearly 14,000 professionals make up Oklahoma's licensed behavioral health workforce. Each of these licenses vary by educational requirement, governing authority, and administrative rules. Yet understanding them is an important starting point for workforce development and policy solutions that increase access to care for Oklahomans with mental health and substance use treatment needs.

This overview of behavioral health licensure explains the requirements of each license type, as well as related legislation recently filed in the Oklahoma House and Senate.

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Licensure
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‍Additional background

Licensed Professional Counselors

A licensed professional counselor (LPC) primarily focuses on assessing and treating mental illness through counseling. As of April 2023, there are 7,515 LPCs with active licenses in Oklahoma.

LPC licensure is governed by the State Board of Behavioral Health Licensure.


Education

An LPC must have a master’s degree in counseling or an equivalent mental health degree with at least 60 hours of counseling-related coursework. A program must also include a practicum or internship experience with at least 300 hours of counseling field experience.

Master’s students can expect classes that cover human growth and development, abnormal human behavior, assessment techniques, counseling theories and methods, ethics, and research. Students can also choose between courses available at their institution that prepare them to work in specific settings, including group counseling, lifestyle and career development, social and culture foundations, personality theories, crisis intervention, marriage and family counseling, addiction counseling, rehabilitation counseling, aging, human sexuality, counseling with children or adolescents, clinical supervision, psychopharmacology, consultation, physical and emotional health, or grief counseling.

Programs approved by the State Board of Behavioral Health Licensure:

* denotes out-of-state online program


Licensure

After graduating a master’s program, a prospective LPC must sit for the required licensure examinations. The applicant submits an application form, application fee of $145, practicum/internship documentation form, official transcript, and completed background check. They must also register for the National Counselor Exam and the Oklahoma Legal and Ethical Responsibilities Examination and pay the $100 license examination fee.

An LPC candidate must complete three years or 3,000 hours of full-time counseling work under the supervision of an approved LPC supervisor and submit semi-annual evaluations of their supervised experience. Once successfully passing the examinations, the applicant sends verification of their passing results and a supervision agreement to the State Board of Behavioral Health to begin supervision. Following supervision, an applicant may be granted full licensure with the payment of a $90 initial license fee.


Related legislation

Two bills filed during the 2023 state legislative session would expand the ability of LPCs licensed in another state to practice in Oklahoma. Sen. Brenda Stanley (R-Midwest City) and Rep. Ellyn Hefner (D-Oklahoma City)'s HB 2723 and Sen. Blake Stephens (R-Tahlequah) and Rep. Randy Randleman (R-Eufaula)'s SB 575 would direct Oklahoma to enter into an interstate LPC compact.

The compact allows licensed professional counselors to practice in Oklahoma if they are licensed in another participating state, and it would allow LPCs from Oklahoma to practice in other states as well. Interstate practice would be achieved mostly through telehealth but is also intended to assist clinicians who relocate to another state.

Psychiatrists

Psychiatrists are medical doctors – either a doctor of osteopathic medicine (D.O.) or a doctor of medicine (M.D.) – who can order tests to examine the relationship between physical and mental health. Psychiatrists can also prescribe medication, which distinguishes them from psychologists (who also have doctoral degrees) and clinicians with master's degrees who provide assessments, diagnoses, and treatment.

As of April 2023, there are 157 actively licensed psychiatric D.O.s and 573 actively licensed psychiatric M.D.s in Oklahoma.
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Licensure for psychiatrists is governed by the State Board of Osteopathic Examiners for D.O.s and the Oklahoma Board of Medical Licensure and Supervision for M.D.s.


Education and residency

Most doctors go through allopathic programs, which tend to be more symptom-focused. Osteopathic programs tend to take a more holistic approach and produce doctors more likely to work in primary care. In the latter half of medical school, students rotate through different specialties to help them decide which area of medicine to practice. Both types of programs produce graduates who are ready for residency even though they have different licensing processes.

After graduating from medical school, a prospective psychiatrist must complete a residency, the length of which is determined by specialty. Psychiatry residencies programs generally last four years. Residents provide direct care to patients under the supervision of a licensed physician. A residency allows future doctors to practice different areas within their chosen specialty in a cohort experience with other residents. This can include emergency psychiatry, inpatient psychiatry, outpatient psychiatry, neurology, and primary care, as well as work with specific populations such as children or adults.

Oklahoma has four psychiatry residency programs for a total of 23 slots:


Licensure and medical specialty exams

The United States Medical Licensing Examination (USMLE) is the universal examination for allopathic (M.D.) physician candidates. The test is broken up into three steps, the first two taken during medical school and the third taken after the first or second year of residency. The Comprehensive Osteopathic Medical Licensing Examination (COMLEX) is the national standardized test for osteopathic (D.O.) candidates. Similar to USMLE, COMLEX is divided into three levels, with the first two taken during medical school and the last level taken during residency.

After passing their licensing examination, a candidate must apply to their respective licensing board. Licensed physicians can go on to be board certified within their medical specialty. This certification is not required to practice medicine but does signify expertise in a field. Board certification in psychiatry requires a doctor to satisfy certain training requirements and pass an examination from the American Board of Psychology and Neurology every 10 years. Subspecialties are also available in addiction psychiatry, child and adolescent psychiatry, clinical neurophysiology, consultation-liaison psychiatry, forensic psychiatry, geriatric psychiatry, pain medicine, and sleep medicine.‍


Related legislation

Two bills filed during the 2023 legislative session aim to increase the number of psychiatry residences in Oklahoma. HB 2036, authored by Sen. John Haste (R-Broken Arrow) and Rep. Jeff Boatman (R-Tulsa), would create the Oklahoma State University Medical Authority Behavioral Health Workforce Development Fund. Sen. Paul Rosino (R-Oklahoma City) and Rep. Cynthia Roe (R-Lindsay)'s HB 2175 would change a current revolving fund to the Behavioral Health Workforce Development Fund to encourage new psychiatrists to practice where they receive their training, improving Oklahomans' access to mental health care.

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