Keeping Up With The
Counseling
Profession: Current
Issues on the
National Level
www.counseling.org/kaplan
David Kaplan
ACA Chief Professional Officer
dkaplan@counseling.org
Art Terrazas
ACA Director of Government Affairs
aterrazas@counseling.org
2014 AASCB Conference
Things we might talk about
• Professional Identity
• Counselor Education Accreditation
• Key legislation
• Practice Issues
• Ethical Issues
Things we might talk about
• Professional Identity
• Counselor Education
Accreditation
• Key legislation
• Practice Issues
• Ethical Issues
Dr. William Glasser
1925-2013
Professional
Identity
20/20:
A Vision for the
Future of Counseling
http://www.counseling.org/20-20
The 20/20 consensus
definition of
counseling
http://www.counseling.org/20-20/definition.aspx
Counseling is a professional
relationship that empowers
diverse individuals, families,
and groups to accomplish
mental health, wellness,
education,
and career goals.
The 20/20 Building
Blocks
to Portability Project
Building Blocks to Portability
The task was to develop:
• A consensus licensure title to recommend to all
state licensing boards
• A consensus scope of practice to recommend to
all state licensing boards
• Consensus education requirements to
recommend to all state licensing boards
The delegates
reached consensus
on the
licensure title!
Licensed Professional
Counselor
And the Scope of
Practice!
www.counseling.org/knowledge-center/20-20-a-vision-for-thefuture-of-counseling/current-activities
Open the sample endorsement letter
Some Key Elements
• Individual, group, couples, & family
•
•
•
•
counseling
Promote mental health wellness,
development across the lifespan, crisis
intervention and the diagnosis and
treatment of mental disorders
Consultation and program evaluation
Supervision
Ability to practice independently
What about the licensure
education requirements?
TWO OUT OF THREE
AIN’T BAD!
Where does 20/20 go
from here?
Counselor Education
Accreditation
The next CACREP
standards revision has
begun
Slated for 2016
Draft # 2 public comment period
ends 1/10/14
Review the draft and give feedback at:
http://www.cacrep.org/template/page.cfm?id=141
More evolutionary than
revolutionary
“Clarify, Simplify, and Unify”
Three significant proposals
• By July 2020, all entry-level
programs, including:
– career counseling
– school counseling
– postsecondary counseling
be comprised of 60 credit hours
• Clinical Rehabilitation
Counseling added as a specialty
• Student Affairs and College
Counseling specialty becomes
Postsecondary Counseling
Important accreditation news
CACREP and CORE have become
corporate affiliates
CORE will jointly implement the
new CACREP Clinical
Rehabilitation Counseling
specialty
Alternative
Counselor
Education
Credentialing
Masters in
Counseling
Accreditation
Council (MCAC)
Initial MCAC programs
• U of Albany (mental health
counseling)
• U of Massachusetts, Boston
(mental health counseling & school
counseling)
Psychology
& counselor education
accreditation
THE COUNSELING PSYCHOLOGIST
VOL. 41, NO. 5, JULY 2013
Articles
• Quality of Master’s Education: A Concern for
Counseling Psychology?
• Looking to the Future – The role of Master’s
Programs in Counseling Psychology
• Integrating Master’s Education in Counseling
Psychology for Quality, Viability, and Value
Added
• Legitimizing and Reclaiming Master’s
Training and Education in Counseling
Psychology: An Urgent Concern
Contributing to the
ambivalent relationship of
counseling psychology to
masters training…
-Jackson & Scheel, p.676
In some situations, the
master’s training programs
were developed …to help
fund the doctoral training
program.
-Palmer, p.703
In some cases, master’s
programs help pay the bills for
doctoral education…in difficult
economic times, counseling
psychology doctoral programs
without master’s programs
may be easier to cut
-Jackson & Scheel, p. 687 &
688
To maintain CACREP accreditation
when budget cuts are required,
deans and other
administrators…may prioritize
master’s over doctoral programs
since master’s training is less
expensive than doctoral training.
-Jackson & Scheel, p.682
…such developments do
threaten counseling
psychology programs…
-Jackson & Scheel, p.682
The new MCAC accreditation
standards may serve to promote
a new direction for counseling
master’s education…consistent
with core values and
contributions of counseling
psychology
-Jackson & Scheel, p. 681
It is questionable…whether
we will be able to avert
eventual professional
annihilation…as a profession
we are experiencing THE
RECKONING
-Palmer, p. 701 & 704
Legislative Issues
Major Issues We’re Following
VA hiring of LPCs
 TRICARE certification of mental health
counselors
 Medicare coverage of LPCs
 Federal education spending
 “Religious freedom of expression”
legislation

VA (Non-)Hiring of LPMHCs

April 2012 – VA Office of Inspector General report: For half
of first-time patients, MH evals took about 50 days
http://www.va.gov/oig/pubs/VAOIG-12-00900-168.pdf

As of August 2012, total number of LPCs hired as mental
health clinicians within the VA nationwide: 29

Number of VA LPMHC positions posted in 2012: 58
Number of VA social worker positions posted: 1,563
ACA Has…




Written to VA Secretary Eric Shinseki , and met repeatedly
with multiple VA staff
Met with White House staff
Met with members of Congress, and worked with them to
draft letters to the VA
Our goals:
Encourage passage of S 1581, which includes a
provision to open up VA paid traineeships to counselors
Have VA central office light a fire under local VA
directors to hire more counselors
VA & counselors: What you can do

Check http://USAJobs.gov if you’re curious about VA
positions. If (surprise!) you find one not open to
counselors, contact the HR person to ask that it be
opened to counselors, and copy us
Contact your Senators and ask that they 1) Vote for S.
1581 and 2) write to the VA to direct them to:
– Broaden the eligibility criteria for LPMHC positions,
and instruct VA facilities to open more positions to
counselors
 Share copies with/direct Q’s to Art Terrazas at
aterrazas@counseling.org

TRICARE requirements: now through 2014
Licensed counselors must:
• have a master's or higher-level degree “from a mental health
counseling program of education and training* and either
– Pass the NCE or NCMHCE (for CACREP-accredited degrees)
OR
– Pass the NCMHCE (for regionally-accredited degrees)
• have 2 years/3,000 hours of supervised clinical practice,
"provided by a mental health counselor”
* For at least CACREP degrees, this is interpreted by
DoD to mean only degrees with the title of “mental
health counseling” or “clinical mental health
counseling”
TRICARE independent practice
requirements: beginning 2015
Licensed counselors must:
 have a CACREP degree
 pass the NCMHCE
 same 2 years/3,000 hours of supervision as
previous slide
Independent practice only.
Practice under physician referral and supervision
will no longer be allowed.
TRICARE Mental Health Counselor Certification
Requirements: Possible Barriers
 Having a degree title other than “mental health
counseling” or “clinical mental health counseling”
 Not having passed the NCMCHE
 Not having 2 years/3,000 hours of supervision
under a licensed professional counselor (not
psychologist, social worker, etc.)
 Not having a CACREP-accredited degree
Comparing the federal standards
Agency
Master’s degree…
Exam
Supervision
Dept. of
Veterans
Affairs
…in mental health counseling or
related field from CACREP program,
Ph.D. not recognized
--
--
TRICARE (after
2014)
…from a mental health counseling
program of education and training
accredited by CACREP
NCMHCE
2 years/3,000
hrs, 100 hrs faceto-face, meets
AMHCA
guidelines
Army SAP
…in counseling from a program
accredited by CACREP
NCMHCE
--
Medicare bill
(S. 562 & HR.
3662)
In mental health counseling or a
related field
--
2 years postmaster’s
Medicare and Counselors
• For the first time since 2009, we have TWO
Bills!
• S. 562 and HR.3662 call for Medicare to
reimburse Licensed Professional Counselors.
• We need you to call your Senators and
Representatives to ask them to support these
bills!
Q: Will Medicare require CACREP degrees?
A: Most likely not
 The House and Senate have each passed Medicare coverage of
LPCs/MFTs twice, without ever including CACREP requirement
 HHS declined to require even regional accreditation of
psychology degrees, said nothing about CSWE when writing
regulations for psychologist/SW Medicare coverage
 Starting 1/1/2014, Affordable Care Act (ACA) prohibits
discrimination against state-licensed providers
 HHS is incredibly busy implementing ACA, doesn’t have time
to start second-guessing state licensure requirements
 Requiring CACREP degrees would defeat the goal of expanding
access to outpt. MH services, especially in rural and
underserved areas
Our best hope: getting a lot of cosponsors on S. 562 & HR.
3662, to build momentum for passage.
Affordable Care Act –
Provider Non-Discrimination Provision
takes effect January 1, 2014
“Sec. 2706.* Non-Discrimination in Health Care.
(a) PROVIDERS.—A group health plan and a health insurance issuer offering
group or individual health insurance coverage shall not discriminate with
respect to participation under the plan or coverage against any health
care provider who is acting within the scope of that provider’s license or
certification under applicable State law. This section shall not require that
a group health plan or health insurance issuer contract with any health
care provider willing to abide by the terms and conditions for
participation established by the plan or issuer. Nothing in this section
shall be construed as preventing a group health plan, a health insurance
issuer, or the Secretary from establishing varying reimbursement rates
based on quality or performance measures.”
* of
the Public Health Service Act
Practice Issues
DSM-5
Licensed counselors eligible
for participation in DSM
field trials for the first time
Current DSM-5 Issues
• Adjusting to the disappearance of the
multiaxial system
• Vague wording has increased confusion
• Autism as a spectrum
• Expanding criterion into the normal
range
Current DSM-5 Issues
• Adjusting to the disappearance of the
multiaxial system
• Vague wording has increased confusion
• Autism as a spectrum
• Expanding criterion into the normal
range
DSM-5 Tools
• ACA Webinars
(www.counseling.org/continuing-education/webinars)
• DSM-5: Navigating the New Terrain (6 hours)
• DSM-5 Specifics, Drilling Down With the
New Diagnostic Tools (2 hours)
• ACA Book
(www.counseling.org/publications/overview)
*DSM-5 Learning Companion for Counselors
New HIPPA Regulation
• Extending HIPPA to billing services,
document storage companies & other
business associates
• Clients can now request health records
in electronic form
• Mitigating and informing clients about
security breaches
Ethical Issues
The 2014 ACA Code
of Ethics
Who is on the ERTF?
• Jeannette Baca
• Janelle Disney
• Perry Francis
(Chair)
• Gary
Goodnough
• Mary Hermann
• Shannon
Hodges
• Lynn Linde
•
•
•
•
•
Linda Shaw
Shawn Spurgeon
Richard Watts
Michelle Wade
Erin Martz (ACA
staff)
• David Kaplan (ACA
staff)
Timeline highlights
•
•
•
•
•
Task force appointed Summer of 2011
Initial call for member input Fall 2011
Draft composed April 2012-2013
Call for draft feedback May 2013
Draft revised based on input June-December
2013
• Final draft presented to ACA Governing
Council March 2014
ERTF Areas of Focus
• Social media
• The imposition of counselor
personal values
• When is a client a client?
• Removing the end of life exemption
• Fee splitting
How licensure board members can
keep up with current national
issues
•
•
•
•
•
•
ACA Connect
Read Counseling Today
Read CT online www.ct.counseling.org
Read ACA e-News
Subscribe to the ACA blogs www.my.counseling.org
Visit www.counseling.org/governmentaffairs/public-policy !
• Visit the ACA Facebook page
• Follow ACA on Twitter
https://twitter.com/#!/CounselingViews
• Subscribe to counseling listservs (cesnet,
counsgrads, icn, etc.)
• Use Google alerts
• Ask Art or David
Let’s schmooze!
Keeping Up With The
Counseling
Profession: Current
Issues on the
National Level
www.counseling.org/kaplan