Category Archives: ACES Association for Counselor Education and Supervision

The Trouble With the CACREP-Only Counselor Movement

A lot of people are wondering what the fuss is about professional counseling moving to CACREP accreditation standards, especially since organizations like the ACA, AMHCA, ACES, and NBCC are promoting this move.

Therein lies the first problem: COMPLEXITY (and acronyms)

A whole post could be written about just the players and organizations involved. (CACREP = Council for Accreditation of Counseling and Related Educational Programs, ACA = American Counseling Association, AMHCA = mental health counseling division of ACA, ACES = counselor education division of ACA, NBCC = National Board of Certified Counselors which handles national testing and increasingly looks like an ACA rival). Then we could badly use a dictionary of terms… then a history lesson… then a paper on each of the problems outlined below…

Busy counselors don’t want to sort through this complexity.

 

The second problem: BOREDOM (and perceived irrelevance)

The CACREP accreditation issue is usually described as a new standard for graduate schools to adhere to. Yawn. If you graduated 10 years ago and work seeing clients, an academic discussion on standards puts you to sleep. Nowhere in the usual discussions of this issue is there a suggestion that your FUTURE CAREER may be affected.

 

The third problem: ASSURANCES

If you have listened at all to the ACA and other advocates, you have been told that this won’t effect those currently licensed, that ACA will advocate for your equality, and that its all for “great reasons” (see below). Official associations keep on speaking ever so carefully so as to not quite lie, while giving the impression all is well.

 

So, in a nutshell (or as short as we can make it), what are the fastest descriptions possible of the problems with a CACREP-Only approach?

CACREP-ONLY: There are other styles of training and other emerging standards. Few people are rallying against the CACREP accreditation standard itself as an optional accreditation. It’s the implications of only having CACREP that is the problem.

FUTURE EMPLOYMENT: Graduation from a CACREP-accredited program in the past increasingly makes a difference in your ability to get a future job. TRICARE and the VA both prefer or require CACREP degrees. CACREP-Only partisans are working very hard to get CACREP mentioned in any Medicare regulations passed to allow professional counselors to accept Medicare. The fewer panels are willing to accept you, the harder it will be to make a living or get hired by employers. (This is why being able to keep your license is not enough. CACREP graduation or CACREP-influenced certifications may also be required.)

MEDICARE – THE GATEWAY: Private insurance companies often set their policies by what Medicare does. This is why we are so worried about CACREP-Only language getting into Medicare.

REPUTATION: The ACA’s official policy is now to lobby all 50 state Boards for CACREP-Only licensure. ACA goes to pains to say they will support the equality of currently licensed non-CACREP counselors. We hope so. How does one get a message of equality out to government, health plans, and the general public in the middle of persuading state Boards that CACREP is the “gold standard” that must be switched to? A DoD official was interviewed last year to discuss TRICARE’s two-tier policy in which certain (mostly CACREP) counselors are allowed independent practice, whereas non-CACREP counselors (otherwise independently licensed) are judged in need of doctor supervision. This kind of messaging will work its way into the public mind.

LOSS OF DIVERSITY: The problem with too rigid a standard is that you can lose some diversity. There are hundreds or thousands of approaches to counseling. Some arguments have been made that special communities (American Natives, disabled counselors-in-training) may be better served by alternatives.

BASIC FAIRNESS, “COUNSELING PSYCHOLOGISTS” AND VENGENCE VENDETTAS: CACREP-Only partisans are dead-set on excluding future students with master’s degrees in counseling psychology from obtaining professional counselor licenses (after a grandfathering period for current students). These programs have been with counseling since its inception. CACREP won’t even accredit these programs unless they make arbitrary changes requiring absurd expense and turn-over of core staff – its closer to truth to just say that CACREP won’t accredit them (see that part about not quite lying in assurances section above). There is a constant campaign to conflate and confuse in the public mind professional counselors holding master’s degrees in counseling psychology (who identify as professional counselors) with Ph.D. psychologists who have psychologist licenses. The two are not the same. More than a few commentators have opined that at one level the intractability of this dispute is about vengeance. The Ph.D. counselor educators are not allowed to teach in Ph.D. psychology programs. They are trying to push Ph.D. counseling psychologists out of their traditional role in teaching master’s level professional counselors (at “counseling psychology” masters programs). This is in part a war between two feuding groups of professors.

CONSOLIDATION OF CONTROL AND MONEY: At another level this may also be about money and control. The ACA helped create CACREP a long time ago, and now does not have official control over standards. CACREP partisans are also persuading state licensing boards to give-up control of their standards to this outside entity. CACREP charges a lot of money to programs wishing to obtain and maintain accreditation. NBCC controls at least two key gateways to the professional counseling career: national exams and national certifications. Currently no one is fighting over their control of the NCE and NCMHCE exams (unless they restrict taking them to only CACREP students…). They also control the NCC (National Certified Counselor) and CCMHC (Certified Clinical Mental Health Counselor) certifications. These certifications are currently of questionable value, but NBCC is working hard to get these certifications required for licensure portability between states, as a stepping stone to independent TRICARE provider status, and more (See Portability below). It costs MONEY and lots of it to maintain certifications in addition to your state license.

PORTABILITY: There are currently conflicting proposed plans from NBCC/AMHCA/ACES and from AASCB (American Association of State Counseling Boards) for licensure portability when counselors move between states. The NBCC/AMHCA/ACES plan requires CACREP graduation to move between states unless a stubborn state board goes its own way or unless current non-CACREP counselors obtain and hold the NCC certification before 2022 (at which point CACREP graduation is required for the NCC). This is one example where NBCC can make millions of dollars from non-CACREP counselors by requiring them to grab an NCC certification while they can if they ever wish to work in another state in the future.

“GREAT REASONS” FOR THE “GOLD STANDARD”: Here are the most prominently mentioned reasons for moving to CACREP-Only:

So far here is what we’ve gleaned from CACREP-Only partisans as to reasons for CACREP-Only:

  1. Obligation to our forefathers. One CACREP-Only inclined historian states “We have an obligation to all of our forefathers/mothers and mentors to be good/honest stewards of the history of Professional Counseling. Please see that we pass on our family’s story.” (This sort of invites you to join a shared destiny and unity in which it is glorious to kick dozens of excellent graduate schools out of existence, destroy professional diversity, and cede immense power and money to organizations like CACREP and NBCC that are far less accountable to members than the ACA with its elections system.)
  2. Only immersion in a CACREP program can impart the correct spirit of shared IDENTITY and UNITY. (No training after-the-fact short of redoing graduate school will give this mystic feeling and purpose. We’ve never managed to get a definition of what this IDENTITY is, other than being told to read the 20/20 vision statement again (hint: nope, that does not solve it). UNITY if you are them we suppose.)
  3. Quality (Which, when challenged, results in vague mutterings about testing and program inspection standards… then reference to really flawed studies about NBCC tests being passed at higher percentage by CACREP students.)
  4. Counseling psychology master’s programs have more reliance on testing and the medical model. (If true, is that a problem?)
  5. Control of the standards of our own profession. (Because master’s in counseling psychology are somehow not our own profession…?)
  6. The government demands one standard. (It’s murky as to whether or not perhaps the government was first advised as to what standard it ought to ask for… Also – the “one standard” could so easily have been two (nursing has a few accreditation bodies) or have been a national certification allowing counselors from several backgrounds to attain the certification after demonstrating competence.)
  7. The IOM Study recommendations (Which some of us have described at some length as flawed.)

This letter is envisioned as something of a 101 primer. Problem is, this is such a complex topic that it will surely need revision and expansion almost as soon as its published. Consider this a draft.

 

WHAT CAN YOU DO?

At the immediate moment – BE LOUD. Participate in this Linked-In Group, on the Concerned Counselors listserv (see www.concernedcounselors.org), on ACA Connect Open Forum, and on CESNET. Plans will shortly be announced for a new national association dedicated to fighting the CACREP-Only injustice.

Two Competing Licensure Portability Plans

A curious thing happened late this summer – two competing plans for licensure portability emerged.  This is a long post, but make sure you also get to the 2nd plan below from AASCB.

AMHCA-ACES-NBCC Portability Standards for Counselors
(link to actual plan document)

This first one is bad.  It is a joint plan by AMHCA, ACES, and NBCC which calls for:

EITHER

• A degree from a clinically focused counselor preparation program accredited by CACREP;
OR
• Certification as a National Certified Counselor;
OR
• Fulfillment of standards adopted by a state counseling licensure board;

AND

• Possession of a counselor license for independent practice for at least two years.

The problem here is that NBCC has indicated that the NCC certification will require a CACREP degree for new applicants after 2022.  So while this plan gives a grandfathering period for all of us non-CACREP counselors to go grab and hold an NCC certification for life,  it very much fits with the CACREP-Only stance.  There does appear to be an exception there for state boards which don’t take their obvious suggestion that CACREP should be involved and instead set their own standards.

This plan also represents a financial bonanza for NBCC.  Non-CACREP counselors – if they ever want to be able to move out-of-state – are going to flock to grab the NCC credential right now while they still can.

Think about the money involved…  Some non-CACREP counselors may need to take another exam.  We are not sure what the original application cost is.  A 2014 newsletter said that annual maintenance fees were $80 per year.  Then of course NBCC sponsors and approves many of the CEU courses necessary for maintaining NCC status, but we won’t count that money…

Let’s do a little bit of back-of-the-envelope calculating although certainly the figures will be off.  Let’s assume:

  • This plan succeeds exactly as written (we’ll see)
  • 56,000 ACA members (although not all counselors are ACA members)
  • 70% are non-CACREP
  • 50% of the non-CACREP folks decide to maintain NCC status in case they ever need to move anywhere in their lifetimes.
  • We magically assume that all of these folks will work another 20 years so they all keep their NCCs for 20 years.

56,000 ACA members X .7 non-CACREP X .5 elect NCC status X $80 X 20 years = $31,360,000

This number is bogus of course, but however you calculate this, NBCC will make a fortune.

On a per person basis (assuming fees never rise) that is:

1 person X $80 X 20 years = $1600

This essentially amounts to extra money these folks would not have had to pay at all, except that NBCC participated in the CACREP-only enterprise of making their non-CACREP degrees second-rate, and then charged this membership fee so that at least these non-CACREP counselors could move around the country.

If they can get a job.  And take insurance and government programs.  And work around TRICARE, the VA, maybe Medicare, etc.  Good luck.

But – if they can make a living – perhaps in time they will appreciate their NCC membership as NBCC continues to offer more and more services that make NBCC nearly indistinguishable from ACA, minus some of the democracy and elected positions.

AASCB (American Association of State Counseling Boards)
(link to actual plan document)

The American Association of State Counseling Boards is what it sounds like – the place where all the state boards in charge of professional counselor licensing get together to hash out high-level issues, such as licensure portability.

Many of the state boards are resistant to the CACREP-Only cry.  Many states have lots of counseling psychology masters programs and/or few CACREP programs.  Others are worried about having enough counselors to serve their population, basic fairness in the profession, or other concerns.

On the other hand, CACREP and NBCC and ACA are all over their annual convention with money, presentations, and officers present.  CACREP and NBCC regularly sponsor events and underwrite costs.  This does not imply undue influence, but does illustrate some of the CACREP-Only pressures this organization is under.

The AASCB has tried to come up with a core set of requirements for years for counselors to be able to port their licenses from state-to-state.  They have finally hit upon an elegantly simple plan:

A fully-licensed counselor, who is licensed at the highest level of licensure available in his or her state, and who is in good standing with his or her licensure board, with no disciplinary record, and who has been in active practice for a minimum of five years post-receipt of licensure, and who has taken and passed the NCE or the NCMHCE, shall be eligible for licensure in a state to which he or she is establishing residence. The state to which the licensed counselor is moving may require a jurisprudence examination based on the rules and statutes of said state. An applicant who meets these criteria will be accepted for licensure without further review of education, supervision and experiential hours.

Furthermore “AASCB is open to research supporting a shorter time period if the research indicates no difference in disciplinary issues with those licensees who have less experience.”

This plan has several benefits, not least of which is that the plan does not mention CACREP by name and is much more inclusive.  Also:

1. It leaves more power to the states to determine what their needs are.

2. It does not tie state governments to the dictates of one outside body (CACREP) with whom they may or may not agree in the future.

3. It places more value and respect with counselor experience than with only the accreditation of the degree obtained.

4. It does not require multiple millions of dollars to be funneled into NBCC by non-CACREP counselors holding onto NCC status in order to have license portability.

In our humble opinion, it suggests that AASCB may not be entirely sold on CACREP and only CACREP as in the best interests of the profession and the public at large.

Please look for every opportunity to support the AASCB plan, including writing letters of support to their Board.

Virginia CACREP-Only Regulations Stalled!

We are writing to report on some hopeful news!

 

Recently several hundred professional counselors took time out of their busy schedules to write letters in opposition to proposed regulations to change Virginia licensing to a CACREP-Only affair:

Virginia Regulatory Town Hall List Comments

Around 300 comments and letters, overwhelming in opposition, were posted.  Please take a moment to look through the sound reasoning as well as strong passions raised against the CACREP-Only movement.

These Virginia regulatory changes were/are largely championed by Dr. Gerald Lawson – a faculty member at a Virginia program, current President of ACA division ACES, and no doubt one of the ACA Governing Council members partly responsible for the new CACREP-Only ACA official positions on licensing.

Petitions for Rulemaking, Vol. 30 Iss. 23 Jul 14, 2014

ACA FAQ on Licensure:

http://www.counseling.org/knowledge-center/faqs-licensure-policies

 

At the Virginia Board of Counseling meeting on 09/11/15 a resolution to adopt CACREP-Only regulatory language was averted at least temporarily!

Virginia Regulatory Town Hall View Meeting

In the words of one person present at the meeting:

“The VA. licensure board had a very lively spirited debate with a packed audience on the CACREP-only regulation.    Vote to advance to next step FAILED on a 6 to 6 vote. It will be back on agenda Nov 13 at 10:00.”

 

We can only imagine what a normally dry administrative meeting must be like when 300+ comments are posted and the room is packed with counselors concerned about the issue!

According to reports and to the draft meeting minutes (linked to above), the resolution to advance the CACREP-Only regulations was voted on and the Board deadlocked 6 to 6.  At that point a move was made to put the issue back on the agenda for November.

We have not won this battle yet and Virginia may very well go CACREP-Only in the near future.  What we have shown is that showing up and being heard COUNTS.  We’ve also shown that even in a CACREP stronghold like Virginia, half of the Board had enough reservations to vote NO.  Half of the Board members voted NO despite a letter sent in support of the resolution from ACA.

It is possible to turn around the CACREP-Only movement and reinstate a vision of professional counseling that is inclusive and kind and has high standards.  We can do this.

Shouldn’t ACES Support All Counselors?

Shouldn’t ACES Support All Counselors?

Counselor Educators Should Lead Our Profession toward Inclusive and Creative Solutions for Ensuring Quality Training

On February 27, 2014, Dr. Robin Lee, President of the Association for Counselor Education and Supervision (ACES), issued a statement entitled “ACES’s Position on Educational Standards” that was widely circulated in counselor education circles.

The statement grew out of the “20/20 process” to envision the Counseling profession’s future, initiated by American Counseling Association (ACA) and American Association of State Counseling Boards (AASCB), and attempted to address one of its main concerns: the inconsistency in state requirements to become a licensed professional counselor (LPC).

In their statement, ACES advocated for uniform licensure standards (in both curriculum and field work) to support licensure portability and guarantee consistency of training. Specifically, they recommended, “Graduation from a clinically-focused counselor preparation program accredited by CACREP (or an approved affiliate of CACREP) that includes a minimum of 60 semester credits (or 90 quarter hour credits) of curricular experiences.  Within those 60 semester credits (or 90 quarter hour credits), students must complete a practicum of at least 100 hours and an internship of at least 600 hours.”

 Unfortunately, if implemented, this solution will disenfranchise the majority of licensed counselors and current students, since currently and historically a minority of counselors and graduate programs have been affiliated with CACREP. Contrary to their stated intention, the ACES proposal would actually diminish portability for the majority of the profession — all of those except CACREP graduates.

The ACES statement disregards the interests of counselors who did not graduate from CACREP schools. The anticipated harm to be experienced by these members of our profession is cast as inevitable in the interest of collective professional development:

“Moving toward a unified standard and licensure portability would represent major growth for the profession.  We also recognize that growth often involves loss, and this process may create challenges for individuals and programs as we try to move forward.”  http://www.concernedcounselors.org/wp-content/uploads/2014/04/ACES-Position-on-Educational-Standards-for-Licensure.pdf

While ACES recommends “liberal grandfathering” language to allow licensure for graduates of CACREP-unaffiliated programs, grandfathering is not a long term solution for the many qualified training programs (and their graduates) that do not choose to become, and/or are not eligible for CACREP accreditation, because of CACREP’s narrowing scope of eligible programs, including the restriction that new core faculty members must hold counselor education degrees.

The Coalition of Concerned Counselors is disappointed that ACES does not support all counselors and all quality counselor preparation programs. The heart of the counseling profession is empathy, tolerance, and the creative development of solutions. There is a place in our profession for all counselors, CACREP and CACREP-unaffiliated, Counseling and Counseling Psychology; and the mission of our professional associations should be to find that inclusive place. The ACES position, when stripped of its patina of higher standards and consistency, argues that the majority of our profession should be marginalized and disenfranchised to allow a “uniformity” based on credentials of a minority to prevail.  

The great irony in this proposed solution is that licensure standards in many states, including Maryland, exceed (and have always exceeded) CACREP standards. (Maryland, for example, has always required 60 graduate credits, including at least one 3-credit course in each of 14 content areas, as opposed to the eight “core curricular” areas required by CACREP’s 2013 Clinical Mental Health Counseling standards).  A far more elegant and fair solution to the “uniformity problem” for current students and licensed clinicians alike would be for ACES to develop model licensure language based on that of states with the most comprehensive licensure requirements.

The Coalition of Concerned Counselors is not against CACREP standards, which have indeed provided important criteria for training in Counselor Education-based programs in a variety of specialties, including mental health counseling. We do object to using CACREP standards to narrow the opportunities of those from all other programs! 

A newly emergent set of standards (MCAC) developed for psychology-based LPC training programs, is comparable CACREP’s but includes additional training in biological foundations and social justice, and other program accreditations may well emerge as our profession continues to meet the complex mental health needs of a nation. No one of these training models should be touted as superior to another absent relevant sound research.   

Our profession strives for evidence-based interventions, and the accumulation of evidence on the relative strengths of different training models should be vigorously encouraged and supported by ACES.  In this way, we will deliver the highest level of care to the public.  Conversely, the public suffers when artificial barriers restrict access to mental health services and choice of practitioner.

In our opinion, state licensure and graduate program accreditation serve different functions and are best kept separate.  It is the responsibility of licensing boards to protect the public interest. In so doing, boards specify and enforce minimally required standards for practice.  It is the responsibility of researchers and educators to continuously develop and promote efficacious interventions and the highest standards for training.  It is important that these continuously evolve together, as new understandings of mental health needs emerge, and research accumulates on effective treatments.  To restrict or lock training programs into a single model, taught by faculty trained only in that model, will stifle diversity of perspectives, types of research, and the creativity that is necessary to the continued development of the profession.

Unlike psychologists and clinical social workers, LPCs graduate from a variety of regionally accredited masters and doctoral level programs leading to graduate degrees in counseling, clinical community counseling, clinical mental health counseling, counselor education, counseling psychology, school psychology, pastoral counseling, and rehabilitation counseling, among others.  These graduates are all eligible to apply for LPC licensure, but must meet a state’s uniform licensure standards.  Furthermore, professionals with a master’s degree in a different counseling specialty often later elect to become LPCs.  For example, many experienced school counselors go on to do additional training and become LPCs.  We believe that the public is well-served by this diversity of training and experience in the mental health counseling field, assuming that practitioners meet the requirements established legislatively by their respective states. It may be well and good for states to strive for national uniformity in their licensure standards, and this will likely facilitate portability, but the uniformity should occur at the level of licensure and not in a student’s original selection of the master’s program.  Licensure should be what unifies and identifies the mental health counseling profession.