Category Archives: Virginia

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.

ACA Commits to CACREP-Only

The ACA governing council has officially committed to CACREP and only CACREP all the way.  ACA is also going to send Virginia a letter of support for their proposed new CACREP-only licensing regulations.

The only good news here is support for grandfathering thru 2020 and (somehow) trying to keep those of us grandfathered as treated equally into the future.  Nonetheless this is a direct threat to dozens and dozens of fine master’s level counseling psychology graduate programs, and so is not really acceptable.

~~~
ACA Governing Council Meeting

July 20-21, 2015

Motions

It was moved by P. Francis and seconded by T. Mitchell to approve the recommendations of the Awards Committee regarding the ACA Fellows Award program. Motion passed.

It was moved by K. Butler and seconded by G. Lawson for the Governing Council to endorse the Multicultural and Social Justice Counseling Competencies. Motion passed.

It was moved by G. Lawson and seconded by P. Francis that to unify the professional identity of counselors, ACA endorses supports and advocates for graduation from a Counselor Education program accredited by CACREP/CORE as the pathway to licensure for independent practice.  Motion passed.

It was moved by S. Haberstroh and seconded by T. Mitchell that ACA, in all advocacy efforts related to licensure for independent practice, endorse licensed professional counselors (including comparable state counseling licenses), licensed on or before July 2020, as qualified independent practitioners with the same professional privileges and practice options as graduates from CACREP and CORE programs. Motion passes.

It was moved by G. Lawson and seconded by P. Francis that ACA shall, within its current legislative advocacy structure, endorse and will advocate for:

Standards that require graduation from a counselor preparation program accredited by CACREP or an approved affiliate of CACREP (e.g. CORE).

Students must demonstrate sufficient preparation in addressing clinical issues in order to be eligible for licensure for independent practice. In addition to concentration on Mental Health, psychological, and human development, this preparation shall include both coursework and practice in assessment, diagnosis, treatment planning, and clinical interventions for individuals with serious mental illnesses and/or serious emotional disturbances. Students must complete a practicum of at least 100 hours and an internship of at least 600 hours. Graduates from programs accredited by CACREP or an approved affiliate of CACREP (e.g. CORE) in Clinical Mental Health Counseling, Clinical Rehabilitation Counseling, Marriage Couple and Family Counseling, or Addictions Counseling are assumed to have met these clinical preparation requirements. Graduates of other CACREP or CORE tracks will need to demonstrate that they have met the clinical coursework requirements.

ACA will support and advocate for a liberal grandparenting period of seven (7) years after the adoption of this language in state regulations, whereby individuals who graduated from regionally accredited programs can still achieve licensure and regionally accredited program have sufficient time to pursue accreditation from CACREP or an approved affiliate of CACREP (e.g. CORE).

This advocacy will be included in the ACA Governmental Affairs Agenda as soon as is practicable.

Motion passed.

CACREP Update–Restricting the Practice of LCPCs

[Posted for Larry Epp — President of Licensed Clinical Professional Counselors of Maryland]

Dear Colleagues,

As President of the Licensed Clinical Professional Counselors of Maryland, I do not usually reach out to you on a professional issue unless it is very important. Some of you may have been following the developments with the accrediting agency, CACREP, whose supporters have been trying to restrict the practice of LCPCs who have not attended their accredited programs in the Commonwealth of Virginia.

Right now, supporters of this organization have instituted a campaign to close practice in Virginia to LCPCs from non-CACREP schools, counseling psychology, school psychology, clinical psychology, art/creative therapy master’s programs in seven years. While veteran LCPCs from Maryland can transfer their license to Virginia as the laws are currently constructed, the underlying concern is that the CACREP restriction will enter insurance regulations such as in Medicaid, Medicare, and private insurance plans, as has already occurred in Tricare, the Veterans Administration, and Department of Defense schools and programs.

Those who believe in the CACREP only standard have an ideological belief in separating psychology from counseling to create a pure and independent “mental health counseling profession.” Whatever the merits or pitfalls of their argument, the fact is that the changes they are promoting could potentially restrict the practice of many Maryland LCPCs in the future, especially if their thinking enters the recently introduced Medicare Bill on Capitol Hill or in the qualifications to practice in a Federally Qualified Behavioral Health Center under the Excellence in Mental Health Act. I do not have a crystal ball to know what will happen precisely, but this movement is certainly concerning and demands a response from those who favor the protection of existing practice rights and greater inclusivity in the future.

I urge you to weigh in on this important issue. I have attached the link below to the Virginia Board of Counseling’s website, who is for 30 days accepting comments on this issue. Virginia is a battle ground state, as it was one of the first to license professional counselors; and it is the headquarters for three national counseling associations. Thank you for considering my suggestion.

Larry

Here is the Virginia Board comment area that can be found online:

http://townhall.virginia.gov/L/comments.cfm?stageid=7071

Virginia Protest Letter Help File and Background

Your assistance is needed to defeat proposed CACREP-only regulations for Virginia licensing.  The Virginia Board has posted a NOIRA (Notice of Intended Regulatory Action) for public comment, after which it will likely issue new CACREP-only license regulations.

The purpose of the proposed regulation states: To require 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 (90 quarter hour credits) of curricular experiences and a practicum of at least 100 hours and an internship of at least 600 hours.  Allow a grandfathering of programs that meet current requirements for seven years from the effective date of the regulations.

Virginia is a particularly vulnerable state because it has far more than usual CACREP accredited programs. There are a few carrots being thrown to the non-CACREP counselors.  One is the 7 year grandfathering period.  After which the doors will be slammed on non-CACREP counselors in the state.  Another is that apparently Virginia does have some sort of process for accepting non-CACREP counselors licensed in other states wishing to move to Virginia.   These carrots are helpful, but really only soften the blow that CACREP is being forced as the superior standard and only standard.  One is also left to wonder at what point the regs allowing out-of-state transfers with non-CACREP backgrounds will be tightened?

Suggested Letter Text:

Please write your own letters, and feel free to cut and paste selections from the suggestions below into your letters.

“Counseling” vs. “Counseling Psychology”

The NOIRA states: “In recent years, the Board of Counseling has worked towards greater professional identity for counseling to help the public understand the clinical services a licensed professional counselor is qualified to provide… the Board continues to review applications for licensure from students whose educational programs are not clearly “counseling” in their identity. The lack of clarity in its regulations has been frustrating for the Board and very problematic for some applicants who have obtained a post-graduate degree that may or may not qualify them for a residency and ultimately licensure”

This innocent-sounding section of the NOIRA appears like it is about professional identity and qualification for licensure.  It would actually seem to be about the ongoing crusade of CACREP advocates to forcibly excommunicate graduates of “counseling psychology” masters programs in favor of “counseling” masters program graduates. One of the primary problems with CACREP is the inability of counseling psychology programs to obtain accreditation under CACREP. The differences, if any, between “counseling psychology” and “counseling” programs quickly fall apart upon examination.  The theories and techniques of “the talking cure” are the same regardless of label.  Most counseling psychology programs utilize the ACA ethics code in coursework (and the APA code is not that different).  There may perhaps be a greater reliance upon testing and medical model in some counseling psychology programs (some would applaud this).  CACREP advocates would like the American Psychological Association (APA) to rescue masters-level counseling psychology graduates (they only license at the Ph.D. level).  Counseling psychology graduates have been licensed as professional counselors and members of the ACA since the beginning.  This is in part a ridiculous petty squabble between Ph.D. level counselor educators versus Ph.D. psychologists dating back decades. Regardless – from the point of view of the public good – this has absolutely nothing to do with competence or public safety, but has great potential to impact the numbers of available counselors.  Booting “counseling psychology” graduates out of the licensing pool for Virginia in no way helps Virginia! (It’s doubtful that even professional identity is seriously different as counseling psychology graduates have always considered themselves professional counselors.)

Factual Corrections to the NOIRA (NOIRA original text in italics.)

“CACREP was established in 1981 to achieve some consistency in counseling educational programs.”

– True.  CACREP spent much of its early history accrediting school counseling (school psychology at one point) and has only accredited larger numbers of mental health counseling programs recently.  In fact CACREP is still in the process of converting even CACREP-accredited 48-credit Community Counseling programs to their newer 60-credit CMHC standard (see http://www.cacrep.org/for-programs/ ).  The point being that when CACREP indirectly gives the impression that they are a very old and very established standard, this is not the case.

“CHEA recognition also assures the public that the programs that achieve CACREP accreditation are legitimate degree programs”

– The majority of non-CACREP programs in this country are also regionally accredited by CHEA and must maintain high quality standards.  This sentence implies that non-CACREP programs are usually not CHEA accredited and are illegitimate.

“One of the goals of CACREP is to establish a uniform set of educational requirements across the United States to facilitate portability of licensure from state to state.”

– True, but other methods of state-to-state portability would include an interstate agreement between the member Boards of AASCB, a simple choice to recognize out-of-state licensed counselors, or even CACREP-equivalent coursework and preparation.

“Three federal agencies have made graduation from a CACREP accredited program a requirement for independent practice in counseling.”

– This is not a reason to make the same mistake elsewhere.  Such requirements place a burden on counseling business owners and on clients who are looking for easy access to counselors in their communities.

“With a large military presence in Virginia, there is a need to equate graduation from a CACREP-accredited program with licensure to avoid public confusion and give licensees access to federal agencies.”

– This is exactly what should NOT happen for the good of both counselors and the public. Thousands of competent seasoned non-CACREP counselors throughout Virginia face increasing public confusion as to their competence.  A public which expects CACREP (despite no evidence of its superior quality) will start demanding CACREP and start discriminating against counselors without this accreditation in their past.  This will result in lack of employment for non-CACREP counselors even in situations where they are licensed and eligible to help with our burgeoning mental health community needs.  The likelihood of public confusion of CACREP with license eligibility and with competence is exactly why grandfathering provisions for non-CACREP counselors fall short of acceptable.

“The Board of Counseling has found that it has neither the resources nor the expertise to examine counseling programs across the country to assess the quality of the education in that program.”

– Plenty of Boards across the country do just this.  They typically require regional CHEA accreditation (for quality) and then require coursework in a variety or required categories.  Sometimes they choose to look for “CACREP-equivalency”.  When state Boards cede control of their standards to an outside entity they lose control over serving the needs of their state constituents.  Furthermore, several professions have two or more recognized accrediting authorities.  With variety comes a greater opportunity for a diversity of training to ensure a flexible and responsive (counseling) workforce for the unique needs of individual clients.  The Virginia Board might also avail itself of discussions amongst the various state Boards at the AASCB association – in which case it could at least have a strong voice in whatever national standards are enacted for standardization and license portability.

“Consistency and quality in educational preparation for professional counselors will provide greater assurance to clients seeking their services that they have been adequately prepared and appropriately licensed to protect public health and safety.”

– CACREP advocates have created a mostly false narrative of a public endangered by poor quality counselor preparation.  No doubt they can find isolated examples of such.  There is no epidemic of poor quality counselor preparation – controls and standards are already in place to protect the public without locking down the profession to one privately controlled gatekeeper.

Requested Public Participation in the NOIRA: The agency is seeking comments on this regulatory action, including but not limited to 1) ideas to be considered in the development of this proposal, 2) the costs and benefits of the alternatives stated in this background document or other alternatives and 3) potential impacts of the regulation. The agency is also seeking information on impacts on small businesses as defined in § 2.2-4007.1 of the Code of Virginia. Information may include 1) projected reporting, recordkeeping and other administrative costs, 2) the probable effect of the regulation on affected small businesses, and 3) the description of less intrusive or costly alternatives for achieving the purpose of the regulation.

Costs of the NOIRA proposal include the nearly $4500 in program application fees, and $2600+ annual maintenance fees charged to each CACREP accredited program (see http://www.cacrep.org/for-programs/cacrep-accreditation-fees/ ) which are paid for in some fashion by state school budgets, counseling students, and ultimately the public. Costs are also paid in terms of flexibility of curriculum in a field with MANY theories of psychology, loss of employment opportunities in CACREP programs for educators with slightly different qualified backgrounds than Ph.D.s in counselor education, and locking counseling psychology graduate students out of future licensure for no discernable reason related to competency to the public good. The future effects of CACREP on small businesses are murky and troubling. Many counselors in private practice are sole proprietors or at small clinics which would qualify as small businesses.  In the short-term under this proposal, these non-CACREP counselors will continue to be licensed and new graduates will be license-eligible until 2022.  However, the CACREP-only push creates a false perception of CACREP quality that is likely to impact these small businesses in the future.  The public may look for CACREP graduates in the false belief that they are more qualified.  Government programs (and private insurers?) may follow the bad TRICARE example and start requiring CACREP for licensure.  Employers may start only hiring CACREP graduates.  There is a potentially devastating longer term effect on small clinics and sole proprietors at risk of being cut out of the market. To the extent that non-CACREP counselors are cut out of the market, the public may experience counselor shortages or have to settle for newer counselors with less experience. Other Points: A careful look at the data will reveal that counselors who have graduated from CACREP programs are not more effective in their work with clients or in their service to their communities. A regulation limiting practice will not serve the people of Virginia well given that a majority of master’s level counselor training programs in the USA are not CACREP-accredited. A regulation limiting practice will not serve clients in Virginia given that the majority of currently practicing counselors graduated from schools free of CACREP accreditation. A restriction such as this would negatively impact current students and alumni from non-CACREP affiliated VA programs; negatively impact the public by reducing access to qualified counselors; negatively impact relocation of qualified and competent counselors from non-CACREP programs; reduce overall services available to VA residents; and increase cost of graduate education. Even the American Counseling Association (ACA), the largest national counseling association, opposes the CACREP-only restrictions highlighted in the rationale for this regulatory change. The people of Virginia need a strong Board that protects their rights to access quality mental health care.

Comments Needed Against Virginia CACREP-Only Regulations for Future Licensed Counselors!

Dear LCPCM Members:

Virginia is about to enact a regulatory change that would only permit CACREP graduates the right practice mental health counseling in the Commonwealth of Virginia. If you disagree with this regulatory change, the Virginia Board of Counseling is accepting comments for 30 days at
http://townhall.virginia.gov/L/comments.cfm?stageid=7071

Veteran practitioners are generally given reciprocity in Virginia after practicing for 5 years in Maryland, but the greater concern is the potential negative perception of non-CACREP and counseling psychology graduates that may follow this change. It seems to emphasize an unproven belief that non-CACREP and counseling psychology graduates are inferior in their educaitonal preparation.
Larry Epp, LCPC

President, LCPCM

CACREP-Only Assault on Virginia Counselor Licensing

The Virginia Board of Counseling has accepted a petition calling for the adoption of CACREP-only licensing in Virginia.

This should be of concern to all professional counselors as restrictions on our ability to practice make moving around the country increasingly difficult.  The continual drumbeat of CACREP as the “gold standard” also subtly undermines public and employer confidence in your abilities even if your practice is not immediately effected.

The language of the petition states:

To require 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 (90 quarter hour credits) of curricular experiences and a practicum of at least 100 hours and an internship of at least 600 hours.  Allow a grandfathering of programs that meet current requirements for seven years from the effective date of the regulations.

This issue is available for public viewing at:

http://townhall.virginia.gov/L/ViewPetition.cfm?petitionid=210

The petition comment period closed on August 13th with only 11 comments, most in favor.  The Board voted on September 19th to “submit a Notice of Intended Regulatory Action (NOIRA) to initiate rulemaking and receive further information and comment.  Once the NOIRA is approved by the Governor, it will be published and a 30-day comment period will be opened.”

If given the go-ahead by the governor, we will see proposed new regulations from the Board with one more public comment period.  (If anyone is more familiar with the regulatory process in Virginia, please improve upon my understanding.  It may be that there is a legislative approval process required for regulatory changes to take effect.)

The petitioner was Dr. Gerald Lawson – the primary CACREP contact for VA Polytechnical Institute and State University:

http://www.cacrep.org/organization/virginia-polytechnical-institute-and-state-university/

 

Of the 11 comments made on the petition, 8 were in favor of it.  Of these 8 favorable comments, every single blessed one of them was made by faculty at a CACREP or CACREP-pending program in Virginia.  At least two of these professors have published papers specifically concerning CACREP.

 

What we appear to have here is a small group of CACREP partisans rather quietly working a CACREP-only agenda on Virginia licensing.  How quietly is in some dispute.  At least one professor at one of the non-CACREP schools in Virginia (George Mason) claims that their faculty were largely left out invitations to a state-wide discussion of the issue whereas CACREP school faculty were invited.

 

Virginia is a particularly vulnerable state because it has far more than usual CACREP accredited programs.  Which means more CACREP new graduates.  However, where does this leave all of the currently licensed practitioners?

 

For that matter, should such debates on the future of the profession be taking part largely in academia?

 

There are a few carrots being thrown to the non-CACREP counselors.  One is the 7 year grandfathering period.  After which the doors will be slammed on non-CACREP counselors in the state.  Another is that apparently Virginia does have some sort of process for accepting non-CACREP counselors licensed in other states wishing to move to Virginia.

 

These carrots are helpful, but really only soften the blow that CACREP is being forced as the superior standard and only standard.  One is also left to wonder at what point the regs allowing out-of-state transfers with non-CACREP backgrounds will be tightened?

 

As for current licensed Virginia non-CACREP counselors they are safe, right?  Most likely.  But then who among us has never had an unforeseen circumstance strike?  Counselors for a variety of good and bad reasons have their licenses temporarily lapse.  I’m just waiting for the first story of a Virginia counselor diagnosed with cancer who lets his license lapse in the face of life and death concerns, and then a year later finds out that he is locked out of the profession forever unless he leaves the state.

 

There is little to no evidence of CACREP being a superior standard.  Yet the approximately 70% of current counselors from non-CACREP schools are to be forced onto ever shrinking islands of practice , with an increasingly skeptical public left to wonder if they are really competent or not.

 

As Dr. Larry Epp wrote elsewhere:

 

“The Institute of Medicine Study on our profession could find no differences in clinical outcomes among the mental health professions, nor between masters prepared and doctoral level therapists, nor between CACREP and non-CACREP counselors. There is no scientific or clinical justification to ban permanently non-CACREP counselors from practice in the Commonwealth.”

 

We are currently assessing what the next steps are in the Virginia fight and consulting with people close to the situation.  In the meantime, please sign-up for our listserv on our website at www.concernedcounselors.org so we can keep in touch on action items.