Below are some Frequently Asked Questions (FAQs) and answers:

1.What is the problem?

We think that licensed counselors (70%+ of all currently working counselors)who have not graduated from CACREP  accredited programs are quietly in danger of being dropped from TRICARE, excluded from MEDICARE (when the legislation is finally passed), gradually losing membership on private insurance panels, and maybe even losing their ability to transfer their license to another state!

We think CACREP has been proactive in promoting a CACREP-only agenda at the local, state, and federal levels.  Many CACREP allies hold key positions on professional association boards’ elected slates. Ironically, CACREP espouses the values of collaboration, openness to growth, and respect for the diversity of instructional approaches. If it truly operationalized these sentiments and found ways to accommodate the diverse professional programs in our field, CACREP could bring professional unity to our field.  We are hoping one day this can happen.

Most professional counselors are very busy.  We tend to wait for problems to actually manifest before taking action.  The CACREP only language emerging in federal regulations is a concerning precedent that could generalize to other spheres of professional regulation, including state licensure requirements, school counselor certification, faculty appointments, scholarships, honor society membership, among others.  This is already beginning to happen. Action now is needed or else  mental health counselors who did not graduate from CACREP programs risk losing their right to practice their profession.

2. What is CACREP?

CACREP stands for the Council for Accreditation of Counseling and Related Educational Programs.  See http://www.cacrep.org/ for their version of things.

3. What’s the problem with the current CACREP standards?

We are not opposed to national accreditation standards for counselor education programs. We endorse national standards that provide quality assurance and safeguard the public. However, what is complicating this objective is that CACREP has assumed a philosophical position that places it at odds with many counselor educators and counselor education programs. CACREP believes in the promotion of a singular counselor identity which is achieved through instruction by a core faculty with doctoral degrees in counselor education, preferably from CACREP accredited programs.

CACREP’s drawing of a philosophical distinction between faculty with doctorates in counselor education and those with degrees in counseling psychology or allied fields seems to accentuate differences that may be unimportant at a time when there is so much convergence in the mental health professions toward a strength based, person centered view of mental health treatment. It is also seems short sighted as the mental health professions move toward integration and “multidisciplinarity.”

A diverse faculty mix may be more conducive to the best counselor education than an insular group of faculty sharing in the same perspectives. Creating silos in graduate education at a time when the mental health field is trying to break them down seems like a curious position for CACREP to take.

CACREP should  first and foremost concern itself with the quality of teaching and the scholarship of the faculty members in counseling graduate programs and not their degree title. Marginalizing faculty with degrees in counseling psychology or allied disciplines, who have made significant contributions to the mental health field,  would be at the cost of the intellectual vigor and quality of the programs CACREP accredits.

There are also other problematic features in the  narrative that CACREP’s accreditation is necessary to assure quality:

There is little to no proof that CACREP standards result in better mental health counselors.  Very good schools including Columbia, Seton Hall, Johns Hopkins (until very recently), George Mason, and more are not CACREP approved.

State licensing boards already do a good job of assuring quality.  They usually require high standards and in some cases surpass those of CACREP (see Maryland).

CACREP only language in regulations could ironically exclude the most experienced and knowledgeable  counselors who attended school at a time when CACREP did not widely accredit.

4. Why isn’t my state license good enough?

We think it should be. States often have very high standards.  Different states have different needs. Insurance companies have lived with this just fine for years.  CACREP and its advocates claim that certain national programs (like TRICARE and MEDICARE) want to see national standards for licensed counselors in order to accept us.  While we agree that national standards are needed, the devil is in the details.  If CACREP is used as a first filter to determine who should practice, most mental health counselors in our country would be excluded, since the majority did not graduate from CACREP programs. Graduation from a CACREP program is not the appropriate standard to use at this point in our development as a profession to confer practice rights. It is too premature to do so.

5. What does graduate program accreditation have to do with my state license or my ability to get paneled?

Good question!  You may have graduated years ago.  You may have been licensed years ago.  There is increasing evidence that CACREP and its supporters may be pressuring state licensing boards to require CACREP graduation as a condition for licensure.  What if you need to move to another state in the future? You may not be able to unless you attended a CACREP school.

If CACREP-only language enters MEDICARE regulations, this could be copied by the private insurance market. Insurers are often looking for ways to restrict their provider panels to better manage cost. They can easily use a CACREP restriction to determine who should be on their panel.

6. What’s the fuss over TRICARE?

If you are already a TRICARE provider, you know the answer.  Counselors have until the end of 2014 to take the NCMHCE exam and meet certain other training requirements in order to remain TRICARE providers.  After this date they must have graduated from a CACREP school.  Reports of difficulties in being allowed to take the NCMHCE exam abound due to new course requirements.  One of the other requirements includes completion of supervision under a counselor — not a psychologist, social worker, or other qualified professional (such as most veteran counselors utilized for supervision).

TRICARE is increasingly viewed as the first domino.  If the CACREP-only regulations at TRICARE stand, future MEDICARE regulations may emulate them.  Private insurers tend to emulate MEDICARE requirements. Mental Health Counselors who did not graduate from CACREP schools may find themselves locked out of government programs and private insurance panels!

7. What about grandfathering?

The professors at counseling psychology programs don’t like this because it may put them out of jobs and shutdown their programs, since many can never be accredited by CACREP so grandfathering becomes a moot point.  Advocates for a diversity of training standards don’t like the one-size-fits-all approach either.  But generous grandfathering might help a majority of counselors working today (70% or more are currently CACREP-unaffiliated) to keep working.  We have seen precious little meaningful work towards grandfathering.  The “grandfathering” in TRICARE is not grandfathering in the traditional sense of the term, since it neither recognizes one’s license nor their past experience, but requires the passing of an exam that many counselors are not allowed to take, if new course requirements emerged since they became licensed.

We would prefer that state licenses are the standard for being allowed to practice; and we believe the American Association of State Licensure Boards should be guiding consistent counselor licensure standards across the states, since they would not benefit personally from the standards set, as would CACREP, who has a non-objective, financial  interest in the expansion of their accreditation.  If national accreditation is needed, CACREP should not be the only gatekeeper, if it continues deny its accreditation based on degree title or faculty composition–basically for ideological reasons and not quality of care.  If CACREP has its way, generous grandfathering provisions are essential to mitigate the potential damage to CACREP-unaffiliated counselors.