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:
- 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.)
- 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.)
- 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.)
- Counseling psychology master’s programs have more reliance on testing and the medical model. (If true, is that a problem?)
- Control of the standards of our own profession. (Because master’s in counseling psychology are somehow not our own profession…?)
- 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.)
- 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.