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.