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Integrating addictions counseling into LPC licensing

By Bethany Bray April 10, 2014

The process to become a licensed professional counselor (LPC) qualifies the license-holder to work with clients who present with posttraumatic stress disorder, schizophrenia, eating disorders and other diagnoses listed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Why then, would addiction – another DSM-5 diagnosis – be any different?

An extra, state-level certification is often required for counselors to work in addictions. That model complicates things for counselors and is turning graduate students off to the field of addictions counseling, contends Keith Morgen, president of the International Association of Addictions and Offender Counselors (IAAOC), a division of the American Counseling Association.

“You have to find a balance,” says Morgen. “You need to have the training to know how to do addictions work, but to [require additional licensure or certification, depending on the state] becomes less of a benefit and more of a hassle. It’s driving people away.”

IAAOCIAAOC recently formed a task force to focus on this issue. The group plans to present its findings – and suggestions for a possible remedy — at ACA’s 2015 Conference in Orlando, Fla. Morgen says IAAOC is looking for more counselors, both entry-level and established counselors, to get involved in this process (see the “get involved” box at the end of this article for more information).

Morgen, an assistant professor of counseling and psychology at Centenary College in New Jersey, says he often hears from students and young counselors who are frustrated with the extra requirements addictions counselors face.

“I’ve seen it firsthand, over and over and over again,” says Morgen, who is an LPC, national certified counselor and approved clinical supervisor.

Students who are very qualified, including those who have completed internships at addictions facilities, are having to get an additional license or certification beyond their LPC to find work in addictions facilities — despite the fact that the scope of practice of LPCs in their states covers all of the DSM, says Morgen.

“Depending on the state, that’s a lot of extra time and extra money,” he says. “Because of an outdated system, [young counselors] are being driven away. … It’s a whole body of counseling being forced into a burdensome process. It’s fragmenting the entire field.”

Some addictions facilities require counselors to have an extra state-level license before they’ll hire them, explains Morgen. “For example, in New Jersey, an LPC can do addictions work, but LPCs or recent grads [who are] logging hours for licensure are being told by facilities that they’d prefer the applicant to get the addictions license on top of the LPC,” he says.

Morgen says he’s also heard of this happening in Illinois, Ohio and Pennsylvania recently.

This model also creates frustration for many veteran counselors. In some states addictions work is restricted for an LPC, and LPCs must refer any client who presents with an addiction issue in a counseling session to a certified/licensed addictions counselor, says Morgen.

Having to refer a client to another therapist mid-program is disruptive to the client and frustrating for the counselor, he says. It’s also counterintuitive, he adds, because addictions are often coupled with anxiety and other issues that clients typically work through with LPCs.

The IAAOC task force formed in February after receiving approval from the committee’s executive board. Morgen co-chairs the task force with Geri Miller, a professor of human development and psychological counseling at Appalachian State University in North Carolina. Also on the task force are Kristina Depue (University of Florida), IAAOC/CACREP training standards committee chair; Nathaniel Ivers (Wake Forest University); and IAAOC legislation/advocacy committee chairwoman Christine Chasek (University of Nebraska-Kearney).

Over the next year, the task force will consider “recalibrations” that could be made to graduate course work and licensure requirements to make things easier for working and incoming counselors to enter the addictions field with their LPC, Morgen says.

However, Morgen stresses that the aim of the task force is not to eliminate the field of addictions counseling.

“We’re not saying ‘get rid of addictions counseling,’ but [instead] ‘get LPCs into the mix,’” he says. “LPCs need to be more integrated into the work with addictions clients alongside addictions counselors. And, just like any other DSM disorder class, LPCs should not be in any way boxed out and declared not eligible or qualified to work with a population. How much graduate school training do we all really get on any DSM disorder class? For example, how much classroom and practical training do we really get focused entirely on mood disorders? Yet, there are no obstacles for LPCs to work with mood disorders once they graduate. They simply transition into working at a facility with no required extra training for additional licensure/certification besides the work for LPC. This issue fits neatly within [the 20/20: A Vision for the Future of Counseling] initiative, and we’re trying to help ACA link our issue to 20/20.”

“Geri [Miller] and I firmly believe that effective counseling on substance use disorders does require specific and rigorous counselor training,” Morgen says. “But we also believe the current national practice of credentialing and training must change. State by state, outdated and burdensome rules are keeping countless qualified and capable counselors from entering the addictions field.”

“That’s what we believe and why we’re doing this.”

 

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Get involved

 

To participate in the IAAOC task force, email Keith Morgen at morgenk@centenarycollege.edu by May 12.

The task force welcomes counselors who have experienced frustration with the issues mentioned in this article, such as having to refer a client out of session to an addictions specialist, or being informed of a need for additional addictions licensure/certification, says Morgen.

 

For more information on IAAOC, see IAAOC.org

 

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Bethany Bray is a staff writer for Counseling Today. Contact her at bbray@counseling.org

Follow Counseling Today on Twitter @ACA_CTonline

 

4 Comments

  1. Bentley

    I completely agree with this article. I am an LPC graduate who just moved to SC but am unable to get a job until I take my NCE. Long story short, I am doing addictions counseling for the state and am going through a 2 year process to obtain my CAC for the state. Ironically, it took me two years to get my Masters in Counseling for MFT/LPC.
    Secondly, working in drug and alcohol I see so many people about drugs with a large amount of mental health issues. Some use to self-medicate for trauma, anxiety, depression or one of the largest, loneliness. I understand that addiction treatment and recovery is a different animal but I also completely agree that not all of our clients need “another appointment” to go to every week or so. Lets try to bridge the gap.

    Reply
    1. Kristina DePue

      Hello Bentley . My name is Kristina DePue, and I am an Assistant Professor at the University of Florida and a member of the IAAOC task force. Thank you so much for your comments above. I would love to get your feedback on a few questions that we have put together focusing on the two-licensing system that is currently in place for addictions counselors. If you would be willing to answer these via email, please let me know, by contacting me at: kristinadepue@ufl.edu

      Thank you again for your comments, and I look forward to hearing back from you.

  2. Enobong Inyang

    One of the ways to deal with this issue is for programs preparing LPCs to recognize that working with clients with addiction problems is to include addiction courses that cover the SAMHAS Competencies Model of Addiction Counseling. I began my counseling career as a Substance Abuse Counselor & Coordinator upon obtaining LCDC in 2000 while I was undergoing my master training in counseling, then my doctorate in counseling. I can testify from experience that addiction counseling without specific training in addiction knowledge and intervention strategies, regardless of the type of degree or license, is a disservice to clients. A national example to follow is the California tier system of addiction counseling. The two courses that I enjoy teaching the most at the master level are Prevention & Treatment of Addiction and The 12 Core Functions of Addition counseling. Because of the share numbers of clients with addiction problems encountered by LPCs, integrating addiction counseling courses into counselor training programs is a step in the right direction.

    Reply
  3. Amy Daum

    I am a recent graduate of a CACREP accredited program and have received my LPC. Luckily, I was able to find a job that is letting me get the hours here for the additional accreditation I need for Illinois. However, I am frustrated by the fact that I just completed a program that was very intensive, completed an internship that lasted an entire academic year, and I still have to get a CADC. I understand that it is a formality, but I do feel that there should be a system set up where this is incorporated into the program.

    Reply

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