Monthly Archives: November 2006

Coming into focus

Angela Kennedy November 10, 2006

The dictionary defines identity as the distinguishing character or personality of an individual or group — in other words, who we are. Members of the “20/20: Vision for the Future of Counseling” project are taking that a step further and also defining who counselors want to be as a group.

Continuing their work from counseling summits held earlier this year at the American Counseling Association Convention in Montréal and the American Association of State Counseling Boards Annual Conference in Phoenix, delegates have split into seven committees that are focusing on the most prominent issues facing the counseling profession:

  • Strengthening identity
  • Presenting counselors (no matter their specialty) as one profession
  • Improving public perception/recognition and advocating for professional issues
  • Creating licensure portability
  • Expanding and promoting the research base of professional counseling
  • Focusing on students and prospective students
  • Promoting client welfare and advocacy

The project, a collaborative effort initiated by ACA and AASCB, includes counselors from all ACA divisions and regions, as well as the National Board for Certified Counselors, the Council for Accreditation of Counseling and Related Educational Programs, the Council on Rehabilitation Education and Chi Sigma Iota. Twenty-eight counseling organizations have united for the first time not only to define what a counselor is, but also to plan, prepare and delineate what the profession could or should look like in the year 2020. The project’s aim is to create a unified professional identity to assist in the implementation of the AASCB portability plan and to eliminate the wide variation of state licensing standards.

Chairing the committee examining the issue of presenting counselors as one profession is NBCC President Thomas W. Clawson. “This topic is one that I have pondered for years,” he says. “It is close to the heart of what the NBCC Board discusses so often. Being able to start a dialogue that includes ideas for real change and real possibilities of unity within the profession, while respecting the differing needs of 28 different counseling organizations, is energizing.”

So far, the committees have submitted first draft bullet points to the project’s Oversight Committee, which is composed of ACA President Marie Wakefield, AASCB President Barry Mascari, ACA Immediate Past President Patricia Arredondo, AASCB Immediate Past President Charles Gagnon, ACA Past President Sam Gladding, AASCB Past President Jim Wilson and ACA Chief Professional Officer David Kaplan (serving as the administrative coordinator).

Beginning in December, all seven workgroup drafts will be sent to the 28 delegates for comments and feedback. Soon, the counseling community at large will be able to provide suggestions via postings on the ACA website and notices sent through Counseling Today, the AASCB newsletter, listservs and other venues. The comment period for both delegates and the counseling community as a whole will last through the middle of February 2007.

As part of the feedback process, the 20/20 Oversight Committee will conduct a town hall meeting in January 2007 at the AASCB Annual Conference in Sarasota, Fla. All 20/20 delegates attending the AASCB conference are encouraged to come to the town hall meeting. Both the internal (delegate) and external (public) comments will be provided to all 20/20 delegates at the beginning of March 2007 for review. Additionally, all delegates will meet at the 2007 ACA Convention in Detroit to review the initial drafts and feedback and to provide direction for the subsequent draft. A final draft will be written over the summer of 2007 and presented to the delegates for ratification. The 28 delegates will also present portions of the final draft to their respective organizations for ratification.

“We are excited about the outcomes that will be generated by the committees and the feedback that we will receive at the AASCB and ACA conventions,” Gladding says.

In addition to serving on the Oversight Committee, Mascari is chairing the Counselor Licensing Portability Committee. “This is really an easy topic for statements of principle,” he says. “I think there is relative consensus on the major points concerning portability, and much of that is contingent on what happens with the rest of the profession. The portability issue is intertwined with other issues, including the CACREP revisions, counselor identity, supervision standards and individual states’ different ways of doing things. Depending on when a state adopted their legislation, reflecting the fact that we are relatively new in the licensing game, regulations look very different. The biggest single roadblock to portability is the wide variation in standards. What are really being reflected in licensure are the areas of weakness in our profession. Many statutes allow the language ‘and related professions’ as part of the counselor licensing, which opens the doors to graduates from psychology degree programs to be licensed professional counselors. This brings people with weak or nonexistent counselor identity into the counselor licensing world.”

Mascari adds that the Counselor Licensing Portability Committee is one piece of the larger puzzle that must address education and training and, ultimately, counselor professional identity. “The work of 20/20 is the fulfillment of a dream of mine ever since my dissertation where I found identity unraveling and the lack of common standards threatening the future health of the counseling profession,” he says. “My dream was to have a summit where all groups from the profession would come together and resolve some of these long-standing issues. Interestingly enough, in reading old AASCB minutes, I found that there was a call for a summit around 1986 to address training and certification standards, (but) it never happened.”

“When legislators look at the diversity of training standards and the counselor professional groups claiming to be separate and distinct professions based on work settings, I would say we have some work to do,” Mascari continued. “Sam Gladding said it best to me. He said his goal was, in 2020, when on an airplane and someone asked a social worker what that was, that person would reply, ‘You know, it’s like a counselor.’”

Counseling Today will continue to provide updates on the progress of “20/20: A Vision for the Future of Counseling.”

Our living history and a time to say farewell

Richard Yep

Richard Yep

One of the best things about being the executive director of the American Counseling Association is that I have the opportunity to work with a great team of dedicated staff. Some have been here for less than a year, while others have been with the association much longer. There is great diversity among our staff. It would be an understatement to say that we are intergenerational, multicultural and different in many ways.

One thing I value in the staff is what they all contribute toward making ACA and the counseling profession so successful. Hardworking, knowledgeable and possessing a strong desire to please our members — those are just a few of the hallmarks that many of my colleagues exhibit.

Unfortunately, there are times when I have to say farewell to those who are taking a new path. And there are those for whom I have a deep respect because of their contribution to our organization. That leads me to the topic of this column. While I am happy to see her embarking on a new chapter in her life, I am also a little sad to announce that my friend Mary Janicke has retired from ACA after 54 years of dedicated service.

Mary’s last day with ACA was Nov. 30. During the Governing Council meeting that was held two weeks prior, she was recognized with a standing ovation from the entire board and others in the room.

Mary was here when four associations came together in 1952 to form ACA (then the American Personnel and Guidance Association). She was here through the good and the not so good times. During her tenure, she saw the organization develop into the world’s largest organization representing the counseling profession. Mary has witnessed ACA grow to 19 divisions, four regions and more than 40,000 members.

Mary was here before any of the states or the District of Columbia had enacted a counselor licensure law. She was here before there was a CACREP, an NBCC, an ACA Foundation or many of the countless other organizations that have played a key role in the development of the profession. While I have obtained a great deal of knowledge and a solid base of experience in my nearly 20 years with ACA, Mary was starting on her path with the association four years before I was even born.

Mary Janicke has worked for 55 ACA presidents and all nine of the executive directors. While I had hoped that Mary would stay through “my watch,” I am pleased to see that she is entering a new (and hopefully more relaxing) chapter of her life. She will be able to focus on many of the activities she enjoys in her leisure time and get to know all the neighbors in her new community.

I was touched when Mary said that she would still be willing to come in from time to time if she could be of help with specific projects. That’s yet another wonderful characteristic of a dedicated ACA employee, and it’s an offer of which I intend to take full advantage.

Without Mary Janicke, ACA will be missing someone who really is a part of our living history. However, we are a better organization because of the many contributions she made in a career that spanned more than five decades. While we will no longer see Mary on a day-to-day basis, we will take solace in knowing that she is finally enjoying the fruits of retirement that she so richly deserves.

In a future issue of Counseling Today, we will be talking to Mary about her long career with ACA. And, for those of you who have known Mary and would like to contact her, you can still use her e-mail address ( through January. She will continue to receive mail until that time at 5999 Stevenson Avenue, Alexandria, VA 22304.

If you are celebrating a holiday this month, or simply taking some time off to enjoy the pleasures of winter, the staff and I wish you a peaceful season.

As always, I hope you will contact me with any comments, questions or suggestions that you might have. Please contact me via e-mail at or by phone at 800.347.6647 ext. 231.

Thanks and be well.

Traditions and rituals: Our cultural identity

Marie Wakefield

With the holidays approaching, we are drawn once again to a blend of traditions and rituals. We sing carols from England, decorate trees (a tradition from Germany) and solicit the goodness of Santa, or St. Nick, whose presence originated in Scandinavia and who arrives in a reindeer-drawn sleigh claimed by Switzerland. Some will light a Menorah, while others will acknowledge the symbolism of Kwanza. Then there are those who will simply be thankful for their place here in the world community or recommit themselves to working for peace and justice in our society.

These family traditions or rituals connect us to our past, maintain our cultural identity, affirm our family values and promote healing from loss and disappointment. Within the richness of our American Counseling Association membership, there are a variety of meaningful experiences to share. I asked some of my colleagues in the ACA community what traditions or rituals they practice during this time of year. Here is what they said.

Suzanne Schmidt: Several years ago, my husband and I were beset by discomfort as we approached another gift-giving season. With amazing clarity, we saw that our family and treasured friends were blessed to have all that they needed and most of what they wanted. The search to symbolize our caring not only became difficult but disquieting. Nothing material captured the depth of our feelings. We kept returning to the belief that wealth is found in a free flow of ideas, which we see as both fundamental to human health and the maintenance of a free society. So, to honor the people we love the most, we created a foundation to fund programming on our local National Public Radio affiliate. Now, as we hear the announcer broadcast that a particular segment is funded by the foundation, we smile just knowing that our gift is participation in a legacy that will nurture the minds of future generations.

Janet Wind Walker Jones: The ceremonial practice of my people and those I walk among are strikingly similar, and all connect powerfully to a collective mind-set. Those ceremonies at this time of the year are often about renewal and peace. I have traveled and participated in ceremonies with people of many tribes from North America, Africa, Asia and Europe. A central theme of peace stands out in all of them. I have visited with the elders, and it has been a wonderful experience to share their journeys as they help others begin a path to inner peace. As I connect with my Texas Cherokee people and Lakota sisters, our ceremonies and talking circles are filled with similar conversations about the sacredness that is at the center of all of us and the need to find that center place to move toward world peace. When engaged in sacred ceremony at this time of year, I find common ground across many nations and lands very meaningful for me. It is this mission of peace that has led me to my work within ACA and AMCD (the Association for Multicultural Counseling and Development).

Jane Goodman: Tradition! The song from Fiddler on the Roof echoes in my mind. Traditions are essentially communal and personal. This is the time of year I often struggle with my desires to follow past customs, forge new ones and meet the diverse needs of my loved ones. My immediate blended family includes Protestants, Catholics, Jews and nonbelievers. We are coupled and single, gay and straight, and range from 1 to 75 years old. Most of us care about traditions, but since the 16 adults come from nine different growing-up traditions, we have differing ideas about how holidays should be spent. The one thing we all agree on is that it is good to be together and that food is central to celebration. Each year we have to decide whether to celebrate holidays separately — Hanukkah and Christmas in particular — or choose a day in the middle and celebrate jointly. We have learned that some traditions grow naturally, and some have to be created to meet the multiplicity of needs in our family. Our little microcosm of multiculturalism provides challenges to understanding and richness of experience.


As you recognize the traditions and rituals in your family, take time to embrace the strengths you gain from them. Family uniqueness, understanding, continuity and appreciation are invaluable. May your holidays be enriched by events that connect you to your cultural identity.

I look forward to hearing from you and hope you will feel free to communicate with me via e-mail at or by calling 800.347.6647 ext. 232.

MCA rolling out the red carpet for ACA Convention attendees

Angela Kennedy

With the 2007 American Counseling Association Convention in Detroit just a few months away, the host branch, the Michigan Counseling Association, is gearing up to show off its revitalized city and help stage another successful convention. Counseling Today caught up with two MCA leaders to find out more about the branch, what’s in store for convention attendees in the Motor City and, of course, where the best places are to eat in town.

Founded in 1965, MCA is the state’s largest association exclusively representing professional counselors in various practice settings. MCA provides leadership training, publications, continuing education opportunities and advocacy services to nearly 1,700 members.

MCA President Laura Kitkowski says the organization’s legislative agenda is geared toward licensure and issues such as mental health parity, Blue Cross Blue Shield and third-party reimbursement, Medicaid, school counselor tenure, college counseling, and K-12 funding and protection.

“There’s a term in Spanish, entre metida, that means you get into everything, and our leaders really do get into a lot of different things such as informal discussion groups and regional positions,” Kitkowski says. “We really have people here who are involved in other professional work and disciplines. It’s really neat to see the different credentials that people have, yet they are still members of the counseling association.”

Since the current economy in Michigan is doing poorly compared with other parts of the nation, Kitkowski says that one of the major issues MCA continues to see is unemployment and the ripple effect that has on both individuals and families. “One of the more challenging issues they are facing, especially in the case where school counselors refer students, is the lack of insurance,” she says.

The ‘new’ MCA

“Communication is the theme that I have been instilling in our Executive Board and leadership. This is the new MCA, because we have so many opportunities to go nowhere but up. We have increased communication, and we are rebuilding trust within the branch,” says Kitkowski, referring to a riff between MCA and Michigan school counselors that led to two school counseling associations — one affiliated with ACA and the other with the American School Counselor Association. She says MCA is working hard to improve communication between leadership and MCA members, while at the same time assisting members to connect with other members. Kitkowski believes it’s vitally important to help counselors utilize one another’s expertise.

“Another huge thing I’m charged with is investigating licensure and communicating to membership on legislative issues,” she says. “State laws can supersede federal laws on some things, so the members need to be aware of what’s going on.” Kitkowski adds that she hopes to both solidify the association’s financial foundation and provide new communication portals. “It’s not just about listservs,” she says. “We have to build on that.” Eventually, she would also like MCA to establish a statewide interdisciplinary discussion group for those in the helping professions.

“Like most professional associations, people are looking outside the box and are trying to find new ways to reach out to the people they are representing,” says Chris Larson, a longtime MCA member and leader. “We are moving ahead like everyone else, but we are also feeling the same growing pains and the impact of the world around us. My vision is that MCA would remain the constant for the helping professional in this ever-changing, global, technological economy and still meet the grassroots needs of professionals in the state.”

Larson would also like MCA to remain in partnership with the state colleges and universities that are training counselors. “We have a very strong graduate student connection,” she says. “We should continue to draw on graduate students for mentoring and for when they become professionals to return and continue to give strength to the organization and to the profession in the state of Michigan. As counselors, we can often be isolated in our work setting, so our professional association is the tie that binds us together, and I see us continuing to nurture that piece within the new MCA.”

Look out Detroit, here we come

“We are really trying to get as many people (to the ACA Convention in Detroit) as we can,” Kitkowski says. “We are rolling it out to divisions and chapters, and they are being very active and supportive. The division and chapter leadership are identifying what they can do beyond volunteering.”

Detroit has had a profound impact on the world. From the invention of the automobile to the Motown sound, the city has played a major role in crafting American culture. Unknown to many, the city and surrounding area are currently undergoing a renaissance with new development and attractions. Both counselors gush about how Detroit is cleaning up its image and re-establishing itself as a safe, big-city tourist stop.

“It’s such a wonderful area,” Kitkowski says. “There’s so much going on — casinos, comedy clubs, (the new) Tigers stadium, riverboats, the history. There is just so much to do and see. We have fantastic microbrews here, and the pubs in the downtown area are great.” She adds that the burgers at the Hockeytown Café, rated the No. 2 sports bar in America by ESPN2, are the best (though not cholesterol-friendly).

Kitkowski and Larson agree that ACA Convention attendees should check out Greektown for dining and entertainment, and perhaps for trying their luck at the blackjack tables. Greektown is located less than half a mile from the Renaissance Center (which is also home to the ACA headquarters hotel, the Marriott Renaissance) and can easily be reached using the Detroit People Mover. Greektown is home to more than 20 restaurants (ranging from fine dining to authentic Greek fare), pastry shops and the Greektown Casino. The famed Astoria Bakery, located on Monroe Street, serves up classic Greek pastries and desserts. Certain buildings in the neighborhood are designed to resemble the Parthenon and other classics of Greek architecture.

Counseling Today will continue to give members the inside dish on what to expect at the ACA Convention in Detroit (March 21-25, 2007) in the months to come. Remember to take advantage of the advance rate now through Feb. 15, 2007. Register online at, or call ACA Member Services at 800.347.6647 ext. 222.

Informing the PCP of client treatment

Robert J. Walsh and Norman C. Dasenbrook

Q: As a counselor in private practice, am I mandated to inform the client’s primary care physician of my treatment of the client?

A: The short answer is no, you are not required to inform the primary care physician (PCP) of your treatment of the client. However, you may be required to ask the client if you can inform the PCP; the client is empowered to consent or refuse. We recommend that a release of information for the PCP be embedded in your informed consent document. The client can then accept or decline the disclosure and “sign off” that you asked. We recommend this for a number of reasons.

First, if you are a participating provider in managed health care, most contracts require that you ask the client to inform the PCP of your treatment. It’s called coordination of treatment between you and the PCP. Whether the client consents or declines the disclosure, it needs to be documented in case your records are ever reviewed.

Second, your state’s practice law may require you to ask the client to inform the PCP. In Illinois, where we practice, we are mandated to ask and document in writing the client’s consent or refusal. So you need to check the practice laws in your state.

Third, if the client consents to the disclosure, it is an opportunity to market your practice to the physician. On average, physicians spend seven minutes with the patient per office visit. Physicians are always looking for mental health professionals to whom they can refer their patients. A short letter to the physician containing the diagnosis, treatment approach and your willingness to provide progress updates is most welcome. In addition to the letter, you can include business cards or a brochure. Some counselors follow up with a phone call. Physicians can be an excellent referral source. (For more on “cross-pollination” and expanding a referral base, see last month’s column.)

One final reason — it is the right thing to do. It is important that the PCP be aware of your treatment of the client, as it may affect how the PCP treats the client for other conditions. Counselors need to be seen by the medical community as the mental health provider of choice.

Q: Do we need to get a National Provider Identifier (NPI) number if we file our claims in the mail (not electronically)?

A: We have answered questions about the NPI before, but it is worth repeating since the deadline to use it is fast approaching. You should get the NPI even if you file insurance claims by mail. According to HIPAA rules, if you are a health care provider, the NPI is your standard unique identifier.

Obtaining your NPI is relatively easy to do. Go to and follow the directions.

Several American Counseling Association members have forwarded concerns to the Private Practice in Counseling column. A private company that handles billing for private practice counselors, ProMedical Billing of Chicago, originated the concerns. ProMedical Billing reports difficulty with many of the managed care and insurance companies. The issues they cite include:

1) Insurance companies have stopped using Social Security numbers and have assigned a special number found on

the insurance card. ProMedical reports that mental health insurance and managed care only accept a Social Security number.

We have found this to be true but in only a few companies. The answer: Collect both the insurance card ID number and the Social Security number. Always copy the insurance card and send it in with your HCFA billing. Copy and send the authorization letter (if there is one) with the bill as well. We have always received a notice of such changes from insurance companies. The more documentation you send with your bill, the better.

2) ProMedical reports that insurance and managed care companies have been changing telephone numbers and addresses without notifying the provider.

This was not true for any of the counselors that I have asked. The problem could be that a billing service is not getting this information if it goes directly to the provider. Any mergers or splits of managed care companies have been sent to me promptly with all change of information.

3) There is a report by ProMedical that it takes three calls to authorize benefits.

We find that most managed care and insurance companies have websites where authorization can be verified if the clinician has the information on the client and the insured as cited above. The larger insurance companies have automated touch or voice recognition systems that work well.

4) ProMedical writes that reimbursement rates are poor and that client co-pays are going up. We suggest that you contact the provider relations department, which is usually easy to do, and ask for higher reimbursement. Every time I have done so, I have been given a raise. Also check the ACA website ( for our list of 55 managed care and insurance companies, including direct hyperlinks to provider relations. The reimbursement rates are listed, so you can avoid the ones that pay poorly.

5) Another issue ProMedical reports is chronic denials.

This has not been a major problem for me, and several other counselors have verified my experience. Regardless, it’s always wise to have the informed consent document notify clients that they are responsible first for any payments, but you will, as a courtesy, bill their insurance or collect from the client and have them file the claim.

As a service to members, ACA also has a “three-part response” template of letters that can be used with denials. The clinician and the client send these letters. They can be found on the members-only section of ACA’s website under “Private Practice Pointers.”

We have worked on many of these problems over the years, and as part of the Private Practice Initiative, we invite you to enlist our help with any of these issues. We are here so you don’t have to reinvent the wheel.

We always encourage counselors to be persistent with managed care. Usually, once you solve a problem, you learn how to keep that problem from repeating itself. Managed care can be your friend, and contrary to some reports, it is getting easier and more user-friendly. I personally don’t believe that any of the major companies are involved in a “conspiracy” to defraud the public or us as providers.

Please send us your feedback on any of these issues via e-mail at If you are having difficulty, we want to know.

If you are going to Detroit to attend the ACA Convention in March, consider attending our preconference Learning Institute on private practice. Also stop by our booth, Walsh and Dasenbrook Consulting, at the Exposition Center and preview our book, The Complete Guide to Private Practice for Licensed Mental Health Professionals. We will also be in the Career Center throughout the conference. Hope to see you there!

Robert J. Walsh and Norman C. Dasenbrook are the co-authors of The Complete Guide to Private Practice for Licensed Mental Health Professionals ( ACA members can e-mail their questions to and access a series of “Private Practice Pointers” on the ACA website at Letters to the editor: