My travels recently took me to Malaysia, a beautiful country with an incredibly diverse culture and perhaps the happiest, most resilient and fun-loving people I have ever had the privilege of meeting. As I learned about the status of counseling and how it has evolved there over the past 20 years, I felt like I had fallen through the looking glass and emerged from the rabbit hole into an upside-down world. You see, in Malaysia there is no licensure for psychologists or social workers — only for counselors. The Malaysian government passed the 1997 Counsellors Act, a title and practice act for professional counselors, to help address mental health and other societal issues. Given that I was a counselor and advocate who helped fight the licensure and assessment wars in the United States, imagine my surprise when psychologists approached me to solicit support for psychology licensure in Malaysia! I politely declined.
Malaysia’s top-down, national counselor law accomplished in one fell swoop what it took us more than 30 years to accomplish in the United States — licensure in every state. I was more than a bit envious. The experience made me reflect on the continuing struggles we are encountering at home. In the United States, it is each state’s right and responsibility to determine how best to protect the public through licensure regulations. The American Counseling Association championed counselor licensure initiatives in all 50 states, plus U.S. territories, and finally made this goal a reality within the past few years. But several unintended consequences have resulted, including widely varying licensure requirements — 36-60 graduate credits, 1,500-4,500 training hours and various required exams — from state to state. With such disparate, unstandardized licensure requirements, it has become a challenge to achieve three critical professional issues: a) licensure portability, b) unification of the counseling profession and c) convincing insurance and governmental entities that all counselors from different states are equivalently trained for clinical practice. ACA is a membership organization, and we advocate for employment opportunities for all of our members. Our position is that states determine a counselor’s required level of qualification for licensure or certification — regardless of how diverse those requirements have become.
Recently, the U.S. government has created a great deal of concern and consternation for many counselors and counselors-in-training. The Department of Defense and the Department of Veterans Affairs have made decisions that place counselor education and training provisions into regulations that are at the high end of the qualification continuum. These regulations also are likely to soon influence proposed Medicare laws and regulations that would allow counselors to provide mental health services independently.
In 2005, to address the license portability and professional identity issues, and in anticipation of the federal standards issue, ACA and the American Association of State Counseling Boards initiated 20/20: A Vision for the Future of Counseling, a consortium of 31 counseling organizations charged with charting a course for the profession. The organizations participating in 20/20 have already reached consensus on seven unifying principles and the definition of counseling — two components critical to our shared professional identity, regardless of practice specialty. Now we are squarely focused on the building blocks to licensure portability, which will allow counselors from one state to transfer their licenses to practice in another state without having to jump through a new set of qualification hoops. The major stumbling block is the widely disparate licensure qualifications that currently exist. To practice in any state, a professional counselor must qualify under the laws existing in that particular state. Obviously, to achieve reciprocity and portability, some states are going to need to change qualification laws and regulations. It is unlikely that those states on the higher end of the continuum are going to lower their standards.
Working collaboratively, the 20/20 delegates are attempting to reach consensus on a model licensure title, educational requirements and scope of practice that counseling advocates can use to change and better standardize state licensure laws. The 20/20 delegates already have gained consensus on the title licensed professional counselor, which currently appears in the laws of more than half of the states. The Scope of Practice Work Group and the Education Standards Work Group have completed their subgroup reports, and soon the full 20/20 delegation will take up these final two building blocks. It is our goal to reach consensus on the scope and education provisions at our meeting in Cincinnati in March during the ACA 2013 Conference and to conclude the work of this important consortium. After that meeting, the governing boards of all 31 counseling organizations will decide whether to endorse the proposals.
Without a doubt, the products of this endeavor will not be universally popular. Anytime standards are increased and the bar is raised, some will feel left out despite best efforts to be inclusive and to provide ample transition time and provisions. But I encourage each of you to consider that where we are as a profession today is a far different place than where we were as a profession 30, 50 or 100 years ago. As we progress and reach consensus on important issues, the landscape shifts and new possibilities, initiatives and opportunities emerge and evolve.
The 20/20 initiative was conceived to envision what we wanted the counseling profession to look like in the years beyond 2020. The ideas generated from this effort are just the next evolution of our profession, an opportunity to embrace change and truly practice what we preach to our clients and students — that we are all in the process of becoming, striving to become better people and better professionals. A more standardized approach to how we prepare professional counselors in the future will help us raise the bar of professional practice, better protect the public, and realize our mutual goals of portability and parity with other mental health disciplines.
Throughout this process I have heard some colleagues say, “But how we are training our counselors is already good enough!” My grandmother had a saying: “Good is the enemy of best, and best is the enemy of better.” Where would we be today as a profession if we still trained our students according to the standards of 1960? Change is inevitable, but growth is optional. Raising the bar is good for the public — and for professional counselors.