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Professional advocacy: A call to the profession

By the ACA Advocacy Task Force June 3, 2020

This past year, American Counseling Association President Heather Trepal commissioned a task force to focus on the topic of professional advocacy. This article is part of our response to that charge.

In this article, we discuss professional advocacy and its importance; ways that counselors can advocate; how ACA has advocated for the profession; what all counseling associations can do to support an advocacy agenda; what individual counselors can do to be advocates; and the important role that a clear, unified counselor identity plays in furthering a professional advocacy agenda.

Professional advocacy and its importance

Professional counselor advocacy involves taking action to promote the profession, with an emphasis on removing or minimizing barriers to counselors’ ability to provide services. Although advocacy as a whole has become increasingly relevant over the past two decades, efforts related to professional advocacy have received less attention and therefore made little headway in comparison with client and social issues advocacy.

Counseling is a mission-based profession, meaning that we each had a reason for choosing this career. There was someone we wanted to serve, or some setting or client population for which we wanted to make a difference. All counselors have felt called to be agents of change. In fact, our ethics codes and professional competencies mandate that we advocate for and alongside our clients.

That being said, when we consider advocacy, we do not often think about our mission for our profession. Concerns such as parity (being reimbursed at the same rate as other mental health professionals with comparable training), public recognition, accurate representation of our profession, and employment opportunities are important if we are to practice our craft. We must know and promote our worth and recognize that if we are not strong and healthy as a profession, we cannot help others. Therefore, professional advocacy must be a top priority for all counselors.

Examples of professional advocacy

Advocacy activities serve to expand counselors’ presence at the community, state and national levels, and counselors should not underestimate the importance of supporting the growth of the profession through actions taken in their local communities. In addition, professional advocacy activities include those aimed at positively promoting the counseling profession.

Larger-scale advocacy actions could be conceptualized as capital “A” advocacy actions, whereas smaller-scale advocacy efforts could be called lowercase “a” advocacy actions. For example, “A” advocacy actions might encompass large, organized efforts such as those aimed at changing federal or state legislation or local policies and practices. They can include teaching and supervising students through setting standards, developing competencies and applying ethics. They are our shared responsibility to unite our voices.

Examples of “a” advocacy actions include those continuous, in-the-moment efforts that positively promote the counseling profession. These efforts may generate positive cultural change regarding counseling, help-seeking or what it means to be a counselor. These efforts can also include mentoring our next generation of professionals.

An important point is that neither “A” nor “a” advocacy actions are more or less important. Both types are needed, and we all have our role to play in professional advocacy efforts.

Today, counselors face myriad barriers to providing care to students, clients and communities. These barriers include the Medicare coverage gap, lack of licensure portability, inadequate funding for mental health treatment across settings, inadequate funding for school counselors, and a lack of public knowledge about counseling as a profession. In addition, the rising cost of graduate education often leaves professional counselors across all settings struggling to pay back student loans years after degree completion.

Each of the aforementioned barriers makes it difficult for counselors to provide care to the people and communities that need them most. For example, if an older adult whose primary insurance is Medicare cannot access the services of a licensed professional counselor, then their options to receive services become limited. When a counselor crosses state lines and cannot work in their new community, it is unjust to both the counselor and the community, especially because there is a nationwide shortage of counselors. Inadequate funding of counseling services means that counselors are not compensated appropriately and that clients cannot access services critical to their well-being. Inadequate student-to-school counselor ratios harm both students and school counselors. In each example, counselors, clients and communities are negatively affected by barriers at the sociopolitical level that prevent counselors from doing their jobs.

What ACA does to advocate for the profession

As an organization dedicated to the counseling profession, ACA has advocacy at the core of its mission. ACA staff, leadership, task forces and committee members work to raise awareness about the profession and support legislation that helps counselors serve myriad communities. By advocating for recognition, compensation and resources, ACA helps counselors continue to perform integral work.

Guided by its 2018-2021 strategic plan and framework, ACA’s advocacy efforts on behalf of the profession involve both legislative and nonlegislative means. For example, ACA continues to advocate for seamless portability across states for independently licensed counselors. To support counselors, ACA recently funded an initiative to pursue an interstate compact for portability. The advisory board for the compact brings together lawmakers, licensing board members, counseling professionals and others to work on advocating for licensure portability.

ACA also employs a team of government affairs and public policy staff members dedicated to advocating with federal, state and local governments on the legislative front to support the profession. These staff members’ efforts, along with those of other counseling organizations and individuals, helped counselors become eligible to provide services through the Department of Veterans Affairs (VA). ACA continues to advocate for more employment opportunities for licensed professional mental health counselors within the VA. ACA also uses an electronic legislative advocacy alert system that all counselors should sign up to receive; by clicking on a link, you can quickly advocate for the profession.

As part of its focus on advocacy, ACA has formed multiple member-led groups to identify the needs of counselors, raise awareness of what counselors do and how they impact communities, expand employment opportunities for new professionals, educate on professional development, and provide information to help counselors advocate for the profession and meet the needs of clients. By harnessing the passion, vision and energy of its members, ACA is invested in training counselors to advocate for the profession, educate the public and promote the needs of counselors and those they serve.

ACA is also working hard to raise awareness of the importance of good mental health. One significant example is ACA’s role in developing Counseling Awareness Month activities. This past April, the Counseling Awareness Month theme encouraged counselors to #BurnBrightNotOut. ACA introduced a Counseling Awareness Month toolkit containing social media resources, fact sheets, contests and sample proclamations that members could use to encourage leaders and governing bodies to recognize counselors and the profession. In addition, ACA promoted Teal Day on April 10. This was a day for counselors to wear the symbolic color of teal to promote the profession. According to the toolkit, “As an outward symbol of advocacy and hope for counselors and the profession, ACA created Teal Day: an enthusiastic social initiative designed to build strong support, recognition and appreciation for professional counselors.”

Suggestions for the profession

Through leadership and advocacy efforts, we have made great strides as a profession in establishing ourselves as vital to the mental health landscape. United, our advocacy efforts have made an impact on critical issues such as insurance reimbursement parity, licensure in all states, and increased consumer awareness of counseling and its value. All of these efforts are vital to our profession and ultimately make a positive impact on the wellness of our clients and communities.

Nevertheless, our profession continues to face threats, so we must never take these successes for granted. Instead, we must double down on our efforts to fortify the health and wellness of the profession moving forward. Ample opportunities exist for growth around professional advocacy initiatives.

One way we can further develop our advocacy efforts is by institutionalizing advocacy supports and structures within counseling organizations. For example, this may include establishing and maintaining an ACA committee, with multiorganizational representation, that focuses solely on the advocacy needs of the profession. ACA, Chi Sigma Iota (CSI), the National Board for Certified Counselors (NBCC), state branches, ACA divisions and other counseling organizations could also build within their structures an advocacy mentoring program. That way, those who have successfully engaged in advocacy efforts — whether legislative, organizational or community advocacy — could share their experiences and pay it forward so that a greater number of counselors would be well prepared to engage in advocacy efforts.

Counseling associations might also create a listing of local “advocacy leaders” as a resource for those facing advocacy challenges and needs in their workplaces or communities. Having the support of a colleague is sometimes all that is needed to encourage a counselor to engage in professional advocacy and help them navigate their way through such efforts. Within and across counseling organizations, spaces can be created for counselors to discuss, connect, consult and get support around advocacy needs.

Collaboration between or within counseling organizations may also provide opportunities for expanding existing advocacy efforts. For example, CSI currently publishes “Heroes and Heroines” interviews on its website, highlighting the lifetime work of highly established counselors who possess a depth of advocacy experience. Three times per year in its online newsletter, the Exemplar, CSI also publishes “Advocacy Agent” interviews with members currently engaged in advocacy efforts. Working together, ACA and CSI could bring these advocacy efforts to an even greater number of individuals through a collaborative advocacy-centric newsletter. Jointly, the organizations could also expand the audience of such efforts through social media, where they could also collaboratively broadcast important advocacy issues, needs and required action.

Furthermore, ACA and CSI members could collaboratively review and offer feedback on revised CACREP standards during the open-comment period to ensure that the standards reflect current and evolving real-world professional leadership and advocacy needs.

Finally, ACA can enhance cross collaboration among ACA divisions and branches by setting up regularly scheduled briefings in which division leaders share advocacy challenges and successes and gather support. One current example is an effort by ACA’s government affairs and public policy staff to host a monthly Advocacy Power Hour with state branch leaders.

Counselors should also engage in interprofessional advocacy. By identifying community partners and potential collaborators, we become stronger and can move more efficiently toward reaching our professional goals.

We are aware that many counselors struggle with understanding how to effectively advocate; they want to help but do not know where to begin. Thus, another way the profession can promote advocacy is through education, both on advocacy directly and on the leadership skills needed to engage in advocacy.

CACREP requires counseling programs to address leadership development. However, training on leadership is not often visible in master’s-level curricula, nor is it prominent in doctoral curricula. Intentional efforts to increase such education is vital.

This leadership and advocacy education can be accomplished in many ways. One means of ensuring that counselors are well armed to engage in advocacy is by making existing leadership and advocacy resources readily accessible. The ACA Conference offers a prime opportunity to promote advocacy education through advocacy-focused educational tracks; an advocacy booth in which resources, networking and support are offered; a keynote speaker focused on advocacy (perhaps with a legislative collaborator); special sessions in which legislators can share and demystify their experiences of working with counselors; and specialized preconference sessions that offer advocacy training.

ACA can further bolster advocacy education through the creation and promotion of short how-to advocacy videos. These videos could focus on inspirational stories of advocacy efforts, with details of how the advocacy got started and what was accomplished. Other videos might fortify our collective professional identity by effectively communicating who we are as a profession and highlighting how we are distinct from other mental health fields. This would help every counselor maintain their pride in the profession.

Additionally, professional associations and organizations could provide webinars on leadership and advocacy to their respective members. They could also create toolkits for counselor educators so that leadership and advocacy training are better represented in master’s and doctoral education.

Advocacy education could also be promoted via Counseling Today, the Journal of Counseling & Development, ACA division journals and other professional literature. These publications could offer dedicated space for featuring research and best practices in leadership and advocacy. Through collaborative, comprehensive, consistent and intentional efforts, counselors can continue to be empowered and united in our efforts to promote the profession, which in turn promotes the wellness and dignity of those in the communities in which we serve.

Suggestions for counselors

Professional counseling organization advocacy is just one piece of the puzzle. The counseling profession never would have evolved if not for the work of individual counselors, and nowhere is that as obvious as with regard to legislative advocacy. Generally speaking, legislators care most about what their constituents think. In fact, individual counselors working in unison with their legislators have facilitated the bulk of the legislative changes that impact our practice.

Each of us has a story to tell about how the law either helps or hinders our work as counselors. Rather than accepting that we have to do our best in a broken system, we must identify barriers that others may perceive to be immovable givens. Sometimes this means taking up the fight — a process that can feel foreign and intimidating, but it is important if we are to thrive.

A simple place for counselors to start is to analyze our social networks and the relationship resources in our own backyards. Who are the power brokers you may already know who can serve as cheerleaders for your cause? Take time to reach out strategically and build relationships. Find reasons to contact a member of your board of education, your religious leaders, a state legislator or your public health administrator. Support efforts in your local community that are consistent with your values, regardless of whether those efforts are directly related to your role as a counselor. For example, counselors can send emails or make calls to support a bill to increase funding for preventing human trafficking or for increasing resources for responding to community crises.

Become visible, and make your presence known. These relationships can be crucial, sometimes in unexpected ways, when you need to advocate for the counseling profession or for the students or clients you serve. When it matters most and when efficiency is essential, those lines of communication will already be open. A counselor constituent might reach out to that one lawmaker who will take up the cause and become a policy champion, thereby influencing others to join the effort. That one lawmaker may determine whether a great idea eventually becomes a law. In sum, individual relationships and networking count. 

Unfortunately, upstream factors such as funding, bureaucracy and scarce resources may cause social services and other constituencies to compete against each other. It is often said that those who are not at the table will not be able to eat. Speaking out about what you or your clients need, either as an individual or, ideally, with your ACA branch or division, and establishing a place at the decision-making table can lead to changes that positively affect the lives of individual clients.

Indeed, such advocacy can also make your work much easier, more efficient and more effective. Counselors should consider how various state or federal government agencies either support or challenge the work of professional counselors. Are there job descriptions and real opportunities for counselors to be employed in the broad variety of settings where other mental health disciplines are already accepted or embraced? Are there loan forgiveness programs that need to include counselors? The need for counselors to be integrated into the VA system and Medicare reimbursement are examples of significant challenges. A natural response to these injustices and barriers to people getting access to care is to become angry or frustrated. Individual counselors who connect with this frustration can use it as momentum to courageously enter unfamiliar territory, including the legislative world.

State counselor practice acts and the licensure boards that enact these laws play an extremely important role in the landscape of our profession. It is helpful for counselors to develop relationships with their licensure board members. Sign up for their email alerts, and take any opportunity you can to forge relationships with them. Attend their meetings if they are public. Seek appointment to serve on the board. Let them know what you need and where you see counselors and consumers struggling. Then encourage others to do the same. Licensure board members are public servants tasked with protecting the public, and many of the issues with which our profession struggles have a significant impact on consumers. Similarly, school counselors can forge connections with their state board of education members.

Professional counselors can help policymakers, members of their local communities and members of their social networks better understand the importance of counseling and the benefit we bring to our clients and communities. Making sure that the power brokers in your respective areas and social circles are aware of counselors’ value is an important task. We know that counseling services help our clients and students to feel supported, reduce their stress and anxiety, and increase their daily functioning. Transferring this knowledge to others is important.

Helping others understand the impact of our work and the ripple effect that counselors have on their communities ultimately influences the profession in various ways. Increasing awareness of counseling’s value can help reduce stigma associated with mental illness and mental health issues. When others understand that 1 in 4 people are living with a mental illness and that our work as professional counselors aids in creating positive change, we can more effectively decrease stigma in our communities. When mental illness is destigmatized, people who need counseling and support are more likely to seek that help in pursuit of living more fulfilling lives.

The importance of a strong counselor identity

A foundational element of effective professional advocacy is a clear professional identity. Unless we know who we are, we cannot communicate that message to stakeholders. ACA, CSI, NBCC, CACREP and other professional counseling organizations have helped to steer counselors toward a shared professional identity. Development of the ACA Code of Ethics, support of CACREP educational and training standards, and the adoption of competencies set forth by ACA divisions are among the ways our profession has worked to define and support counselor identity.

The public’s lack of knowledge about counseling as a profession is an additional barrier to services and is intrinsically tied to legislative barriers. Legislators may not have enough knowledge about professional counseling to make laws that create equitable access across professions or for all clients. Similarly, when managed care companies are not aware of the valuable care that professional counselors can provide, we may be inadequately reimbursed. Even potential and current clients may be unaware of the unique professional identities of counselors and thus misunderstand or undervalue our services. It is critical that we educate the public, including lawmakers, on who we are and what we do.

We work in an increasingly interdisciplinary world. Thus, counselors must work to expand public knowledge and awareness about the services, skills and training provided by professional counselors. As suggested by Stephanie Burns in a 2017 article in the Journal of Counselor Leadership and Advocacy, every counselor should have a one-minute professional identity “elevator speech” that they can share with others. Such a speech can succinctly communicate who we are and what we do to support public understanding of our work.

Some practice settings require counselors to work alongside other mental health professionals under titles such as caseworker or therapist. Similarly, clients may be called consumers or patients depending on the setting. It is important for counselors to use the word “counseling.” When able, counselors should refer to themselves as counselors, not as therapists or guidance counselors, and be clear about who they are as unique helping professionals.

We cannot expect to thrive in an interdisciplinary world if the public does not understand who we are. Educating the public about important issues related to mental health and well-being continues to be an essential role of counselors.

In summary, the counseling profession has come a long way, but we still have work to do. Counselors continue to experience many barriers that get in the way of our ability to practice. All counselors, and all of our professional associations and organizations, have an obligation to commit to and work toward advocacy efforts that will grow our profession.

 

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ACA Advocacy Task Force members who contributed to the development of this article were (in alphabetical order) Angie Cartwright, Madelyn Duffey, Louisa Foss, Cheryl Fulton, Denise Hooks, Victoria Kress, Christine McAllister and Jordan Westcott. Direct questions or comments regarding this article to task force chair Victoria Kress at victoriaEkress@gmail.com.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Michigan LPCs block attempt to take away their right to practice

By Laurie Meyers January 16, 2020

Your voice matters. Those who doubt the power of speaking out and advocating for the profession need only look to the counselors of Michigan. This fall, approximately 10,000 licensed professional counselors (LPCs) participated in a grassroots campaign that thwarted an attempt to take away their ability to practice.

On Friday, Sept. 13 — some would say an appropriately ominous date — Michigan’s Department of Licensing and Regulatory Affairs (LARA) released a notice of public hearing for comments on proposed changes to the state rules that define the scope of practice for LPCs. The notice served as confirmation that despite the objections of the state’s board of counseling and months of protest from local advocates, LARA was moving forward with its plan not only to change, but also to repeal, virtually all of the previous rules governing scope of practice. Most critically, the proposed changes would repeal LPCs’ practice of “counseling techniques” and ability to “diagnose and identify the problem.” In other words, LARA intended to strip away Michigan LPCs’ rights to diagnose clients and practice psychotherapy.

Absent this ability to diagnose, neither counselors nor clients would be able to seek insurance reimbursement — a devastating blow to practitioners. But the damage wouldn’t stop there. LARA’s proposed repeals would have threatened the very existence of the counseling profession in Michigan by taking away LPCs’ right to provide psychotherapy. How do counselors who can’t counsel practice? The answer: They don’t.

“The ramifications [if LARA was successful] would’ve been that 10,000 counselors would be unable to practice legally,” says Michael Joy, president of the Michigan Counseling Association (MCA). “They essentially would have lost their jobs.”

Joy, a member of the American Counseling Association and an LPC in private practice, adds that LARA’s repeal would have also left up to 150,000 clients in the lurch. With their counselors unable to practice, clients would have needed to seek treatment from other therapists. Because most of Michigan’s mental health practitioners are already carrying heavy caseloads, the search could have taken months, during which time these clients would not have been receiving help, Joy continues. This rupture in the continuity of mental health care would have been a significant therapeutic setback and could have potentially endangered clients’ well-being, he asserts. Those with more acute symptoms might even have needed hospitalization, he says.

LARA’s interest in changing the scope of practice rules for LPCs in Michigan is not new. Many veteran counselor advocates had been bracing for an official proposal for years and were working on several fronts in hopes of preventing a crisis. Although advocates attempted to work with LARA, the Michigan Mental Health Counselors Association (MMHCA) —a former division of MCA —initiated a backup line of defense by engaging a lobbyist and appealing to the state Legislature.

In March 2019, House Bill 4325 was introduced in the Michigan Legislature. Its aim was to create a statute updating the scope of practice and licensing requirements for LPCs, thus ensuring that counselors would retain their ability to diagnose and treat clients. HB 4325 would supersede LARA’s proposed changes. The bill had strong bipartisan support and was steadily making its way through the Michigan Legislature, but there were questions about whether it would pass in time.

The clock was ticking — loudly.

“Really, no one exactly knew that the trigger was going to be pulled until there was that public announcement [from LARA], and so then, the madness actually began,” explains Stephanie T. Burns, an LPC in both Michigan and Ohio and an active member of ACA, MCA and MMHCA. “LARA had made their proposals, and the Michigan Board of Counseling at that point had unanimously vetoed all the changes and, in response to that, the powers that be at LARA decided to just go ahead and put them forward anyway …”

If LARA was not swayed by the comments and testimony given at the public hearing in October, the repeal of the counselors’ scope of practice could have become effective as early as November. Michigan LPCs needed to fight hard and fast for their jobs. And they did.

A groundswell of advocacy was triggered as news of LARA’s plan spread. MCA sent out a distress signal to the American Counseling Association (ACA), whose government affairs team swung into motion. Brian Banks, ACA’s director of public policy and intergovernmental affairs, began strategizing with MCA to formulate a plan. ACA sent out a VoterVoice email alert — which guides subscribers through the process of contacting legislative representatives on federal and state issues — to its members in Michigan. The ACA government affairs team expanded the call to action by posting advocacy alerts targeting all Michigan counselors on Twitter and Facebook. ACA also reached out to the Michigan branch of the National Association of Social Workers, the Michigan Primary Care Association and the national offices of the National Alliance for Mental Illness and the American Federation of State, County and Municipal Employees. MCA began circulating a petition and lining up members who were ready to testify at the LARA hearing to the countless clients they had helped and the lives they believed they had a hand in saving. MMHCA also urged members to testify at the hearing in person if possible or, if not, to email their written testimony to LARA before Oct. 4.

In the meantime, Burns, an associate professor of counselor education at Western Michigan University, began spreading the word among alumni and colleagues about the threat to all LPCs and the urgent need to contact LARA and state legislators. In addition to engaging in her own advocacy work, Burns teaches her students how to advocate effectively, so she had already formulated action steps and language — posted as a template on MMHCA’s website — for email and letter appeals.

Thousands of counselors responded to the call to action ahead of the hearing, pelting LARA with protests and urging their representatives to move forward and approve HB 4325. And on Oct. 4, counselors bombarded the hearing. In fact, the turnout exceeded the venue’s fire code restrictions, so not everyone who showed up was able to come inside, according to Joy.

Banks attended the hearing to present ACA’s testimony, written by Chief Executive Officer Richard Yep.

“ACA wants to support our members and the profession at the highest level,” Banks says. “Being in Michigan to support the profession was a vital step in showing LARA and the Legislature how important these issues are.”

ACA’s statement emphasized the critical role that LPCs play in providing mental health and drug abuse treatment to the residents of Michigan. Preventing counselors from treating clients would greatly exacerbate the shortage of mental health providers, particularly in rural areas of the state. In addition, LARA’s actions would have created a violation of ACA’s code of ethics, which requires that counselors make a proper diagnosis before providing treatment.

Burns also focused on the ACA Code of Ethics in her written messaging and when meeting with the Michigan Senate Health Policy Committee. She specifically referenced the part of the ethics code that says professional counselors cannot abandon or neglect their clients. “I said [to the committee], ‘LARA will be responsible in that moment for causing harm — serious harm — to our clients.’”

In the end, the combined efforts of MCA, MMHCA, ACA and — most importantly — thousands of counselors from across the state paid off. In October, both houses of the Michigan Legislature voted unanimously to pass HB 4325. On Oct. 29, the bill was signed into law by Gov. Gretchen Whitmer.

Burns and Joy both praised ACA for its assistance, in particular noting its decision to send Banks to testify in person at the hearing rather than merely submitting the statement from afar. Joy adds that the knowledge he gained at ACA’s Institute for Leadership Training helped him to form an effective course of action for MCA.

“Michigan is a perfect example of how grassroots advocacy works when effectively organized,” says Banks, adding that the campaign was one of the strongest he’s seen in his 20 years in the field.

Sometimes it takes a Michigan-sized crisis to spur large-scale grassroots efforts. But Burns and Banks urge counselors not to wait. The profession is facing numerous critical issues — such as the fight for Medicare reimbursement. Lawmakers and regulatory officials will make decisions about the profession with or without counselors’ input, Banks emphasizes.

“We have to have a seat at the table.”

 

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Laurie Meyers is senior writer at Counseling Today. Contact her at LMeyers@counseling.org

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Human rights 101, Part 2: Implications for graduate students and counselor education programs

By Clark D. Ausloos and Taylor Nelson December 2, 2019

Part one of our two-part series provided a foundation of the importance of human rights, the relevance to professional counseling, and practical strategies to use when working with clients who have experienced human rights violations. Part two focuses on human rights, social justice and advocacy related to counseling graduate students and counselor education programs.

Many people enter the counseling profession because they have a desire to help people. They have a knack for listening and possess a genuine curiosity for the human condition. Many students have a passion for mending, repairing and supporting others towards self-actualization. In many introductory graduate classes, students explore the foundations of the counseling profession, learning about psychotherapy pioneers such as Sigmund Freud, Carl Jung, Alfred Adler, Frank Parsons, and Carl Rogers, and learn necessary basic skills in order to best help clients.

However, graduate students are not often given clear direction on how to execute one essential ethical mandate dictated in the ACA Code of Ethics: to “advocate at individual, group, institutional, and societal levels to address barriers and obstacles that inhibit access and/or the growth and development of clients” (A.7.a). Advocacy can seem confusing and challenging to graduate students – some might even think: I didn’t become a counselor to engage in advocacy. Many graduate students are unclear as to the multifaceted roles that counselors have, including the component of advocacy as it relates to human rights issues. This lack of clarity is not unfounded  –  professional counselors often lack consensus on how best to advocate for and on behalf of their clients’ human rights.

Multiculturalism, social justice and human rights

Counseling is a young profession and has seen many developments throughout the years. Starting in the late 1980s, professional counselors saw a need for attention to diversity in clinical and educational settings. Increasingly, counselors were diagnosing and treating individuals who differed culturally from themselves. Therefore, the needs of the profession shifted, however slowly, to meet the needs of consumers. At that time, scholarship focused on racial and ethnic identities in counseling, and mainly examined the relationship between a professional counselor’s ethnocultural identity and that of the client. In the 1990s, Garry Walz and colleagues identified significant trends that should inform future counseling, including developing skills in counseling older adults, counseling family systems, a commitment to multiculturalism, and most salient to this article, the development of advocacy skills.

In 1992, ACA’s first Multicultural Counseling Competencies (MCC) were developed for professional counseling. Becoming competent in multicultural counseling would require counselors to not only understand and honor the diverse customs of different cultures but to recognize the additional barriers many client groups faced. Meeting the needs of disadvantaged clients would require not just knowledge, but action. In 1998, the American Counseling Association (ACA) formed a new division — Counselors for Social Justice (CSJ)— to implement social action strategies aimed at the empowerment of clients and oppressed individuals and groups. With the increasing awareness that social justice concerns must take a prominent role in the profession, the need for individual counselors to gain competency became clear. Because social justice and multicultural issues are inherently linked, the competencies were incorporated into an adapted version of the MCC in 2015, creating the Multicultural and Social Justice Counseling Competencies (MSJCC). At the same time awareness of the importance of advocacy—both for the profession itself and for counselors’ work with clients—was growing and became a focus for ACA leaders. A task force was created to develop advocacy competencies. The ACA Advocacy Competencies were completed in 2003 to provide guidance for counselor advocacy at the micro (e.g., clients, students), meso (e.g., communities, organizations), and macro (e.g. to reflect the profession’s growing understanding of the use of advocacy with clients and their communities and were updated in 2018.

Still, with all of this information, graduate students may be left wondering, “what exactly does this mean for me?”

As mentioned in part one of our series, human rights are civil, political and/or cultural rights that are afforded to humans regardless of our intersecting identities. When these rights of our clients are violated, there are tremendous mental health repercussions. Counselors-in-training need to understand the complexities of human rights issues, when and how these rights are violated, and the ways they can engage in advocacy around these issues.

There is a clear connection between social justice, advocacy and human rights. At times, social justice can be combined with advocacy, creating social justice advocacy, which can be described as organized efforts aimed at influencing sociopolitical outcomes, often with or on behalf of vulnerable, marginalized populations. Whether direct system intervention or collaborative advocacy with clients or client groups, counselors-in-training and practicing counselors need to be able to conceptualize and execute advocacy and social justice strategies to mitigate health disparities caused by human rights violations.

The impact of human rights on graduate students

Beginning counseling students are asked to reflect upon their own worldviews and to begin to form a framework from which they will work with clients – a theoretical orientation. It is likely that human rights issues have, in some way, affected students’ lives prior to entering graduate school.

Tracy, for example, is a graduate student who has encountered societal barriers due to their non-binary gender identity (non-binary denotes a gender identity that is not defined in terms of the traditional binary of male or female). Tracy has faced discrimination in schools, was forced to use a bathroom that was not congruent with their identity and has encountered challenges with changing their gender marker on legal documents. This pattern of harassment and obstruction has not only impeded Tracy’s pursuit of their right to a quality education—it has threatened their personal safety. As a counselor in training, Tracy’s worldview and the way they approach counseling will be directly affected by these violations of their human rights.

In contrast, Anthony is a counseling graduate student with numerous identities. As a White, heterosexual, cisgender male, Anthony has experienced very few human rights violations. Yet human rights issues have already had an effect on Anthony’s worldview and theoretical orientation. Because Anthony has not experienced discrimination due to gender identity or sexual orientation, has not experienced poverty, harsh criminal sentencing and does not face obstacles related to legal documents or using public restrooms, his understanding of the relationship between human rights and counseling will be markedly different than Tracy’s.

These two examples demonstrate that when students begin their counselor training, their views on human rights issues have already been shaped by their experiences. A student who has not experienced violations has potentially started to develop a worldview that may not include an understanding of human rights issues. In contrast, a student who has experienced violations not only has an understanding of human rights issues but has been shaped by the difficulties they faced. These divergent experiences will affect the students’ training and may have a significant influence on their work as professional counselors. Thus, it is essential to intentionally address these issues in graduate school.

Learning the effectiveness of clinical interventions in counseling sessions is an established and vital part of graduate students’ training. However, it is equally imperative that counselors-in-training learn how effective—and necessary—it is to work with clients in varying groups and levels, such as families, groups, and at the community or other systemic level. Using a social justice and advocacy approach allows counselors to empower marginalized clients while also working to change the existing external environments for the clients.

For example, as a counselor-in-training, Anthony may work with a 14-year old bisexual, transgender person of color who has experienced time in the criminal justice system. To provide effective counseling, Anthony not only needs to know information about the current justice system, youth under the law, gender, sexuality and racial and ethnic identities and how this impacts his clients health, but also ways to systemically advocate with and on behalf of this client, as an essential part of ethical treatment and attention to social justice.

Anthony can get this critical information by using resources such as Human Rights Watch, an international organization which investigates and reports on human rights-related violations around the world lists several current human rights concerns on their website: Harsh criminal sentencing, racial disparities, drug policy and policing, children in the criminal justice systems, hate crimes, rights of non-citizens, sexual orientation and gender identity, women’ and girls’ rights, and national security, among others.

Human rights and counselor education programs

In many counselor education programs, human rights issues are often introduced in multicultural and diversity courses, as well as in courses that teach about ethical and legal issues within counseling. However, this is not enough. Additional training is needed but is unlikely to be available to students because most education programs do not offer elective courses in human rights issues. It is often the responsibility of course instructors to take the lead by incorporating human rights issues throughout coursework.

Sufficiently educating students on human rights issues will require curricula and systemic change and will also require counselor educators to self-reflect and understand how human rights issues shaped their own worldview, which will, in turn, affect their work with students. If instructors model silence surrounding these issues, students may graduate from counselor education programs lacking the human rights knowledge that is critical to their work as professional counselors. Counselor educators need to teach students that any reflection on the factors that have shaped their worldview is incomplete without examining human rights issues. The extent of the effect of human rights issues on individuals is evident by examining the significant difference in the lived experiences of Anthony and Tracy.

Although scholarly research plays a part in any graduate program, the expectations for master’s level counseling students are different than those in doctoral programs. Some master’s programs may not assign regular research projects to students. In contrast, doctoral students undertake rigorous research into clinical counseling practices and improvement in counselor education and training. Because human rights issues play an important role in these topics, students are likely to encounter clear examples of violations. For example, research examining the counseling experiences of single mothers of color in poverty might explore systemic barriers and oppression these people face, which are direct violations of human rights.

By not giving students significant exposure to research, counselor education programs are missing an opportunity for counselor trainees to be exposed to human rights issues. The old adage “meet clients where they are at” provides a helpful framework for understanding the need to integrate human rights issues into counseling programs. As part of their training, counseling students provide services to a client base that includes members of society who regularly experience human rights violations. Without an understanding of the myriad forms human rights violations can take (see part one of this series for examples) and an awareness of which populations regularly experience issues—and the physical and mental health damage caused—counselors-in-training will be ill-equipped to meet the needs of their clients.

When counselor education programs minimize or outright ignore human rights concepts in students’ training, they could potentially be causing potential harm to future clients. Nonmaleficence — avoiding actions that cause harm — is one of the fundamental ethical principles of counseling set out in the ACA Code of Ethics preamble. Intentionally infusing social justice advocacy and human rights components into the array of coursework will benefit graduate students’ self-efficacy, their clients, and, ultimately, society at large.

 

In the following section, we provide several strategies for graduate students, counselor educators, and counselor education programs to attend to human rights issues and incorporate advocacy and social justice strategies into the classroom:

For graduate students:

  • Mitigate imposter syndrome related to advocacy by managing self-talk, reflecting on accomplishments, normalizing with other graduate students, and practicing self-grace and compassion.
  • Call, text, email, or write to local, state and national legislative representatives on issues that directly impact human rights issues.
  • Engage in continuous self-assessment related to your own advocacy and social justice competency, by using advocacy competency self-assessment tools and surveys.
  • Conduct research that relates to human rights issues and propose/present it at local, regional, and national counseling conferences.
  • Develop and update a list of local, regional, state, and national resources for clients who experience human rights violations.

For counselor education programs and educators:

  • Foster intentional discussions about current human rights issues throughout all areas of counselor training, in addition to diversity, lifespan, and legal/ethical courses.
  • Integrate human rights issues into case studies and clinical examples so graduate students can experience “real world” examples of clients in training programs, prior to practicum and internship experiences.
  • Co-construct specific advocacy and social justice plans as part of coursework that allows graduate students an opportunity to actively participate in these strategies outside of their practicum or internship counseling sessions.
  • Structure clinical experiences that allow students to work with diverse clients and settings. One way to do this might be to work with the program’s clinical coordinator to ensure practicum and internship sites are varied and, if possible, host a variety of clients with a variety of presenting issues.
  • Teach human rights violation assessment as part of a comprehensive biopsychosocial diagnostic evaluation.
  • Allow guest speakers who have experienced human rights violations in the classroom. The personal stories of people who have lived through human rights violations provide a more vivid and compelling understanding than a lecture containing abstract examples. Mentor and model students in research that relates to human rights issues and empower them to propose/present it at local, regional and national counseling conferences.

 

Counselor education programs can also expand outside awareness of human rights issues in a variety of ways:

  • Create statements (with university permission) of support or resolutions that can increase the visibility of and address barriers to human rights issues.
  • Host “days of awareness,” with various human rights topics addressed on different days through flyers, posters or with guest speakers via workshops or panels.
  • Partner with other departments, when possible, in order to cast a wider net of influence and awareness of human rights issues.

 

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Clark D. Ausloos is a doctoral candidate at the University of Toledo. He is a licensed school counselor and currently practices as a licensed professional counselor in a private practice setting in Northwest Ohio. Contact him at clark.ausloos@utoledo.edu.

Ausloos was a member of the American Counseling Association’s Human Rights Committee, as were the authors of the first article in this series.

Taylor M. Nelson is a second-year doctoral student at the University of Toledo. She is a licensed professional counselor in Ohio, working in an inpatient psychiatric hospital setting. Contact her at Taylor.Nelson2@rockets.utoledo.edu.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Counselors, represent!

By Carol Z.A. McGinnis November 13, 2019

Tragic events tend to mobilize local and national news reports with questions and concerns that relate directly to the work that we do as professional counselors. Shootings, disasters, immigration issues, and political fallout are just a few examples that come to mind at the time of this writing.

What is particularly troubling to me is the lack of counseling expertise represented in the news in response to these events. Instead, we often endure ad hoc theories from professionals with no counseling experience who errantly connect tragic events to mental health issues. These individuals may mean well, but they make broad statements that connect video games with shootings, promote mental health policy that is rooted in subjective ambivalent “right” versus “wrong” societal thinking (rather than empirical research), and engage in ignorant blaming or scapegoating that leads to even more conflict and mental strife for the general population. What better time for licensed professional counselors to provide empirical context for these issues and offer hope for healing when it is needed most?

At the same time, I think we can largely blame ourselves as counselors for this gap in the national consciousness. We have fantastic representation in our state and national counseling associations and plenty of empirical research on topics of interest, yet we are not insistent on providing that content to our communities. As counselors, we have been trained to advocate through appropriate channels that include citizen-driven activities to challenge federal and state legislation, yet we have not learned how to promote our profession in the times we are most needed. Alfred Adler and Carl Rogers both held a global vision for our profession that included change and advocacy for the community at large. So, where do we start?

As a whole, the general public would find it useful to know a little more about what we do as professional counselors. People need to know that we are trained to probe more deeply about family dynamics, to inquire about the presence of guns and the use of prescription or illegal drugs, and to listen for evidence of strained relationships that may need immediate attention. We need to share that we have expertise in evaluating suicidal thoughts and potential homicidal intentions and that we often determine neglect or abuse for mandated reporting. People often worry about the ramifications of going to a counselor; our presence in the news media can go a long way toward easing those concerns.

After a tragic event occurs, these basic counselor skills can be invaluable for parents worried about their teenagers, spouses concerned about the safety of their mate, and adult children fretting about the welfare of their elderly parents. We can provide confidentiality that may be just the ticket when social concerns, political stressors, and environmental issues seem to be ever-present. As professional counselors, we are qualified to share insights on what symptoms to look for in a troubled family member, what signs might be particularly worrisome when a child withdraws, and how to find help when a particular mental health issue is occurring. It is information such as this that often seems to be lacking when the larger community is hurting.

 

Action steps

You may be asking: What can I do? Here are a few suggestions to get started.

First, take a moment to consider your particular skills and expertise. Do you work with people who struggle with depression? What information could you share publicly that might help others to cope, have hope, or seek help from a professional counselor? Alternatively, if your experience is with anxiety, what compassionate message might you share for people who are afraid to go to the mall or to the movies? If you work with people through illness or grief and loss, consider what messages you might be able to offer when the community at large is suffering with a particular loss. As a licensed professional counselor, you have knowledge, awareness and skills that would be tremendously useful in times of strife. It is just a matter of getting that content “out there” in the public.

Next, consider how you may want to advertise your availability to news outlets and the general public. One way to do this is to write an email or a letter to your local news station to identify yourself and the work that you do. Be brief in your communication, pointing to the specific issue or circumstance for which you may be most helpful. Include a business card or a link to a website if you have one. This is not the time to expound on your many research interests or on why you became a counselor. Be concise, clear and direct in describing what you specialize in so that news outlets can easily place you into a resource category.

It helps tremendously to have a professional Facebook, Twitter, Instagram or LinkedIn account that can connect your expertise to an active news media database or digital rolodex. Give some time and attention to this virtual representation to ensure that you are abiding by the ACA Code of Ethics. Consider locking down your settings to avoid inadvertent negligence on the part of potential clients who may try to direct message you. As stated in Standard H.6.a. in the ACA Code of Ethics, it is important to maintain a professional virtual presence that is separate from your personal presence online. It may be tempting to connect your professional site to your personal account, but resist this temptation.

Your professionally oriented social media sites should be designed to help local and national news media locate you should a specific need arise. Likewise, make it easy for the general public to find pertinent information on your credentials, expertise, and research interests. These details should clearly inform the general public about counseling and the specific work that you do, with special attention given to technology/social media competency (Standard H.1.a.) and your social media policy (Standard H.6.b.). Note how you may be of assistance to the community and the means for contacting you as a news source. Be sure to “friend” or “follow” all pertinent news outlets and local organizations that may need your help, and then take time to keep up with any interactions that occur with these entities.

Also, take a moment to consider what populations or groups in your area might especially appreciate a free workshop or presentation on the topic in which you specialize. Advocacy often begins in your local area, and people are more likely to ask questions about the counseling profession when they have the opportunity to get to know you better. Churches, synagogues and mosques tend to be places where disheartened and disenfranchised people go to get support. Offering to discuss your services in these places can open up new opportunities for the general public to understand what you do. Public clubs, parent groups, and schools may also grant you the opportunity to speak on a specific topic. Once these populations have the opportunity to learn about your work, they can also advocate for inclusion of a counseling perspective from their news sources.

If someone is searching for you in your area of practice, how will they find you? Psychology Today offers a “find a therapist” option that is helpful to the general public, but it incurs a monthly fee that some counselors may find distasteful. Another option to consider is starting a podcast, blog or streaming channel to bring your professional identity into the public eye. Although these options take time and energy, the results can include bringing your expertise to the consciousness of your immediate community. The creation of a website can also be useful as a less dynamic online platform where these other social media delivery systems can be “housed” in a central location. A unique domain for this purpose can be purchased and maintained with minimal cost and low effort. Community websites that provide free postings for mental health professionals at the county or city level can also be helpful. You may need to dig to find these, but they do exist.

Finally, don’t be shy about introducing yourself as a professional counselor when you are “off duty” and, if possible, take time to volunteer for an Advocacy Day sponsored by most state branches of the American Counseling Association. There are very helpful tips and tools located on the ACA website that provide direction on how to interact with local, state and national legislators, and steps for developing ethical social media sites. Another useful suggestion is to include a pertinent hashtag with your counselor postings (e.g., #CounselorsAdvocate) that can bring attention to that topic. Be creative in using hashtags that are specific to your knowledge, awareness and skills (e.g., #counselorforanger, #askacounselor, #counselinganxiety, #counselorgriefandloss). Connect with similarly named social media groups, and offer your availability in times of community tragedy.

In short, when tragic or troubling events occur, take a moment to think about your own skills, and then reach out to offer your perspective as a professional counselor to the news media. We often hear about the impact of public happenings in clients’ counseling sessions and may feel that we cannot act outside of that environment without sacrificing client trust. But there is a way to do this in an ethical manner. Remember, we don’t have to “take sides” on a controversial topic to provide much-needed positive messages to our communities. It may take courage for us to make this happen, but it is important for us to promote what we do as counselors when the people in our communities need it most.

 

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Carol Z.A. McGinnis is a licensed clinical professional counselor, national certified counselor and board certified telemental health provider. She is associate professor and clinical mental health track coordinator for Messiah College in Mechanicsburg, Pennsylvania. She is currently president-elect of the Maryland Counseling Association and specializes in research that focuses on anger processing (www.anger.works) and videogaming. Contact her at cmcginnis@messiah.edu.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

ACA advocates for Medicare bill on Capitol Hill

By Bethany Bray July 20, 2017

ACA leaders gather for a day of advocacy on Capitol Hill on July 18. (Photo by Paul Sakuma)

A bill that would allow professional counselors to be reimbursed for the treatment of clients under Medicare has been introduced in the House of Representatives, and more than 100 counseling professionals added to its momentum by advocating in person on Capitol Hill earlier this week in an event organized by the American Counseling Association (ACA).

Currently, Medicare does not reimburse licensed professional counselors (LPCs) for the treatment they provide for older adults who carry this federal insurance coverage. However, ACA is advocating for a bill that would add LPCs to the list of providers who can be reimbursed under Medicare – a list that already includes clinical social workers and marriage and family therapists. H.R. 3032 was introduced last month by Rep. John Katko (R-N.Y.) in the House of Representatives, and a companion Senate bill is expected to be introduced shortly by Sen. John Barrasso (R-Wyo.) and co-sponsored by Sen. Debbie Stabenow (D-Mich.).

H.R. 3032 currently has three co-sponsors: Reps. Mike Thompson (D-Calif.), Elise Stefanik (R-N.Y.) and Zoe Lofgren (D-Calif.). If passed, the measure would add an estimated 165,000 mental health providers to the Medicare network, providing much-needed access to care for older adults in the United States.

On July 18, 125 ACA members from across the United States visited the Capitol Hill offices of their senators and House representatives to ask for support for the Medicare bill. The counselors were gathered in Washington, D.C., for ACA’s annual Institute for Leadership Training (ILT), a four-day conference of education sessions, trainings and business meetings for leaders in the counseling profession.

“In the United States, exercising our First Amendment rights under the Constitution is vitally important to ensure that we have a strong and responsive government,” said ACA Director of Government Affairs Art Terrazas. “I am so happy that we were able to help ACA leaders from across the country meet and speak with their federal lawmakers about the needs of the counseling profession.”

Amanda DeDiego, an ACA member from Casper, Wyoming, talks with Sen. John Barrasso (R-Wyo.) in his Capitol Hill office. (Photo by Bethany Bray)

Amanda DeDiego, an ACA member from Casper, Wyoming, met with Sen. Barrasso to thank him for his upcoming sponsorship of the Medicare bill. Barrasso expressed his support for the issue, saying “the needs are great” in Wyoming. For example, the average life expectancy on Native American reservations is 47 years – decades below that of Wyoming’s general population – and issues related to mental health are part of the cause, Barrasso said.

A delegation from the American Counseling Association of New York (ACA-NY) met with staff in the office of Sen. Kirsten Gillibrand (D-N.Y.) to ask for co-sponsorship of the bill that Barrasso soon will introduce in the Senate.

ACA-NY leaders Summer Reiner, Allison Parry-Gurak and Tiphanie Gonzalez (ACA-NY president) explained that LPCs have training and graduate coursework that is equal to or exceeding that of the social workers and other mental health practitioners currently covered under Medicare. In the rural parts of New York, a dearth of mental health providers already exists, and that number shrinks further for people who rely on Medicare coverage for treatment, Reiner explained.

“There’s a huge need,” said Reiner, an associate professor at the State University of New York (SUNY) in Brockport and ACA-NY past president. “There are more than enough clients to go around, and we all have a different perspective for a reason.”

“We’re very much cousins in the exact same family, with different specialties,” agreed Gonzalez, an assistant professor at SUNY Oswego.

ACA members who visited legislative offices on July 18 also advocated for full funding of the Title Four block grant as part of the Every Student Succeeds Act (ESSA). The grants, some of which goes to support school counseling programs, were funded at $400 million, or just 25 percent of the $1.6 billion that was authorized this year. President Trump’s proposed budget for 2018 recommends no funding for the block grant at all.

Terrazas, in a training session held prior to the Day on the Hill event, urged the assembled ACA leaders to follow up with their legislators, stay informed and continue pushing for issues that are vital to the counseling profession.

“Advocacy doesn’t start and end with just this day [on Capitol Hill] tomorrow; it is year-round,” said Terrazas.

 

ACA members from Louisiana speak with staff in the office of Congressman Steve Scalise (R-La.) on July 18. (Photo by Bethany Bray)

 

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By the numbers: ACA Day on the Hill 2017

125 ACA members from 37 states, plus the District of Columbia, U.S. Virgin Islands and Puerto Rico, visited 74 Senate offices and 95 House offices

ACA President Gerard Lawson also met with

  • James Paluskiewicz, staff, House Committee on Energy and Commerce
  • Nick Uehlecke, staff, House Committee on Ways and Means
  • Allison Steil, deputy chief of staff, U.S. House Speaker Paul Ryan (R-Wis.)
  • Wendell Primus, office of House Minority Leader Nancy Pelosi (D-Calif.)

 

Cynthia Goehring and Sarah Shortbull, ACA members from South Dakota, met with Sen. John Thune (R-S.D.) on July 18. (Photo by Paul Sakuma)

 

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ACA awards Murray, Lieu

ACA has recognized Rep. Ted Lieu (D-Calif.) and Sen. Patty Murray (D-Wash.) with an Illumination Award for their work against harmful conversion therapy. Lieu and Murray have introduced bills in the House and Senate, respectively, that would classify commercial conversion therapy and advertising that claims to change sexual orientation and gender identity as fraud.

An ACA delegation met Murray on July 18 to recognize her on Capitol Hill; Lieu was previously honored at last month’s Illuminate symposium, a three-day conference in Washington, D.C., focused on the intersection of counseling and lesbian, gay, bisexual, transgender, questioning or queer (LGBTQ) issues.

Sen. Patty Murray (center left, in grey suit) is given an ACA Illumination Award on July 18 by ACA Past President Catherine Roland, current ACA President Gerard Lawson and ACA President-elect Simone Lambert, along with ACA members from Washington state. (Photo by Paul Sakuma)

 

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To stay up-to-date on the Medicare bill and other current issues, sign up for updates from ACA Government Affairs at counseling.org/news/aca-blogs/aca-government-affairs-blog

 

Search for the hashtag #ACAILT2017 for social media posts from ILT and the Day on the Hill

 

See more photos on the ACA flickr page: flickr.com/photos/23682700@N04/albums/72157686345016025

 

A delegation from the American Counseling Association of New York (left to right) Tiphanie Gonzalez (ACA-NY president), Summer Reiner and Allison Parry-Gurak met with staff in the office of Sen. Kirsten Gillibrand (D-N.Y.) to ask for cosponsorship of the Medicare bill that Sen. Barrasso will soon introduce in the Senate. (Photo by Bethany Bray)

 

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

 

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