Tag Archives: advocate

Supporting transgender and gender-expansive youth

By Cortny Stark July 29, 2022

Transgender and gender-expansive (TGE) children and youth continue to experience marginalization, as institutions across the United States institute new oppressive policies that challenge and, in many cases, altogether prevent access to gender-affirming health care. TGE children and youth include young people between ages 3 and 17 whose gender identity is different from the sex designated at birth; the label “transgender” implies alignment with the gender binary (e.g., “I was designated female at birth and am a transgender man”), whereas gender-expansive identities do not align with the gender binary (e.g., “I was designated female at birth and am nonbinary — meaning that I am not a girl or boy”).

The realities of living as a TGE child or youth in today’s social, legal, educational and health-related environments are harrowing. Every day, new policies and legislation are introduced regarding TGE youth’s rights to access medically necessary gender-affirming health care, present as their authentic self at school, participate in extracurricular programs and sports, and have their appropriate name and pronouns honored in educational spaces.

As the parent of an incredible 12-year-old TGE child, my tolerance for the headlines is waning. I wake up each morning and check the latest news, and suddenly, I feel anxiety rising in my chest. I feel breathless and sick to my stomach. I have to put down my device and find a comforting television show or familiar rerun to watch before continuing with my day.

But we can do something about it. As helping professionals, we have an ethical obligation to support members of this community, as well as their caregivers and loved ones, and to advocate for dissolution of oppressive policies and legislation.

The current crisis

Despite over a decade of research and clear medical guidance supporting the efficacy of affirming social and medical interventions, several state and local governments across the United States have initiated anti-TGE legislation. In April 2022 alone, more than 20 pieces of legislation targeting the rights of TGE persons were introduced across the country.

On April 20, the Florida Department of Health released guidance on the treatment of gender dysphoria for children and adolescents, which states: “social gender transition should not be a treatment option for children or adolescents” and “anyone under 18 should not be prescribed puberty blockers or hormone therapy.” Alabama enacted a similar prohibition on affirming health care, but with more severe consequences for providers who violate the ban. The Vulnerable Child Compassion and Protection Act, which took effect May 8, states that health providers who provide gender-affirming puberty blockers or hormones will be charged with a Class C felony. Sanctions for violating the ban could include 10 years in prison or $15,000 in fines.


Standards of practice from the American Academy of Pediatrics and World Professional Association for Transgender Health, however, continue to support social and medical transition as a necessary option for the health and well-being for many TGE youth.

Earlier this year, Texas Attorney General Ken Paxton issued an opinion stating that gender-affirming medical interventions, referred to as “elective sex changes,” are part of a “novel trend” and “constitute child abuse.” The fact that this opinion equates gender-affirming care with “child abuse” is of particular importance for helping professionals because this means credentialed providers are legally obligated to notify child protective services within 48 hours of learning that a minor is receiving gender-affirming medical care.

Many families and caregivers of TGE youth in Texas are now unable to access medically necessary gender-affirming interventions, such as puberty blockers and hormone replacement therapy. In addition, major TGE advocacy organizations are encouraging families and caregivers of TGE youth to maintain a “safe folder” — a collection of documentation that debunks the “affirming care is abuse” myth. The folder includes “carry letters,” which are documents written by licensed counselors, helping professionals and/or pediatricians who have worked with the youth. These letters contain the professional’s credentials, their relationship to the youth, a statement from the American Academy of Pediatrics supporting gender-affirming medical interventions as evidence-based and best practice, and an overview of the youth’s gender identity development process.

A call for advocacy

I share these current events not to stir your compassion but to make a request: Please act and advocate for TGE youth. You can pursue positive change in whatever realm you hold power, privilege or space. As a professional, I wear many hats, including assistant professor, mental health and substance use counselor, rehabilitation counselor, training facilitator and advocate. These professional roles provide a space for me to channel my anxieties and distress over these recent oppressive policies targeting TGE youth and work toward positive change.

For me, advocating for this population serves as a source of nourishment and a way to derive meaning from what feels like hopeless circumstances, and I hope that engaging in this work may do the same for my colleagues. Here are some ways helping professionals can better support the advocacy efforts for the TGE community:

  • Use a humanistic lens when working with TGE children and youth and recognize the client as the expert on their own experience.
  • Get to know the standards of care and research regarding evidence-based care with TGE youth. And make sure the research you consume and the information you share with others all come from prominent and reliable scholarly sources.
  • Elevate the voices of TGE youth. If you work with this population, know what prominent TGE community organizations provide safe and brave spaces for TGE youth, and be prepared to share this information with your clients. If you facilitate trainings or educational opportunities for responsive and competent practice with the TGE community, and you yourself are not a member of this community, use panels of TGE folx to share their experiences and expertise.
  • Inform people that gender-affirming social and medical interventions are medically necessary and are a key component of suicide prevention. According to a 2009 report by Caitlin Ryan, the director of the Family Acceptance Project, TGE children experiencing caregiver or family rejection are more than eight times as likely to have attempted suicide and nearly six times as likely to report high levels of depression than TGE youth who were not or only slightly rejected by their parents and caregivers. This report also found that TGE youth who were in accepting homes, with caregivers who supported social and/or medical affirming interventions, had rates of anxiety, depression, and suicidal ideation and attempts similar to their cisgender peers.
  • Advocate with and on behalf of these youth in their living environments, schools and greater communities; this may include educating others about the role of affirming health care in preventing suicide and improving TGE youth’s overall health and well-being, testifying against oppressive anti-TGE legislation, or supporting affirming legislation.
  • Honor the history of TGE communities by acknowledging the role of colonization and historical trauma in the erasure of histories of gender diversity. Recognize the systemic influence of adverse experiences in health care, schools, the legal system and other institutions on TGE individual’s ability to trust institutions. This history along with the major influential events in the lesbian, gay, bisexual, transgender and queer (LGBTQ+) rights movement are key to understanding the intergenerational trauma and resilience of members of TGE communities.
  • Keep learning! Developing one’s ability to provide culturally responsive care requires lifelong education and reflective practice. Sign up for workshops and continuing education regarding serving TGE individuals. And join consultation and supervision groups that focus on providing care to this population.
  • Connect and advocate. Connect with a local TGE advocacy organization and volunteer to support their efforts; if time does not allow for this level of engagement, consider donating to these causes to support their advocacy work.

As LGBTQ+ advocate, actress and film producer Laverne Cox once stated, “Each and every one of us has the capacity to be an oppressor. I want to encourage each and everyone of us to interrogate how we might be an oppressor and how we might be able to become liberators for ourselves and for each other.” At this point in history, it is critical that we as helping professionals identify how our actions contribute to the oppression of our TGE clients and do better. The health and well-being of an entire generation of TGE youth need helping professionals who are willing to use their power and privilege to elevate their voices and serve as liberators.



Cortny Stark

Cortny Stark (she/her/hers) is an assistant professor and the substance use and recovery counseling program coordinator in the Department of Counseling and Human Services at the University of Colorado, Colorado Springs. She is also a telehealth therapist with the Trauma Treatment Center and Research Facility, where she provides trauma reprocessing and integration, clinical services for substance use and process addictions, and support for transgender and gender-expansive youth. Her research focuses on LGBTQQIA+ issues in counseling, integrative approaches to trauma reprocessing and integration, and substance use and recovery.


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.

Behind the Book: Counseling Leaders and Advocates: Strengthening the Future of the Profession

Compiled by Lindsey Phillips March 14, 2022

The future of the counseling profession depends on the leadership and advocacy of its current and future members. But what makes a good leader or advocate and what can clinicians learn from current counseling leaders?

Counseling Leaders & Advocates: Strengthening the Future of the Profession, an ACA-published book co-edited by Cassandra Storlie and Barbara Herlihy, explores these questions by examining the personal and professional experiences of prominent leaders and advocates in the field.

The profiled leaders in this book do not name a single leadership theory that guides their work, but as Storlie and Herlihy point out in the introduction, they all “speak of leadership as a process of empowering others and as an opportunity to advocate.” They don’t “espouse a traditional view of leadership as a power-over position,” they note, “rather, they speak of ‘leading from behind,’ working ‘behind the scenes,’ and ‘leading by doing,’ not for their own aggrandizement but to move our profession forward and improve services to our clients.”

The COVID-19 pandemic and systemic racism and injustices will continue to challenge leadership and advocacy. Storlie and Herlihy hope this book will encourage the next generation of leaders and advocates who, they argue, “must embrace the complex issues facing our clients, the profession as a whole, and our national and global societies if we are to advance and continue to distinguish excellence in professional counseling.”


Q+A: Counseling Leaders and Advocates: Strengthening the Future of the Profession

Responses are written by editors Storlie and Herlihy. Storlie is a licensed professional clinical counselor supervisor and an associate professor and doctoral program coordinator in the counselor education and supervision program at Kent State University. Herlihy is a professor in practice and doctoral program director in the counselor education program at the University of Texas at San Antonio as well as professor emeritus in the College of Education and Human Development at the University of New Orleans.


How are leadership and advocacy similar and how are they different?

As counselors, it is natural for us to consider ourselves advocates. We advocate for clients, groups, families and communities and on behalf of our profession. Advocates are driven by a passion to make positive change in the lives of their clients, in the systems that contribute to marginalization and oppression of clients and client populations, and in the profession for the purpose of increasing our capacity to reach and help those in need. Yet, many of us do not consider ourselves leaders.

Leadership and advocacy are inherently related, and advocacy initiatives taken on by counseling leaders affect our world today. Most importantly, leadership in counseling has been emphasized from the servant leader perspective (a phrase coined by Robert K. Greenleaf in 1970). The leaders profiled in our book did not view leadership as a power-over position. Instead, they saw it as leading by doing and working behind the scenes for the sake of moving the profession forward and improving client services. As such, one can deduce that leadership in counseling is ineffective when leadership practices move away from our core values as professional counselors. That said, if you are a leader in counseling, you are most likely an advocate. If you are an advocate in counseling, you are most likely a leader!


What qualities or personal characteristics are essential to being a good leader or advocate?

Taking information from the areas of servant leadership (Greenleaf, The Servant as Leader, 1970), authentic leadership (Bill George, Authentic Leadership: Rediscovering the Secrets to Creating Lasting Value, 2003) and transformational leadership (Ronald Piccolo and Jason Colquitt, “Transformational leadership and job behaviors: The mediating role of core job characteristics,” 2006) literature, good leaders and advocates share power and allow for space to include all voices. They are genuine, relational, ethical, motivating and inspirational. In addition, given the challenging times in which we are living, it is essential for leaders to be adaptive and to help others understand the complexities of their environment to better help people deal with change.


How does being culturally responsive change the way a counselor approaches leadership?

We don’t know where we are going if we don’t know where we have been. By striving for culturally responsive counseling leadership, we embark on a journey in which we voluntarily accept both the privilege and responsibility of intervening. Culturally responsive leaders will help our profession become stronger and more inclusive, representing more diverse voices and combatting systemic injustices. These leaders also examine how their intersectionality (a term coined by Kimberlé Crenshaw) affects others. They focus on challenging their worldviews to uncover unconscious bias and move forward reflectively to ameliorate barriers to inclusion.


Leadership does not always mean serving in formal positions (e.g., president of a counseling organization). What other ways can counselors be leaders and advocates within and outside the profession?

Formal leadership is just one of the ways you can be a leader and advocate in our profession. In Chapter 3 of the book, Michael Brubaker and Andrew Wood highlight previous scholars who have shown us the importance of developing advocacy dispositions, relationships and knowledge to set up and best execute and evaluate advocacy plans. These efforts can be conducted within the counseling profession or outside the profession. We also think it’s important to carefully select counseling sites or populations you work with and partnerships that allow you to best formulate your leadership and advocacy plans. Perhaps it’s partnering with a school district or joining a local National Alliance on Mental Illness (NAMI) group to better support the mental health needs of your community. There are myriad ways in which counselors can be leaders and advocates — and as we mentioned earlier, you probably already are!


What are some key takeaways from the stories of counseling leaders and advocates in the book?

Ahhh … key takeaways! Well, one thing that stood out for us is how many leaders have served as role models and mentors to others within the profession, and how deeply they appreciated their own mentors. Additional principles that were woven throughout their stories were having a vision for the future, encouraging and empowering others, recognizing the contributions of others, and engaging in self-reflection. We think it is also important to point out that each leader shared their own experiences of adversity that they overcame — showing us that these individuals, who have passion and purpose, also had to dig deep to gain resilience as leaders and advocates.


How do counselors overcome challenges and setbacks in their career and how does this shape the leader or advocate they become?

Of the leaders and advocates we profiled, each had their own unique challenges and setbacks. As Devon Romero, Madelyn Duffey and myself (Cassie) synthesized in Chapter 17, these leaders were “People who encountered doubt and persevered in the face of grief, loss, and adversity … [and] who made mistakes and desired to learn from them. …[This] adversity shaped who they are, how they lead, and what they value.”

One of the ways counselors can overcome challenges and setbacks in their career is to use their skill sets to be reflective about what they are experiencing. Both of us have reflected on setbacks in our own careers and found it helpful to explore what we have learned from the challenging experiences. If we can use a professional challenge to bring added value to our lives, then we are navigating our professional journey with perseverance.


What role do mentors and supervisors play in shaping new leaders and advocates in the profession?

Mentoring is crucial for the development of new leaders and advocates. Good mentors are those who make time to be available to their mentees (often throughout several decades), who convey a belief in these mentees when they don’t yet believe in themselves, and who open doors to provide opportunities to gain leadership and advocacy experience. Mentors can also be sponsors in that they are looking out for possibilities for their mentees when those mentees are not present.

We believe that being a good role model and truly modeling culturally responsive leadership can be a valued lesson for mentees. My (Cassie’s) mentors have been and still are culturally responsive leaders and open to growth in their own development as professionals and individuals.

The counselors profiled in the book spoke with gratitude of their own mentors, and they took pride in the mentoring they have provided to others over the years. Our current leaders and advocates have a strong commitment to “pay it forward,” which seems to make it inevitable that this commitment will transfer to the next generation and to generations to come.


What practical advice do you have for counselors as they move into leadership and advocacy positions in the counseling profession?

In the book, we offered five suggestions for aspiring leaders and advocates. First, find a mentor. Mentors can help you navigate your way toward gaining leadership experience and learning to advocate in ways that fit with your passions. Second, start small. Most of us have difficulty even imagining ourselves ever becoming as accomplished as the leaders and advocates profiled in the book. Rather than immobilize yourself with comparisons, realize that opportunities for leadership and advocacy are all around you, and volunteer for a small opportunity to serve a cause about which you care deeply. Third, keep your balance. This suggestion serves as a reminder of the importance of self-care and life-work balance. Fourth, lead to serve rather than acting out of a need to fill a line on one’s vita or to feel important. Servant leaders are absolutely the most effective leaders we have in our profession. Last, trust yourself. If someone sees something in you, it’s because it’s already there.


What is the most important or surprising lesson you have learned about leadership throughout your own counseling career?

For Barbara, it was the realization that leadership is composed of a set of behaviors rather than holding a formal title or position. Many, if not most, of our leaders and advocates are working behind the scenes, fostering change and furthering social justice initiatives without a need for recognition.

I (Cassie) second all that Barbara outlined above, and I also want to point out the important need to intentionally “pay it forward” and help to mentor others’ leadership development.


What does being a leader mean in today’s social climate, especially considering the ongoing COVID-19 pandemic and social unrest?

That is an excellent question! In the current political and social climate, a starting point for bringing people together in peace is for us to use our basic counseling skills such as listening — really listening — in an attempt to understand beliefs and values that clash with our own. We counselors have the skills to build bridges!

We also need to ensure we can have the crucial conversations necessary to help make sustainable change. We recognize this change does not happen overnight, but we also realize that change will never happen if we don’t talk about uncomfortable topics and honor the human dignity of everyone.


What practical actions can leaders take to combat systemic injustices and racism in the counseling profession and society at large?

We believe that silence in the face of injustice and racism is collusion. Leaders who are in the privileged position of being respected and admired have an obligation to speak up and confront injustice and prejudice, both within our profession and in the larger world. Although practical actions may look different at the microsystem level versus the macrosystem level, counselors can tailor their actions to advocate with and on behalf of those most marginalized. Additional actions can be further developed when integrating the Multicultural and Social Justice Counseling Competencies into one’s work.


In the book, you call on the counseling profession “to nurture, mentor, and increase diversity among future leaders.” How can the counseling profession address the lack of diversity within counseling leaders moving forward?

One thing we can do is to monitor our own implicit biases as we identify up-and-coming leaders who might benefit from opportunities to join with us in the work we are doing. We can also remember that diversity involves the intersection of multiple identities, not just those that are visible. Many of the leaders profiled in the book were aware of their privilege and were committed to ensuring they were inclusive as they were “paying it forward.”



Counseling Leaders & Advocates: Strengthening the Future of the Profession was published by the American Counseling Association in 2021. It is available both in print and as an e-book at counseling.org/store or by calling 800-298-2276.

Watch ACA President S. Kent Butler’s conversation with Cassandra Storlie in a recent episode of the “Voice of Counseling” video podcast: https://youtu.be/157o_3QrHwk



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 as agents of change

By Laurie Meyers July 19, 2021

Bernadine Craft was the only female senator during her time in the Wyoming legislature. Photo courtesy of Bernadine Craft.

Counselors speak for the least, the lost and the lonely, says American Counseling Association member Bernadine Craft. That advocacy, she believes, should extend beyond office and classroom walls.

Craft has worn many professional “hats,” including former school counselor, licensed professional counselor, volunteer lobbyist, former Wyoming state legislator and ordained Episcopal priest, and she reflects on her innate passion for advocacy and the path to policymaking that started with her involvement in ACA governance.

A counselor takes the stage

Craft’s journey as an advocate began on the stage, so to speak. “I started out as a piano performance major, but I figured out that they didn’t eat so well,” she jokes. So, she switched her undergraduate major to speech and theatre with the intent of getting her teaching certification and continuing on to graduate school.

A chance conversation with the director of one of the plays Craft performed in set her on a course to become a counselor. Knowing that Craft had set her sights on a master’s degree, the director asked her what her area of study would be.

“I have no idea,” Craft told him. And he replied, “I think you should go into psychology. I think you’d make a hell of a counselor — you interact so well with people.”

Although psychology did intrigue her at the time, she wanted to work in a school setting. Craft’s director suggested she take a few classes to see if she liked it. The more Craft thought about it, the more the idea appealed to her. She loved talking — and listening — to people, so she took some psychology courses and ended up loving it. Craft went on to get her master’s in educational psychology and became a school counselor.

Speaking up

While working as a school counselor, Craft became active in ACA at the regional level as chair of the Western Region and president of the Wyoming Counseling Association, where she found her passion for advocacy in the push for counseling licensure. She also served on the Governing Council as president of the Association of Humanistic Counseling. Craft credits her training in speech and theatre as well as her experience on her high school debate team for giving her the confidence to campaign so passionately.

“I wasn’t afraid to speak in front of others,” she says.

Craft decided to continue her education by earning a doctorate in professional psychology. At first, she intended to become a counselor educator, but a severe illness kept her from pursing this career path. Instead, she maintained her private practice and started lobbying for educational issues as a volunteer. In 2004, Craft became the executive director of the Sweetwater Board of Cooperative Educational Services, an educational co-op created between Western Wyoming Community College and Sweetwater County School Districts 1 and 2 to provide educational services not otherwise available to community members.

Working for Wyoming

In 2006, in a move Craft describes as “out of the blue,” a former schoolmate approached her about filling an upcoming vacancy in the Wyoming legislature.

“I responded almost exactly the way I would have responded if someone had said they wanted me to run down the street nude,” Craft says. Although she’d always been interested in current affairs and advocating for issues that she cared about, the thought of running for political office had never occurred to her. Craft’s friends and colleagues urged her to run because they saw something special in her. It took a long time for her to decide, but in the end, Craft realized that if she didn’t do it, she would spend the rest of her life wondering what it would have been like.

“I decided to be the voice of the voiceless,” she says. “Big lobby groups can make their voice heard because they have the money.”

Craft was particularly passionate about women’s rights and the protection of children and animals. During her time in the Wyoming House of Representatives (in 2006) and later as the only woman serving in the Wyoming Senate (from 2013 to 2017), Craft helped sponsor bills such as the 2011 Wyoming Safe Homes Act, which allows people who are experiencing sexual or intimate violence to break their leases without penalty. She also worked to protect survivors of intimate violence and helped make strangulation a felony in Wyoming.

Counselors as natural advocates

Craft ran as a Democrat, but during her ten years as a legislator, she was able to hammer out agreements with her colleagues on both sides of the aisle. She believes that counselors are uniquely qualified to build consensus.

“Counselors are particularly good at listening [and] seeing both sides of issues,” she points out. They’re also good at going beyond binary thinking, or as Craft puts it, “not falling into the pit of black and white-ism.”

“I wish more counselors would consider elected office,” Craft says. People go into counseling because they care about people and want to make life better for them in whatever way they can, so she asks, “Who better to advocate for ‘the average citizen’ than counselors?”

“Granted, not everyone is comfortable running for office,” she acknowledges. “Not everyone is comfortable standing up speaking, but I bet you are comfortable identifying someone who is.”

There are other ways counselors can engage in political advocacy. Craft notes that everything she accomplished was through the help of an “army” of people who sent out emails, made phone calls, knocked on doors and coordinated mailings.

Legislators also need people to research, she says. Craft and a colleague who was a women’s studies professor worked together on legislation involving human trafficking, which is a broad and complex topic, she notes. The colleague’s aides were invaluable when it came to doing background research, Craft recalls.

“If you’re interested and really do want to be an advocate at some level, don’t let anything stop you,” she urges. “What can you do in your hometown? I think you can find a niche at whatever level you’re comfortable with, whether it be local, state or national.”

Craft notes that people often think that if they can’t make a big and splashy effort, they can’t do anything at all. But there are so many things counselors can do that will still move issues forward. Even two hours a week researching or contacting legislators can go a long way, she says.

“Don’t say, ‘I don’t have any time; [I] don’t have any money,’” Craft advises. “Don’t do the big stuff. Do what you can at the level you can.”

Craft is pictured at the Wyoming capitol building sitting at the feet of another pioneering Wyoming woman, Esther Hobart Morris, the first woman to hold judicial office in the modern world. Photo courtesy of Bernadine Craft.



On March 11, Bernadine Craft was a featured speaker for Mapping a Courageous Leadership Journey, a professional development webinar cosponsored by ACA and She Should Run.



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


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.

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.



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.


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.”




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



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.