What Do Counselors Do?
by Bridget Nash
Where it all started:
There’s been some crazy sh*t happening recently in Michigan regarding counselors’ right to practice. I originally caught wind of it through a counselor networking group I’m a part of on Facebook. At first, I chalked it up to people overreacting. “They’re probably just blowing a rumor out of proportion,” I figured. Fast forward a few days to my husband and I traveling upstate to spend a few days with his family before the summer was over. Almost as soon as we arrived at our destination, I got one text message after another from the owner of our private practice ‘not wanting to alarm us,’ but wanting to ‘alert’ (read: “alarm”) us ‘to the situation. ((I love you, Paul. You’re awesome.))
The “situation”:
In Michigan, we have a licensing board called LARA. This organization reviews documents when you apply for a license to practice a given occupation (i.e. cosmetology, air quality purification, counseling, etc.) and determines if you’re eligible to receive the license you are pursuing. Every so often, rules about what qualifies someone to earn a license need to be updated to keep current with changes in the industry.
The rules for counseling had not been updated in quite some time because the basic structure of counseling (diagnose, write treatment plan, implement) has not changed much in the last 30 years since the most recent set of rules were established. A bill defining the scope of practice for counselors had been introduced about a year prior, but was squashed before it made its way into law. Strangely, I had never heard anything about it while I was in grad school. None of my professors mentioned it. I didn’t see it anywhere in news coverage or on social media. I had no idea so much contention existed over what counselors could do.
LARA decided—without any warning—that drastic alterations should be made that would ultimately leave licensed counselors with useless credentialing. The new rules would limit our scope of practice, taking away our ability to diagnose mental illnesses and use therapy techniques, despite a laughable lack of evidence to suggest that counselors are uneducated in these areas and unfit to do our jobs. Additionally, LARA’s proposed changes would put us in violation of our own ethical standards. If we cannot counsel because our Code of Ethics requires us to properly diagnose, create treatment plans, and use therapy techniques, yet LARA is trying to eliminate those skills from our scope of practice, our collective hands are tied. This would force more than 10,000 (according to LARA, there are10,536 licensed counselors in Michigan, https://www.bridgemi.com/michigan-health-watch/michigan-counselors-fighting-ban-right-diagnose-give-psychotherapy) counselors out of work, leaving an estimated 300,000 people without help form caring and qualified mental health practitioners.
Bear in mind I applied for my limited license for professional counseling in May of this year, FOUR MONTHS before the proposed changes began to surface. I spoke with LARA representatives on the phone multiple times about the status of my LLPC application (because I’m impatient) and never caught a whiff that they felt I was unqualified. Wouldn’t you think that if AN ENTIRE field of mental health practitioners were incompetent, they would have said something during our application processes?
Enter Representative Aaron Miller (to quote June OsborneFrom The Handmaiden’s Tale, “praise be”), who sponsored House Bill 4325 wherein the scope of practice for licensed professional counselors was outlined in detail and phrased modern language. Miller and several other representatives did some amazing work advocating for counselors and I will be forever grateful.
What we were instructed to do:
Thankfully, I was added to another amazing Facebook group. (Let me emphasize again, I FOUND OUT ABOUT ALL OF THIS AND HOW TO STOP IT THROUGH FACEBOOK. Not by communication from LARA, the state licensing body intending to make these changes.) Among other heroes for our cause were Napoleon Harrington, Paul Krauss, Bryan Nixon, Andy Brown, and Benjamin Lee. In this group, we were kept up to date with the progression of HB4325 and the ticking clock of LARA’s rule changes. We were instructed to write emails, make phone calls, show up at public hearings, and share every news story we could find talking about this issue. So I did.
In the process of spreading the word on Facebook (because apparently that’s how stuff gets done these days), I made the mistake of reading the comments on a particular local news article. I then realized, as the blood drained out of my face in the cortisol-disturbing blue light emanating from my phone screen at 2 a.m., that many people out there have no idea what counselors do.
Here are the facts:
Calley and Hawley (2009) wrote a great condensed fact sheet with education and credentialing requirements. The copy I had was quite old, so I took the time to transcribe it below for your edification and enjoyment. (Scroll to the bottom to read)
If you would rather watch me ramble through the highlights and give my own commentary, watch my YouTube video linked below!
And if you want an even more thorough explanation, check out Paul Krauss’ podcasts from September 18, and October 25, 2019. http://paulkrauss.podbean.com
So what happened?
Miraculously, HB4325 passed unanimously through the House of Representatives on October 8, unanimously through the Senate on October 17, and was signed into Michigan law by Governor Gretchen Whitmer on October 29, 2019.
The recap:
1. LARA acted like a coward. They tried to make changes without informing people and then lied about it in a shabby attempt to cover their butts.
2. Thousands of counselors across the state united together to save our jobs and the future of mental health care in Michigan. From what I heard, this was the biggest public groundswell over a house bill in recent history.
3. Counselors are educated appropriately. Counselors are tested to prove competency. Counselors are a necessity.
4. We WON.
October 17, 2019
Lansing, MI
The day HB4325 passed unanimously through the Senate.
Michigan Counseling Association
Licensure Committee
Licensed Professional Counselor Quick Fact Sheet
(Calley & Hawley, 2009)
Licensed Professional Counselor Defined
Master’s or doctoral-level mental health clinician specially trained in the assessment, treatment, and prevention of behavioral, emotional, and mental health issues and addiction.
LPC Licensure Requirements
· Hold a Master’s degree or a doctorate from a Board-approved academic program
· Possess a Limited License as a Professional Counselor (LLPC) and complete a minimum of 3,000 post-graduate clinical hours under the supervision of a fully licensed counselor (LPC) in no less than 2 years
· Successfully pass the National Counselor Examination
Michigan Law & Public Health Recognition of Licensed Professional Counselors
· Since 1988, Licensed Professional Counselors have been recognized in Michigan as mental health clinicians through the counselor licensure law
· The Michigan Counselor Licensure Law and the Administrative Rulesare the primary sources of guidance to understanding the scope of practice of professional counselors in Michigan
· LPC/LLPC’s are Qualified Mental Health Providers as authorized by the Michigan Department of Community Health and for the purposes of services provided through Medicaid
Scope of Practice-Brief
Licensed Professional Counselors’ scope of practice includes all of the following:
· Assessment, testing, and evaluation
· Individual, family, and group counseling and psychotherapy
· Diagnosis and treatment planning for mental and emotional disorders
· Prevention, behavior modification, and guidance to individual, families, and organizations
Section 333.18101of the MI Counselor Licensure Law:
Counseling principles, methods, or procedures means a developmental approach that systematically assists an individual through the application of any of the following procedures:
(i) Evaluation and appraisal techniques
(ii) Exploration alternative solutions
(iii) Developing and providing a counseling plan for mental and emotional development
(iv) Guidance
(v) Psychoeducation consulting
(vi) Learning theory
(vii) Individual and group techniques emphasizing prevention
(viii) Counseling techniques
(ix) Behavior modification techniques
Diagnosis
R338.1751, Rule 1 (f) of the Administrative Rules for Counseling defines counseling techniques:
Counseling techniques means the application of basic counseling and psychotherapy skills and theories in the counseling process in order to do all of the following:
(i) Establish and maintain the counseling relationship
(ii) Diagnose and identify the problem
(iii) Formulate a preventative, treatment, or rehabilitative plan
(iv) Facilitate appropriate interventions
Testing and Evaluation
Rule 338.1751 of the Administrative Rules for Counseling defines preparation for testing and evaluation procedures that include:
Group and individual psychometric theories and approaches to appraisal and diagnosis.
Selecting, administering, scoring, and interpreting instruments that are designed to assess all of the following with respect to the individual:
· Abilities
· Achievements
· Aptitudes
· Attitudes
· Interests
· Personal characteristics
· Factors that influence appraisals
· Use of appraisals and diagnostic results in helping processes
Qualifications for Use of Testing & Assessment Instruments
LPC’s typically qualify at the highest level of test evaluators for purchasing and using testing instruments. According to Pearson Assessments (2009), one of the largest publishers of clinical tests,
Tests with a C qualification require a high level of expertise in test interpretation, and can be purchased by individuals with Licensure or certification to practice in your state in a field related to the purchase OR a doctorate degrees in psychology, education, or closely related field with formal training in the ethical administration, scoring, and interpretation of clinical assessments related to the intended use of the assessment.
· Qualification levels are established by the publishing companies that hold the rights to testing instruments and therefore, are not partial to any one mental health profession.
· The National Fair Access Coalition on Testing (FACT) exists to protect fair access to testing by professionals with proper training and to stipulate a model Code of Ethics for testing practices.
Psychotherapy vs. Counseling
The term psychotherapy does not refer to any particular mental health profession, and within the counseling literature, the terms counseling and psychotherapy are used interchangeably to refer to the therapeutic process, with no differential of the terms. As such, the scope of practice for Licensed Professional Counselors includes both counselingand psychotherapy.
Insurance companies typically use the term psychotherapyfor reimbursement of services provided by mental health clinicians.
Academic Preparation of Licensed Professional Counselors
In accordance with CACREP (national accrediting body), academic preparation of Licensed Professional Counselors includes the following 8 core areas:
· Professional Orientation & Ethical Practice
· Human Growth & Development
· Helping Relationships
· Assessment
· Social & Cultural Diversity
· Career Development
· Group Work
· Research & Program Evaluation
In addition, counselors must complete a minimum of 700 supervised clinical practice hours that includes assessment, individual, and group counseling.
Limited Licensure Scope of Practice
There are no differences in the scope of practice between LLPC’s and LPC’s.
Availability and Access to LPC’s in Michigan
Because of the number and location of Licensed Professional Counselors in Michigan, individual in the need of mental health counseling and related activities can easily find a counselor.
· In 2009, there were 5,013 LPC’s/LLPC’s in Michigan (MI Board of Health Professions)
· In 2009, there were LPC’s/LLPC’s in all but 2 Michigan counties
