By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.
What is a Licensed Counselor?
I wrote this in response to a question from U. K. on how our mental health system works. It has since occurred to me that one major difference between the U. S. system and those in other countries is the funding source. When you have a national health care system most of the expenditures are paid for by the government so if you get on the list and can provide services or you work for the government you get paid. The government can have some amount of control over quality.
Here in the U. S. most service is paid for by the individual directly or indirectly through the purchase of insurance. No money or insurance and you may get no services. This requires the government to regulate who can open an office and then sell medical or psychological services.
We have a licensing system for most professions so that just anyone does not open up an office and then start doing surgeries which kill people before they get sued and have to stop. The point of licensing is to control entry into a profession and ensure some minimum level of consumer protection.
Here then is the somewhat edited version of my reply to her question about how we do things in the American Mental health system.
Thanks for the comment. Interesting question. It had not occurred to me that there might be such differences on the U.K. Now I am thinking that given the number of readers of counselorssoapbox.com from countries other than the U. S.
Most of this has to do with our legal and governmental system. Not being either a lawyer or a politician. (We do not have separate Barristers and Solicitors but combined most of what they do into one group – lawyers who are also called Attorneys, and sometimes counselors in the sense of legal counselors.)
This whole area is a bit complicated.
Regulation of professions is left to what we call states. Each of the 50 states may have their own law or some may not require a license to practice a particular profession. So in one of our states if you graduate from a school with a degree in counseling you may be able to open an office and charge people for counseling. In another, there may be strict regulations on the quality of your degree, your internship and your experience under another professional before you can get a license. If a state has high standards other states may accept that license. People who come from states with no or low standards will find that if they move to a state with high standards their background may not allow them to practice that profession. For example, if you became a doctor in a third world country many U. S. states will require that person to do more work and take more tests before they can become a doctor in that state. The big states like New York and California generally have the highest standards.
(With the health care expansion this year the ability to bill federal programs may alter this thinking a bit.)
In California, we have 29 separate codes and the one of those that regulates counselors and other professionals is called the “Business and Professions Code (BPC.)”
In the BPC there are sections for each regulated profession. Contractors have a section, hairdressers and so on. Doctors and nurses have their own section also.
In the mental health field in California, we recognize a number of professions.
Psychiatrists are licensed as Medical Doctors.
Psychologists are licensed by the board of psychology
The Department of Health Care Services, Alcohol and Drug Programs licenses drug and alcohol programs but not drug counselors. So the programs have a set of standards on who they can hire.
The Board of Behavioral Sciences licenses Clinical Social Workers, Marriage and Family Therapists and Professional Clinical Counselors.
Without a state-issued license, you may not practice a profession except in a few places specifically listed in the law as “exempt settings.” (Schools can hire school counselors who do not have to be licensed.)
The goal of this procedure is to protect the public from people who do not have the training and skills doing work that might harm or cheat the client. This process also gives clients some redress for wrongs short of a suit in court.
The law sets out the specific things you need to do to be issued a license. And each profession has their separate list of the things they can do and the requirements to qualify to do those things.
A Professional Clinical Counselor would need to possess a Bachelor’s degree (4 years), in most any subject, or take some remedial classes called prerequisites, to enter a masters in counseling program. They would then need to complete and graduate from an accredited or approved Master’s program (5th and 6th-year college.)
After graduation, that person must register with the Board of Behavioral Science (BBS) who evaluated the education they have and if it meets the board’s requirement the candidate receives an intern number.
From this point on the prospective counselor is required to be supervised by a licensed person until they receive their own license.
They must accumulate a total of 3,000 hours of supervised experience. There are some complicated rules on what counts and what doesn’t count and how much supervision they need for each hour of client contact.
When they have accumulated those supervised hours, the applicant submits the paperwork to BBS and if this is approved they are eligible to test. In my own experience, I took first a long test on specific questions to show that I understood the process of doing therapy, the laws and the ethics and so on. If you pass that first test you then return for a second test in which you are given stories (vignettes) and you apply your knowledge to answer questions about Howe you would work with these people.
If you pass both tests you are then sent an application for a license.
At each step of this process, you pay a fee for BBS to handle your paperwork.
Once you send in your approved application and pay the fee, if all has gone well you will be issued a license to practice Professional Clinical Counseling in California. You can then work for someone else or open your own office.
But it does not end there
Every two years you will need to complete a certain number of approved continuing education classes, and pay a fee to renew your license.
After the first two years of being licensed, you can take a class and then you are eligible to begin supervising newly registered people.
So do things operate differently in the area in which you reside?
Staying connected with David Joel Miller
Two David Joel Miller Books are available now!
Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.
Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.
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For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.