13 things your counselor should know – part 2

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

In a previous post, we talked about the first 6 things that a Professional Clinical Counselor should know. Today the rest of that list.

7. Counselors know the principles of the diagnostic process.

What would you think of a doctor who sent all his patients for cancer chemotherapy first and then checked to see what was wrong later? You wouldn’t want to be treated for something you did not have, would you?

That is why diagnosis is so very important. It is also controversial and sometimes the diagnosis on a client’s file is flat wrong. I have written in previous posts about why we professionals may get it wrong and there is room for improvement but one thing a good counselor is to be able to do is to diagnose.

We may change that diagnosis over time. You may turn out to have more than one problem or we may treat the thing that looks the worse first, then move on to another thing.

However it is done, a good counselor needs to be able to diagnose and they need to be able to explain that diagnoses to their client. The diagnosis drives the treatment. We should treat the problem and leave the other things in the client’s life alone unless they want to change them.

8. Counselors know about research and evaluation.

Counselors need to know how to read research and understand the information. Some stuff looks good on paper but does not work when we try it on clients.

I read a lot of research in preparing to write this blog. I will not say I “get” it all. But I can spot some really suspicious research.

Recently I looked up a new counseling theory; there are over 300 of those and counting. This new therapy had one study done by the author of the book on this new system and then his study included only 5 or 6 of his patients.

I do not call that evidence.

See why professional clinical counselors need to know how to evaluate research? Would you want them trying out something on you that might not work or might even harm you?

9. Counselors know professional orientation, ethics, and laws in counseling.

Interesting that the law that created Licensed Professional Clinical Counselors lumped all three of these things together. In another context, this might be three separate things.

What this is telling the prospective clinical counselor is that they should know about their profession and presumably related professions. Who does what, when and why?

It is always really important to understand a little about the law. It is recommended that counselors have lawyers rather than trying to memorize all the things in applicable laws.

Clinical counselors also need training in ethics. Not that ethical principles are hard and fast rules, but the code of ethics for a profession are general guidelines for how to conduct yourself.

The big ones as you may have gathered from my past posts on ethics are avoiding things that would harm clients. You can read more about this topic by clicking on the law and ethics category in the list of categories to the right.

10. Counselors should know about psychopharmacology.

Professional Clinical Counselors do not prescribe medication here in California or anywhere else that I know of. That is fine with me, as I think that if you are prescribing meds you need to have attended a medical school and know about medicine.

Still, we Profession Counselors see a lot of people who are taking meds, psychiatric or others. We need to have an awareness of what the meds are that clients are taking, are they complying with their doctor’s instructions and so on.

Some medication that is prescribed for physical health issues can cause symptoms that might be mistaken for a mental health condition. We need to know when to refer clients to an MD and when to send them back so their primary care doctor might be able to take another look at the meds they take and the side effects they are experiencing.

11. Addictions Counseling.

Clinical counselors are supposed to have knowledge about the field of substance abuse. In the future, I expect to see more LPCC’s working in the substance abuse areas. I say supposed to because while LPCC’s have some training in substance use disorders. Some is just not enough.

It is amazing how little training in substance use disorders mental health professionals get. A standard MFT program might include a one weekend class, Friday evening and all day Saturday.

Contrast this with 36 units, eleven full semester classes on substance abuse and related problems, which are included in the CAADE Drug and Alcohol counseling curriculum which I teach over at FCC.

More training is needed but look to LPCC’s as the branch of the mental health field that combines mental health treatment with substance use disorder treatment in the future.

12. Crisis or trauma counseling.

Would you believe that there are mental health professionals that are uncomfortable handling a crisis? Sorry, you other professionals. I do not have time to wait around to make a referral to a program when someone is suicidal. (I know most of you don’t do that either.)

Crisis and trauma are huge parts of what brings people to counseling.

Stress, acute or chronic is a significant factor affecting mental health. Professional clinical counselors are trained to help clients with issues in these areas.

13. Advanced counseling and psychotherapeutic theories and techniques.

Beyond the basics, there are times when you may need tools in your counselor’s toolbox beyond the everyday ones.

This concludes part two of the discussion of the 13 things every Professional Clinical Counselor should know and understand. As I tell my students, these things probably will be on the test.

For more on Professional Clinical Counselors, LPCC’s and PCCI’s check out the CALPCC website.

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.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

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.

13 things your counselor should know.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

What are the 13 Core Competencies of a Clinical Counselor?

Professional Clinical Counselors study and are expected to know these 13 important “Core Competency” areas.  Quality counseling should include a lot more than giving you a diagnosis, prescribing or referring you for medications and then listening to you talk.

As important as listening is for any health care professional, the meat of counseling contains a lot more substance than diagnosis and listening. Here are the 13 areas a professional clinical counselor needs to know to help their clients. It helps to know this stuff if you ever expect to pass your licensing exam.

1. Counseling and psychotherapeutic theories and techniques.

Theories are about what we think causes those things we call mental, emotional and behavioral problems. Sometimes we professionals get trapped into thinking all we are treating are diseases and disorders and we lose sight of the person with the disease.

If you and your partner can’t get along that is a relational issue. To treat this we do not need to give you a diagnosis of a mental illness. Could someone with a serious and persistent mental illness have a relationship issue? Sure they can.

The theory maps out the terrain you will cover in counseling. As any hiker in the woods knows, around the next bend in the trail, there could be a patch of flowers or there could be a hungry bear.

Those two situations call for different actions. That is where the therapeutic techniques come in. We may use one tool for someone who is having difficulty making decisions because they have no clear goals and a different set of techniques if their indecision is the result of abuse and being told they would never be any good.

2. Human growth and development across the lifespan.

There are common, almost predictable, events at certain times in our lives that have a high propensity to get us off track. Knowing what might happen to a client at a specific age and why can help a counselor and the client in taking this journey we call therapy.

Teens and early twenties have a high risk of suicidal thoughts, so do elderly men. For teens the risk may have to do with school, launching a career or a failed relationship. His risk may also be increased by drugs and alcohol. Being the victim of bullying increases these risks.

Senior have a high risk also, especially elderly men who live alone. The challenge at that point is coping with the loss of the things that used to give life meaning, their partner, their job, their health. Being alone, having to give up things they used to love are risks here.

A good counselor adapts their treatment to the life stage of the client.

3. Counselors know about career development theories and techniques.

Professional Counselors are specifically trained in Career counseling. Your Therapist may listen to how sad your lack of a job makes you, they may give you encouragement and tell you to just go out there and keep trying.

The Professional counselor can help you explore the world of work, find a direction that is right for you and gets you started on a lifetime career journey. They can also really help displaced workers find something new to do with their work lives.

Nothing so improves a client’s mood as having a job they enjoy and that pays reasonably well. Having a relationship can improve your mood, but having a job can reduce a lot of the stress and fights that are a part of so many relationships these days.

4. Group counseling theories and techniques.

Group counseling is not second-class services. I know there are still a bunch of therapists who don’t like doing group. Many are flat afraid of it. But hearing from other people who have problems and how they are overcoming them, that can be very powerful.

Group has been the standard treatment for Substance abuse since the beginning. We are seeing some wonderful things happening in mental health groups these days.

Clinical Counselors are specially trained in running group. (Note to employers, this makes them very productive and worth the extra effort to get an LPCC hired in an agency or governmental settings.)

5. Assessment, appraisal, and testing of individuals.

Several other mental health professions specifically do not engage in testing. Professional clinical counselors do testing for their clients and can help you make sense of these results. Yes, there are limitations on the amount of testing they do, sometimes they need to refer clients out to a clinical psychologist, but LPCC’s can do a whole lot more testing that their “sister” mental health professions.

6. Multicultural counseling theories and techniques.

Culture includes a lot more things than just race and ethnicity. Military families and their dependents have a culture that needs to be recognized and treated in special ways. Clients who come from backgrounds of poverty, regardless of their race have different cultural experiences.

Recent immigrants and their children have a whole set of problems that make their emotional problems more difficult.

African-Americans may or may not have come from poverty but their experience has been different. Many find it difficult to define who and what they are. One African-American described this to me as a form of cultural amnesia. I know where my ancestors came from, more or less, but most African-Americans, their cultural memories dead-end at slavery. So what part of their culture do they keep and what do they reform?

There is some theoretical justification for trying to match the counselor and the client. Women who have been abused may prefer a female counselor. Men may prefer a male counselor unless the female one is really good-looking. Most counselors are women.

Matching the counselor and the client is not always possible. Hence the whole need for training in multicultural counseling.

Next time part two of this list.

For more on Professional Clinical Counselors, LPCC’s and PCCI’s check out the CALPCC website. 

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.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

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.

CALPCC board meeting – Professional Clinical Counseling

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Just returned from the CALPCC board meeting. http://calpcc.org/

CALPCC stands for California Association for Licensed Professional Clinical Counselors. It is an honor and privilege to be able to hang out with a group of people who are so concerned about the future of the Counseling profession.

The things we talked about will affect those who work in the field and those who receive services from Professional Counselors everywhere. I try to balance posts on the counselorssoapbox.com blog between things that are of interest to clients, people in recovery from whatever challenge you have, and those who consider themselves professionals. Some people fit into multiple categories.

Today a quick summary and then in the future I plan to write some posts about things I learned and thoughts I have had as a result of this meeting. Today just the highlights of my thoughts, and while I can’t speak on behalf of the organization or the board, as always I have plenty of thoughts of my own.

CALPCC’s primary mission is to further the profession of Clinical Counseling here in California. Many of our board members are very active at the National level and beyond.

I see a difference between the processes of counseling, therapy, and coaching. My students know that while I am licensed as both a Marriage and Family Therapist and a Professional Clinical Counselor I see those functions as two different things and describe myself as a counselor first and a therapist second.

One size does not fit all

There are some disturbing trends in mental health treatment these days.

The first step for most clients is to get them on meds. If they need them that is all well and good, but sometimes the meds cause harm.  In this era of “there is a pill for everything,” it is hard to convince those who pay that clients might benefit more from some counseling than from a meds only approach.

Meds can only do so much, to help a person to have a life worth living; they may need some help learning new skills, like living without drugs or setting and accomplishing goals.

It is estimated that California will need an additional 5,000 mental health clinicians by the year 2019. Many of those clinicians will be working with the poor, the unemployed and the addicted.

Professional Clinical Counselors are uniquely qualified to fill that need. They are trained in 13 separate “core areas.” Including career counseling – getting a job, addiction counseling, and many have extra training in working with non-verbal clients or those whose primary learning styles is a mode other than words.

As more Clinical counselors get their license some are asking about the prospects of going into private practice. I am working on a power point and a longer article on the topic of counselors in private practice. That old Business Administration degree keeps calling to me. If that topic interests you, send me an email or other communication and I will put you on a list to get the link or the article when it is finished. The same goes if you are interested in the book that is in progress.

If you are interested in the role of Professional Clinical Counselors consider visiting the CALPCC website. (Links to CALPCC.org or counselorssoapbox.com are always appreciated.)

If you are a student, trainee or intern, consider becoming a member. The Unlicensed rate is a paltry $30 and includes some perks like accesses to the member’s only page, info on job opportunities and a discount on your liability insurance. That discount alone will pay for the membership or come real close.

CALPCC is a small but growing group. Most of the work is done by the members and volunteers, not paid professional staff. So when you join, consider volunteering to help and serving on a committee. Member input and participation in CALPCC is welcomed.

At this time the job openings for LPCC’s and PCCI interns are thin. CALPCC is working on getting more government and insurance positions open to LPCC’s. I believe that as more people know the things that LPCC’s can do the more job openings there will be. (Yes Mental Health Directors and other employers, LPCC’s are trained to and may see children.)

I know there are some behemoth counseling organizations who advocate for all mental health professionals, but if you are or plan to become a Clinical Counselor or another professional counselor then you owe it to yourself to join a group that advocates for Professional Clinical Counselors, particularly if you live here in California.

As you might guess I am a bit tired from the long drive and the writing schedule for the counselorssoapbox.com blog is behind schedule. It is a long drive from Fresno California to almost anywhere. If you find any typos that did not get corrected in the proofing, be kind, please.

Please – please, leave a comment or question. Those responses help me know if the things I am writing are useful and what other topics you would like to see posts about.

Where did the LPCC Gap exam go?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

About the grandfathering test for Licensed Professional Clinical Counselors.

Both CALPCC and CAMFT have reported that the California Board of Behavioral Sciences has stopped administering the Gap exam for those wishing to grandfather in as LPCC’s.

The information I have heard is that the testing company has notified potential candidates for the exam that BBS has temporarily stopped the test.

At this point, we do not know why or when the exam will be resumed.

My suggestion for those who plan to take the exam is to keep reviewing those things that were listed as inside the LPCC’s scope of practice. Especially focus on those things that were not emphasized in you testing for the LMFT or LCSW.

Let us hope this will be a short delay and that BBS will announce something soon. For more on this, I would encourage all potential LPCC’s and PCC Interns to join CALPCC and make use of the latest news and information in the member’s only area. If you are already a member of CAMFT, I encourage you to continue your membership in CAMFT as I have done.

The Mental Health Field needs all the advocates it can get.

LPCC’s PCCI’s and Medi-Cal – News update from CALPCC

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

LPCC’s PCCI’s and Medi-Cal – News update from CALPCC

CALPCC the state-wide association for LPCC’s and PCC interns today released a news update confirming that LPCC’s and PCCI’s will be able to bill Medi-Cal here in California. This greatly increases the job opportunities for this new mental health profession.

Professional Clinician Counselors in California will be able to see adults and children. If they wish to see couples or families they will need to have had specific training in family therapy.

This SPA (state plan amendment) was signed in December 2012 with an effective date of July 1, 2012. The result of this SPA is that Professional Clinician Counselors will be able to bill Medi-Cal during the current fiscal year.

For more information please check the CALPCC website. Those of you who plan to practice as Professional Clinician Counselors in California should plan to join CALPCC if you have not already done so.

Ca. Professional Counselors – CALPCC and LPCC’s

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

October CALPCC board meeting.

This year California became the 50th state to License Professional Counselors. The official designation in California is “Licensed Professional Clinical Counselor” LPCC for short. Other states had some form of professional counselor’s licensure before California, so we are still finding our way as this profession matures and adapts to California.

CALPCC, a non-profit organization, is the statewide organization for this new profession. Last weekend was the annual “retreat” for CALPCC’s board of directors which I was able to attend.

CALPCC has seen fit to appoint me to that board to fill out an open board member term. I am excited about this opportunity.

Some short recaps of what we talked about are below. Remember that as a new board member these are my impressions and that I can’t speak officially for the board. So any sentiments expressed are purely my own. Here are some of the questions that came up.

1. Why are Marriage and Family Therapists (MFT’s or LMFT’s) becoming LPCC’s also?

At least 4 of the CALPCC board members, myself included, are also licensed as LMFT’s so there was some discussion of why LMFT’s might want to also become LPCC’s.

My belief is that there are things that each profession does that the other does not do and to best serve my clients I needed to be trained in both areas.

Most LMFT’s work with couples, families and sometimes children. Since I see some children, couples, and families I need to stay licensed, active and up to date in the LMFT field.

Much of my private practice is in individual counseling, particularly something I loosely call “men’s issues.”  LPCC’s are specially trained in things like career counseling and mediation. Sometimes this shades over into the area of life coaching. I approach these issues by trying to help clients solve problems that are causing social or occupational problems or interfering with having a happy life.

2. Why should someone join CALPCC?

Lots of counselors are already members of one or more professional therapist or counselor organizations. They asked why they should join another group.

My view is that if I was solely an LMFT I would need to belong to the one or two organizations in that field. Since I am also an LPCC I felt the need to join the organization that is specific to LPCC’s, which would be CALPCC. I chose to be a member of organizations in both fields and would recommend that to other people who are dually licensed.

3. What are the benefits of being a member of CALPCC?

CALPCC maintains a website. There is information on the website for anyone who is interested in the new Professional Clinical Counselor profession. There is also a member’s only area with additional information that is useful to LPCC’s that may not be of interest to non-counselors. Other professional associations also use this member’s only format for some of their website content to encourage those who use the resources to help pay the cost.

I recommend that if you are licensed or seeking licensure as an LPCC, you want to be a member of CALPCC and get access to the members-only content on the website.

4. Can LPCC’s bill Medi-Cal?

Not yet, but we believe this is coming and coming soon. At this point, there are only a few LPCC’s licensed in California. The last license number I heard was about LPC200. Those who are getting licensed now are people with previous other licenses who are getting a second license.

We were told that there is a huge pile of applications for the LPCC license that were mailed on the last day of 2011. BBS will be working on that pile for a while. By the time those licenses are completed and the BBS moves to issuing new licenses to people who did not have a previous license we hope that the Medi-Cal approval will be completed.

There are other federally funded programs in which LPCC’s are already being hired.

5. Can LPCC’s open a private practice and take private insurance?

Yes, they can. Who the insurance company place on their panel is up to each individual insurance company. I am on several panels and each one that I have looked at will take LPCC’s.

That does not mean that if you are newly licensed as an LPCC the insurance company will automatically add you.  Most insurance companies want to know they are sending their customers to someone who is reliable. They require providers to have a certain length of time in the profession before they add you to their panel. They also look to see if they have too many or too few counselors on their list for your area.

This is not insurance companies picking on the new LPCC profession. These rules have also been applied to existing LMFT’s and LCSW’s.

Most insurance companies I have looked at require you to have been licensed for 2 to 5 or even 6 years before they will consider you for their panel unless you have a particular skill they need on their list. So if you speak Russian and Swahili you may get on insurance panels sooner.

6. Should students join CALPCC now or wait till graduation?

I recommend that you join while still in school and read the members only updates while you are preparing for your exams. This keeps you up to date on the latest events and trainings in your field.

Also – the CALPCC student member price is VERY reasonable.

Consider that the really good counselors and therapists do not stop learning when they graduate. If you want to be the best possible therapist or counselor you can be, stay active and up to date in your field.

If you are a client or an out of California professional forgive the very California LPCC specific post. The last two weeks have been extra busy for me. Shortly I will return to my posts on recovery, resiliency and having a happy life.

Staying connected with David Joel Miller

Three 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.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

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. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Job stress?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Stress person

Stress.
Photo courtesy of Pixabay.com

Job stressing you out?

Feel trapped in your current position? Is your work contributing to your anxiety and depression? A new post up tonight at counselorfresno.com titled “Work stress getting you? Is it you or the Job?” explores the relationships between job satisfaction and your mental health.

David Miller, LMFT, LPCC.

Best of Blog – May 2012

Counselorssoapbox.com

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Here it is – The Best of Blog Recap for May 2012 –

Thanks so much to all of you for making this another great month. I appreciate all those of you that have read the blog and especially appreciate those who have left “likes” and comments. Please feel free to leave a comment or ask a question.

I have included 5 posts since the last two in both categories were tied or very close.

Best of blog for May

How much should you tell a therapist?

Are you Hyperthymic?

Why can’t we forget the painful past?

Posttraumatic Growth (PTG) vs. Posttraumatic Stress Disorder (PTSD)

Is it Complex Grief, Depression or Bereavement?

The best of blog all-time posts are

How much should you tell a therapist?

How does therapy help people?

Are you Hyperthymic?

Why can’t we forget the painful past?

Grandma is the drug connect

To date, there have been readers in over fifty countries. Thanks to all of you. Stay tuned for more to come.

Till next time, David Miller, LMFT, LPCC saying “Hope you are having the happy life you deserve.”

LPC or LPCC? – Brief news update – plus the LPCC gap exam

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

Is there a difference between LPC’s and LPCC’s and if so what is that difference, and how hard is the gap exam?

There have been several web searches on this topic and a couple of emails so now might be a good time to explain this. This question primarily applies to California clients and professionals.

Mental health practitioners in California are regulated by the California Board of Behavioral Sciences (BBS). They administer the laws passed by the California legislature and their rules and regulations. A recent news update from CALPCC explained the sudden appearance of multiple sets of initials for mental health clinicians.

The difference between LPC’s and LPCC’s has to do with the BBS computer system not any difference in the licenses or qualifications.

The BBS computer program only allows for three initials in front of the license number no matter what the designation of the practitioner. The correct designations are:

Licensed Professional Clinical Counselors are designated LPCC’s. Their license number begins with LPC.

Licensed Clinical Social workers are designated LCSW’s. Their license begins with LCS.

Licensed Marriage and Family Therapists are called LMFT’s. Their license number begins with MFC.

MFC is a throwback to the days when they (we) were called Marriage, Family and Child Counselors. MFT’s are the same thing as LMFT’s since you can’t call yourself an MFT unless you are licensed. Marriage and family therapy interns and trainees should be identified as MFT intern and MFT trainee – NOT MFTI or MFTT. Both of these groups are working under the supervision of a licensed clinician.

How hard is the LPCC gap exam?

People have been asking “How hard is the LPCC gap exam?” Personally, I would say based on my experience – well that depends on whether or not you knew the answers. Since the exam is only on the differences between LCSW, LMFT and LPCC’s, there is a lot of material to cover in a very few questions. If you graduated recently or have been studying LPCC material since graduation you should be in good shape. Some of the material was very specific so if your school covered if you were in luck. If your particular instructor did not cover an item it would have been hard to know what to study.

I would recommend a review course, though it is early for the review classes to know what to teach you. Also, study anything in the BBS booklet that looks unfamiliar. The wider your knowledge base the better you should do.

Hope this helps explain LPC’s, LPCC’s and the gap exam.

Update on gap exam and the changes in initials.

The period for grandfathering in as an LPCC has come and gone. No more Gap exam. Also, the new computer system fixed the initial problems. My most recent license renewal shows my licenses as LPCC and LMFT.

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.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

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.

Therapist, Counselor or Social Worker?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Therapist

Therapist.
Photo courtesy of Pixabay.com

LPCC, LMFT or Social Worker?

Recently a number of people have asked me about the different mental health professions and which they should go to see. Students in my Substance Abuse Counseling classes also ask me about which career they should pursue. It might be helpful to talk about where these professions came from, what they do and why you would choose to see or become one of these professionals. Many professionals in these fields are in recovery also and they often make excellent helpers.

Here is a brief explanation of my point of view on the subject. Remember that I am licensed as both a Licensed Professional Clinical Counselor (LPCC) and a Licensed Marriage and Family Therapist (LMFT), have taken classes in the Psychology Doctorate program but am a long way from finishing that one and that these are just my opinions.

The titles and what they are allowed to do depend on your jurisdiction.

California was the last of the 50 United States of America (North America) to license Professional Clinical Counselors. Substance abuse counselors in California are registered or certified not licensed and in some states, there are no requirements other than getting hired to do the work. Educational requirements and licensing rules can vary widely and have changed over the years.

These titles and what they may legally do vary from place to place. Check with your appropriate state or national agency to see what the regulations are in your location. Consumer protection agency can sometimes tell you what the rules are in your locality.

Licenses, Job titles and Educational degrees are not the same things.

Agencies hire people to work in a particular field. Not everyone who works in a social work agency has either an educational degree or a license in social work. Someone who processes welfare applications or inspects homes for child abuse or neglect may be called a social worker. Sometimes these workers have a degree in the field but not always. This depends on the rules of this agency.

If you are looking for work and have not yet finished your education there are far more entry-level positions for doing social work than any other of the behavioral health professions. There are two-year degrees (AA or AS) in social work and Substance abuse counseling but not much else in the Mental Health field. There are also many social work bachelor degrees which qualify you to work in the field but not to be a clinical social worker.

There is a large difference between a “social worker,” someone with a master’s degree in social work (MSW) and a Licensed Clinical Social Worker (LCSW.) To be an LCSW you would need to complete a master’s degree, complete a number of hours of supervised experience and pass a test. LCSW’s spend a lot more time working with clients and some specialize in therapy around certain issues, such as foster family and abused or neglected children.

All of the licensed professions also have beginner categories of learners who are being trained and supervised by licensed people.

So what are the primary types of behavior health specialists?

They would be Social Workers, Marriage and Family Therapists, Clinical Counselors, psychologists, and Psychiatrists. Here is my oversimplified description of what each profession does. Let’s take a short look at a scenario that might show us how all these professions may interact with one family.

Police are called to the home where a domestic disturbance is in progress. The adults are both drunk and they are fighting. The kids are scared and under the bed. Parents are out of work and about to be evicted. Mom has a history of depression. Both parents are yelling about wanting a divorce.

So what does each profession do?

Social Workers (LCSW’s or beginners are called ASW)

They might be called to the scene. They will evaluate the home and maybe take the children into custody and place them in foster care. Once the parents are released from jail for the domestic violence charges the social worker might meet with the mother, get her in a battered woman’s shelter, arrange for both adults to attend substance abuse treatment and enroll them in domestic violence counseling. A Licensed Clinical Social Worker could be assigned to work with the children to see if they have PTSD and need treatment for the effects of living in a violent home.

While an LCSW may do long-term therapy, they are specially trained in policy and referrals. They are likely to be running programs, deciding to leave the kids or take them and making referrals to long-term treatment.

DV and substance abuse counselors

These professionals often have a short-term, two-year or less training in their specialty. They are limited to working on one problem only and most often they must work for a licensed agency or under the supervision of a licensed person.

Parents may be required to complete a Substance abuse program and or Domestic Violence or anger management groups before the kids are returned to the home.

Once the parents stop drinking and they have learned how to control their anger, or not get angry in the first place they may decide to try to get back together.

Marriage and Family Therapists

Marriage and Family Therapists (LMFT’s, or MFT’s if they are licensed and beginners are called MFT interns or MFT trainees.)

MFT’s work from a systems approach which say that all humans have relationships and relationships are like dances. If one person changes the others may change and then the dance changes. So they would with couples or families on better communication and having a good relationship.  They most often work with the couple or the whole family at once. If they work with one person it is most often about that client learning skills to improve their relationship.

They might also have to tackle working with mom on how her depression or dad’s unemployment is affecting the kids and the family.

All the Marriage and Family Therapist programs I know of are 45-60 unit masters degrees. MFT’s often have bachelor’s degrees in all sorts of things unrelated to therapy. They frequently have had some life experiences that pointed them in this direction.

Professional Clinical Counselors (LPC or LPCC in California)

These counselors are specifically trained in mental health and problems solving. They might work with mom on changing her long-standing depression or they might work with dad on how to find a new job.

Should the marriage counseling fail they might also work on meditation and working out custody arraignments.

These three professions, LMFT, LCSW, and LPCC despite having differences in training may do very similar things. Beyond the basic degree or license, they are required to take continuing education classes each year. Some professional counselors or therapists specialize in a particular issue, some are generalists. If clients only had one problem we could all get really specialized but most people have multiple problems and so over time a counselor learns to work with clients on many issues.

Psychiatrists.

Psychiatrists are medical doctors with additional training in psychiatric medicines. Child Psychiatrists are even more specialized and unfortunately, there are never enough of these professionals. Because of the high demand for their services they are very busy. Most psychiatrists see clients for an initial “assessment” which is a medical assessment and very different from the counseling assessments we therapists do. After that first appointment, most psychiatrists will be seeing clients for a ten to fifteen-minute med check appointment every month or even every few months. They are looking for side effects of the medication and to see if they need to change meds or doses.

Psychiatrists generally do not have the time to spend talking with clients that are required for therapy. Most often they oversee the meds and refer the clients to see a counselor or therapist to work on the thought and behavior parts of the problem.

In our example of the couple above, the Social worker, therapist or counselor might refer the mother to a psychiatrist if the depression was severe. Some clients are so affected by their disorder that they can’t benefit from therapy until they are on medication. Some conditions are the result of changes in the brain and that person may need medication for the rest of their life. Meds may stabilize them but they will often need counseling for other problems like relationships and careers.

Psychologists.

This is a doctor’s level degree. I completed 6 units in this program before deciding that I did not have time for another degree and license. What their training appears to be directed towards are long-term problems. They can spend a lot of time studying, testing and personality structure.

Many psychologists work with clients over the long-term on problems that are slow to change. They are also likely to be called upon to do evaluations for court or disability insurance.

In the example of the couple above the man might be court ordered to see a psychiatrist to determine if he should be allowed back around the family. The wife might be evaluated if she puts in for long-term disability saying she is so depressed or traumatized that she is unable to work.

So there you have it, a brief oversimplified outline of what the larger professions in the mental health field do. Whether you are a client or an aspiring professional you need to pick the profession that will be a good fit for you.

Licensed Professional Clinical Counselor (LPCC), Marriage and Family Therapists (LMFT), Social Workers, Psychiatrists and Psychologists which is the right fit for you?

Staying connected with David Joel Miller

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