Answers to Consumer Questions
Question:
What is the difference between a registered
counselor, a certified counselor, an associate counselor and a licensed counselor?
Note: The answer on this page has been here for some time but was recently
reviewed and updated to reflect 2008 second
Senate House Bill 2674 “Counselor Credentialing Standards” legislation [also called by some, "
The 2008 Registered Counselor Law"] modifying credentialing standards for counselors,
that was signed March 25, 2008 by Governor Chris Gregoire.
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In Washington State, anyone who practices as a counselor must be registered, certified or licensed by the state.
However, new applications for "Registered Counselor" can not be
submitted after July 1, 2009, and the Registered Counselor category
will cease to exist on July 1, 2010.
The differences are complicated, but basically there were no educational,
experience, or testing requirements to be a registered counselor. Registering with the state made the
registered individual subject to review and disciplinary action by the state including loss of registered status which would
mean the person could no longer legally practice.
Registered counselors included a vast
variety of counselors--something that the new state is correcting at
this time. Registered counselors qualifications have varied in the extreme--from the
person with no degree and no professional mental health training and possibly no
experience, to the person with a bachelors degree in some sort of mental health
area, to a person with a related degree and years of counseling experience (who
is unwilling or unable to expend the additional time and money to meet
requirement for licensing), to the highly qualified mental health counselor with
an appropriate Masters Degree who is right now working as a professional to
obtain the supervised hours of experience to become licensed. If you want
to know a counselors credentials and qualifications, you need to ask. Before you start counseling with ANY mental
health counselor, carefully
read their disclosure information (required by law to be furnished to
clients before therapy starts).
I have run across some registered
counselors who mistakenly identified themselves as "a licensed registered counselor in
Washington State." This is an error. The counselor who
was
"registered" by the state--NOT licensed.
Associate counselors
are counselors who have completed their masters degree in a
counseling related field and are now working under supervision to
get the required number of supervised counseling hours to qualify
for licensing. These new (2009) categories include the Mental
Health Counselor Associate (MHCA), the Marriage and Family Therapist
Associate (MFTA), and the Social Work Associate Independent Clinical (SWAIC).
Licensed counselors generally must have a masters degree, a minimum number of years of
supervised practice, pass an
examination and be issued a license by the State of Washington. Licensed counselors are most likely to be recognized by third-party payees, such as health insurance companies.
The term "certification" is complicated by the fact that certification can be by the state, by a national certifying body, or by
a training facility. (Certification by a training facility is
the lowest of these as "certification" is too often a sales device,
with the offer of certification presented to entice counselor
expenditure for the training program.)
In Washington State, the
process of achieving licensure for counselors was a two-step
process. The first major breakthrough
occurred when the state set up a testing process and began to issue permits to be a: 1.
Certified Mental Health Counselor, 2. Certified Marriage and Family Therapist, and
3. Certified Social Worker.
During 2000, the licensure law finally passed and the certified categories became licensing categories: 1.
Licensed Mental Health Counselor (LMHC), 2. Licensed Marriage and Family Therapist (LMFT), and 3. a
Licensed Independent Clinical Social Worker (LICSW).
If you looking in the Yellow Pages under
counselors, social workers, or hypnotherapists, you will find
listing of counselor names followed by initials. The initials should indicate the person's degree and types of registration, certification, or licensure. [See: Dictionary
of Initials, Acronyms and Abbreviations Used by Counselors and Social Workers.]
Generic
Initials: Unfortunately,
a small number of counselors sometimes
make add unofficial "generic" initials to their counselor
credentials. Those who lack licensure or
national certifications may add initials after
their names so that they don't seem so naked. Counselors may
justify or rationalize using these generic initials saying, "this
is what
I do," even though the initials have no official standing and may
mislead the public. Most common are MHC for mental health
counselor and MFT for marriage and family therapist [except in the state of
California where MFT indicates a licensed Marriage and Family Therapist] or CBT for cognitive behavioral therapist.
Generic initials are not permitted in counselor listings on
CounselingSeattle.com as a matter of policy, but sometimes may be
(misleading and unethically) listed by a counselor after his/her
name on some other websites.
[ Is it ethical? Professional? ]
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In the past, the terms "registered" or "licensed"--have
not necessarily indicated differences in education and experience.
A counselor with twenty years of counseling experience may simply
have decided not to apply for licensure because of difficulty in
getting a degree, or in documenting training or supervision hours. Nor do the terms
necessarily reflect differences in the individual counselor's skill as a
counselor. As a matter of policy and to establish a baseline,
CounselingSeattle.com lists only masters level counselors.
Regardless of training and experience, people vary greatly in their natural interpersonal skills and counseling abilities. Add the potential
client's personal biases and you can understand how one person may really like a particular counselor's personality and counseling
techniques while another person would dislike them.
As one example: While one counselor may lead you by facial expression and questions and
never ever suggest you take any specific action (preferring to have you develop your own
solutions) another counselor may focus on educating you to different perspectives and
suggest specific solutions that might never have occurred to you. Which would you prefer?
With regard to degrees, "John Doe, MA"
only tells you the person has a masters degree--not the type of degree. When you make initial contact with a counselor it is
wise to ask what field a degree is in. My masters degree is in counseling. However, the counselor's degree might
be in accounting or music. If so, as a consumer, your next question might be "So how did you get from being an
accountant to being a counselor?" The answer might tell you whether this is someone with whom you feel comfortable
and feel you can trust. Remember, your primary job as a consumer is to find a counselor/therapist that you trust and
feel comfortable with. If on your initial meeting you don't feel comfortable, don't go back--keep looking.
HISTORY: The basic idea of creating a category "Registered
Counselors" was a good one--intended to "grandfather in" those counselors who had been practicing for
some time so as not to cut off their livelihood and yet bring them under state regulation. And many of the more
recent registered counselors have been masters level counselors, and many of these have been under working under clinical
supervision in order to become licensed.
However, Registered Counselor category has remained open
for years. Applicants have registered for a small fee with no educational or experience requirements
other than completing an HIV/AIDS course, and become a "registered counselor."
According to the Seattle Times, the registered counselor category has now become the biggest source of
complaints of sexually inappropriate behavior with clients. (However, the series also discloses that, on a
basis of rate offenders per thousand, Chiropractors were disciplined 1.5 times more often for sexually abusing and
exploiting their clients. The Seattle Times series mentioned above is "
License to Harm: The unchecked problem of sexual misconduct by health-care professionals," 2006, by Julia Sommerfeld
and Michael J. Berens, Seattle Times staff reporters.)
Mental health professionals
have worked with the legislature and health department and developed a plan to divide and classify registered
counselors into a number of new categories by education, preparation, and
other qualifications. See counselor credentials in
Washington State.
Most people look up a counselor in the phone book or on the Internet and give them a call. They chat
briefly about their problem and--if they feel comfortable--make an
appointment.
The counselor should provide you
with a packet of client disclosure
information that explains the counselor's education and
training as well as other information required by state law. This form
must be signed by the client and the counselor before you can legally be charged for therapy.
(You get to keep a copy for your files.) This is done to inform you
of counselor's qualifications, fees and treatment methods and does not require you to enter into
or continue treatment with that therapist, if you do not wish to do so.
[See also:
What is the difference between the terms counselor, therapist, and psychotherapist?]
Question 2. Can you tell me the advantages
for a counselor in Washington State to apply for licensing as a
LMHC or LMFT vs. just registering as a counselor?
In the past, I would have recommended that, even if you were planning
to apply for licensing, you would want to register as a counselor immediately, in order to qualify for employment
as a counselor in Washington State. Registration once was the minimum and first requirement to work as a counselor
in Washington State. Once you were licensed, it was not necessary to renew your registration, only to
keep your licensure current. However,
under the new credentialing law of 2008, no new applications for registered counselor are accepted after July 1, 2009. The
registered counselor credential will cease to exist after July 1, 2010.
Eight new credentials were created to replace the registered counselor category. So you would probably apply for one of
those categories. (See
requirements.)
I can think of several
advantages of licensure. (If readers are aware of other
advantages,
please let me know and I
will add them to this list.
First, because licensing
requires a masters degree, a specific, verified number of supervised hours of
practice and passing an examination, consumers (members of the public)
who are looking for counseling services may place more faith in
licensed practitioners.
Second, insurance
companies generally only accept licensed counselors as eligible to
serve on their provider panels and receive third-party reimbursement.
(The third party is the insurance company that pays the counselor on
behalf of the insured client.)
Third, (Kathryn Kemp reminds
me) If you were to move to another state that requires licensure in order to
practice, the license you obtained in Washington may be transferable, rather
than starting all over in another state.
Fourth, since
registration does not require any training or preparation minimums,
an educated consumer should expect to pay a registered counselor
less than a licensed counselor.
Fifth, the
registered counselor credential has been a
controversial category and is being
legislated out of existence effective July 1, 2010.
See also:
(1) Suggestions for choosing a counselor or therapist.
(2)
Provider Credentials Look-up System
Health Professions Quality Assurance of Washington State
Health Department.
(3) For counselors: Counseling in Washington State.
Floyd Else, MA, LMHC, NCC, MAC
(See what I mean!)
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Initials and Acronyms Used By Counselors
