Answers to Consumer Questions

Question 5.  What is the difference between a registered counselor, a certified counselor, and a licensed counselor? 

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In Washington State, anyone who practices as a counselor must be registered, certified or licensed by the state. 

The differences are complicated, but basically there are no educational, experience, or testing requirements to be a registered counselor.  Registering with the state makes 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 include a vast variety of counselors--something that the state is struggling with right at this time.  Registered counselors qualifications vary 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, 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).

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 is only "registered" by the state is NOT licensed.

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.

In Washington State, the process of achieving licensure for counselors was a two-step process.  The first major break though 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 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. Graduates of the Bastyr University's LIOS Leadership Institute of Seattle often add "ABS" (for Applied Behavioral Science) after their "MA," in what I consider to be a continuing lapse of mature judgment for which the school has accepted responsibility.  [ Is it ethical? Professional? ]

The terms "registered" or "licensed"--do not necessarily indicate differences in education and experience.  A counselor with twenty years of counseling experience may simply simply have decided not to apply for licensure because of difficulty documenting training or supervision hours.  Nor do the terms necessarily reflect differences in the individual counselor's skill as a counselor.  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?

"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.

The basic idea of creating a category "Registered Counselors" was a good one--grandfathering in those counselors who had been practicing for some time so as not to cut off their livelihood and to make them subject to state regulation.  And many of the current registered counselors have appropriate mental health training and degrees, and many of these are in a supervised practice in order to become licensed.

However, Registered Counselor category remains open for others to apply and for a small fee and no educational or experience requirements other than completing an HIV/AIDS course, 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 are now working with the state to develop a plan to divide and classify registered counselors into a number of new  categories by education, preparation, and other qualifications.   

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 therapy can begin.  (You get to keep a copy for your files.)   This is done to inform you of counselor's 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?]

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Question 10. 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?

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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 is the minimum and first requirement to work as a counselor in Washington State.  Once you are licensed, it is not necessary to renew your registration, only to keep your licensure current.

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, this is a controversial category and I would expect it to eventually be legislated out of existence.

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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!)
-- Initials and Acronyms Used By Counselors

           

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