Professionalism and Beyond as Clinical Mental Health Counselors

Presented by: Jim Messina, Ph.D., NCC, CCMHCAssistant Professor: Troy University Tampa Bay SiteWebsite: www.coping.us

From Dream to Reality in 1976On an impulsive whim Nancy and Jim:•Coined term “Mental Health Counselor”•Coined Association Title: The American Mental Health Counselor’s AssociationAs the process caught fire •Established the Profession of Mental Health Counseling•Set out to create its “Hallmarks of a Profession”

What are the Hallmarks of a Profession?

1. Professional Membership Organization

2. Code of Ethics3. Accreditation4. Certification and Licensure5. Research into Effectiveness of

Service Delivery

History Timeline of Creation of Mental Health Counseling

Profession• 1976 – Coining of term Mental Health Counselor

and formation of American Mental Health Counselor’s Association as Division of ACA

• 1979 – Creation of the National Academy of Certified Clinical Mental Health Counselors

• 1981 – First State Law to license Mental Health Counselors put into effect in Florida

• 1985 – AMHCA had over 12,000 members• 2011 – AMHCA put out its newest Standards of

Practice in Mental Health Counseling-Helping to put Health back into Clinical Mental Health Counseling

• 2013 – AMHCA has over 7,000 members

The National Professional Association of Mental Health

Counselors

American Mental Health Counselors Association

Founded in 1976 when term Mental Health Counselor was coined

Suncoast Chapter of FMHCA

Florida Chapter of AMHCA

Association AMHCA Belongs to

American Counseling AssociationWas known as APGA-American Personnel and Guidance Association in1976 and in 1983 as AACD American Association of Counseling and Development until 1992 when it changed to ACA

CODES OF ETHICS Governing

Mental Health Counselors

Research in the field is Reported in AMHCA’s Journal

AMHCA’s Online Newsletter

Accreditation: Standards for Training of CMHCCACREP (The Council for Accreditation of Counseling & Related Educational Programs)1988 CACREP set out its first Standards for accreditation of CMHC Programs using 60 hour requirement put out in 1979 by AMHCA – But it also had Community Counseling Programs with up to 48 hours – Most went Community Counseling2009 CACREP adopted standards for CMHC which included 60 hour requirement

2009 CACREP Standards for CMHCRequired both core CACREP areas & specialized training in clinical mental health Core CACREP areas include:1.Professional Orientation and Ethical Practice2.Social and Cultural Diversity3.Human Growth and Development across the lifespan4.Career Development5.Helping Relationships6.Group Work7.Assessment8.Research and Program Evaluation

2009 CACREP Standards for CMHC Specialized CMHC Training:1. Ethical, Legal & Practice Foundations of CMHC2. Prevention & Clinical Intervention3. Clinical Assessment4. Diagnosis & Treatment of Mental Disorders5. Diversity & Advocacy in Clinical Mental Health

Counseling6. Clinical Mental Health Counseling Research &

Outcome EvaluationThese areas of CMHC preparation address clinical

mental health needs across the lifespan (children, adolescents, adults and older adults) & across socially & culturally diverse populations.

AMHCA 2011 Standard Additional Requirement for CMHC TrainingThe 2011 AMHCA standards also recommend these additional areas of training for CMHC Training programs:1.Biological Bases of Behavior (including psychopathology and psychopharmacology)2.Specialized Clinical Assessment3.Trauma4.Co-Occurring Disorders (mental disorders and substance abuse)

Implications of AMHCA’s 2011 Expanded Clinical Standards for Training of CMHC’s1. Evidenced-Based Practices

a. Diagnosis and Treatment Planning using EBP’sb. Diagnosis of Co-Occurring Disorders & Trauma

2. Biological Basis of Behaviorsa. Knowledge of Central Nervous Systemb. Lifespan Plasticity of the Brain

3. Psychopharmacology4. Behavioral Medicine

a. Neurobiology of Thinking, Emotion & Memoryb. Neurobiology of mental health disorders (mood,

anxiety, psychosis) over life spanc. Promotion of optimal mental health over the

lifespan

Accreditation-CACREP74 Graduate Programs in the USA are CACREP approved in Clinical Mental Health CounselingIn Florida they are:1.Argosy Sarasota2.Barry University3.Florida Atlantic University4.Florida Gulf Coast University5.Florida International University6.Florida State University7.Rollins College8.Troy University Southeast Region: Orlando, Tampa, Ft. Walton Beach, Panama City & Pensacola9.University of Central Florida10.University of Florida11.University of North Florida12.University of South FloridaOnline:1.Cappella University2.Walden University

National Certification

Two National Certifications

•NCC: National Certified Counselor – Over 48,000

•CCMHC: Certified Clinical Mental Health Counselor – Over 1,000 are CCMHC’s

State Licensure-FL 491License BoardIn Florida•7,784 Licensed Mental Health

Counselors• 1,545 Licensed Marriage & Family

Therapists•10,070 Licensed Social Workers

State Licensure for Counselors and Related Fields

In USA•120,429 Licensed Professional Counselors•54,785 Licensed Marriage & Family

Therapists•202,924 Licensed Social Workers

All 50 States have Licensed Professional Counselors but only 15 have Mental Health Counseling in their Title (Major way of taking Health out of Clinical Mental Health Counseling!)

15 States with MHC’s in Title• Delaware-License Professional Counselor of Mental Health (LPCMH)• Florida-Licensed Mental Health Counselor (LMHC) First Licensed 1981• Hawaii-Licensed Mental Health Counselor (LMHC)• Indiana-Licensed Mental Health Counselor (LMHC)• Iowa-Licensed Mental Health Counselor (LMHC)• Massachusetts-Licensed Mental Health Counselor (LMHC)• Nebraska-Licensed Independent Mental Health Practitioner (LMHP)• New Hampshire- Licensed Clinical Mental Health Counselor (LCMHC)• New Mexico-Licensed Mental Health Counselor (LMHC)• New York-Licensed Mental Health Counselor (LMHC)• Rhode Island-Licensed Clinical Mental Health Counselor (LCMHC)• South Dakota-Licensed Professional Counselor-Mental Health (LP-MH)• Tennessee-Licensed Professional Counselor-Mental Health Service

Provider (LPC/MHSP)• Utah-Licensed Clinical Mental Health Counselors (LCMHC) as of 2012 • Vermont-Licensed Clinical Mental Health Counselor (LCMHC)• Washington-Licensed Mental Health Counselor (LMHC)

Major Recommendation to Promote Professional Identity of CMHC’s

Given only 15 out 50 states licensed CMHC’s, it is imperative that we who have LMHC licensure encourage the LPC’s in the other 35 states to gain Certified Clinical Mental Health Counselor (CCMHC) status through the NBCC which would be a clear way of putting HEALTH into Clinical Mental Health Counseling and a way to get counselors in all 50 states enabled to call themselves Clinical Mental Health Counselor

The Growth of Mental Health Counseling as a Profession•In 2008, according to US Department of

Labor: 120,000 Mental Health Counselors were employed & only 6.7% of them were self-employed

•By 2018 43,000 jobs will be added (for a for a total of 163,000), representing a 36.3% growth

• Median annual wages in 2008 for Mental Health Counselors was $38,150. This is High when compared to other jobs.

Parity with the Other Mental Health ProfessionsThe median reimbursable fee for service:•Clinical Mental Health Counselors is $63 •Psychologists is $75 for psychologists•Clinical Social Workers & Marriage and Family Therapists is $60

(January 2006 study by Psychotherapy Finances)

SO! What do Mental Health Counselors Currently Do?

Mental Health Counselors offer full range of services:

•Assessment & diagnosis•Treatment planning and utilization review•Psychotherapy•Brief and solution-focused therapy•Alcoholism and substance abuse treatment•Psycho-educational & prevention programs•Crisis management•Trauma Intervention

ACA’s 20/20 Commission’s Definition of Counseling

Counseling is a professional relationship that empowers diverse individuals, families and groups to accomplish mental health, wellness, education and career goalsThey also established:The counseling profession shall establish uniform licensing standards with LPC as an entry-level title for counselor licensure.

What Skills Do Mental Health Counselors Need?

•Ability to understand dynamics of Human Development to capture good psychosocial history of clients

•Diagnosis of and treatment for behavioral pathology

•Evidenced based practices in psychotherapy to provide credible treatment to clients

•Understanding of basic neuroscience of brain and nervous system to understand roots of emotional responses to life’s stressors

•Understanding of psychopharmacological treatment of psychopathology

What are the future prospects for the profession?

•Recognized for VA Positions in VA Hospitals and Field Agencies

•Approved for TRICARE-for military and their families

•AMHCA hopes to soon be recognized for Medicare Services

• Increased work in Behavioral Medicine in Hospitals, Rehab Centers & Primary Care Physicians’ Offices

• Increased work in Substance Abuse & Alcohol Treatment Facilities

Potential Clinical Setting Openings for CMHC’s with ACA ImplementationClinical Mental Health Counselors will be ideally situated to provide Behavioral Medical Interventions based on their expanded training and implementation of AMHCA’s Clinical Standards. They will then need to promote themselves in the following settings:

General Practice: Family Practice & Internal Medicine Clinics

Rehabilitation In-patient and out-patient Centers

General and Specialized HospitalsSenior Citizen’s Independent housing,

Assisted Living & Nursing Homes

Mental Health Needs of OEF & OIF Vets

•The invisible wounds which our OIF and OEF vets return with are staggering

•PTSD and TBI along with Combat Depression are staggering disorders which are impacting from 1/3 to 2/3’s of these vets. The Mental Health system over the next 5 to 10 years will become overwhelmed in meeting their individual as well as marital and family needs.

•CMHC’s need to be ready to serve this population

Baby Boomer Generation are Aging

•The increase in Boomers aging and their impact on the medical and mental health field cannot be ignored or underestimated

•It is imperative that CMHC’s be armed with Behavioral Medicine techniques to address the needs of this geriatric population to address their chronic health issues, disabilities and cognitive decline needs

Continuing Education Tools Needed by Clinical Mental Health Counselors

1. Evidenced Based Practices2. Neuroscience3. Psychopharmacology4. Behavioral Medicine5. Use of Telehealth Apps with Clients6. Military Focused Materials7. Multicultural Perspective as a

Mental Health Counselors

Get Professionally Active!

•Join AMHCA•Join FMHCA•Join SMHCA•Get Certified as NCC and CCMHC by

NBCC•Get Licensed in State of Florida as LMHC•Continue to expand competencies by

Continuing Education Programming