TPC-Journal-V1-Issue3

The Professional Counselor \ Volume 1, Issue 1 195 advocacy, or personal and environmental coping (Gladding, 2009; Hershenson, Power, & Seligman, 1989). The argument has now shifted to one of maintaining counseling’s traditional developmental, wellness approach moving towards an outcomes-oriented, pathology-based medical model (McAuliffe & Eriksen, 1999), or yet to be defined approach (J. S. Hinkle, personal communication, May 12, 2011). In the U.S., the influence of insurance corporations (e.g., HMOs) has moved the field towards cheaper, time-limited therapy, requiring particular Diagnostic & Statistical Manual- Fourth Edition-Text Revised ( DSM-IV-TR ; 2000) Axis I diagnoses to bill for counseling services (Remley & Herlihy, 2007). Faculty educated in a traditional wellness model are likely dismayed when counselor education programs adopt a pathology-based approach (Hansen, 2005; Remley & Herlihy, 2007). CACREP accreditation standards for mental health counselors appear to be aligned to a psychiatric rather than a developmental philosophy (CACREP, 2009) and credentialing boards (e.g., for licensure and certification) and influential organizations such as the World Health Organization (WHO) and related mental health professionals (e.g., psychiatrists, psychologists) create pressure on counselor education programs to educate their students in the DSM-IV-TR nomenclature. Accreditation standards and the marketplace demand adherence to a psychiatric model making it critical for counselors to become facile in understanding and applying the DSM-IV-TR . Although the psychiatric model has many critics (Gladding, 2009; Glasser, 2003) it remains the standard within the mental health field (Maddux & Winstead, 2010; Gladding, 2009; 2008; Remley & Herlihy, 2007). University counselor education departments also have expanded and diversified. School counseling programs frequently are offered alongside mental health counseling programs; two counseling disciplines moving in radically different directions. Given that the emphasis in counseling divisions varies from a developmental model (e.g., school counseling) to a DSM -driven model (e.g., mental health counseling), can traditionally-minded, developmentally- oriented counselor education faculty ethically support a pathological, DSM -based approach? Conversely, can mental health counseling faculty support a non-pathology driven approach? What about the potential confusion among graduate counseling students enrolled in programs offering these disparate philosophies? Do the philosophical differences dividing the various counseling specialties mean such divisions will be perpetuated in the classroom and among the faculty? Furthermore, what should be the driving force in shaping counselor education programs: philosophical orientation or marketplace demands (e.g., the need to be facile with and use the DSM-IV-TR )? According to Hansen (2003), “It is not unreasonable to assume that the juxtaposition of these completely opposite models in counselor training has an impact on the development of counselor trainees and the profession as a whole” (p. 98).These foundational fault lines within counselor education have yet to be adequately resolved, as developmental approaches are taught alongside medical- pathological approaches, likely resulting in confusion for students and disharmony among faculty. Perhaps the most realistic statement to make is that counseling is a broad profession encompassing both developmental approaches (e.g., school counseling) and clinical, diagnostic approaches (e.g., mental health counseling) for the purposes of insurance reimbursement. Gazing into the Future: Challenges and Opportunity Besides fractionalization, differences in training and concerns regarding marketplace parity, additional challenges have recently emerged. The highly technical nature of the twenty-first century has created challenges and opportunities unforeseen in previous eras. In his seminal opus The World is Flat , Friedman (2005) argues the Internet age has transformed the media, financial markets, the military, education and virtually everything else. For the counseling profession, the Internet represents more tidal wave than ripple effect, impacting types of institutions offering programs (e.g., traditional vs. virtual), where and how they are offered (e.g., residential vs. web delivery) and who will teach them (e.g., full-time faculty or adjunct faculty). In June 2010, a national conference titled “Who Needs a College Campus” was held (EduComm, 2011).The past decade has seen a spike in the numbers of college students enrolled in virtual institutions. The University of Phoenix, primarily a virtual, for-profit institution, sports a CACREP-accredited counseling program and though they hold counseling classes in-person, one wonders if this will soon change. The University of Phoenix now boasts the largest collegiate enrollment in the U.S. with over 400,000 students (Lederman, 2010). Many elite brick-and-mortar institutions including Harvard University now offer virtual degrees. Small liberal arts institutions have begun offering web degrees and using satellite campuses. For example, Tiffin University, a small institution in the U.S. Midwest, has doubled the number of its graduate students and seen its total enrollment rise more than 50% in five years (Blumenstyk, 2008). The increasing options and delivery methods for course offerings and degrees are likely to change the number and types of counselor education programs as well.