Mar 30, 2018 | Volume 8 - Issue 1
April D. Johnston, Aida Midgett, Diana M. Doumas, Steve Moody
This mixed methods study assessed the appropriateness of an “aged-up,” brief bullying bystander intervention (STAC) and explored the lived experiences of high school students trained in the program. Quantitative results included an increase in knowledge and confidence to intervene in bullying situations, awareness of bullying, and use of the STAC strategies. Utilizing the consensual qualitative research methodology, we found students spoke about (a) increased awareness of bullying situations, leading to a heightened sense of responsibility to act; (b) a sense of empowerment to take action, resulting in positive feelings; (c) fears related to intervening in bullying situations; and (d) the natural fit of the intervention strategies. Implications for counselors include the role of the school counselor in program implementation and training school staff to support student “defenders,” as well as how counselors in other settings can work with clients to learn the STAC strategies through psychoeducation and skills practice.
Keywords: bullying, bystander intervention, consensual qualitative research (CQR), high school, mixed methods
Researchers have defined bullying as “when one or more students tease, threaten, spread rumors about, hit, shove, or hurt another student over and over again” (Centers for Disease Control & Prevention [CDCP], 2017, p. 7). Bullying includes verbal, physical, or relational aggression, as it often occurs through the use of technology (e.g., cyberbullying). National statistics indicate approximately 20.5% of high school students are victims of bullying at school and 15.8% are victims of cyberbullying (CDCP, National Center for Injury Prevention and Control, 2016). Although school bullying peaks in middle school, it remains a significant problem at the high school level, with the highest rates of cyberbullying reported by high school seniors (18.7%; U.S. Department of Education, National Center for Education Statistics, 2016).
There are wide-ranging negative consequences experienced by students who are exposed to bullying as either a target or bystander (Bauman, Toomey, & Walker, 2013; Doumas, Midgett, & Johnston, 2017; Hertz, Everett Jones, Barrios, David-Ferdon, & Holt, 2015; Rivers & Noret, 2013; Rivers, Poteat, Noret, & Ashurst, 2009; Smalley, Warren, & Barefoot, 2017). High school students who are targets of bullying report higher levels of risky health behaviors, including physical inactivity, less sleep, risky sexual practices (Hertz et al., 2015), elevated substance use (Doumas et al., 2017; Smalley et al., 2017), and higher levels of depression and suicidal ideation (Bauman et al., 2013; Smalley et al., 2017). Adolescents who observe bullying as bystanders also report associated negative consequences, and, in some instances, report more problems than students who are directly involved in bullying situations (Rivers & Noret, 2013; Rivers et al., 2009). Specifically, bystanders have been found to be at higher risk for substance abuse and overall mental health concerns than students who are targets (Rivers et al., 2009). Bystanders also are significantly more likely to report symptoms of helplessness and potential suicidal ideation compared to students not involved in bullying (Rivers & Noret, 2013). Furthermore, although bystanders are often successful when they intervene on behalf of targets of bullying (Gage, Prykanowski, & Larson, 2014), bystanders usually do not intervene because they do not know what to do (Forsberg, Thornberg, & Samuelsson, 2014; Hutchinson, 2012). Failure to respond to observed bullying leads to feelings of guilt (Hutchinson, 2012) and coping through moral disengagement (Forsberg et al., 2014). Thus, there is a need to train bystanders to intervene to both reduce bullying and buffer bystanders from the negative consequences associated with observing bullying without acting.
To address the negative effects that can result from being exposed to bullying, researchers have developed numerous bullying prevention and intervention programs for implementation within the school setting. Many of these programs are comprehensive, school-wide interventions (Polanin, Espelage, & Pigott, 2012; Ttofi, Farrington, Lösel, & Loeber, 2011). However, findings indicate these programs are most effective for students in middle and elementary school (Yeager, Fong, Lee, & Espelage, 2015). Additionally, a recent meta-analysis indicates that bystander intervention is an important component of bullying intervention; however, few comprehensive programs include a bystander component (Polanin et al., 2012). Further, those programs that do include a bystander component have been normed on children within the context of the classroom setting (Salmivalli, 2010). High school students experience greater independence at school, with less adult supervision in the hallways and at lunch, and move to different classroom locations throughout the day. Thus, there is a need for effective bullying bystander programs and interventions that have been “aged up” specifically for the high school level (Denny et al., 2015).
The STAC Program
The STAC program is a brief bystander intervention that teaches students who witness bullying to intervene as “defenders” (Midgett, Doumas, Sears, Lundquist, & Hausheer, 2015). The STAC acronym stands for the four bullying intervention strategies taught in the program: “Stealing the Show,” “Turning It Over,” “Accompanying Others,” and “Coaching Compassion.” The second author created the STAC program for the middle and elementary school level with the intention of establishing school counselors as leaders in program implementation. The program includes a 90-minute training with bi-weekly, 15-minute small group follow-up meetings, placing low demands on schools for implementation. Findings from studies conducted at the elementary and middle school level indicate students trained in the STAC program report an increase in knowledge and confidence to intervene as defenders (Midgett et al., 2015; Midgett & Doumas, 2016; Midgett, Doumas, & Trull, 2017), as well as increased use of the STAC strategies (Midgett, Doumas, Trull, & Johnston, 2017). Additionally, research demonstrates students trained in the STAC program report reductions in bullying (Midgett, Doumas, Trull, & Johnson, 2017), as well as increases in self-esteem (Midgett, Doumas, & Trull, 2017) and decreases in anxiety (Midgett, Doumas, Trull, & Johnston, 2017), compared to students in a control group.
Development of the STAC Program for High School
The authors conducted a previous qualitative study to inform the modification of the original STAC program to be appropriate for the high school level (for details, see Midgett, Doumas, Johnston, et al., 2017). Based upon data generated from high school students, the authors “aged up” the STAC program by incorporating the following content into the didactic and role-play components of the training: (a) cyberbullying through social media and texting, (b) group dynamics in bullying, and (c) bullying in dating and romantic relationships. The authors also aged up the program by including developmentally appropriate language (e.g., breaks vs. recess) and content, including common locations where bullying occurs (e.g., school parking lot vs. the school bus) and age-appropriate examples of physical bullying (e.g., covert behaviors such as “shoulder checking,” “backpack checking,” and “tripping” vs. physical fights).
Purpose of the Study
The purpose of this study was to extend the literature by evaluating the appropriateness of the aged-up STAC program for the high school level and to explore the experiences of students trained in the program. Following guidelines suggested by Leech and Onwuegbuzie (2010), the literature review guided the formulation of the study rationale, goal, objectives, and research questions. Despite the need to provide anti-bullying programs to high school students, the majority of bullying intervention research has been conducted with elementary and middle school students (Denny et al., 2015). Although intervening on behalf of students who are targets of bullying is associated with positive outcomes (Hawkins, Pepler, & Craig, 2001), research on bystander intervention programs aged up for high school students is limited. The present authors could find only one program, StandUP, developed specifically for high school students. Results of a pilot study indicated students participating in the 3-session StandUP online program reported an increase in positive bystander behavior and decreases in bullying behavior (Timmons-Mitchell, Levesque, Harris, Flannery, & Falcone, 2016). The research noted several methodological limitations that limit the generalizability and validity of the findings, including a 6.8% response rate, 22% attrition rate with differential attrition by race and bullying status, and the use of a single-group design.
Thus, the goal of this study was to add to the knowledge on bullying interventions for high school students. Our objectives were to (a) examine the influence of the STAC program on knowledge and confidence, awareness of bullying, and use of the STAC strategies, and (b) describe and explore the experience of high school students participating in the STAC intervention. We were interested in answering the following mixed method research questions: (a) Do students trained in the aged-up STAC intervention report an increase in knowledge and confidence to intervene as defenders? (b) Do students trained in the aged-up STAC intervention have an increased awareness of bullying? (c) Do students trained in the aged-up STAC intervention use the STAC strategies to intervene when they observe bullying? and (d) What were high school students’ experiences of participating in the aged-up STAC intervention and using the STAC strategies to intervene in bullying situations?
Methods
Mixed Research Design
A mixed methods design was implemented with a single group of participants who completed the STAC training. We were interested in the influence of the STAC intervention on students’ knowledge and confidence, awareness of bullying, and use of the STAC strategies. An additional interest was to understand students’ experiences of the STAC training. The purpose of selecting a mixed methods design was to maximize interpretation of findings, as mixed methods designs often result in a greater understanding of complex phenomena than either quantitative or qualitative studies can produce alone (Creswell, 2013). Hesse-Biber (2010) also advocates for the convergence of qualitative and quantitative data to enhance and triangulate findings. Following the guidelines described by Leech and Onwuegbuzie (2010), we chose to supplement the quantitative data with qualitative data to investigate the in-depth, lived experiences of high school students trained as defenders in the aged-up STAC program. Our research design was a partially mixed, sequential design (Creswell, 2009; Leech & Onwuegbuzie, 2010). The quantitative design was a single-group repeated-measures design and the qualitative component included consensual qualitative research (CQR; Hill et al., 2005).
Participants
Our sampling design was sequential-identical (Leech & Onwuegbuzie, 2010), with the same participants completing surveys followed by focus groups. The sample consisted of 22 students
(n = 15 females [68.2%]; n = 7 males [31.8%]) recruited from a public high school via stratified random sampling in the Northwestern region of the United States. Participants ranged in age from 15–18 years old (M = 16.82 and SD = 0.91), with reported racial backgrounds of 59.1% White, 18.2% Asian, 13.6% Hispanic, and 9.1% African American. Of the 22 participants trained in the STAC program, 100% participated in follow-up focus groups and follow-up data collection.
Procedures
The current study was completed as part of a larger study designed to develop and test the effectiveness of the aged-up STAC intervention. Following institutional research board approval, the researchers randomly selected 200 students using stratified proportionate sampling and then obtained parental consent and student assent from 57 students, for a response rate of 28.5%. The current sample consists of the 22 students who participated in the STAC intervention. The recruiting team included school counselors, a doctoral student, and master’s students. A team member met briefly with students selected to discuss the project and provided an informed consent form to be signed by a parent or guardian. A team member met with students with parental consent to explain the research in greater detail and to obtain student assent. Researchers trained participants in the 90-minute aged-up STAC program and then conducted two 15-minute bi-weekly follow-up meetings for 30 days following the training. Students completed baseline, post-training, and 30-day follow-up surveys. Six weeks after the STAC training, team members conducted three 45-minute open-ended, semi-structured focus groups to investigate students’ experiences being trained as defenders in the aged-up STAC program. Researchers audio recorded the focus groups for transcription purposes. The team provided pizza to students after the follow-up survey and at the end of each focus group. The university and school district review boards approved all research procedures.
Measures
Knowledge and Confidence to Intervene. The Student-Advocates Pre- and Post-Scale (SAPPS; Midgett et al., 2015) was used to measure knowledge of bullying, knowledge of the STAC strategies, and confidence to intervene. The questionnaire is comprised of 11 items that measure student knowledge of bullying behaviors, knowledge of the STAC strategies, and confidence intervening in bullying situations. Examples of items include: “I know what verbal bullying looks like,” “I know how to use humor to get attention away from the student being bullied,” and “I feel confident in my ability to do something helpful to decrease bullying at my school.” Items are rated on a 4-point Likert scale ranging from 1 (I totally disagree) to 4 (I totally agree). Items are summed to create a total scale score. The SAPPS has established content validity and adequate internal consistency with Cronbach’s alpha ranging from .75–.81 (Midgett et al., 2015; Midgett & Doumas, 2016; Midgett, Doumas, & Trull, 2017; Midgett, Doumas, Trull, & Johnston, 2017). Cronbach’s alpha was .83 for this sample.
Awareness of Bullying. Awareness of bullying was assessed using one item. Students were asked to respond Yes or No to the following question: “Have you seen bullying at school in the past month?” Prior research has used this question to test the impact of the STAC program on observing and identifying bullying behavior post-training (Midgett, Doumas, Trull, & Johnston, 2017).
Use of STAC Strategies. The use of each STAC strategy was measured by a single item. Students were asked, “How often would you say that you used these strategies to stop bullying in the past month? (a) Stealing the Show—using humor to get the attention away from the bullying situation,
(b) Turning It Over—telling an adult about what you saw, (c) Accompanying Others—reaching out to the student who was the target of bullying, and (d) Coaching Compassion—helping the student who bullied develop empathy for the target.” Items were rated on a 5-point Likert scale ranging from 1 (Never/Almost Never) to 5 (Always/Almost Always). Prior research has used these items to examine use of STAC strategies post-training (Midgett, Doumas, Trull, & Johnston, 2017).
High School Students’ Experiences. Researchers followed Hill et al.’s (2005) recommendation to develop a semi-structured interview protocol to answer the question, “What were high school students’ experiences of participating in the aged-up STAC intervention and using the STAC strategies to intervene in bullying situations?” Researchers developed questions based on previous qualitative findings with middle school students (Midgett, Moody, Reilly, & Lyter, 2017), quantitative results indicating students trained in the program use the STAC strategies (Midgett, Moody, et al., 2017), and a review of the literature (Jacob & Furgerson, 2012). Researchers asked students the following questions: (1) Can you please talk about the personal values you had before the STAC training that were in line with what you learned during the STAC training? (2) Please share your experience using the STAC strategies (Stealing the Show, Turning It Over, Accompanying Others, and Coaching Compassion), (3) Can you share how using the STAC strategies made you feel about yourself? (4) How did being trained in the STAC program impact your relationships? (5) Can you please talk about your fears related to using the strategies in different bullying situations? and, (6) Overall, what was it like to be trained in the STAC program and use the STAC strategies?
The STAC Intervention
The STAC intervention began with a 90-minute training, which included information about bullying and strategies for intervening in bullying situations (Midgett et al., 2015). Following the training, facilitators met with students twice for 15 minutes throughout the subsequent 30 days to support them as they applied what they learned in the training. During these meetings, researchers reviewed the STAC strategies with students, and asked students about bullying situations they witnessed and whether they utilized a strategy. If students indicated they observed bullying but did not utilize a strategy, researchers helped students brainstorm ways in which they could utilize one of the four STAC strategies in the future.
Didactic Component. The didactic component included icebreaker exercises, an audiovisual presentation, two videos about bullying, and hands-on activities to engage students in the learning process. Students learned about (a) the complex nature of bullying in high school often involving group dynamics rather than single individuals; (b) different types of bullying, with a focus on cyberbullying and covert physical bullying; (c) characteristics of students who bully, including the likelihood they have been bullied themselves, to foster empathy and separate the behavior from the student; (d) negative associated consequences of bullying for students who are targets, perpetrate bullying, and are bystanders; (e) bystander roles and the importance of acting as a defender; and (f) the STAC strategies used for intervening in bullying situations. The four strategies are described below.
Stealing the Show. Stealing the Show involves using humor or distraction to turn students’ attention away from the bullying situation. Trainers teach bystanders to interrupt a bullying situation to displace the peer audience’s attention away from the target (e.g., tell a joke, initiate a conversation with the student who is being bullied, or invite peers to play a group game such as basketball).
Turning It Over. Turning It Over involves informing an adult about the situation and asking for help. During the training, students identify safe adults at school who can help. Students are taught to always “turn it over” if there is physical bullying taking place or if they are unsure as to how to intervene. Trainers also emphasized the importance of documenting evidence in cyberbullying cases by taking a screenshot or picture of the computer or cell phone over time for authorities (i.e., school principal and resource officer) to take action.
Accompanying Others. Accompanying Others involves the bystander reaching out to the student who was targeted to communicate that what happened is not acceptable, that the student who was targeted is not alone, and that the student bystander cares about them. Trainers provide examples of how students can use this strategy either directly, by inviting a student who was targeted to talk about the situation, or indirectly, by approaching a peer after they were targeted and inviting them to go to lunch or spend time with the bystander. This strategy focuses on communicating empathy and support to the student who was targeted.
Coaching Compassion. Coaching Compassion involves gently confronting the student who bullied either during or after the bullying incident to communicate that his or her behavior is unacceptable. Additionally, the student bystander encourages the student who bullied to consider what it would feel like to be the target in the situation, thereby fostering empathy toward the target. Bystanders are encouraged to implement Coaching Compassion when they have a relationship with the student who bullied or if the student who bullied is in a lower grade and the bystander believes they will respect them.
Role-Plays. Trainers divided students into small groups to practice the STAC strategies through role-plays that included hypothetical bullying situations. The team developed the scenarios based on student feedback on types of bullying that occur in high school, including cyberbullying, romantic relationship issues, and covert physical bullying (Midgett, Doumas, Johnston, Trull, & Miller, 2017). See Appendix A for the STAC scenarios.
Post-Training Groups. STAC training participants met in 15-minute groups with two graduate student trainers twice in the 30 days post-training. In these meetings, students reviewed the STAC strategies, shared which strategies they used, and explained whether they felt the strategies were effective in intervening in bullying. Trainers also addressed questions and supported students in brainstorming other ways to implement the strategies, including combining strategies or working as a group to intervene together.
Data Analysis
Quantitative. The authors used quantitative analyses to test for significant changes in knowledge and confidence and to provide descriptive statistics for frequency of awareness of bullying and the use of the STAC strategies. An a priori power analysis was conducted using the G*Power 3.1.3 program (Faul, Erdfelder, Lang, & Buchner, 2007) for a repeated-measures, within-subjects ANOVA with three time points. Results of the power analysis indicated a sample size of 20 was needed for power of > 0.80 to detect a medium effect size for the main effect of time with an alpha level of .05. Thus, the final sample size of 22 met the needed size to provide adequate power for analyses.
Before conducting primary analyses, all variables were examined for outliers and normality. The authors found no outliers and all variables were within the normal range for skew and kurtosis. To assess changes in knowledge and confidence, we conducted a GLM repeated-measures ANOVA with one independent variable, time (baseline, post-intervention, follow-up), and post-hoc follow-up paired t-tests to examine differences between time points. To evaluate awareness of bullying, we computed descriptive statistics to determine how many participants observed bullying at baseline and follow-up. To evaluate the use of STAC strategies, we computed descriptive statistics to examine the frequency of use of each strategy at the follow-up assessment. The authors used an alpha level of p < .05 to determine statistical significance and used partial eta squared (h2p) as the measure of effect size for the repeated-measures ANOVA and Cohen’s d for paired t-test with magnitude of effects interpreted as follows: small (h2p > .01; d = .20), medium (h2p > .06; d = .50), and large (h2p > .14; d = .80; Cohen, 1969; Richardson, 2011). All analyses were conducted using SPSS version 24.0.
Qualitative. The authors conducted focus groups and employed CQR methodology to investigate participant experiences (Hill et al., 2005). Specifically, CQR was chosen because it uses elements from phenomenology, grounded theory, and comprehensive process (Hill et al., 2005). CQR is predominantly constructivist with postmodern influence (Hill et al., 2005), which was a good fit for the project as we were interested in students’ experiences being trained in the aged-up STAC program. Furthermore, we selected CQR because it includes semi-structured interviews to promote the exploration of participants’ experiences, while also allowing for spontaneous probes that can uncover related experiences and insights, adding depth to findings (Hill et al., 2005). CQR was well suited for this study because it requires a team of researchers working together to reach consensus analyzing complex data (Hill et al., 2005). Focus groups were chosen because they allow researchers to observe participants’ interactions and shared experiences such as teasing, joking, and anecdotes that can add depth to the findings (Kitzinger, 1995). Focus groups have potential therapeutic benefits for participants, including increasing feelings of self-worth (Powell & Single, 1996) and empowerment (Race, Hotch, & Parker, 1994). Additionally, focus groups can be especially useful when power differentials exist between participants and decision makers (Morgan & Kreuger, 1993).
Three team members (the first and second authors and a master’s in counseling student) employed the CQR methodology to analyze the data. After the data transcription, each member worked individually to identify domains and core ideas prior to meeting as a group. The team met three times in the next month to achieve consensus. Researchers relied on participant quotations to resolve disagreements, to cross-analyze the data, and to move into more abstract levels of analysis (Hill et al., 2005). The team labeled domains as general (typical of all but one participant or all participants), typical (more than half of participants), and variant (at least two participants; Hill et al., 2005). An external auditor analyzed the data separately, utilizing NVivo qualitative analysis software (Version 10; 2012), and reported similar findings with the exception of a minor modification to one domain, which the team incorporated into final findings. Next, the researchers conducted member checks (Lincoln & Guba, 1985) by emailing all participants with an overview of the findings. All participants who responded agreed the findings were an accurate representation of their experience.
Strategies for Trustworthiness. As recommended by Hays, Wood, Dahl, and Kirk-Jenkins (2016), we used multiple strategies to strengthen the trustworthiness of the study. First, our process was reflexive with continuous awareness of expectations and biases. Prior to conducting focus groups, we discussed and wrote memos about our expectations and biases (Creswell, 2013). To triangulate data, all three analysts were involved throughout the process and in comparing findings among the team. An external auditor was included to provide oversight and increase credibility of findings. Once all researchers reached agreement about major findings, we elicited participant feedback to increase credibility and confirmability of our findings (Lincoln & Guba, 1985).
Findings
Knowledge and Confidence
The researchers examined changes in knowledge and confidence across three time points (baseline, post-intervention, and follow-up). Results indicated a significant main effect for time: Wilks’ Lambda = .31, F (2, 20) = 6.85, p < .000, h2p = .31. Follow-up paired t-tests indicated a significant difference in knowledge and confidence between baseline (M = 35.68, SD = 4.35) and post-intervention (M = 40.64, SD =3.11), t(21) = -6.52, p < .001, Cohen’s d = -1.46; and between baseline (M = 35.68, SD = 4.35) and 30-day follow-up (M = 40.68, SD = 4.10), t(21) = -4.96, p < .001, Cohen’s d = -1.06; but not between post-intervention (M = 40.64, SD = 3.11) and 30-day follow-up (M = 40.68, SD = 4.10), t(21) = -0.05, p = .96, Cohen’s d = -.01. Findings indicate students reported an increase in knowledge and confidence from baseline to post-intervention, and this increase was sustained at the 30-day follow-up.
Awareness of Bullying
The researchers examined rates of observing bullying at baseline and at the 30-day follow-up to determine if students became more aware of bullying after being trained in the STAC program. Rates of observing bullying increased from 54.5% to 63.6%, indicating that the STAC program raised awareness of bullying.
Use of the STAC Strategies
The researchers examined how frequently students in the intervention group used the STAC strategies at the 30-day follow-up. Among students who reported witnessing bullying (63.6%, n = 14), 100% indicated using one or more STAC strategies in the past month. Specifically, 64.3% reported using Stealing the Show, 42.9% reported using Turning It Over, 100% reported using Accompany Others, and 85.7% reported using Coaching Compassion.
Qualitative
Through CQR analysis, the team agreed on four domains with supporting core ideas. All of the domains below are general or typical and endorsed by participants via member checks.
Domain 1: Awareness and Sense of Responsibility. Participants (n = 8; 57%) talked about the STAC program enhancing their awareness of bullying behavior and increasing their sense of responsibility to act. Students spoke about some types of bullying being difficult to recognize and that the STAC training helped them become more aware of covert bullying situations. One participant gave an example about being able to recognize types of bullying that can often be overlooked. The student shared, “People look like they’re joking around and you . . . ignore it, but now it’s like they’re not [joking]. You can tell a little bit. I think . . . [the STAC program] brought . . . [awareness] out in us.” Students also talked about their experience being able to recognize different types of bullying and being equipped to intervene, as well as becoming aware that their actions can have an impact on others. One participant shared that “learning the different ways you can address . . . [bullying] also helps you realize the different forms it happens in, so it makes you value being aware of what’s going on and how your own actions affect other people.” Another student also spoke about the connection between being trained to act as a defender and a newfound sense of responsibility and shared that after STAC training, “there’s not really a reason to say that you don’t want to [get involved] because you’re scared, because you know what’s happening to the person is wrong and if you can change it, you should.” Another participant stated that “there’s some others that don’t have this training, so we’re the ones that should be stepping in if we see it. Everyone should, but . . . we know what to do.”
Domain 2: Empowerment and Positive Feelings. Participants (n = 9; 64%) spoke about a sense of empowerment and associated positive feelings that came from using the STAC strategies to intervene in bullying situations. For example, one participant stated, “It makes you feel a little bit more empowered because you realize you actually can make a difference in someone else’s life or in the whole community at your school or community in general.” Students also talked about the STAC program empowering them to make decisions about their friendships. A participant shared, “I actually told some people I didn’t want to talk to them or be friends with them [because] I can’t be around someone who is making fun of people with disabilities. . . . So, it changed the way I picked my friends.” Some students talked about the association between a sense of empowerment to make a difference in a bullying situation and feeling good about themselves and helping other students. A student said, “I feel like it made us feel good, like we made a positive difference in some way regarding the person that’s being bullied. So it makes it feel like we did something good, like a good deed.” Another student shared, “Somebody actually went to talk to him [ethnic minority student who was bullied] . . . and that was me. It was good to see him happy after he was feeling sad.”
Domain 3: Fears. Almost all participants (n = 12; 86%) spoke about how acting as a defender elicited fears related to judgment from peers or creating tension with friends. For example, one student shared, “I have a fear of being judged, which is kind of the thing of bullying. So, I try not to be so active with people at school.” Another participant also talked about fears related to peer judgment and creating tension with friends when utilizing the STAC strategy Accompanying Others by having lunch with a student who was a target of bullying. The student said, “It’s a social fear, or like ‘why are you hanging out with them?’ . . . and it’s kind of tense between you and your other friends because you brought this person that they didn’t want.” Students also talked about fears of making a situation worse. In particular, participants spoke about fears about reporting bullying situations to adults by using the STAC strategy Turning It Over. For example, one participant stated, “When you get teachers involved or your parents . . . [bullying] kind of . . . escalates . . . a lot of kids will avoid going to adults if they can until it gets physical.” However, most participants were encouraged to act despite their fears, and many discovered that the STAC program allowed them to overcome their fears. One participant stated, “I think starting out my biggest fear was that [using STAC strategies] wasn’t going to do anything, that nothing was going to change, but it really did, and I was pretty shocked that I had a positive effect on people.”
Domain 4: Natural Fit of STAC Strategies and Being Equipped to Intervene. Many participants (n = 10; 71%) indicated the STAC strategies were a natural fit and equipped them with tools to intervene when they witnessed bullying. For example, one student shared, “Stealing the Show [was a natural fit]. I think it happened during accelerated PE. Someone was making fun of someone’s bench max, and I could tell the person was uncomfortable, so I just made a joke or something and changed the subject.” Another participant spoke about Coaching Compassion: “It’s probably one of my favorite ones because it actually does something in the moment, [and] it actually taught me how I can put out the effort without feeling uncomfortable when doing it.” Further, participants shared that implementing the strategies increased their knowledge and confidence to intervene. For example, one participant shared, “You know when to use them [the strategies] and when it’s not necessary and how far you should go when using them.” The strategies seemed to successfully meet participants at their level of understanding and equip them with more structure and guidance to intervene more confidently and consistently.
Discussion
The purpose of this study was to investigate the appropriateness of the aged-up STAC program for the high school level and to explore the experiences of high school students trained in the program. Quantitative data indicated students trained in the aged-up program reported an increase in knowledge and confidence to intervene and an increase in awareness of bullying, and also reported using the STAC strategies when they observed bullying at school. Qualitative data enhanced the interpretation of quantitative findings, depicting students’ experiences being trained in the program and using the STAC strategies.
Findings indicate that participating in the STAC training was associated with an increased awareness and sense of responsibility. Reported rates of observing bullying increased from baseline to the 30-day follow-up (54.5% to 63.6%). These findings are consistent with research showing students trained in the STAC program report increased awareness of bullying behavior (Midgett, Doumas, Trull, & Johnston, 2017). Further, students indicated that once they became aware of covert bullying, they felt responsible to intervene. One explanation for this finding is that participating in the training leads to an increase in awareness of bullying situations, which promotes a sense of responsibility to act. This explanation is consistent with research suggesting that awareness of negative consequences to others leads to an increase in feelings of personal responsibility, which in turn, leads to action (de Groot & Steg, 2009).
Our data also revealed that the STAC training was associated with an increase in knowledge and confidence and a sense of empowerment associated with positive feelings and changes in friendships. These findings are consistent with research showing that when students intervene in bullying situations they feel a sense of congruence, a positive sense of self (Midgett, Moody, et al., 2017), and a sense of well-being (Schwartz, Keyl, Marcum, & Bode, 2009). Researchers also have shown that when bystanders do not intervene, the lack of action leads to guilt (Hutchinson, 2012) and moral disengagement (Forsberg et al., 2014). Further, researchers have found that students have a desire to belong to a peer group with similar values in “defending” behaviors as their own (Sijtsema, Rambaran, Caravita, & Gini, 2014). Thus, it is possible that the confidence and positive feelings associated with being trained to act as defenders extended to feeling empowered to disengage from peers who do not intervene on behalf of targets of bullying.
Results indicated students used Turning It Over the least frequently among the strategies, with only 49% of students using this strategy. This finding is in direct contrast to research with middle school students suggesting Turning It Over is used by 91% of students (Midgett, Doumas, Trull, & Johnston, 2017). Qualitative data revealed that students felt fearful about intervening; specifically, students talked about being afraid that Turning It Over to an adult would make the situation worse. This finding parallels research suggesting that high school students believe adults at school do not handle bullying effectively (Midgett, Doumas, Johnston, et al., 2017) and that when they report bullying to teachers, the situation either remains the same or worsens (Fekkes, Pijpers, & Verloove-Vanhorick, 2005). Coupled with research indicating students are more likely to report bullying when they believe their teachers will act (Cortes & Kochenderfer-Ladd, 2014) and will be effective in intervening (Veenstra, Lindenberg, Huitsing, Sainio, & Salmivalli, 2014), our findings suggest it may be useful to provide teachers with knowledge and skills so that they may effectively support students who report bullying.
Finally, findings indicated that 100% of students who witnessed bullying post-training used at least one STAC strategy and that students experienced the STAC strategies as a natural fit and felt equipped with tools to act in bullying situations. These findings are consistent with prior research indicating students trained in the STAC program report using the strategies (Midgett, Moody, et al., 2017; Midgett, Doumas, Trull, & Johnston, 2017). The most frequently used strategies were Accompanying Others and Coaching Compassion, used by 100% and 85.7% of students, respectively. One explanation for these two strategies being the most natural fit for students is that the formation of peer relationships is an important developmental priority for adolescents (Wang & Eccles, 2012). Accompanying Others allows students to foster relationships in a way that feels natural and altruistic. Also, as adolescents mature emotionally and their ability to empathize grows (Allemand, Steiger, & Fend, 2015), Coaching Compassion can encourage bystanders and students who bully to develop empathy toward targets.
Limitations and Future Research
Although this study contributes to the literature regarding developmentally appropriate bullying interventions for high school students, several limitations must be considered. First, because of our small sample size and lack of control group, we cannot make causal attributions or generalize our findings to the larger high school student population. Although we enhanced the significance of our findings with a mixed methods design, there is a need for future studies investigating the efficacy of the aged-up STAC program through a randomized controlled trial. Further, since our study was intended as a first step in the development of an age-appropriate program for high school, we did not assess decreases in bullying victimization or perpetration. Therefore, future randomized controlled trial studies should include these outcome variables. Another limitation is related to the measures used. Specifically, both awareness of bullying and use of each STAC strategy were measured by a single item, which can result in decreased reliability. Further, although the developers constructed the items to have face validity, there are no studies investigating the psychometric properties of these items in measuring awareness of bullying or use of the STAC strategies. Additionally, our quantitative and qualitative findings were based on self-report data. It is possible that students’ responses were influenced by their desire to please the researchers, especially within the context of the focus groups. Thus, including objective measures of observable defending behaviors would strengthen the findings.
Practical Implications
Our findings provide important implications for counselors in both school and other settings. First, high school counselors can implement aged-up bullying intervention programs such as the STAC program. High school counselors can find encouragement in our findings indicating high school students are invested in helping reduce school bullying and that being trained to intervene can be associated with increased awareness and sense of responsibility. Further, findings suggest it might be helpful for school counselors to provide students trained in the program with an opportunity to meet in small groups to foster friendships with peers who are committed to acting as defenders.
Results also suggest that high school students believe reporting bullying to adults may not be an effective strategy. School counselors are well positioned as student advocates to establish anonymous reporting procedures to counteract potential student fears related to being negatively perceived when they report bullying to adults. In all bullying intervention efforts, school counselors should coordinate with administration to ensure success. School counselors can facilitate teacher and staff development to help them understand students’ fears related to reporting bullying and provide teachers with necessary tools to help students who report bullying to them. Additionally, although a teacher training would increase the required time and resources needed to implement the STAC program, it may be an important addition at the high school level. In this module, school counselors could educate teachers about bullying and the STAC strategies so that teachers could reinforce the strategies with students. The training would emphasize Turning It Over, explaining to teachers their important role in helping student bystanders intervene when they observe bullying.
Lastly, this study also has implications for counselors working with adolescents outside the school setting. There are negative associated consequences to witnessing bullying as a bystander (Rivers & Noret, 2013; Rivers et al., 2009). In addition, adolescents report not knowing how to intervene on behalf of targets (Forsberg et al., 2014; Hutchinson, 2012), which can lead to feelings of guilt (Hutchinson, 2012). Thus, counselors can empower clients to act as defenders by providing psychoeducation regarding the STAC strategies. They can focus on strategies that clients feel are a natural fit as a starting point. Counselors can encourage clients to share bullying situations they most commonly observe at school and invite clients to talk through how they could use a favorite STAC strategy.
Bullying is a significant problem among high school students. This study provided support for the aged-up STAC intervention as an anti-bullying approach that is appropriate for high school students. Specifically, the STAC program helped students be more aware of bullying, feel a stronger sense of responsibility to intervene, and feel empowered to use the STAC strategies.
Conflict of Interest and Funding Disclosure
The authors received internal funding for this project from a College of Education Seed Grant from Boise State University.
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Appendix A
Aged-Up STAC Scenarios
Scenario 1
In the PE locker room, you overhear some girls talking about another girl who is going through a break-up. You hear them call her a “loser” (and some other hurtful names) and gossip about the reasons she and her boyfriend broke up. They also talk about how the girl is not skinny or pretty enough to date the guy.
Scenario 2
For a few weeks during break, you have noticed a group of students stand in the middle of the hallway and “shoulder check” another student as he tries to walk by to get to his next class on the other side of the school. Today, the student is tripped by one of the students standing with a group and something he was carrying was damaged.
Scenario 3
Your friends are hanging out at your house after school, looking through Twitter. One friend decided to follow a girl from school that they do not like and then repost one of her posts making fun of her in a humiliating way. This is not the first time your friend has done something like this.
Scenario 4
You are in the parking lot and suddenly you hear yelling coming from a car that is trying to pull out of a parking spot. You see a guy yelling at his girlfriend that she can’t go to lunch with a certain friend because he saw the text messages they sent last night. You know this happens a lot with this guy, and you’ve been concerned for a while.
April D. Johnston is a doctoral student at Boise State University. Aida Midgett is an associate professor at Boise State University. Diana M. Doumas is a professor at Boise State University. Steve Moody, NCC, is an assistant professor at Idaho State University. Correspondence can be addressed to April Johnston, 1910 University Blvd, Boise, ID 83725, aprilwatts@u.boisestate.edu.
Mar 30, 2018 | Volume 8 - Issue 1
Seth Olson, Kathleen Brown-Rice, Andrew Gerodias
Although professional counseling licensure portability has been a topic of interest for many years, limited empirical research has been conducted to examine state requirements to become a licensed professional counselor. To bridge this gap, state counseling license applications, including the District of Columbia, were investigated using descriptive statistics to determine similarities and differences. Results of this study determined that many states require coursework beyond Council for Accreditation of Counseling & Related Educational Programs (CACREP) standards, and there are numerous other factors beyond educational prerequisites that licensing boards consider when endorsing an applicant as a licensed professional counselor. Developing a central location to review applications is one recommendation discussed to address many of the individual states’ concerns and requirements, organize uniform agreements on comportment behaviors, and improve client and professional counselor protection.
Keywords: licensed professional counselor, licensure portability, state counseling license applications, descriptive statistics, CACREP
States began licensing professional counselors 41 years ago. The first state to implement a counselor license was Virginia in 1976 (Bloom et al., 1990), and the last was California in 2009. Because each state independently licenses counselors, significant variances exist in educational, training, and supervision requirements for licensure (American Counseling Association [ACA], 2017). State-by-state criteria has created great variations in what a counseling license is called (i.e., Licensed Professional Counselor, Licensed Clinical Professional Counselor, Licensed Professional Clinical Counselor, Licensed Mental Health Counselor, Licensed Professional Clinical Mental Health Counselor, Licensed Clinical Mental Health Counselor, Licensed Professional Counselor – Mental Health; National Board for Certified Counselors [NBCC], 2017a). Further, a great diversity in examination requirements for state licensing also exists (e.g., National Counselor Examination [NCE], National Clinical Mental Health Counselor Exam [NCMHCE], Certified Rehabilitation Counselor Examination; ACA, 2017).
Since the beginning of the licensing process, counselor licensure portability, or the ability for a license to be easily carried elsewhere, has been an issue of discussion and continues to be a key trending topic in the counseling profession (ACA, 2017; Kaplan & Gladding, 2011; Kaplan, Tarvydas, & Gladding, 2014; NBCC, 2017b). However, complex legislature processes and differing requirements have led to licensure portability having limited success (Mascari & Webber, 2013; NBCC, 2017b). In fact, ACA (2016) provides a detailed list of state-by-state licensure requirements for professional counselors, which includes a description of the vast differences in licensure by endorsement for each state. Given that these divergent requirements are seen as impediments to counseling licensure portability (Bergman, 2013), it is surprising there is a dearth of literature related to comparing and contrasting jurisdictional requirements for professional counselor licensure.
Historical Perspectives
In 1974, the Board of Directors of the American Personnel and Guidance Association (APGA, now ACA) approved a position paper, “Licensure in the Helping Professions,” and created a special committee to implement “the formulation and dissemination of model credentialing legislation for counselors” (Bloom et al., 1990, p. 511). As a result of these efforts, counselor licensing bills began in 1976. At the same time, the counseling profession’s efforts to standardize and improve the preparation of professional counselors also were occurring. In 1973, the Association for Counselor Education and Supervision (ACES) adopted Standards for Entry Preparation of Counselors and Other Service-Personnel Specialists (Sweeney, 1992). In 1981, ACA established the Council for Accreditation of Counseling & Related Educational Programs (CACREP) to develop educational standards in training counselors. CACREP has been seen as “the national standard for counseling programs . . . [which] has set the profession on a path toward clear counselor identity through its process of preparation program accreditation” (Mascari & Webber, 2013, p. 16).
Currently, researchers (Mascari & Webber, 2013) and associations (ACA, NBCC) are promoting the idea that licensing and certification should be tied to graduating from a CACREP-accredited program. However, other researchers seem less supportive of this position because of the strain they believe CACREP accreditation places on educational institutions related to the need for additional faculty, curriculum changes, fees and site team expenses, and accreditation maintenance requirements (Cato, 2009; D’Andrea & Liu, 2009). Additionally, counseling psychology literature provides that restricting counselor licensure to graduating from programs that are CACREP-accredited only impacts the sustainability of professional counseling (Brady-Amoon, 2012; Hansen, 2012). In fact, the Council of Counseling Psychology Training Programs developed the Masters in Counseling Accreditation Committee (Kurpius, Keaveny, Kim, & Walsh, 2015), which eventually formed the Masters in Psychology and Counseling Accreditation Council (MPCAC). The MPCAC (2018) now provides an alternative accreditation for master’s degree counseling programs. This example showcases a variation in counselor training (CACREP versus non-CACREP), which may contribute to complications related to licensure portability. Even though it is not possible to accurately identify every non-CACREP program for perspective, currently there are 738 CACREP-accredited programs (master’s, doctoral, educational specialist; CACREP, 2017) and 50 MPCAC programs. Furthermore, NBCC and all 50 states provide alternative paths for both CACREP and non-CACREP programs. However, in an attempt to improve license portability, starting January 1, 2022, NBCC (2018) will require a master’s degree or higher from a CACREP-accredited counseling program.
Licensure Portability Efforts
The 20/20: A Vision for the Future of Counseling initiative, a collaboration between ACA and the American Association of State Counseling Boards (AASCB), found that in order to advance the future of professional counseling, licensure portability is needed (Kaplan & Gladding, 2011). To answer this call, various agencies have established policies to address a counselor’s ability to carry a license between states. ACA (2017) supports that a counselor who is “licensed at the independent practice level in their home state and who has no disciplinary record shall be eligible for licensure at the independent practice level in any state or U.S. jurisdiction in which they are seeking residence” (paragraph 7). Further, this portability policy allows for a state to require a jurisprudence examination based on the rules and procedures of that state.
Some organizations have found success in their advocacy efforts toward portability. In fact, AASCB has been on the forefront regarding “efforts to develop a seamless process for counselors to transfer their license without repeating the application” (Mascari & Webber, 2013, p. 17). AASCB (2017) provides that Delaware, Iowa, Kansas, Louisiana, Michigan, Oklahoma, Vermont, Ohio, Idaho, District of Columbia, and Utah have all adopted a 5-year endorsement process (if the counselor has worked 4,000 hours). This means that if a counselor in Utah meets the standard of agreement, they are able to obtain a license in Kansas. More specifically, AASCB (2017) provides that:
A fully-licensed counselor, who is licensed at the highest level of licensure available in his or her state, and who is in good standing with his or her licensure board, with no disciplinary record, and who has been in active practice for a minimum of 5 years post-receipt of licensure, and who has taken and passed the NCE or the NCMHCE, shall be eligible for licensure in a state to which he or she is establishing residence. The state to which the licensed counselor is moving may require a jurisprudence examination based on the rules and statutes of said state. An applicant who meets these criteria will be accepted for licensure without further review of education, supervision and experiential hours. (AASCB, 2017, p. 3)
Additionally, to assist with licensed counselors, AASCB created the National Credential Registry to save and transfer portability-related documents between boards (Tarvydas & Hartley, 2009).
Most recently, AASCB has joined with NBCC, ACES, and the American Mental Health Counselors Association (AMHCA) in having completed a state-by-state analysis that resulted in a Joint Statement on a National Counselor Licensure Endorsement Process, which states:
Any counselor licensed at the highest level of licensure for independent practice available in his or her state may obtain licensure in any other state or territory of the United States if all of the following criteria are met:
- The licensee has engaged in ethical practice, with no disciplinary sanctions, for at least 5 years from the date of application for licensure endorsement.
- The licensee has possessed the highest level of counselor licensure for independent practice for at least 3 years from the date of application for licensure endorsement.
- The licensee has completed a jurisprudence or equivalent exam if required by the state regulatory body.
- The licensee complies with ONE of the following:
- Meets all academic, exam, and postgraduate supervised experience standards as adopted by the state counseling licensure board.
- Holds the National Certified Counselor (NCC) credential, in good standing, as issued by the National Board for Certified Counselors (NBCC).
- Holds a graduate-level degree from a program accredited by the Council for Accreditation of Counseling & Related Educational Programs (CACREP).
(NBCC, 2017a)
The goal of this multi-agency portability policy was to establish “minimum licensure endorsement standards for public protection and moving the profession toward the future goal of unified education standards, examination requirements, and years of postgraduate experience” (NBCC, 2017a).
Although some states have agreed to licensure portability, the majority of states require applications to meet the specific rules of licensure in their state (AASCB, 2017). However, little attention has been paid to examining the differences in states’ requirements to become a licensed professional counselor. The purpose of this manuscript is to bridge this gap in the literature by investigating the U.S. licensed professional counselor application forms. This included analyzing specific application requirements, such as historical disclosures (e.g., criminal history, drug and mental health history, ethical violations, malpractice proceedings) and educational prerequisites. This manuscript will identify common and uncommon requirements to become a licensed professional counselor and will identify specific jurisdictional standards that may impact licensure portability.
Methods
A descriptive design is often used to share quantitative descriptions in a manageable form (Trochim, Donnelly, & Arora, 2016). Essentially, this allows for the simplification of large amounts of data in a sensible way. State license applications consist of many elements and information gathering points. In order to understand the various similarities and differences among licenses, a detailed examination of the elements of the applications is needed. This study utilized a non-experimental descriptive design to provide a summary of data (Huck, 2011) related to the following broad research question: What are the similarities and differences between state professional counseling licensure applications?
From 2016–2017, the authors completed an extensive search for counseling licensure applications from all 50 states and the District of Columbia. This included the capture of states with multiple counseling licenses. State applications were obtained via online downloads. Once all applications were collected, the authors constructed a list of pertinent items after reviewing each application. Specifically, the first and second author independently reviewed each licensure application and created independent lists of key elements. These items were separated into broader categories that frequently followed major section headings on the applications. Each category was independent of the others. After the first review, the first and second authors compared their organization of items and refined their data collection points. These authors then reviewed the applications independently for a second time and once again compared findings. Common categories were identified as follows: supplemental documentation, licensure history, criminal history, alcohol or other drug history, mental and physical illness history, unethical and professional problems, organization history, malpractice history, employment/training history, fraud history, required supervised hours, and educational courses completed. Categories were then comprised of multiple elements representing more detailed information. For example, Maine labeled a prominent section “Criminal Background Disclosure.” Within this section there were two questions: whether the applicant was convicted of any crime and whether there was any disciplinary action toward the applicant. For comparison, Idaho did not have a section clearly identifying criminal activity background, but did ask if the applicant had been convicted of a felony. In examples such as this, the first and second authors came to an agreement that a category of criminal activity was needed and questions such as the ones found on the Maine and Idaho applications would be placed within that category.
For a third time, these authors jointly compared the lists, made notes of discrepancies, discussed wording and language, and reached consensus (i.e., inter-rater agreement was 95%) for what each item would include. It is important to note that states often asked for similar information, but with different language. More specifically, states would often ask follow-up questions on the same topic. For instance, some states would only ask if another board ever licensed the applicant, whereas other states would provide a follow-up requirement that the applicant provide verification of license from another state board. After three organizational reviews and high inter-rater agreement was established, the third author began a process of reviewing each application to document frequencies for categories and items within those categories. During this process, the third author discovered errors, which the first and second authors discussed and addressed. The third author then conducted the frequency process for a second time to arrive at a final, error free frequency report for all included applications.
Results
Overall, 49 state license applications were reviewed and the District of Columbia (D.C.) was added for a total of 50 applications. To simplify, this study uses the term “states” to include D.C. and the 49 states in the review of license applications. Ohio was omitted from this research because of an online process that required account creation. It was discovered that of the 50 states, 10 (Idaho, Illinois, Kansas, Maine, Minnesota, Nebraska, New Mexico, North Dakota, South Dakota, and Tennessee) have two distinct licenses that operate as a tiered approach to professional counselor licensure. To clarify, states utilizing provisional counseling licenses (e.g., Missouri) or associate designations (e.g., North Carolina) were not included, as they were determined to be a subset of a license or a path toward a license as opposed to a separate and distinct license found with multiple-tier licenses. In addition, states using levels of progression (e.g., Utah) or providing multiple types of counseling licenses (e.g., marriage and family, drug and alcohol, grief, supervisor designations) also were omitted to simplify the research. In short, second-tier licenses for this research focused on counseling licenses specific to mental health with the ability to practice independently and were uniquely separate from the first tier. This resulted in a total of 60 licenses specific to professional counseling reviewed in this research. Given the broad scope of information available, the researchers separated results into two areas: first-tier licenses from 50 states (i.e., 49 states and D.C.) and second-tier licenses from 10 states, which were typically identified with additional descriptors in the licensure title (e.g., Licensed Mental Health Counselor, Licensed Professional Clinical Counselor). Moreover, it was determined that second-tier licenses tended to require slightly more information from applicants related to more graduate training and post-training clinical direct and indirect counseling-related hours. Categories and tier license data can be found in Table 1.
First-Tier Licenses
A review of the licensure applications for first-tier professional counseling licenses revealed common trends in the licensure requirements for the 49 states and D.C. These included requiring: (a) educational requirements, (b) completed client direct and indirect counseling-related hours, (c) examination, (d) application fee, (e) supplemental documentation to the application (e.g., criminal background check, letters of reference, photograph, birth certificate, videotape of counseling session), and (f) attestation of the applicant related to past behaviors (e.g., state licensure history, criminal history, mental health history, ethical complaints against applicant, professional organization complaints against applicant, and liability insurance history).
Educational requirements. Of the 50 first-tier licenses reviewed, a total of 30 course-related topics were identified as required. Courses most frequently identified were connected to CACREP core curriculum standards. To point, both research and program evaluation and group counseling and group work (also identified as group dynamics on applications) were identified by 66% (n = 33) of the state applications. Other core standard–related education areas were assessment and appraisal at 64% (n = 32); human growth and development, professional counseling orientation and ethics, and social and cultural foundations at 62% each (n = 31); and finally career development at 60% (n = 30). After these seven CACREP core-related standards, there was a significant drop in representation. Helping relationships, which is the eighth CACREP core standard, was identified by 46% (n = 23) of the states, and counseling theories and techniques by 42% (n = 21). A third cluster of courses seemed to be more specialized, likely related to specialty areas in the 2016 CACREP standards. These included family counseling (24%, n = 12), substance abuse (20%, n = 10), diagnosis (20%, n = 10), psychopathology (18%, n = 9), and clinical supervision (16%, n = 8). A fourth and final clustering of courses seemed to be highly specific to a small number of states. For example, psychopharmacology and human sexuality were required by five states (10%), and even more finitely required were courses such as a course on the chronically mental ill (Washington) and a course on understanding HIV (Florida). Thus, when comparing the 50 state applications, 42% (n = 21) of the applications required all eight of the CACREP-related core standard courses. Interestingly, 22% (n = 11) of the applications required two or fewer of the eight CACREP-related core standard courses and 36% (n = 18) did not specifically note any of the core standards as required.
Table 1
State Licensure Frequency Report For Prominent Categories and Items
State Licenses State LicensesTier 1 (n = 50) Tier 2 (n = 10)
|
n |
% |
n |
% |
Supplemental Application Documentation: |
|
|
|
|
Only NCE required |
28 |
56% |
0 |
0% |
Only NCMHCE required |
10 |
20% |
10 |
100% |
Both NCE and NCMHCE required |
10 |
20% |
0 |
0% |
Either NCE or NCMHCE required |
3 |
6% |
0 |
0% |
Application fee: $100 or less |
15 |
30% |
6 |
60% |
Application fee: $101–$199 |
17 |
34% |
3 |
30% |
Application fee: $200+ |
14 |
28% |
1 |
10% |
Educational Courses: |
|
|
|
|
Group Dynamics |
33 |
66% |
8 |
80% |
Research and Program Evaluation |
33 |
66% |
10 |
100% |
Assessment and Appraisal |
32 |
64% |
9 |
90% |
Human Growth and Development |
31 |
62% |
10 |
100% |
Social and Cultural Foundations |
31 |
62% |
7 |
70% |
Professional Counseling Orientation and Ethics |
31 |
62% |
8 |
80% |
Career Development |
30 |
60% |
9 |
90% |
Helping Relationships |
23 |
46% |
8 |
80% |
Complete Attestation Regarding: |
|
|
|
|
Board/Licensure History: |
|
|
|
|
Refused a license/attestation |
33 |
66% |
4 |
40% |
License suspended by board |
29 |
58% |
6 |
60% |
License revoked by board |
29 |
58% |
6 |
60% |
Disciplined by a board |
27 |
54% |
5 |
50% |
Licensed by another board |
24 |
48% |
6 |
60% |
Criminal History: |
|
|
|
|
Convicted of a crime (misdemeanor or felony) |
38 |
76% |
8 |
80% |
Charged with a crime (misdemeanor or felony) |
30 |
60% |
3 |
30% |
Ever been convicted of a felony |
19 |
38% |
6 |
60% |
Criminal background check required |
14 |
28% |
1 |
10% |
Medical/Mental Health/Alcohol and Other Drug History: |
|
|
|
|
General investigation of mental health problems |
27 |
54% |
3 |
30% |
Impaired by alcohol/drugs and not able to perform professional duties |
11 |
22% |
3 |
30% |
Ever diagnosed with an addiction/participated in addiction treatment |
8 |
16% |
2 |
20% |
Unethical/Professional Organization/Malpractice History: |
|
|
|
|
Censured or judged guilty of any unethical practice |
6 |
12% |
2 |
20% |
Professional membership denied |
4 |
8% |
3 |
30% |
Professional membership revoked |
3 |
6% |
3 |
30% |
State applications were varied in minimum required graduate training credits. Nearly all states cited CACREP training as a requirement, but the minimum number of hours required was nearly evenly split. A little more than half (54%, n = 27) of the first-tier licenses required a minimum of 60 semester credit hours, while 46% (n = 23) required a minimum of 48 semester hours. Additionally, CACREP language related to a specialty degree title was found. For example, Florida requires 60 semester hours and cites CACREP accreditation and core curriculum standards, but adds that the degree must be in mental health counseling with specific courses in substance abuse and human sexuality. Florida is not alone: Close to 75% (n = 37) of the applications note language specific to additional course topics and/or degree title needed from CACREP training.
Direct and indirect counseling-related hours. States ranged from 2,000 to 4,000 required counseling-related hours, with the most frequent prerequisite being 3,000 hours (62%, n = 31). Nearly all states noted postsecondary hours, but a few, Pennsylvania in particular, allowed for hours earned during training to be included. Overall, most had clear distinction not only with the number of hours required, but also the ratio of total hours and direct client hours (i.e., 3,000:1,500), whereas other states utilized a formula of sorts related to years worked. Georgia, for example, noted that direct experience must be a minimum of 600 hours per year, but the number of years was degree-dependent, such that an applicant with a master’s would require 4 years (2,400 hours) and one with a doctoral degree would require one year (600 hours). Washington reduced the number of required postgraduate hours by 500 if the applicant graduated from a CACREP-accredited program. Still others only identified a total number of hours, or in the case of Florida, only direct hours. The bulk of states had relatively simple definitions for hours, such as South Dakota stating 2,000 total hours with 800 being direct. Others were more complex, such as California, which noted an applicant needed a minimum of 1,750 “direct psychotherapy” hours, a minimum of 500 “group counseling” hours, a maximum of 250 hours in “telephone counseling,” a maximum of 250 hours related to administering tests and writing reports, and a maximum of 250 hours involved in workshops or other trainings. It also was found that there was a range of time frames associated with individuals completing their hours (i.e., 2 years minimum to 4 years maximum). To this point, Tennessee noted that an applicant needed “a minimum of 2 years of supervised post-masters professional experience,” totaling 1,000 clinical hours, and the hours had to accumulate at a rate of no less than 10 hours per week.
Examinations. All states required some version of examination. Overall, the NCE was identified by a majority of the states (n = 41), with 23 states identifying the NCMHCE. In many cases, states only required the NCE (n = 28), whereas others only required the NCMHCE (n = 10). Some states (n = 10) gave the applicant a choice of completing either the NCE or the NCMHCE, while three states (Arkansas, Utah, Vermont) required the applicant to complete both examinations. It is important to note that there were six states that added a jurisprudence exam.
Application fees and supplemental documentation. A large majority of states required an application fee (92%, n = 46), but the amount varied. Fees ranging between $101–$199 were most frequent (34%, n = 17), followed by $100 and under (30%, n = 15), and $200 and over (28%, n = 14). The highest amount per application was $415, required by Minnesota. Application fees were rarely the only cost associated with an application for licensure. Along with national exam costs, an applicant can expect to pay for a jurisprudence exam or Center for Credentialing & Education (CCE) course equivalence reviews. CCE provides a service for state licensing boards, at the cost of the applicant, to review and evaluate completed courses as being a match to the state-specific required course topics. For example, if an applicant completed 48 credit hours from a CACREP-accredited program and then completed an additional 12 credit hours elsewhere (in order to meet a required 60 credit hours of training), CCE would provide a recommendation to a state board regarding the quality of the courses. Along with application processing fees, applicants may be required to submit a photograph of themselves (36%, n = 18) or letters of recommendation (24%, n = 12). Unique requirements also existed. Rhode Island required a birth certificate and North Dakota requested a videotaped counseling session.
Attestation. All states required applicants to sign an attestation regarding past behaviors and experiences. The most common attestation focused on state licensure history as well as criminal history. Uncommon attestations related to applicants’ mental health history and past unethical behaviors, sanctions by professional organizations, and liability insurance history.
Licensure history. Of the 50 states, most asked whether any previous license had been refused (66%, n = 33), suspended (58%, n = 29), or revoked (58%, n = 29). About half (48%, n = 24) of the states wanted to know if another board had licensed the applicant, with 79% (n = 19) of those states requiring verification of the previous license. Additionally, 27 (54%) states asked about discipline by a state board; however, few states probed further on these issues, such as asking about any pending investigations by a board (32%, n = 16) or complaints filed with a board (16%, n = 8). Along with problems experienced with any license, 10 states (20%) requested whether or not the applicant was prohibited from taking any counseling licensing exam. Only one application (West Virginia) specifically required attestation regarding previously failed licensing or professional exams, and two states (Delaware, Missouri) required applicants to attest to never providing deceptive information regarding licensure. Eighty percent (n = 40) of states did not query about malpractice settlement history or if the applicant was ever a defendant in legal action related to malpractice. Only one state (Iowa) queried about any pending malpractice actions, and Michigan was the lone state to request if the applicant had three or more malpractice settlements, awards, or judgments totaling $200,000 in consecutive 5-year time periods.
Criminal history. All states queried applicants about criminal background, yet there were limited requests for basic conviction or charge information. Thirty-eight states (76%) inquired about conviction of a crime (i.e., misdemeanor or felony), but fewer (60%, n = 30) inquired about being charged with a crime (i.e., misdemeanor or felony). Moreover, 72% (n = 36) did not require a background check. An even smaller group of states went a step further to ask about incarceration. Georgia, Indiana, Mississippi, and Utah asked if the applicant had “ever been incarcerated,” with Michigan and South Dakota asking if the applicant had ever been convicted of a crime that would result in incarceration for more than a year. States infrequently pressed for more detailed information regarding conviction, such as information about being a defendant in criminal court (n = 4) or having expunged convictions (n = 3), pardons (n = 3), and/or diversions (n = 1). Indiana, for example, was the only state to ask if the applicant ever had a pre-trial diversion or deferred prosecution, and Delaware and D.C. were the only states to query if a felony had ever been expunged or pardoned.
Only three states emphasized criminal activity related to abuse. Illinois was the only state to question if an applicant had ever been charged with or convicted of an act that required registration as a sex offender and the only state to inquire about physical abuse toward a client. Kansas and Utah asked about physical, emotional, mental, and sexual abuse or neglect; however, they only connected these concerns to a government agency claim. No state required information about any sex offense. Ten percent of states (n = 5) asked if the applicant had been investigated related to acts or behaviors that violate community standards.
Ten first-tier license applications inquired if the applicant had ever been charged with driving under the influence. Alaska was the only state that inquired if the applicant had a DUI conviction in the past 5 years. Other states asked for different controlled substance conviction information, such as: ever found guilty of using, possessing, or distributing a controlled substance (Michigan, Oregon, and Pennsylvania); ever charged or convicted of violating a federal or state drug law (Missouri, New Mexico); or ever convicted of a crime involving drugs or alcohol (New Hampshire, North Carolina). Some states (Colorado, Michigan, New Mexico) required that applicants provide information to two or more of these controlled substance-related questions.
Mental health problems and treatment. The mental health history category includes alcohol or other drug history to simplify results. Most states (n = 27) were interested in mental problems experienced by the applicant. These interests ranged from drug and alcohol usage (e.g., impaired during professional duties, use of illegal drugs or non-prescribed controlled substances, addicted or abusing drugs) to specific disorders, as well as requesting information about treatment related to those problems and when the problems occurred (e.g., ever, in the past 2–10 years, currently). However, the depth of interest was limited. For example, two applications queried about ever being diagnosed with a mental disorder that involved potential health risk to the public, and ever being hospitalized for any mental or emotional illness. Furthermore, only six states (12%) inquired if the applicant had been impaired by a mental health issue and not able to perform professional duties. A handful of states, ranging from one to four, applied a time frame to mental health concerns impairing abilities or resulting in hospitalizations. To that point, Arizona inquired about an applicant, within the past 5 years, being hospitalized for emotional or mental illness, and Minnesota and North Carolina requested affirmation regarding a 5-year time frame for any “raised” issues related to drugs, alcohol, and mental disorders.
Although the majority of states (94%, n = 47) did not specify disorders of concern, there were three that required information about particular disorders and within a certain time frame. Minnesota specifically queried regarding diagnosis and treatment for mood disorders, schizophrenia, and psychotic disorders, all within a 10-year time frame. Arizona queried about similar disorders, but with a 5-year time frame, and Colorado did as well, except it did not include psychotic disorders. Interestingly, slightly more states (Mississippi, New Jersey, Tennessee, and Washington) were interested in the applicant being diagnosed or treated for paraphilia(s).
Contrarily, substance abuse disorder information was investigated more thoroughly by states across the country. Of the 50 first-tier applications reviewed, 22% (n = 11) requested if the applicant had ever been impaired by alcohol or other drugs and was not able to perform professional duties, and 16% (n = 8) asked if the applicant had ever been diagnosed with an addiction or participated in an addiction treatment program. As with mental health problems, substance use- and abuse-related questions varied in terms of time frame, definition of impairment, and specificity of information required. States wanted information about addiction ranging from 2 to 5 years all the way to “ever.” They also varied in word choices, such as illegal drugs, controlled substances, alcohol, and drugs.
Unethical behaviors, professional organizations, and liability insurance history. The most infrequent category of attestation related to an applicant’s unethical behavior, history with professional organizations, or issues with liability insurance. Six states (12%) requested that applicants attest to being censured or judged guilty of any unethical practice. This apparently vital attestation was unconnected to a licensing board or any other specific entity and was simply a standalone request. Aside from general unethical practice, a small handful of states wanted specific information related to professional membership. No application identified specific organizations (e.g., state-specific or national counseling-related organizations) and only vague attestation was requested regarding denial of professional membership (n = 4), professional membership revoked (n = 3), professional membership suspended (n = 2), and professional membership limited (n = 1). It is interesting to note that Oklahoma queried about all four of these professional membership attestations. None of the 50 states asked if the applicant needed to resign from a professional society. New Hampshire and Utah were the only states to request information about liability insurance. Their request was detailed in that it was asked if liability insurance had been denied, revoked, suspended, reduced, limited, or not renewed.
Second-Tier Licenses
Ten states offered two counseling licenses (Idaho, Illinois, Kansas, Maine, Minnesota, Nebraska, New Mexico, North Dakota, South Dakota, Tennessee). These states represented differences to their first-tier counterparts. All together (60 first- and second-tier licenses), there were a total of 13 required supplemental items represented (e.g., birth certificate, application fee) and 137 attestation items related to nine broad categories (e.g., criminal history, mental health history, education history). The 50 first-tier licenses requested approximately 20% (n = 2.65) of the possible 13 supplemental items and nearly 14% (n = 18.7) of the possible 137 attestation items, whereas the 10 second-tier licenses requested slightly more information. On average, 24% (n = 3.12) of the supplemental items and 17% (n = 23.3) of the attestation items were noted on second-tier license applications. All of the second-tier licenses required 60 credit hours of training and at least 3,000 total hours of work post-degree. Moreover, all utilized “mental health” or “clinical” in the title and expected applicants to pass only the NCMHCE. By and large, these licenses followed similar frequency patterns as first-tier licenses with attestation items. However, there were differences nonetheless. For instance, the second-tier licenses were more likely to inquire specifically about felony conviction (38% of first-tier licenses vs. 60% of second-tier licenses), if child support was owed (16% of first-tier licenses vs. 50% of second-tier licenses), and if any problems were related to ethics or professional organizations (5% of first-tier licenses vs. 42% of second-tier licenses). Moreover, second-tier licenses required more frequent attestation with CACREP core curriculum (61% of first-tier licenses vs. 86% of second-tier licenses) and with specific courses, such as diagnosis (20% of first-tier licenses vs. 60% of second-tier licenses) and family counseling (24% of first-tier licenses vs. 60% of second-tier licenses). On the other hand, none of the second-tier licenses asked about consumer fraud–related items or problems experienced in training programs and were less likely to ask about general mental health issues (54% of first-tier licenses vs. 30% of second-tier licenses).
Discussion and Implications
Given the growing interest in counseling licensure comparisons (Bergman, 2013; Kaplan & Gladding, 2011; Mascari & Webber, 2013) and the apparent lack of research exploring differences in the licensure process, this study attempted to provide more detailed information that might impact the portability issue. Counselor licensure state portability has many impediments, but one is clearly evidenced in the heterogeneity with respect to required elements (e.g., supporting documents, hours, required courses, character, and psychological fitness). Counseling boards serve as the final arbiters of an applicant’s suitability to practice counseling, yet there appears to be limited consensus regarding elements required on applications (ACA, 2017). As noted previously, counseling organizations have begun efforts to increase portability. In 2015, AASCB was successful in developing an agreement to transfer licenses between 11 states with similar requirements. More recently, in April 2017, NBCC (2017a) announced a statement laying the groundwork for possible portability efforts moving forward. This statement identified criteria so that one may obtain licensure in another state. However, as this study discovered, most licenses remain disconnected and operate independently of one another. Moreover, limited evidence was found to confirm a seamless license transition between any states, including the 11 states identified via AASCB. A review of this study’s findings will focus on categories noted in the results section and include implications for ease of reading.
Educational Requirements
It was clear from license application reviews that CACREP featured prominently. Graduating from a CACREP-accredited program and gaining knowledge from CACREP core curriculum standards were commonplace in all states. One would assume that with CACREP prominence in licensure applications there would be core curriculum standard representation in nearly 100% of states. However, the percentages of states identifying CACREP-related core curriculum standards were far from 100%; instead, CACREP core courses appeared in only 46–66% of the first-tier licenses. This investigation discovered that licenses often provided two paths regarding education. First, an applicant from a CACREP-accredited program could indicate completion of a degree and would not be required to provide proof of course completion or match courses to required training topics. For the second path, not graduating from a CACREP-accredited program, they would need to match training courses to a list of required topics. Interestingly, the applicant not from a CACREP program is essentially expected to meet about half of the CACREP core curriculum. As noted previously, 36% (n = 18) of first-tier licenses do not specifically require any of the CACREP core standards for those applicants needing to match training courses. This disparity complicates the matter of portability when one group of applicants is operating under different education requirements than another group.
Similar problems seem to exist regarding the CACREP-approved core curriculum requirements adding to a total of 48 or 60 credit hours. Certainly, if one graduated from a 48-hour program and wanted to obtain a license requiring 60 hours, more courses would be needed. Conversely, many licenses utilized the term minimum regarding credit hour requirements. Vermont, for example, noted the need for a psychopharmacology course, and Florida noted a specific course in human sexuality. Neither of these topics clearly fits into one of the eight CACREP core curriculum standards. There also were requirements for additional training, such as Washington needing a minimum of 4 hours of education in understanding the prevention of HIV. It appeared that in some cases, graduation from a CACREP-accredited program was not enough for a state license, and future applicants must anticipate additional coursework and training. Furthermore, all second-tier licenses required 60 hours of graduate coursework, but only about half of the first-tier licenses had this requirement. Thus, if licensed under a 48-credit-hour state, attempting to move into a 60-credit-hour state will be problematic.
Related to a general education theme was the lack of inquiries into graduate program behavior. Researching problematic behaviors in graduate training is an emerging trend (Duba, Paez, & Kindsvatter, 2010; Herlihy & Dufrene, 2011; Ziomek-Daigle & Christensen, 2010). As Brown-Rice and Furr (2013) discovered, 74% of counselors-in-training reported that a peer had exhibited problems with professional competence (e.g., psychological dysfunction, unethical behavior). Hence, it is imperative that states recognize the potential of significant concerns existing in the profession and investigate accordingly. One of the more surprising outcomes from this study was the finding that only three state applications (D.C., Florida, Minnesota) investigated disciplinary action related to graduate training. D.C. and Minnesota provided the most detailed inquiry regarding training programs (e.g., ever placed on probation, restriction, suspension, or revocation, or forced to resign from professional training not because of grade). Florida provided a more generalized request by querying about any disciplinary action from an educational institution.
Unfortunately, no evidence existed for a query related to more significant educational matters, such as dismissal from a program. Considering the reality that graduate programs for counselor training are likely the first place undesirable professional behaviors may be observed or recorded, it is potentially problematic that so few states would investigate this area. On one hand, the issue of portability cuts two ways regarding educational experiences. An applicant with less than the needed coursework and unseemly professional behaviors could be reasonably denied practice from one state to another. On the other hand, because an applicant was granted licensure in one state, that individual may be able to practice in a different state with limited vetting. In either case, the inconsistencies are a challenge worth addressing in the counseling profession.
Direct and Indirect Counseling-Related Hours
Nearly all states were consistent in clearly indicating a number of total hours and direct hours needed for licensure. Simultaneously, however, states specified a wide range of required hours. For example, Kentucky required 4,000 total hours with 1,600 being direct. Conversely, North Carolina required 3,000 total hours with 2,000 being direct. The difference of 1,000 total hours and 400 direct hours may not appear significant at first. The implication here is that the time needed to accumulate the deficient hours could take the applicant months to achieve, thus missing out on potential earnings. As the counseling profession grapples with portability, it will be important to determine a coherent plan to address hour requirement differences.
Examinations
The NCE and NCMHCE are widely used across all states. Having two required exams provides applicants with a simple message for needed exams. The challenge for an applicant is determining which exam to complete. If an applicant started working in D.C. and completed the required NCE, they would then need to complete the NCMHCE if they ended up working in Connecticut. Given the cost ($275 each for NCE and NCMHCE), the decision could be an expensive venture for an applicant. So while NBCC works to ensure that its exams are utilized by every state, portability remains sticky with considerable emphasis placed on the exam-of-choice decision for applications.
Application Fees and Supplemental Documentation
Similar to possible added examination costs are application expenses. Applicants can expect to pay an application fee, as 92% of states assign a cost to applying. Interestingly, cost per state application could range from no cost up to $415. Applicants also can expect to submit supplemental items, such as a photograph of themselves, letters of recommendation, a birth certificate, or a videotape of a counseling session. Although the authors believe states likely have sound reasoning behind their requirements, the issue of portability seems disjointed in regards to wide differences in fees and supplemental documentation. Common ground regarding cost of supplemental materials would expedite any portability process by simplifying the understanding of such a process.
Attestation
Licensure History. At the heart of portability is the applicant’s previous experience. Surprisingly, approximately 40% of states did not inquire about a previous license being refused, suspended, or revoked. If agreed-upon standards for portability are to move forward, it is reasonable for states to expect consistent vetting of problematic licensure history. The concerning issue here is that an applicant may have moved between one or more states that did not include licensure history vetting. Said applicant with a problematic license history could move to states without license history vetting and subsequently engage in counseling practices, potentially impacting client welfare.
Criminal History. Although all applications for licensure inquired about criminal actions, often applications left the applicant room to determine whether they were convicted or charged with a relevant crime, whether the crime was a misdemeanor or felony, if the applicant pled guilty or were found guilty, and if convicted, for example, whether they could be incarcerated for more than a year. A small number of states inquired if the applicant was a defendant in a lawsuit related to the profession (n = 3), had a felony expunged or pardoned (n = 2), or experienced deferred prosecution (n = 1). Based on language in some applications, it is possible that there can be sentencing without conviction and that some criminal activities may go unchecked. Second-tier licenses seemed to be requesting more specifics in the area of criminal activity; however, there are obvious issues with portability. In any case, clarifying the nature of the information requested could be beneficial. Another potential area of concern was related to the question of being convicted of moral turpitude. As noted previously, only 10% of states (n = 5) deemed it important to investigate acts or behaviors that violate community standards or moral turpitude. In one respect, the broad definition of moral turpitude would seem to be common sense for inclusion in a counselor licensure application. However, the definition of moral turpitude could be so diverse across the country that behavior unacceptable in one state may be considered acceptable, insignificant, or simply ignored in another. This legal concept not only embodies a challenging theme related to defining these activities more uniformly, but also speaks directly to such important queries being avoided across most states.
Mental Health Problems and Treatment. States should be applauded for putting emphasis on important matters, such as mental health, alcohol or other drug issues, treatment, and even psychological fitness, but the frequency of that emphasis appeared to be limited and the breadth of defining mental health problems and treatment was mottled. As a whole, states were interested in mental health problems ranging from drugs and alcohol usage to specific disorders, as well as requesting information about treatment related to those problems. States also ranged in interest regarding when these problems occurred (i.e., ever, in the past 2–10 years, currently). Even though applications inquired about mental health problems, they often lacked investigation regarding the level of impairment from mental health problems. Few states inquired about significant mental health problems. For example, the large majority of states (88%, n = 44) did not inquire about schizophrenia, psychotic disorders, hospitalizations, or if an applicant had ever been declared a potential health risk to the public. Even fewer states (8%, n = 4) inquired about sexual misconduct issues, such as pedophilia and voyeurism. It would be intuitive to be cautious with a potential counselor with high impact disorders providing service to a client, and yet so few states are doing so. So while the ACA Code of Ethics (2014) notes the importance of client welfare and professional responsibility matters such as impairment, licensing boards are missing potentially risky conditions. This may be related to the fact that only 18 of 52 states (i.e., 50 states, District of Columbia, Puerto Rico) have adopted the ACA Code of Ethics (ACA, 2014). Also, it is important to note that states provide a check and balance of sorts, whereby a potentially troubling issue may be called into question by a state. Conversely, there is also a fundamental question about what the counseling profession views as the competent characteristics to practice. State licensure boards have an inherent problem with determining whether or not the inquiry fits, depending on the applicant. Or to the issue of portability specifically, one may be considered fit to practice in one state but not another.
Recommendations Regarding Licensure Portability Standards
Given the limited empirical literature regarding differences in states’ requirements to become a licensed professional counselor, this article provides needed insight for professional counselors into the vast differences across states for licensure requirements. This examination has produced specific recommendations to enhance the success of professional counselor licensure portability across all U.S. states. First, previous portability efforts have focused on proposing that if a counselor is licensed in one state then they should have portability to another state (ACA, 2017). Nevertheless, the results of the study would indicate that specific and consistent standards related to specific educational requirements, completed client direct and indirect counseling-related hours, examinations, and attestations are needed. Legislative bodies may be more inclined to incorporate universal standards if the criteria are more representative of their current licensure requirements.
While the AASCB, NBCC, ACES, and AMHCA joint statement provides the most specific licensure by endorsement requirements (NBCC, 2017a), our investigation of applications found missing elements that would be important to include or consider. To point, there is a reference to background checks in the statement; however, there is no specific language regarding criminal history included in the endorsement process. What is incorporated in the joint statement is applicants attesting that for a period of 5 years they have engaged in ethical practice and have no disciplinary actions. This lack of addressing the potential criminal history of applicants may cause some states not to be open to this endorsement policy. It seems prudent that language be added to a portability policy that includes guidelines regarding inquiring about criminal behavior. Further, the endorsement policy makes no reference to the number of counseling hours required for licensure. Although the joint statement does provide that an applicant must have a license for independent practice for at least 3 years, the results of our study show great differences in what states accept as appropriate licensure hours accumulated. Therefore, more specific direct and indirect hour requirements would assist with clarifying endorsement standards.
Our second recommendation relates to the formation of a task force to examine the area of mental health history and treatment in counselor licensure portability. Given the stigma related to mental health disorders, non-counselors (e.g., legislators) may not understand that having a mental health disorder or receiving treatment for a disorder does not in itself relate to a competency problem that would impede an individual’s ability to practice. It would seem beneficial for the counseling profession to provide clear guidelines and uniform definitions and language so professionals who have or are currently experiencing mental health concerns (Zerubavel & Wright, 2012) are not overly restricted during the licensure process. On the other side, it is important for the counseling profession to provide reasonable restrictions related to mental health issues to protect the quality of care for clients.
Our final recommendation relates to the complex adjustments to language created by multiple legislative bodies. We propose a central hub for vetting professional counselor licensure applications. For example, an organization could be sanctioned with the task of vetting counselor applications much the same way CCE (n.d.) is sanctioned with vetting course equivalency for some state counseling licensure boards. A central hub for professional counselor license applications could provide state boards with a full-service provider model that could analyze specific application requirements related to hours, criminal history, drug use, mental health problems, malpractice, ethical violations, and educational prerequisites. Having a central location could address many of the individual states’ concerns and requirements, plus more uniform agreements on comportment behaviors. In addition, the cost for utilizing this full service could be added to the application fee. Thus, licensing boards would be able to focus more on their main purpose, consumer protection.
Conclusion
In the forefront of counselor licensure portability efforts is the concept that professional counselor licensure should be joined to obtaining a degree from a CACREP-accredited program (ACA, 2017; Mascari & Webber, 2013; NBCC, 2017b). The results of our investigation determined that many states require coursework beyond CACREP standards, and there are many other factors beyond educational prerequisites that licensing boards consider when endorsing an applicant as a licensed professional counselor. Therefore, our profession needs to continue to take a more encompassing view of licensure requirements and be in the forefront of developing common standards–related education requirements. Further, we need to determine universal criteria related to what is acceptable and unacceptable related to applicants’ criminal history, comportment, drug use, mental health problems, malpractice history, and ethical standards. It is time for the counseling profession to take a more proactive stance and set the standards and a model for state licensure boards to utilize with confidence. We understand this task is challenging; however, it is feasible. Failure to take a more practical, encompassing stance regarding counselor licensure portability will result in members of our profession continuing to be frustrated by the anticipation of a comprehensive licensure portability process.
Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest or funding contributions for the development of this manuscript.
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Seth Olson, NCC, is an associate professor at the University of South Dakota. Kathleen Brown-Rice, NCC, is an associate professor at the University of South Dakota. Andrew Gerodias is a doctoral candidate at the University of South Dakota. Correspondence can be addressed to Seth Olson, 414 E. Clark Street, Vermillion SD, 57069, seth.olson@usd.edu.