TPC Journal-Vol 9- Issue 4-FULL ISSUE

The Professional Counselor | Volume 9, Issue 4 269 This is a very good topic to explore because it is easy for professional counselors to forget when there used to be little respect of our profession, despite our graduate training being comparable to that of others in the mental health field. The mental health professional world and the public at large knew very little about our training and our professional license. As a result, employers were quite wary about considering us in their hiring opportunities overall, and particularly while candidates were still accruing full licensure status. Health insurance companies, including those federally or state funded, were not accepting our licensed clinicians on their provider panels. Being fully aware that the nature of our profession’s historical presence may vary from state to state, I can only speak of it based on my experience practicing in North Carolina. Thanks to the work of a handful of dedicated colleagues, professional counselors gradually but steadily gained acknowledgment by prospective employers and attained full third-party reimbursement status from insurance companies that operate within the state. In North Carolina, we were among the first in the field to institute distinct formal licensing tiers for associate, fully licensed, and supervisory levels. This offers a way to clearly reflect differential levels of training within our profession. However, it is evident that more work needs to be done by our professional associations in educating the public at large about who we are, how we are trained, and what exactly each of these tiered licensure levels means. Nationally, of course we know that Medicare recognition is the next desired achievement, but we have certainly come a long way as a profession. It behooves us all to look back in gratitude in order to look forward to new horizons. Lastly, I want to say how encouraging it is to see the impetus of several national organizations working together toward a more cohesive licensing nomenclature and criteria, as well as reciprocity across states. Implementing uniformity in licensing standards can only benefit all of us in attaining increased professional recognition throughout the U.S. Witnessing the profession evolve and change throughout the years has been both encouraging and at times concerning. Particularly in private practice, the salient point is the impact of increasing administrative requirements and treatment barriers placed by insurance companies, while compensation for counseling services has remaining unchanged or lowered for over 15 years. Over time, insurers established a fee-for-service model that has resulted in a decline in previously available salaried employment opportunities, giving way to contract-based type arrangements. This model may pose many challenges to new graduates who may not feel fully ready to venture on their own into private practice, while also finding percentage fee-for-service remuneration positions financially unsustainable. At the state level, we also have seen a significant transformation involving the transition of publicly funded county mental health clinics to outsourcing management and provision of all services to large private sector companies. This, too, has impacted the nature of the job market for counselors. Overall, we have seen an increase in new graduates starting out in private practice immediately after graduation, but for some this might be too soon or too daunting. I think that graduate programs can help pave the way by a two-fold approach: providing students with at least the basics of practice management skills and impressing upon them the importance of ongoing supervision and consultation with peers. It is no secret that private practice can at times feel isolating, thus establishing regular contact with colleagues for support and consultation can make a significant and positive impact.