Independently Licensed Counselors’ Connection to CACREP and State Professional Identity Requirements

Stephanie T. Burns, Daniel R. Cruikshanks

Many professional counseling organizations act to strengthen counselor professional identity to achieve parity for counselors. However, independently licensed counselors often identify themselves as “therapists” or “psychotherapists” as a means of helping others understand their occupational role and establishing their professional community as encompassing all mental health professions. A random sample of 494 independently licensed counselors from state counseling licensure board lists answered five questions about Council for Accreditation of Counseling & Related Educational Programs (CACREP) and state professional identity requirements required for clinical mental health counseling students. These professionals rated supervision pre- and post-graduation by an independently licensed counselor, counselor educators licensed and trained as counselors, the unique philosophy of the profession of counseling taught in counselor education programs, and the importance of CACREP accreditation for clinical mental health programs between Slightly and Moderately Important. Results suggest that independently licensed counselors see some value in a consistent and clear professional identity as a means to help current concerns experienced by independently licensed counselors.

Keywords: counselor professional identity, CACREP, parity, clinical mental health counseling, state counseling licensure board

In order to work successfully with other professionals, each individual must thoroughly understand the role and scope of practice of their profession and be able to communicate that professional identity to others (Ewashen, McInnis-Perry, & Murphy, 2013; Johnson, Stewart, Brabeck, Huber, & Rubin, 2004; Palermo, 2013). Every mental health profession educates its students on its values, perspectives, and socialization processes, which results in each profession having different visions of the scope of practice of other professions (Leipzig et al., 2002). Distinguishing the separate as well as the similar roles and scopes of practice among the mental health professions highlights role ambiguity, power and status conflicts, and stereotypes that often constrain counselors when working with other professionals (Mellin, Hunt, & Nichols, 2011).

After first being identified in 1949 at the Council of Guidance and Personnel Associations conference (Simmons, 2003), counselor professional identity remains a large concern in the profession (Gale & Austin, 2003; Gibson, Dollarhide, & Moss, 2010; Kaplan & Gladding, 2011; Mellin et al., 2011; Myers, Sweeney, & White, 2002). In 2010, delegates from 31 American Counseling Association-affiliated organizations voted to create a definition of counseling specific to professional counselors, as opposed to psychologists, social workers, and the generic dictionary definition of counseling. This definition states: “counseling is a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals” (Kaplan, Tarvydas, & Gladding, 2014, p. 366).

Despite the concerns and the attempt at defining counseling for counselors, people can use the terms counselor and counseling in a variety of ways that are unrelated to the profession of counseling. For example, the terms counselor and counseling are used to describe the job title and services performed by camp counselors, debt counselors, attorneys, and other occupations. Additionally, physical, performed by camp counselors, debt counselors, attorneys, and other occupations. Additionally, physical, respiratory, speech, occupational, and massage therapists use the term therapist. Many licensed mental health providers utilize the terms therapist and psychotherapist, which ultimately leads to confusion when distinguishing the license of a mental health provider (Lincicome, 2015).

Consequently, many independently licensed counselors avoid the terms counselor and counseling altogether and strive instead to align with the entire mental health field. For this article, the term independently licensed counselors is defined as counselors who have graduated with a master’s or doctoral degree, obtained postgraduate clinical supervision, and currently hold a license to practice as a counselor without supervision in their state. Burns and Cruikshanks (2017) found that 54% of independently licensed counselors never used the words counselor or counseling when talking to others about their occupational role. In addition, the results of a qualitative study identified that independently licensed counselors view their professional community as comprised equally of counselors, psychologists, social workers, and educators (Moss, Gibson, & Dollarhide, 2014). Counselors look to all mental health–related professions for professional mentoring, guidance, and information. Therefore, it is likely that independently licensed counselors identify themselves as therapists or psychotherapists as a means of resolving confusion while also affirming their connection to the global mental health community.
However, individuals are as tied to the identity of their profession as the profession is tied to the professional identity statements expressed by its members (Simpson, 2016). Because of a lack of a well-established professional identity in society (Myers et al., 2002), counselors must simultaneously communicate their specific professional identity within the centralized identity of the profession of counseling (Simpson, 2016). Ultimately, the way each counselor communicates their professional role recurrently defines the profession of counseling (Burns, 2017). For counselors to successfully communicate with potential employers, clients, other professions, and the public, they must convey counselor professional identity as well as how they specifically function as a counselor within the profession (Burns, 2017). Therefore, a counselor using generic terms to describe themselves, such as therapist or psychotherapist, negatively impacts their job as well as the profession of counseling.

Professional Identity Ramifications

Lincicome (2015) suggested that confusion in counselor professional identity has led to non-parity for counselors because of legislators not being able to understand or clearly define the profession of counseling. For example, in many states psychology students with a master’s degree can become licensed counselors (Lincicome, 2015). The Institute of Medicine, while reporting on behalf of TRICARE, has condemned counselor licensing boards that allow non-counseling master’s graduates (such as individuals with a master’s in psychology) to qualify for counseling licensure (Mascari & Webber, 2013). Adding to the mix, the American Psychological Association (2016) hosted a Summit on Master’s Training in Psychological Practice to consider re-implementing the licensure of master’s-level psychologists. Because of these variables, a consistent and clear professional counselor identity could potentially help to solve many contemporary problems, such as transferring licensure to another state, achieving equality with other mental health professions in hiring practices, addressing the lack of recognition of the counseling profession in U.S. society, and being reimbursed for services by private and government health insurance providers (Calley & Hawley, 2008; Myers et al., 2002; Reiner, Dobmeier, & Hernández, 2013).
Many professional counseling organizations have looked to the Council for Accreditation of Counseling & Related Educational Programs (CACREP) Standards to strengthen counselor professional identity (Mascari & Webber, 2013). Three CACREP standards focus exclusively on counselor professional identity. Standard 1.x articulates that core counselor education faculty be educated, licensed, and professionally associating as counselors. Standard 2.1 stipulates that students learn the history and philosophy of the profession of counseling. Standard 3.p proposes, but does not require, that licensed professional counselors supervise the practicum and internship experiences of master’s- and doctoral-level students. Additionally, doctoral-level students are not required to seek doctoral-level licensed professional counselors to supervise their internship experiences. Ultimately, student training in counselor professional identity provides the foundation for the uniform skill sets required in CACREP-accredited programs to assure quality care for clients (Engels & Bradley, 2001)

Counselor Professional Identity

Ibarra (1999) stated:

Professional identity is defined as the relatively stable and enduring constellation of attributes, beliefs, values, motives, and experiences in terms of which people define themselves in a professional role. . . . Professional identity forms over time with varied experiences and meaningful feedback that allow people to gain insight about their central and enduring preferences, talents, and values. (pp. 764–765)
More specifically, Calley and Hawley (2008), Puglia (2008), Remley and Herlihy (2014), and Weinrach, Thomas, and Chan (2001) identified counselor professional identity as a fundamental set of values, beliefs, and assumptions about the counseling profession that distinguishes it from other mental health professions. Counselors with a strong professional identity understand their scope of practice, roles, and functions and how those roles and functions differ from other mental health professionals; therefore, they passionately defend against inaccurate definitions of a counselor’s scope of practice (Brott & Myers, 1999; Ponton & Duba, 2009; Remley & Herlihy, 2014).

Professional counseling organizations promote counselor identity and the profession of counseling in several ways. Organizations, such as the American Association of State Counseling Boards (AASCB), the American Counseling Association (ACA), CACREP, and the National Board for Certified Counselors (NBCC), are working together to achieve parity in terms of ability to be reimbursed by third-party payers for providing counseling services (Mascari & Webber, 2013). For nine years, ACA and AASCB facilitated 31 counseling organizations to perform focused strategic planning to elevate the counseling profession through the 20/20: A Vision for the Future of Counseling initiative. The first two principles of 20/20 state that “sharing a common professional identity is critical for counselors” and “presenting ourselves as a unified profession has multiple benefits” (Kaplan & Gladding, 2011, p. 372). ACA (2015) has acted on these two principles by endorsing CACREP as the accrediting body for counseling programs. NBCC responded to the call of 20/20 by restricting applications for the National Certified Counselor (NCC) credential to only CACREP-accredited program graduates beginning January 2022 (NBCC, 2014).

State licensure boards ensure licensees have appropriate educational degrees consisting of appropriate training, practicum, and internship experiences under supervision to protect the public from harm (Simon, 2011). Across the United States, state counseling licensure laws and rules define the particular roles and responsibilities of independently licensed counselors and directly impact professional identity requirements. These laws and rules define the scope of practice aligned with the profession of counseling and require clearly expressing a counselor professional identity to others and not asserting to be a psychologist, social worker, or therapist when not licensed as such. The AASCB’s Standards Commission (2010) suggested accepting common standards of training and curricula for the counseling profession, such as those held by CACREP. The course structures of CACREP-accredited programs are more uniform and equivalent than non–CACREP-accredited programs (Mascari & Webber, 2013). Requiring uniform accreditation standards for a profession helps licensing boards by allowing for the accelerated review of licensure applications and a centralized way to measure minimum training criteria (Mascari & Webber, 2013). Graduates from CACREP-accredited programs more often follow board regulations and adhere to the state scope of practice for counselors (Mascari, 2004; Mascari & Webber, 2006). Studies have proposed positive relationships between accreditation and student performance on exams, certifications, and licensure, as these require understanding the history, values, and scope of practice of professional counselors (Milsom & Akos, 2007; Scott, 2001). Despite all of this, counselors are not clearly identifying as counselors in the profession of counseling.

Further, government agencies look to accreditation standards to ensure consistency in training and skill sets. In 2010, both the U.S. Veteran’s Administration (VA) and the Institute of Medicine for the TRICARE system of the Department of Defense recognized clinical mental health counseling graduates from CACREP-accredited programs as qualified professionals to work in their organizations because of the combined unified identity and standardized educational preparation required by CACREP accreditation (Bobby, 2013). ACA, AASCB, and NBCC have identified CACREP as the accrediting body for the profession of counseling in an attempt to solidify counselor professional identity and equality with the other mental health professions. Three CACREP standards focus exclusively on counselor professional identity and are training requirements of clinical mental health counseling students. The following three sections explore CACREP 2016 Standard 1.x, Standard 2.1, and Standard 3.p to demonstrate how these standards attempt to address concerns with counselor professional identity.

1.x Counselors as Counselor Educators

Counselor educators supervise students, model professional counseling behavior, monitor conduct, infuse ethics, and help students understand their scope of practice as counselors (Mascari & Webber, 2013). A 2008 study indicated that over 25% of counselor educators held other mental health licenses in addition to counseling, such as social work and psychology (Calley & Hawley, 2008). Counselor educators with multiple mental health licenses or without a mental health license can inhibit professional counselor identity development in counselor education students (Emerson, 2010; Mascari & Webber, 2006; Mellin et al., 2011). In these studies, master’s students reported feeling inadequate when individuals with other mental health licenses taught their classes, and gave students negative impressions of the profession of counseling. These negative impressions included a lowered perception of the value of counseling licenses and counselors’ counseling, research, and assessment abilities as compared to other mental health professions (Lincicome, 2015; Reisetter et al., 2004).

Bobby and Urofsky (2011) stated: “We are not familiar with any other profession that chooses to defer the training of its future professionals primarily to a different profession” (p. 53). The suggestion is that counselor educators with a secure counselor professional identity better ensure an enduring counselor identity in master’s and doctoral students (Emerson, 2010). To strengthen counselor professional identity, CACREP accreditation requires core faculty members to have degrees specifically from counselor education programs, as well as hold professional memberships, certifications, and licenses within the profession of counseling (Bobby, 2013). Currently, CACREP standards do not require a specific length of time an individual must clinically counsel clients before becoming a counselor educator. Counselor educators abstaining from clinical counseling practice are not fully immersed in the profession of counseling. Therefore, they are not confronted with the need to thoroughly understand their role and scope of practice to communicate their professional counselor identity to others. Counselor educators would then find it difficult to help students understand how to correct other mental health professionals holding inaccurate visions of the scope of practice of counselors to address role ambiguity, power and status conflicts, and stereotypes.

2.1 Professional Counselor Identity Training

Counselor professional identity rests upon specifically imparting the values, attitudes, and behaviors of the counseling profession to master’s and doctoral students (Choate, Smith, & Spruill, 2005). A strong professional counselor identity requires pride in the profession of counseling and learning from faculty with a solid professional counselor identity (Woo, 2013). Several counseling professional organizations have established the foundation of counselor professional identity. The Chi Sigma Iota (CSI) Counselor Advocacy Leadership Conferences in 1998 stressed that counselor education students should graduate with a clear counselor professional identity and pride in the profession of counseling (Chi Sigma Iota, 1998). Sweeney (2001) stated that the counseling profession’s values and how those values guide professional behaviors determine counselor professional identity as opposed to specific techniques, such as cognitive behavioral therapy, used in a counseling session. More specifically, Burns and Cruikshanks (2017) discussed at length how the five hallmarks of the counseling profession (normal development, prevention, wellness, advocacy, and empowerment) are not exclusively valued by counselors but differ in focus from other mental health professions. For example, in the profession of counseling, counselors use empowerment by encouraging client autonomy, self-advocacy, self-validation, and self-determination. In comparison, social workers encourage clients’ socially responsible self-determination to balance the needs of clients and society. In psychology, empowerment occurs when the psychologist respects cultural differences, safeguards client welfare, and allows the client to make their own decisions.

Several professional counseling organizations work to impart the values of the profession of counseling. The ACA Code of Ethics (2014), Section C, states that counselors should join counseling organizations at local, state, and national levels and properly articulate their roles and scope of practice to others. Additionally, ACA endorses the principles of counselor professional identity generated by the 20/20 workgroup (Kaplan & Gladding, 2011). Two of those principles state that “sharing a common professional identity is critical for counselors” and “presenting ourselves as a unified profession has multiple benefits” (Kaplan & Gladding, 2011, p. 372). These two principles validate that a consistent and clear professional counselor identity could potentially help counselors become licensed in another state, have an equal chance at being hired as the other mental health professions, improve recognition of the counseling profession as distinct from other professions, and obtain reimbursement for services by all private and government health insurance providers (Calley & Hawley, 2008; Myers et al., 2002; Reiner et al., 2013).

The CACREP 2016 Standards (2015) require a professional orientation course that covers the history, ethical standards, professional roles and responsibilities, professional associations, credentialing and licensure processes, professional advocacy, wellness, and public policy issues relevant to the counseling profession. Additionally, the National Counselor Examination (NCE; NBCC, 2012), used in most states as the examination to obtain a counseling license, tests counselors on eight CACREP domains: human growth and development, social and cultural diversity, counseling and helping relationships, group counseling and group work, career counseling, assessment and testing, research and program evaluation, and professional counseling orientation and ethical practice. Therefore, to obtain a counseling license, most counselors will be tested on the history and values of the profession of counseling (Emerson, 2010).

Unfortunately, before 2017, no research measured the communications of independently licensed counselors for professional identity. Therefore, no rubric existed to determine if independently licensed counselors expressed to others a clear counselor professional identity, and if not, how communications could be improved. Burns and Cruikshanks (2017) examined independently licensed counselors’ professional identity when communicating their occupational role to others. They found 54% of participants completely avoided the terms counselor or counseling, and only 29% referred to themselves as a professional counselor. Although various professional counseling organizations and CACREP-accredited programs discuss counselor professional identity, results of this study indicate most independently licensed counselors do not communicate a counselor professional identity. Because the professional identity statements generated by the members of a profession directly result in the professional identity of that profession (Simpson, 2016), counselor professional identity remains a concern.

3.p Counselors as Supervisors

To achieve an independent counseling license, foster a counselor professional identity, and ensure ethical practice, counselors must obtain post-degree clinical supervision toward building experience in the field (Barnes, 2004; Britton, Goodman, & Rak, 2002). Counselors’ professional identity development occurs through associations and connections with other professional counselors (such as supervisors, colleagues, and counselor educators) who have a strong counselor identity (Luke & Goodrich, 2010; Puglia, 2008). Mascari (2004) interviewed 22 counseling leaders and found they were concerned with the lack of counselor professional identity, especially when diluted by other mental health professionals supervising counselors establishing their independent license.

Counselors lacking a strong professional counselor identity drift toward generic mental health professional identities and struggle to identify what distinguishes the unique roles and responsibilities of professional counselors (Hansen, 2003). Master’s students in an internship with licensed professional counselor supervisors self-reported stronger professional identities than students supervised by other mental health professions (Gray & Remley, 2003). Many state counseling licensure boards promote professional identity requirements by mandating that independently licensed counselors exclusively provide postgraduate supervision. Those state counseling licensure boards want counselors to understand the role and scope of practice of their profession and be able to communicate that professional identity to others.

Many studies have focused on counselor professional development with master’s students (Gibson et al., 2010; Luke & Goodrich, 2010; Moss et al., 2014; Prosek & Hurt, 2014). However, only one study focused on a professional counselor identity among independently licensed counselors. Mellin et al. (2011) qualitatively researched the professional identity of 238 counselors who had passed the NCE within the past 10 years. They examined perceptions of counseling as distinct from psychology and social work. Participants’ views converged to discern that the profession of counseling focused on a developmental, prevention, and wellness orientation. They delineated that psychology targeted assessment concerns and social work targeted systemic concerns. Although terms such as prevention, wellness and development are commonly used in the profession of counseling, these terms alone do not help counselors thoroughly understand their role and scope of practice to be able to communicate that professional identity to others.

We investigated independently licensed counselors’ views on counselor professional identity training and state supervision standards to achieve independent counseling licensure. Ultimately, we wanted independently licensed counselors’ views on the importance of identifying as a counselor to others as well as five professional identity standards. First, we wanted independently licensed counselors’ views on CACREP Standard 1.x, which articulates that core counselor education faculty be educated, licensed, and professionally associating as counselors. Second, we wanted independently licensed counselors’ views on CACREP Standard 2.1, which stipulates that students learn the history and philosophy of the profession of counseling. Third, we wanted independently licensed counselors’ views on CACREP Standard 3.p, which proposes but does not require that licensed professional counselors supervise master’s- and doctoral-level students. Fourth, we wanted independently licensed counselors’ views on the states that require only independently licensed counselors to supervise graduate students and postgraduates earning their independent license. Fifth, we wanted independently licensed counselors’ views on states that require all graduate counseling programs to be CACREP-accredited.

We also wanted to examine the relationship between independently licensed counselors’ clarity in identifying as a counselor to others and their scores on the combined 5-item scale of professional identity standards. Lastly, we wanted to examine the relationship between independently licensed counselors’ clarity in identifying as a counselor to others and their views on each of the five separate professional identity standards. Independently licensed counselors from across the United States helped us answer these questions.

Method

For this study, approved by the HSIRBs of our universities, we analyzed a subset of data collected about professional issues from independently licensed counselors. We analyzed five questions asking independently licensed counselors about professional identity development in the context of CACREP training and state supervision standards to achieve independent counseling licensure. We have not published results from this subset of data previously, nor will the data in this study be used in future data analyses.

Participants

We defined independently licensed counselors as counselors who have graduated with at least a master’s degree, have obtained postgraduate clinical supervision, and currently hold a license to practice as a counselor independently without supervision in their state. Every state in the United States independently determines the graduate degree requirements for licensure—if that degree must come from a CACREP-accredited program, the length of time spent in postgraduate supervision, and the license required to provide supervision. Because states drive licensure requirements, we purposely refrained from asking if the independently licensed counselor graduated from a CACREP-accredited program, the length of time they spent in postgraduate supervision, the license of the individual who provided them postgraduate supervision, or if their master’s degree was from a counselor education program. We included any currently active independently licensed counselors in the United States because every independently licensed counselor creates the professional identity of the counseling profession. Therefore, we sought the views of independently licensed counselors in the United States, not any given subset of that total population. To achieve independent licensure, the counselor must complete state-approved training and have at least two years of practice under supervision. Consequently, participants had spent several years in clinical practice prior to participating in the study.

Participants included 494 independently licensed counselors with a mean age of 41 (range = 25–73, SD = 10.5) who completed the specific sections of the measure analyzed in this study. A majority identified as female (n = 410, 83%) and European American (n = 418, 84%). Other racial demographic responses from participants included: African American (n = 23, 5%), Hispanic (n = 19, 4%), Biracial (n = 17, 3%), No Response (n = 9, 2%), Asian American (n = 5, 1%), and Native American (n = 3, <1%). Participants worked in various settings: counseling agency (n = 177, 36%), private practice (n = 124, 25%), state and federal government (n = 47, 10%), hospital and clinic (n = 43, 9%), college setting (n = 35, 7%), not currently working as a counselor (n = 29, 6%), K–12 setting (n = 28, 6%), managed care (n = 7, 1%), unemployment (n = 3, <1%), and retired (n = 1, <1%). The average year of master’s graduation for participants was 2005 (SD = 6.16). Because it takes individuals seeking independent license as a counselor at least two years to complete their postgraduate supervision, we believe the average participant in this study had been an independently licensed counselor for eight years. Every participant held an independent license as a counselor by a state counseling licensure board. Dually licensed counselors comprised only 6% of the total participants.

Data Collection Procedures

Our universities’ HSIRBs approved the use of human research subjects and the specific questions asked of participants. Survey Monkey’s (2016) power analysis calculator for survey designs identified a need for at least 384 survey respondents given a 95% confidence level, 135,000 population size (U.S. Bureau of Labor Statistics, 2016), and confidence interval of +/- 5%. We selected a simple random sample of 2,496 participants from a total list of 66,143 independently licensed counselors from eight state counseling licensure boards in the United States (two states from each of the four ACA regions). When creating our simple random sample of 2,496 participants, we randomly selected 312 participants from each state counseling licensure board list to ensure capturing the same number of participants from each of the four ACA regions.

Four hundred ninety-four participants completed the study, which resulted in a 20% response rate. Each participant received a postcard of explanation that included a link to a Survey Monkey questionnaire where they responded to four sections. Participants (a) reviewed and consented to the informed consent form on Survey Monkey, (b) answered questions about their demographics on Survey Monkey, (c) rated six Likert scale questions on Survey Monkey, and (d) had the option of providing their name and email address on the first author’s personal website to receive a $5 e-gift card to Amazon.com, Starbucks, or Target. By using Survey Monkey to collect study data and then directing participants to the first author’s website to store gift card requests, we maintained participant anonymity.

Measure

A search of the literature failed to yield examples of existing measures about independently licensed counselors’ views on CACREP training and state supervision standards to achieve independent counseling licensure. We, therefore, created a survey instrument to measure these constructs. The six Likert scale items stemmed from the standards of professional identity from ACA, AASCB, NBCC, and CACREP, as these professional counseling organizations form the foundation for counselor professional identity. Table 1 provides the verbatim text used. First, participants responded to one question focusing on clarity in articulating a professional counselor identity. Those responding with Never Clear scored a 0 and those responding with Always Clear scored a 5.

For the following five scale questions, participants who responded Extremely Unimportant scored a 0 and those who responded Extremely Important scored a 5. These five scale questions covered the topics of graduate and postgraduate supervision being limited to independently licensed counselors as required by many states in the AASCB; counselor educators having a professional counselor identity as stipulated by the ACA Code of Ethics and the 2016 CACREP Standards; training counseling students in the history, philosophy, and values of the profession of counseling as outlined by the ACA Code of Ethics, NBCC, and the 2016 CACREP Standards; and CACREP accreditation for counselor education programs as supported by ACA, NBCC, and some states in the AASCB. Table 1 provides the verbatim text used for the five scale questions.

 

Table 1

Likert Item Responses for all 494 Participants

M          SD

I am consistently clear in my language with clients, other professionals, and the

public that I am a counselor (as opposed to saying I am a psychotherapist,

therapist, etc.)                                                                                                                                  3.39         1.59

Scale Questions

  1. In your opinion, how important is it that clinical mental health

counselors-in-training in graduate school are supervised only by independently

licensed counselors?                                                                                                                         3.65         1.44

2. In your opinion, how important is it that clinical mental health counselors under
supervision post-graduation seeking independent licensure are supervised only

by independently licensed counselors?                                                                                               3.62         1.45

3. Is it important for the profession of counseling for counselor educators to be

licensed and/or educated as counselors (as opposed to psychologists, social

workers, etc.)?                                                                                                                                 3.75         1.43

4. Is it important for the profession of counseling for graduate students to be

taught the distinct occupational role, philosophy, and professional approach of

the field of professional counseling (as opposed to psychologist, counseling

psychology, social work, etc.)?                                                                                                         3.68         1.33

5. Is it important for the profession of counseling for graduate programs to be

Council for Accreditation of Counseling & Related Educational Programs

(CACREP) accredited?                                                                                                                     3.73         1.52

Because this was a new and untested instrument, we sought content validity before its use. Ten experts from the counseling profession rated each item presented in the study for clarity, representativeness, and appropriateness to establish content face validity. These 10 experts from four states had PhDs from counselor education and supervision programs, published on CACREP standards in counselor education, taught at CACREP-accredited programs, and served on state or national counseling association professional identity committees. These experts wanted items addressing the CACREP 2016 standards focused on counselor professional identity, the importance independently licensed counselors place on CACREP accreditation, and views on state board mandates for independently licensed counselors to provide postgraduate supervision. These individuals also suggested revisions to survey items to increase focus and clarity.

Three sections comprised the survey: (a) questions about participants’ demography, (b) one Likert scale question asking about the participants’ clarity in consistently identifying professionally as a counselor, and (c) five Likert scale questions about the participants’ views on counselor professional identity standards for clinical mental health counseling students. The demographic variables included: gender identity, age, all licenses held by a state licensure board, year of graduation from their master’s counseling program, current employment setting, and race.
We calculated Cronbach’s alpha for the 5-item scale using the following interpretation: > .9 defined as Excellent, > .8 defined as Good, and > .7 defined as Acceptable (George & Mallery, 2003). Cronbach’s alpha was excellent at .9 for the 5-item scale. We retained all five items in the scale because each item in the scale contributed to increasing Cronbach’s alpha for the scale and the items correlated well. We calculated a principal component factor analysis using all participants for the 5-item scale. We used three criteria to determine the number of factors in the scale: the a priori hypothesis that the measure was unidimensional, the scree test, and the factor solution. The scree plot confirmed the initial hypothesis that there was one factor in the 5-item scale. Based on the plot, we rotated one factor using the Varimax rotation procedure, and this factor accounted for 67.5% of the variance. The Kaiser-Meyer-Olkin measure of sampling adequacy for the survey was 0.8 (Great) based on the responses given by participants. Values between 0.8 and 0.9 classify as Great, and values above 0.9 classify as Superb (Hutcheson & Sofroniou, 1999).

Data Analysis Procedures

We ran five data analyses for the study. Cronbach’s alpha calculations calculated the internal consistency among survey items. Principal components factor analysis determined the number of factors in the scale. The Kaiser-Meyer-Olkin measure of sampling adequacy explained the degree of common variance among the variables. To answer the first research question, we used descriptive statistics from a mail survey designed to explore survey responses from independently licensed counselors (Fink & Kosecoff, 1998). To answer the second research question, we used Kendall’s tau-b correlation coefficient to determine the relationship between independently licensed counselors clearly identifying as a counselor to others and their views on the 5-item scale measuring counselor professional identity standards for clinical mental health students. To answer the third research question, we used Kendall’s tau-b correlation coefficients as a post hoc analysis to determine the relationship between independently licensed counselors clearly identifying as a counselor to others and their views on each of the five counselor professional identity standards separately.

Results

We used descriptive statistics to quantify independently licensed counselors’ responses to the six Likert scale items measured in the study. First, for the question asking about the importance of clearly identifying as a counselor to others, participants’ scores fell at 3.39 between Sometimes Clear and Often Clear (see Table 1). When asked about being supervised in graduate school and post-graduation by a licensed counselor, counselor educators being licensed and trained as counselors, the unique philosophy of the profession of counseling being taught to graduate students, and the importance of CACREP accreditation for clinical mental health programs, participants’ scores ranged from 3.62 to 3.75, which fell between Slightly Important and Moderately Important (Table 1).

Second, we examined the relationship between independently licensed counselors’ clarity in identifying as a counselor to others and their scores on the combined scale of professional identity standards. We found significance at a moderate effect size with a positive association between consistently identifying as a counselor to others and finding counselor professional identity standards important when training clinical mental health counselors, τb = .32, p < .01. Consistently identifying as a counselor to others statistically explained 10% of the variability in finding it important to require counselor professional identity standards during and after training.

Lastly, we examined the relationship between independently licensed counselors’ clarity in identifying as a counselor to others and their views on each of the five separate professional identity standards. We ran Kendall’s tau-b correlation coefficients as a post hoc to determine if differences existed among the five individual scale questions. Using the Bonferroni approach to control for Type I error across the five correlations, we used a p-value of < .01 for significance. The results in Table 2 show that four out of five correlations were significant at a moderate effect size with a positive correlation. Identifying as a counselor consistently to others explained 9% of the variability in finding it important for a licensed counselor to supervise students in graduate school, 8% of the variability in finding it important for a licensed counselor to supervise postgraduates, 9% of the variability in the importance of counselor educators being licensed and trained as counselors, and 15% of the variability in the importance of teaching the unique philosophy of the profession of counseling to students. Only the item discussing the importance of CACREP accreditation was not significant.

Table 2

Kendall’s Tau-b Correlations for Clarity in Identification as a Counselor

τb              p

  1. Graduate Supervisor Counselor .298 <.001
  2. Postgraduate Supervisor Counselor .286 <.001
  3. Counselor Educator Counselor .304 <.001
  4. Unique Philosophy Taught in Master’s Program .389 <.001
  5. CACREP-Accredited Program .080   .030

Discussion

We investigated independently licensed counselors’ views on counselor professional identity training and state supervision standards to achieve independent counseling licensure. Using descriptive statistics, we first examined independently licensed counselors’ views on the importance of identifying as a counselor to others. Scores for participants fell between Sometimes Clear and Often Clear when asked about consistency in identifying to others as a counselor. It could be that independently licensed counselors are at times identifying themselves as therapists, psychotherapists, or other generic terms as a means of helping others understand their occupational role (Lincicome, 2015). Therefore, current counselor professional identity concerns appear warranted (Gale & Austin, 2003; Gibson et al., 2010; Kaplan & Gladding, 2011; Mellin et al., 2011; Myers et al., 2002). These results might indicate a need for more emphasis on training counselors to understand their roles and functions, counseling ethical codes, professional counseling association memberships, and expressions of pride in the profession of counseling as identified by Remley and Herlihy (2014), the first two principles of the 20/20 workgroup (Kaplan & Gladding, 2011), and the ACA Code of Ethics (2014).

Second, using descriptive statistics, we examined the results of the five items measuring the importance of professional identity standards. Participants rated: supervision pre- and post-graduation by an independently licensed counselor (items one and two); counselor educators licensed and trained as counselors (item three); the unique philosophy of the profession of counseling taught in counselor education programs (item four); and the importance of CACREP accreditation for clinical mental health programs (item five) between Slightly Important and Moderately Important. These five results suggest that independently licensed counselors are aware that a consistent and clear professional identity could help with several concerns, such as transferring licensure to another state, being as valued as the other mental health professions in hiring practices, improving recognition of the counseling profession, and achieving equality in reimbursement for services by private and government health insurance providers (Calley & Hawley, 2008; Myers et al., 2002; Reiner et al., 2013).

While there were no significant differences between the five items measuring the importance of professional identity standards, the ranking of the five items can offer some insight. Independently licensed counselors ranked counselor educators licensed and trained as counselors first, the importance of CACREP accreditation second, teaching the unique philosophy and history of the profession of counseling third, supervision in graduate school by a licensed counselor fourth, and supervision post-graduation by a licensed counselor last. They saw the most value in having students trained by counselor educators with degrees specifically from counselor education programs who also hold professional memberships, certifications, and licenses in the profession of counseling, as proposed by Bobby (2013), Emerson (2010), and Woo (2013). This result suggests participants supported clinical mental health students associating and connecting with other professional counselors (such as supervisors, colleagues, and counselor educators) with a strong counselor identity, as suggested by Gray and Remley (2003), Luke and Goodrich (2010), and Puglia (2008). Next, they acknowledged that CACREP accreditation had some value for clinical mental health programs, as recommended by ACA (2015), NBCC (2014), the AASCB Standards Commission (2010), the VA, and the Institute of Medicine for the TRICARE system of the Department of Defense (Bobby, 2013). Third, independently licensed counselors found it somewhat helpful to impart the values, attitudes, and behaviors of the counseling profession to master’s counseling students, as recommended by CSI (1998) and Choate et al. (2005). Participants ranked lowest supervision pre- and post-graduation by a licensed counselor. It appears that state requirements for licensed counselor supervision are least valued among current professional identity standards.

Using inferential statistics, we first investigated the relationship between independently licensed counselors’ clarity in identifying as a counselor to others and their scores on the combined scale of the five items measuring the importance of professional identity standards. We found significance with a moderate, positive association between independently licensed counselors consistently identifying as a counselor and finding some value in CACREP and state standards for clinical mental health counseling students. This outcome suggests that developing a counselor professional identity rests upon isolating the counseling profession’s unique and distinguishing features from psychology and social work (Woo, 2013). It also suggests that independently licensed counselors had some connection to the fundamental set of values, beliefs, and assumptions specific to the counseling profession.

Lastly, we used inferential statistics to examine the relationship between independently licensed counselors’ clarity in identifying as a counselor to others and their views on each of the five separate professional identity standards. When breaking apart these five standards, it is of note that we found significance with a moderate, positive relationship for four items: consistently identifying as a counselor to others, finding it important for independently licensed counselors to supervise students pre- and post-graduation, having students educated by counselor educators licensed and trained as counselors, and having students educated in the unique philosophy of the profession of counseling. However, the relationship between consistently identifying as a counselor and finding importance in CACREP accreditation for clinical mental health programs was not significant. Nonsignificance is an important finding, as the mean for finding importance in CACREP accreditation was the second highest (3.73) of the six Likert scale items measured in this study. The CACREP accreditation mean rests closer to being viewed as Moderately Important by independently licensed counselors. This outcome implied that consistently identifying as a counselor to others is not likely to correlate with finding value in CACREP accreditation. The outcomes from the five separate professional identity standards suggest that independently licensed counselors weakly support the work of organizations such as AASCB, ACA, CACREP, and NBCC in promoting counselor identity and the profession of counseling to achieve parity (Mascari & Webber, 2013).

Limitations

Social desirability bias can occur with self-report Likert scale–based surveys. We recruited participants from only eight state counseling boards across the United States. The $5 gift card could have altered participant answers or appealed to certain types of participants, and the topic may have drawn a certain type of participant. We included all independently licensed counselors regardless of dual licensure, the length of time with an independent license, the amount of time spent in postgraduate supervision, and the license of the individual who provided them postgraduate supervision. We developed and used a new survey instrument. Only one self-report item determined whether a participant was “consistently identifying as a counselor.” Lastly, we generated survey items by the recommendations of 10 experts accepting CACREP standards in counselor education who served on state or national counseling professional identity committees, which could possibly result in biased study questions.

Implications and Future Research

The results have several implications for the profession of counseling, as current inconsistencies in counselor professional identity have led to negative consequences for independently licensed counselors. There has been concern that independently licensed counselors do not support and therefore disconnect from counselor professional identity standards. Our results suggest that independently licensed counselors have some connection to counselor professional identity and see some value in the continued work to improve counselor professional identity (Gibson et al., 2010; Kaplan & Gladding, 2011; Mellin et al., 2011; Myers et al., 2002). The distinct values of the profession of counseling, the focus of scholarship, the understanding of the history of the profession, the philosophical foundations of counseling, and the credentials of those training and supervising clinical mental health counseling students held some importance to independently licensed counselors. However, opportunities still exist to tie independently licensed counselors to the profession of counseling. These implications impact teaching, supervision, practice, and research in the profession of counseling.
Brott and Myers (1999), Weinrach et al., (2001), and Woo (2013) suggested that the counseling profession has a unique and distinguishing set of values, beliefs, and assumptions. Independently licensed counselors acknowledged this view by rating the training of clinical mental health students in counselor professional identity between Slightly Important and Moderately Important. Therefore, independently licensed counselors make some connections with the first two principles of 20/20: “sharing a common professional identity is critical for counselors” and “presenting ourselves as a unified profession has multiple benefits” (Kaplan & Gladding, 2011, p. 372). However, this weak connection does nothing to improve the current state of counselor professional identity.

ACA, AASCB, and NBCC look to CACREP accreditation to address current issues such as licensure portability, equality in employment practices, appreciation of the counseling profession as separate from other mental health professions in U.S. society, and private and government health insurance providers compensating for services. To strengthen counselor professional identity, CACREP standards encourage clinical mental health programs to have pre-graduates supervised by licensed professional counselors; have counselor educators educated, licensed, and professionally functioning as counselors; and have students educated in the history and philosophy of the profession of counseling. We found that independently licensed counselors weakly supported those mandated standards for clinical mental health students between Slightly Important and Moderately Important. Independently licensed counselors might see some positive connection to NBCC restricting applications for the NCC credential to only CACREP-accredited program graduates beginning January 2022 (NBCC, 2014).

Ultimately, independently licensed counselors did not rate the profession’s counselor professional identity standards as Extremely Important. Therefore, professional counseling organizations need to help independently licensed counselors connect with counselor professional identity and the profession of counseling. Moss et al., (2014) suggested that independently licensed counselors naturally see their professional community to include psychologists, social workers, and educators, which might hinder strengthening counselor professional identity. If independently licensed counselors seek other mental health professions to educate, validate, and shape their occupational role, they cannot define their scope of practice and function to address role ambiguity, power and status conflicts, and stereotypes that often constrain counselors when working with other professionals (Mellin et al., 2011).
Future research could investigate how an expanded view of their professional community to include psychologists, social workers, and educators impacts independently licensed counselors’ professional identity development and ability to achieve parity with other mental health professions. Additional research could examine what independently licensed counselors would recommend to strengthen counselor professional identity. Research could discern how independently licensed counselors view the various competencies put forth in the literature as constructs of counselor professional identity and their thoughts on NBCC allowing only graduates of CACREP-accredited programs to apply for the NCC. Other research could eliminate independently licensed counselors with a dual license, participants recently receiving their independent license, counselors with limited time spent in postgraduate supervision, and counselors who received postgraduate supervision from a supervisor without a counseling license. Furthermore, research could use an already established survey instrument to measure the same constructs. Finally, future research also could use more than one self-report item to determine whether a participant consistently identifies as a counselor.

Conclusion

For several decades, the academy, state licensure boards, and professional counseling organizations have expressed concerns about counselor professional identity. During this time, various professional counseling organizations have made attempts to address the critical issue of counselor professional identity, as it leads to inequities for independently licensed counselors. ACA, AASCB, and NBCC support CACREP accreditation of counseling programs to improve counselor professional identity and alleviate current counseling profession concerns. Over the last 20 years, CACREP standards have evolved to encourage clinical mental health programs to: have graduate students supervised by licensed professional counselors; have counselor educators be educated, licensed, and professionally functioning as counselors; and educate students in the history and philosophy of the profession of counseling. Our results demonstrated only Slight to Moderate support by independently licensed counselors for the various CACREP and state standards required of clinical mental health counseling students. A clear and consistent counselor professional identity could help independently licensed counselors when seeking licensure in another state, employment in the mental health field, understanding of the counseling profession in U.S. society, and payment from private and government health insurance providers (Calley & Hawley, 2008; Myers et al., 2002; Reiner et al., 2013). Moreover, the counseling profession needs to take additional steps to ensure a strong professional counseling identity so that independently licensed counselors can achieve parity with other mental health professionals.

 

Conflict of Interest and Funding Disclosure

The authors reported no conflict of interest or funding contributions for the developmentof this manuscript.

 

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Stephanie T. Burns, NCC, is an assistant professor at Western Michigan University. Daniel R. Cruikshanks is a professor at Aquinas College. Correspondence can be addressed to Stephanie Burns, 1903 W. Michigan Avenue, Kalamazoo, MI 49008-5226, s19burns@gmail.com.

Evaluating Independently Licensed Counselors’ Articulation of Professional Identity Using Structural Coding

Stephanie Burns, Daniel R. Cruikshanks

Inconsistent counselor professional identity contributes to issues with licensure portability, parity in hiring practices, marketplace recognition in U.S. society and third-party payments for independently licensed counselors. Counselors could benefit from enhancing the counseling profession’s identity as well as individual professional identities within the counseling profession. A random sample of 472 independently licensed counselors self-rated and then documented their individual professional identity via their occupational role discussions with others. Results demonstrate that independently licensed counselors rarely accurately self-evaluate their occupational role communications. Further, counselors rarely establish the counseling profession’s identity when discussing their occupational role. Participants’ responses guided the creation of a model that can guide counselors in evaluating and improving the communication of their professional identity to clients, other professionals and the general public.

Keywords: counselor professional identity, licensed counselors, occupational role, parity, structural coding

 

Authors have expressed concerns about counselor professional identity for over 10 years (Gale & Austin, 2003; Gibson, Dollarhide, & Moss, 2010; Kaplan & Gladding, 2011; Mellin, Hunt, & Nichols, 2011; Myers, Sweeney, & White, 2002). An inconsistent counselor professional identity contributes to issues with licensure portability, parity in hiring practices, marketplace recognition in U.S. society and third-party payments for independently licensed counselors (Calley & Hawley, 2008; Myers et al., 2002; Reiner, Dobmeier, & Hernández, 2013). Additionally, the lack of counselor professional identity has been a factor related to students with master’s degrees in psychology becoming licensed as counselors in many states (Lincicome, 2015). If the profession of counseling appears the same as all the other mental health professions, legislators struggle to understand how specific licenses tie to specific professions that have specific graduate education programs. Licensure boards protect the public from harm by ensuring that counselors have appropriate graduate degrees based on relevant curricula and direct application experiences under supervision (Simon, 2011). Licensing boards require uniform standards to measure minimum training criteria for a profession to assist in expeditious reviews of licensure applications (Mascari & Webber, 2013). A strong counselor professional identity increases counselors’ ability to work with their client populations of interest, receive third-party reimbursement, offer all of the appropriately trained services afforded in their scope of practice and make a greater impact when advocating for clients (Calley & Hawley, 2008; Myers et al., 2002; Reiner et al., 2013).

 

Apprehensions exist about counselors articulating their profession in generic, non-counseling terms such as therapists or psychotherapists as a method for establishing their ability to diagnose and treat mental and emotional disorders. Confusion increases because other health providers, such as physical therapists, respiratory therapists, speech therapists, occupational therapists, massage therapists, psychologists, social workers and psychiatrists, also utilize the same generic descriptors (Lincicome, 2015). The profession of counseling lacks a consistent identity in U.S. society (Myers et al., 2002); thus, counselors must establish the counseling profession’s identity as well as counselors’ unique role within the counseling profession. This requires clearly articulating the counselor’s client population of interest and specific counseling techniques utilized and articulating the unique identity of the profession of counseling when discussing their occupational role with others (Simpson, 2016). Counselors who are strong in their professional identity understand how counselors differ from other mental health professions (Remley & Herlihy, 2014) and are able to clearly articulate how the profession of counseling is distinguished from other professions when communicating their occupational role.

 

The Profession’s Mandate for Counselor Professional Identity

 

In order to achieve parity with other mental health professions, the American Association of State Counseling Boards (AASCB), the American Counseling Association (ACA), the Council for Accreditation of Counseling and Related Education Programs (CACREP), and the National Board for Certified Counselors (NBCC) have taken up the call to promote counselor identity and the profession of counseling (Mascari & Webber, 2013). Additionally, Chi Sigma Iota (CSI; 1998), the counseling profession’s honor society, has taken steps to promote the profession of counseling and counselor identity. The following sections outline how these various organizations document counselor professional identity.

 

Section C of the ACA Code of Ethics (2014) articulates that counselors are to join local, state and national counseling associations and appropriately communicate their roles and scope of practice. In addition, ACA has endorsed principles directly tied to counselor professional identity through the 20/20: A Vision for the Future of Counseling workgroup. Part of that vision declares that “sharing a common professional identity is critical for counselors” and “presenting ourselves as a unified profession has multiple benefits” (Kaplan & Gladding, 2011, p. 372).

 

The 2016 CACREP Standards (2015) stipulate student training in the history, ethical standards, professional roles and responsibilities, professional associations, credentialing and licensure processes, professional advocacy, wellness and public policy issues relevant to the counseling profession. The CACREP Standards also require core faculty members be graduates of counselor education programs and hold counseling profession-specific memberships, certifications and licenses to strengthen counselor professional identity and the profession of counseling. These standards exist because counselor educators with dual or non-counseling identities can confuse master’s students’ professional identity in counselor education programs (Emerson, 2010; Mascari & Webber, 2006; Mellin et al., 2011).

 

Lastly, ACA, AASCB, CSI, and NBCC have identified CACREP accreditation as a foundation for solidifying counselor professional identity and achieving parity for counselors. CSI (2016) requires CACREP accreditation to establish a new CSI chapter. Further, starting January 2022, NBCC will allow only graduates of CACREP-accredited programs to apply for the National Certified Counselor credential (NBCC, 2014a). Additionally, securing a state counseling license often requires understanding and articulating the history and values of the profession of counseling (Emerson, 2010). The National Counselor Examination for Licensure and Examination (NCE; Loesch & Whittinghill, 2010), used in most states as the examination to obtain a counseling license, includes knowledge of the counseling profession in the professional orientation section.

 

The Counselor’s Development of a Professional Identity

 

Sweeney (2001) stated that counselor professional identity concerns how the counseling profession’s values and philosophy impact the counselor’s behaviors with clients. He noted that counselor professional identity is not based on the profession of counseling owning specific techniques. For example, cognitive behavioral therapy (CBT) is used in the professions of counseling, psychology and social work. CBT is not owned by any one profession but is used differently by the professions because of differences in each profession’s values and philosophy. Similarly, human development is not owned by any of the three professions. However, the emphasis and application of human development in each profession is different. This is like MRIs being used by oncologists, physical therapists and neurosurgeons. Although all three professions use MRIs, each profession is using that assessment differently to gather information pertinent to their specific occupational role. As such, counselor professional identity is based on the counselor embracing the distinct philosophy and values of the counseling profession.

 

Components of Counselor Professional Identity

Counselor professional identity first centers on distinguishing the counseling profession’s unique philosophy and values from those of other mental health professions (Calley & Hawley, 2008; Choate, Smith, & Spruill, 2005; Puglia, 2008; Remley & Herlihy, 2014; Weinrach, Thomas, & Chan, 2001; Woo, 2013). Normal development, prevention, advocacy, wellness and empowerment are hallmarks of the unique philosophy and values of the counseling profession (Healey & Hays, 2012). A summary of the five distinct hallmarks and the differentiation from other mental health professions follows.

 

First, counselors consider that the client’s human growth and development is ultimately positive and often expected when conceptualizing changes and challenges in clients’ lives (Remley & Herlihy, 2014). This hallmark can be found in the Preamble, Purpose, and Section A of the ACA Code of Ethics (2014). The Preamble of the ACA Code of Ethics lists “enhancing human development throughout the life span” as the first core professional value for the counseling profession (p. 3). Additionally, this hallmark is found in several 2016 CACREP Standards: five standards under Human Growth and Development, six standards under Career Development, two standards under Counseling and Helping Relationships and two standards under Assessment and Testing. Lastly, this hallmark is tested in the NCE under Counseling Process (assessing the course of development), Diagnostic and Assessment Services (assessing client’s educational preparation, conducting functional behavioral analysis, observing non-verbal behaviors, and performing a mental status exam), and Professional Practice (applying multicultural counseling models; NBCC, 2014b). In comparison, the National Association of Social Workers (NASW) Code of Ethics (2008) indicates that “Social workers should promote the general welfare of society, from local to global levels, and the development of people, their communities, and their environments” (Section 6.01, Social Welfare). Although both professions talk about development, counselors are applying development in the context of the client (individual, couple or family) while social workers focus on development in the context of local to global societies. Lastly, the American Psychological Association’s (APA’s) Ethical Principles of Psychologists and Code of Conduct (2010, p. 3) states: “Psychologists are committed to increasing scientific and professional knowledge of behavior and people’s understanding of themselves and others and to the use of such knowledge to improve the condition of individuals, organizations, and society.” In psychology, development is researched to provide information to ultimately improve conditions for individuals, organizations, and society.

 

Prevention services occur when counselors provide psychoeducation, help clients increase resilience and encourage healthy client development throughout the lifespan to prevent, delay or reduce the severity of client symptoms (Granello & Young, 2011). This hallmark can be found in the Preamble and Section A of the ACA Code of Ethics (2014). Section A states: “Counselors facilitate client growth and development in ways that foster the interest and welfare of clients and promote formation of healthy relationships” (p. 3). Additionally, this hallmark is found in two 2016 CACREP Counseling and Human Relationship standards. Lastly, this hallmark is tested in the NCE under Counseling Process (conducting school/community outreach, consulting with client’s support system, directing community initiatives/programs, facilitating client access to community resources, helping clients develop support systems, identifying client support systems and providing psychoeducation) and Professional Practice (conducting school/community outreach and directing community initiatives/programs; NBCC, 2014b). In comparison, the NASW Code of Ethics (2008) states that “Social workers strive to ensure access to needed information, services, and resources; equality of opportunity; and meaningful participation in decision making for all people” (Ethical Principles Section). Differences exist in how the two professions talk about prevention. Counselors apply prevention in the context of the client (individual, couple or family) while social workers focus on prevention in the context of local to global societies. Lastly, APA’s Ethical Principles of Psychologists and Code of Conduct (2010) states: “They strive to help the public in developing informed judgments and choices concerning human behavior” (p. 3). In psychology, prevention occurs when psychologists offer the public accurate information, which leads to better choices and judgments about aspects of human behavior in specific contexts.

 

Advocacy occurs when counselors defend both clients and the profession of counseling in the face of oppressive systems (Erford, 2013). This hallmark can be found in A.7.a and the Section C Introduction of the ACA Code of Ethics (2014): “When appropriate, counselors advocate at individual, group, institutional, and societal levels to address potential barriers and obstacles that inhibit access and/or the growth and development of clients” (p. 5). Additionally, this hallmark is found in several 2016 CACREP Standards (2015): one standard in the Faculty and Staff section, two standards in the Professional Counseling Orientation and Ethical Practice section, one standard in the Social and Cultural Diversity section, one standard in the Career Development section and one standard in the Clinical Mental Health Counseling Practice section. Lastly, this hallmark is tested in the NCE under Counseling Process (facilitating client access to community resources, identifying barriers affecting client goal attainment, identifying dynamics, obtaining pre-authorization from third-party payors, and providing adequate accommodations for clients with disabilities) and Professional Practice (advocating for client needs, advocating for the professional of counseling, participating in media interviews, providing expert testimony, consult with justice system, consult with providers about medication, consult with school staff, and participate in multidisciplinary team meetings; NBCC, 2014b). In comparison, the NASW Code of Ethics (2008) states: “Social workers pursue social change, particularly with and on behalf of vulnerable and oppressed individuals and groups of people. Social workers’ social change efforts are focused primarily on issues of poverty, unemployment, discrimination, and other forms of social injustice” (Ethical Principles Section). Counselors advocate for the client (individual, couple or family) and the profession of counseling. Social workers advocate for local to global societies. Lastly, APA’s Ethical Principles of Psychologists and Code of Conduct (2010) indicates: “Psychologists recognize that fairness and justice entitle all persons to access to and benefit from the contributions of psychology and to equal quality in the processes, procedures, and services being conducted by psychologists” (p. 3). In psychology, advocacy occurs when the research created by and the services provided by psychologists are available to all members of society.

 

Fourth, counselors promote wellness when helping clients establish affirmative attitudes, create self-care plans and design life balance strategies (Granello & Young, 2011). This hallmark can be found in the Preamble, Section A Introduction, A.1.a, A.1.c, A.2.c, Section C Introduction, C.2.g, Section E Introduction, F.1.a., F.5.b, F.6.b, F.8 and Section I Introduction of the ACA Code of Ethics (2014). In the Preamble, it states: “Counseling is a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals” (p. 3). Additionally, this hallmark is found in one standard each in the Professional Counseling Orientation and Ethical Practice, Social and Cultural Diversity, Human Growth and Development, and Career Development sections of the 2016 CACREP Standards. Lastly, this hallmark is tested in the NCE under Counseling Process (assessing one’s appropriateness for working with a specific client, consulting with client’s support system, consult with school staff, determining need for referral for other services, facilitating client access to community resources, helping client develop support systems, identifying client concerns, identifying client’s support system, providing adequate accommodations for clients with disabilities, providing client follow-up, and triage clients for service), Diagnostic and Assessment Services (assessing potential for harm to self and others, conducting functional behavioral analysis, and using test results to facilitate client decision making), Professional Practice (applying multicultural counseling models, reporting abuse to the proper authorities, and supervising contact/visitation between family members), and Professional Development, Supervision, and Consultation (consult with justice system, consult with prescribers about medication, maintain appropriate boundaries, monitor and address personal compassion fatigue, monitor personal strengths and limitations, and monitor self-reflective versus self-absorbed states of mind; NBCC, 2014b).

 

In comparison, the NASW Code of Ethics (2008) states that “Social workers seek to strengthen relationships among people in a purposeful effort to promote, restore, maintain, and enhance the well-being of individuals, families, social groups, organizations, and communities” (Ethical Principles Section). Counselors promote wellness in both the client (individual, couple or family) and the counselor while social workers focus on wellness with the client and local to global societies. Lastly, APA’s Ethical Principles of Psychologists and Code of Conduct (2010) indicates: “In their professional actions, psychologists seek to safeguard the welfare and rights of those with whom they interact professionally and other affected persons, and the welfare of animal subjects of research” (p. 3). In psychology, the wellness of the client is safeguarded by the psychologist.

 

Lastly, empowerment occurs when counselors encourage client autonomy, self-advocacy, self-validation and self-determination (Erford, 2013). This hallmark can be found in the Preamble and A.1.d of the ACA Code of Ethics (2014). The Preamble states the following as a core professional value: “honoring diversity and embracing a multicultural approach in support of the worth, dignity, potential, and uniqueness of people within their social and cultural contexts; promoting social justice” (p. 3). Additionally, this hallmark is found in several 2016 CACREP Standards: five standards in the Social and Cultural Diversity section, three standards in the Human Growth and Development section, seven standards in the Career Development section, four standards in the Counseling and Helping Relationships section, and one standard in the Assessment and Testing section. Lastly, this hallmark is tested in the NCE under Counseling Process (exploring cultural values and mores, facilitating client access to community resource, facilitating conflict resolution, facilitating interpersonal feedback, helping the client develop support systems, identifying barriers affecting client goal attainment, identifying client concerns, identifying the client’s support system, obtaining informed consent, providing adequate accommodations for clients with disabilities, and providing counseling services in the client’s preferred language), Diagnostic and Assessment Services (implementing tests for client decision making and using test results to facilitate client decision making), Professional Practice (advocating for client needs, applying multicultural counseling models, developing referral sources, empowering clients, collaborative goal setting, and decision-making skills), and Professional Development, Supervision, and Consultation (consult with justice system, consult with prescribers about medication, consult with school staff, and maintain appropriate boundaries; NBCC, 2014b).

 

In comparison, the NASW Code of Ethics (2008) states that:

 

Social workers promote clients’ socially responsible self-determination. Social workers seek to enhance clients’ capacity and opportunity to change and to address their own needs. Social workers are cognizant of their dual responsibility to clients and to the broader society. They seek to resolve conflicts between clients’ interests and the broader society’s interests in a socially responsible manner consistent with the values, ethical principles, and ethical standards of the profession (Ethical Principles Section).

 

Although both professions empower clients, counselors focus on empowering the client (individual, couple or family) while social workers additionally consider how an individual’s empowerment impacts society. Lastly, the APA’s Ethical Principles of Psychologists and Code of Conduct (2010) states: “Psychologists respect the dignity and worth of all people, and the rights of individuals to privacy, confidentiality, and self-determination” (p. 3). In psychology, empowerment of clients includes the right to make their own decisions, respecting cultural differences and safeguarding their welfare.

 

This section has demonstrated that no mental health profession exclusively owns the rights to the words human development, prevention, advocacy, wellness and empowerment. At the same time, this section has clearly outlined how the profession of counseling views these five values differently from psychologists and social workers. It becomes imperative that counselors understand how the profession of counseling views these five values in order to create a counselor professional identity.

 

Creating a Counselor Professional Identity

A strong counselor professional identity reportedly increases ethical behavior, counselor wellness and an accurate understanding of the counselor’s scope of practice (Brott & Myers, 1999; Grimmit & Paisley, 2008; Ponton & Duba, 2009). Many authors have discussed ways counselors can establish their professional identity. Puglia (2008) suggested behaving in harmony with the philosophy of counseling, becoming licensed and or certified as a counselor, and engaging in professional counseling associations. Calley and Hawley (2008) recommended counselors identify with the distinct values of the counseling profession, engage in professional counseling associations, disseminate scholarship for and about the profession of counseling, utilize theoretical orientations that align with the values of the counseling profession, understand the history of the counseling profession and obtain training, licensure and certifications in the profession of counseling. Remley and Herlihy (2014) identified familiarity with current and historical contexts of the profession of counseling, knowledge of the unique philosophy of counseling, understanding counselors’ roles and functions, utilizing counselor ethical codes, and obtaining memberships in professional counseling associations as six ways counselors could establish their professional identity.

 

Even with these recommendations, membership in ACA and being licensed as a counselor do not guarantee the ability to articulate a strong counselor professional identity (Cashwell, Kleist, & Scofield, 2009; Mascari & Webber, 2006). Several other factors also could impact counselor professional identity development. Contact with other professional counselors who have a strong counselor professional identity (such as supervisors, contemporaries and counselor educators) increases the development of an appropriate counselor professional identity (Luke & Goodrich, 2010; Puglia, 2008). Additionally, a mixture of self-reflection and connection to the unique philosophies and values of the profession of counseling drives counselor professional identity (Brott & Myers, 1999). Further, holding the counseling profession in high regard combined with a connection between the self and the profession of counseling contributes to a strong counselor professional identity (Brott & Myers, 1999; Gale & Austin, 2003; Sweeney, 2001). CSI supports this premise and states that counselor education students should graduate with pride in the profession of counseling and a strong counselor professional identity as outlined in one of the six key themes from the Counselor Advocacy Leadership Conferences in 1998 (CSI, 1998). This theme stands today as a call to action for CSI members and chapters. This combination purportedly leads to counselors who passionately defend the counseling profession against inaccuracies (Remley & Herlihy, 2014).

 

Purpose of the Research

Master’s counselor education students have been the focus of prior studies on counselor professional identity (Coll, Doumas, Trotter, & Freeman, 2013; Gibson et al., 2010; Healey & Hays, 2012; Luke & Goodrich, 2010; Moss, Gibson, & Dollarhide, 2014; Nelson & Jackson, 2003; Prosek & Hurt, 2014). Over half (55%) of 203 master’s-level counseling students found it of considerable importance and 28% found it of great importance to better understand the counseling profession and how to identify as a professional counselor (Busacca & Wester, 2006).

 

Fewer studies have focused on the articulation of professional counselor identity with independently licensed counselors. Rønnestad and Skovholt (2003) found that expressing a strong counselor professional identity required postgraduate counselors to assimilate the personal self and the professional self. Moss and colleagues (2014) stated that client contact was essential to counselor identity development along with an integration of the personal and professional self over the course of a counselor’s career. Mellin and colleagues (2011) found that independently licensed counselors developed a strong counselor professional identity when they aligned with the counseling profession’s unique philosophy and values.

 

Although each of these studies touches on some aspect of counselor professional identity with independently licensed counselors, none of these studies offers a concrete understanding of how independently licensed counselors articulate their professional identity to others. Further, ACA, AASCB, CACREP, CSI, NBCC have taken steps to attempt to secure a strong counselor professional identity. However, there is no understanding as to whether these efforts impact how independently licensed counselors articulate their professional identity with others. Although there is much discussion about clearly establishing a strong counselor professional identity, there is no systematic way for independently licensed counselors to determine if they articulate a counselor professional identity to others and, if not, what adjustments might be made to improve their communications.

 

The purpose of this study was to answer the following research questions: (a) what are the different ways (formulas) independently licensed counselors use to articulate their professional role to others, (b) would we assign more advanced professional identity formulas to independently licensed counselors who have recently graduated, (c) would we assign more advanced professional identity formulas to independently licensed counselors licensed in a specific state or region, and (d) would an independently licensed counselor’s self-ranking as consistently identifying professionally as a counselor to others agree with our classification of that counselor with an advanced counselor professional identity formula? To answer these questions, we surveyed independently licensed counselors from across the United States.

 

Method

 

Participants

We defined independently licensed counselors as counselors who have graduated with at least a master’s degree, obtained postgraduate clinical supervision and have a license to practice as a counselor without supervision in their state. Participants were 472 independently licensed counselors with a mean age of 41 (range = 25–69, SD = 10.5) who completed all sections of the survey. A majority identified as female (n = 392, 83%) and European American (n = 396, 84%). Other races represented included: African American (n = 24, 5%); Hispanic (n = 19, 4%); Biracial (n = 14, 3%); No Response (n = 9, 2%); Asian American (n = 5, 1%); and Native American (n = 5, 1%). All participants were currently independently licensed as a counselor by a state counseling licensure board; however, 14 (3%) also were licensed marriage and family therapists, nine (2%) also were licensed psychologists, and five (1%) also were licensed social workers. Thankfully these individuals comprised only 6% of the total sample. We included these 28 dually licensed participants as they are independently licensed counselors in their state and represent independently licensed counselors in the United States. These individuals are tied to counselor professional identity in the United States as well as represent independently licensed counselors to other mental health professionals, legislators, clients and society. Participants worked in various settings: counseling agency (n = 170, 36%), private practice (n = 118, 25%), state and federal governments (n = 47, 10%), hospitals and clinics (n = 42, 9%), college settings (n = 33, 7%), not currently working as a counselor (n = 28, 6%), K–12 settings (n = 24, 5%), managed care (n = 5, 1%) and unemployed (n = 5, 1%). The mean year of master’s graduation for participants was 2005 (SD = 6.08).

 

Data Collection Procedures

SurveyMonkey’s (2016) power analysis calculator for survey designs identified a need for at least 384 survey respondents given a 95% confidence level, 135,000 population size (United States Bureau of Labor Statistics, 2016) and confidence interval of +/- 5%. Two state counseling licensure board lists in each of the four ACA regions (eight states total) were randomly selected. The combined lists from the eight state counseling licensure boards generated a total list of 72,436 independently licensed counselors. A total stratified random sample of 2,144 participants was randomly selected with 268 participants selected from each state to ensure that the same number of participants were randomly selected from each of the four ACA regions. Because many counselors had moved from one of the eight states and were now practicing in another state, independently licensed counselors from 49 states and the District of Columbia were part of the final sample; North Dakota was not represented. Four hundred seventy-two participants completed the study, resulting in a 22% response rate.

 

Each participant received a postcard of explanation that included a link to a webpage. Participants received one of eight URLs to participate in the study corresponding to the state issuing the independent counseling license to participants. On the webpage, participants responded to five sections when participating in the study. They (a) consented to the informed consent form, (b) answered questions about their demography, (c) rated one Likert scale question, (d) completed the open text box prompt and (e) had the option of providing their name and e-mail address to receive a $5 e-gift card to Amazon.com, Starbucks, or Target on a separate website.

 

Measure

A search of the literature failed to yield examples of existing measures relevant to the topic. We established content validity before the use of this new and untested instrument. Ten experts from the counseling field completed the instrument and rated items for clarity, representativeness and appropriateness. They rated the one Likert scale question asking about the participant’s clarity in consistently identifying professionally as a counselor as well as the open text box asking participants to write how they describe their occupational role as a professional counselor to others. These 10 experts had published on counselor professional identity or served on state or national counseling professional identity committees.

 

Three sections comprised the survey: (a) questions about participants’ demography, (b) one Likert scale question asking about the participant’s clarity in consistently identifying professionally as a counselor, and (c) an open text box asking participants to respond to the prompt: “Please write below how you describe your occupational role as a professional counselor to others (clients, other professionals, and the public).” The demographic variables included the following: gender identity, age, all licenses held with a state licensure board, year of graduation from master’s counseling program, current employment setting, and ethnicity and race.

 

One Likert scale question asked about the participant’s professional identity: “I am consistently clear in my language with clients, other professionals, and the public that I am a counselor (as opposed to saying I am a psychotherapist, therapist, etc.).” Participants responding “Never Clear” scored a 0 and those responding “Always Clear” scored a 5.

 

Data Analysis Procedures

We performed several data analysis procedures. First, structural coding allowed for the creation of categories that summarize the different formulas used by independently licensed counselors to talk about their profession with others (Saldaña, 2013). Additionally, it allowed for the detection of the number of individual participants who endorsed each formula. We first analyzed the data using structural coding separately, and then we reevaluated the data simultaneously to check for agreement. In the separate analyses, we each found that all 472 responses naturally categorized into six different formulas. We then re-reviewed our separate analyses jointly and found complete agreement.

 

After utilizing structural coding, we re-analyzed the data using magnitude coding (Miles & Huberman, 1994). Magnitude coding adds a symbol (such as a number or character) to existing code to indicate the code’s intensity, direction or valuation (Saldaña, 2013). We used magnitude coding to add a numeric value to the six formulas with 0 denoting the formula with the least amount of counselor professional identity to 5 denoting the formula with the greatest amount of counselor professional identity.

 

Further, we performed structural coding again within each of the six main formulas to create sub-formulas that would further explain nuances found within each of the six main formulas. We separately analyzed sub-formulas for each of the six formulas. Later, we reevaluated the results simultaneously to check for agreement. We found that there were four sub-formulas within each of the six main formulas. Magnitude coding was performed by adding a numeric value to the four sub-formulas generated in this study, with a value of “a” denoting the formula with the least amount of counselor professional identity to a value of “d” denoting the formula with the greatest amount of counselor professional identity. Hence, a participant rated as a 5d demonstrated the greatest amount of counselor professional identity, and a participant rated as a 0a demonstrated the least amount of counselor professional identity (Table 1). Further, a participant rated as a 1d demonstrated more counselor professional identity than a participant rated as a 1c.

 

Next, we used descriptive statistics to explore survey responses from independently licensed counselors using a mail survey design (Fink & Kosecoff, 1998; Heppner, Kivlighan, & Wampold, 1992) to understand our study subjects better. Additionally, we used descriptive statistics to see how closely participants’ ratings of their expressions of professional identity matched our ratings of their professional identity statements. To determine if ratings improved with more recent graduates, we ran a Mann-Whitney U test to see if our ratings varied by participant date of graduation from their master’s counseling program. To determine if different ACA regions obtained better ratings, we performed a Kruskal-Wallis test to see if our ratings varied based upon the state that issued the independently licensed counselor’s license. Finally, we calculated Cohen’s kappa to determine the interrater agreement between participants’ self-rating about identifying consistently as a counselor to others and our ratings of their description of their occupational role as a professional counselor to others.

 

Results

 

We identified six different ways (formulas) that independently licensed counselors communicate their professional role to others; a narrative description of each of the six formulas and their four corresponding sub-formulas follows. Table 1 outlines direct quote examples, including the number and percentage of participants using the six formulas and four corresponding sub-formulas. Additionally, Figure 1 displays graphically the total number of participants in each of the six formulas as well as the number of participants in each sub-formula a–d. As noted in the literature review, the counseling profession does not own specific techniques and tools, such as CBT, the Minnesota Multiphasic Personality Inventory or the Diagnostic and Statistical Manual of Mental Disorders (DSM–5). However, counselors articulating their counselor professional identity will likely refer to their connection to specific counseling tools and techniques to help others understand their services.

 

 

Table 1

Direct Quote Participant Examples for Each of the Six Formulas With Corresponding Sub-Formulas

 

n, %                                   Formula     Quotes

 

256, 54%    Formula 0      No mention of the word counselor or counseling

164, 64%    Formula 0a     No title, ambiguous clients and/or techniques

“A person who walks with a client to help achieve the specified goals of a client.”

                                          “I assess, diagnose and treat clients presenting mental health issues.”

51, 20%      Formula 0b     No title, specific clients and/or techniques

“I am a psychotherapist for children 5–12 living in a psychiatric community residence.”

“I assist people with disabilities with obtaining and maintaining employment.”

10, 4%        Formula 0c     Title, ambiguous clients and/or techniques

“I am a mental health therapist working with children, adults, couples, and families.”

“I am a program director and clinical supervisor at a mental health agency.”

31, 12%      Formula 0d     Title, specific clients and/or techniques

“I am an In-Home Intensive Multisystemic Therapist working with willfully defiant adolescents and their families.”

“I am a Unit Manager in a treatment center for adult male inmates.”

19, 4%        Formula 1      Generic mention of the word counselor or counseling along with other terms such as therapist, psychotherapist, etc.

7, 37%        Formula 1a     Ambiguous title, ambiguous clients and/or techniques

“I am a private practice clinician, counselor and therapist. I work in my community serving adults.”

“I provide individual, group, couples, and family therapy to those seeking counseling.”

3, 16%        Formula 1b     Ambiguous title, specific clients and/or techniques

“I am an independent clinician who works with people 15 and up doing individual and group counseling. I specialize in substance abuse, eating disorders, BPD, co-occurring diagnosis, and trauma.”

“I work in a school setting as a mental health therapist. The school invites our agency in the building and we provide outpatient counseling to children.”

5, 26%        Formula 1c     Title, ambiguous clients and/or techniques

“You can call me a Licensed Professional Counselor, Behavioral Therapist, Mental Health Therapist, or Psychotherapist. I am a helping professional in the health care field.”

“I am a therapist and counselor at a community hospital and cancer center.”

4, 21%        Formula 1d     Title, specific clients and/or techniques

“I am a Trauma Specialist. I provide counseling in grief and loss, couples counseling and assistance with gay and lesbian issues.”

“I am a dual-role counselor. I work as an Infant Mental Health Therapist with children ages 0–6 and their families. I also work as a Maternal and Infant Health Therapist working with mothers of all ages and providing them with therapeutic services and case management.”

52, 11%      Formula 2      Identifies generically as a counselor or someone doing counseling

14, 27%      Formula 2a     No title, ambiguous clients and/or techniques

“I provide professional counseling skills for individuals, couples, and groups.”

“My role is to skillfully help clients meet their goals regarding the issues that brought them to counseling.”

19, 36%      Formula 2b     No title, specific clients and/or techniques

“I provide crisis intervention counseling to children and families.”

“I offer strength-based, solution-focused cognitive behavioral therapy but draw from a variety of theories and foundations to provide individualized counseling and assessment services.”

15, 29%      Formula 2c     “Counselor” title, ambiguous clients and/or techniques

“As a counselor I diagnose and treat mental and emotional disorders as well as give people empathy, feedback, advice, and guidance in dealing with life issues. In addition, I provide a safe place for people to process thoughts and emotions in an effort to come to a deeper understanding of themselves, others, and the world.”

“I am a counselor providing counseling in a safe environment to people struggling with mental health issues.”

4, 8%                                 Formula 2d                 “Counselor” title, specific clients and/or techniques

“I am a counselor for a hospice agency, providing emotional support to patients and their families as the patient faces end of life.”

“I am a full-time counselor on a small, private college campus working only with students.”

9, 2%                                Formula 3 Identifies generically as a counselor or someone doing counseling along with discussing at least one or more distinct hallmarks of the profession of counseling

4, 45%        Formula 3a     No title, ambiguous clients and/or techniques, identifies one or more hallmarks of the profession of counseling

“I provide counseling services (diagnostic and biopsychosocial assessments, treatment planning, individual, group, couples counseling) and practice from a wellness model and advocate for clients as needed.”

“I provide counseling as well as advocacy for those individuals who are seeking help for a variety of issues in their lives.”

1, 11%        Formula 3b     No title, specific clients and/or techniques, identifies one or more hallmarks of the profession of counseling

“I provide counseling to children, adolescents and families contracted through the juvenile justice system. I also advocate for clients with community resources.”

3, 33%       Formula 3c     “Counselor” title, generic clients and/or techniques, identifies one or more hallmarks of the profession of counseling

“As a counselor, I help people learn more about themselves and the things which promote their well-being. I educate people about mental illness and mental well-being.”

“As a counselor, I provide various services in the field of mental or emotional health. At times this means being a source of support, other times it’s a source of information and empowerment. Ultimately I believe I’m there to serve the client, not to force them into my plan.”

1, 11%        Formula 3d     “Counselor” title, specific clients and/or techniques, identifies one or more hallmarks of the profession of counseling

“I am a counselor for individuals who have committed domestic violence offenses and sex offenses. I provide mental health therapy to these individuals as well as psychoeducational groups about tools to help make healthier choices.”

94, 20%      Formula 4      Identifies specifically as a counselor

27, 29%      Formula 4a     “Professional counselor” or “mental health counselor” title, ambiguous clients and/or techniques

“As a professional counselor I assist people in navigating their complex worlds in order to live a healthier, happier life.”

“As a professional counselor, I diagnose and treat mental and emotional disorders and addictive disorders.”

20, 21%      Formula 4b     “Professional counselor” or “mental health counselor” title, specific clients and/or techniques

“I am a professional counselor at an incarceration facility and I work primarily with federal inmates and U.S. probation clients.”

“As a professional counselor, I primarily offer career counseling with employees in transition.”

24, 26%      Formula 4c     Identifies as their state counseling license title, ambiguous clients and/or techniques

“I am a Licensed Mental Health Counselor in private practice.”

“I am a Licensed Professional Counselor. I see my role as coming alongside people and helping them cope with difficulties in life, or helping them manage emotions.”

23, 24%      Formula 4d     Identifies as their state counseling license title, specific clients and/or techniques

“I am a Licensed Mental Health Counselor (LMHC) who works in the correctional setting by working to rehabilitate inmates.”

“I am a Licensed Mental Health Counselor working with adolescents on a U.S. military base conducting individual, group, and family therapy.”

42, 9%        Formula 5      Identifies specifically as a counselor as well as identifies one or more hallmarks of the profession of counseling

33, 79%      Formula 5a     “Professional counselor” or “mental health counselor” title, ambiguous clients and/or techniques, identifies one or more hallmarks of the profession of counseling

“As a professional counselor, I help clients reach their personal goals with a focus on wellness, client empowerment, developmental awareness, and prevention.”

“As a professional counselor, I offer counseling, psychoeducation, and empowerment in addition to advocating for my clients in areas where they may need assistance.”

1, 2%                                 Formula 5b “Professional counselor” or “mental health counselor” title, specific clients and/or techniques, identifies one or more hallmarks of the profession of counseling

“I am a professional counselor working with children and their parents to help them improve their relationships and reduce habits that get in the way of positive healthy lives as a means of increasing client wellness.”

2, 5%                                 Formula 5c Identifies as their state counseling license title, ambiguous clients and/or techniques, identifies one or more hallmarks of the profession of counseling

“My role as a Licensed Mental Health Counselor is to provide guidance, increase empowerment, and promote wellness for clients.”

“My goal as a Licensed Professional Counselor is to help people maximize their full potential and wellness through advocacy, empowerment, and self-determination.”

6, 14%        Formula 5d     Identifies as their state counseling license title, specific clients and/or techniques, identifies one or more hallmarks of the profession of counseling

“I am a Licensed Professional Counselor specializing in working with women healing from abuse and trauma. I focus on empowerment and wellness with my clients.”

“I’m a bilingual Licensed Mental Health Counselor who works with Latino families in an outpatient setting. My role is to provide counseling services as well as to advocate on behalf of my clients so that they can maximize their well-being.”

 

 

 

Figure 1. Total number of participants in each of the six formulas as well as the number of participants in each sub-formula a–d.

Formula 0 participants, the lowest rated on the scale, never used the term “counselor” or “counseling” when talking about their role in the counseling profession with others. The majority of participants categorized into this formula. There were four main ways participants expressed themselves in Formula 0 when talking about their role in the counseling profession with others. Formula 0a did not offer a title and was ambiguous about clients and techniques. Formula 0b did not offer a title and was specific about clients and techniques. Formula 0c offered a title, but ambiguously discussed clients and techniques. Formula 0d offered a title and was specific about clients and techniques.

 

Formula 1 participants generically used the term “counselor” or “counseling” somewhere in their formulations, along with the titles clinician, specialist, social worker, educator, coordinator, administrator, coach, therapist or psychotherapist, when talking about their role in the counseling profession with others. Few participants categorized into this formula. There were four main ways participants expressed themselves in Formula 1 when talking about their role in the counseling profession with others. Formula 1a offered an ambiguous title and was ambiguous about clients and techniques. Formula 1b offered an ambiguous title but discussed specific clients and techniques. Formula 1c offered a title but ambiguously discussed clients and techniques. Formula 1d offered a title and was specific about clients and techniques.

 

Formula 2 participants generically used the term “counselor” or “counseling” in their formulations. This was the third largest category. There were four main ways participants expressed themselves in Formula 2 when talking about their role in the counseling profession with others. Formula 2a offered an ambiguous title and was ambiguous about clients and techniques. Formula 2b offered an ambiguous title but discussed specific clients and techniques. Formula 2c offered the generic title “counselor” but ambiguously discussed clients and techniques. Formula 2d offered the generic title “counselor” and discussed specific clients and techniques.

 

Formula 3 participants generically used the term “counselor” or “counseling” in their formulations along with discussing at least one distinct hallmark of the profession of counseling (normal development, prevention, wellness, advocacy or empowerment). This was the smallest category. Among the nine participants, there were at least five mentions of the concepts of wellness and empowerment along with four mentions of the concept of advocacy. There were four main ways participants expressed themselves in Formula 3 when talking about their role in the counseling profession with others. Formula 3a offered an ambiguous title and was ambiguous about clients and techniques but did mention at least one or more hallmarks of the profession of counseling. Formula 3b offered an ambiguous title, discussed specific clients and techniques and stated at least one or more hallmarks of the profession of counseling. Formula 3c offered the generic title “counselor,” ambiguously discussed clients and techniques and stated at least one or more hallmarks of the profession of counseling. Formula 3d offered the generic title “counselor,” discussed specific clients and techniques and stated at least one hallmark of the counseling profession.

 

Formula 4 participants identified specifically as counselors. This was the second largest category. There were four main ways participants expressed themselves in Formula 4 when talking about their role in the counseling profession with others. Formula 4a offered “professional counselor” or “mental health counselor” as a title but was ambiguous about clients and techniques. Formula 4b offered “professional counselor” or “mental health counselor” as a title and discussed specific clients and techniques. This formula offered a state counseling license title but used ambiguous descriptions of clients and techniques. Formula 4d offered a state counseling license title and used specific descriptions of clients and techniques.

 

Formula 5 participants identified specifically as counselors along with discussing at least one distinct hallmark of the profession of counseling (normal development, prevention, wellness, advocacy or empowerment). This was the fourth largest category. Among the 42 participants, there were at least 18 mentions of empowerment, 13 mentions of advocacy, 10 mentions of wellness, nine mentions of prevention and seven mentions of normal development. There were four main ways participants expressed themselves in Formula 5 when talking about their role in the counseling profession with others. Formula 5a offered “professional counselor” or “mental health counselor” as a title, was ambiguous about clients and techniques and discussed at least one distinct hallmark of the profession of counseling. Formula 5b offered “professional counselor” or “mental health counselor” as a title, discussed specific clients and techniques and stated at least one distinct hallmark of the profession of counseling. Formula 5c offered a state counseling license as a title, used ambiguous descriptions of clients and techniques and discussed at least one distinct hallmark of the profession of counseling. Formula 5d offered a state counseling license as a title, used specific descriptions of clients and techniques and discussed at least one distinct hallmark of the profession of counseling.

 

We further wanted to investigate differences between participant self-ratings about identifying consistently as a counselor to others and our ratings of their professional identity statements to determine the level of counselor professional identity actually expressed by the participant. Overall, participant scores fell in the range between “Mostly to Frequently Clear” when asked about identifying consistently as a counselor to others (N = 472, M = 3.40, SD = 1.51). We next grouped all self-ratings together from “Never Clear” (0) to “Always Clear” (5). We separated these five groups and then calculated the means and standard deviations of our ratings of the statements for each of the six self-rated groups. We rated the statements of the 38 participants who self-rated a 0 as having formulations with a mean of 1.20 (at the level of Formula 1) and a standard deviation of 1.79. We rated the statements of the 33 participants who self-rated a 1 as having formulations with a mean of 1.02 (at the level of Formula 1) and a standard deviation of 1.64. We rated the statements of the 47 participants who self-rated a 2 as having formulations with a mean of 1.57 (between Formula 1 and Formula 2) and a standard deviation of 1.93. We rated the statements of the 90 participants who self-rated a 3 as having formulations with a mean of 1.54 (between Formula 1 and Formula 2) and a standard deviation of 1.89. We rated the statements of the 108 participants who self-rated a 4 as having formulations with a mean of 1.58 (between Formula 1 and Formula 2) and a standard deviation of 1.95. We rated the statements of the 156 participants who self-rated a 5 as having formulations with a mean of 1.74 (between Formula 1 and Formula 2) and a standard deviation of 1.95. Figure 2 is a bar chart showing in black the total number of participants for the six levels of clarity in consistently communicating a professional identity to others by formula rating each participant’s statement.

 

 

Figure 2. Total number of participants’ clarity in consistently communicating a professional counselor identity to others by formula rating of each participant’s statement.

We conducted a Mann-Whitney U test to see if our rating of participants’ statements changed based upon the participant’s date of graduation: 1969–1999 (n = 57, M = 1.97, SD = 2.03) and 2000–2012 (n = 415, M = 1.50, SD = 1.90). The year 2000 saw the release of the 2001 CACREP Standards (CACREP, 2001), which emphasized student and faculty professional identity and professional orientation. Individuals graduating up to 1999 rated at Formula 2 and individuals graduating 2000 and after rated between Formula 1 and Formula 2. Median researcher ratings for participants graduating with their master’s degree from 1969–1999 (272.91) and participants graduating with their master’s degree from 2000–2012 (244.12) were not statistically different: U = 11170.5, z = -1.585, p = .11. We did not assign more advanced professional identity formulas to independently licensed counselors who had graduated more recently.

 

We conducted a Kruskal-Wallis test to see if our rating of participants’ statements changed based upon the state issuing the independent counseling license to participants: North Atlantic state 1 (n = 54, M = 1.96, SD = 2.07), North Atlantic state 2 (n = 68, M = 1.10, SD = 1.71), Southern state 1 (n = 47, M = 2.00, SD = 2.02), Southern state 2 (n = 64, M = 1.58, SD = 1.93), Midwestern state 1 (n = 65, M = 1.66, SD = 1.91), Midwestern state 2 (n = 71, M = 1.63, SD = 1.89), Western state 1 (n = 53, M = 1.52, SD = 1.94) and Western state 2 (n = 50, M = 1.10, SD = 1.83). Participants from one North Atlantic state rated highest with Formula 2 while participants from one Western state and one North Atlantic state rated lowest with Formula 1. When the mean was computed by region, the two Southern states rated highest with a 1.79, and the two Western states rated lowest with a 1.31. However, both ratings fell between a Formula 1 and Formula 2. Median researcher ratings for participants by state were not statistically different: χ2(7) = 11.88, p = .11. We did not assign more advanced professional identity formulas to independently licensed counselors licensed in a specific state or region.

 

We calculated Cohen’s kappa to determine the interrater agreement between the participants’ Likert scale self-rating about identifying consistently as a counselor to others and our rating of that participant’s discussion of their occupational role as a professional counselor to others. A kappa value of less than .20 represents poor agreement; between .21 and .40 represents fair agreement; between .41 and .60 represents moderate agreement; between .61 and .80 represents good agreement; and between .81 and 1.0 represents very good agreement beyond chance (Landis & Koch, 1977). The interrater reliability indicated k = 0.003 (95% CI, .000 to .034, p = .84). Participants’ self-rating of “Always Clear” identifying to others as a professional counselor did not agree with our ratings of these participants’ formulas. Participants’ self-rating of “Never Clear” identifying to others as a professional counselor did not agree with our ratings of these participants’ formulas. An independently licensed counselor’s self-ranking as consistently identifying professionally as a counselor to others did not agree with classification as an advanced counselor professional identity formula.

 

Discussion

 

Participants’ scores fell in the “Mostly to Frequently Clear” range when self-rating as clearly articulating to others as a professional counselor. As 56% of the participants rated themselves with the two highest ratings on the scale, it would seem that counselor professional identity is not a serious issue. However, when we evaluated participants’ narratives about their occupational role, we placed only 29% of counselors in the two highest formulas, 4 and 5. As 54% of participants never used the term “counselor” or “counseling” when discussing their occupational role with others, the continued concerns about counselor professional identity are warranted (Gale & Austin, 2003; Gibson et al., 2010; Kaplan & Gladding, 2011; Mellin et al., 2011; Myers et al., 2002). As counselors rated themselves high and the articulations shared rated low, it is not surprising that there was little agreement between a high or low self-rating of articulation and our assigning a high or low formula level to descriptions of their occupational role to others. Results also demonstrated that counselor professional identity articulations have not improved over time. We rated counselors who graduated before 2000 at a Formula 2 and those graduating 2000 and after between Formula 1 and Formula 2. There was no statistical difference between the two groups. Additionally, this study identified that all ACA regions performed on average between a Formula 1 and Formula 2.

 

Researchers and the major professional counseling organizations agree that counselor professional identity centers on distinguishing the counseling profession’s unique philosophy and values from other mental health professions (Calley & Hawley, 2008; Choate et al., 2005; Puglia, 2008; Remley & Herlihy, 2014; Weinrach et al., 2001; Woo, 2013). Mellin and colleagues (2011) reported that counselors naturally distinguish the counseling profession from other mental health professions by being grounded in a developmental, preventive and wellness orientation despite practicing in different counseling subspecialties. It would appear that the profession and its members have agreement on the counseling profession’s distinct hallmarks of prevention, advocacy, wellness, empowerment and normal human development. However, results from our study indicated that only 11% of participants alluded to one or more of the counseling profession’s distinct hallmarks when articulating their occupational role to others. It does not appear that independently licensed counselors are communicating how the counseling profession’s unique values and philosophy shape their professional practice (Sweeney, 2001). Clearly the ACA Code of Ethics, the NCE and the 2016 CACREP Standards are all guided by these five hallmarks of the profession of counseling. However, independently licensed counselors are not connecting consciously to the philosophy and values of the counseling profession. Once they evolve into clinical practice, independently licensed counselors severely struggle to articulate not only a counselor professional identity, but also to clearly articulate their services. Although this is a problem for the profession of counseling, this is a greater potential problem for the counselor who cannot clearly articulate why they should be hired, why a client should choose their services, why a legislator should listen to their point of view or why an individual from another health profession should make a referral.

 

The majority of participants (65%) used ambiguous terms to describe clients or techniques used in their counseling practice. Further, over half of the participants (54%) did not offer any title when discussing their occupational role to others. A few participants (5%) used a title that did not mention the word “counselor.” Roughly 8% of participants used their job title, which did not include the word “counselor.” Approximately 5% titled themselves only as a “counselor” while 17% titled themselves a “professional counselor” or a “mental health counselor.” About 11% identified themselves by their state counseling license. This study supports the premise that being licensed as a counselor does not guarantee a strong counselor professional identity (Cashwell et al., 2009; Mascari & Webber, 2006).

 

Within each of the six distinct formulations independently licensed counselors used to discuss their occupational role with others, there was a pattern of progression from the ambiguous to the specific. This progression happened in two ways; titling as well as describing clients and techniques. First, the profession of counseling in many respects “owns” the words counselor and counseling. In the ACA Code of Ethics, the word counselor or counseling occurs over 600 times. It should, as counselors are licensed at the state level as counselors and receive specialized training in providing counseling. This is a major reason that there is a license at the state level for counselors as opposed to being licensed at the state level as a psychologist or social worker. The word counseling appears in the NASW Code of Ethics four times and the APA Code of Conduct five times. It is extraordinarily problematic that 54% of participants never even used the generic terms counselor or counseling. Further, it is troubling that only 29% of participants gave themselves at least the generic “title” of professional counselor. Additionally, it is troubling how often counselors did not describe the typical types of clients they see or their expertise in working with specific counseling techniques. The inability to articulate their expertise negatively impacts their occupational role. Namely, the progression moved from (a) a weak or nonexistent title with an ambiguous discussion of clients and techniques to (b) a weak or nonexistent title with a specific discussion of clients and techniques to (c) a stronger title with an ambiguous discussion of clients and techniques to, finally, (d) a stronger title with a specific discussion of clients and techniques. Over half (52%) of participants offered some form of a weak or nonexistent title with an ambiguous discussion of clients and techniques. One fifth of the participants communicated some form of a weak or nonexistent title with a specific discussion of clients and techniques. Around 13% of participants used a stronger title with an ambiguous discussion of clients and techniques, and 15% of participants used a stronger title with a specific discussion of clients and techniques.

 

Implications

 

A poor counselor professional identity in the United States has been blamed for issues with licensure portability, parity in hiring practices, marketplace recognition in U.S. society, psychologists being licensed as counselors, and third-party payments (Calley & Hawley, 2008; Myers et al., 2002; Reiner et al., 2013). A strong counselor professional identity reportedly remedies these issues and allows counselors to take full advantage of securing their ability to work with a wide range of client populations, receive third-party reimbursement, offer all of the services afforded in their scope of practice and make a greater impact when advocating for clients (Calley & Hawley, 2008; Myers et al., 2002; Reiner et al., 2013). There is clearly much room for improvement in counselor professional identity when independently licensed counselors discuss their occupational role with others.

 

ACA, AASCB, CACREP, CSI and NBCC have all taken steps to attempt to secure a stronger counselor professional identity. With only 11% of participants mentioning even one of the hallmarks of the profession of counseling, it is imperative that counselors learn one unified message about the hallmarks of the profession of counseling. Healey and Hays (2012) have identified these hallmarks as normal development, prevention, wellness, advocacy and empowerment. These hallmarks are commonly found in the ACA Code of Ethics, CACREP Standards, the NCE, counselor professional identity research, and counselor professional issues and ethics textbooks. The question arises whether counselor educators are teaching counselor professional identity in ways that impact how counselors articulate their occupational role with others. Although the CACREP Standards require documentation that counselor professional identity is taught to students as well as requiring that those same standards be measured, the quality of the measurement of those standards is not under CACREP’s purview. The results of this study suggest that all of the counselor professional identity efforts of ACA, CACREP, NBCC and counselor educators have made little impact on independently licensed counselors when 54% of them do not use the generic terms counselor or counseling and only 29% assign themselves the title professional counselor. There has been much talk about counselor professional identity, but the outcomes suggest that most independently licensed counselors have no connection to counselor professional identity.

 

A systemic problem exists in the counseling profession’s training of counselors to adopt and articulate a counselor professional identity. It seems as if the organizations of the profession of counseling (ACA, CACREP, NBCC and CSI) know counselor professional identity is the foundation of the profession and have integrated these concepts into the ACA Code of Ethics, 2016 CACREP Standards, the NCE, and CSI’s Six Advocacy Themes. What is not known is what they mean when counselor educators state that they adopt a counselor professional identity. Do counselor educators who say they adopt a counselor professional identity actually understand how the five hallmarks of the profession of counseling are foundationally tied to the ACA Code of Ethics, the 2016 CACREP Standards, and the NCE? If counselor educators fail to tie counselor professional identity to the foundational blocks, and teaching students counselor professional identity amounts to encouraging membership in ACA and state counseling associations, it is little wonder that students graduate not tied to the foundations of the profession of counseling. As discussed in the literature review, many authors have discussed methods to support counselors in establishing their professional identity: behaving in harmony with the philosophy of counseling, becoming licensed and/or certified as a counselor, engaging in professional counseling associations, disseminating scholarship for and about the profession of counseling, understanding the history of the counseling profession, understanding counselors’ roles and functions and utilizing counselor ethical codes. The profession of counseling clearly lacks a concrete understanding of what is truly required to create a counselor professional identity with independently licensed counselors. What is apparent is that the status quo in developing counselor professional identity is not working.

 

The biggest threat to counselor professional identity is that over 54% of participants did not use the words counselor or counseling when discussing their occupational role. The word counselor can be used by attorneys, camp counselors, debt counselors and others. It is possible that independently licensed counselors are avoiding using the term because they do not know how to distinguish those words from other, unrelated professional roles. This is certainly an issue for independently licensed counselors which does not occur for psychologists or social workers. The reality is that independently licensed counselors are licensed at the state level as counselors and have specialized training to provide counseling. The words counselor and counseling cannot effectively be abandoned by independently licensed counselors.

 

More resources need to be made widely available to make an impact on how independently licensed counselors articulate their occupational role with others. They need tools to help them effectively discuss their occupational role as a counselor doing counseling. In the past, there has been no systematic way for independently licensed counselors to evaluate their counselor professional identity when communicating their role to others. Further, if the counselor is off track, there has been no resource to help them understand what adjustments could be made to improve their communication. Independently licensed counselors could use guidance to evaluate their ability to articulate a strong counselor professional identity to others.

 

The coding strategies identified through this research may help independently licensed counselors to evaluate their current narratives and make improvements when communicating their occupational role with others. Counselor educators may use the six formulations with their corresponding four sub-formulas in classes to help students develop their counselor professional identity statements. Lastly, professional counseling associations may use the six formulations and corresponding four sub-formulas to help professional members develop their counselor professional identity statements.

 

Further, Burns (2017) created a 7-step format to craft a One-Minute Counselor Professional Identity Statement. The tool helps counselors articulate a succinct and powerful counselor professional identity statement that showcases the unique contributions of the counselor as well as the field of counseling. Here is an example of a One-Minute Counselor Professional Identity Statement for an independently licensed counselor introducing themselves to a psychiatrist for referrals:

 

I’m Susan Jones, a Licensed Professional Counselor. I’d appreciate your consideration of my counseling services for your patients experiencing eating disorders in Detroit. My counseling practice helps clients achieve their optimal level of development and wellness through a focus on client empowerment, prevention and advocacy. I have used evidence-based treatment approaches over the last 7 years such as the Maudsley approach, a family-based therapy, and cognitive behavioral approaches. I also assist clients negotiating the use of antidepressant medications with their prescriber. I am trained to use a variety of assessment, diagnostic and counseling techniques specific to individuals experiencing eating disorders in individual, family and group settings. I promote a healthy relationship with food and others as well as help to overcome barriers to goal attainment. I am a member of the American Counseling Association, as well as the American Mental Health Counselors Association, and am bound by their codes of ethics.

 

This 7-step format can be used by counselors at all developmental levels and adjusted for various audiences. The 7-step format can help define counselor professional identity to ensure global audiences hear a unified voice of the hallmarks of the counseling profession.

 

Future Research and Limitations

 

Future research could examine how independently licensed counselors use the six formulations presented in this study to evaluate their professional identity statements, if they use them at all. Additionally, research could discern how independently licensed counselors view the importance of moving from lower to higher formula levels. Finally, research could determine how independently licensed counselors connect with the distinct hallmarks of counseling.

 

Limitations of this research include: Likert scale-based surveys suffer from self-report and social desirability bias, recruiting participants from the state counseling boards lists of only eight states across the United States, the $5 incentive could have influenced participant responses or attracted a certain type of participant, and a certain type of participant may have been drawn to respond to the survey topic. Additional limitations include the use of non-parametric data, which may lack power as compared with more traditional approaches. There is a potential bias of interpretation and research embeddedness in the topic with qualitative coding. Lastly, we do not know if any study participants hold doctorates in counselor education.

 

Conclusion

 

As inequities exist for independently licensed counselors, there has been much discussion for five decades about counselor professional identity, along with many attempts by various counseling constituencies to address this critical issue. We investigated how independently licensed counselors expressed their role as a professional counselor to others and evaluated their consistency in expressing a counselor professional identity. This study provides a concrete description of how independently licensed counselors are expressing their professional identity when describing their role as a counselor to others. Counselors may wish to review the various formulations outlined to evaluate their own communications to see if and how counselor professional identity can be strengthened.

 

 

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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Stephanie Burns, NCC, is an Assistant Professor at Western Michigan University. Daniel R. Cruikshanks is a Professor at Aquinas College. Correspondence can be addressed to Stephanie Burns, 1903 W. Michigan Avenue, Kalamazoo, MI 49008-5226, stephanie.burns@wmich.edu.