Dear Governor McAuliffe, 

I urge you to OPPOSE the proposed regulation 18 VAC 115-20 aimed at governing the practice of Counseling in Virginia (aka, the CACREP-only regulation regarding eligibility to become a Licensed Professional Counselor). The proposed regulations will negatively impact mental health in Virginia, especially in rural areas. It will unnecessarily reduce the number of qualified mental health providers in this state and deny needed care to our citizens. It also will be detrimental to non-CACREP accredited programs at several Virginia Universities.

I am concerned that this CACREP-only regulation regarding eligibility to become a Licensed Professional Counselor (LPC) may at first glance appear to be a non-controversial proposal designed to protect citizens and ensure competent mental health professionals. Stated in this misleading and overly-simplistic way, I believe that most individuals would be inclined to support it. However, the proposed regulation will NOT protect citizens NOR ensure competent mental health professionals. Rather, it will simply grant CACREP (the Council for Accreditation of Counseling & Related Educational Programs) a monopoly that will exclude a wide variety of otherwise competent mental health professionals from master’s level licensure in Virginia.

In an effort to help you better understand some of the relevant issues, I will provide historical background as it relates to the Clinical-Counseling Psychology Master’s Degree Program at Radford University. I also will share how the proposed regulations will negatively impact mental health in Virginia, by restricting the number of qualified mental health professionals, especially in rural areas. It is extremely important for you to know, for example, that if the proposed regulation is approved, after the 7 year grandparent clause, the vast majority of master’s level graduates from Psychology Programs around the country will NOT be license-eligible in Virginia. Additionally, the vast majority of graduates from master’s level Counselor Education programs around the country will NOT be license-eligible in Virginia either, (including those from George Mason University), unless such programs are coerced into becoming CACREP accredited, due to regulations such as this. It is important to emphasize that only three states in the entire country have CACREP-only licensing regulations, and thus it cannot be argued that the proposed regulations are necessary to ensure competently trained licensed mental health professionals. The requirement of CACREP accreditation is an exception rather than the standard in the profession. I would also bring to your attention the primary conclusion from the Virginia Department of Planning and Budget Economic Impact Analysis that the “Costs will likely outweigh benefits for this proposed change” (page 2). It further concludes that “In Virginia, requiring CACREP education would not appear to improve the quality of counselors as there is no reported differential in complaints or efficacy of practice between counselors that have CACREP education and those that have non-CACREP education.” (page 4).

It is troubling that one important reason for the proposed changes to the regulations is because  the task of determining who is eligible for the LPC has become too onerous for the Board of Counseling, and that requiring CACREP accreditation would simplify the job of the credentialing committee. While one might sympathize with this position on the surface, I believe that it is a self-imposed burden that is the direct result of the Board’s adoption of a very narrow definition of “counselor” that specifically excludes certain groups of professionals, including individuals trained primarily by psychologists. The Virginia Board of Counseling reports that “it has neither the resources nor the expertise to examine counseling programs across the country to determine their rigor or assess the quality of the education in those programs” (Town Hall Agency Background Document, page 5). Given that 46 other states have found a way to do so, I can’t help but wonder what is making it so difficult for Virginia. I suggest that this onerous burden could easily be eliminated if the Board of Counseling would discontinue use of the narrow definition of “counselor” and “professional identity” which draws a sharp distinction between master’s level mental health professionals who are trained by “psychologists” versus those trained by “counselors” in Departments of Counselor Education. I understand that the “professional identity” of individuals trained by psychologists and counselor educators is different, but that does not mean the master’s level licensure in Virginia should be granted exclusively to individuals representing only one of these perspectives, or even more narrowly, only to those graduating from CACREP-accredited programs. This restrictive definition currently in use by the Board of Counseling is arguably consistent with that advocated by CACREP and has already had adverse effects on graduates from Radford University, Norfolk State University, and Virginia State University. If it is assumed that both Counseling Psychologists and Counselor Educators can train competent master’s level mental health professionals, then there would no longer be the onerous burden of trying to distinguish between the two. The Virginia Board of Counseling needs to assure a diversity of counseling perspectives and “professional identities” that represent the best interests of regarding mental health for citizens of the Commonwealth, rather than the interests of a single accrediting body such as CACREP. I want to emphasize that I am not questioning the quality of CACREP-accredited programs in any way. In fact, Radford University is extremely fortunate to have an outstanding CACREP-accredited counseling program in the College of Education and Human Development. I am simply suggesting that CACREP-accreditation should not be required for licensure in Virginia.

It is also troubling that the “Proposed Regulation Agency Background Document” explicitly states that “there are no disadvantages to the public” and “there are no disadvantages” to the Commonwealth from the proposed regulatory changes (page 4). THIS IS SIMPLY NOT TRUE. These conclusions fail to acknowledge the feedback the Board has received in other contexts about the negative consequences of such regulations. It completely ignores the extensive number of problems, concerns, and disadvantages cited in a) communications which were initiated in 2009 from faculty from Radford University’s Clinical-Counseling Psychology master’s degree program about CACREP-related LPC issues, and b) in the 154 comments provided on the “Town Hall Public Comment Forum Link” on a 2013 petition that also addressed issues related to CACREP accreditation (the Acceptance of Clinical-Counseling Psychology degree for licensure). http://townhall.virginia.gov/L/comments.cfm?petitionid=195). The Board of Counseling’s conclusion that there are no disadvantages to the public or to the Commonwealth is also inconsistent with comments received in response to the Notice of Intended Regulatory Action (in which 296 of the 328 comments opposed the current CACREP-only proposal) (http://townhall.virginia.gov/L/ViewStage.cfm?stageid=7071). It is also inconsistent with opposition to the proposed regulations cited on this current “Town Hall Public Comment Forum Link” by faculty members at George Mason University, Radford University, and Virginia Commonwealth University, as well as with the current Virginia Department of Planning and Budget Economic Impact Analysis regarding this proposed regulation. The fact is, there are numerous disadvantages and costs to the public and Commonwealth that simply cannot be ignored.

In an effort to help you better understand the issues, allow me to provide a brief history relevant to the current proposed CACREP-only regulation. For at least 30 years, the Virginia Board of Counseling has successfully evaluated candidates for licensure at the master’s level regardless of whether or not the program from which they earned their degree was CACREP-accredited. Consistent with the vast majority of other states, there were (and continue to be under current regulation) multiple requirements to ensure the competence of applicants for licensure (including required coursework, lengthy residency requirements, and the licensing exam). At the completion of all the required coursework and training, every individual was required to take the LPC licensing exam. Only those who passed became Licensed Professional Counselors. Thus, evaluation for LPC eligibility in Virginia was based on rigorous licensure standards without the requirement of CACREP accreditation.

In 2009, the Virginia Board of Counseling’s criteria for determining LPC-eligibility changed. For the first time in the history of Radford University’s Clinical Psychology program, three of our graduates were denied approval to complete the first step toward licensure (i.e., approval for registration for supervision). This also prohibited them from taking the objective LPC licensing exam that students from the same program had been allowed to take (and successfully pass) for over 30 years. In the rejection letters these students received from the Board of Counseling, three specific reasons were cited: “there was insufficient emphasis on counselor preparation in the academic curriculum and program description, there was a clear intent to prepare students to become clinical psychologists rather than counselors, or the faculty roster does not have an identifiable “counselor training faculty”. The stated reasons for rejection are arguably based on CACREP’s narrow definition of the “counseling profession” and the “professional identity of counselors”. It is important to note that these changes implemented by the Virginia Board of Counseling in 2009 had a significant negative impact on graduates from our program, as well as on graduates from the non-CACREP accredited master’s degree programs in Psychology at Norfolk State and Virginia State. In fact, it is my understanding that the changes in 2009 directly resulted in Norfolk State ultimately eliminating their Master’s degree program in Psychology because their students were no longer LPC-eligible. If the proposed CACREP-only regulations are adopted, it would potentially impact the viability of master’ level programs in Psychology at other Virginia universities as well.

In response to the rejection of our three students in 2009, the faculty made numerous changes to the Clinical Psychology Program at Radford University in an effort to bring it into compliance with Virginia LPC eligibility requirements. Subsequently, in November 2013, Dr. Jeffrey Chase from Radford University, submitted a petition to the Board of Counseling regarding Virginia Code 18 VAC115-20-49 regarding “degree program requirements.” Specifically, he asked the board to consider amending definitions regarding degree program requirements to accept Master’s degree graduates from a non-CACREP accredited Clinical-Counseling psychology program such as that at Radford University. The public comment forum http://townhall.virginia.gov/L/comments.cfm?petitionid=195  generated 154 comments, many of which were directly relevant to the current CACREP-only proposal. These comments documented many concerns and ways in which students had been negatively impacted by the adoption of LPC eligibility criteria that appear to be based on CACREP standards. Comments and concerns were posted by students and faculty from three Virginia Universities, Radford, Norfolk State, and Virginia State, which clearly articulated the harm to students and programs caused by the changes implemented by the Virginia Board of Counseling in 2009. Given the public forum comments and concerns raised from both mental health professionals and graduates from non-CACREP accredited programs, the Board of Counseling should be fully aware of the disadvantages that would result to the public and the Commonwealth if the proposed regulations are adopted. This is not a new issue. The proposed regulations are simply an attempt to formally institute a policy that has been informally applied by the Virginia Board of Counseling since 2009.

Rejecting students on the grounds that their program’s faculty did not have identifiable “counselor training faculty” is particularly alarming. The proposed regulation would effectively exclude the vast majority of all graduates from Psychology Master’s Degree programs in the country from being eligible for the LPC in Virginia, even if their master’s degree were in “Counseling Psychology”, and they were eligible for licensure in 46 other states! This is the reason that so many professionals from universities around the country have posted comments on the Public Comment Forum Link. There is significant concern that if Virginia becomes a CACREP-only state, other states may follow. It is important to emphasize that faculty teaching in Counseling Psychology Programs typically do not meet the CACREP criteria to be considered “core faculty” as outlined in the CACREP  “Guiding Principles for the 2016 Faculty Standards” http://www.cacrep.org/wp-content/uploads/2017/05/Guiding-Principles-for-the-2016-Faculty-Standards.pdf.  Specifically, Standard 1.W states that core faculty must have a doctoral degree from a Counselor Education program, preferably from a CACREP accredited program. The alternative way to meet the core faculty degree requirement under 1.W is to have a doctoral degree in a related field (e.g., Counseling Psychology, Social Work, Marriage and Family Therapy, Educational Administration) AND to have been employed as a full-time faculty member in a Counselor Education program for at least a full academic year BEFORE July 1, 2013. (Page 1 of CACREP Guiding Statement). It is clear from this standard, that most psychology programs in the country would NOT be eligible for CACREP accreditation because the majority of their faculty would not meet CACREP’s standards to be considered a core faculty member. Additionally, no individuals who received their PhD “in a related field” after 2013 would be eligible to become core faculty in a CACREP accredited program. Again, the direct implication of the CACREP core faculty degree requirement is that most graduates from psychology programs in the country would not be license-eligible in Virginia because their program in psychology was not eligible to be CACREP-accredited. Going forward, this effectively means that if the proposed regulations are adopted, only graduates from Counselor Education programs will be license-eligible in Virginia. This will greatly limit the number of qualified mental health professionals and the diversity of perspectives and techniques offered by individuals with “professional identities”.

There are many competent graduates from master’s programs in both Psychology and Counselor Education, and to limit license-eligibility in Virginia ONLY to graduates from CACREP accredited programs, would be analogous to the Board of Medicine deciding that it would no longer license individuals from a Virginia medical school who graduated with a D.O. rather than an M.D. Why would Virginia want to exclude one highly qualified set of graduates trained to provide mental health services from licensure, simply because they were trained by clinical or counseling “psychologists” rather than by “counselors” in a Department of Counselor Education. Clearly, psychologists have a long history in training competent mental health professionals both nationally and in the Commonwealth. It would be ludicrous to argue that Clinical and Counseling Psychologists are not trained in “counseling” as defined in § 54.1-3500 in the Code of Virginia. It also would be ludicrous to argue that doctoral level clinical and counseling psychologists are not competent to train master’s level mental health professionals, or that the students they train are not competent to become master’s-level licensed mental health professionals in Virginia. The proposed regulations would ultimately limit both the number and diversity of qualified mental health professionals and would thus be detrimental to the citizens of Virginia.

I encourage you to also read the post that is being submitted by Dr. Jeffery Aspelmeier, the Chair of the Psychology Department at Radford University in which he will provide a list of negative consequences that adoption of the CACREP-only regulation could have for citizens of the Commonwealth, for graduates from non-CACREP accredited programs, and for Mental Health Agencies and Universities in Virginia. This provides a very nice bulleted overview of numerous concerns that he has compiled from a variety of sources.

In summary, it would be a gross disservice to the Commonwealth of Virginia to exclude competently trained master’s level mental health professionals from the ability to earn the LPC simply because their graduate program was not-CACREP accredited or their “professional identity” was not that advocated by CACREP. I understand the benefits that CACREP would gain from the proposed regulations, but I do not understand how this could possibly benefit the citizens of Virginia. Such restrictions are unnecessary and do not protect citizens or ensure the competence of mental health professionals. Given that there is a serious shortage of mental health professionals in the Commonwealth and many rural regions are severely underserved, Virginia cannot afford to adopt regulations that limit the number of qualified mental health professionals.

I thus have three recommendations.

• First, I urge Governor McAuliffe to OPPOSE the proposed regulation 18 VAC 115-20 aimed at governing the practice of Counseling in Virginia (aka, the CACREP-only regulation regarding eligibility to become a Licensed Professional Counselor).
• Second, I urge the Board of Counseling to reject CACREP’s narrow definition of “counselors” and return to the more inclusive definition used prior to 2009, when graduates from three Virginia University’s Psychology master’s degree programs were not excluded from LPC-eligibility in Virginia. The Commonwealth cannot afford to endorse restrictive guidelines and definitions for “counselors” that exclude qualified mental health professionals who have graduated from non-CACREP accredited programs in Psychology (e.g., Radford University) or from non-CACREP accredited programs in Counselor Education (e.g., George Mason University). If the Board is so inclined, it could again consider graduates from master’s level programs in Psychology to be eligible for the LPC in Virginia, as they were prior to 2009.  I encourage them to do so.
• Third, I believe that the best way to accomplish this goal is to assure that the composition of the Board of Counseling includes a balanced number of a) members of both CACREP and non-CACREP accredited programs in Counselor Education, as well as b) faculty who can represent the interests of non-CACREP accredited master’s degree programs in Clinical or Counseling Psychology. Currently the Virginia Board of Counseling has one board member who previously served as vice-chair of CACREP and others who are faculty in CACREP-accredited programs. I hope that the interests and perspectives from non-CACREP accredited programs are adequately represented on the Board as well.

In summary, for all of the reasons cited above, I respectfully request that you OPPOSE the proposed regulation 18 VAC 115-20 aimed at governing the practice of Counseling in Virginia (aka, the CACREP-only regulation regarding eligibility to become a Licensed Professional Counselor). 

Ann Elliott