American Counseling Association Research Articles

A Call for Social Justice in the American Counseling Association (ACA)

Leaders and members of seven social justice-oriented divisions of the American Counseling Association (ACA) met at a Social Justice Summit called by the Counselors for Social Justice in March 2019 at the ACA National Convention in New Orleans. The goal of the summit was to create conversations among members of these seven divisions around ways to improve social justice within the ACA. These discussions at the summit were transcribed and summarized for the purpose of creating a document to outline how ACA could improve its social justice practice. The resulting call for social justice in ACA includes three topics derived from discussions of social justice in the counseling profession: social justice in the organization of ACA, social justice for the people in ACA, and social justice at the ACA conference. Implications for improved social justice practice in the organization are provided.

Knowledge is Power: An Analysis of Counseling Professionals’ Medicare Policy Proficiency

This study examines counseling professionals’ knowledge concerning the Medicare program and related advocacy efforts. American Counseling Association members (N = 5,097) answered a series of true-false questions that were intended to measure proficiency in two areas: Medicare policy and the counseling profession’s advocacy for provider eligibility. Statistical analyses indicated that members have a wide range of Medicare knowledge. A significant difference in advocacy history knowledge was found when comparing counselor educators, practicing counselors, doctoral students, and master’s students. However, no differences in policy knowledge were present among these groups. Implications for the counseling profession and counselor training are discussed.

A Content Analysis of the Counseling Literature on Technology Integration: American Counseling Association (ACA) Counseling Journals between 2000 and 2018.

This content analysis provides an overview of articles specific to technology integration in the field of counseling published in American Counseling Association (ACA) journals between the years 2000 and 2018. In addition to the number of articles on this topic published during this time period, the study identified other aspects such as authors and institutional affiliations; methodology, study locations, and application settings; target populations and sample characteristics; and areas and types of technology integration. Recommendations are provided for counseling research in general and for future research extending from specific circumstances such as the COVID-19 pandemic.

Deconstructing Ethical Ambiguity: Ethical Decision Making When Working With Multiple Ethical Codes of Conduct

ABSTRACT Adherence to ethical standards is an ever-evolving topic in the counseling field. At different times throughout the educational and licensing processes, there are moments of ambiguity that can muddle professional judgment. Understanding ethical ambiguity as it occurs on a personal and systemic level is essential for the advancement of the profession. State mandated standards versus the American Counseling Association (ACA) ethical code, potentially create ethical dilemmas rooted in ambiguity of ideals. This article will deconstruct the ideology of ethical ambiguity as it exists within the Counseling field.

The Role of Decision‐Making Models and Reflection in Navigating Ethical Dilemmas

The ACA Code of Ethics (American Counseling Association [ACA], 2014) mandates counselor competency in using ethical decision‐making models (EDMs) and mandates that counselors use an EDM when confronted with making ethical decisions. Additionally, researchers have highlighted the importance of counselors continually evaluating and reflecting when faced with ethical dilemmas and working through a decision‐making model. Using a phenomenological research design, the authors examined how counselors address ethical dilemmas, including how reflection and EDMs are incorporated into the decision‐making process. Emergent themes from data analysis include (a) incomplete following of EDMs, (b) varied dilemmas, (c) power, and (d) ethics training.

Analyzing the Impact of the Medicare Coverage Gap on Counseling Professionals: Results of a National Study

The authors surveyed 6,550 members of the American Counseling Association regarding the current impact of Medicare policy on counseling professionals. More than half of respondents (54.8%) had been directly affected by Medicare reimbursement barriers, including 70.0% of practicing counselors. Statistical analyses indicated significant associations between years in the profession, direct experience with the Medicare coverage gap, and participation in professional advocacy related to Medicare. Implications for counselors, counselor educators, and counseling scholarship are discussed.

Medicare Reimbursement for Counselors: Counseling Professionals’ Advocacy Beliefs and Behavior

The authors analyzed data from 5,528 American Counseling Association members to examine advocacy beliefs and behavior regarding Medicare reimbursement and advocacy for counselors. Nearly half (49.3%) of the respondents had participated in one or more forms of Medicare reimbursement advocacy. Advocacy participation differed significantly by professional status.

EFFECTIVENESS EVALUATION OF THE POSTGRADUATE PROGRAM IN MENTAL HEALTH COUNSELING IN UKRAINE

Ukraine is a country that has lacked access to adequately trained mental health professionals. As in other countries the development of the field of Counseling in Ukraine has some parallels to that of the US. One of the most notable parallels is the push for a better and more effective approach to mental health, driven by the impact of war, with WWII being the catalyst for refinement in the US and current war in Ukraine as the drive there. As the American Psychology Association and American Counseling Association have highlighted, the effects of trauma and unresolved problems do not need to last a lifetime. A developing initiative in Ukraine was brought by U.S.-based teams that established a postgraduate Counselor Education Program. Professional American Counselor Educators, trained in the trenches of wars abroad and representing vast ranges of experience, have volunteered their time as visiting faculty and distance supervisors. This study measures the initial progression of treatment symptomology of clients seen by Postgraduate Program in Psychological Counseling and Trauma Therapy trained Counselors. This study utilized an analysis of repeated measures over the first five sessions of counseling with the program-trained Counselor. The following measurement methods were utilized: Outcome Rating Scale (ORS), Impact Event Scale (IES-R), Beck Depression Inventory (BDI II), PTSD Checklist (PCL-5), Symptom Checklist (SCL-9). The resulting data obtained from the clients was compared to the outcomes of treatment with similarly trained therapists in the United States, United Kingdom, Australia and Denmark. Results indicated overall significance as measured on 3 out of 5 instruments (ORS, BDI-II, IES-R). The data from this sample revealed similarities to the outcomes of comparable early treatment research, conducted outside of Ukraine. These results provide a preliminary overview of how effective mental health counselors (educated by the American standards) are in mitigating client mental health symptomology. This study is a logical and necessary step in the continued development of the field of Counseling in Ukraine.

Professional Development in Social Justice: Analysis of American Counseling Association Conference Programming

This study was designed as a content analysis of 2012–2017 American Counseling Association conference sessions to examine how social justice was presented. Four findings emerged from the qualitative content analysis: (a) rates of social justice sessions varied over time; (b) there were more multicultural sessions than social justice sessions; (c) populations that were addressed least often and most often were identified; and (d) there was a decline in the number of social justice content sessions. Implications are presented.

The innovative breakthrough of neurocounseling through overview of phobia student’s brain waves

Counselors are striving to make sure that their counseling process is scientifically based. A new Counseling paradigm that related to neuroscience, called Neurocounseling, is acknowledged by the American Counseling Association (ACA) and became a new branch of Counseling in 2015. This study is used Neurocounseling paradigm to understanding the psychological condition of the client (student) in the counseling stage. Preliminary study showed us that 46 students from 80 students had showed phobia symptom. It means that 50% students are suffering learning disorder with various levels. We designed our research to record students with phobia symptom’s brainwaves through Electroencephalography (EEG). The record of counselee brainwave will make counselors achieve a better result of counseling because it will help them to choose the right counseling technique. We used qualitative approach and case study to find out student with phobia symptom’s brainwave and mental condition. We used some data collecting techniques: interview, observation, and documentation. The finding showed us that the main brain wave of counselee with phobia symptom is Beta wave in frequency 20-30Hz, it means counselee has a high level of anxiety. Counselee also had a deep tension on nerves and muscles during brainwaves record in the counseling process.

Advocacy-in-Action: Case Portrait of a Helping Professional Pursuing Positive Social Change for Transgender and Gender-Expansive Youth

Transgender and gender-expansive youth experience discrimination and marginalization in the healthcare setting, school environment, their communities, and families. These experiences of rejection and adversity are correlated with higher rates of suicidality, depression, and other mental health concerns. Helping professionals play an essential role in mitigating experiences of oppression by advocating for positive social change for their transgender and gender-expansive clientele. Through the provision of a single case portrait, this article explores the advocacy-in-action of Craig, a helping professional and advocate, as he pursues positive social change for transgender and gender-expansive youth. Merriam’s (1988) interpretive case study was used to guide data collection and findings. Emergent themes provided concrete examples of how the American Counseling Association (ACA) endorsed an advocacy model, and the Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling Competencies for Counseling Transgender Clients apply to this population. Including the concepts of intrapersonal and interpersonal advocacy to the current advocacy model is critical to advancing the health of transgender and gender-expansive youth. Implications for counselors and counselors in training will also be discussed.

MEDICARE IS THE LAST HOLDOUT: EXAMINING THE IMPACT OF MEDICARE POLICY ON OLDER ADULTS’ ACCESS TO MENTAL HEALTH CARE

Medicare is the primary insurance provider for approximately 59 million Americans, and the number of beneficiaries is expected to surpass 80 million by 2030. Currently, Medicare regulations allow psychiatrists, psychologists, clinical social workers, and psychiatric nurses to provide mental health services. These providers were last updated in 1989 with passage of the Omnibus Budget Reconciliation Act of 1989. Since that time, the mental health marketplace has changed dramatically, and Medicare beneficiaries are unable to access care from approximately 200,000 graduate-level mental health professionals with similar training to eligible Medicare providers. There is evidence that this Medicare mental health coverage gap (MMHCG) impacts both providers and beneficiaries. For example, some beneficiaries may begin treatment only to have services interrupted, or stopped altogether, once the provider is no longer able to be reimbursed by Medicare. We surveyed 6,550 members of the American Counseling Association, including 3,815 who identified themselves as practicing counselors. These individuals work in diverse contexts (e.g., community mental health agencies, private practice, and integrated care settings). Survey results indicated that a significant number of practicing counselors turn away or refer Medicare beneficiaries who seek mental health care due to the MMHCG. In-depth interviews were also completed with eight licensed mental health professionals who detailed the challenges they and their clients experienced. Participants perceived a discrepancy between Medicare’s intended aims to promote health and provider restrictions that were confusing and frustrating to navigate. Participants concluded that the MMHCG has a negative impact on older adult clients.

Medicare and mental health coverage: An analysis of how current Medicare policy encumbers the Medicare-insured

ABSTRACTThis study illuminates the impact of existing Medicare mental health provider policy on individuals seeking counseling services. The authors applied qualitative content analysis to data provided by members of the American Counseling Association. Two superordinate themes, current Medicare policy encumbers the Medicare-insured and creates a unique hardship on specific client populations are presented in depth in this article, in addition to several emergent themes. The results suggest that current Medicare policy has far-reaching undesirable consequences for the Medicare-insured.

Guide Me In The Right Direction: Obtaining Quality Clinical Supervision

The supervisory-counselor relationship is an evaluative, hierarchical, and unremitting process. This paper explores the competency of supervisors in multicultural supervision, the knowledge of ethical mandates, the advantages and disadvantages of administered supervision models, and the clinical supervisory delivery. Cumulative research data reveal participants who reported a positive clinical supervision experience during practicum and internship were more likely to engage in professional development training, which ensured that supervisees were within the American Counseling Association (ACA) compliance and meeting clinical hallmarks. This paper is a meta-analysis of the clinical supervisory relationship and process. Keywords: Clinical supervision, Multicultural competency, Metaphors, Supervision models

Students' Ethical Decision‐Making When Considering Boundary Crossings With Counselor Educators

Counselor education students (N = 224) rated 16 boundary‐crossing scenarios involving counselor educators. They viewed boundary crossings as unethical and were aware of power differentials between the 2 groups. Next, they rated the scenarios again, after reviewing 1 of 4 ethical informational resources: relevant standards in the ACA Code of Ethics (American Counseling Association, 2014), 2 different boundary‐crossing decision‐making models, and a placebo. Although participants rated all resources except the placebo as moderately helpful, these resources had little to no influence on their ethical decision‐making. Only 47% of students in the 2 ethical decision‐making model groups reported they would use the model they were exposed to in the future when contemplating boundary crossings

A Pilot Survey of the Integration of Technology into Counseling Practice

A random sample of 218 American Counseling Association members responded to a survey related to the integration of technology into the field of counseling pertaining to perceptions of possible barriers and benefits to providing online counseling. Results indicate that 11% of respondents currently provide some type of online counseling and that less than 20% of respondents would consider providing online counseling. Respondents identified both potential barriers and benefits of online counseling indicating that while counselors can recognize benefits to online counseling, they are still wary of potential challenges. Implications for the counseling field and future research directions are discussed.

A Pilot Survey of the Integration of Technology into Counseling Practice

A random sample of 218 American Counseling Association members responded to a survey related to the integration of technology into the field of counseling pertaining to perceptions of possible barriers and benefits to providing online counseling. Results indicate that 11% of respondents currently provide some type of online counseling and that less than 20% of respondents would consider providing online counseling. Respondents identified both potential barriers and benefits of online counseling indicating that while counselors can recognize benefits to online counseling, they are still wary of potential challenges. Implications for the counseling field and future research directions are discussed.

Licensure Portability Through an Ethical Lens: Considering Multiple Stakeholders

Counselors have been licensed to practice in all 50 U.S. states and the District of Columbia since 2009, but licensure portability (the ability to transfer a license from one state to another) remains elusive, due in large part to variations in educational and training requirements between states. In this article, we extend the American Counseling Association and American Mental Health Counselors Association counseling codes of ethics beyond the counseling relationship to consider license portability along ethical dimensions at the macro level. We apply an ethical decision-making model to demonstrate how lack of portability may have ethical implications related to both counselors and clients. We submit several considerations for how the profession can conceptualize and address these issues through an ethical lens.

School Counseling Intervention Research: A 10-Year Content Analysis of ASCA- and ACA-Affiliated Journals

Authors performed a content analysis of school counseling–related intervention research in 21 journals affiliated with the American Counseling Association and the American School Counselor Association across the 10-year span of 2006–2016. Results indicated that minimal school counseling intervention research articles were published ( N = 53) in these 21 journals during that time period and that most studies were quasi-experimental, single-group, pre-/posttest design with a fairly small N, raising questions about validity and generalizability of findings. We discuss implications for practice and future research.

Behavioral science licensure: Merit and applications

This article provides an overview of occupational licensure as applied to the behavioral sciences. Licensure enactment is inherently an interdisciplinary phenomenon with educational, ethical, and community welfare implications. The aim of the current study is to conduct a review of the literature pertaining to licensure and compare the findings with the ethics code of the American Counseling Association. The results reveal that the common reasons given for licensure are of questionable validity. Voluntary certification is suggested as a viable alternative.