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A measure that advocates say spares 10,000 Michigan counselors from crippling limits on their practice is headed to likely signature by Gov. Gretchen Whitmer after unanimous approval Thursday in the state Senate.
The bill came in response to proposed new practice guidelines issued by the state that would deny licensed professional counselors the right to diagnose patients and use psychotherapy – limitations that members of the profession said could put many of them out of business.
The measure passed Thursday, first proposed by state Rep. Aaron Miller, R- Sturgis, enshrines those practice rights in state law – circumventing changes proposed by the Department of Licensing and Regulatory Affairs. It previously was unanimously approved by the House on Oct. 8.
“This is a great moment for this profession,” said James Blundo, executive director of the Michigan Mental Health Counselors Association. “When you codify it, it’s the law.”
Blundo told Bridge that LARA’s proposed limits on counseling scope of practice “would have been devastating” to the profession.
Blundo said that’s largely because without the right to diagnose patients, counselors could not bill insurance for counseling – in effect, cutting off many patients from care and putting counselors out of business.
Advocates for counselors also warned that licensing restrictions proposed by LARA could harm approximately 150,000 clients across Michigan who depend on counseling services, at a time when suicide is on the rise across the state and many rural regions lack access to a range of professional mental health care.
In a statement to Bridge, Whitmer spokeswoman Tiffany Brown said: “Licensed professional counselors play an integral role in the mental health services system in Michigan. The Administration would support legislation to broaden LPCs’ scope of practice.”
Rep. Miller called the bill’s passage “very important.”
“I always call counselors the front line for mental health care. Chances are if you have a mental health issue, you are going to there first,” Miller told Bridge.
LARA acknowledges that licensed counselors in Michigan have for years been essentially “allowed to diagnose and use psychotherapy techniques” on patients.
But in proposing new guidelines for counseling scope of practice, it asserted that those practices conflict with a 1988 state statute defining the parameters of what licensed counselors are allowed to do. LARA interpreted the 1988 law as prohibiting counselors from diagnosing clients and using psychotherapy.
Sara Sue Schaeffer, a licensed professional counselor appointed in 1988 as the first chair of the Michigan Board of Counseling, asserts that LARA is wrong in its interpretation of the 1988 law. Schaeffer said she was also involved in writing the language of that law.
Schaeffer said the section of the law that prohibits counselors from diagnosis only refers to diagnostic tests – not to a diagnostic interview, which is how counselors commonly assess and diagnose clients.
“The state has been operating this way for 30 years,” Schaefer earlier told Bridge of the more expansive view of counselors’ practice. “That’s why this is a head-scratcher.”
The Michigan Psychological Association ‒- which includes doctoral-level psychologists, who receive more training in diagnosing patients and providing mental-health therapy ‒ has long contended that licensing rules should be updated to ensure counselors receive more training in mental health diagnosis before they treat those clients.
In Michigan, licensed professional counselors have to earn at least a master’s degree in counseling, pass a national exam and complete 3,000 hours of post-degree counseling experience over two years with at least 100 hours in the immediate presence of the supervisor. According to LARA, there are 10,536 licensed counselors in Michigan.
Psychologists ‒ of which there are 7,417 in Michigan ‒ must earn doctoral degrees, in addition to complete 2,000 hours of a supervised internship, 2,000 hours of supervised psychology experience under a limited license and pass a professional exam.
Licensed master’s degree social workers must earn a master’s degree from an accredited program and complete at least 4,000 hours of post-degree supervised social work experience over at least a two-year period. Of 28,248 licensed social workers in the state, 22,655 have master’s degrees (MSW).
Judith Kovach, public policy consultant for the Michigan Psychological Association, told Bridge the group supports the measure passed Thursday “with reservations.”
Kovach said the group “certainly would not want to see 10,000 people lose their ability to earn a living.”
But Kovach said the group wanted “more explicit” language in the bill on the mental health coursework required for a degree in counseling.
The MPA had also pushed for limits on certain kinds of assessment tests counselor could administer. Kovach added her view that language in the bill “is helpful in talking about who could do assessments.
“We came to the belief that we enhanced it as much as we could,” she said.