The history of counseling is a fascinating evolutionary process, particularly how the profession developed, and how quickly it has evolved through the professionalization process during the past half century. This chapter reviews and highlights the major events that led to the development of professional counseling, including the numerous professional specialty groups that make up the family of professional disciplines in counseling that provide services to clients in diverse practice settings. One of the critical issues that continues to challenge the counseling profession and related specialty areas are professional identity and professional unification. The unique divisions within the American Counseling Association (ACA) represent areas of specialized practice and special-interest areas that relate to a broad constituency of counselors regardless of their specialty areas of practice. Examination and certification standards for the certified rehabilitation counselor (CRC) credential have been established through empirical research throughout the Commission on Rehabilitation Counselor Certification’s (CRCC) history.

This chapter provides readers with an overview of the roles, functions, and knowledge base of counselors and addresses the professional issues that influence the identity and practice of counselors today. The primary role of a counselor is to assist clients in reaching their optimal level of psychosocial functioning through resolving negative patterns, prevention, rehabilitation, and improving quality of life. Rehabilitation counselors work with clients with disabilities and/or chronic illnesses, including those with psychiatric conditions, in settings such as state vocational rehabilitation agencies, hospitals, and so on. Addiction counseling, a recently acknowledged master’s-level counseling specialty, involves working in the substance abuse/addictions field and provides addiction prevention, treatment, recovery support, and education. The shared practice and knowledge domains of counselors and other helping professions coupled with the diversity within the counseling profession has, on the one hand, produced a rich, comprehensive, and inclusive field.

This chapter addresses what counselors need to know about professional credentialing, including trends and considerations that counselors may need to monitor. It concludes with basic tips for counselors interested in licensure and certification. Professional credentialing is critical to defining and regulating the practice of counseling. Licensure, certification, and accreditation are distinct forms of professional credentialing. Although each serves the common purpose of protecting public safety by establishing the minimum standards of knowledge and skill for professional counselors. Credentialing is likely to evolve rapidly as the U.S. health care system becomes more politicized. With such progress in professional credentialing, professional counselors need to look ahead for opportunities and challenges in licensure laws and national certification standards. The variety of counselor licensure laws nationally presents a serious problem for professional counselors in their ability to move from state to state without disruption and the ability to practice counseling.

This chapter clarifies differences between two aspects of supervision and reviews the need to evaluate training interventions to improve clinical supervision competence. It examines evidence-based practice as it relates to qualities and competencies needed to work as an effective clinical supervisor. The chapter addresses the benefits of using group supervision and its potential for developing multicultural competence; examines possibilities through distance supervision; and concludes with a brief discussion of the importance of ethical standards in clinical supervision. It provides foundational material that is expounded elsewhere in this desk reference as applied to rehabilitation counselor supervision practice. Using the available information from various clinical and research sources to inform the professional field is commonly referred to as evidence-based practice. In general, supervisors who are knowledgeable about counseling theory and practice and help supervisees to develop a deeper understanding of clinical issues through constructive feedback, demonstrate respect and concern for their supervisees.

Private practice for most counselors has been a goal. Currently, with licensure in all states, parity with other mental health professionals, and the ability to bill third-party payers, the goal has become more realistic. Being a well-trained and ethical counselor is the foundation for starting a private practice, but while being competent is essential, the challenge is to think outside of traditional training. Successful counselors in private practice are able to incorporate business principles into a counseling practice. As a counselor in private practice, one needs to see oneself as the chief executive officer (CEO) of a corporation, not only needing to make good clinical decisions, but also needing to make good business decisions. As a counselor in private practice, one needs to see oneself as an entrepreneur. An entrepreneur, as defined by Webster’s dictionary, is someone who “organizes, manages, and assumes the risks of a business or enterprise".

The 2014 edition of the ACA Code of Ethics raises the bar for the ethical practice of professional counselors and is the first edition of the code that delineates the core values of the counseling profession. This chapter provides an overview of new concepts and professional responsibilities in such areas as professional values, ethical decision making, avoidance of the imposition of counselors’ personal values, counselor education, social media, and distance counseling. It concludes with a list of resources for learning more about the ethics code for the counseling profession. The Ethics Revision Task Force (ERTF) spent time researching and discussing counseling codes of ethics from around the world. The counselor-in-training cited personal religious beliefs as the basis for their decision. In order to protect a client’s privacy when conducting distance counseling, the revised ethics code requires counselors to verify a client’s identity at the beginning of each electronic session.

The passage of the 1996 Health Insurance Portability and Accountability Act (HIPAA) was originally an effort by Congress to ensure portability of health insurance between jobs for American workers. This chapter provides a brief overview of HIPAA regarding mental health services, compliance issues for providers, filing and investigating complaints, violation penalties, a list of terminology, and resource links for more detailed information. Patients must be informed of their rights and are required to sign the appropriate forms authorizing the health care provider to obtain and/or provide information to other health care providers as relevant. All psychotherapy notes recorded on any medium by a mental health professional such as a licensed counselor or psychologist must be kept by the author and filed separately from the rest of the patient’s medical records to maintain a higher standard of protection.

A national expert on managed care was invited to help explain what counselors were up against as they tried to be recognized as providers on insurance plans. Managed health care plans negotiate lower prices with therapists so that employers can give their employees discounted services. There are three types of managed health care plans: health maintenance organization (HMO), preferred provider organization (PPO) and point of service plan (POS). All licensed counselors who work with insurance and managed care plans must use the national provider identifier (NPI) number when filing an insurance claim. The specter of managed care has caused anxiety and frustration for counselors, but many times the issues can be tackled with an old-fashioned problem-solving approach. A medical billing software system allows the counselor to keep patient information on the computer and send claims directly to a clearinghouse that will format and send the claim to the insurance carriers.

To develop an appreciation for the electronic health record (EHR) it is important to understand the barriers to its adoption among mental health professionals. This includes the belief that it is easier and more convenient to document care using paper and pen. The chapter mentions a scenario, where even if the emergency room personnel were able to gain access to the patient’s paper medical record, they would have had a hard time understanding the record’s content. Another common problem with the paper record is the lack of organization especially under circumstances in which the patient has multiple mental health issues. After addressing a major concern with EHRs among mental health professionals and the inherent problems with paper records, the chapter focuses on the functionality that makes the EHR an appealing proposition. When health care data are stored electronically, the capability to share data among health care providers is heightened.

Codes of ethics must undergo periodic revision to ensure that the contents of the code reflect current trends and issues in counseling practice. This chapter provides a brief overview of some of the more common ethical and legal terms counselors may encounter in ethical complaints. Often one of the most confusing concepts for counselors is credentialing. A credential simply indicates that a counselor’s education and experience have been reviewed by a professional or legal body, and he or she can legitimately hold himself or herself out as a professional possessing specific knowledge and skills that meet the minimum standards of the profession. The chapter discusses professional ethics committees and state licensure boards. It also explains the court system briefly as it applies to ethical complaints in counseling. There are four legal entities that regulate the practice of counseling: professional ethics committees; state licensure boards; criminal courts; and civil courts.