LPC Interns became LPC Associates in 2020. Not many people understand the ‘why’ behind this change, but I have a few ideas. The following is my educated guess based on conversations with the folks that make these types of decisions, and I like the way it sounds. If, after reading mine, you prefer your own educated guess, then I’d love to hear what it is. The truth is mine is a little pie-in-the sky, which is why I like it, but if yours brings me down to earth then I’m not afraid to fall. A bit anyway. So let’s talk about how re-naming post-graduates under supervision is how we are winning the battle to close the gaps in mental health care in rural Texas.
Texas Mental Health Gaps
Texas, we have a problem. As a nation we aren’t the greatest at making mental health services accessible to everyone, heck we aren’t the greatest at making any health services accessible to everyone, but in Texas we’ve taken it to an all-time low. In fact according to the Texas Tribune, in 2020 Texas ranked 50 out of 51 in overall access to mental health care. That leaves prisons to pick up the slack. Sure we have agencies and hospitals like most states, but they are expensive or require insurance. Nobody is saying that going back to the good old days of institutional ‘insane asylums’ or ‘lobotomies on demand’ is the way to go. What I am saying is a sustainable business model for mental health practices and reasonable reimbursement rates for providers are great steps toward helping to put multiple mental health resources in underserved areas.
LPC Associates to the Rescue
Every year Texas universities graduate thousands of eager folks who want to be one of those multiple resources. Brand new counselors under supervision exude hope and trust, they are talented, and they believe they can make a difference. What a shame then when we tell them they are greedy when they say they want to make a living and have a life. They enter agency jobs where they are expected to have 30-40 (or more) direct client hours each week. Private practice owners exploit them by undercharging clients for their services and over charging them for everything from supervision to SEO to keeping the lights on in the practice.
It doesn’t take long for these exploited ‘multiple resources’ to figure out agency work or the mental health industry in general, is not for them. No one can carry around 30-40 stories each week for barely a livable wage and remain balanced for long. As my friend and executive wellness coach Dr. Shana Lewis says, success in the corner office suite isn’t success if you lose yourself. The difference is executives in the corner office at Exxon are compensated fairly. Partners in the local law firm get a bonus at the end of the year. The surgeon at the local orthopedic clinic is allowed to leave a patient in the care of capable nurses while she takes her kids on the lake for the afternoon. Exploited counselors under supervision (and some fully licensed mental health providers for that matter) are always on call, always available, and always doing more, but not being fairly compensated.
To Be Fair
Fair compensation for the LPC under supervision could come in the form of insurance reimbursement if ‘they’ (the insurance companies) would panel them. Pre-2019 the LPC under supervision license was called a ‘temporary’ license and I believe no insurance company in their right mind would panel someone with only a temporary license. So in 2019 the Texas LPC Board changed the name of the license to an ‘intern’ license. It was a good start, but again, what insurance company would panel an intern? After all universities were calling students in their practicum courses interns. Finally in 2020 the LPC Board and finally the Texas Behavioral Health Executive Council (BHEC) changed the ‘LPC Intern’ moniker to ‘LPC Associate.’
I believe changing the name of our most plentiful and eager mental health resource to ‘LPC Associate’ is one of the most important steps in helping insurance companies see the potential value in adding them to their panel of providers. Changing a name may not seem that big of a deal, but those who have the power to make these types of decisions seem to understand ‘Interns’ are less likely to be paneled than ‘associates.’ Regardless of whether I am right or wrong, I believe re-naming post graduates under supervision can and will lead to insurance companies paneling them, reimbursing them for their services, and ultimately this is how we will win the battle to close the gaps in mental health care in rural Texas.