Texas Mental Health Crisis: Intern Supervision and Underserved Areas

Texas supervisor training program, speaking, consulting

Texas We Have a Problem

Here’s the thing. In light of recent events I want to speak to all of the problems Texas has when it comes to providing excellent, accessible, and affordable mental health care. I want to outline solutions, propose law changes, and rally the troops. Texas seems to enjoy competing for 49th or 50th place when it comes to quality mental health care in America and this little blog post probably won’t change that. So, as a counselor supervisor, counselor educator, and practicing clinician, I will talk about what I know. This post is about counselor intern supervision and supervisor training.

For those readers who aren’t familiar with Texas rules governing licensed professional counselors:

  • Every Licensed Professional Counselor (LPC) in Texas must spend 3000 hours as a Licensed Professional Counselor Intern under the supervision of a Licensed Professional Counselor Supervisor (LPC-S).
  • There are places in Texas where there are no licensed professional counselors or supervisors (see the white areas in the map below).
  • There are strict limits on the number of supervision hours interns can accrue using technology.

Training more supervisors in rural areas and lifting the restrictions on webcam supervision would be easy first steps to helping Texans gain access to quality mental health care.

Texas supervisor training program, speaking, consulting

 

Counselors and Webcams

Increasing allowable intern supervision hours via technology is a no-brainer. The Telemedicine Wellness, Intervention, Triage, and Referral Project at the Texas Tech University Health Sciences Center is pioneering the use of technology to screen junior high and high school students, identify those most at risk for committing violence in schools, and intervene before anything happens. Data are already showing that the screenings have helped avert violent incidents and provide students the help they need. Why can’t interns attend supervision using the same technology? Counseling graduates on the fence about where to practice might choose underserved areas if they did not have to travel long distances to receive face to face supervision. Arguments against using technology in mental health are archaic and have become a roadblock to care.

Counselor Supervision Training

Changing the rules about technology and supervision is only a start. Long story short, we need seasoned counselors and counselor supervisors in underserved areas. One LPC Supervisor Course attended by five participants who agree to take on just two interns can impact hundreds of people in need of quality mental health care. Recently I, along with Dr. Christopher Taylor offered a six hour course to twenty participants in El Paso interested in offering their own 40 hour training. How exciting is that? Twenty seasoned licensed professional counselor supervisors near one of the most underserved areas in the state are now trained and willing to provide their own courses. Their impact alone could be a game-changer for interns who feel called to work in underserved areas.

Texas supervisor training, speaking, consulting

Lifting limits on technology and increasing the number of supervisors won’t solve everything but it’s a start. We still need to give interns the ability to bill Medicaid. We still need to convince the military and Tricare to hire licensed professional counselors. And we need to help Medicare understand that refusing to allow counselors to be credentialed under their plans makes them part of the problem. Texas, we need counselors and supervisors more than ever before. And we need them now.

Dear Future Counselor

Texas Supervisor Training Speaker Consultant

As a mental health practice consultant, supervisor, and speaker, I enjoy sharing good information. Luckily I have amazing colleagues who share their wisdom with me. In my book “My Next Steps: Create a Counseling Career You’ll Love,” I had a blast learning from five amazing experts in the field. If I could put all of their good advice in a letter to a future counselor, I think it might look something like this:

Dear Future Counselor,

Now that you have decided to become a professional helper, I want to welcome you to the field! It won’t be easy and it won’t always be neat and tidy, but it will be the most satisfying thing you have ever done. As I think back to my own journey from ‘thinking about counseling’ to ‘actually counseling,’ I remember some key elements.

Our Story

We all have a story that led to our passion.

Ask any professional counselor (and that includes licensed professionals and school counselors) ‘what made you choose counseling?’ and you will hear the story. It is usually a tale of heartbreak, perseverance, pain, and victory. The teller will probably explain how an important person, perhaps a counselor, clergy member, or family member, listened and served as a guide through the fire. The professional counselor may then relate how this experience led to the desire to become a helper and provide hurting people with the same unconditional positive regard he or she received.

Our Supervisor and Our Training

Once we decided that we could not live a moment longer without actually becoming a counselor, we started our training. Not gonna lie, the search for the perfect school has gotten a little more complicated (CACREP, non-CACREP, online, etc.). I cannot emphasize enough Future Counselor, the importance of choosing a school that will actually enable you to get PAID once you have your almighty license or certification. Even if you earn your master’s degree and pass your exams, many organizations and third party payers (think insurance panels, the VA, some schools) will NOT hire you (or pay you) if you went to the wrong type or insufficiently accredited counseling program. Choose a good school and choose a good supervisor. You will be supervised for THOUSANDS of hours while you practice your craft as an intern.  Make sure you and your supervisor are a good fit. Once you are fully licensed/certified you will continue gaining continuing education. The learning and growing never end!

So, Future Counselor, the Stakes are High

A license protects the public from individuals who may be ‘good listeners,’ but don’t have the skills to help. Ditto with school counselor certification. If you choose to practice without a license, that is grounds for a conviction. If a school district hires you to be their school counselor and you are not certified, then you, and the students you serve, are being set up for failure. So accrue your hours, earn your license or certificate, and get to work. In the end, it is worth it.