The accomplishments of the 2008-2009 year are attributed to the joint effort of OMHCA Board of volunteers. Board members willingly donated their time and resources to causes promoting the needs of consumers, membership, and the profession. In particular, I would like to acknowledge two new members to the board, Gregg Pollock and Nikol Bowen, who exemplify the meaning of service. Gregg Pollock coordinated efforts to encourage both OMHCA and OCA members to advocate for counselor Medicare reimbursement. Nikol Bowen served as student intern and secretary in addition to volunteering to work on the OMHCA newsletter and the Mental Health Depression Screening Day. The success of OMHCA this past year would not have been possible without their assistance and the combined effort of all OMHCA Board members.

This OMHCA Year-in-Review provides a summary of the work and commitment to members, the consumers they serve, and to the counseling profession:

SERVICE TO CONSUMERS

Outreach

• As part of AMHCA’s mental health awareness week, Mark Carli, Jodi Jones, Renee Kolecki, and Nikol Bowen presented a free public depression screening at Tuttle Crossing Mall in Columbus, Ohio (May 2009).

Legislative Advocacy

• Jodi Jones and Renee Kolecki visited the Washington, DC offices of Senators George Voinovich and Sherrod Brown to advocate for the inclusion of counselor Medicare reimbursement (July 2009). 
• Jodi Jones attended two Ohio Mental Health Caucus meetings to advocate for State Representatives to support consumer mental health needs (Jan. & March, 2009)
• Members collected signatures for Mental Health Awareness Commemorative Stamp petition at OMHCA Booth during the All Ohio Counselors Conference (Nov., 2008) and the depression screening booth at the Tuttle Crossing Mall (May 2009).

SERVICE TO THE PROFESSION

Continuing Education Workshops

• On behalf of the OMHCA Speakers’ Bureau, Donna Tromski-Klingshirn gave a presentation on case conceptualization at South Community in Dayton (May 2009).
• On behalf of the OMHCA Speaker’s Bureau, Jodi Jones provided a presentation on treatment of obsessive-compulsive disorder at Clark County Mental Health in Springfield (July 2009).

Programs at Annual State, Regional, and/or National Conferences

• Co-sponsored with the Ohio Chapters of Chi Sigma Iota, a forum/reception for student poster presentations at the All Ohio Counselors Conference (Nov., 2008).
• Division session at the All Ohio Counselors Conference on the topic of vicarious trauma (Nov. 2009).
• Co-Sponsored OCA Legislative Advocacy Day (April 2009).

Support for Counselor Licensure and Certification at State and National Levels

• OMHCA committee members and OCA Past-President Dr. Bill O’Connell  (2008-2009) revised the definition of professional counseling for the Ohio Counselor Social Worker Marriage & Family Therapist Board (OCSWMFT) website.
• Mailed twenty-five letters to community mental health agencies to increase advocacy efforts for inclusion of Medicare reimbursement for counselors in S. 671/H.R. 1693 (April 2009).

SERVICE TO OMHCA MEMBERS

• Richard Wantz moderated and maintained OMHCA listserv.
• Linda Pelton administered the OMHCA website.
• Renee Kolecki and Nicole Bowen edited the OMHCA Advocate newsletter.

In closing, I would like to thank OMHCA members for the opportunity to serve as president. I have learned many lessons from the experience and a new respect for those who take on the challenge of a leadership role. I would like to thank Donna Tromski-Klingshirn for sharing all her knowledge from her term as president (2007-2008). I would like to acknowledge Robert Wilson for his legislative advocacy support and increasing my knowledge of parliamentary procedure. I am pleased to welcome President Renee Kolecki and President-Elect Robert Wilson as OMHCA’s new leadership. I know they will continue to build upon OMHCA’s commitment to serve the needs of practicing mental health counselors.  

While many counselors, especially those who have had a difficult time arranging for the evaluation of a client who is at serious risk for harming self or others by someone authorized to sign the state mental hold, support this bill, some counselors have voiced concerns.  

I already have enough work to do.  I don't need any more responsibilities added to my work load.

If counselors are granted the authority to complete the "Application for Emergency Admission," each counselor will still be free to choose whether or not to exercise the authority. On a case by case basis, each counselor can choose whether to complete the form or, if they want, to ask a physician, psychiatrist, psychologist, health officer, or the mobile crisis unit for help in evaluating the client and applying for emergency admission to the hospital.  No counselor will be forced to perform this evaluation.

I wouldn't know where to get a copy of the form if I needed one.

The state mental hold form is easy to obtain.  It is "on the web."  Any counselor can get quick access to the ODMH mental hold form by typing "Application for Emergency Admission" into Google.  It will pop right up.

I don't want to have to be the one to send my client to the hospital.  I am worried that the therapeutic alliance would be damaged.

As we said before, each counselor will still be free to choose whether they want to ask a physician, psychiatrist, psychologist, health officer, or the mobile crisis unit for help in evaluating the client and applying for emergency admission to the hospital.  No counselor will be forced to perform this evaluation.

I am not sure I have enough training to be able to fill out the form.

Any licensed professional clinical counselor who evaluates clients' mental status and renders diagnoses of mental and emotional disorders has sufficient training to fill out this form.  After all, a health or police officer or a sheriff or deputy sheriff can fill out the form.  The first part of the form asks if the client (1) is a mentally ill person subject to hospitalization by court order under division B of Section 5122.01 of the Revised Code; and (2) 

represents a substantial risk of physical harm to self or others if allowed to remain at liberty pending examination.  It then asks for a brief narrative description of the circumstances under which the individual was taken into custody and the reason for the person's belief that hospitalization is necessary.

I have read that this bill gives us the authority to transport the client to the hospital.  I don't want to have to provide transportation for clients, especially clients who have threatened violence to others.

The bill does not require the counselor to physically take the client into custody or provide transportation for clients.  It says that the client may be taken into custody by the police without them having to hear the client's threats to harm self or others for themselves.  If the client is cooperative, transportation may be provided by ambulance, as it already is in some counties. If prudence suggests the client should be taken into custody, the counselor can call the police to take this action.  The police will take a signed "Application for Emergency Admission" as evidence that they can proceed.  If the police take the client into custody, they will provide the transportation.

Please consider offering your support for the Mental Health Hold Bill.  If you would like further information, you may contact OMHCA President, Renee Kolecki, at rtkole@yahoo.com.

 

Prosecutor:  In previous testimony we have heard that as required by law, you have posted a professional disclosure statement in your office and that it says, in part, that you have a Master of Arts degree in Community Counseling from Old School University and that you have competence in the following areas:  (a) Interpersonal and Social Counseling, (b) Relationship Counseling, (c) Group Counseling (d) Cognitive Enhancement Therapy, (e) Holistic Counseling, (h) Spiritual Integration, (i) Stress Management and Guided Imagery, (j) Mental Health Assessment/Counseling, (k) Substance Abuse Assessment, (l) Risk Assessment and Safety Planning, (m) Rape Crisis Intervention, (n) P.T.S.D., (o) MRDD / Intellectual Disability Behavioral Management, (p) Severe Mental Illness (SMD), (q) Relapse Prevention, and (r) Diagnosis and Treatment of Mental &  Emotional Disorders. Starting with the first item, would you please describe the specific coursework or supervised training you have had that supports your claim of expertise in Interpersonal and Social Counseling?

Counselor: "Interpersonal and social counseling is, like, what we do as counselors."

Prosecutor:  "So, if I looked at the syllabus from each of the courses you took, I would expect to find in at least one or more courses, evidence that you were taught "interpersonal and social counseling."

Counselor:  "Well, not really.  I mean, none of my teachers ever used that term.  It's just sort of what I call what I do."  

Prosecutor: "Oh, so what you really mean is that you advertise yourself to engage in counseling practices for which you have not had specific training."

Counselor:  "No, that's not what I meant at all.  In one class I read an article about 'Interpersonal Therapy'."

Prosecutor:  "You read an article about it.  Hmmm.  Did your teacher describe the skills necessary in order to use 'Interpersonal Therapy'?" 

Counselor:  "No, I read about it for a term paper."

Prosecutor:  "So it was never discussed in class.  Did you ever participate in supervised practice of the skills necessary to perform 'Interpersonal Therapy'?"

Counselor:  "No, I said I read about it for a term paper."

Prosecutor:  "In other words, you read about it but you were never given instruction in how to do it or engaged in supervised practice of it.  Is this correct?

Counselor:  "Well, if you put it that way, no I did not."

Prosecutor:  "Well then, let's look at Spiritual Integration.  Is this a form of counseling that is taught at Old School State University?"

 The Ohio Counselor, Social Worker, and Marriage and Family Therapy (OCSWMFT)Board requires all counselors in the State of Ohio to prepare, submit, and publicly display a Professional Disclosure Statement.  This statement must describe: (1) the name, title, business address, and business phone number of the licensee performing the services; (2) the formal professional education of the licensee, including their academic degrees, the institutions awarding those degrees, and the dates awarded, and (3) the licensee's areas of competence and the services they provide (as defined in division (A) of section 4757.01 of the Revised Code and in rules 4757-15-01 and 4757-15-02 of the Administrative Code).

When a counselor sets forth an area of competence on his or her disclosure statement, he or she is saying, "In this I am an expert.  For this I charge a fee. For this I should be held accountable."  In other words, when one lists a skill, a technique, or an area of professional competence on a disclosure statement, it is the equivalent of saying, "I am ready to be thoroughly examined in this area and to have my competence judged in a public forum.

In an attempt to help counselors prepare their disclosure statements, The Ohio CSWMFT Board provides a list of skills, techniques, and areas of professional competences a counselor might choose to declare as areas of personal competence. The Board's sample list included:  Career counseling, child and adolescent, counseling, personal and social counseling, educational counseling, marriage counseling, family counseling, pastoral counseling, gerontological counseling, rehabilitation counseling, human resources counseling, employee assistance counseling, mental health counseling, chemical dependency counseling, addictions counseling, consultation, supervision, administration, and diagnosis and treatment of mental and emotional disorders under supervision. The Board's list is not a list of competencies that all counselors could claim.  It is, rather, a list of competencies that are within the general scope of practice permitted under our licensing law. In fact, it is highly unlikely that any counselor could legitimately claim expertise in all of them. 

After reviewing the professional disclosure statements submitted to the OH CSWMFT Board over the last year or so, the Board reports that all too often it appears that counselors are simply copying the Board's list of examples into their personal disclosure statements.  Quite reasonably the Board questions whether such a counselor could supply evidence of competence in each and every competence area claimed.  And so...the fictional encounter between a counselor and a prosecutor could become a reality.  

Although we would like to believe that legal proceedings are about facts, they are perhaps even more about perceptions.  A counselor may have been treating a client using only skills and techniques for which he or she could supply persuasive documentation of education and supervised training.  But, if a prosecuting attorney could find any element of the counselor's professional disclosure statement to be unsupportable by documented education and supervised training, the prosecuting attorney could then utter those words that damn the counselors' testimony from that point forward:  "If the counselor's claim of expertise in X is fraudulent, how can we know whether anything the counselor claims is true or fraudulent?"  

The Ohio Mental Health Counselors Association (OMHCA) urges each mental health counselor to protect your license and your reputation by carefully thinking about each and every item you list on your Professional Disclosure Statement.  Naturally you should claim anything that you can support with documented evidence of education and supervised training.  But to protect your license and your reputation, avoid listing anything for which you would have a hard time documenting your education and supervised training in a court hearing.  

OMHCA suggests the following guidelines:

1. When describing your program of study, be sure to list the only academic degrees earned which meet the educational requirements for licensure. For each degree listed, include the degree, the institution from which it is earned, its accreditation status, and the date the degree was awarded.   

If your degree is from a CACREP accredited program, be sure to mention that fact.  That way, anyone looking at your Professional Disclosure Statement immediately sees that your program of study was approved by the accrediting body of the counseling profession. CACREP accreditation immediately establishes the credibility of a counselor's training, and should help the counselor provide a more credible response to the first question posed by the Prosecutor in the above scenario. Doing this may save the counselor from having to face some of the follow-up questions that were posed by the Prosecutor.

2. When describing your competence areas, be sure to list only those competencies for which you can provide documentation of training and supervised practice.

Rather than listing generic descriptors in “potpourri” fashion on a professional disclosure statement, use the specific language of the accrediting or credentialing body for documenting areas of competence. Each CACREP-accredited counselor education program lists the specific courses that meet each CACREP standard in both the “core” curricular areas and counseling specialty areas (e.g., in Community Counseling, Mental Health Counseling, per the CACREP, 2001 Standards; in Clinical Mental Health Counseling, per the CACREP, 2009 Standards). This listing provides an organizational framework for documenting your areas of competence, with the corresponding specific coursework you’ve taken to support your claims of competence. Your faculty advisor or department chair from your counselor education program should be able to provide you with a grid illustrating how the program's courses are linked to the accreditation standards. Organized documentation of competencies should also help the counselor provide a logical, more credible response to the first three questions posed by the Prosecutor in the above scenario.

For any additional professional training you receive and claim as an area of expertise, (e.g., Gestalt Therapy), list any credential you may have received (e.g., certificate of completion, certification of competence), the training institute, and date received--the same type of information you list for counselor licensure. Be prepared to also submit documentation verifying completion of hours of supervised training required for certification in this area.

Save all documentation verifying practicum and internship completion (e.g., as stated in Clinical Instruction area of CACREP Standards; Field Experience Evaluation submitted to the OCSWMFT Board for PC/PCC licenses). Prepare a chart summarizing your supervised training so you will have it as a ready reference when needed.

Collect data about your supervised, post-graduation agency work.  Billing clerks for agencies and private practices keep records for how many hours of (billable) service performed by each professional in the following areas: diagnostic (intake) assessments, ongoing individual counseling, family counseling, group counseling, crisis intervention, etc. We would recommend that counselors keep a record of total hours spent in each of those service activities from every agency/practice when under supervision.

Certainly, Counselor Trainees (CTs) and Clinical Residents are vulnerable to close examination by attorneys in court cases, but even independently licensed counselors (PCCs) may be asked, “With about how many clients have you used the xyz therapy/intervention/technique?”  With any area of expertise claimed, be prepared to give a best estimate (range) for the number of clients seen and hours of supervision received. We would also recommend keeping track of the types of interventions used with clients (e.g., documented on the treatment plan). Supervisors should also document what interventions their supervisees are using. One may need to set up a database (e.g., in an Excel file) for treatment interventions used if one's agency or practice does not keep track of this information electronically.

3.  Before being called to give an accounting of one's training and work, practice thinking like a witness.  

While we all hope we may never be subjected to a grilling by unfriendly council, OMHCA urges all counselors to prepare for the day we may find ourselves on the witness stand defending our education, our claims of competence, and our actions with clients.  To prepare for such a day, we can all routinely practice describing what we do with our clients in crisp, descriptive language and describing the preparation we have had for engaging in the counseling practices we are using. Role play being a witness with trusted colleagues, accounting for oneself and one's actions. Preparation can prevent making embarrassing misstatements when on the witness stand.

OMHCA wishes you well in your professional training and practice, while hopefully avoiding the pitfalls of the counselor in the courtroom scenario.

Now, returning to this courtroom scenario, imagine . . .

Prosecutor:  In previous testimony we have heard that as required by law, you have posted a professional disclosure statement in your office and that it says, in part, that you have a Master of Arts degree in Community Counseling from Old School University and that you have competence in the following areas:  (a) clinical psychopathology, personality, and abnormal behavior including substance use disorders, (b) evaluation of mental and emotional status, (c) diagnosis of mental and emotional disorders, (d) individual and group psychoeducation for the prevention of mental and emotional disorders, and (e) individual cognitive-behavioral treatment of mental and emotional disorders.  Starting with the first item, would you please describe the specific coursework or supervised training you have had that supports your claim of expertise in clinical psychopathology, personality, and abnormal behavior, and then the others you listed?

Counselor: “Yes. The Community Counseling program I completed at Old School University was a nationally accredited program. The areas of competency I have listed on my Counselor Professional Disclosure Statement reflect the clinical areas of counselor training and supervision required by the Ohio Counselor, Social Worker, and Marriage and Family Therapy Board for me to obtain my Professional Counselor (PC) license in Ohio.” Since I have not yet completed my post-PC supervised practice requirements, I may only practice the assessment, diagnosis, and treatment of mental and emotional disorders under the direct supervision of a Professional Clinical Counselor who has authority to supervise. To satisfy the Board’s training requirements in the area of clinical psychopathology, personality, and abnormal behavior, I completed two academic courses in which the clinical and personality disorders itemized in the Diagnostic and Statistical Manual of Mental and Emotional Disorders were described in depth. I also completed one course in addictions counseling and have attended four professional workshops on assessing and treating substance dependence.  While in training, I completed 700 clock hours of supervised practice of counseling in which I conducted assessments, rendered diagnoses, and engaged in treatment planning for individuals who suffered from many of these disorders including substance use disorders. …

Need For Mental Health Hold Privileges for Counselors