Academic journal article Journal of Mental Health Counseling

Scope of Practice Impact on Employability in New York State: Director and Counselor Views

Academic journal article Journal of Mental Health Counseling

Scope of Practice Impact on Employability in New York State: Director and Counselor Views

Article excerpt

An exploratory survey revealed the effects of New York State's Licensed Mental Health Counselor Law on hiring Licensed Mental Health Counselors. The state Office of the Professions interpreted the absence of the word diagnosis in the law as indicating that LMHCs are ineligible to diagnose mental disorders. Directors of mental health agencies (n = 22) reported that LMHCs are qualified to work in state-licensed programs and are satisfied with the quality of their work, yet they hesitate or are unwilling to hire LMHCs due to reimbursement obstacles arising from the law. LMHCs (n = 23) reported being denied opportunities for employment, promotion, and insurance reimbursement and that consumer access to care is being restricted. It is advised that licensed professional counselors advocate for inclusion of the term diagnosis in the law in New York and in other states where the practice of professional counseling is unduly restricted.


Among the professions that the New York State Education Department (NYSED) Office of the Professions (OP) licenses and regulates is the profession of mental health counseling. The OP has interpreted the absence of the word diagnosis in the scope of practice for Licensed Mental Health Counselors (LMHC; New York State OP Mental Health Practitioners Law, 2010) to mean that LMHCs cannot diagnose mental disorders in New York State. As a result, the New York State Office of Mental Health (NYSOMH), which regulates delivery of mental health clinic services in state-licensed programs, does not include LMHCs among the five professions able to sign off on a treatment plan that includes provision of an initial diagnosis (New York Department of State [NYDOS], 2012, Clinic Treatment Part 599.10.[e]). It is likely that this OMH Part 599 regulation has affected the decisions of mental health agency directors to hire, promote, and in some cases, retain LMHCs. This survey study is the first attempt to document how mental health agency directors and LMHCs view the impact of the OP limitation of the LMHC scope of practice on hiring and related employment and insurance reimbursement practices.


In 2009 California became the 50th state to pass a professional counselor license law (Shallcross, 2009). Professional licensure is essential to establishing a profession's identity (American Counseling Association [ACA], 2010; Cashwell, Kleist, & Scofield, 2009; Daniels, 2002; Kaplan & Gladding, 2011; Myers, Sweeney, & White, 2002; Pistole & Roberts, 2002). Counseling programs are required to assist students to achieve professional identity through knowledge of counseling licensure (Council for Accreditation of Counseling and Related Education Programs [CACREP], Professional Identity, G.l.g., 2009). The ACA (2005) Code of Ethics addresses the role of professional licensure several times, making it the responsibility of licensed counselors to be qualified to practice their profession (F.5.d). The ruling out of diagnosis from the LMHC scope of practice in New York State raises questions about the viability of this license in New York.

New York State passed the Mental Health Counselor Law in 2005; it went into effect in January 2007 (New York Mental Health Counseling Association [NYMHCA], 2011). Article 163 of Title 8 of New York State Education Law, [section] 8402 states the scope of practice for LMHCs as follows:

a. the evaluation, assessment, amelioration, treatment, modification, or adjustment to a disability, problem, or disorder of behavior, character, development, emotion, personality, or relationships by the use of verbal or behavioral methods with individuals, couples, families or groups in private practice, group, or organized settings; and

b. the use of assessment instruments and mental health counseling and psychotherapy to identify, evaluate, and treat dysfunctions and disorders for purposes of providing appropriate mental health counseling services. …

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