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Standards of Practice: Introduction
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I. Introduction

Since its formation as a professional organization in 1976, the American Mental Health Counselors Association, AMHCA, has been committed to establishing and promoting vigorous standards for education and training, professional practice, and professional ethics for clinical mental health counselors. Initially, AMHCA sought to define and promote the professional identity of mental health counselors. Today, with licensure laws in all 50 states, AMHCA seeks to enhance the practice of clinical mental health counseling and to promote standards for clinical education and clinical practice that anticipate the future roles of clinical mental health counselors within the broader health care system. As a professional association, AMHCA affiliated with APGA (a precursor to the American Counseling Association [ACA]) as a division in 1978; in 1998, AMHCA became a separate not-­for-profit organization, but retained its status as a division of ACA.
In 1976, a group of community mental health, community agency and private practice counselors founded AMHCA as the professional association for the newly emerging group of counselors who identified their practice as “mental health counseling.” Without credentialing, licensure, education and training standards, or other marks of a clinical profession, these early mental health counselors worked alongside social workers and psychologists in the developing community mental health service system as “paraprofessionals” or “allied health professionals” despite the fact that they held master’s or doctoral degrees. By 1979, the early founders of AMHCA had organized four key mechanisms for defining the new clinical professional specialty:

  1. identifying a definition of mental health counseling;
  2. setting standards for education and training, clinical practice, and professional ethics;
  3. creating a national credentialing system; and
  4. starting a professional journal, which included research and clinical practice content.

These mechanisms have significantly contributed to the professional development of clinical mental health counseling and merit further explication.

A. Scope of Practice
A crucial development in mental health counseling has been defining the roles and functions of the profession. The initial issue of AMHCA’s Journal of Mental Health Counseling included the first published definition of mental health counseling as “an interdisciplinary, multifaceted, holistic process of: 1) the promotion of healthy lifestyles; 2) identification of individual stressors and personal levels of functioning; and 3) the preservation or restoration of mental health” (Seiler & Messina, 1979). In 1986, the AMHCA Board of Directors adopted a more formal, comprehensive definition: “clinical mental health counseling is the provision of professional counseling services involving the application of principles of psychotherapy, human development, learning theory, group dynamics, and the etiology of mental illness and dysfunctional behavior to individuals, couples, families and groups, for the purpose of promoting optimal mental health, dealing with normal problems of living and treating psychopathology. The practice of clinical mental health counseling includes, but is not limited to, diagnosis and treatment of mental and emotional disorders, psycho-­educational techniques aimed at the prevention of mental and emotional disorders, consultations to individuals, couples, families, groups, organizations and communities, and clinical research into more effective psychotherapeutic treatment modalities.”

Clinical mental health counselors have always understood that their professional work encompasses a broad range of clinical practice, including dealing with normal problems of living and promoting optimal mental health in addition to the prevention, intervention and treatment of mental and emotional disorders. This work of clinical mental health counselors serves the needs of socially and culturally diverse clients (e.g. age, gender, race/ethnicity, socio-­economic status, sexual orientation) across the lifespan (i.e. children, adolescents and adults including older adults and geriatric populations). Clinical mental health counselors have developed a strong sense of professional identity over the last 35 years. AMHCA has sought to support this sense of professional identity through legislative and professional advocacy, professional standards, a code of ethics, continuing education, and clinical educational resources.

B. Standards of Practice and Research
A key development for the profession was AMHCA’s creation of education and training standards for mental health counselors in 1979. The Council for Accreditation of Counseling and Related Educational Programs (CACREP) adopted and adapted these AMHCA training standards in 1988 when it established the first set of accreditation standards for master’s programs in clinical mental health counseling. In keeping with AMHCA standards, CACREP accreditation standards for the mental health counseling specialty have consistently required 60 semester hours of graduate coursework. AMHCA remained an active advocate for vigorous clinical training standards through the 2009 CACREP accreditation standards revision process, during which community counseling accreditation standards were merged into the new clinical mental health counseling standards. After careful review, AMHCA endorsed the clinical mental health counseling standards.
Another important step in the further professionalization of clinical mental health counseling, AMHCA established the National Academy of Certified Mental Health Counselors, the first credentialing body for clinical mental health counselors, and gave its first certification examination in 1979. In 1993, this certified clinical mental health counselor credential (CCMHC) was absorbed into the National Board for Certified Counselors credentialing process where it remains. AMHCA clinical standards have always recognized and incorporated the CCMHC credential as an important means of recognizing that a clinical mental health counselor has met independent clinical practice standards, despite significant differences that exist among state counselor licensure laws, as well as among educational and training programs.

Finally, since 1979, AMHCA published the Journal of Mental Health Counseling, which has become widely recognized and cited as an important contributor to the research and professional literature on clinical mental health counseling.

Taken together, these four mechanisms (definition of scope of practice; educational and training standards, professional practice standards and code of ethics; credentialing; and professional journal) resulted in the recognition of clinical mental health counseling as an important profession to be included in our health care system. In recognition of the central importance of vigorous professional educational and clinical practice standards, AMHCA has periodically revised its professional standards in 1993-­94, 2003, and 2010-­11 to reflect evolving practice requirements. These professional standards, as well as the 2010 AMHCA Code of Ethics, constitute the basis from which AMHCA continues to advocate for, and seek to advance, the practice of clinical mental health counseling.

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