In this episode the X-Podcast team discusses the different specialties within the counseling profession. They make clear distinctions between the individual counseling specialties and the distinctive differences. They also focus on their specialty, mental health, within the counseling professions and explore how CACREP accreditation plays an important role in pursuing a college program in any of the counseling specialties. 

Host Xiomara A. Sosa, and co-hosts Lisa Early and JRoc have a relatable discussion about the different counseling specialties available for clients to consider for their mental health needs and for students to consider in choosing their career path. 

What are counselors? 

Counselors help people from all walks of life overcome their problems. Couples may seek out the help of a marriage counselor to help them resolve interpersonal issues, while students may ask school counselors for help if they’re being bullied.

Professional counselors work with individuals, groups, and families to help people achieve their career, education, and wellness goals. 

Individuals interested in pursuing this career path will need to decide what type of counseling services they’re interested in providing because there are several counseling specialties to choose from. 

• Addiction/Substance Abuse Counseling
• School/Career Counseling
• Clinical Mental Health Counseling
• Clinical Rehabilitation Counseling
• College Counseling and Student Affairs
• Marriage, and Family Counseling
• Grief Counseling

What is CACREP?

CACREP (Council for Accreditation of Counseling and Related Educational Programs) is a nationally-recognized accrediting body that offers accreditation to graduate-level counseling programs. 

CACREP accredits over 983 master’s and doctoral degree programs in Counseling and its specialized practice areas offered by 472 colleges and universities across the United States. 

CACREP also accredits doctoral programs in Counselor Education and Supervision.

Is CACREP accreditation important?

CACREP accreditation should be a top consideration when applying to a master's or doctoral counseling program. CACREP accreditation validates the overall quality of a counseling program against a set of third-party standards and helps prepare students to work as professional counselors. 

CACREP Standards

CACREP accreditation is both a process and a status, and denotes a commitment to program excellence. 

• Section 1, The Learning Environment
• Standards pertaining to the institution, the academic unit, and program faculty and staff.
• Section 2, Academic Quality
• The following standards apply to all entry-level and doctoral-level programs for which accreditation is being sought unless otherwise specified.
• Section 3, Foundational Counseling Curriculum
• The following standards apply to all entry-level programs for which accreditation is being sought unless otherwise specified.
• Section 4, Professional Practice
• The following standards apply to entry-level programs for which accreditation is being sought. Professional practice, which includes practicum and internship, provides for the application of theory and the development of counseling skills under supervision. Fieldwork experiences will provide opportunities for students to counsel diverse clients.
• Section 5-A, Entry-Level Specialized Practice Areas, Addiction Counseling
• Specialized content for addiction counseling programs.
• Section 5-B, Entry-Level Specialized Practice Areas, Career Counseling
• Specialized content for career counseling programs.
• Section 5-C, Entry-Level Specialized Practice Areas, Clinical Mental Health Counseling
• Specialized content for clinical mental health counseling programs.
• Section 5-D, Entry-Level Specialized Practice Areas, Clinical Rehabilitation Counseling
• Specialized content for clinical rehabilitation counseling programs.
• Section 5-E, Entry-Level Specialized Practice Areas, College Counseling and Student Affairs
• Specialized content for college counseling and student affairs programs.
• Section 5-F Entry-Level Specialized Practice Areas, Marriage, Couple, and Family Counseling
• Specialized content for marriage, couple, and family counseling programs.
• Section 5-G, Entry-Level Specialized Practice Areas, Rehabilitation Counseling
• Specialized content for rehabilitation counseling programs.
• Section 5-H, Entry-Level Specialized Practice Areas, School Counseling
• Specialized content for school counseling programs.
• Section 6, Doctoral Standards for Counselor Education and Supervision
• Standards for doctoral-level program requirements, including the specialized content for the doctoral-level core curriculum, and doctoral-level practicum and internship requirements.

What does it mean for an institution to be CACREP-Accredited?

Two different kinds of accreditation: institutional accreditation and specialized accreditation.

Institutional accreditation looks at the institution as a whole. Curriculum, credit hours, faculty qualifications, and the university’s operations and financial viability are all taken into consideration. Institutional accreditation recognizes that an academic institution has met the standards set by its accrediting body. There are six regional accrediting organizations in the United States; these are overseen by the Council for Higher Education Accreditation (CHEA).

Specialized accreditation applies to specific programs within an institution, often professional preparation programs at the graduate and postgraduate levels. Specialized accreditations mean that a specific program is meeting or exceeding standards established by a profession. They ensure that a program will offer students a quality education that sufficiently equips them for licensure and/or their career. CACREP falls into this  category because it accredits programs designed to prepare students for a profession in counseling.

Upon being evaluated by CACREP, an individual program is granted accreditation for either an 8-year cycle or a 2-year cycle.

Why attend a CACREP-Accredited program?  

CACREP-accredited programs come with a host of benefits: 

1. They meet or exceed national and professional standards. A CACREP-accredited program has been evaluated against standards set by the counseling profession. The number of credit hours, rigor of student internships and practicums, expertise of faculty, and professionalism of the program have all been reviewed and found to be in alignment with best practices and professional standards. You’ll graduate knowing you’ve been prepared for licensure as well as your career in counseling.
2. They create a more direct path to licensure. Many states will conduct a review of your academic credentials as a part of the licensing process. Because of CACREP’s nationally recognized status, most state exam boards recognize the work students have completed in their CACREP programs. By graduating from a CACREP program, your academic work will most likely be recognized when you apply for licensure. View your state’s requirements.
3. They prepare you for professional counseling. If your goal is to enter professional counseling, as opposed to other helping professions or careers in psychology or education, a CACREP-accredited program will likely be the best fit, as it’s designed to prepare you for counseling in a professional setting.
4. They use and continue to pursue best-practices. To be considered for CACREP accreditation, programs undergo rigorous self-review and create a detailed self-study report. This self-directed evaluation demonstrates a program’s commitment to pursuing excellence. You can be sure that you’re investing in a program that values quality.

What can I expect from a CACREP-accredited program?  

1. Core Faculty. You can expect CACREP-accredited programs to be taught by faculty who hold full-time positions in an academic institution, as opposed to part-time or adjunct faculty.

Learn more about CACREP

What are the goals of counseling?

The basic goal of counseling is to facilitate positive behavior change, improve the client’s ability to maintain relationships, enhance the client’s ability to cope and improve decision-making.

How does a counselor treat you?

In counseling, there are 5 main stages - disclosure, in-depth exploration, commitment, intervention, and evaluation. The counselor will do psychotherapy based on your mental health condition. 

Types of Counseling/Counseling Specialties

Addiction/Substance Abuse Counseling – Addiction/Substance Abuse Counseling programs prepare graduates to work with persons and families affected by alcohol, drugs, gambling, sexual and other addictive disorders (e.g., food-related).  These programs focus on models of treatment, prevention, recovery, and relapse prevention of addiction, along with the appropriate application of appropriate interventions.  Graduates of Addiction Counseling programs may choose to work in private practice or may work in a variety of community agencies offering counseling services for addiction/substance abuse.

Addiction/substance abuse counselors assist clients who are struggling with or have experienced addictions to drugs, alcohol, or both. Professionals in this specialization will help clients assess their behaviors with a critical eye, determining the kinds of behavior that the clients want to change and the triggers that they need to avoid.  In addition to assessing client behavior, addiction/substance abuse counselors will offer assistance with the development of strategies to enable clients to achieve lives of recovery and subsequent sobriety. In some cases, addiction/substance abuse counselors may connect clients living with substance abuse disorders with psychiatrists for additional services.

Treatment models for counseling in this field tend to embrace the notion of steps or stages, often mirroring the process devised by Alcoholics Anonymous. These stages encourage not only ways of finding sobriety from drugs and alcohol but also strategies for rebuilding a life that is both physically and mentally healthy.

Addiction/substance abuse counselors can be found in an array of professional settings, from private clinics to hospitals and even prisons. They can work with clients in support groups or conduct one-on-one meetings.

According to the National Survey on Drug Use and Health (NSDUH), in 2021, an estimated 46.3 million Americans aged 12 or older were battling a substance abuse disorder — 16.5% of the population.  Because of the prevalence of this important issue, a third type of counseling that master’s degree candidates may be interested in pursuing relates to addiction support.

Addiction/substance abuse counselors work with clients individually or in a group setting, and in some cases, they may also work alongside registered nurses, physicians or psychiatrists to coordinate care and develop treatment plans. These professionals may specialize in providing services to specific populations, such as veterans or teenagers, while others work with clients who have been referred to a treatment program as part of a court order.

School/Career Counseling – Help clients wanting to make career decisions and explore the intersection of their education, skills, interests, and personality to determine and plan for possible career paths.  School/career counselors often use inventories and other assessment tools to assist clients in making decisions.  School/career counselors may work in a variety of settings from private practice, to career resource centers or employee assistance programs associated with specific industries or organizations.

In an age of cyberbullying and in-school lockdown drills, a school counselor’s role is more important than ever. Children of all ages are at risk of feeling overwhelmed, whether it’s due to problems at home, arguments with friends, or something they’ve seen on the evening news. School counselors do more than help students have a positive educational experience. In many cases, they’re called upon to provide social-emotional support.

Counselors who work in high school settings also help students make career plans and fill out college, scholarship, and trade school applications. Career counselors, on the other hand, focus on helping job seekers identify their interests and aptitudes so they can define their professional goals. They work in a broad range of settings, including high schools, colleges, and government agencies. Some choose to work in private practice. The primary role of career counselors is to help students and clients develop interviewing, networking, and job-searching skills. They may provide guidance on how to resolve conflicts within the workplace as well.

School Counselors work with students ranging from kindergarten through high school. School counselors are prepared to promote the academic, career, and personal/social development of all K-12 students through understanding how to design and implement comprehensive school guidance and counseling programs that include time for individual counseling, group counseling, classroom guidance, and family and teacher consultations within the school setting. School counselors work within both private and public school systems at the elementary, middle, and high school levels.

College Counselors  work in higher education and student affairs offices after graduation. Such positions might include working at a college or university’s housing and residential life office, assisting with management activities at a student union, offering student leadership activities and orientation sessions, or providing counseling, career services, and multicultural support services. 

Clinical Mental Health Counseling – Clinical Mental Health Counselors work with clients across a spectrum of mental and emotional disorders and promote mental health and wellness.  Clients may be seen individually, in couples, in families, or in group settings. Clinical Mental Health Counselors are knowledgeable in the principles and practices of diagnosis, treatment, referral, and prevention and often work in interdisciplinary teams with other health professionals (e.g., psychiatrists, social workers, MDs).  Employment opportunities may include private practice, community-based mental health centers, hospitals, and other treatment centers.

Clinical mental health counselors provide psychotherapy treatment. Although some choose to work with specific demographics, such as children or older adults, others provide services to people of all backgrounds and age groups. The primary role of mental health counselors is to promote mental and emotional health. Specifically, clinical mental health counselors may help clients with issues relating to marital problems, substance abuse, self-esteem, and stress management.

Clinical Rehabilitation Counseling – Clinical Rehabilitation Counselors help clients with cognitive, physical, sensory, psychiatric, and other disabilities work through a variety of mental health issues and provide treatment of mental disorders, including co-occurring disorders. They are knowledgeable in the principles and practices of clinical counseling including assessment, diagnosis, treatment, referral, and prevention. Clinical rehabilitation counselors may work in a variety of settings including private practice, community-based mental health facilities, substance treatment facilities, schools, hospitals, and/or other treatment centers.

Marriage and Family Counseling –  Marriage and Family Counselors are prepared to work with individuals, couples, and families from a family systems perspective across a variety of mental and emotional disorders, relationship issues, or communication issues. They also work in a variety of settings including inpatient facilities, community mental health centers, private practice offices, and social service agencies.

Marriage and family therapists work with families and couples through any number of issues that can impact intimate and loving relationships.  They work with clients experiencing mental illness, as well as with individuals recovering from traumatic or abusive situations. They work with clients who have experienced physical or sexual abuse at the hands of a partner or family member, or they may offer group counseling to a family wherein one or more members are living with mental illness.

Other issues include common family and marriage-based problems such as infidelity, divorce, and grief over a loved one’s death. They work with individuals, couples, or groups.

Marriage and family counselors help married couples or entire families navigate different challenges. Challenges within a marriage may encompass anything from infidelity to more mundane, domestic tensions. Additionally, marriage and family counselors may provide guidance for families experiencing major life transitions, including the adoption of a new child or the loss of a loved one.

Marriage and family counselors can provide their clients with strategies to improve communication or troubleshoot problems that arise within family life. Ultimately, marriage and family counselors strive to help their clients build happier, healthier and more harmonious lives at home.

Rehabilitation Counseling – Rehabilitation Counselors work collaboratively with individuals with disabilities, their support systems, and their environments to achieve their personal, social, psychological, and vocational goals. They help clients maximize levels of independence, integration, and participation of all individuals with disabilities through the use of counseling, technology, advocacy, support, and the development and application of services that eliminate barriers to their clients’ development. Rehabilitation counselors may work in a variety of settings including rehabilitation facilities, hospitals, universities, schools, and/or government agencies.

Sometimes, physical or mental disabilities may make it difficult for people to accomplish everyday tasks. Rehabilitation counseling is devoted to helping these people develop the tools and strategies needed to live as independently as possible. Specifically, rehabilitation counselors may work with visually impaired clients, clients who have sustained spinal cord injuries, or clients who have limited mobility due to an accident or a surgical procedure.

Grief counselors are professionals who specialize in the field of grief counseling and help clients find healthy ways to navigate the often complex and emotionally challenging terrain of the grieving process.   Grief counselors help clients find ways to move on with their lives in healthy and positive ways. Much like other forms of counseling, grief counseling can be administered on a one-on-one basis or in a group format.

A Closer Look at Areas of Specialization

Although it is possible to work as a general counselor, helping clients in an array of situations, and facing a variety of issues, many professionals on the verge of entering the field look to specialize,   

Why specialize?

Some counseling professionals opt to specialize in a certain area.  

Pros:

• Opting to specialize can breed a sense of intimacy and familiarity with the topic and issue at hand, which can boost a counselor’s confidence that she or he is providing the very best care to clients.
• Through a specialization, a counselor can become a leader in a certain area, providing guidance and education to other counselors.
• Individuals who follow a specialty tend to have a passion for that particular issue, whether it may be marriage and family counseling or substance abuse counseling. Counselors who are passionate about a certain area tend to be more invested and dedicated to their role, providing better counseling services as a consequence.  Counselors often will opt to specialize — to find a niche — to increase their commercial viability. The same rationale can be applied when deciding to generalize. Counselors who generalize will be able to work with a wide client base, enhancing their marketability.

Cons:

• Counselors who specialize risk becoming unfulfilled professionally or, to borrow a phrase from Adams, “burned out.” This result is perhaps because counselors who specialize come to know their area so well that they no longer feel stimulated or challenged.
• Counselors who specialize can be less marketable overall, particularly if there is minimal demand for the services they offer in the area in which they live and practice.

Regardless of the counseling specialty they choose, there are several skills that all aspiring counselors need to develop to be effective.

Empathy for the Client

People who seek help from counselors are often feeling stressed and overwhelmed. Aspiring counselors will need to learn to empathize so they can build trust with their clients. This is important because it can help improve clients’ willingness to be open and forthcoming about their problems.

Creating a Safe Space for the Client

For counseling to be effective, clients need to feel as if their thoughts, behaviors and feelings aren’t being judged. Clients who feel that their counseling sessions provide a safe space for them to discuss their problems, without fear of disapproval, are more likely to share information freely.

Communicating Positive Intentions to the Client

Counselors who understand how to be genuine and authentic with their clients show they are trustworthy. Authentic communication, which involves speaking to clients simply, clearly and respectfully, helps encourage clients to express their true thoughts and feelings.

Inspiring Active Participation

A counselor is not a mechanic who fixes clients’ problems while they wait. Counselors want clients to take an active role in their progress, because the more clients put into sessions, the more they will get out of them. Counselors can help clients take responsibility for their success by encouraging them to work hard on change between sessions, to share experiences with other participants during group sessions, and to be open to alternative perspectives. Thus, an essential skill for all counselors is the ability to engage clients and encourage them to get involved in their recovery.

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References

https://www.cacrep.org/counseling-specialties/

https://www.corban.edu/cacrep-accredited-program/#:~:text=What%20is%20CACREP%3F,to%20graduate%2Dlevel%20counseling%20programs.

https://onlinedegrees.bradley.edu/blog/a-career-in-counseling-a-closer-look-at-areas-of-specialization/#:~:text=Through%20a%20specialization%2C%20it%20is,counseling%20or%20substance%20abuse%20counseling.

https://counseling.online.wfu.edu/blog/types-of-counseling-specialties/#:~:text=Professionals%20who%20choose%20to%20pursue,all%20backgrounds%20and%20age%20groups 

Resources

https://www.thex-studio.org/resources