1. Christopher J. Quarto, Ph.D. Middle Tennessee State University
Should Licensure Boards Play a Role in Shaping Distance Counseling Training Standards Among Counselors-in-Training?
Christopher J. Quarto, Ph.D.
Middle Tennessee State University

2. Topics of Presentation
General information pertaining to distance counseling to assist in decision-making/rules
Role of boards in specifying training requirements at graduate level for practice of distance counseling

3. Distance Counseling Issues
1. Reasons to consider implementing rules & regulations pertaining to distance counseling
2. Rise of distance counseling/history (e.g., NBCC) – including research support
3. Reluctance to engage in distance counseling/develop progressive rules for the practice of distance counseling

4. Distance Counseling Issues
4. State counseling boards – summary of current state of affairs
5. Counselor education – importance/efforts to train students in distance counseling
6. Study highlights
7. Implications for state counseling boards/graduate programs

5. Reasons to consider implementing rules & regulations pertaining to distance counseling
1. Technology revolution
Impact on human functioning
Application of distance technologies
Distance counseling guidelines

6. Reasons to Consider Implementing Rules & Regulations Pertaining to Distance Counseling
2. Shortage of providers & accessible services
HRSA – more mental health providers needed! (Ostrowski & Collins, 2016)

7. Reasons to Consider Implementing Rules & Regulations Pertaining to Distance Counseling
3. Trajectory of counseling as a field
“20/20” initiative
Seven areas identified
Licensure portability

8. Rise of Distance Counseling/History (e.g., NBCC) & Research Support
Distance counseling isn’t new!
“You can’t really help people by talking on a telephone.”
Issues (e.g., privacy & confidentiality, etc.)
“We’ve always done it this way!”
“The only thing
constant is change.”

9. Rise of Distance Counseling/History (e.g., NBCC) & Research Support
Standards for the Ethical Practice of Web Counseling
Ethical Guidelines for Online Counseling
2005, 2012
NBCC Policy Regarding the Provision of Distance Professional Services

10. Rise of Distance Counseling/History (e.g., NBCC) & Research Support
Distance counseling works!!
Hilty et al., 2013 – effective for assessment, diagnosis & treatment; across many populations; comparable to in-person care

11. Rise of Distance Counseling/History (e.g., NBCC) & Research Support
Backhaus et al., 2012 – good user satisfaction (client + counselor) and similar clinical outcomes to traditional face-to-face psychotherapy

12. Rise of Distance Counseling/History (e.g., NBCC) & Research Support
Simpson, Outcomes were comparable to face-to-face interactions for CBT.
Satisfaction comparable to face-to-face interactions

13. Rise of Distance Counseling/History (e.g., NBCC) & Research Support
50-State Survey of Telemental/Telebehavioral Health (2016)
Credible & effective
Similar satisfaction levels and treatment outcomes

14. Reluctance to Engage in Distance Counseling/Adopt Progressive Rules
Bias
Too difficult
Risky
Lack of knowledge, education & training

15. What Can be Done to Improve Acceptance of Distance Counseling?
Becoming knowledgeable of research
Openness to change
Training
Theory, research & ethics in graduate program

16. State Counseling Boards – Current State of Affairs Pertaining to Distance Counseling

17. State Counseling Boards – Current State of Affairs Pertaining to Distance Counseling

18. Counselor Education – Importance/Efforts to Train Students in Distance Counseling
Consumers will drive demand
Maheu et. al (2012) “Telemental health is increasingly consumer-driven, to an extent that is outrunning professional readiness and opening opportunities for nonprofessionals (e.g., life coaches) to displace [counselors] in supplying counseling… The health industry – including insurance companies – are steadily responding to patients’ demands....”

19. Counselor Education – Importance/Efforts to Train Students in Distance Counseling
Anthony (2015) - “Understanding cyberculture and the psychology of online behavior… is fast becoming a prerequisite for empathy with one’s clients. We are producing a profession that simply cannot connect to clients at a basic level. This level of education for potential graduates of counseling and psychotherapy not only needs to happen within core training, but it also requires a constant updating of the fast pace of how new technologies bring new issues.”

20. Counselor Education – Importance/Efforts to Train Students in Distance Counseling
“Old guard” vs. “New guard” of faculty
More counselors providing distance counseling following grad school
Train grad students in distance counseling?

21. Study Highlights 48 counselor educators 2/3 male, 1/3 female
Average age: 52
“Videoconferencing (sometimes referred to as ‘videocounseling’) is the closest medium to traditional face-to-face counseling and involves two people – a client and a counselor - communicating with one another on computer monitors through the use of web cams.”

22. Results – Strongest Areas of Agreement

23. Results – Strongest Areas of Disagreement

24. Study Highlights
Randomly assigned to read one of two scenarios – videocounseling in university counseling center
Scenario 1 – no training; uses standard counseling approach
Scenario 2 – training in videocounseling

25. Study Highlights
Just using counseling skills & experience should not be a standard practice for offering videocounseling services vs. training in use of videocounseling
Counselor educators value training in videocounseling

26. State Counseling Board’s Role in Shaping Distance Counseling Training Standards Among Counselors-in-Training
Two sides:
Isn’t board’s role to determine curricula
Board should specify minimal standards to protect the public

27. State Counseling Board’s Role in Shaping Distance Counseling Training Standards Among Counselors-in-Training
Distance counseling – a medium of delivering counseling services
Does it require regulation & training to occur in graduate school?

28. State Counseling Board’s Role in Shaping Distance Counseling Training Standards Among Counselors-in-Training
Distance counseling still too new
Legitimacy of approach will take time
Infrastructure costs
State board requires training as part of educational requirements
Scope of practice

29. Advantages of State Counselor Boards Having a Say in Training Standards/Requirements for Practice of Distance Counseling
1. Helps establish/reinforce legitimacy of distance counseling
2. Protects the public
3. Reduce ethics complaints

30. Disadvantages of State Counselor Boards Having a Say in Training Standards/Requirements for Practice of Distance Counseling
1. Lack of training/experience to specify curricular standards
2. Potentially lengthen graduate programs
3. Usurping power

31. Food for Thought
Does the medium/form of service delivery require training at the graduate level as opposed to continuing education post-masters?
Is it important for counselors to demonstrate that they possess the core knowledge and skills of distance counseling that comes from studying in a graduate program?
Should there be core competencies that counselors should possess/demonstrate pertaining to distance counseling that should be included on exams like the NCE or NCMHCE required by many licensure boards?

32. Questions/Discussion