8.1 Historical Perspectives
The mental health therapy and counseling field primarily consisted of doctoral-level helpers explicitly trained in counseling psychology until the late 20th century. In 1957, the Soviet Union’s success in space ventures led the United States to encourage young students to pursue careers in technical and scientific fields. This meant training and recruiting counselors that would help guide high school students into pursuing science. Early training in counseling was given to high school teachers who were given courses to become guidance counselors (Committee on the Qualifications of Professionals Providing Mental Health Counseling Services Under TRICARE [CQPPMHCSUT], 2010). Rehabilitation counselors gained momentum in the early 1900s to provide rehabilitation services for wounded veterans. By the 1950s, the government recognized the need to provide adequate help to the veterans of World War II so they could become productive in society. This increasing demand for rehabilitation counselors led to legislation that approved master’s level trained counselors to function more autonomously to provide rehabilitation services (CQPPMHCSUT, 2010).
The combined social situation paved the way for master-level counseling professionals to be separated from the required doctorate-level candidates. The first counselor licensure bill was passed in 1976, and all states implemented it by 2009. For over a decade, the counseling profession education expanded its educational program, providing more extensive training (CQPPMHCSUT, 2010). This historical perspective sheds light on a counseling profession emerging from needing counseling services in various settings, emphasizing personal growth and wellness and addressing mental health disorders. While community-based and mental health counseling differentiated in their practice and education requirements, the two were later integrated into clinical mental health counseling in 2009 (CQPPMHCSUT, 2010). However, the mental health field had other professionals working toward the same goal of addressing mental health and assisting clients in different aspects of their lives. Here is a table that provides an overview of mental health professionals and the required education.
Below (Table 8.1) is an overview of educational requirements for mental health professionals (Remley & Herlihy, 2010, as cited in CQPPMHCSUT, 2010, p95).
| Profession and Graduate Education Required | Summary of Required Courses and Required Supervised Field Experience |
| Counseling
48–60 graduate credits required for master’s degree |
Graduate coursework required in professional identity; social, cultural diversity; human growth, development; career development; helping relationships; group work; assessment; research, program evaluation; specialty (mental health counseling, community counseling, school counseling, career counseling, marriage and family counseling and therapy, college counseling, gerontologic counseling, student affairs)
100-hour practicum, 600-hour internship required |
| Pastoral Counseling | Field of pastoral counseling does not accredit academic preparation programs; people may become certified as pastoral counselors by American Association of Pastoral Counselors, but academic preparation programs not accredited |
| Marriage and Family Therapy
Minimum number of graduate credits not specified |
Graduate coursework required that covers 128 competencies in six domains: admission to treatment; clinical assessment, diagnosis; treatment planning, case management; therapeutic interventions; legal issues, ethics, standards; research, program evaluation
Number of hours of practicum, internship not specified |
| Social Work
60 graduate credits required for master’s degree |
Coursework required in professional social worker identity; ethical principles; critical thinking; diversity, difference; advancing human rights, social and economic justice; research-informed practice, practice-informed research; human behavior, social environment; policy practice; contexts that shape practice; engaging, assessing, intervening, evaluating individuals, families, groups, organizations, communities
Minimum of 900 hours of field experience required |
| Nursing
Minimum number of graduate credits not specified |
Graduate nursing coursework in research; policy, organization, financing of health care; ethics; professional role development; theoretical foundations of nursing practice; human diversity, social issues; health promotion, disease prevention; advanced health, physical assessment; advanced physiology, pathophysiology; advanced pharmacology; psychiatric nursing
Minimum of 500 hours of direct clinical practice (Additional requirements are placed on persons practicing in psychiatric nurse specialties) |
| Psychology
3 full-time years of graduate study required for doctoral degree |
Graduate coursework required in biological aspects of behavior; cognitive, affective aspects of behavior; social aspects of behavior; history, systems of psychology; psychological measurement; research methodology; techniques of data analysis; individual differences in behavior; human development; dysfunctional behavior or psychopathology; professional standards, ethics; theories, methods of assessment, diagnosis; effective intervention; consultation, supervision; evaluating efficacy of interventions; cultural, individual diversity; attitudes essential for life-long learning, scholarly inquiry, professional problem solving
1 full-time year of residency required |
| Psychiatry
130 weeks required for medical degree (usually 4 years) |
MD requires coursework in anatomy; biochemistry; genetics; physiology; microbiology, immunology; pathology; pharmacology, therapeutics; preventive medicine; scientific method; accurate observation of biomedical phenomena; critical analysis of data; organ systems; preventive, acute, chronic, continuing, rehabilitative, end-of-life care; clinical experiences in primary care, family medicine, internal medicine, obstetrics and gynecology, pediatrics, psychiatry, surgery in outpatient, inpatient settings; multidisciplinary content, such as emergency medicine, geriatrics; disciplines that support general medical practice, such as diagnostic imaging, clinical pathology; clinical, translational research, including how such research is conducted, evaluated, explained to patients, applied to patient care; communication skills as related to physician responsibilities, including communication with patients, families, colleagues, other health professionals; addressing medical consequences of common societal problems, for example, providing instruction in diagnosis, prevention, appropriate reporting, treatment of people for violence, abuse; how people of diverse cultures, belief systems perceive health, illness and respond to various symptoms, diseases, treatments; sex, cultural biases; medical ethics, human values
Psychiatry residency curriculum must include patient care; medical knowledge; practice-based patient learning, improvement; interpersonal, communication skills; professionalism; systems-based practice; research; required topics include supervised practice in providing psychiatric services to diverse populations 48-month residency in psychiatry is required, which includes 12-month internship in primary-care clinical setting |
Table 8.1. Adapted from Remley and Herlihy (2010) as cited in CQPPMHCSUT, 2010, p95.
These differences in education training meant each professional was limited in their training field. Hence, it is essential to recognize a counselor’s scope of practice and not go beyond our professional training in clinical practice.
Key Takeaways