Professional Orientation & Ethics

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Counseling
The application of mental health, psychological or human development principles, through cognitive, affective, behavioral, or systemic interventions, strategies that address wellness, personal growth, or career development, as well as pathology (as defined by the American Counseling Association [ACA]).
In 2010 the ACA sponsored task force, "20/20: A Vision for the Future of Counseling," achieved consensus on the following definition of counseling: Counseling is a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals.
Historical Review [1879-1909]
1879--First psychological laboratory established--Wilhelm Wundt
1890--Sigmund Freud used psychoanalysis in treating mental illness
1898--Jesse Davis began working as a counselor in a Detroit high school
1908--Clifford Beers exposed conditions in mental health institutions by writing, "A Mind That Found Itself."
1909--Parson's book, "Choosing a Vocation," was published; established the trait-factor guidance approach.
Historical Review [1913-1945+]:
1913--National Vocational Guidance Association founded--first professional counseling association
1917--Smith-Hughes Act grants federal funds for vocational education and guidance
1927--Strong-Vocational Interest Blank published
1939--E.G. Williamson published "How to Counsel Students" which modified Parson's trait-factor approach
1942--Carl Rogers published "Counseling and Psychotherapy"
1945+--during the post WWII years, counseling services to veterans in the VA were greatly expanded
Historical Review [1951-1976]:
1951--The American Personnel and Guidance Association was founded
1954--The Office of Vocational Rehabilitation was created
1958--The National Defense Education Act was passed. This provided money for training of school counselors
1960's--Several new theoretical counseling approaches were developed such as behavioral, reality, gestalt, and rational emotive
1962--Gilbert Wrenn published "The Counselor in A Changing World," emphasizing counseling as a profession focused on developmental needs
1976--State of Virginia passed the first general practice counselor licensure law
Historical Review [1981-2010]:
1980's--Counseling credentialing (licensure and certification) mushroomed
1981--Council for the Accreditation of Counseling and Related Educational Programs (CACREP) was established
1983--APGA changed its name to American Association for Counseling and Development (AACD); became ACA in 1992
1990's--Counseling expands services and specialty areas increase
1990's and onward--more federal legislation recognizes counseling as a distinct profession
2000's--number of certified and licensed counselors in US approaching 100,000
2010--California passed counselor licensure legislation. Now all 50 states, the District of Columbia, and Puerto Rico have licensure.
Disaster mental health (current and continuing trends and issues)
A number of events, circumstances, and natural phenomena are leading to an increased focus of the profession on disaster, trauma, and crisis counseling. Natural disasters, wars and conflicts, terrorism, and other traumatic events require particular mental health diagnostic skills and treatment interventions.
Beginning with the 2010 national convention of the ACA, a new category of programs titled Disaster Mental Health appeared. The recent revision of the Council for Accreditation of Counseling and Related Educational Programs (CACREP) includes counselor training standards for disaster, trauma, and crisis counseling.
Definition and scope of practice (current and continuing trends and issues)
Counseling continues to define areas of interest and competence such as violence/trauma/crises, multiculturalism, spirituality, wellness, and technology. Because of the diversity of what counselors do, a "collective identity" is difficult to establish.
Scope of counseling practice is dynamic as changing state laws and other professions exert influence on the profession.
Portability (current and continuing trends and issues)
The American Association of State Counseling Boards (AASCB) is taking an active role in implementing a process of easing the transition of licensed counselors moving from one state to another. The National Credentials Registry, one part of this process, was established in 2005. You an access this organization and the registry at: www. aascb.org.
Social justice counseling (current and continuing trends and issues)
Building on the advances of multicultural counseling, the principle of social justice is expanding. Social justice counseling addresses issues of unequal power, unearned privilege, and oppression, and seeks a greater balance of power and resources in society. To better empower clients, advocacy competencies for counselors have been identified by ACA and implemented in counselor training programs.
Mind-body connections and implications (current and continuing trends and issues)
There is a need for counselors to understand the relationships between body functions, nutrition, medications/drugs, and mental states and behavior. Much behavior may be rooted in biological and brain functions which cannot be overlooked to ensure proper diagnoses and counseling approaches. This trend is manifested through coursework in counselor training programs as well as workshops and seminars for professionals in the field.
WebCounseling (current and continuing trends and issues)
WebCounseling, also called cybercounseling, E-counseling, and online counseling, is a reality and growing in scope. There is great potential to benefit or harm consumers. WebCounseling guidelines have been published by ACA in their "Code of Ethics." The National Board for Certified Counselors has also published guidelines for online counseling titled, "The Practice of Internet Counseling."
ACA Advocacy Competencies
In order to provide a more socially just community and system in which their clients live, counselors feel the need to advocate for their clients, not only in the counseling office but in the communities from which they come. This is true for their school clients as well as clients in the community.
At the direction of ACA, a task force developed a set of counselor advocacy competencies that applied to individual clients and students, to the community and systems, and to the general public in social and political arenas.
Profession
a vocational activity with an underlying body of theoretical and research knowledge, and a publicly professed, self-imposed set of behavioral guidelines.
Counseling is a profession arising out of the many influences of the past 130 years.
Accreditation
a process through which public recognition is granted to a college or university or specialized program of study which meets certain established qualifications or standards.
Accreditation applies to programs of study, not to individuals.
Council for Accreditation of Counseling and Related Educational Programs (CACREP)
a. The Council was founded in 1981. This is the body that accredits counselor training programs at the master's and doctoral levels. It establishes standards for professional competence and prepares future practitioners. CACREP encourages continual review and development of academic and professional practice programs. Most state licensure boards accept CACREP program standards and requirements for licensure.
b. The latest revision of the CACREP standards occurred in 2009 and identified 6 master's level programs. These are: addictions; career; clinical mental health; marriage, couple, and family; school; and student affairs and college. The 1 doctoral program accredited by CACREP is counselor education and supervision.
c. There are over 200 academic institutions with accredited programs in the US and many have 2 or more for a total of over 500. Additionally, about 60 accredited doctoral programs exist.
d. Those programs accredited under the 2001 standards may complete their accreditation cycle under those program names and standards. However, they are free to change to the 2009 standards.
Other accrediting bodies:
a. Council on Rehabilitation Education (CORE) accredits rehabilitation counseling programs. About 100 programs are accredited by CORE.
b. American Psychological Association (APA) accredits clinical, counseling, and school psychology programs--all at the doctoral level.
c. American Association for Marriage and Family Therapy (AAMFT) accredits marriage and family therapy training programs at the master's doctoral, and postdoctoral levels.
Certification
is a voluntary process through which recognition is granted to an individual who has met certain predetermined qualifications.
Certification is a title control process.
For example: For the designation National Certified Counselor, the work controlled is "Certified." Others cannot use that word without threat of lawsuit by whoever does the certification.
National Counselor Certification is mobile; it goes with you wherever you move.
National Board for Certified Counselors, Inc. (NBCC)
a. This Board provides for generic counselor certification (National Certified Counselor--NCC). General requirements include a master's degree in counseling, coursework in 8 content areas, pre-degree field experiences (practical, internships), 3,000 hours of post-degree supervised work experience, and successful completion of the National Counselor Exam (NCE). There are over 45,000 active certificants.
b. Following receipt of the NCC, specialty counselor certification is also possible in these areas with an exam required: National Certified School Counseor (NCSC); Certified Clinical Mental Health Counselor (CCMHC); Master Addictions Counselor (MAC).
c. NBCC requires continuing education units to remain certified--100 clock hours for each 5 years of certification.
d. Graduate students in counseling near the end of their programs can apply for and take the NCE. If they are in a CACREP program, they can become certified upon graduation without post-degree work experience. Graduate students in a non-CACREP program become Board Eligible at graduation and must complete post degree work experience (3,000 hours).
Other certifying bodies
Commission on Rehabilitation Counselor Certification
States certify school counselors, drug and alcohol counselors, and other counseling related groups
Licensure
refers to the passing of a law at the state level to control the practice and/or title of an occupation (e.g., counseling). In this process, a state gives permission to an individual to practice counseling (as defined in that state's law) and to use a title such as Licensed Professional Counselor or something similar. There is no licensure at the national level.
General requirements around the country for licensure are a master's degree in counseling coursework in the 8 content areas, pre-degree field experiences, post-degree supervised counseling work experience, and successful completion of an exam.
There are variations in requirements from state to state. For example, some require a 48-hour degree and others 60. Most states require between 2,000 and 4,000 hours of post-degree work experience. Most states use the National Counselor Examination for licensure, some use the National Clinical Mental Health Examination, and some states allow either exam. Some states have 2 levels of licensure and use a different exam for each level.
The vast majority of states have "title and practice-control" laws which mean no one practices counseling unless s/he has a license. A few states have "title-control" laws which mean anyone can practice counseling but cannot use the title (e.g., Licensed Professional Counselor) legally unless they are licensed. Licensure is state-bound. It does not move with you although you can go through the licensure process in another state. You can be licensed in several states simultaneously.
All 50 states, the District of Columbia, and Puerto Rico have licensure of counselors. Portability of the licensure credential between states is difficult without going through the licensure process again in the "new" state.
Some threats to licensure for counselors include:
a. As state licensure laws are revised, the scope of practice for counselors may be redefined more narrowly, and
b. Proposed changes to some states' laws suggest disallowing counselors the use of psychological tests.
Reciprocity
This is a process whereby one credentialing agency (e.g., state) accepts the credential of another agency as equivalent to its own.
For example: One state licensure board accepts the license of another state as equivalent. Some states call this process endorsement instead of reciprocity.
Confidentiality
is an ethical concept. It springs from the privacy expected in a counseling relationship and is respected by the counselor.
Privileged communication
is a legal concept. It is granted to counselors when a state law has been passed, such as a licensure law. This legal right to privileged counselor-client communication is similar to the privilege exercised by those in medical, legal, and psychology professions. It means that in a court of law, the counselor does not have to reveal what was said in counseling.
There are several circumstances under which privileged communication is waived and confidentiality is broken:
a. client is a danger to self or others
b. child abuse or neglect is alleged
c. client requests that counseling records be released
d. a lawsuit is filed against you
e. the material is used in supervisory sessions
f. involuntary hospitalization is being considered
g. a court orders the release of information
Duty to warn (Tarasoff Case)
The Tarasoff family sued the Board of Regents of the University of California after Tatiana Tarasoff was murdered by Prosenjit Poddar, a client of a university psychologist.
The California court ruled in this 1976 case that failure to warn an intended victim was professionally irresponsible. Under such circumstances, you must break confidentiality (and waive the privilege if you have it) and warn the intended victim(s). Clearly, the ability of the counselor to adequately and appropriately determine the client's intentions is critical.
Court cases in other states have generally reaffirmed and expanded this landmark legal decision.
Duty to protect
In cases of suicidal clients, there is an obligation to protect the client. Formal operating procedures and referral options should be identified in advance.
The duty to protect also applies to others such as children, and in most states, the elderly and others with physical or mental disabilities.
some signs in assessing the seriousness of suicide risk:
a. direct verbal warnings and previous attempts
b. definite plan established and the means available (gun, pills, etc).
c. depression and sense of hopelessness
d. giving possessions away
e. history of drug or alcohol abuse
Statement of disclosure and informed consent
A statement of disclosure or informed consent is an ethical necessity and may be required by law (in your state). This document may identify counseling procedures, techniques, counselor credentials, and grievance procedures and is given to the potential client before the counseling relationship begins. The disclosure can alert the client in advance under what circumstances you as a counselor, will break confidentiality depending upon disclosures made by the client. Informed consent includes the process for releasing client information.
Professional liability
Counselors can be held liable, sued, and taken to court for causing harm through mental distress, defamation, sexual harassment or conduct, negligence, misrepresentation of professional service, and battery.
Malpractice
the failure to provide professional services, or to provide those services at a level below that which would be expected of a professional in similar circumstances. In order for a malpractice claim to succeed in a court of law, all 4 of the following conditions must be met:
a. a professional relationship was established
b. there was a breach of duty--the therapist was negligent or services did not meet community standards
c. the client suffered physical or psychological injury
d. the injury was caused by the breach of duty
Professional liability insurance
This insurance is highly recommended. Several insurance providers are available.
The American Counseling Association sponsors a professional liability insurance program for members.
Different rates are available for counselors employed, counselors self-employed, and graduate students.
Family Educational Rights and Privacy Act of 1974 (FERPA)
This federal law is also referred to as the Buckley Amendment.
The intent of the act was to protect the privacy of individuals.
It allows parents of students under 18 years of age and students themselves, if they are at least 18 years old, access to information in their educational (not counseling) records.
Title IX of the educational amendments
This 1972 legislation bans sex discrimination in school (K-12 and colleges) in academics and athletics. The focus of this law has been mostly on providing women equal opportunities as men in sports. The same sports do not need to be available, but women must be provided the same proportional participation opportunities (same number of athletes, not number or kinds of teams).
Third party payment
This is reimbursement from an insurance company (3rd party) to a private practice counselor who provides services to a client insured by that company, usually through the client's employer.
Payment to master's level counselors, even if they are licensed, is not automatic.
Some counselors work under the general supervision of psychologists or psychiatrists and receive insurance reimbursement through them. Some private practice counselors will only see clients who can pay them directly and the client may or may not file for insurance reimbursement.
In some states, insurance laws have been changed so licensed counselors must be reimbursed by insurance companies for the treatment of certain mental illnesses.
Managed health care
refers to requirements promoted by insurance companies to reduce health care costs. It includes strict compliance with policies regarding diagnosis, treatment plan, record-keeping, etc.
Many mental health professionals including counselors, social workers, and psychologists, who choose to practice privately, apply for provider list status which are managed by Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs). Without such provider status, many potential clients cannot be referred to them.
Health Insurance Portability and Accountability Act (HIPPA)
This national law establishes standards for protecting the privacy of patient information in the health industry including psychotherapy records which include medication, treatment, diagnostic, and clinical test information. It regulated the transmission of client records and insurance claim information including that sent through electronic means. Clients must sign a document stating they have been informed of HIPPA rules.
Mental health clients must sign a release before their information may be shared with others. HIPPA alows them to inspect their records and request changes. Strictly general, summary counseling notes, not at all medical in nature, are not subject to HIPPA and require a separate release of information for disclosure.
Mental health parity
The federal law titled Paul Wellstone and Pete Domenici Mental Health Parita and Addiction Equity Act is now in effect. Private sector health plans covering 50 or more employees and state and local government plans (not self-insured) must now provide the same level of coverage to individuals with mental health and addiction issues as to individuals with medical and surgical issues. The law does not speak to providers of those mental health or addiction services.
TRICARE
allows active and retired military service members and their families to get services from licensed professional mental health counselors without first seeing a physician, getting a referral from a physician, and practicing under the supervision of a physician.
The Veteran's Administration (VA)
has approved the hiring of licensed professional mental health counselors, and if they have one or more years of mental health counseling experience, they are authorized to practice independently within the various VA institutions and its components.
Employee assistance counseling
Counselors who work in Employee Assistance Programs (EAPs) identify, counsel, and/or refer out troubled workers. Sometimes the EAP is located within the company and other times the company has a contract with an outside EAP provide.
Counseling program planning and development
The planning of a counseling program begins with conceptualization of the program, and then proceeds to development, implementation, and evaluation.
Critical steps in program planning include:
a. Conceptualize the system: Examine and understand the broader system in which the counseling program will be located.
b. Establish philosophy and assess needs: The general philosophy or mission of the counseling program must be established. An assessment of needs is a critical data gathering effort.
c. Develop goals and objectives of the counseling program: Goals are broad statements of the general intentions of the program. Objectives are specific, behavioral, and measurable, and based on the goals of the program. Goals and objectives are developed based, in part, on the needs assessment data collected.
d. Process information: Throughout the planning of the counseling program, a feedback loop of information should be in place to assure program development is proceeding appropriately, all steps are covered, etc.
e. Conduct a pilot study: If possible, a small scale pilot should be conducted in order to determine if development is on target, and any major problems may be uncovered before full-scale implementation.
f. Develop a plan: The plan is a roadmap guiding the development to assure the goals and objectives will be met. Personnel, facilities, resources, and money are part of the plan.
g. Implementation: Depending on how extensive the counseling program is to be, a plan and schedule for implementation, hiring, training and related issues must be developed.
h. Operate the counseling program: The doors open and clients make use of the services. Fine tuning of the procedures and services occurs.
i. Evaluate the program: This is the process of determining whether the goals and objectives established for the counseling program have been met.
j. Modify the counseling program: Depending on the data gathered in the evaluation process, the program will be modified, or perhaps, eliminated.
Needs assessment
A need is a discrepancy between what is and what is desired. A needs assessment measures these discrepancies. The actual form of the needs assessment may vary although a written questionnaire is often used. For efficiency and cost purposes, a needs assessment may be conducted electronically. However, needs assessments may also be conducted through interview and focus groups.
To insure validity of the needs assessed, random sampling is critical in order to get a representative response and accurate picture of the needs. The needs assessment process should be structured so the data gathered can be compiled, analyzed, and interpreted.
Counseling program management
Managing a counseling program requires the knowledge and skills that other management positions require. Management requires some or all of the following skills and activities:
a. Strategic planning: assessing the nature of the counseling program and what it might look like in the future.
b. Program design and development: in addition to goals and objective, performance objectives and standards must be designed or adapted from other similar counseling programs.
c. Budgeting: forecasting and resource allocation skills are necessary. Managing the budget is essential.
d. Personnel management: hiring and training staff and professional employees including attention to affirmative action issues.
e. Supervision: occurs at 2 levels. There must be program supervision as well as supervision of personnel around job performance and counseling skills.
f. Evaluation: necessary to determine whether the counseling program is meeting its goals and objectives and whether staff are meeting performance standards.
g. Marketing and public relations: successful program management includes developing and disseminating information about the counseling program, advocacy, fund raising efforts, etc.
Code of ethics
a profession's statement of standards as to what is right or wrong regarding professional behavior. A code of ethics comes from distilled wisdom of its members, cultural values and mores, and legal judgments and opinions.
Study the "ACA Code of Ethics." A number of ethical issues or dilemmas, which may be presented in vignette form, will appear on the NCE.
The NBCC Code of Ethics is available from NBCC. Since there is much overlap between the 2 codes, studying the ACA code is sufficient.
Principles underlying ethical decision making
Faced with the same ethical dilemma, different counselors might use different principles to guide them. The following principles have been identified as those which typically underlie an ethical decision made by counselors:
a. beneficence: doing good and preventing harm
b. nonmaleficence: not doing or inflicting harm
c. autonomy: respecting freedom of choice and self-determination
d. justice: fairness
e. fidelity: faithfulness and honoring commitments
A number of ethical decision making models have been proposed. A common thread includes the steps found in a problem-solving process. Obtaining consultation during this process is an important additional step.
Legal and ethical issues and dilemmas
State laws for counselor licensure usually incorporate many standards of practice from the "ACA Code of Ethics." In fact, many states now require that licensed counselors follow the "ACA Code of Ethics."
Professional Standards of Practice
a. Know what these standards are and apply them as well as you can. Read your state statue and the "ACA Code of Ethics."
b. Use some form of diagnostic system so you can assess the needs of clients and apply your services reasonably tailored to the needs of the clients.
c. Apply services which have a theoretical basis so you can justify the methods and techniques you use.
d. Your training and/or experience level must be consistent with the diagnostic system and theoretical methods and techniques you use.
e. Counselors must know and practice within their boundaries of competence based on such things as education, training, and supervised experience.
f. Be careful not to misrepresent your training or credentials.
g. Be prepared to terminate the relationship if your services are no longer helpful.
Ethical Standards of Practice
a. Subscribe to a professional code of ethics and operate accordingly.
b. Know what is ethical in terms of professional practice in your field.
c. Obtaining informed consent will prevent troubles later.
d. Let clients know in advance what you will do (such as break confidentiality) to different client disclosures.
e. For minors, you may need to get a guardian's consent before a counseling relationship can begin.
g. Let clients know if you are recording, receiving supervision, or are in a training program.
Sexual contact (Ethical Standards of Practice)
is not ethical. A hug or touch used appropriately may enhance therapy. Sexual attraction toward clients should be recognized, not acted upon, and may be a good reason to obtain consultation.
Sexual relationships between counselor educators and their students or supervisees are unethical.
Sexual contact is unethical if it occurs less than 5 years after therapy ends ("ACA Code of Ethics"). Some state laws mandate a different time period.
HIV/AIDS (Ethical Standards of Practice)
The "ACA Code of Ethics" indicates that counselors may be "justified" in telling a partner that a client is HIV positive or has AIDS if the client does not do so. No state law requires disclosure to a client's partner. Be sure to seek consultation.
Confidentiality (Ethical Standards of Practice)
Ethical practice requires confidentiality which is the basis of trust. You must recognize the limitations of confidentiality which include:
* serious and foreseeable harm to the client or others
* discussion with other counseling professionals who may be helpful
* discussion with superiors or instructor if the counselor is a student
* client requests counseling records be released
* a lawsuit is filed against you
* when a court orders it
* clerical personnel in the counseling office
* managed care providers and insurance companies
Dual relationships (Ethical Standards of Practice)
with clients may be exploitative because of the power differential and generally are not ethical. The referral process should be used to avoid dual relationships.
Sometimes dual relationships cannot be avoided. This may occur most frequently in small communities.
Examples: * The 17-year-old daughter of your office secretary wants counseling, and you are the only therapist for many miles.
* One of your clients joins the community fraternal organization to which you belong.
Engaging in more than one role (dual relationship) may be beneficial for the client and not unethical.
Examples: * You are invited to an important event in the client's life such as a wedding or funeral.
* You participate in a community event that is highly valued to the client such as a cultural festival or Gay Pride activity.
Diversity (Ethical Standards of Practice)
Counselors will be committed to increasing their knowledge, awareness, and sensitivity in order to work effectively with diverse client groups. Without adequate preparation, counseling such individuals may be unethical.
Some cultures may have customs and traditions which may require particular counselor sensitivity.
Example: * Giving a gift to the counselor is highly valued and refusing the gift may be very culturally insensitive.
* Confidentiality may be perceived differently within a collectivistic culture than in many other cultures.
Legal Standards of Practice
a. There is considerable overlap of legal and ethical practices in counseling. As licensure laws were formulated and passed by states, many ethical principles of the counseling profession were built into the law. There are some behaviors and practices that only the law addresses.
b. The law requires the reporting of abuse or suspected abuse of children who are under 18 years of age. In many states, reporting of abuse is also required when elderly or those with disabilities are involved.
c. Sexual contact between clients and counselors is illegal in most states.
d. The laws in some states allow counselors to put "holds" on clients for medical observation and assessment.
e. Legally, parents of minors have a right to know about matters pertaining to their children. Ethically, it might be helpful to the counseling relationship if the parents agree to the need for confidentiality. Under some circumstances, minors can enter counseling without parental consent.
f. "Privileged communication" is a legal right offered to counselors in most states, usually through licensure statutes.
g. Assigning diagnostic codes (or certain codes) to clients simply for insurance reimbursement purposes may constitute insurance fraud and is both unethical and illegal.
Ethical issues in group counseling
a. Informed consent: providing information (about rights and expectations) to prospective group members prior to the start of the group.
b. Confidentiality: group members have an ethical obligation to maintain confidentiality. However, confidentiality cannot be assured when there are multiple clients, and group members must be informed of that. Exceptions to confidentiality should be identified. Privileged communication (a legal concept) is ordinarily not applicable.
c. Social relationships: group members are discouraged from forming social relationships and discussing group issues in cliques or subgroups outside the group session. Discussion of this possibility should occur in the group and agreement should be reached as to how to deal with it.
d. Diverse groups: group leaders may need to discuss their values and their cultural assumptions. They need to respect cultural differences and world views of group members and model these behaviors for group members. Group members need to respect other members' diversity.
Ethical issues in family counseling
a. Counselor responsibility and values: who is the client--the family or each member of the family? Does the counselor align with the abused spouse? Or the neglected child? What if one spouse wants to divorce and the other wants to preserve the marriage?
b. Confidentiality and secrets: family members should discuss the limits of confidentiality. Will material brought up in individual sessions remain confidential or will "such secrets" be brought into the family session? Child abuse and incest must be reported.
c. Custody and other legal implications: diagnostic labels on family members could be used in court later. What will be the counselor's role or how will the counselor's information be used in child custody hearings? Who is the client?
d. What is the counselor's perception of the role of women in families? Does the counselor espouse traditional gender roles?
e. Role values and expectations: There are many issues in counseling with families that
are different culturally. What are the family roles and dynamics in that culture?
Chi Sigma Iota
This is the Counseling Academic and Professional Honor Society International begun in the 1980's under the leadership of Thomas Sweeney. The purpose of Chi Sigma Iota is to promote scholarship, research, professionalism, and excellence in counseling. Members are students, educators, and counseling practitioners.
There are over 55,000 members in more than 260 chapters in the US and abroad. Another function of Chi Sigma Iota is the development of leaders in the field of counseling.
American Counseling Association
ACA consists of 19 divisions. Many divisions and ACA have agreed that counselors may be members of a division and not be required to join ACA. There are 19 chartered divisions in ACA. ACA has over 50 chartered branches in the US and in many international territories and regions with a total membership of over 45,000.