There’s a regrettable trend emerging in behavior health (mental health and substance use disorder[i]) that non-clinical professionals should be licensed.
Proponents generally argue:
(1) that certain non-clinical practitioners (specifically, peer support specialists under a multitude of confusing titles, including – erroneously, if popularly – “recovery coaches”) cannot be trusted to stay within their role boundaries in a service environment where organic course correcting mechanisms are presumed not to exist;
and
(2) there’s no difference between “licensing” (clinical scope of practice) and “certification” (voluntary confirmation of non-clinical competence). In reality, the former is mandatory where applicable. The latter is always voluntary, although professionals may be encouraged into becoming certified by external factors such as eligibility for Medicaid-billable services (e.g. “CRPA” certification in NYS[ii]).
In sum, a license describes (circumscribes) what I’m permitted to do by law. A certification, by contrast, confirms what I’m capable of doing as a competent professional.
Which is appropriate? That depends on the purpose of the professional practice – is it clinical (medicine, etc.) or non-clinical (coaching)? This distinction is summarized by the INTERNATIONAL CERTIFICATION & RECIPROCITY CONSORTIUM(IC&RC) which has developed a wide range of licenses and certifications applicable in the behavioral health field (https://tinyurl.com/ICRC-lic-cert): “A license is a state’s grant of legal authority to practice a profession within a designated scope of practice. Certification represents the achievement of a level of professional competency.”
So what do non-clinical behavioral health professionals do? And should they be licensed or certified?
Peer recovery support specialists “boost individuals’ engagement in treatment and commitment to recovery; [and] connect patients to community-based recovery supports consistent with treatment, recovery, and discharge plans.” (NYS Office of Addiction Services and Supports[iii]) OASAS proceeds to list a number of specific tasks which may be summarized as engaging in purposeful non-clinical conversation.
The coaching industry’s International Coaching Federation (ICF), meanwhile, defines what coaches do as: “partner with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential.”[iv] A non-clinical practice.
Conversation? Free speech between consenting adults. There’s a constitutional amendment to protect that!
Non-clinical? Nothing to license. But the public, clients and employers, and other stakeholders (including taxpayers contributing to Medicaid reimbursements), will appreciate a certification of role competence as a measure of the credibility and accountability of any professional.
Let’s be very careful what we wish for in our non-clinical practice: confirmed competence and credibility (certification)–YES! Censorship for our conversations (license)–NO!
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[i] American Medical Association https://tinyurl.com/AMA-behavioral-health-2022
[ii] Centers for Medicare & Medicaid Services https://tinyurl.com/DHHS-CMS-2007
[iii] NYS OASAS https://oasas.ny.gov/recovery/become-certified-recovery-peer-advocate
[iv] ICF https://coachingfederation.org/
