My last post was about the diplomas. Now, I’d like to tell you more about objects that are hung nearby. These are the licenses.

The first one, strictly speaking is not a license, it’s a certification. It’s a document that attests that I am a Credentialed Alcoholism and Substance Abuse Counselor, or CASAC.


Most people don’t know the difference between a license and a certification. A license gives me permission to set up an office as a counselor. In the substance abuse field in New York, individuals don’t have licenses. Substance abuse treatment is very highly regulated by the state and they only give out licenses to big clinics that they can regulate more thoroughly. The certification is supposed to verify that I know how to provide treatment, but it doesn’t give me permission to actually provide it outside of a licensed clinic. Luckily, I am able to set up an office as a counselor because of a different license.

Even though the CASAC is not worth much to me now, it was a hard thing to get. I had to complete a long training program, thousands of hours of supervised experience, take a test, get fingerprinted, pay a bunch of money, and present a case to a panel of judges. The last part was the hardest. I flunked the orals two or three times before I passed. The final time, on Halloween, I walked in and one of the judges was already wearing his costume, a Star Trek uniform. I took the hint that I was taking the judges far too seriously and I would do better if I dumbed it down a bit. Later, I took the course to become an examiner myself and found that when I had been trying to blow them away with my sophisticated erudite formulations; I was blowing myself away; or, shall we say, blowing myself. They were looking for simple answers. Substance abuse treatment in those days was all about simple answers to a very complex problem.

I’m happy to say that substance abuse treatment and substance abuse counselors have changed since then. It used to be that you barely needed training to enter the field. The strongest qualification was that you had a problem with alcohol or drugs yourself. No wonder they didn’t want to give them licenses.

The true license I have on my wall is one to be a Mental Health Counselor, or LMHC.


This is the meaningful one that allows me to practice my profession. Ironically, it wasn’t hard to get at all. The New York State Legislature created the profession after I had already been in the field many years, working under the license of a community mental health clinic. I got grandfathered in. I understand people who get an LMHC these days have to go through a lot to get it, as much as I did for the CASAC, minus the oral exam.

The law obligates me to display my license, so that’s why it’s up on the wall; but I’m not sure how I feel about it. I’m not ashamed that I have one; I’m ashamed I participate in licensing. You see, the purpose of any license is to keep people out of a profession, so the people in the profession can charge more for their services. If this sounds like a big racket, it is; except that it protects the tremendous investment of time and money counselors must make to learn to perform their skills well.

People in favor of licensing are always going on about how it protects the consumer from people who say they know how to do counseling, but don’t, really. I’m not sure I buy that. Just because you’ve been taught how to do counseling, doesn’t mean you actually do it well.

The license gives me permission to call what I do counseling or psychotherapy. If I didn’t have a license, I could still do counseling or psychotherapy, I just couldn’t call it that. I would call it something else, like coaching. You can get some perfectly good counseling or psychotherapy from a person who calls himself a coach and isn’t licensed and hasn’t gone through all the rigamarole I did. Can you trust that your coach is competent? I don’t know, but I don’t suppose she would be in business long if she isn’t and the word spread. A licensed counselor, on the other hand, could stay in business as long as he doesn’t do anything blatantly unethical, even if he is incompetent because people would trust him, anyway; he has a license.

The CASAC is an interesting case. If all I had was a CASAC, I would be certifiably competent to counsel people about their alcohol and drug use, but I wouldn’t have permission to call it counseling. Try to wrap your head around that one. If you can, then I think you’d be a lawyer; but I believe you’d have to graduate from law school to be able to call yourself one.

Published by Keith R Wilson

I'm a licensed mental health counselor and certified alcohol and substance abuse counselor in private practice with more than 30 years experience. My newest book is The Road to Reconciliation: A Comprehensive Guide to Peace When Relationships Go Bad. I recently published a workbook connected to it titled, How to Make an Apology You’ll Never Have to Make Again. I also have another self help book, Constructive Conflict: Building Something Good Out of All Those Arguments. I’ve also published two novels, a satire of the mental health field: Fate’s Janitors: Mopping Up Madness at a Mental Health Clinic, and Intersections , which takes readers on a road trip with a suicidal therapist. If you prefer your reading in easily digestible bits, with or without with pictures, I have created a Twitter account @theshrinkslinks. MyFacebook page is called Keith R Wilson – Author.

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