In a previous post, we discussed the required hours of supervised experience for psychotherapist licensure and the history of that requirement. In this post, we examine the ever-growing educational requirements for a master’s degree that leads to licensure as family therapist, clinical social worker, or counselor.
Those educational requirements are generally established by accrediting bodies. The accrediting bodies for the master’s level mental health professions include:
- Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE)
- Council on Social Work Education (CSWE)
- Council for Accreditation of Counseling & Related Educational Programs (CACREP)
If your degree comes from an accredited program, it typically will qualify you for licensure within that profession. Some state licensing boards use their own standards instead for some license types (hello, California MFTs), but most defer to current accreditation standards. If you graduate from a program that isn’t accredited by one of the groups listed above, you may still qualify for licensure if you can demonstrate that your program was equivalent to an accredited one, or if your state otherwise allows non-accredited degrees. (You also may not; exact rules vary by state and license type.) Demonstrating that equivalency can be simple or highly complicated, depending on the program and the state. In any case, getting licensed means meeting minimum degree requirements.
Those requirements have grown significantly. In the 1980s, a student was typically required to complete at least 36 semester units of coursework for their master’s degree to qualify them for licensure. Today, that number has nearly doubled to 60 total units. Combined with tuition inflation, which has grown faster than general inflation in the economy and even faster than inflation in health care prices, the increased educational requirements have meant that even in inflation-adjusted dollars, it costs about five times as much today as it did in the 1980s to complete the minimum graduate degree necessary for master’s-level licensure.
Why the unit requirement grew
Ideally, the number of units would have been changed to account for new information or practices relevant to each particular profession. As new methodologies arise, new courses are created, and curriculum requirements for students are adjusted to include for the new courses.
The reality, however, is more complicated. This is one of those areas where a lot of economic and political incentives point in the same direction.
The professions do compete in some ways, with each looking for ever-greater employer and payor recognition. So professional accrediting bodies are incentivized to make their profession look like the best-trained at the master’s level, creating a constant race upward. If one accrediting body raises its unit requirement, the others will likely soon follow.
Graduate programs typically don’t protest this growth in requirements, because the result is that they get more tuition money, more faculty hires, and the greater prestige associated with a newly-more-demanding degree program.
Students are typically told that this makes for better training, despite the significant added cost. And of course, students have no choice but to go along if they intend to get licensed.
To be fair, accrediting bodies do follow a formal process for reviewing and adjusting educational requirements. They collect a great deal of information from accredited programs about how well current standards are working, and what adjustments need to be made. Unfortunately, however, few of those involved have any incentive to fight to keep requirements down, or even stable. Pushing for the removal of some required content means fighting with entrenched interests in any profession. It’s a lot easier to simply add.
The high cost of no data
There is currently not any data linking higher educational standards with improved therapy outcomes. Indeed, there is no data to suggest that master’s-level therapists are more effective with 60-unit degrees than they were at 36. Without this data, decisions are being made that are driving the continual addition of coursework without the modification or removal of others. These increased requirements, although well intentioned, have negative impacts on students in both the time spent to complete schooling and, for most, student loan debt.
There is an obvious and growing need for data more concretely linking clinical performance with educational requirements for master’s level therapy degrees. The upward race in requirements can only go so far before students decide that they would rather avoid the licensure process entirely.