National Academies Press: OpenBook
Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×

PROVISION OF MENTAL HEALTH COUNSELING SERVICES UNDER TRICARE

Committee on the Qualifications of Professionals Providing Mental Health Counseling Services Under TRICARE

Board on the Health of Select Populations

INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.
www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×

THE NATIONAL ACADEMIES PRESS
500 Fifth Street, N.W.
Washington, DC 20001

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This study was supported by a contract between the National Academy of Sciences and the US Department of Defense via HHS award HHSP23320080006T, TO#24. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

International Standard Book Number-13: 978-0-309-14766-8

International Standard Book Number-10: 0-309-14766-2

Additional copies of this report are available from the

National Academies Press,

500 Fifth Street, NW, Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu.

For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu.

Copyright 2010 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

Cover credit: Image © Neville Elder/Corbis.

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

Suggested citation: IOM (Institute of Medicine). 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×

“Knowing is not enough; we must apply.

Willing is not enough; we must do.”

—Goethe

INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES

Advising the Nation. Improving Health.

Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine


The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.


The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.


The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.


The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.


www.national-academies.org

Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×

COMMITTEE ON THE QUALIFICATIONS OF PROFESSIONALS PROVIDING MENTAL HEALTH COUNSELING SERVICES UNDER TRICARE

GEORGE J. ISHAM (Chair), Medical Director and Chief Health Officer,

Health Partners, Inc., Bloomington, Minnesota

KATHRYN K. BASHAM, Professor,

Smith College School of Social Work, Northampton, Massachusetts

ALISA B. BUSCH, Assistant Professor of Psychiatry and of Health Care Policy,

Harvard Medical School and McLean Hospital;

Director of Integration of Clinical Measurement and Health Services Research,

McLean Hospital, Belmont, Massachusetts

N. EMMANUEL G. CASSIMATIS, President and CEO,

Educational Commission for Foreign Medical Graduates, Philadelphia, Pennsylvania

JOHN H. MOXLEY III, Independent Consultant,

Solvang, California

HAROLD A. PINCUS, Professor and Vice Chair,

Department of Psychiatry and

Associate Director,

Irving Institute for Clinical and Translational Research, Columbia University;

Director of Quality and Outcomes Research,

New York Presbyterian Hospital, New York, New York

THEODORE P. REMLEY, JR., Professor and Batten Endowed Chair in Counseling,

Department of Educational Leadership and Counseling, Old Dominion University, Norfolk, Virginia

PHYLLIS W. SHARPS, Professor and Chair,

Department of Community Public Health Nursing, Johns Hopkins University School of Nursing, Baltimore, Maryland

ROY A. SWIFT, Senior Director,

Personnel Credentialing Accreditation Programs, American National Standards Institute, Washington, DC

VILIA M. TARVYDAS, Professor,

Counseling, Rehabilitation, and Student Development, College of Education, University of Iowa, Iowa City, Iowa

Consultant

RHONDA J. ROBINSON BEALE, Chief Medical Officer,

OptumHealth Behavioral Solutions, Glendale, California

Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×

Program Staff

DAVID A. BUTLER, Senior Program Officer; Study Director

JESSICA L. BUONO, Research Associate (until August 2009)

SARAH GAILLOT, Christine Mirzayan Science and Technology Policy Fellow

ANDREW BRADLEY, Intern

TIA S. CARTER, Senior Program Assistant

PAMELA RAMEY-MCCRAY, Administrative Assistant

FREDERICK (RICK) ERDTMANN, Director,

Board on the Health of Select Populations and Medical Follow-up Agency

NORMAN GROSSBLATT, Senior Editor

Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×

Reviewers

This report has been reviewed in draft form by persons chosen for their diverse perspectives and technical expertise in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of the independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards of objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We thank the following for their review of the report:

Paula G. Allen-Meares, Chancellor, University of Illinois at Chicago

Dwight L. Evans, Chairman, Department of Psychiatry, University of Pennsylvania School of Medicine

Samuel Templeman (Sam) Gladding, Professor and Chair of Counseling, Wake Forest University

Sharon M. Goldsmith, President, Goldsmith International SP

Michael A. Hoge, Professor of Psychology and Director, Yale Behavioral Health, Yale University

Kevin C. Kiley, Associate Professor and Chairman of the Department of Obstetrics and Gynecology, Albany Medical College

Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×

Janice L. Krupnick, Professor of Psychiatry and Director, Trauma and Loss Program, Georgetown University

Richard A. McCormick, Consultant, Clinical Psychologist, and Senior Scholar, Center for Health Care Research and Policy, Case Western Reserve University

Robert J. Ursano, Chair, Department of Psychiatry, Uniformed Services University of the Health Sciences

Myrna M. Weissman, Professor of Epidemiology and Psychiatry, Columbia University College of Physicians and Surgeons, and Chief, Department of Clinical-Genetic Epidemiology, New York State Psychiatric Institute

Reg Arthur Williams, Professor of Acute, Critical and Long Term Care Programs, School of Nursing and Professor of Psychiatry, Medical School, University of Michigan

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of the report was overseen by Dan G. Blazer, J.P. Gibbons Professor of Psychiatry, Duke University Medical Center, and Paul S. Appelbaum, Elizabeth K. Dollard Professor of Psychiatry, Medicine, and Law, Columbia University. Appointed by the National Research Council and the Institute of Medicine, they were responsible for making certain that an independent examination of the report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of the report rests with the authoring committee and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×

Acknowledgments

This report could not have been prepared without the guidance and expertise of numerous persons. Although it is not possible to mention by name all those who contributed to the committee’s work, the committee wants to express its gratitude to a number of them for their special contributions.

Sincere thanks go to all the participants at the public meetings convened on April 9 and July 7, 2009. The intent of the workshops was to gather information regarding issues related to the practice of mental health counselors in various care setting. The speakers, who are listed in Appendix A, gave generously of their time and expertise to help inform and guide the committee’s work. Many of them also provided additional information in response to the committee’s myriad questions.

We are indebted to Rhonda Robinson-Beale, who served as a consultant to the committee and who shared her deep knowledge of the provision of mental health–care services in managed-care settings.

The committee extends special thanks to the dedicated and hardworking staff of the Institute of Medicine’s Board on the Health of Select Populations, who supported and facilitated its work. Board Director Rick Erdtmann helped to ensure that this report met the highest standards of quality.

Finally, the committee members would like to thank the chair, George Isham, for his outstanding work, leadership, and dedication to this project.

Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×

This page intentionally left blank.

Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×

3

 

REQUIREMENTS RELATED TO THE PRACTICE OF COUNSELING

 

91

   

 The Profession of Counseling,

 

91

   

 Accreditation of Counselor Educational Institutions,

 

103

   

 Means of Professional Recognition,

 

112

   

 Licensing,

 

113

   

 Certification by Standards Associations,

 

127

   

 Recognition of Third-Party Certifications by the Department of Defense,

 

131

   

 Credentialing and Privileging,

 

132

   

 References,

 

144

4

 

INDEPENDENT AND SUPERVISED PRACTICE OF COUNSELORS IN OTHER HEALTH–CARE SYSTEMS

 

149

   

 Independent and Supervised Practice Under Other Federal Programs,

 

149

   

 Independent and Supervised Practice Under the Federal Employee Health Benefits Program,

 

155

   

 References,

 

164

5

 

RESEARCH REGARDING THE DETERMINANTS OF HIGH-QUALITY MENTAL HEALTH CARE

 

167

   

 General Concepts of Health–Care Quality and “Evidence-Based Practice,”

 

168

   

 Evidence-Based Practice for Psychosocial Interventions to Address Clinical Issues of Special Relevance to the TRICARE Population,

 

176

   

 Empirical Evidence Regarding Distinctions Between the Practice of Counselors and the Practice of Other Mental Health Professionals,

 

182

   

 Strategies for Monitoring and Improving the Quality of Behavioral Health Care,

 

183

   

 Barriers to Implementing Clinical and Systems Quality-Improvement Strategies,

 

193

   

 Quality-of-Care Initiatives in TRICARE and the Military Health System,

 

194

   

 Observations,

 

197

   

 References,

 

197

Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×

This page intentionally left blank.

Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×
Page R1
Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×
Page R2
Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×
Page R3
Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×
Page R4
Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×
Page R5
Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×
Page R6
Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×
Page R7
Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×
Page R8
Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×
Page R9
Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×
Page R10
Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×
Page R11
Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×
Page R12
Page xiii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×
Page R13
Suggested Citation:"Front Matter." Institute of Medicine. 2010. Provision of Mental Health Counseling Services Under TRICARE. Washington, DC: The National Academies Press. doi: 10.17226/12813.
×
Page R14
Next: Summary »
Provision of Mental Health Counseling Services Under TRICARE Get This Book
×
Buy Paperback | $70.00 Buy Ebook | $54.99
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

In this book, the IOM makes recommendations for permitting independent practice for mental health counselors treating patients within TRICARE--the DOD's health care benefits program. This would change current policy, which requires all counselors to practice under a physician's supervision without regard to their education, training, licensure or experience.

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    Switch between the Original Pages, where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text.

    « Back Next »
  6. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  7. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  8. ×

    View our suggested citation for this chapter.

    « Back Next »
  9. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!