(Commentary written while director of advocacy nonprofit bemoaning state’s plan to quickly train therapists in Cognitive Behavioral Therapy while requiring much more extensive training for cosmetologists.)
Thank you, thank you, thank you is all I have to say to the folks at the Department of Health and Human Services responsible for implementing Cognitive Behavioral Therapy as part of mental health services now offered in North Carolina and paid for by Medicaid.
Certainly having CBT incorporated into treatment is reason for thanks. The evidence-based therapy that’s provenso effective in treating depression, post-traumatic stress and other mental health conditions has been a godsend to many families over the years.
And now in including CBT – well, sort of – in Medicaid billable services, DHHS has also exposed
the myth perpetuated by many private psychologists that long-term education and training is required to be proficient with the therapy. Heck, the state requires infinitely more training and expertise for its cosmetology instructors than it does for its CBT instructors.
To instruct cosmetology students, an individual has to have practiced for five years or completed at least 800 hours of cosmetology teacher curriculum in an approved school. And, of course, you have to have a cosmetology license, which entails 1,500 hours of curriculum and another 1,500 hours training with mannequins and live models.
Under current Medicaid definitions, to practice Cognitive Behavior Therapy a person must be a professional and take a 24-hour course. And to instruct CBT to others, you have to be a professional and take a 24-hour course. No tests, no mannequins, no models. Actually, requirements as written now would allow professional cosmetology instructors who take a 24-hour CBT course to teach both cosmetology and CBT. Just think of it: one instructor who can train others to help you look good and feel good, too.
The trainings, “Cognitive Behavior Therapy: Use It and Teach It,” are offered through the LMEs NC Council of Community Programs. The target audience is listed as social workers, psychologists, counselors and licensed substance abuse professionals. But training therapists to be proficient in CBT in just 24 hours, a task that’s taken private psychologists many, many more hours of study, just seems akin to a podiatrist giving training on the latest brain surgery techniques or a brain surgeon offering the latest in foot care.
While it might all seem nonsensical, consider that now DHHS gets to tout that it’s offering yet another evidence-based therapy. And since it just takes 24 hours not only to learn it but to learn to teach it, CBT “therapists” can multiply faster than rabbits at an oyster bar.
It’s a sham, pure and simple. It’s outrageous. To so corrupt an evidence-based practice that has the power to so positively impact people’s lives is reprehensible. And it redefines absurdity when a state government requires infinitely more expertise of those who work with what’s on your head than those who work with what’s in your head.