Counseling vs Psychotherapy in Israel: Current Status

About 123 years ago, Sigmund Freud, a neurologist, developed a method of therapy named "psychoanalysis" that left its mark on psychiatry and psychology and spread throughout the world. Following Freud's doctrine, mental health services adopted the biomedical model in 1952. As a result, the first edition of the Diagnostic and Statistical Manual of Mental Disorders – DSM was developed and classified 60 mental disorders based on their symptoms. Seeing human beings through the psychiatric diagnostic categories of mental illness is still prominent in Israel. An increasing proportion of the population will continue to be included in the failed classification framework in its fifth edition DSM-IV focused on the myth of psychiatric illnesses.

For example, nowadays, we know that same-gender sexual orientation per se is not pathogenic. However, homosexuality was classified as a mental disorder named "sociopathic personality disturbance" until 1973 in the DSM and until 1975 by the American Psychological Association – APA. However, the social stigma is still prominent and explains the high rates of psychopathology among LGBTQ even in western countries such as Israel and the United States.

Fortunately, a psychologist named Carl Rogers dared to present a humanistic approach in his two revolutionary books – "Counseling and Psychotherapy: New Concepts in Practice" and "Client-Centered Therapy." Rogers consciously chose the terms "counseling" and "client" more than 70 years ago, not to distinguish between counseling and psychotherapy, which are pretty similar, but to liberate the treatment of the human psyche from the medical-pathological model (De-Pathologizing) in favor of a legitimate and valid response to both developmental and human beings' physiological needs throughout the lifespan.

This approach, identified as humanistic psychology, led to the development of the profession of counseling and the establishment of the American Association for Counseling – ACA in 1952, which remains the largest professional body in the world that strives to establish the professional identity of counseling. As a result, the definition of counseling has gained broad consensus and is defined as follows:

"Counseling is a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals."

Counseling as a profession in the U.S. enables counselors and psychologists who have completed their doctoral studies to become full members of the Counseling Psychology Division of the American Psychological Association (Originally named "The Counseling and Guidance Division") In the State of Israel, the Council for Higher Education – CHE, approved in 2003 studies in psychology at colleges, including clinical psychology, without thesis. Even non-therapeutic/clinical expertise, in its essence, enables the provision of psychotherapy within the framework of the law (e.g., occupational-organizational-social psychology).

In the U.K., the terms counseling and Psychotherapy are grouped under one unified organization named: BACP – The British Association for Counseling and Psychotherapy, and their job definition is well established:

"Counsellors and psychotherapists play a crucial role in improving the health and well-being of our society. They help people talk about their feelings, think about their choices or behavior, and make positive changes in their lives".

In Australia, counseling and educational psychology are grouped in a joint national trade union of over 1000 members: APACS – The National Professional Association for School Psychologists, School Counsellors, and Guidance officers in Australia.

In 1966, the International Consulting Association – IAC, was founded, to establish the counseling profession, which has been defined as follows:

"Counselling changes lives for the better and reduces suffering. IAC advances the development of counseling to improve people's lives and well-being".

In 1992, the European Association for counseling – EAC was founded, and the state of Israel is represented by the Israeli Association for Therapeutic Counseling (ILAT), which defines counseling as follows:

"Counseling is essentially a humanistic psychotherapy centered on the person and aimed at helping him in the various conflicts that arise in the various stages of life and the variety of life cycles while maintaining human dignity and cultural values."

At the same time, in Israel, counseling was not officially recognized as a profession that stands on its own despite the influence of psychology on the development of educational counseling. In any case, counseling cannot be defined as "Counseling psychology" since the term "Psychology" is reserved in Israeli law for psychologists, and other professionals, including related mental health professionals, can't claim to be Counseling psychologists, as opposed to the case of the United States.

In 1964, a new profession called "Educator – Counselor" emerged in Israel. This historical term is related to the declaration of the Deputy Minister of Education, Ami Assaf, that "the educational guidance should be a constant and prolonged process for helping an individual by teachers who will be trained for the position of "Educator – Counselor." Indeed, in 1968, 43 teachers were trained to engage in counseling.

In 2023, the number of educational counselors in Israel who work for the Psychological and Counseling Service in the Ministry of Education stands at about 7077 people. The Ministry of Education's requirement that the educational counselor also serves as a teacher does not stem from a professional-counseling or pedagogical worldview but is intended to ensure that Educational counselors can complete their part-time positions by teaching (Even supervisors in educational institutions in Israel usually meet the broad and simple definition, "teaching staff"). As part of the "Ofek Hadash" and "Oz Le Tmura" reforms, the term "Educator – Counselor" was changed to the educational counselor.

Since 2005, all educational counselors in Israel have been required to have at least a master's degree in educational counseling (M.A. or MEd) from an academic institution recognized by the Council for Higher Education – CHE, and with a teaching certificate as a prerequisite for their employment (Director General Circular 7(a) 2002). Following the U.S., the research universities in Israel have abolished the requirement for a teaching certificate. The candidates for a master's degree in educational counseling do indeed reach advanced studies from all faculties, including social sciences. However, the demand for advanced studies does not exist in a therapeutic profession such as social work, nor is it raised in any healthcare para-professions in Israel. The legislature had determined that the requirement of a bachelor's degree, i.e., a graduate in social work (B.A. or BSW) and registration in the register of social workers in the Ministry of Social Affairs, enable social workers to practice "counseling, psychotherapy, rehabilitation, and guidance to improve the personal and social functioning of the individual, families, and the community. However, the legislator had not defined what counseling means? What is Psychotherapy? What is rehabilitation? What is guidance? In addition, the law does not refer to the requirement for expertise in various fields (clinical, medical-rehabilitation, educational, social-community).

Even the term so commonly used by the masses, "clinical social worker" – borrowed from the English language "Licensed Clinical Social Worker – LCSW," had never received any reference in Israeli law or even in the procedures of the Social Work Association. Social work remains integrative (professional practice at all levels: individual, couple, family, group, systemic, and multi-systemic). The magic term "clinical" was added to almost all areas of study for a master's degree in social work at the University of Haifa, for example, "Health and rehabilitation – clinical," so who is a clinical social worker in Israel and who is not?

The Professional Ethics Committee of the Association of Social Workers in Israel addressed the issue and ruled in 2017 as follows:

"In the absence of a clear definition in the law and objective procedures that would confirm the title of clinical social worker, this title cannot be indicated next to the employee's name."

From: "Addition and clarification to the review of the discussions of the Professional Ethics Committee of the Association of Social Workers in Israel."

It is no coincidence that the Bob Shapell School of Social Work at Tel Aviv University had determined that the three-year master's degree program in social work – MSW will be in integrative approaches to therapeutic interventions. All graduates of the master's degree in social work receive the same certificate of completion in all tracks (and the track is not listed on it). It should be emphasized that the Social Workers Law – 1996 was not accepted by psychologists, who strongly opposed it due to a fear of overlap between their bodies of knowledge and those of the social workers. As a result, the term "clinical" would have interfered with the legislative maneuver. However, "clinical criminologist" is part of the Israeli law for "The Regulation of the Practice of Health Professions – 2008", amended in March 2010.

Adding the term "therapeutic/clinical" is not a unique practice for social work. The education system tends to label "teaching" and "small classrooms" as "therapeutic" when dealing with excluded students in a learning environment that presents them with obstacles and barriers to the great extent of the lack of accessibility accommodations. The Ministry of Education has instilled the terms "Deficiency" and "Therapeutic Classroom" in an unprofessional manner to exclude students and relinquish responsibility.

Regarding psychologists in Israel, whose training is highly selective and demanding, are entitled, based on the amendment of the Psychologists Law, to provide mental health care (psychotherapy) even if they are not clinical psychologists but within the limits of other recognized expertise: educational psychology, Social-Occupational-Organizational psychology, Rehabilitation psychology, medical psychology, and developmental psychology. Despite the amendment, the psychology of sports still needs to be legally addressed, and as a result, this expertise still needs to be recognized in Israel. Even psychologists, while in the stages of internship and at the beginning of their professional careers, are legally allowed to provide mental health care as long as they receive professional guidance. A psychologist in the State of Israel is not a "prescriber" as opposed to a Doctor of Medicine M.D.

So, similar to social work and educational psychology, educational counseling belongs to the helping professions and unquestionably answers, by definition, Mental health-related professions. The educational counselors provide psychotherapy, counseling, and guidance to students, their families, and a multidisciplinary team, on various issues and problems in the academic, developmental, educational, social, emotional, and occupational aspects of students as an integral part of their work routine.

Indeed, the 14 master's degree programs in educational counseling in Israel focus on developmental psychology, cognitive psychology, social psychology, psychopathology, psychopedagogy, personality theory, short-term counseling, intervention in crises, parental guidance, group facilitation, professional ethics, a basis for the work of the educational counselor with a wide range of populations. In addition, individual counseling and individual psychotherapy are similar and overlapping and are significantly reinforced throughout the educational counseling curriculum in academic institutions in Israel.

The Israeli Association for Couples and Family Therapy, founded in 1977, recognizes a master's degree in educational counseling as a therapeutic degree identical to those in other professions: psychology, social work, expressive and creative therapy, clinical criminology, and medicine. The "educational counseling," indeed, allows at the end of the training process to receive certification subject to meeting all the criteria of the Israeli Association for Couples and Family Therapy in the same way as other therapeutic professions.

To the Israeli Association for Cognitive Behavioral Therapy – ITA, the only organization in Israel that is a member of the European Association for CBT Treatments called:

EABCT – European Association for Behavioral and Cognitive Therapies

Educational counselors are accepted as members, subject to compliance with all the criteria, including a two-year CBT curriculum recognized by the Association and providing Psychotherapy under the guidance of an "expert member–instructor." However, educational counselors, by their professional definition, are obligated, categorically and without affiliation with any particular trade union, to a master's degree (M.A. or MEd), from an academic institution recognized by the Council for Higher Education – CHE.

Educational counseling is sometimes translated into School Counseling. Still, the Council for Higher Education (CHE) was required to address the issue in light of the recommendation of two professors – one a social psychologist – Prof. Moshe Israelashvili at Tel Aviv University, and the other an educational psychologist, Prof. Nir Madger, Bar-Ilan University, paragraph 11.1.2022:

"The English name of the program will remain Educational Counseling for the following reasons: The names of most of the related programs in other academic institutions, except one institution, are called Educational Counseling. In addition, since the master's degree program in educational counseling at the College of Management is also suitable for those who choose to engage in educational counseling in informal frameworks (i.e., outside of schools), it has been decided to accept the institution's argument that it is correct to leave the name as it is."

Although the CHE ruling has not received any public visibility and resonance, it is fascinating. However, the educational counselor in Israel, like the School Counselor in the United States, is currently required, in contrast to the theoretical studies in psychology and the practical training in therapy, including an internship under the guidance of two trainers of counselors for two years in two different Settings for multi-system work that includes:

Consultation of the multidisciplinary team.

Educators training in implementing a life skills program that has existed for 30 years and is now in its updated version – Social-Emotional Learning (SEL).

Development and operation of developmental and preventive programs Program-Managing at the school level – reducing violence and risk behaviors.

Coordination between complementary roles inside and outside the school.

Removing learning barriers and improving the achievements of all students while being committed to accountability.

These requirements leave no time nor resources for the educational counselor, the mental health agent in the education system, to counsel students in emotional distress, especially during their adolescence (late elementary to late high school). The "service gap" – the number of students needing psychological assistance compared to the prevalence of those who turn to it as a source of professional and formal aid, will not narrow. To this, it should be added that for counseling to be relevant and accessible in a changing society and the postmodern era, it must also be online, anonymous, and available to all students on the Internet. One of the challenges educational counselors face is overcoming their research phobia and technophobia.

The multi-system model, which adds to the counselor's role, the school's organizational development, and the demand for proactive leadership that promotes social justice, is unrealistic. The processes of assimilating the systemic paradigm in the work of educational counselors from the 90s for more than three decades have remained between myth and reality at the level of the Official definition of the role of the counselor in psychological-counseling services. The transition from counseling to individuals in distress to indirect counseling for the school as an organizational unit and for the community has nothing to do with the essence of educational counseling but instead with relying on the research that shows that the reduction of school bullying in educational institutions requires that the object of intervention be the entire school – teachers, students, and parents. However, Educational counseling in Israel has developed as a profession utterly detached from the school system. For many years the management of the Counseling Division has encouraged the autonomy of educational counselors to choose their fields of practice, which until now is linked to the essence of counseling to which the renowned American psychologist Carl Rogers referred more than 70 years ago.

Now that you have a robust research-based foundation, you can consciously and attentively choose whether to receive advice regarding your well-being from an art therapist? From an occupational psychologist? or a social worker? From a psychiatrist or an educational counselor?

The same old lady in a new dress?

Eyal Ben Ami

Cognitive Behavioral & Acceptance and Commitment Psychotherapist – Independent Practitioner.
M.A. (Magna Cum Laude) Educational Counseling, Tel-Aviv University.

References‏

Akos, P., & Duquette, K. (2022). Trends and Changes in School Counselor CACREP Standards in the United States. Journal of School-Based Counseling Policy and Evaluation, 4(1), 1-10. https://doi.org/10.25774/aa2n-z983

Erhard, R., & Sinai, M. (2022). Subjective Wellbeing of Israeli School Counselors: Personal and Environmental Explaining Variables. International Journal for the Advancement of Counselling, 1-22. https://doi.org/10.1007/s10447-022-09487-9

Heled, E., & Davidovitch, N. (2022). School Counseling during the COVID-19 Crisis — From Crisis to Growth. Journal of Education and Learning, 11(1), 28-39.

https://doi.org/10.5539/jel.v11n1p28

‏Heled, E., & Davidovitch, N. (2022). On the Association between Academic Studies and Professional Training–The Case of School Counseling: Do Academic Studies Train School Counselors for Their Work, as Perceived by Them Retrospectively? International Journal of Higher Education11(1), 160-174. https://doi.org/10.5430/ijhe.v11n1p160

Heled, E., Ukrop, S., & Davidovitch, N. (2022). Between Academia and the Field: The Case of School Counselling Effectiveness of School Counselling Training and Its Impact on Professional Identity. International Journal of Higher Education, 11(6), 1-17. https://doi.org/10.5430/ijhe.v11n6p1

Lambie, G. W., Stickl Haugen, J., Borland, J. R., & Campbell, L. O. (2019). Who Took "Counseling" out of the Role of Professional School Counselors in the United States? Journal of School-Based Counseling Policy and Evaluation, 1(3), 51-61. https://doi.org/10.25774/7kjb-bt85

Rogers, C. R. (1942). Counseling and psychotherapy: newer concept in practice. Boston: Houghton Mifflin.

Rogers, C. R. (1952). Client-centered therapy. Boston: Houghton Mifflin.

Rogers, C. R. (1961). On becoming a person: A therapist's view of psychotherapy. Boston: Houghton Mifflin.

Copyright © Eyal Ben Ami 2023

אייל בן עמי
אייל בן עמי

יועץ חינוכי מוסמך (M.A), מטפל רגשי במתבגרים (גילאים 18-13) ובבוגרים
מטפל בגישות טיפוליות קוגניטיביות התנהגותיות CBT ומתמחה בתרפיית קבלה ומחויבות ACT. טיפולים מכווני מטרה וקצרי מועד. פגישה טיפולית של שעה, אחת לשבוע, עד כ-15 פגישות. תכיפות ומספר הפגישות משתנים בהתאם לסוג הבעיה ומצב הלקוח.

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