A response to criticism of wellness counsellors

On 5 April, an article appeared in the Mail & Guardian that raised questions about wellness counsellors. The following article puts wellness counselling in context and highlights its value and benefits. 

Background overview 

No one can deny that the need for professional counselling services is increasing in a country with a toxic society, rampant crime, high unemployment, financial burdens, substance abuse and gender-based violence, to name but a few of the severely challenging conditions. 

For the past decade, credentialed wellness counsellors have been serving the South African public in the domain of well-being. 

Prior to that, informal counselling was a lay movement, largely comprising volunteers working in informal settings in the role of helpers at churches, schools, hospitals and NGO centres. 

There was no system for regulation, formal training, professional structure or standardised scope of practice and ethical code. Nevertheless, these counsellors provided much-needed support, help and guidance as peer counsellors to fellow people, especially in communities that had no, or meagre, access to professional mental healthcare services. 

It seems that the public is largely ignorant of the role of supportive counsellors and how they fit into the bigger scheme of healthcare. In this article, I hope to shed some light on the topic. 

With the revival of the trade and industry sector in South Africa, based on Sector Education and Training Authority-accredited skills training, an opportunity presented itself to introduce a formal counselling services system. 

During 2008, amendments to the National Qualifications Framework (NQF) Act provided for the establishment of professional bodies across the spectrum of trades and occupations. 

Later, the Quality Council for Trades and Occupations compiled the Organisational Framework for Occupations of listed and recognised occupations. The South African Qualifications Authority (SAQA), as a statutory body, being mandated to implement the NQF, became the custodian of the professional bodies covering a wide spectrum of occupations, ranging from accountants and auditors to tourism management and religious practitioners. 

A professional body is understood as a body of expert practitioners in an occupation or profession. In order to qualify as a professional body, an entity representing a recognised occupation has to apply for an ID and undergo a stringent assessment of their terms of reference, scope of practice, administrative capacity, etc. 

Once approved, a professional body is bound to undergo a continuous five-year cycle audit to ensure ongoing compliance with the requirements. 

A professional body thus plays an important role in society by registering lay counsellors in providing NQF-listed designations, providing an acceptable scope of practice and applicable regulation in terms of professional guidelines, ethical codes and disciplinary measures. 

Not only does this bring standardisation across the spectrum, it also protects the public against unprofessional conduct. 

Against this background, former chief executive of SAQA, Joe Samuels, declared that: “The recognition of [professional bodies] will contribute to strengthening social responsiveness and accountability within the professions and promote pride in association for all professions.” 

In this light, the Association for Supportive Counsellors and Holistic Practitioners (ASCHP) is proud to represent the 

“supportive counselling” industry within the wellness domain to differentiate it from psychotherapies. 

Credentialing and professionalism 

The ASCHP strives to contribute in a meaningful, constructive and effective way to the primary healthcare needs of communities. The World Health Organisation defines professional healthcare communities “as a whole-of-society approach to health that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people’s needs and as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care, and as close as feasible to people’s everyday environment”. 

Aligned with this, the mission of the ASCHP, as a professional body, is to establish wellness counselling as a basic support system for job creation in the counselling professions and the holistic well-being of the public. 

This ties in with its vision — to promote wellness as a systems approach to counselling and preventative healthcare through training, practice and lifestyle coaching. 

In order to achieve its mission and vision, three aspects are critical: training, credentialing and scope of practice. 

Credentialing. Credentialing is the process of granting a designation, such as a certificate, by assessing an individual’s knowledge, skills and performance level. 

The ASCHP has a designation for every NQF level of an applicable and/ or accredited qualification. 

Wellness 

counsellors are required to have at least a bachelor’s degree or equivalent and a specialist wellness counsellor must be trained on at least postgraduate level. 

In order to remain in good standing, counsellors, like all other professionals, are obliged to 

complete annual Continuous Professional Development training relative to wellness counselling. 

The scope of practice. Every designated level is defined by a specific scope of practice relative to the competence and training of the counsellor in that position. The scope of any profession is of the utmost importance as it defines a specific vocation, demarcates its boundaries of legal and acceptable practice, and justifies its existence. 

The scope of practice describes the procedures, actions and processes that a healthcare practitioner is permitted to undertake, in keeping with the terms of their professional certification. 

The scope of practice is limited to that which the law allows for their specific level of education and experience, as well as demonstrated competency. It describes the range of responsibilities — types of practices or caseload and practice guidelines that determine the boundaries of professional practices. 

Any deviation from, or transgression of, the scope can be reported via the channels in the rules of the disciplinary policy of the ASCHP. The disciplinary panel will deal with this accordingly, should it arise. 

Training. The ASCHP has memorandums of understanding with preferred training providers that can offer training across an entire spectrum, ranging from skills certificates to post-graduate accredited qualifications, as aligned to the scope of practice. 

In the process of providing a learning pathway for our members, the ASCHP is also encouraged to apply recognition of prior learning for membership access. As practical knowhow is crucial, applicants are required to submit a logbook of practical internship records. 

The wellness domain of counselling 

In a meeting with the Health Professions Council of South Africa (HPCSA) in 2012, prior to the establishment of the professional body, the delegation was required to identify a field of counselling that would clearly differentiate it from that of psychology and related conventional psychotherapies. 

Wellness was selected by the ASCHP as the preferred domain of counselling. The latter constitutes a salutogenic approach to counselling that differs in principle from a normal pathogenic one. Hence, wellness counsellors do not diagnose or treat, but aim to enhance, wellness. 

This is understood as “the complete integration of body, mind and spirit — the realisation that everything we do, think, feel and believe affects our state of well-being”. The client is accordingly regarded as a bio-psychosocial, spiritual being and illness is the expression of an entire life lived (Gabor Maté). 

Principles like these shift the healthcare service from favouring sick care (Jeffrey Bland) to a focus on wellness enhancement across the spectrum of human existence by employing various wellness modalities. 

This is the space in which wellness counsellors work to fulfil a pressing need in society. In rendering this service, they ideally complement HPCSA-registered healthcare therapists by referring clients when and where required. 

Dr Marius Herholdt is the founding president of the ASCHP, a SAQA recognised professional body for counsellors who operate in the domain of wellness.