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Loneliness epidemic. Mental health crisis. These terms are often used to describe the state of mental health in the US, all while the country is also experiencing a behavioral health staffing shortage.
That’s where lay counselors come in.
These mental health professionals provide counseling without going through the traditional state licensure process. One group, the Lay Counselor Academy (LCA), is helping train groups like social workers, legal aid staff, and community health workers to become lay counselors.
Co-founder Alli Moreno brings her own expertise as a defense investigator and lay counselor to provide guidance for others interested in a “nonconventional pathway.”
After leaving the legal field when she started a family, she told us she was looking “for something that would be intervening or making a meaningful difference in people’s lives.” She joined up with co-founder Elizabeth Morrison in 2021 to see how Morrison’s psychology background and Moreno’s experience could help shape the field.
Healthcare Brew spoke with Moreno about her career and what people might not know about lay counseling.
This interview has been edited for length and clarity.
What do you think are some of the biggest misconceptions about lay counselors?
One that comes to mind is this misconception that mental health counseling is only being provided by licensed professionals. The reality is that, as we all know, the mental health crisis is acute, and the workforce shortage is severe, so there’s that ongoing barrier to access.
There’s tons of different ways to approach this issue, but one of them is to acknowledge that mental health counseling is happening. Really pour in rigorous professional development like workshops, training, practice opportunities, adding weekly clinical supervision and support, all of that to make structural adjustments so that counseling that’s already happening is more effective and the people providing it are more confident in doing so.
[Another] misconception is the idea of a triage, or the idea [lay counseling] is a cheaper way to provide care. Our hope is that it is equivalent in terms of value.
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What are the biggest challenges you’re trying to address through the LCA?
It’s really access to quality mental health support. The need is so severe, and it’s only increasing as more marginalized, vulnerable communities are targeted in government policies and cuts to services and threats of deportation. It’s already affecting young people and immigrants and LGBTQ+ community members; it’s already affecting people in rural communities.
There are so many competent, skillful people who are nowhere in this conventional licensure pipeline. But they have skill, and they have community connection, and they have the desire to be helpful. So, bridging that gap of helping folks, who are already in connection with people who need the help, to help them be able to do that even better and more competently and confidently and feel acknowledged is the biggest challenge.
What are the ways health equity plays into how you’re approaching this?
When you think about people who have lower resources, have lower social power, they’re less likely to be able to get care that they need. When we’re supporting people who are already in those communities—who already have relationships to meaningfully respond to those needs and to do so in a way that’s supported and there’s continual learning and growth—we’re responding to people who have the least access. That’s where we’re gravitating toward first.
What’s your biggest achievement in your career so far?
These [cohorts] are hearing these mental health struggles from people, which means that they’re doing something to indicate to the people that they’re safe. And that means that they have some sort of skill. And then not only is that person telling them, but they keep coming back.
I always feel so proud and happy to be able to elevate and amplify and acknowledge that skill in other people who come through our course and who are on our team, too.