Preparation of Medicare‐Enrolled Mental Health Counselors: Descriptions of Training Experiences and Predictors of Attitudes and Competencies

ABSTRACT Counselors are newly eligible to enroll as providers in the Medicare program as of January 1, 2024, yet little is known about their preparedness to work with Medicare beneficiaries and related training experiences. This gap in the literature inhibits our understanding of historical and current counselor education practice, thereby preventing us from identifying strengths and weaknesses in counselor training practices and preparation among current Medicare‐enrolled mental health counselors (MEMHCs). Participants were recruited from a publicly available database of MEMHCs in conjunction with contact information from state licensure boards. This study examined training experiences of 333 MEMHCs who enrolled during the first year of Medicare eligibility. Using hierarchical multiple regression, we also explored whether graduating from a CACREP‐accredited program, time since graduation, and perceived preparedness to work with older adults or people with disabilities at the time of graduation predicted gerontological counseling competency and attitudes toward practice with people with disabilities. Time since graduation predicted gerontological counseling competency and perceived preparedness at the time of graduation predicted gerontological counseling competency with a moderate effect size ( f 2 = 0.171). Only perceived preparedness at the time of graduation predicted attitudes toward practice with people with disabilities with a small effect size ( f 2 = 0.107). Our results suggest that perceived preparedness at the time of graduation may be especially salient in MEMHCs’ perceived competencies and attitudes toward practice later in their careers. Counselor education programs may therefore need to more intentionally integrate these topics into their curricula. However, more information is needed about current practices.