How to Become a Mental Health Counselor

According to the National Institute of Mental Health, roughly 46.6 million adults in the United States were diagnosed with some form of mental, behavioral, and/or emotional disorder in 2017. About 42.6 percent of diagnosed adults received mental health services in the past year. As a result there may be a greater need for mental health professionals now than ever and this page will help you understand what you need to do in order to become one.

What is the role of a mental health counselor?

Mental health counselors combine psychotherapy with problem-solving to help individuals, couples, families, and groups dealing with a variety of mental health issues, according to the American Counseling Association (ACA). They may work with diverse populations or offer specialized therapy to a specific population, such as the elderly, disabled, military personnel, adolescents or children.

We’ll dive in further into the work of mental health counselors below, but first we’ll outline the steps to becoming a mental health counselor.

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Steps to Become a Mental Health Counselor

1. Complete a bachelor’s degree in a behavioral, social science, or psychology field.

Because a master’s degree is a requirement for licensure as a mental health counselor, pursuing a bachelor’s degree in counseling related fields sets the groundwork for graduate studies in counseling. Bachelor’s degrees in other similar fields may be accepted as prerequisites for a master’s degree program. Coursework for undergraduate studies in these fields will typically include the evaluation of human development, counseling skills and foundation, introduction to psychology, and/or basic approaches to counseling/therapy.

2. Earn a master’s degree in mental health counseling.

There are many CACREP accredited universities that offer studies specifically in mental health counseling. Obtaining your graduate degree in mental health counseling is a requirement for practice as a licensed professional mental health counselor. The CACREP is the preferred accreditor for mental health counseling degrees, but there may be other accreditors for specific degree specializations.
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3. Complete graduate and postgraduate internship experience for certification/licensure requirements.

As a crucial aspect of accredited counseling master’s programs, graduate supervised counseling experience allows students to dive into their future role as a licensed professional mental health counselor, gaining hands-on experience under licensed professional counselors. Postgraduate activities include internships that occur after the completion of an undergraduate degree, and graduate internships are a part of the requirements to complete a master’s degree program.

4. Pass any required counseling exams for licensure.

Some states and/or counseling programs require the passing of a recognized counseling examination for gradation or licensure such as the National Counselor Examination (NCE) and/or the National Clinical Mental Health Counseling Examination (NCMHCE). Some states require intermediary licensure before counselors can be fully eligible for an independent practice. Some states may have additional requirements for licensure, which aspiring counselors should become familiar with, depending on the state in which they intend to pursue licensure.

5. Apply for and earn additional mental health certifications.

Licensed professional counselors can pursue a national certification through the National Board of Certified Counselors (NBCC). Mental health counselors can also pursue specializations in grief, pastoral, school-based mental health counseling, or other mental health challenges, concerns, or disorders.

6. Continue your education and stay up to date on mental health counseling trends and changes.

Continuing education is imperative to maintaining professional counseling licensure and keeping in the know on changes, updates, and movements in trends on mental health care, counseling, and client advocacy.

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What Is a Mental Health Counselor?

A mental health counselor is a licensed professional who provides care for clients with emotional and behavioral issues. They typically see clients on a recurring schedule to help with an ongoing issue. Counselors use psychotherapy, cognitive-behavioral therapy and other models of psychological treatment that they’ve learned from an accredited mental health counseling degree program.

A mental health counselor is not the same as a psychiatrist, which is a medical professional who is licensed to prescribe medication for diagnosed disorders. Counselors may work in teams with other types of health professionals to provide comprehensive care to a client in need.

What Do Mental Health Counselors Do?

The practice of professional mental health counseling includes the diagnosis and treatment of mental, behavioral and emotional disorders, including:

  • Anxiety
  • Depression
  • Mood disorders
  • Personality disorders
  • Obsessive compulsive disorder
  • Post-traumatic stress disorder
  • Eating disorders
  • Behavioral addictions
  • Psychoses

Mental health counselors also see clients who may not have a specific diagnosed disorder, but need support navigating challenges including anger management, bullying, grief, self-esteem and body-image, relationships, chronic stress, and other topics.

The ACA says a career in mental health counseling may include the following duties:

  • Recognizing the symptoms of mental health disorders in their clients
  • Planning treatment for clients over a period of time
  • Supporting clients through recovery or therapeutic practices
  • Conducting group sessions with a client’s family or supportive peers
  • Helping clients unpack complicated emotions and behavioral patterns
  • Educating clients about different types of therapy
  • Tracking the progress of clients as they move through treatment
  • Referring clients to other sources of help, like support groups, out-patient clinics, health care providers and social work organizations
  • Providing clients with strategies and behavioral skills they can use to problem-solve in the future.

Counselors in the mental health field take a client-centered, holistic approach to providing care for their clients. They are trained to understand how environmental, interpersonal and physical factors can contribute to a person’s mental health.

Though mental health counselors do not prescribe medication to their clients, they often work in multidisciplinary teams with other providers, such as psychiatrists or primary care providers who are licensed to write prescriptions. In non-medical settings, counselors may also work alongside social workers, school counselors and other professionals who ascribe to holistic care models.

Job Description at a Glance

A mental health counselor’s job includes working with clients from various backgrounds to improve their mental health, understand complicated emotions and work toward wellness goals. Mental health counselors offer support to individual clients, couples, families or groups with similar situations.

Skills Necessary for Mental Health Counselors

Mental health counselors develop skills through education and training in order to safely, legally and effectively serve the needs of their clients who may have a variety of mental health diagnoses.

Through courses and experiential learning, counselors will build skills for interpersonal communication, listening, problem-solving, research, and critical thinking.

  • Communication: The vast majority of counseling services require conversations and clear communication between the counselor and their clients. Being able to educate clients about the treatment process and implement treatment plans requires effective understanding of verbal and non-verbal communication.
  • Listening: Being an active listener is a crucial skill for counselors to understand and untangle the concerns and needs of their clients. Counselors will learn what language to listen for and how to identify what information isn’t being said.
  • Problem-Solving: Working through complicated issues is a key part of helping clients solve problems in their own lives or with others in their lives.
  • Research: Scientifically studying patients and their behavioral patterns is a part of counselor’s role, which they will learn through education and clinical residencies. Counselors can conduct studies of participating patients or work with universities to build larger bodies of research.
  • Critical-Thinking: Counselors combine communication and active listening to make diagnoses, implement therapy models and conduct research with clients.

Where Do Mental Health Counselors Work?

Mental health counselors work in the public and private sector in a variety of settings, including community centers, hospitals, public schools, universities, veteran health agencies, outpatient facilities, recovery centers, career centers, religious institutions, and private practices, according to the ACA.

If they choose to specialize in a specific population, counselors will likely work in agencies or organizations that serve those populations. For example, specializing in children’s mental health could lead a counselor to work in elementary schools, pediatric hospitals, youth homes, foster care organizations or social service agencies. Specializing in geriatric counseling might lead to working in veteran medical hospitals, assisted living facilities, senior community centers, retirement homes and palliative care facilities.

Counselors who choose a career in the public sector work with organizations that are publicly funded, like government organizations, non-profits, correctional facilities, elementary, middle and high schools, colleges and universities, social services organizations, and publicly-owned hospitals.

Working in the private sector would include counseling individual clients, couples or small groups of clients on a recurring basis to work on chronic issues over time. Counselors can also open their own private practices to serve clients, which could require managing a small number of other counselors and administrative staff, as well as the performing the responsibilities of running a small business.

What Are the Licensing Requirements?

State licensure is required in order to practice as a mental health counselor. Counseling licensure requirements vary by state, but typically include completion of a counseling master's degree program from an accredited university, 3,000 to 5,000 hours of postgraduate supervised clinical experience, and a passing score on a state-recognized licensing exam. Practicing mental health counselors may also be required to take continuing education to maintain their license.

Licensing requirements vary by state and should be checked thoroughly by counselors pursuing licensure in any state. Detailed information for state licensing requirements for mental health counselors is available through the National Board for Certified Counselors state board directory.

Detailed information for state licensing requirements for mental health counselors is available through the National Board for Certified Counselors.

Are There Certification Requirements?

While not mandatory, mental health counselors can earn certification through The National Board for Certified Counselors (NBCC). NBCC’s National Certified Counselor designation gives you an additional credential that demonstrates your experience, education and level of counseling skills.

Career Outlook for Mental Health Counselors

According to the Occupational Outlook Handbook from the U.S. Bureau of Labor Statistics, mental health counseling positions are projected to grow 22% from 2018 to 2028, faster than average. The industries that employ the most mental health counselors include outpatient care centers, individual and family services, inpatient/residential care facilities, and local government. The Bureau of Labor Statistics also lists California, Pennsylvania, Virginia, Massachusetts, and New York as having the highest employment levels.

The Occupational Outlook Handbook reports that the average annual salary for a mental health counselor in the U.S. is about $45,000. Salaries vary depending on the industry and setting. For example, counselors employed by the government could earn about $52,000 per year while mental health counselors employed in individual and family services earn about $44,000 per year. Level of education, location and experience may also influence salary level.

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