How to Become a Mental Health Counselor

By: Lee Kehoe, MS, LMHC, NCC

Last Updated: December 26, 2018

A career as a mental health counselor is richly rewarding for compassionate, empathetic people who want to make a significant difference in the lives of others. A skillful counselor leads a client on a journey of growth and self-discovery that allows him or her to overcome obstacles, reach personal goals, and lead a productive life.

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Central duties of mental health counselors are:

• To assess, diagnose, and treat psychological disorders
• To support clients through difficult life experiences
• To teach the skills and attitudes needed to bring about behavior change

By assisting clients with clinical conditions such as depression, substance abuse and anxiety, counselors help people learn to adapt to change and function positively in their day-to-day lives.

Mental health counselors use a variety of approaches to help their clients develop the emotional resilience and interpersonal skills to navigate life’s challenges. One widely used approach involves cognitive behavioral therapy, which replaces problematic thoughts, feelings, and behaviors with more adaptive ones. Other counselors use emotion-focused therapies, which emphasize the impact of deeper emotions in a person’s life. Meanwhile, some counselors are more solution-focused, working with people to develop problem-solving skills. The emphasis a counselor places on one aspect of a person’s thoughts, emotions, or problems depends on a counselor’s personal background, belief systems and training. A counselor in training can expect to do a great deal of self-exploration during his or her degree program in order to align with a certain area of counseling.

Workplace Details

Mental health counselors are employed by not-for-profit agencies, substance abuse treatment facilities, general and specialty hospitals, universities, and private businesses. Many also run their own practices.

Mental health counseling may take many forms. Clients may see the counselor one on one, in couples sessions, or in family therapy. Some also attend group therapy sessions in which several people come together to support one another and work toward a common treatment goal. Many counselors see a wide variety of clients, while others specialize in certain conditions or populations.

Most mental health counselors work full time. Those in private practice have greater flexibility to set their own schedules. Hours often include evenings, weekends and early mornings to accommodate clients who may only be able to meet at those times due to work or family obligations.

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According to the US Bureau of Labor Statistics (BLS), the median annual salary for mental health counselors is $41,880, and most earn between $26,300 and $68,790. Wages vary geographically and by industry, with municipal government and health practitioner offices offering the highest starting salaries. Level of degree will also impact a mental health counselor’s salary; counselors who obtain a doctoral degree often receive a higher salary as they often go on to teach within universities.

Employment of mental health counselors is expected to grow by 20% between 2014 and 2024, according to the BLS. This robust growth is due in part to the fact that more insurance companies are offering reimbursement for mental health counseling services.

The prospective student must hold a bachelor’s degree from a four-year university. Many students pursue bachelor’s degrees in related fields such as psychology, human development, and social work; however, this is not a requirement to enter into a mental health counseling master’s program afterward.

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Mental health counselors must hold at least a master’s degree in counseling from an accredited institution. The Council for Accreditation of Counseling and Related Educational Programs (CACREP) is the governing body that overseas the accreditation of mental health counseling programs within the United States. Master’s programs are 60 semester credit or 90 quarter credit programs, with a full-time student being able to finish the degree within 2 years.

Accredited counselor training programs include extensive, supervised field experience in the form of practicums and internships. CACREP requires the practicum experience to consist of the following:

• A minimum of 100 hours, with 40 of those hours being direct client experiences, in which the student is providing counseling services to clients
• 1 hour supervision sessions with an appointed supervisor
• Weekly 1 1/2 hour group supervision sessions facilitated by program faculty
• Evaluation based on audio/video recordings of the student’s interactions with clients

Upon successful completion of the practicum experience as determined by a passing grade from practicum supervisors and faculty, CACREP requires completion of an internship, which includes the following:

• A minimum 600 hour internship with 240 of those hours being direct client experiences
• 1 hour supervision sessions with an appointed supervisor
• Weekly 1 1/2 hour group supervision sessions facilitated by program faculty
• Evaluation based on audio/video recordings of the student’s interactions with clients
• Evaluation based on student’s involvement in activities and development in record keeping, assessment, treatment approaches, clinical judgment, and teamwork relationships

Licensure of mental health counselors is mandatory in most states. This usually requires a master’s degree and 2,000-4,000 hours of supervised clinical experience, but requirements do vary from state to state. In some areas, counselors must pass a knowledge exam prior to practicing. Some states prefer candidates who have earned national certification (link to link anchor of certification section). Counselors maintain licensure throughout their careers by fulfilling continuing education requirements.

The National Board for Certified Counselors (NBCC) awards two levels of certification for mental health professionals.

• The entry-level national certified counselor (NCC) credential requires completion of required coursework and 3,000 hours of work experience (waived for graduates of CACREP-accredited training programs). Candidates must also pass the National Counselor Exam.
• Experienced professionals can pursue additional credentialing as a certified clinical mental health counselor (CCMHC). Candidates must be certified as NCCs, meet rigorous education and experience requirements, submit recordings of clinical sessions and pass the National Clinical Mental Health Counseling Examination (NCMHCE).

To maintain certification, as with licensure, all counselors must engage in continuing education throughout their careers. Credits may be earned by taking courses in person or completing trainings online. Counselors who hold NBCC credentials are subject to additional continuing education requirements.

With the goal of obtaining their master’s degrees in counseling, undergraduate students must obtain a bachelor’s degree first. But there is no mandated major.

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Despite this freedom to major in a multitude of areas, students ought to fulfill coursework in psychology, human behavior and cognitive development should. Consequently, many students find it easiest to earn their bachelor’s degree in a related area such as the majors below, for example, which naturally incorporate those subjects:

Prospective students may confront several options. Broadly, they may face a choice between a Master of Science (MS) or Master of Arts (MA) degree, and sometimes may see a “Master of Counseling” option (MCoun). These paths typically require 2 years to complete, but students are often understandably confused by the differences. The best way to decide on the right path is to consider the experience you’ve gained thus far and also your specific career goals.

• If you have earned a bachelor’s degree in a psychology-centered major, you’re well positioned for the MS in counseling or the MCoun. These paths provide the ability to specialize in a particular concentration while earning a master’s degree – and one common concentration is mental health counseling. Coursework for these degrees with a mental health concentration often includes classes in psychopathology, psychopharmacology, mental health counseling, group counseling, crisis intervention, substance abuse, and counseling techniques and theory. Additionally, the MS or MCoun degrees prepare a budding counselor to become licensed and provide therapy and other patient services.
• Students who have earned a less related bachelor’s degree – for instance, comparative literature – are more likely to find the best fit with the Master of Arts degree. This degree is also more generalized in nature, eschewing specializations in favor of a broader counseling education, which students often find to be a great springboard into research and educational careers.