Clinical mental health counseling – an overview
According to Mental Health America, nearly 1 in 5 American adults will have a diagnosable health condition in any given year. The latest statistics available from the Centers for Disease Control and Prevention (CDC) are also telling. They reveal that there were 56.8 million visits to a physician’s office with behavioral and neurodevelopmental disorders as the primary diagnosis in 2016 alone.
Changes in public policy, evolving social needs, and groundbreaking research continue to transform the mental health landscape. Appreciation for the personal, societal, and economic benefits of treatment have contributed to a rise in the demand for outpatient services, too.
Clinical mental health counselors (CMHCs) play a vital role in meeting the population’s ever-increasing need for sufficient mental healthcare. In fact, the Bureau of Labor Statistics (BLS) projects employment in the field to grow by 25% between 2019 and 2029. That’s faster than the average for other occupations.
Passionate about helping others address mental, emotional, and behavioral health concerns? Want to work with various groups such as families, adolescents, children, military personnel, the elderly, or the disabled? Interested in developing sustainable treatment strategies, teach problem-solving, and offer therapeutic support, psychotherapy, and crisis management? If so, then a career in CMHC may be for you.
Scope of practice
This profession takes an interdisciplinary, multifaceted, and humanistic approach to address the unique mental health challenges of individuals affected by macro-systemic, environmental, family, and personal factors.
Whereas clinical psychologists focus more on severe mental illnesses and behavioral problems, clinical mental health counselors are concerned with strengthening and restoring development and mental health. They identify and diagnose mental and emotional disorders, behavioral issues, and addictions to devise holistic treatment plans, often in collaboration with other mental health professionals.
CMHCs can work in various settings, including:
Licensed CMHCs can build businesses and pursue private patients. They can also choose to specialize in particular conditions or areas, such as family/marriage counseling, addiction, depression, and rehabilitation.
Hospitals and healthcare facilities
Counselors in these settings treat patients in collaboration with other healthcare professionals. They typically focus on the emotional and mental aspects of an illness or condition. These health professionals can also work in specialized centers that treat specific demographics, such as teenagers, the elderly, and trauma victims.
Children face unique challenges while growing up. School counselors can identify behavioral problems and help parents navigate treatment. College students are also susceptible to stress-related and relationship problems that could affect their mental health. Counselors help them address these issues and offer support and guidance.
Large companies can employ counselors to render clinical services to staff members, helping them manage stress and develop healthy coping mechanisms to adopt a better work/life balance.
Becoming a clinical mental health counselor
Given the wide array of mental health counseling specialties, licensed professionals have the flexibility to pursue various roles and work in many settings. However, before considering possible career pathways, it’s crucial to understand the educational, licensing, and accreditation requirements to become a clinical mental health counselor.
Professional and educational prerequisites
The BLS indicates that counseling jobs only require a bachelor’s degree. However, employers in the public and private sectors typically expect candidates to have a Master’s of Science (M.S.) degree and a completed internship.
Additionally, a M.S. is generally required for licensure as a mental health counselor. Therefore, earning a bachelor’s degree in counseling-related fields such as psychology, behavioral, or social science sets an excellent foundation for graduate studies. Undergrad coursework may include human services delivery, case management, general psychology, counseling methods, and crisis intervention.
While specific admission requirements for master’s degree programs vary, they may include an online application and a fee, as well as the following:
- An accredited undergraduate degree
- Minimum average GPA score of between 2.5 and 3.0
- Official transcripts from previous universities or colleges
- Letters of recommendation
- GRE test scores
- Personal statement
- Background check
CMHC master’s degree programs
An accredited master’s degree in clinical mental health counseling can equip students with in-depth knowledge and skills in the profession to:
- Become competent and licensed clinical mental health counselors
- Assess, diagnose, and support clients effectively
- Address multicultural, developmental, and societal influences affecting mental health
- Provide ethical and evidence-based treatment that promotes wellness
- Utilize case management services and community resources according to their roles
These programs generally teach candidates how to help clients effectively manage and overcome mental and emotional disorders, as well as career, personal, and family issues.
Mental health is a complex and intertwined field, so CMHC coursework often overlaps with other professions, such as psychology. Similarly, specializations in CMHC may intersect. This allows fluidity and opens up a broader range of employment opportunities.
However, to choose a degree suited to your preferred career path, it’s crucial to know the differences between the types of master’s degrees.
Master of Arts (M.A.)
M.A. degrees are generally interdisciplinary and humanities-based. These programs focus on liberal arts and usually include literature, linguistics, culture, ethics, history, psychology, and philosophy.
An M.A. may be ideal for students with a bachelor’s in a non-scientific or general field. The completion of a thesis is typically required to graduate. While M.A. graduates can still apply for licensure, they often pursue research and education in counseling, and some go on to earn their doctorate without getting their licenses.
Still, M.A. graduates who wish to practice clinical mental health counseling usually need to be licensed and may choose a specialty such as addiction, family, or child counseling.
Coursework can include:
- Counseling theories and practice
- Assessment techniques
- Fundamentals in research and statistics
- Group counseling and theory
- Crisis intervention
- Treatment planning
- Psychological evaluation
- Family and relationship dynamics
- Social justice and ethics
- Human growth and development
Master of Science (M.S.)
M.S. degrees are usually evidence-based and focus more on the scientific aspects of the profession. It’s an ideal choice for undergraduates who studied a field related to clinical mental health counseling. Students are normally required to complete their practicums and internships to graduate and fulfill licensure prerequisites.
M.S. programs usually require students to choose a specialization, such as career, school, marriage/family, or geriatric counseling. M.S. graduates can also go on to earn their doctorate degrees.
Master’s degrees in clinical mental health counseling may include the following program concentrations:
- Introduction to counseling
- Counseling theory and skills
- Advanced psychopathology
- Assessment and testing
- Clinical practices and treatment
- Legal and ethical issues
- Gender and sexuality
- Multicultural counseling
- Human development and growth
- Clinical instruction
- Research and program evaluation
Master of Education (M.Ed.)
M.Ed. degrees in CMHC are mainly designed for professionals who wish to work in educational establishments as a school counselor or researcher. These programs usually focus on nurturing a student-teacher therapeutic relationship with clients.
They often incorporate theoretical and practical subjects such as educational theory and psychology. M.Ed. program admission requirements may include working experience as an educator or an academic degree. Additionally, M.Ed. graduates may also pursue their licensure.
CMHC postgraduate certificates
Once students earn their master’s, they can also pursue a postgraduate or post-master’s certificate. Various schools offer these programs online, with on-campus and hybrid options also available.
These curricula are generally designed to equip candidates in specialized areas through supervised experience and advanced preparation. Students who need to fulfill their academic requirements for licensure may also earn a postgraduate certificate to accomplish this goal.
Individuals usually need a minimum amount of credits to qualify. They may also be required to complete additional coursework to fulfill state licensure prerequisites. Subjects may include:
- Orientation and ethics
- Diagnosis and treatment planning
- Human development and growth
- Family counseling
- Addiction counseling
- Family/marriage counseling
- Career counseling development
- Social and cultural diversity
- Advanced clinical mental health counseling
CMHC specializations and career pathways
With a master’s in CMHC, professionals can focus on a wide range of counseling niches, including but not limited to:
In this high-demand niche, CMHCs work with individuals and families to treat gambling, sexual, substance, alcohol, and even food addictions. Counselors implement and monitor treatment, intervention, and prevention, and devise strategies against relapsing.
They can work in community service centers and private practices. Addiction counselors make a median wage of $46,240, according to the BLS. However, it’s worth noting that the BLS groups behavioral and mental health counseling together with substance abuse.
Trauma and crisis counseling
CMHCs use tailored treatment models and intervention strategies to help families and individuals heal from trauma. Professionals in this category assist communities to deal with crises. They also teach first responders how to manage their career demands. CMHCs may work in public institutions, crisis centers, and trauma facilities. Crisis counselors earn an hourly median wage of $17.65, according to PayScale.
CMHCs in this field work in both the mental health and legal environments. They evaluate inmates or those on probation, determine and monitor treatment plans, and help individuals adjust to new circumstances. As such, they often work in correctional facilities or other government institutions. On average, they earn a median salary of $46,295 and up to $66,000, reports PayScale.
How long does it take to complete?
Master’s degree programs in this category typically comprise 60 credit hours, which can take between 2 and 4 years. A combination of 100 practicum and 900 clinical internship hours may also be required, but the exact number and overall course length depend on various factors.
These include the educational institution, the program’s structure, whether it’s available online, offline, or as a combination (hybrid), and if you’re studying part- or full time. Many accredited schools facilitate online master’s degrees, which are usually more flexible and allow candidates to study at their own pace. Students can usually enroll in accelerated programs, too.
Hybrid learning may also be available for students that want to earn their master’s online and on-campus. It’s an ideal option for those that work full time or have other family responsibilities.
What’s the cost?
The cost of earning a master’s in clinical mental health counseling can vary greatly. Expenses depend on the educational institution and whether you’re studying in- or out-of-state. According to the Trends in College Pricing and Student Aid 2020 Report, a public 4-year master’s program costs an average of $8,860 for 2020/2021. At private nonprofit institutions, the price is $29,670 for the same period. These figures are for tuition and fees only and exclude textbooks, boarding, and other fees.
Licensure or certification is mandatory for the vast majority of counselors. While specific requirements vary from state to state, the following may apply:
- An accredited graduate degree in counseling
- A minimum number of supervised clinical hours (usually 3,000+)
- A background check with fingerprints, proof of identification, and references
- A passing score on a state-recognized counselor exam
Most states require applicants to pass either one or both the National Clinical Mental Health Counselor Examination (NCMHCE) or the National Counselor Examination for Licensure and Certification (NCE). These examinations are available from the National Board for Certified Counselors (NBCC).
Accreditation happens when a university, college, or program voluntarily undergoes review by an esteemed accrediting body. This ensures it meets industry standards. In the counseling profession, accreditation is crucial and is often a licensure requirement. Here are the relevant accreditation authorities for this profession:
- The National Association of School Psychologists (NASP) accredits psychology programs independently or as part of the Council for the Accreditation of Educator Preparation (CAEP), a body nationally recognized by the Council for Higher Education Accreditation (CHEA).
- The Council for the Accreditation of Counseling and Related Educational Programs (CACREP) accredits doctoral and master’s programs (rather than institutions) in specialities relating to and including counseling. CAPREC accreditation is often a licensure requirement and is also nationally recognized by CHEA.
- The American Psychological Association accredits doctoral programs, internships, and postdoctoral residencies in various areas, including counseling, clinical, and school psychology.
Additional certification from the NBCC may be compulsory depending on the areas of specialization. However, even if it’s not a requirement, these credentials can be helpful. They often demonstrate a counselor’s willingness to learn voluntarily.
While other specialized organizations may also offer certification programs, the NBCC has the following certifications available:
Various organizations may provide financial aid such as grants, scholarships, and work-study programs. Candidates can use the Free Application for Federal Student Aid (FAFSA) to determine their eligibility for federal financial assistance. The Federal Student Aid also has numerous resources that students may find helpful.
Additionally, the American Psychological Association offers The Predoctoral Mental Health and Substance Abuse Services (MHSAS) Fellowship and The Esther Katz Rosen Fund Grants. Educational institutions may also have financial aid options available, so it’s worth investigating.
Continuing education programs are usually necessary to maintain licensure and certification. Each state sets its own standards for the minimum required continuing education units (CEUs). These programs keep counselors up to date with the latest advancements in mental health treatment and psychotherapy. Organizations such as the American Counseling Association, as well as private institutions, offer CE programs.