How to Become a Clinical Mental Health Counselor

To become a clinical mental health counselor, you must hold a formal degree in counseling, meet several other requirements mandated by the state in which you intend to practice, and pass a state licensure exam. The prerequisites for applying for licensure include the completion of an approved master’s in clinical mental health counseling program, and a specified number of supervised clinical internship hours, typically between 2,000-4,000.

What is Clinical Mental Health Counseling?

Clinical mental health counseling encompasses the professional delivery of psychotherapeutic services to those suffering from a wide range of emotional, behavioral, and cognitive issues. Clinical mental health counselors – often referred to as professional counselors – learn psychological theories of personal and social development. They receive instruction in the causes and effects of common psychological problems, including anxiety, depression, substance abuse, eating disorders, trauma, and grief. And they are trained to treat individuals, couples, families, and groups using the tools of psychotherapy.

How to Become a Licensed Clinical Mental Health Counselor

Formal training in clinical mental health counseling takes place in master’s degree programs, and in the subsequent internships required for licensure. The primary prerequisite for admissions to a master’s in counseling program is a bachelor’s degree. While some schools offer a counseling major for undergraduates, a bachelor’s in counseling is not sufficient for state licensure, nor is it required for admission to a master’s in counseling program. Common majors for students who intend to pursue a career in counseling include psychology, sociology, and education. Some master’s in counseling programs may require or prefer some introductory undergraduate coursework in psychology or another behavioral science.

Curricular guidelines for master’s in counseling programs are maintained by the Council for Accreditation of Counseling and Related Education Programs (CACREP), which provides voluntary accreditation to schools that offer counseling programs. Not all schools apply for CACREP accreditation, but most programs adhere to CACREP’s curricular standards. This includes training and instruction in eight core areas: the professional and ethical practice of counseling; social and cultural diversity; human growth and development; career development; counseling and helping relationships; group counseling and group work; assessment and testing; and research and program evaluation. In addition, CACREP requires master’s programs to provide a training practicum of 100 hours, and a minimum of 600 additional hours of internship experience.

A master’s in counseling from a program recognized and approved by the state, plus 2,000-4,000 hours of supervised clinical internship experience is the licensure standard for licensed professional counselors (LPCs) in all 50 states. Candidates who have met these requirements must then pass a state counseling exam in order to become an LPC or, in some states, a licensed professional clinical counselor (LPCC).

Steps to Becoming a Licensed Professional Counselor

  1. Earn a bachelor’s degree from a regionally accredited college or university, with some coursework in psychology, sociology, or a related behavioral science.
  2. Check with the state licensing board to find out what the specific licensure requirements are in that state, including coursework and clinical training requirements.
  3. Earn a master’s degree in clinical counseling from a state-approved program, and complete the 700 hours of practicum and internship hours recommended by CACREP.
  4. Apply for provisional licensure as a counseling intern in states that provide this option.
  5. Complete 18-24 months (2,000-4,000 hours) of clinical internship experience, as mandated by the state.
  6. Pass a licensing exam and any other examinations required by the state.

Clinical Mental Health Counseling Specializations and PhD programs

There are a number of counseling specializations at the master’s level, including substance abuse counseling, rehabilitation counseling, school counseling, and marriage and family therapy. Master’s in clinical and mental health counseling programs often include an introduction to one or more of these specializations, but they are designed to offer broad training for a range of careers in the counseling profession. Often, these programs are referred to simply as master’s in counseling programs.

Doctoral programs in counseling, clinical counseling, and mental health counseling are also available to those who desire or require further training in order to advance their career, or teach counseling at the college level. A doctorate in counseling is not required for state licensure.

Clinical Counseling Internships and Residencies

CACREP mandates that master’s in clinical counseling programs include a practicum of at least 100 hours, and 600 hours of supervised internship experience. In addition, each state has internship and residency requirements for LPCs. Specific requirements vary by state, from 2,000-4,000 hours, a portion of which typically includes direct client contact. In some states, this pre-licensure professional experience must take place over a certain number of months (typically 18-24 months). For example, in the state of Texas, graduates from master’s in counseling programs first apply to become Licensed Professional Counselor Interns, after which they need to complete 3,000 hours of supervised experience over a period of at least 18 months. Those 3,000 hours must include 1,500 hours of direct client contact under the supervision of a clinician approved by the state.

Additional Licensing Requirements for Clinical and Mental Health Counselors

The final step in the licensure process for counselors is a state mandated exam. The two exams most commonly given are the National Counselors Examination and the National Clinical Mental Health Counselor Examination, both of which are administered by the National Board for Certified Counselors. There are a number of states in which LPCs must also pass a jurisprudence exam, which tests the candidate’s knowledge of state laws pertaining to counseling, and many states require a criminal background check.


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