What is an LMHC?
A Licensed Mental Health Counselor (LMHC) is a type of licensure obtained by mental health clinical professionals to practice mental health services. The job duties of an LMHC are quite similar to that of a Licensed Professional Counselor (LPC), but the type of licensure is named differently based on the state of licensure. LMHCs operate on assessing, diagnosing, conceptualizing, and treating a variety of general mental health issues with individuals, groups, and couples from a clinical perspective. This means that LMHCs operate from a psychological perspective of diagnosis and treatment of disorders.
Licensed Mental Health Counselors work in a variety of settings including in-patient and out-patient mental health facilities, hospitals, schools, rehabilitation centers, private practice settings, and government facilities. The main focus of an LMHC is to address personal and environmental barriers that hinder the adaptive functioning of the individual. Becoming an LMHC is a stringent process that requires years of education and training to be able to obtain licensure as a competent clinician, and able to provide mental health services in a variety of contexts and environments.
What are LMHC Programs?
The educational requirements to become an LMHC include the minimal education of holding a bachelor’s and master’s degree in the field of psychology, counseling, social work, or a relevant behavioral science degree, which may vary depending on state requirements for licensure. Most mental health counseling programs prepare students for licensure (per state licensing requirements) which includes a portion of the degree requirements to include clinical training. This is where students receive supervised clinical work experience, much like a ‘residency’ in order to prove competency and be deemed ready for licensure post-graduation.
How to Choose the Right LMHC Program
Choosing the right graduate program depends on several factors, which will be highlighted later in this article, however, the main considerations boil down to, the educational focuses, and appropriate accreditation.
Educational preferences include the likelihood of your personal and professional interests aligning with the areas of emphasis within your program of choice. Some programs offer a Master of Science degree while some offer a Master of Arts degree. The distinguishing factor between these two degrees is that Master of Science degrees have an emphasis, exposure, and involvement of research as a part of your education. Master of Art degrees focuses more on the clinical knowledge and training aspect of mental health.
Pursuing a career as an LMHC can be a long enduring process that requires years of education and training. It is a master’s level qualification that requires a graduate degree and post-graduation licensure. When it is time for you to choose the right graduate program, it may boil down to several factors ranging from personal interests, professional and career goals, and the best fit for faculty and students. One of the most important considerations is the accreditation of the institution to which you are applying.
Accreditation is a program status obtained by graduate programs through an accrediting body that ensures the program adheres to the guidelines and standards set by the licensing board. The National Board for Certified Counselors (NBCC) is the governing body that sets these statutes for those included under the umbrella of a licensed counselor. An advantage of pursuing an accredited program is that completion of the program requirements includes accruing the necessary educational and training requirements for post-graduation licensure. This includes the completion of state-required coursework and meeting the number of clinical training hours to qualify for licensure.
Most LMHC programs that are accredited by the NBCC are accredited by the Council for the Accreditation of Counseling and Related Educational Programs (CACREP). CACREP is a globally recognized accreditation body that encompasses areas of mental health including programs for general clinical mental health, marriage and family therapy, addiction counseling, adolescent and school counseling, and rehabilitation counseling. Examples of CACREP-accredited programs include the University of North Texas and Auburn University. You will be able to search for accredited programs based on your desired state and degree on the CACREP website or by clicking this link.
If you choose to attend a program that is not accredited, it is highly recommended that you have an idea of any discrepancies between the degree requirements and your state requirements for licensure. This may mean that you would have to complete additional coursework or accrue training beyond the institution’s requirements, which is completely achievable and has been done by several practicing clinicians.
What are the educational requirements to complete an LMHC program?
In your journey of pursuing a career as an LMHC, the first step is the completion of a bachelor’s level degree in psychology or a related field (including social work, education, etc.). The next step would be to complete 60 credit hours of graduate study with at least a 48-hour master’s degree. The specific core curriculum and competency areas required are as follows:
- Counseling Theories: Understanding of the major theories and techniques of mental health counseling in a variety of therapeutic settings, competence in the theoretical application.
- Human growth and development: Competence in assessing the nature and deeds of individuals in various developmental stages. Knowledge of the developmental theories accounting for physical, cognitive, affective, and social development.
- Psychopathology: Assessment and diagnosis of dysfunctional or abnormal behaviors/disorders while being competent to develop treatment procedures.
- Social and cultural foundations: Multicultural competence in working with diverse populations from a variety of demographics.
- Clinical Skills: Understanding the theoretical basics of counseling and applications, competence in basic clinical skills.
- Group counseling: Theoretical knowledge and application of group process, dynamics, and counseling methods.
- Special treatment issues: Areas relevant to the practice of mental health (psychopharmacology, addition, school or career issues, MFT, sexuality, and special populations).
- Testing and assessment: The use and understanding of psychometric assessment in areas of cognitive, personality, and affective assessment. Competence in the creation of reports and presenting findings.
- Research and evaluation: Understanding the use of and engaging in psychological evaluation methods through the scientific research process.
- Professional orientation: Knowledge of professional roles, ethical guidelines, obligations, and limitations. Ethical case conceptualization, understanding of the code of conduct standards set by the American Counseling Association. Knowledge and understanding of licensing and regulatory practices.
- Practicum: Completion of pre-graduation practicum requirements.
- Internship: Includes 600 supervised clinical practice hours of which:
- 240 hours are direct client contact hours
- 45 supervision hours
The American Counseling Association (ACA) oversees the standards for competent clinicians produced in the field of mental health and is the national governing body for all counseling professions. Upon successful completion of a graduate program, the next step would be to successfully pass the national licensing examination. As an LMHC, you may have a few options for testing to choose from. The National Counselor Examination (NCE) is the most common examination required by most states. The National Clinical Mental Health Counselor Examination (NCMHCE) also administered by the NBCC has more of a clinical focus and is required based on your state of licensure. Other examinations that may be state dependent include the Certified Rehabilitation Counselor Examination (CRCC) and Examination of Clinical Counselor Practice (ECCP).
Knowing which examination is required depends on your state of licensure and the standards of core competencies required.
Upon completion of the licensing examination, you would then receive a probationary license during which you would have to accrue the needed requirements of post-graduation clinical experience. Typically this includes approximately 3400 total supervised clinical hours. Of this:
- At least 960 hours must be direct clinical contact hours
- Have at least 10 client contact hours to be considered a full-time employee
- At least 130 hours of supervisory contact hours
After completion of the required hours post-graduation, you would then submit the proof of completion to your state board, and become fully licensed as an LMHC. This means that you would be able to independently practice as a clinician without the need for clinical supervision or oversight.
Should I Pursue an Online LMHC Program?
In the last three years, there has been an increase in the shift towards distance education and the availability of online degree offerings. This is starting to include the availability and accessibility of specialized degrees including mental health. With a field that has a large component of theoretical application and practice, there may be many considerations in what modality of degree offering would be the best fit for you. Programs are moving towards more flexibility from in-person, hybrid formats, to fully-online formats, which gives students a variety of options to choose from. Outlined below are some considerations that may help your choice.
Going to graduate school in itself is a step and commitment that requires significant planning and preparation due to the demands and changes to your lifestyle. Pursuing a degree in mental health counseling is particularly challenging as there is an equal emphasis on the completion of coursework, along with rigorous training and assessment requirements that are applied and hands-on. Beyond the basic requirements of the program, one could always benefit from pursuing additional educational and career endeavors such as additional placements, academic involvement, and conducting research.
With the availability of online, hybrid, and in-person modalities, students have more flexibility in choosing a program that is a right fit for them in terms of time commitment to coursework. Most online and in-person programs are similar in the pace of administering coursework, but the distinguishing factor would be whether you choose to enroll part-time or full-time. Northwestern University is an example of a fully online program that offers full-time and part-time enrollment. For students wanting to speed up the process, this program offers an accelerated track as well.
A vital aspect of being able to pursue education is considering the financial implications whilst still being a student. Obtaining a graduate degree is an investment to further your financial stability and advance your career, however, it is important to plan for what the time in between would look like. Pursuing an online degree may offer more freedom to maintain an existing part-time or full-time job while completing program requirements. It also enables distance education from a university of your choosing without having to relocate or commute. For students that are already in a place in their lives with other life commitments, online education would be a more convenient option.
Advanced degrees like mental health counseling include a drastic advancement in knowledge and skill, unlike a bachelor’s level degree. Your learning style is an aspect to consider to ensure you are setting yourself up for success in the program. For individuals that work better with faculty and peer support, and who like a hands-on, interactive approach, an in-person or hybrid degree would be the best option. On the other hand, individuals that learn better at their own pace, and prefer self-study may benefit from an online format. If you want to pursue academic research (to pursue further education at a doctoral level), you may want to consider the logistics of doing so remotely. Oftentimes, universities that have an emphasis on research, require students to attend their program in person.
Which fits better?
Choosing the right fit is more complicated than one initially could anticipate. Considering time commitment, lifestyle changes, finances, and learning styles are all important aspects. The final choice depends on the alignment of your personal and career interests with what the program is able to offer. This includes areas of specialization, practicum training availability and focuses, research interests, and fit with faculty and peers. After all, the education and training you receive at this level would significantly impact the trajectory of your career.
LMHC Salaries and Outlook
According to the Bureau of Labor Statistics (BLS), LMHC salaries range anywhere from $30,870 to $77,890 with a median pay of $48,520. This occupation has a bright outlook with projected growth in available jobs to be at 11% or higher, which is much faster than average.
Choosing a field like mental health requires more than the ability to perform job duties. Aligning work values and styles with personal traits and strengths is an indicator of career success. Work values common to this profession include the ability to build and maintain relationships with peers, coworkers, and clients (even the most resistant ones). A sense and drive for achievement would serve you well in pursuing more knowledge and contributing to the field. The ability to work independently improves work satisfaction but also being able to work collaboratively could benefit an overall success.
Work styles in this profession include a genuine concern for others, where empathy and relatability are significant aspects in forming relationships, especially in clinical practice. Having a higher stress tolerance would serve mental health professionals well due to the level of unpredictability situations could bring. Also, LMHCs are bound to be exposed to several instances where they would help others deal with trauma and significant mental health issues, which requires a collected temperament and composure. Mental health professionals are expected to act with integrity, upholding the ethical obligations and requirements of the profession and field.
A career in mental health is not one that would interest and suit everyone. Not only does it have a demanding journey of obtaining licensure to be able to practice, but the demands of the job go beyond work requirements, where one has to be prepared for the psychological and personal stressors that go along with it. Though this field is demanding, being a professional who is able to make an impact that resonates beyond just the client, makes this career fulfilling and worthwhile. A major component of the training students receive in graduate school is dedicated to honing in on strengthening personal skills and resilience to help them go out in the field as competent clinicians, ready to pursue more and make a lasting contribution to society.
American Counseling Association
Bureau of Labor Statistics
Council for the Accreditation of Counseling and Related Educational Programs https://www.cacrep.org/
Certified Rehabilitation Counselor Examination
Examination of Clinical Counselor Practice
National Board of Certified Counselors
National Counseling Examination
National Clinical Mental Health Counselor Examination
The University of North Texas