Mental health counseling is one of the most rewarding paths you can pursue as a healthcare professional. Helping people to process their thoughts and emotions or to manage mental health conditions, trauma, and stress is just as valuable as taking care of patients suffering from physical illness or injury. The demand for mental health counselors is growing consistently as we understand more about how the mind works and how what we think and feel affects every aspect of our everyday lives.
If you decide to specialize in mental health counseling, then there are many opportunities to advance your career and progress in terms of gaining qualifications, experience, and more senior positions. The counseling field is full and varied, with a multitude of different options to choose from depending on your personal preferences and aptitude. It’s an exciting profession with lots to learn and new theories and approaches being developed all the time. If you’re just beginning your career journey, then this could feel overwhelming, but in fact the basic foundations are simple and straightforward.
What is counseling?
Counseling is a form of talking therapy. This means that clients or patients talk to a professional therapist or counselor about their problems or feelings with the aim of finding ways to cope better. A client may seek counseling as an alternative to other forms of medical treatment like drugs, or they may be receiving counseling as well as appropriate medication.
All counselors are by definition mental health counselors, but many have further specializations. Possible areas to focus on include addiction; families, marriages, and relationships; trauma; or work-related stress. In all cases, counseling provides a safe space for people to talk about their thoughts, emotions, and behavior, without being judged.
The counselor isn’t expected to provide all the answers but rather to give gentle guidance and encouragement that will assist the client in developing a better understanding of themselves and will help them to make sense of their thoughts and emotions. Although we often try to dismiss or downplay them, feelings are powerful and complex drivers of our behavior and if unacknowledged can cause us to act in ways we may later regret.
Through counseling, clients can start to recognize patterns in the way they think and act, and through this they can gain more agency and control over both their inner and outer lives. It’s up to the client to want to change, but a counselor can help to clarify and reinforce that intention and then give the client the tools to carry out the necessary work.
Types of counseling
The terms “counseling” and “therapy” are often used interchangeably. Psychotherapy and psychological therapy are both forms of counseling that draw on psychological and psychoanalytical theory. Specialist types of counseling in this area include cognitive behavioral therapy (CBT), which is often used to treat depression and anxiety, and dialectical behavior therapy (DBT), which is a method for treating borderline personality disorders.
Counselors may help clients in dealing with difficult life events like managing grief after bereavement, coping with divorce, or moving on after redundancy. They may also address long-term mental health conditions like depression or bi-polar disorders. Trauma, whether rooted in childhood or more recent causes, can be effectively treated with counseling. Counseling can also be used to help clients adjust to ongoing physical health problems or disabilities and with managing problematic emotions or behavior.
While some counselors may specialize in one particular form or approach, others may choose the approach for an individual session from a number of disciplines that they are trained in. It’s important that the type of counseling being offered fits with the client’s needs rather than trying to make it work the other way around.
Psychology, analytical psychology, existential psychology, individual psychology, person-centered psychology, and other approaches are all different frameworks that a counselor can make use of, based on theories developed by influential thinkers in the psychology field such as Freud, Jung, Adler, and Rogers. Gestalt therapy, cognitive therapy, rational-emotive behavioral therapy, and acceptance and commitment therapy are also methods that can be applied in different circumstances.
Some approaches focus more on thoughts, others on emotions. Some look into a client’s past for explanations and causes while others are more concerned with changing present behavior. Counselors may draw from multiple approaches when working with a client until they find the one that gets the best results.
An addiction counselor may focus on overcoming problems with alcohol or drugs, but they may also address less obvious addictive behavior like gambling, compulsive sex, or hoarding. While one-to-one addiction counseling is available, addiction counselors usually employ group therapy techniques such as those used by Alcoholics Anonymous. Private addiction counseling might involve the client’s family or friends in talking about how they’re affected by the client’s behavior.
A family, marriage, or relationship counselor usually provides short, focused sessions for talking about specific problems that have arisen between a couple or family members. The aim is to find some kind of resolution, which may involve compromise from all parties. It’s still up to the clients to solve their own problems, but counseling can help everyone to see the issues with greater clarity and also how they look from different perspectives.
Religious or pastoral counselors may work out of a church or similar institution and provide counseling with a spiritual foundation. They may help with the same general problems as other mental health counselors but will approach matters from a faith-based perspective. They may also provide help and guidance on matters specific to a religious life, such as spiritual crises, doubt, or resisting temptation.
Working with specific groups
Counselors sometimes specialize in working with particular demographic groups – for instance, children or older people. These often have unique needs and benefit from an approach that takes factors like age and social environment into account from the start. Other counselors may provide talking therapy to people with a particular condition, such as cancer patients, while working as part of a wider health team meeting the patient’s overall needs.
As a counselor, you’ll need first-rate communication skills. You’ll need to be able to put people at ease, making them feel relaxed and secure, but also be able to challenge them when necessary in a way that feels positive and empowering. A counselor needs to be self-aware and able to recognize their own mental quirks and habits. They should be capable of seeing all aspects of life from different perspectives and to understand that their own viewpoint is just one among many – not necessarily right or wrong but conditioned by their individual experiences and education.
A counselor needs to be non-judgmental and extremely patient when working with clients. In any session, you will be focused on the client’s needs and circumstances rather than trying to make them fit in with how you think they should be. Above all, a counselor should be an excellent listener.
The relationship between a counselor and their client is the bedrock of their work together and is crucial to enabling positive outcomes. The client needs to be able to trust their counselor and to feel safe talking to them. The subjects discussed in counseling are likely to be intimate, private, and sensitive. The client may need to discuss thoughts, feelings, or behavior that they feel uncomfortable with or are ashamed of.
There should be an agreement beforehand between the client and the counselor about what they are there to talk about. The counselor will guide the client back to the agreed topic if they seem to wander. They will encourage the client to open up but will also challenge them on certain statements or assumptions if this is appropriate. While remaining empathetic, they may also push the client to see matters from a different perspective or in a more objective manner.
Counseling is a partnership. A counselor and their client work together over a session or, more frequently, a number of sessions, to explore the difficulties faced by the client and to help them develop skills and strategies for overcoming or managing said difficulties. The ultimate goal must be agreed between the counselor and the client, but both will be hoping for an improvement in mental and emotional health on the client’s part.
Improved mental and emotional health will often lead to more material improvements as well. For example, if a client feels better about themselves, then they may be more capable of getting a better job. Working as a mental health counselor lets you address all aspects of a client’s life and in many cases see tangible progress being made toward a more satisfactory and empowered existence.
Becoming a counselor
Although all potential counselors will need to have appropriate qualifications from recognized institutions, different states have different requirements in terms of becoming fully licensed. While this article explains how to become a licensed mental health counselor in NY, the situation may be different in other states like California or in the Midwest. St. Bonaventure University offers a fully online MSED in clinical mental health counseling that covers all the core subjects in this discipline and includes a relevant internship. Students learn how to develop appropriate strategies through diverse counseling practices and working with the needs of specific communities.
The first step in becoming a licensed mental health counselor is to secure a bachelor’s degree in a relevant subject. Sociology or psychology are good examples, or you could start with a Bachelor of Science in Nursing (BSN). Once you’ve completed your undergraduate degree, you can go on to take a master’s degree in counseling from an accredited institution.
Acquiring a license
Before they can become licensed, prospective counselors must complete a supervised internship of between 2000 and 3000 hours. The exact number of hours required for licensure varies from state to state. While completing their internship, students will need to have an initial license that lets them practice under the supervision of a licensed mental health practitioner. Those working with this provisional or temporary license may be known as an associate licensed practitioner, a registered mental health counselor, or by another name, again depending on the state.
Aspiring counselors will need to pass at least one National Board for Certified Counselors (NBCC) exam – for instance, the National Counselor Examination (NCE) or the National Clinical Mental Health Counseling Examination (NCMHCE). Again, different states may have their own exams.
After passing a licensing exam, mental health counselors must apply for a license to practice in a particular state. The state counseling board will set out the specific requirements that need to be met. Once you’re licensed and practicing, you can continue to acquire additional mental health counseling certifications. These can be in further specializations like addiction counseling or school-age counseling. You may also want to build on your master’s degree and take a doctor’s degree as well.
As your counseling career progresses, you might decide to open your own private practice or move into a senior position at a clinic or hospital mental health department. Counselors also have many transferable skills with other professions. Some counselors may decide to move into teaching, consultancy work, or administration. Social and psychological research positions are also open to candidates with counseling experience and qualifications. Becoming a life coach or business coach is also a great fit for someone with counseling skills.
Where you can work from
Mental health counselors can work in many different settings besides having their own office as part of a dedicated private practice. Counselors can be found working in hospitals, community health centers and clinics, or in residential institutions like care homes or prisons. Schools, colleges, and universities also employ counselors on their staff.
Since the Covid-19 pandemic, there has been a huge surge in the use of telemedicine, where people receive consultations, health advice, and even treatment remotely, often in their own homes. Mental health counseling can also be conducted this way, for instance via a video conferencing app, making the service more widely accessible than it has previously been.
Choosing a path
Finding a mentor is a good way for new counselors to find out about the career options open to them. A mentor might be someone you already work alongside, or they might be someone you meet through joining a local or national professional organization. Talking to people currently working in positions you might like to hold one day lets you discover what’s required and decide whether it’s really the right role for you.
Trying out different jobs or counseling pathways early on will let you get a feel for different roles. You might find that your inclinations and aptitude take you in different directions from the one you’d originally envisioned for yourself.
The job outlook for mental health counselors over the coming decade is extremely promising. Growing awareness of the importance of mental health and the role that talking therapies can play in helping those with difficulties means that counselors will continue to be in high demand. New job opportunities are expected to exceed the average rate of growth for all professions in the next ten years.
More counseling positions targeted at specific demographics are likely to be among the new openings in years to come. These will include more school counselors and counselors working independently to address the mental health needs of children and young adults. Further mental health counselors are expected to be required to work with America’s military veterans as the affects of battlefield trauma and post-traumatic stress disorder (PTSD) are more widely understood. Advanced counselors who are interested in moving more into research work will also be welcomed.
Addiction and substance abuse is another category where more counseling jobs are expected. Finally, with an aging population and life expectancy rising, counselors who are trained to work with older people and to address the specific issues facing them will be increasingly in demand.
Mental health counseling is a demanding career but one offering a high level of job satisfaction. Counselors can work in a wide variety of different settings and with many different types of people. The problems you find yourself helping people with will also vary greatly, although you will also come to appreciate how people from very different backgrounds still share the same essential concerns and anxieties.
Becoming a counselor is a way to feel more connected to other people. Helping them with their mental health is a privilege, and many counselors feel they learn more about themselves through working with their patients and clients. This may help facilitate your career journey where, as you get to know yourself better, your employment goals and ambitions change, and you begin to seek out new challenges.
The opportunities open to fully trained mental health counselors are growing all the time. By continuing to learn and develop your skills, you’ll find that there are many ways to progress in your career and move forward toward your ultimate outcome.