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Professionalization of the Field of 

Clinical Mental Health Counseling

A Training Resource

Edited by

James J. Messina, Ph.D., CCMHC, NCC, DCMHS-T


Professionalization of the Field of Clinical Mental Health Counseling

You will learn the answers to the following questions:

  1. What is the Purpose of a Professional Association?
  2. What issues need advocacy from the various mental health professional associations in the USA?
  3. When and why was the profession of clinical mental health counseling founded?
  4. What was the reason for the founding of AMHCA and creation of the Clinical Mental Health Counseling Profession?
  5. How does the profession Clinical Mental Health Counseling fit into the profession of counseling?
  6. How does AMHCA fit into the American Counseling Association?
  7. What are the six pillars of a profession in the mental health field?
  8. When did all six pillars get put into place for the Clinical Mental Health Counseling field?
  9. What accreditation means and what is CACREP is and what are its standards for training Clinical Mental Health Counselors?
  10. What is the CCMHC? Why it is important for all CMHC trainees to know about and work at attaining it?
  11. What were the political pressures within the field of professional counseling which inhibited the recognition and acceptance of the field of Clinical Mental Health Counseling as legitimate and viable profession?
  12. Why are there only a third of the states which carry the title Licensed Clinical Mental Health Counselor and the rest of the 50 states carry the title Licensed Professional Counselor?
  13. What can be done to insure there is portability of licensure from state to state and how can the use of the CCMHC help make this happen?
  14. What does the future of the Clinical Mental Health Counseling Profession look like with the implementation of the National Affordable Care Act?
  15. What trends in the Mental Health Field does the Clinical Mental Health Counseling Profession need to embrace? And why is this so important?
  16. How important is it to belong to a professional association and which professional association(s) should Clinical Mental Health Counselor belong to?
  17. What are Codes of Ethics and which ones are important to CMHCs?
  18. What social advocacy issues need to be addressed by CMHCs during their professional careers?
  19. What Self Care Needs do CMHCs need to address during their professional careers?
  20. What are some good references you can use to learn more in-depth information about the founding and growth of the Clinical Mental Health Counseling Profession?


Overview of the Clinical Mental Health Counseling Profession

By: Jim Messina, Ph.D., CCMHC, NCC, DMHCS-T

Clinical Mental Counselors work in public mental health settings or private practice. They assist their clients to address a myriad of emotional, behavioral and interpersonal issues. They utilize evidenced based practices and are fully accountable to their clients, reassuring them that the procedures, exercises, and homework used in their counseling sessions are effective, efficient and life-changing. Mental Health Counselors interface with their clients’ primary care physicians to insure that their physical health is not impairing consumer emotional or mental health. Mental Health Counselors work alongside psychiatrists if their clients require psychopharmacological assistance for their mental health conditions. For many reasons, Mental Health Counselors are knowledgeable about the neuroscience of emotional wellbeing and the most impactful findings of behavioral medicine. Mental Health Counselors work hard to be cognizant of the cultural, vocational, familial, and social factors which accompany their clients facing targeted mental health counseling challenges.


The 2011 standards of the American Mental Health Counselor’s Association define “Mental Health Counseling” as “an interdisciplinary, multifaceted, holistic process of: 1) The promotion of healthy lifestyles, 2) Identification of individual stressors and personal levels of functioning, and 3) The preservation or restoration of mental health” (Seiler & Messina, 1979).


 In 1986, the AMHCA Board of Directors adopted a more formal, comprehensive definition: “Clinical Mental Health Counseling is the provision of professional counseling services involving the application of principles of psychotherapy, human development, learning theory, group dynamics, and the etiology of mental illness and dysfunctional behavior to individuals, couples, families and groups, for the purpose of promoting optimal mental health, dealing with normal problems of living and treating psychopathology. The practice of clinical mental health counseling includes, but is not limited to, diagnosis and treatment of mental and emotional disorders, psycho-educational techniques aimed at the prevention of mental and emotional disorders, consultations to individuals, couples, families, groups, organizations and communities, and clinical research into more effective psychotherapeutic treatment modalities” (AMHCA, 2011).

What do Clinical Mental Health Counselors Do?

Clinical Mental Health Counselors offer a full range of services: clinical assessment and clinical diagnosis of mental health disorders; treatment planning and utilization review; psychotherapy for individuals, couples and families; alcohol and substance abuse treatment; psycho-educational and prevention programs; crisis intervention and management and trauma intervention.


What Skills Do Clinical Mental Health Counselors Need?

Mental Health Counselors need the following skills to do their work well: 1) Ability to understand the dynamics of human development to capture a good psychosocial history of clients, 2) Ability to diagnose and treat a variety of conditions within the spectrum of all human behavioral pathology, (3) Ability to provide evidenced based practices in psychotherapy thus providing credible treatments to clients, 4) Understanding of basic neuroscience of the brain and nervous system in order to better conceptualize the neurological basis of human emotions and responses to life stressors, 5) Understanding of psychopharmacological treatments of psychopathology


History and Timeline of the Clinical Mental Health Counseling Profession

1976 – Coining of term "Mental Health Counselor" and formation of American Mental Health Counselor’s Association (AMHCA) as a Division of ACA

1979 – Creation of the National Academy of Certified Clinical Mental Health Counselors (NACCMHC) which eventually become a component of the National Board of Certified Counselors (NBCC)

1981 – First State Law to license Mental Health Counselors put into effect in Florida and is now under the State of Florida's Health Administration's 491 Board

2011 – AMHCA published its newest Standards of Practice in Mental Health Counseling

The Pillars of the Clinical Mental Health Counselors Profession

  1. Professional Association: The American Mental Health Counselors Association educates and advocates for counselors with over 7,000 members. 
  2. Code of Ethics: The first AMHCA code of ethics was written in 1976 with regular updates culminating in the 2010 edition.
  3. Accreditation of Training Programs: The Council for Accreditation of Counseling and Related Education Programs (CACREP) enacted its full 60 graduate-hour standards for Clinical Mental Health Counseling in 2009. At present, one hundred Clinical Mental Health Counseling Training Programs are fully accredited by CACREP.
  4. National Certification: The National Academy of Certified Clinical Mental Health Counselors was founded in 1979.
  5. State Licensure: The first Licensed Mental Health Counselor law was passed in Florida in 1981. At present, all fifty states license mental health counselors in some form.
  6. Research into the Effectiveness of Clinical Mental Health Counselors: The Journal of Mental Health Counseling published its first volume in 1979 and today the journal is printing the thirty-fifth volume.


Professional Associations Related to Mental Health Counselors

Two national associations exist to serve the needs of Clinical Mental Health Counselors.

The American Counseling Association (ACA) serves the needs of many types of counselors and was founded in 1952. The American Mental Health Counselors Association (AMHCA) was founded in 1976 to serve the needs of Clinical Mental Health Counselors exclusively. AMHCA is affiliated with the ACA and both organizations claim state and local chapters nationwide.


National Certification

Two national certification organizations function to meet the needs of Clinical Mental Health Counselors. The National Board of Certified Counselors (NBCC) credentials over 48,000 National Certified Counselors (NCC). A branch of the NBCC, known as the National Academy of Clinical Mental Health Counselors, certifies over one thousand Certified Clinical Mental Health Counselors (CCMHCs).


State Licensure

All fifty states in the U.S. regulate the “Licensed Professional Counselor” profession while fifteen states offer licensure for “Licensed Mental Health Counselor” (LMHC). Florida fields the largest number of LMHCs with close to eight-thousand licensed by the state board.


 Training and Experience Requirements to Become a Licensed Mental Health Counselor

Currently CACREP has accredited over one hundred graduate programs to award Masters degrees in Clinical Mental Health Counseling. Program requirements entail sixty semester hours including courses in all aspects of the field, plus a practicum and internship. Graduates of such programs become Licensed Mental Health Counselors or Licensed Professional Counselors (LPCs) after completing a two-year post-Master’s residency under the supervision of an approved LMHC or LPC supervisor. Following these supervised hours, the graduate must pass the state-approved licensing exam to receive a license to practice psychotherapy.

Online Resources Related to the Profession of Clinical Mental Health Counseling

Professional Membership Organizations

National Certification Organization

Accreditation of Graduate Educational Programs

State Licensure for Mental Health Counselors

States with specific Licensure for Mental Health Counselors:

  1. Delaware-License Professional Counselor of Mental Health (LPCMH)
  2. Florida-Licensed Mental Health Counselor (LMHC) - State of Florida 491 Board:
  3. Hawaii-Licensed Mental Health Counselor (LMHC)
  4. Indiana-Licensed Mental Health Counselor (LMHC)
  5. Iowa-Licensed Mental Health Counselor (LMHC)
  6. Massachusetts-Licensed Mental Health Counselor (LMHC)
  7. Nebraska-Licensed Independent Mental Health Practitioner (LMHP)
  8. New Hampshire- Licensed Clinical Mental Health Counselor (LCMHC)
  9. New Mexico-Licensed Mental Health Counselor (LMHC)
  10. New York-Licensed Mental Health Counselor (LMHC)
  11. Rhode Island-Licensed Clinical Mental Health Counselor (LCMHC)
  12. South Dakota-Licensed Professional Counselor-Mental Health (LP-MH)
  13. Tennessee-Licensed Professional Counselor-Mental Health Service Provider (LPC/MHSP)
  14. Utah-Licensed Clinical Mnetal Health Counselor (LCMHC)
  15. Vermont-Licensed Clinical Mental Health Counselor (LCMHC)
  16. Washington-Licensed Mental Health Counselor (LMHC)