Licensed Mental Health Counselor (LMHC) Jobs & Career Guide 2023

What is a Licensed Mental Health Counselor or LMHC?

A licensed mental health counselor is a professional who is trained and licensed to provide counseling and therapy services to individuals, families, and groups to help them deal with mental and emotional issues, including anxiety, depression, relationship problems, addiction, and other mental health concerns.

These professionals typically have a master’s degree in counseling psychology, counseling or a related field and have completed a certain number of supervised clinical hours.

Many mental health counselors conduct their therapy holistically, employing a “wellness” paradigm (rather than a “sickness” one) that emphasizes and promotes individuals’ strengths.

What does a Licensed Mental Health Counselor do?

LMHCs play an important role in helping individuals, families, and communities improve their mental health and well-being.x

Some common responsibilities of LMHCs include:

1. Conducting assessments: LMHCs are trained to conduct comprehensive assessments of clients’ mental health and well-being, including identifying any mental health disorders, substance use disorders, or other issues that may be impacting their overall functioning.
2. Developing treatment plans: Based on their assessments, LMHCs develop personalized treatment plans to help clients address their mental health concerns. These plans may include individual or group therapy, medication management, and other interventions.
3. Providing therapy: LMHCs provide therapy to clients using evidence-based approaches, such as cognitive-behavioral therapy, psychodynamic therapy, or other modalities. They help clients work through their emotional and mental health issues and provide them with coping skills to manage symptoms and improve their overall functioning.
4. Monitoring progress: LMHCs monitor clients’ progress throughout the course of treatment and make adjustments to treatment plans as needed. They may also conduct regular assessments to track changes in clients’ mental health and well-being.
5. Advocating for clients: LMHCs may advocate for their clients to receive appropriate mental health care and services, as well as to access community resources and support.
6. Maintaining confidentiality: LMHCs are required to maintain strict confidentiality with their clients, except in certain situations where disclosure is legally required, such as in cases of child abuse or if a client is a danger to themselves or others.

Here is a typical daily schedule for an LMHC:

8:00 am – 9:00 am: Review client charts and prepare for the day’s appointments, including reviewing treatment plans and notes from previous sessions.

9:00 am – 12:00 pm: See clients for individual or group therapy sessions, conducting assessments, and updating treatment plans as needed.

12:00 pm – 1:00 pm: Take a lunch break and engage in self-care activities, such as mindfulness meditation or exercise.

1:00 pm – 4:00 pm: Continue seeing clients for therapy sessions or conducting group sessions, as well as charting notes and updating client records.

4:00 pm – 5:00 pm: Attend team meetings or supervision sessions with colleagues or supervisors to discuss challenging cases and receive feedback and support.

5:00 pm – 6:00 pm: Complete administrative tasks, such as responding to client emails and phone calls, submitting insurance claims, and updating billing records.

Where Do LMHCs work?

There are many opportunities for LMHCs to work in a variety of settings and make a meaningful impact on the mental health and well-being of their clients. Here are some common employers of LMHCs:

1. Mental health clinics: Many LMHCs work in mental health clinics, which provide a range of mental health services to clients, including therapy, medication management, and crisis intervention.
2. Hospitals: Some LMHCs work in hospitals, providing therapy and support to patients with mental health conditions who are receiving medical treatment.
3. Private practices: LMHCs may also choose to start their private practices, where they can see clients and provide therapy services independently.
4. Schools and universities: LMHCs may work in schools and universities, providing counseling services to students, staff, and faculty.
5. Government agencies: LMHCs may be employed by government agencies such as the Department of Veterans Affairs or Department of Defense to provide mental health services to veterans or military personnel.
6. Nonprofit organizations: LMHCs may work for nonprofit organizations that provide mental health services to underserved populations, such as low-income individuals or those without insurance.

How to become a Licensed Mental Health Counselor

The process to become an LMHC can take several years and involves significant education, training, and clinical experience

Earn a Bachelor’s Degree

The first step to becoming an LMHC is to earn a Bachelor’s Degree in psychology or a related field, such as social work.

Earn a Master’s Degree

The next step is to earn a Master’s Degree in counseling psychology, counseling or a related field from an accredited program. A master’s degree program typically takes 2-3 years to complete and involves coursework in psychology, counseling theories, human development, and counseling techniques.

Complete clinical experience

After earning a master’s degree, prospective LMHCs must complete a certain number of supervised clinical hours under the supervision of a licensed mental health counselor or other licensed mental health professional.

Clinical experience is a critical component and involves providing direct counseling services to clients.

Clinical experience requirements vary by state but typically involve completing a certain number of hours (usually around 3,000) of supervised counseling or psychotherapy with clients. The purpose of this requirement is to ensure that prospective LMHCs gain the necessary skills, knowledge, and experience to provide safe and effective counseling services.

Pass the NCMHCE or NCE exam

Once the required clinical hours are completed, prospective LMHCs must pass a state-recognized licensure exam.

The National Clinical Mental Health Counseling Examination (NCMHCE) and the National Counselor Examination for Licensure and Certification (NCE) are two exams that are commonly required for individuals who wish to become licensed mental health counselors in the United States.

The NCMHCE is a clinical examination that assesses an individual’s knowledge and skills in the areas of assessment, diagnosis, treatment planning, and case management for clients with mental health disorders. The exam consists of 10 clinical simulations that assess the candidate’s ability to apply counseling theory and practice to real-world clinical situations. The NCMHCE is typically required for LMHC licensure in many states.

The NCE, on the other hand, is a more general exam that assesses an individual’s knowledge of counseling theory, ethical and legal issues in counseling, and general counseling practices. The exam consists of 200 multiple-choice questions and covers a broad range of topics related to counseling practice. The NCE is required for LMHC licensure in some states.

Both exams are administered by the National Board for Certified Counselors (NBCC) and are computer-based tests that can be taken at testing centers across the United States. The cost of the exams varies by state and may range from several hundred dollars to over a thousand dollars.

Apply for licensure

After passing the exam, individuals must apply for licensure in the state where they wish to practice. Requirements for licensure can vary by state but typically involve completing an application, providing documentation of education and clinical experience, and paying a fee.

Ongoing education

Once licensed, LMHCs are required to complete ongoing education and training to maintain their license and stay current on developments in the field.

How Much Do Licensed Mental Health Counselors Earn?

According to the Bureau of Labor Statistics (BLS), the average annual income for a mental health counselor is $47,660.

Income varies considerably by location so here are the 5 states with the highest average annual salary:

1. New Jersey – $70,450
2. District of Columbia – $67,900
3. Hawaii – $67,160
4. California – $65,020
5. Alaska – $64,040

It is important to note that these figures are from the BLS and group substance abuse as well as behavioral disorder professionals with counselors which may skew the figures slightly. Additionally those entering the profession can expect to earn significantly less whilst they build their experience and credentials.

Here are some ways to improve you earning potential:

• Specialization: such as trauma, addiction, or marriage and family therapy. LMHCs can develop a niche in the market and become a sought-after expert in that area, which can lead to higher pay rates.
• Obtaining additional certifications: LMHCs can increase their earning potential by obtaining additional certifications, such as board certification in specialties such as addictions or counseling psychology. These certifications can demonstrate advanced training and knowledge in specific areas and can increase the value of an LMHC’s services.
• Starting a private practice: LMHCs who start their private practice can set their rates and have more control over their earning potential. While starting a private practice requires additional business skills and may involve more administrative responsibilities, it can provide a greater opportunity for increased earning potential.

Get more insights with our LMHC salary guide.

What is the difference between an LMHC and an LPC?

An LMHC and an LPC (Licensed Professional Counselor) are both licensed mental health professionals who provide counseling services to individuals, families, and groups. However, there are some differences between the two:

1. Scope of Practice: In general, LMHCs tend to focus more on the treatment of mental health disorders, while LPCs may have a broader scope of practice that includes issues such as career counseling, personal growth, and life transitions.
2. Education and Training: Education and training requirements for LMHCs and LPCs can vary by state. In some states, the requirements for both professions may be similar or identical, while in other states, there may be different education and training requirements.
3. Licensing Exam: LMHCs and LPCs typically take different licensing exams. For example, LMHCs may be required to take the National Clinical Mental Health Counseling Examination (NCMHCE), while LPCs may be required to take the National Counselor Examination (NCE).
4. Scope of Practice: In some states, there may be differences in the scope of practice between LMHCs and LPCs. For example, in some states, LMHCs may be authorized to diagnose and treat mental health disorders, while LPCs may not have this authorization.

Learn more about becoming a Licensed Professional Counselor