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LMHC: Licensed Mental Health Counselor

“Counselor” is a broad term that encompasses a number of professions and requires different types of licensure. This page focuses on one specific type of counselor and licensure: licensed mental health counselors (LMHCs). You’ll find out what they are, the services they provide, and how to become one.

What Is a Licensed Mental Health Counselor (LMHC)?

A licensed mental health counselor (LMHC) is a professional licensed by their state to treat a wide range of mental health issues one-on-one in a clinical setting with a client. Note the dual nature of the term “LMHC”: While it denotes a type of profession, it is also a licensure title that one must earn to practice in that profession. LMHC licensure is what separates these professionals from other types of counselors.

All 50 states, the District of Columbia, and Puerto Rico have their own state-specific licensing requirements, and not all states use the same terminology. The following is a list of alternate titles that some states use. The table further down the page explains which states use which titles in issuing licenses.

Licenses Considered Equivalent to the LMHC

  • Licensed Professional Counselor (LPC)
  • Licensed Professional Clinical Counselor (LPCC)
  • Licensed Clinical Professional Counselor (LCPC)
  • Licensed Clinical Mental Health Counselor (LCMHC)
  • Several states, like Nebraska, use slight variations on the above titles

You’ll notice that some titles include terms like “mental health” or “clinical.” Those titles typically indicate that the holder is specifically qualified and licensed to diagnose and treat mental illnesses. LPC, on the other hand, is a broader term. It can refer to professionals trained to treat mental health issues as well as counselors who specialize in areas like rehabilitation or career counseling.

Some states that offer LPC licenses, like Maine, Minnesota, North Dakota, Ohio, Nebraska, and New Mexico, also offer a second license—one of the others listed above—that tends to be more specific and requires more training hours. Other states issue licenses for certain specialties that, elsewhere, would fall under the umbrella of LMHC. Among the most common are marriage and family counseling, substance abuse, and social work. To discover what options your state has, check out the American Counseling Association’s site, which provides links to the governing boards in all 50 states.

States also issue provisional or temporary licenses. These lesser credentials allow counselors to work under the supervision of licensed professionals while they acquire the experience needed for full licensing. Examples include Associate Licensed Counselor (ALC) and Licensed Professional Counselor Intern (LPC-I).

Professional Counselor Licenses by State

License Abbreviation States Issuing
Licensed Mental Health Counselor LMHC Florida, Hawaii, Indiana, Iowa, Massachusetts, New Mexico, New York, Washington, District of Columbia
Licensed Professional Counselor

LPC Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, Georgia, Louisiana, Maine, Michigan, Minnesota, Mississippi, Missouri, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Texas, Utah, Virginia, West Virginia, Wisconsin, Wyoming
Licensed Professional Counselor-Mental Health LPC-MH South Dakota
Licensed Professional Counselor/Mental Health Service Provider LPC/MHSP Tennessee
Licensed Professional Clinical Counselor LPCC California, Kentucky, Minnesota, North Dakota, Ohio
Licensed Professional Counselor of Mental Health LPCMH Delaware
Licensed Clinical Professional Counselor LCPC Idaho, Illinois, Kansas, Maine, Maryland, Montana, Nevada
Licensed Clinical Mental Health Counselor LCMHC New Hampshire, Rhode Island, Vermont

 

What Does an LMHC Do?

A licensed mental health counselor provides support and guidance to people struggling with challenges in their lives as well as those diagnosed with a specific mental illness such as depression or schizophrenia. Some provide a broad spectrum of counseling services, while others limit their scope to areas such as addiction, relationships, or specific mental illnesses. An LMHC might work with many types of people or focus on specific populations like children, the elderly, the homeless, the LGBTQ+ community, military veterans, or people in prison.

Regardless of focus, counselors all work toward helping people understand their mental health challenges and guide them in managing or alleviating their issues. This typically involves making an assessment or diagnosis and then applying one or more types of therapeutic approaches.

Most counselors use therapeutic approaches based on their “theoretical orientation,” which is their philosophy about how problems develop and the best ways to resolve them. Below are several of the more common approaches.

  • Psychodynamic therapy: The goal of this approach is to help clients understand how repressed thoughts, fears, and emotions from the past affect their current thinking and behavior. It is a type of talk therapy in which clients are encouraged to say whatever comes into their minds and explore their wishes, fantasies, and dreams.
  • Behavioral therapy: This type of therapy is action-oriented. It uses behavioral approaches to get rid of unwanted behavior such as phobias or anxiety. Techniques include systematic desensitization, where a client is gradually exposed to the thing they fear, and aversion therapy, which involves pairing an unwanted behavior with something unpleasant or uncomfortable.
  • Humanistic therapy: This type of therapy is client-centered—counselors don’t interpret the feelings of the client but rather guide and support them. The goal is to help clients make positive changes by identifying and leveraging their inherent strengths.
  • Cognitive-behavioral therapy: Often people engage in negative thought patterns that affect their behavior and emotions. The aim of this short-term approach is to help clients recognize, challenge, and replace these negative patterns with realistic and positive thoughts. Practitioners who use this therapy often encourage mindfulness, journaling, or rehearsing scenarios that trigger negative thoughts or behaviors.

LMHCs may tailor these or other approaches to the needs of their specific clients. Although LMHCs can explore medication options with a client, they cannot prescribe it. If the LMHC and client decide medication would be beneficial, the counselor will refer them to a psychiatrist.

LMHCs can work in settings as varied as government agencies (such as Veterans Affairs), social service agencies, colleges and universities, prisons, community health centers, hospitals, and mental health clinics. Some opt to work in private practice.

How to Become a Licensed Mental Health Counselor

Although the requirements for becoming an LMHC can vary from one state to the next, there are a few basic steps that are universal:

  1. Earn at least a master’s degree.
  2. Complete a certain number of clinical practice hours—generally between 1,500 and 3,000—under the supervision of a licensed professional. You may need a provisional license for this.
  3. Take one or more exams.
  4. Undergo a background check.
  5. Apply for licensure and pay any relevant fees.

In all states, you’ll have to keep your license in good standing by completing continuing education credits and renewing your license periodically, usually every two years.

To learn about your state’s specific requirements, visit the website of your state board.

LMHC Master’s Degree Programs

To enter a master’s program, you must already have a bachelor’s degree—usually with a specified minimum GPA. It’s helpful if your bachelor’s is in psychology, but many programs will accept you with a degree in a different subject. If that is your situation, you may be expected to take some undergraduate-level classes to catch up.

Schools may offer Master of Arts (M.A.) and/or Master of Science (M.S.) degrees. Often you can choose a concentration—such as mental health counseling.

Programs generally take two to three years to complete and include courses such as:

  • Counseling Theory and Practice
  • Family Diagnosis and Therapy
  • Cognitive Behavioral Therapy
  • Ethics and Standards
  • Human Development and Growth

You will also need to engage in a specified number of hours of clinical practice.

Before you enroll in a program, make sure it’s accredited by a body specified by your state’s licensing board—it will be much harder to earn a license if it’s not. In most cases, accreditation will be granted by the Council for Accreditation of Counseling and Related Educational Programs (CACREP).

LMHC Doctoral Programs

Getting a doctorate in counseling can help you advance your skills as a practicing counselor or move on to supervisory and educator roles. It’s also ideal for people who have a degree in another area who want to transition into counseling.

Doctoral programs generally take from two to four years to complete, and most programs require you to have a master’s degree. In addition to coursework, students engage in research, complete internships or residencies, and write a dissertation or complete a capstone project.

LMHC Licensure Exams

The National Board for Certified Counselors (NBCC) administers two different licensure exams. All states require you to pass at least one of them, sometimes both. Some states specify which test you need to take, while others let you choose.

  • National Clinical Mental Health Counseling Examination (NCMHCE): The NCMHCE uses ten different simulated cases designed to test your clinical problem-solving skills. Each of the ten simulations is divided into five to ten sections that deal with subject matter like assessment and diagnosis, counseling and psychotherapy, and administration, consultation, and supervision.
  • National Counselor Examination (NCE): The NCE consists of 200 multiple-choice questions designed to assess your skills, abilities, and knowledge in the field of mental health counseling.

Some states also have their own state exam. These written or oral tests focus on your mastery of state-specific regulations and ethical standards. For example, California has the California Law and Ethics Exam, Colorado the Colorado Jurisprudence Exam, and Oklahoma the Oklahoma Legal and Ethical Responsibilities Examination.

Board Certification

Once you are licensed, you can opt to pursue certification. While board certification is not a requirement to practice, it demonstrates that you have met high national standards in the practice of counseling.

The NBCC offers a general counseling certification—National Certified Counselor (NCC)—as well as three specialty certifications: Certified Clinical Mental Health Counselor (CCMHC), Masters Addiction Counselor (MAC), and National Certified School Counselor (NCSC). To earn board certification you need to have an eligible graduate degree, pass either the NCE or the NCMHCE exam, meet work experience requirements, and comply with conduct standards.