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South Carolina Professional Counselor — Requirements & Free Practice

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Licenses, application pathways and examination requirements

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Professional Counselor Associate

Supervised practice license preceding completion of post-degree clinical experience.

Licensing authority: South Carolina Board of Examiners for Licensure of Professional Counselors, Marriage and Family Therapists, Addiction Counselors and Psycho-Educational Specialists · Application information

Extension of the associate license
No examination is required for this applicant pathway.
Application
Apply before expiration through Document Submission; explain the need for an extension and submit clinical supervision documentation.
Experience
Post-master’s experience has not been completed within the two-year associate term.
Practice
Continue only under Board-approved supervision.
Supervisor change
The Board page exempts continuing same-supervisor associates from resubmitting the plan, confirmation and log; when changing supervisors request removal of former supervisors and submit confirmation and supervision log and an updated plan.

Official no-examination sources

Effective from 2026-09-22.

Associate licensure with foreign academic equivalence
Application
Submit the Board-approved application, fees and required supporting records, identification and lawful-presence verification. Comply with Board requests for other applicable documentation.
Background check
Under Section 40-75-220(B), the applicant bears the cost of fingerprint-supported South Carolina Law Enforcement Division and FBI criminal-record checks; results are reported to LLR.
Education
Graduate education must satisfy Regulation 36-04: a qualifying CACREP Clinical Mental Health Counseling program with at least 60 graduate semester hours, or the specified master’s, specialist’s or doctoral degree with at least 60 counseling graduate semester hours and qualifying program and institution accreditation. Non-CACREP applicants submit coursework descriptions and practicum/internship review materials and official transcripts.
Examination
Pass either NCE or NCMHCE. A score already obtained is accepted; after education and application approval the Board sends examination-registration instructions to applicants who have not already passed. The score remains a requirement even when obtained before the application.
Experience status
Educational and examination requirements are met; the post-degree supervision/experience requirements for full licensure are not yet completed. The associate license has a two-year term.
Foreign equivalence
Section 40-75-260(C) requires all ordinary licensure requirements plus Board satisfaction with the applicant’s experience, command of English and foreign academic program equivalence to a relevant accredited United States program.
Military training
Military education, training and experience receive the favorable consideration required by Section 40-1-640, subject to all stated licensing standards.
Supervision plan
Submit a Board-satisfactory clinical supervision plan. The plan may accompany the application or follow employment, but counselor services may not begin until the Board has received and approved the plan and issued the associate license. Practice must remain supervised.
Initial associate licensure
Application
Submit the Board-approved application, fees and required supporting records, identification and lawful-presence verification. Comply with Board requests for other applicable documentation.
Background check
Under Section 40-75-220(B), the applicant bears the cost of fingerprint-supported South Carolina Law Enforcement Division and FBI criminal-record checks; results are reported to LLR.
Education
Graduate education must satisfy Regulation 36-04: a qualifying CACREP Clinical Mental Health Counseling program with at least 60 graduate semester hours, or the specified master’s, specialist’s or doctoral degree with at least 60 counseling graduate semester hours and qualifying program and institution accreditation. Non-CACREP applicants submit coursework descriptions and practicum/internship review materials and official transcripts.
Examination
Pass either NCE or NCMHCE. A score already obtained is accepted; after education and application approval the Board sends examination-registration instructions to applicants who have not already passed. The score remains a requirement even when obtained before the application.
Experience status
Educational and examination requirements are met; the post-degree supervision/experience requirements for full licensure are not yet completed. The associate license has a two-year term.
Military training
Military education, training and experience receive the favorable consideration required by Section 40-1-640, subject to all stated licensing standards.
Supervision plan
Submit a Board-satisfactory clinical supervision plan. The plan may accompany the application or follow employment, but counselor services may not begin until the Board has received and approved the plan and issued the associate license. Practice must remain supervised.
Reinstatement following impairment related suspension
No examination is required for this applicant pathway.
Competence reports
Provide two Board-approved reports that assess capability to practice to prevailing standards and explain the determination.
Discipline
Serve any specified ineligibility period; indefinite ineligibility requires successful completion of conditions and the Board’s determination that the period served is commensurate with the violations.
Medical assessment
A Board-ordered physical or mental health examination is a fitness evaluation, not a licensing examination of the counseling profession.
Monitoring
Comply with Board monitoring and consent/order conditions, then submit annual sworn progress reports for at least two years following termination of the consent agreement.
Treatment
Complete required Board-approved inpatient treatment and comply with aftercare contracts or consent agreements.
Underlying license
The previously issued license is the subject of reinstatement.

Official no-examination sources

Effective from 2026-09-22.

Restoration after voluntary surrender
No examination is required for this applicant pathway.
Board decision
Restoration requires a majority Board vote and satisfaction of Board-imposed conditions. Neither defining statutory provision identifies a professional examination; any individualized eligibility determination is an applicant condition.
Practice limit
No practice is permitted during surrender.
Surrender
The previous practice authorization was voluntarily surrendered while under investigation.
Underlying license
The previously issued license is the subject of restoration.

Official no-examination sources

Effective from 2026-09-22.

Licensed Professional Counselor

Ordinary professional counselor license for independent practice.

Licensing authority: South Carolina Board of Examiners for Licensure of Professional Counselors, Marriage and Family Therapists, Addiction Counselors and Psycho-Educational Specialists · Application information

Licensure by endorsement
No examination is required for this applicant pathway.
Application
Submit the Board-approved application, fees and required supporting records, identification and lawful-presence verification. Comply with Board requests for other applicable documentation.
Background check
Under Section 40-75-220(B), the applicant bears the cost of fingerprint-supported South Carolina Law Enforcement Division and FBI criminal-record checks; results are reported to LLR.
Certification
Certify that the Board statutes, regulations and profession-specific Code of Ethics have been read and understood. This is a certification condition, not an examination.
Existing license
Hold a current, active, unrestricted license in good standing in another United States jurisdiction at an equivalent credential level.
Investigations
No current or pending investigation in the jurisdiction of licensure; Section 40-75-260(B)(3) also bars licensure while an investigation of a potentially disqualifying act remains pending in this or another jurisdiction.

Official no-examination sources

Effective from 2026-09-22.

Initial licensure with foreign academic equivalence
Application
Submit the Board-approved application, fees and required supporting records, identification and lawful-presence verification. Comply with Board requests for other applicable documentation.
Background check
Under Section 40-75-220(B), the applicant bears the cost of fingerprint-supported South Carolina Law Enforcement Division and FBI criminal-record checks; results are reported to LLR.
Education
Graduate education must satisfy Regulation 36-04: a qualifying CACREP Clinical Mental Health Counseling program with at least 60 graduate semester hours, or the specified master’s, specialist’s or doctoral degree with at least 60 counseling graduate semester hours and qualifying program and institution accreditation. Non-CACREP applicants submit coursework descriptions and practicum/internship review materials and official transcripts.
Examination
Pass either NCE or NCMHCE. A score already obtained is accepted; after education and application approval the Board sends examination-registration instructions to applicants who have not already passed. The score remains a requirement even when obtained before the application.
Experience
Hold a current, active, unrestricted South Carolina professional counselor associate license and document at least 1,500 post-master’s clinical experience/supervision hours over at least two years: at least 1,380 direct client contact hours and 120 supervision hours, including at least 60 individual/triadic supervision hours; remaining supervision may be individual/triadic or group. The Board must approve the qualified supervisor before supervision begins.
Foreign equivalence
Section 40-75-260(C) requires all ordinary licensure requirements plus Board satisfaction with the applicant’s experience, command of English and foreign academic program equivalence to a relevant accredited United States program.
Initial licensure following associate supervised experience
Application
Submit the Board-approved application, fees and required supporting records, identification and lawful-presence verification. Comply with Board requests for other applicable documentation.
Background check
Under Section 40-75-220(B), the applicant bears the cost of fingerprint-supported South Carolina Law Enforcement Division and FBI criminal-record checks; results are reported to LLR.
Education
Graduate education must satisfy Regulation 36-04: a qualifying CACREP Clinical Mental Health Counseling program with at least 60 graduate semester hours, or the specified master’s, specialist’s or doctoral degree with at least 60 counseling graduate semester hours and qualifying program and institution accreditation. Non-CACREP applicants submit coursework descriptions and practicum/internship review materials and official transcripts.
Examination
Pass either NCE or NCMHCE. A score already obtained is accepted; after education and application approval the Board sends examination-registration instructions to applicants who have not already passed. The score remains a requirement even when obtained before the application.
Experience
Hold a current, active, unrestricted South Carolina professional counselor associate license and document at least 1,500 post-master’s clinical experience/supervision hours over at least two years: at least 1,380 direct client contact hours and 120 supervision hours, including at least 60 individual/triadic supervision hours; remaining supervision may be individual/triadic or group. The Board must approve the qualified supervisor before supervision begins.
Military training
Section 40-1-640 requires favorable consideration of military education, training and experience upon satisfactory evidence; it does not waive examinations or other eligibility standards.
Expedited endorsement for a military spouse
No examination is required for this applicant pathway.
Application
Submit the Board-approved application, fees and required supporting records, identification and lawful-presence verification. Comply with Board requests for other applicable documentation.
Background check
Under Section 40-75-220(B), the applicant bears the cost of fingerprint-supported South Carolina Law Enforcement Division and FBI criminal-record checks; results are reported to LLR.
Certification
Certify that the Board statutes, regulations and profession-specific Code of Ethics have been read and understood. This is a certification condition, not an examination.
Existing license
Hold a current, active, unrestricted license in good standing in another United States jurisdiction at an equivalent credential level.
Investigations
No current or pending investigation in the jurisdiction of licensure; Section 40-75-260(B)(3) also bars licensure while an investigation of a potentially disqualifying act remains pending in this or another jurisdiction.
Military spouse
Be married to and living with an active-duty United States Armed Forces member relocated to and stationed in South Carolina under official orders; submit orders, marriage record and verification of every license held. LLR prioritizes the application and may request further documentation.

Official no-examination sources

Effective from 2026-09-22.

Licensure under the Board reciprocity agreement
No examination is required for this applicant pathway.
Application
Submit the Board-approved application, fees and required supporting records, identification and lawful-presence verification. Comply with Board requests for other applicable documentation.
Background check
Under Section 40-75-220(B), the applicant bears the cost of fingerprint-supported South Carolina Law Enforcement Division and FBI criminal-record checks; results are reported to LLR.
Certification
Certify that the South Carolina statutes, regulations and LPC Code of Ethics have been read and understood.
Existing license
Hold the current, active, unrestricted NC LCMHC license in good standing specified by South Carolina’s Board page. This is an applicant condition; no other jurisdiction’s law or examination was researched.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after lapse of more than five years
No examination is required for this applicant pathway.
Application
Submit application, required identification, lawful-presence records and reinstatement fees.
Board review
Appear before the Board to determine whether and on what terms the license will be reinstated. Case-specific Board conditions remain applicant conditions; the defining rule and application do not identify a profession examination for this reinstatement route.
Lapse
License has been lapsed for more than five years.
Practice affidavit
Submit a notarized affidavit that the applicant did not practice the profession or supervision while the license was not active.
Underlying license
Seek restoration of the previously issued LPC license.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after lapse of fewer than five years
No examination is required for this applicant pathway.
Application
Submit application, required identification, lawful-presence records and reinstatement fees.
Continuing education
Pay fees for each lapsed licensing period and the reinstatement fee; provide satisfactory proof of required CE for every lapsed year. The Board may waive any CE requirement for good cause on appropriate conditions. Regulation 36-16 includes the suicide hour; the May 21, 2025 form’s older 34-hour general description does not override that regulation.
Lapse
License has been lapsed for fewer than five years.
Practice affidavit
Submit a notarized affidavit that the applicant did not practice the profession or supervision while the license was not active.
Underlying license
Seek restoration of the previously issued LPC license.

Official no-examination sources

Effective from 2026-09-22.

Biennial license renewal
No examination is required for this applicant pathway.
Active duty exemption
Sections 40-1-610 and 40-1-620 exempt active-duty military licensees from CE while serving and license fees for a calendar year with any active-duty service.
Continuing education
Complete 40 Board-approved CE hours per two-year period: 33 discipline-related, one suicide assessment/treatment/management and six ethics; first-time licensees are exempt for their initial licensing period. Multiple professional licenses require 50 hours allocated as stated in Regulation 36-16.
Existing license
Renew an existing license every two years during the Board renewal period; pay applicable renewal fees.
Underlying license
Maintain the conditions of the underlying professional practice authorization.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement following impairment related suspension
No examination is required for this applicant pathway.
Competence reports
Provide two Board-approved reports that assess capability to practice to prevailing standards and explain the determination.
Discipline
Serve any specified ineligibility period; indefinite ineligibility requires successful completion of conditions and the Board’s determination that the period served is commensurate with the violations.
Medical assessment
A Board-ordered physical or mental health examination is a fitness evaluation, not a licensing examination of the counseling profession.
Monitoring
Comply with Board monitoring and consent/order conditions, then submit annual sworn progress reports for at least two years following termination of the consent agreement.
Treatment
Complete required Board-approved inpatient treatment and comply with aftercare contracts or consent agreements.
Underlying license
The previously issued license is the subject of reinstatement.

Official no-examination sources

Effective from 2026-09-22.

Restoration after voluntary surrender
No examination is required for this applicant pathway.
Board decision
Restoration requires a majority Board vote and satisfaction of Board-imposed conditions. Neither defining statutory provision identifies a professional examination; any individualized eligibility determination is an applicant condition.
Practice limit
No practice is permitted during surrender.
Surrender
The previous practice authorization was voluntarily surrendered while under investigation.
Underlying license
The previously issued license is the subject of restoration.

Official no-examination sources

Effective from 2026-09-22.

Temporary Professional License — Professional Counselor

Statutory military-spouse temporary professional license, expiring one year after issue and not renewable.

Licensing authority: South Carolina Board of Examiners for Licensure of Professional Counselors, Marriage and Family Therapists, Addiction Counselors and Psycho-Educational Specialists · Application information

Military spouse temporary licensure with equivalent domestic credentials
No examination is required for this applicant pathway.
Application
Submit the Board-prescribed temporary-license application and required proofs of marriage, military orders, licensure and good standing.
Background check
Applicant-funded SLED and FBI fingerprint checks apply because ordinary LPC licensure requires comparable checks.
Endorsement eligibility
Qualify for Section 40-75-260(B) and Regulation 36-14(A): equivalent, current, active, unrestricted United States license in good standing; no pending investigation; certify understanding of Board laws, rules and ethics; provide Board-required documentation.
Existing license
Hold a valid professional counselor license from another state, the District of Columbia, a United States possession or territory, or a foreign jurisdiction, with a certificate of good standing.
Military spouse
Be married to and living with an active-duty United States Armed Forces member relocated to and stationed in South Carolina under official orders; submit orders, marriage record and verification of every license held. LLR prioritizes the application and may request further documentation.
State standards
Section 40-1-630(A) preserves all applicable state-law requirements; temporary licensure is not an unconditional waiver.
Term
The temporary license expires one year after issuance and may not be renewed.

Official no-examination sources

Effective from 2026-09-22.

Military spouse temporary licensure through foreign qualification review
Application
Submit the Board-prescribed temporary-license application and required proofs of marriage, military orders, licensure and good standing.
Background check
Applicant-funded SLED and FBI fingerprint checks apply because ordinary LPC licensure requires comparable checks.
Clinical experience
Hold a current, active, unrestricted South Carolina professional counselor associate license and document at least 1,500 post-master’s clinical experience/supervision hours over at least two years: at least 1,380 direct client contact hours and 120 supervision hours, including at least 60 individual/triadic supervision hours; remaining supervision may be individual/triadic or group. The Board must approve the qualified supervisor before supervision begins.
Education
Graduate education must satisfy Regulation 36-04: a qualifying CACREP Clinical Mental Health Counseling program with at least 60 graduate semester hours, or the specified master’s, specialist’s or doctoral degree with at least 60 counseling graduate semester hours and qualifying program and institution accreditation. Non-CACREP applicants submit coursework descriptions and practicum/internship review materials and official transcripts.
Examination
Pass either NCE or NCMHCE. A score already obtained is accepted; after education and application approval the Board sends examination-registration instructions to applicants who have not already passed. The score remains a requirement even when obtained before the application.
Existing license
Hold a valid professional counselor license from another state, the District of Columbia, a United States possession or territory, or a foreign jurisdiction, with a certificate of good standing.
Foreign equivalence
Section 40-75-260(C) requires all ordinary licensure requirements plus Board satisfaction with the applicant’s experience, command of English and foreign academic program equivalence to a relevant accredited United States program.
Military spouse
Be married to and living with an active-duty United States Armed Forces member relocated to and stationed in South Carolina under official orders; submit orders, marriage record and verification of every license held. LLR prioritizes the application and may request further documentation.
State standards
Section 40-1-630(A) preserves all applicable state-law requirements; temporary licensure is not an unconditional waiver.
Term
The temporary license expires one year after issuance and may not be renewed.

National Counselor Examination

Provider
National Board for Certified Counselors (NBCC); administered through the Center for Credentialing & Education (CCE) and delivered by Pearson VUE at test centers or online through OnVUE
Format
200-question, multiple-choice, non-sectioned examination; scored and unscored items appear in jumbled order; a different form is compiled for each administration
Exam questions
200 multiple-choice questions: 160 scored and 40 unscored field-test items
Time limit
225 minutes to complete the examination within a 255-minute test session (one scheduled 15-minute break after question #100)
Passing score
Criterion passing score set by a modified Angoff method and adjusted for each form by statistical equating; passing scores may vary slightly for each version
Examination outline
  • 1. Professional Practice and Ethics — This section encompasses counselors’ knowledge, skills, and abilities related to maintaining proper administrative and clinical protocols. (12% of items; 19 scored items) (12%)
    • A. Assess your (the counselor) competency to work with a specific client
    • B. Understand statistical concepts and methods in research
    • C. Practice legal and ethical counseling
    • D. Clarify counselor–client roles
    • E. Discuss client’s rights and responsibilities
    • F. Discuss limits of confidentiality
    • G. Explain counselor agency policies
    • H. Review payment, fees, and insurance benefits
    • I. Explain counseling processes, procedures, risks, and benefits
    • J. Explain uses and limits of social media
    • K. Inform clients about the legal aspects of counseling
    • L. Obtain informed consent
    • M. Discuss confidentiality as it applies to electronic communication
    • N. Establish group rules, expectations, and termination criteria
    • O. Assess competency to provide informed consent
    • P. Monitor the therapeutic relationship and build trust as needed
    • Q. Review client records
    • R. Provide adequate accommodations for clients with disabilities
    • S. Provide information to third parties
    • T. Provide referral sources if counseling services are inadequate/ inappropriate
    • U. Advocate for professional and client issues
    • V. Seek supervision/consultation
    • W. Create and maintain documentation appropriate for each aspect of the counseling process
    • X. Awareness and practice of self-care
  • 2. Intake, Assessment, and Diagnosis — This section encompasses counselors’ knowledge, skills, and abilities to effectively conduct client intake, assessment, and diagnosis. (12% of items; 19 scored items) (12%)
    • A. Conduct a biopsychosocial interview
    • B. Conduct a diagnostic interview
    • C. Conduct cultural formulation interview
    • D. Conduct an initial interview
    • E. Determine diagnosis
    • F. Perform a Mental Status Exam (MSE)
    • G. Consider co-occurring diagnoses
    • H. Determine level of care needed
    • I. Determine the appropriate modality of treatment
    • J. Assess the presenting problem and level of distress
    • K. Evaluate an individual’s level of mental health functioning
    • L. Screen clients for appropriate services
    • M. Select, use, and interpret appropriate assessment instruments
    • N. Use formal and informal observations
    • O. Assess for trauma
    • P. Assess substance use
    • Q. Obtain client self-reports
    • R. Evaluate interactional dynamics
    • S. Conduct ongoing assessment for at-risk behaviors (i.e., suicide, homicide, self/other injury, and relationship violence)
    • T. Use pre-test and post-test measures to assess outcomes
    • U. Evaluate counseling effectiveness
  • 3. Areas of Clinical Focus — This section encompasses counselors’ knowledge and skills related to areas of clients’ concern(s). (29% of items; 47 scored items) (29%)
    • A. Adjustment related to physical loss/injury/medical condition
    • B. Aging/geriatric concerns
    • C. Behavioral problems
    • D. Bullying
    • E. Caregiving concerns
    • F. Cultural adjustments
    • G. End-of-life issues
    • H. Fear and panic
    • I. Financial issues
    • J. Gender identity development
    • K. Grief/loss
    • L. Hopelessness/depression
    • M. Loneliness/attachment
    • N. Hyper/hypo mental focus
    • O. Intellectual functioning issues
    • P. Insomnia/sleep issues
    • Q. Maladaptive eating behaviors
    • R. Remarriage/recommitment
    • S. Developmental processes/tasks/issues
    • T. Obsessive thoughts/behaviors
    • U. Occupation and career development
    • V. Physical issues related to anxiety
    • W. Physical issues related to depression
    • X. Physical/emotional issues related to trauma
    • Y. Process addictions (pornography, gambling)
    • Z. Racism/discrimination/oppression
    • AA. Religious values conflict
    • AB. Retirement concerns
    • AC. Ruminating and/or intrusive thoughts
    • AD. Separation from primary care givers
    • AE. Sexual functioning concerns
    • AF. Sleeping habits
    • AG. Spiritual/existential concerns
    • AH. Stress management
    • AI. Substance use/addiction issues
    • AJ. Suicidal thoughts/behaviors
    • AK. Terminal illness issues
    • AL. Visual/auditory hallucinations
    • AM. Worry and anxiety
    • AN. Adoption issues
    • AO. Blended family issues
    • AP. Child abuse-related concerns
    • AQ. Child development issues
    • AR. Dating/relationship problems
    • AS. Divorce
    • AT. Family abuse/violence (e.g., physical, sexual, emotional)
    • AU. Interpersonal partner violence concerns
    • AV. Marital/partner communication problems
    • AW. Parenting/co-parenting conflicts
    • AX. Emotional dysregulation
  • 4. Treatment Planning — This section encompasses counselors’ knowledge, skills, and abilities to develop an effective course of treatment. (9% of items; 14 scored items) (9%)
    • A. Collaborate with client to establish treatment goals and objectives
    • B. Establish short- and long-term counseling goals consistent with clients’ diagnoses
    • C. Identify barriers affecting client goal attainment
    • D. Identify strengths that improve the likelihood of goal attainment
    • E. Refer to different levels of treatment (e.g., outpatient, inpatient, residential, etc.)
    • F. Refer to others for concurrent treatment
    • G. Guide treatment planning
    • H. Discuss termination process and issues
    • I. Discuss transitions in group membership
    • J. Follow-up after discharge
    • K. Use assessment instrument results to facilitate client decision making
    • L. Review and revise the treatment plan
    • M. Engage clients in review of progress toward treatment goals
    • N. Collaborate with other providers and client support systems (documentation and report writing)
    • O. Discuss with clients the integration and maintenance of therapeutic progress
    • P. Educate client to the value of treatment plan compliance
  • 5. Counseling Skills and Interventions — This section encompasses counselors’ knowledge, skills, and abilities to conduct effective counseling. (30% of items; 48 scored items) (30%)
    • A. Align intervention with client’s developmental level
    • B. Align intervention with counseling modality (individual, couple, family, or group)
    • C. Align intervention with client population (e.g., veterans, minorities, disenfranchised, disabled)
    • D. Implement individual counseling in relation to a plan of treatment
    • E. Establish therapeutic alliance
    • F. Apply theory-based counseling intervention(s)
    • G. Address addiction issues
    • H. Address cultural considerations
    • I. Address family composition and cultural considerations
    • J. Evaluate and explain systemic patterns of interaction
    • K. Explore family member interaction
    • L. Explore religious and spiritual values
    • M. Guide clients in the development of skills or strategies for dealing with their problems
    • N. Help clients develop support systems
    • O. Help facilitate clients’ motivation to make the changes they desire
    • P. Improve interactional patterns
    • Q. Provide crisis intervention
    • R. Educate client about transference and defense mechanisms
    • S. Facilitate trust and safety
    • T. Build communication skills
    • U. Develop conflict resolution strategies
    • V. Develop safety plans
    • W. Facilitate systemic change
    • X. Provide distance counseling or telemental health
    • Y. Provide education resources (e.g., stress management, assertiveness training, divorce adjustment)
    • Z. Provide psychoeducation for client
    • AA. Summarize
    • AB. Reframe/redirect
    • AC. Facilitate empathic responses
    • AD. Use self-disclosure
    • AE. Use constructive confrontation
    • AF. Facilitate awareness of here-and-now interactions
    • AG. Facilitate resolution of interpersonal conflict
    • AH. Use linking and blocking in a group context
    • AI. Management of leader–member dynamics
    • AJ. Model giving and receiving of feedback
    • AK. Address impact of extended families
    • AL. Contain and manage intense feelings
    • AM. Explore the influence of family of origin patterns and themes
    • AN. Address the impact of social support network
    • AO. Use “structured” activities
    • AP. Promote and encourage interactions among group members
    • AQ. Promote and encourage interactions with the group leader
    • AR. Use psychoeducation as a part of the group process
    • AS. Explain phases in the group process
    • AT. Identify and discuss group themes and patterns
    • AU. Create intervention based on the stage of group development
    • AV. Challenge harmful group member behaviors
    • AW. Address the potential interaction of members outside of the group
  • 6. Core Counseling Attributes — This section encompasses behaviors, traits, and dispositions of effective counselors. (8% of items; 13 scored items) (8%)
    • A. Awareness of self and impact on clients
    • B. Genuineness
    • C. Congruence
    • D. Demonstrate knowledge of and sensitivity to gender orientation and gender issues
    • E. Demonstrate knowledge of and sensitivity to multicultural issues
    • F. Demonstrate conflict tolerance and resolution
    • G. Empathic attunement
    • H. Empathic responding
    • I. Foster the emergence of group therapeutic factors
    • J. Non-judgmental stance
    • K. Positive regard
    • L. Respect and acceptance for diversity
    • M. Use foundational listening, attending, and reflecting skills
Examination sources

National Clinical Mental Health Counseling Examination

Provider
National Board for Certified Counselors (NBCC); administered through the Center for Credentialing & Education (CCE) and delivered by Pearson VUE at test centers or online through OnVUE
Format
11 clinical case studies, each with one narrative in three sections (initial intake summary and two counseling sessions) followed by 9–15 four-option, single-answer multiple-choice questions; one case study is unscored
Exam questions
130–150 multiple-choice items, of which 100 are scored
Time limit
225 minutes to complete the examination within a 255-minute test session (one scheduled 15-minute break after the fifth case study)
Passing score
Cut score set through standard setting and applied to other forms through statistical equating; the total score is the number of correctly answered scored items
Examination outline
  • 1. Professional Practice and Ethics — This section encompasses counselors’ knowledge, skills, and abilities related to maintaining proper administrative and clinical protocols. (15% of scored items) (15%)
    • A. Assess your (the counselor) competency to work with a specific client
    • B. Understand statistical concepts and methods in research
    • C. Practice legal and ethical counseling
    • D. Clarify counselor/client roles
    • E. Discuss client’s rights and responsibilities
    • F. Discuss limits of confidentiality
    • G. Explain counselor/agency policies
    • H. Review payment, fees, and insurance benefits
    • I. Explain counseling processes, procedures, risks, and benefits
    • J. Explain uses and limits of social media
    • K. Inform clients about the legal aspects of counseling
    • L. Obtain informed consent
    • M. Discuss confidentiality as it applies to electronic communication
    • N. Establish group rules, expectations, and termination criteria
    • O. Assess competency to provide informed consent
    • P. Monitor the therapeutic relationship and build trust as needed
    • Q. Review client records
    • R. Provide adequate accommodations for clients with disabilities
    • S. Provide information to third parties
    • T. Provide referral sources if counseling services are inadequate/inappropriate
    • U. Advocate for professional and client issues
    • V. Supervision
    • W. Create and maintain documentation appropriate for each aspect of the counseling process
    • X. Awareness and practice of self-care
  • 2. Intake, Assessment, and Diagnosis — This section encompasses counselors’ knowledge, skills, and abilities to effectively conduct client intake, assessment, and diagnosis. (25% of scored items) (25%)
    • A. Conduct a biopsychosocial interview
    • B. Conduct a diagnostic interview
    • C. Conduct cultural formulation interview
    • D. Conduct an initial interview
    • E. Determine diagnosis
    • F. Perform a Mental Status Exam (MSE)
    • G. Consider co-occurring diagnoses
    • H. Determine level of care needed
    • I. Determine the appropriate modality of treatment
    • J. Assess the presenting problem and level of distress
    • K. Evaluate an individual’s level of mental health functioning
    • L. Screen clients for appropriate services
    • M. Select, use, and interpret appropriate assessment instruments
    • N. Use formal and informal observations
    • O. Assess for trauma
    • P. Assess substance use
    • Q. Obtain client self-reports
    • R. Evaluate interactional dynamics
    • S. Conduct ongoing assessment for at-risk behaviors (i.e., suicide, homicide, self/other-injury, and relationship violence)
    • T. Use pre-test and post-test measures to assess outcomes
    • U. Evaluate counseling effectiveness
  • 4. Treatment Planning — This section encompasses counselors’ knowledge, skills, and abilities to develop an effective course of treatment. (15% of scored items) (15%)
    • A. Collaborate with client to establish treatment goals and objectives
    • B. Establish short- and long-term counseling goals consistent with client’s diagnosis
    • C. Identify barriers affecting client goal attainment
    • D. Identify strengths that improve the likelihood of goal attainment
    • E. Refer to different levels of treatment (e.g., outpatient, inpatient, residential)
    • F. Refer to others for concurrent treatment
    • G. Guide treatment planning
    • H. Discuss termination process and issues
    • I. Discuss transitions in group membership
    • J. Follow up after discharge
    • K. Use assessment instrument results to facilitate client decision-making
    • L. Review and revise the treatment plan
    • M. Engage clients in review of progress toward treatment goals
    • N. Collaborate with other providers and client support systems (documentation and report writing)
    • O. Discuss with clients the integration and maintenance of therapeutic progress
    • P. Educate client to the value of treatment plan compliance
  • 5. Counseling Skills and Interventions — This section encompasses counselors’ knowledge, skills, and abilities to conduct effective counseling. (30% of scored items) (30%)
    • A. Align intervention with client’s developmental level
    • B. Align intervention with counseling modality (individual, couple, family, or group)
    • C. Align intervention with client population (e.g., veterans, minorities, disenfranchised, disabled)
    • D. Implement individual counseling in relation to a plan of treatment
    • E. Establish therapeutic alliance
    • F. Apply theory-based counseling intervention(s)
    • G. Address addiction issues
    • H. Address cultural considerations
    • I. Address family composition and cultural considerations
    • J. Evaluate and explain systemic patterns of interaction
    • K. Explore family member interaction
    • L. Explore religious and spiritual values
    • M. Guide clients in the development of skills or strategies for dealing with their problems
    • N. Help clients develop support systems
    • O. Help facilitate clients’ motivation to make the changes they desire
    • P. Improve interactional patterns
    • Q. Provide crisis intervention
    • R. Educate client about transference and defense mechanisms
    • S. Facilitate trust and safety
    • T. Build communication skills
    • U. Develop conflict resolution strategies
    • V. Develop safety plans
    • W. Facilitate systemic change
    • X. Provide distance counseling or telemental health
    • Y. Provide education resources (e.g., stress management, assertiveness training, divorce adjustment)
    • Z. Provide psychoeducation for client
    • AA. Summarize
    • AB. Reframe/redirect
    • AC. Facilitate empathic responses
    • AD. Use self-disclosure
    • AE. Use constructive confrontation
    • AF. Facilitate awareness of here-and-now interactions
    • AG. Facilitate resolution of interpersonal conflict
    • AH. Use linking and blocking in a group context
    • AI. Management of leader–member dynamics
    • AJ. Model giving and receiving of feedback
    • AK. Address impact of extended families
    • AL. Contain and manage intense feelings
    • AM. Explore the influence of family of origin patterns and themes
    • AN. Address the impact of social support network
    • AO. Use “structured” activities
    • AP. Promote and encourage interactions among group members
    • AQ. Promote and encourage interactions with the group leader
    • AR. Use psychoeducation as a part of the group process
    • AS. Explain phases in the group process
    • AT. Identify and discuss group themes and patterns
    • AU. Create intervention based on the stage of group development
    • AV. Challenge harmful group member behaviors
    • AW. Address the potential interaction of members outside of the group
  • 6. Core Counseling Attributes — This section encompasses behaviors, traits, and dispositions of effective counselors. (15% of scored items) (15%)
    • A. Awareness of self and impact on clients
    • B. Genuineness
    • C. Congruence
    • D. Demonstrate knowledge of and sensitivity to gender orientation and gender issues
    • E. Demonstrate knowledge of and sensitivity to multicultural issues
    • F. Demonstrate conflict tolerance and resolution
    • G. Empathic attunement
    • H. Empathic responding
    • I. Foster the emergence of group therapeutic factors
    • J. Non-judgmental stance
    • K. Positive regard
    • L. Respect and acceptance for diversity
    • M. Use foundational listening, attending, and reflecting skills
Examination sources