JOB ALERT: We are hiring!

As I begin to wind down my professional career as a licensed counselor, my hope is to inspire others to take the reign and continue the important work in mental health. Most people do not fully understand the difference in mental health professions or the type of preparation each field requires in order to practice.  The United States is experiencing a critical shortage of mental health providers.  The Bureau of Labor and Statistics projects that within the next 10 years the need for mental health professionals will increase up to 21%.  Particularly needy areas are: underserved rural areas as well as the Pacific North and South West states. Recently, I was asked by a pediatrician friend to help provide career path information, for this reason, I want to share my personal journey to becoming a therapist.

My story

After high school, I went to cosmetology school because I did not know what I wanted to do and it was only a 9 month commitment.  I worked for a few years and then decided that I really wanted to go to college.  I have always had an affinity to “trying to understand what make people tick”.  In growing up, my mother especially encouraged me to learn about diverse cultures and ways of living.  I obtained by bachelor’s degree and then I got married. I worked in a residential treatment facility for adults with intellectual disorders.  After 5 years, I started having children with my husband.  During this time, I experienced significant post-partum depression.  I opted to begin some psychotropic medication, at the advice of my physician as well as engaging in individual counseling.  In looking back, I do believe that I was attending “mental health boot camp” which helped to cultivate in me the desire to continue my education and to become a counselor.

Fast forward, when our children were young, both my husband and I were both in grad school.  I was feeling like I was spreading myself too thin, so I waited until the kids were in middle school before I went back to gets my master’s degree in Counselor Education at St. Bonaventure University in New York State dually completing both the Clinical Mental Health Counseling track as well as the School Counseling track.  I did consider the Social Work degree but after reviewing the curriculum of a Counseling program, I felt that this was the better choice for me.   My graduate work focused on micro-counseling skills as required the credentialing body, CACREP, the Council for Accreditation of Counseling and Related Educational Programs.  I completed: 60 graduate level credits, a 100 hour practicum and 1,500 internship hours. (Later in order to become licensed I had to have 3,000 hours work experience with clinical supervision).

Upon graduation, my first job was as a school counselor.  While I did enjoy the work at a rural middle school, I felt that my “calling” was more in the clinical realm.  So, in order to obtain required clinical experience I began working at a university counseling center providing individual therapy to college student in order to obtain the needed supervised hours for licensure.  I took the board National Counselor Exam and passed as a Licensed Professional Counselor in Pennsylvania.  In addition I also, obtained licensure in New York State which require the passing of the National Clinical Mental Health Counselor Exam.  During my formative years as a counselor, the most challenging, yet worthwhile professional setting was as a therapist at a community mental health clinic.  I was very much of generalist at first but then discovered how many of my clients had a history of trauma.  So, I focused my advanced training in trauma therapy, including EMDR (Eye Movement Desensitization Reprocessing).  I worked in a psychiatric unit and then returned to higher education to be a university counselor and to teach graduate courses in the Counselor Education program.  I am now a Clinical Supervisor assisting new and upcoming counselors by providing the required supervision and consultation for licensure.  Presently, I am a private consultant as well as working as a 1099 employee for an online platform providing clinical supervision to clinicians in both NY and PA.  I can honestly say that becoming a counselor has been one of the best decisions that I have made for myself.  I enjoy working in the counseling field and I believe that I am good at what I do.  I continue to consider it an honor and a privilege to be invited into the some of the most intimate places in people’s lives. One of my most favorite moments in session, is when the client will say:  “Wow, I never thought of it that way before”.

The process

There are several professional pathways to becoming a counselor.  Many different titles are used inter-changeably to describe the same position.  Other terms are:  Psychotherapist, therapist, mental health clinician in addition to counselor.  This expose will show 3 different pathways to becoming a mental health practitioner:   Professional Counselor, Marriage and Family Therapist and Clinical Social Worker.  In addition, many psychologists often provide similar services (while they often specialize in testing and assessment).  Historically, “counseling” tends to be a brief, solution focused approach whereas therapy tends to imply and more in depth psychodynamic approach.

Finding a well-trained, experienced and skilled counselor can often be a daunting task especially in under-served areas.  Unfortunately, according to Rachel McCrickard, CEO of Motivo:  According to licensure bodies, 64% of those who have received their master’s degrees (in the counseling field) never go on to complete the required clinical supervision required.

As a Licensed Mental Health Counselor and Clinical Supervisor in NY and PA, I am passionate about helping to streamline the arduous process of licensure for MH clinicians.

Each of the 3 types of mental health professionals (PC, MFT and CSW) all follows similar career pathways each with unique and differentiating requirements.  In addition, each discipline has individual state regulations.  Presently, there is a national movement to increase reciprocity between states.  For example, in June of 2023 a program called Counseling Compact will be instated to assist counselors in becoming licensed in several states without having to apply to each one.  The concept of universal licensing will be beneficial to not only the professional but also to prospective clients by providing easier access.  In addition, presently tele-mental health services are growing exponentially requiring MH clinicians to be licensed in different states.  The present law states that the clinician must be licensed in the state in which the client lives and is present.  So, a Counselor in Pennsylvania can virtually provide counseling through a secure online platform to a client in California if the clinician is licensed in CA.  This opportunity will open a plethora of options in mental health providing a wider choice of professionals and specialists.  Agencies like BetterHelp, Aptihealth, Talk Space, ReGain, Cerebral, Grow Therapy, Calmerry.  For example, BetterHelp hires over 23,000 therapist who serve 2.5 million clients/consumers.  Many platforms will bill insurance companies with a co-pay of an average of $30 (TalkSpace); while others charge self-pay rates between $65-90 a session (BetterHelp).

There is such a high need for mental health workers.  The CDC NAMI estimate that more than 1 in 5 US adults live with a mental illness.  Johns Hopkins estimates about 1:4 at 26% of the population.

Training a counselor is a complex process which ensures that they are properly trained and experienced to manage a wide range of needs to include not also the more common conditions of depression and anxiety but also eating disorders, psychosis, marital conflict, substance abuse problems and other addictions, autism disorders, ADHD to name a few.

The licensed mental health professional pathway includes:  Masters education, practicum/internships, clinical experience with consultation/supervision and passing a state or national board exam.

Professional Demographics

Professional settings: Outpatient Clinic, Intensive Out-Patient Program, Inpatient Hospital, **Private Practice, Schools and Universities, Jails and Prisons, Rehabilitation Programs, Employee Assistance Programs.

Note:  According to Cunningham (2010), mental health counselors in private practice significantly experience more job satisfaction.

Types:  Individual, Couples, Families, Groups

Specializations:  Tele-therapy, Trauma therapy, Play Therapy, Addiction, Crisis Intervention, Death and Dying, Career Counseling, Sports Psychology, LGBTQIA+ focus, Applied Behavior Analysis, Music/Art/Dance Therapy, Sex Therapy, Behavioral Health Specialists working as Co-Responders with Law Enforcement

Exciting upcoming advances in this field include applying for reciprocity of a privilege to practice in other states through a national initiative called the Counseling Compact.  This program will increase access for both providers and consumers.  Also, many states are beginning to allow mental health counselors the ability to diagnose.  This is especially important in working with insurance companies for reimbursement.

Finally, while the preparation is extensive and the pay is moderate, many find great satisfaction from the education, training and lived experience as a professional counselor.

If you know of someone who may be interested in further exploring this career path, please have them contact me at amy.mickle61@gmail.com for more information.

Amy Mickle, LPC, LMHC

Independent Clinical Mental Health Supervisor for Licensure

Resources:

Cunningham, Linda
Bureau of Labor and Statistics
McCrickard, Rachel
Indeed
ACA
ACSW
MFT