Clinical mental health counselors: Scope of practice


Clinical mental health counselors work with clients to identify and overcome personal challenges such as stress management, substance abuse, relationship problems, and career guidance, as well as more serious behavioral disorders that are disruptive and sometimes life-threatening: attention deficit hyperactivity disorder (ADHD) and severe depression.

Mental illness can be caused by temporary factors such as overwork, financial hardships, or poor health, or there may be underlying physical or chemical conditions, traumatic childhood experiences, or long-term substance abuse.

The latest statistics published by the Centers for Disease Control and Prevention indicate that more than one in five adults in the US is currently living with a mental illness, and one in 25 adults has a serious mental illness such as bipolar disorder, schizophrenia, or acute depression. People with mental issues often resort to drugs and alcohol to dampen or divert feelings, but this is not treating the source of the problem and may lead to counselors having to treat their clients for multiple issues.

In spite of the high incidence of mental illness, access to mental healthcare is limited, even for those with healthcare insurance. A combination of inadequate insurance coverage, high costs, and a shortage of mental healthcare professionals has resulted in limited access to counseling services for those in need. 

By obtaining a bachelor’s degree and a Masters degree, students can nurture their passion for helping people with mental health issues. For instance, an Online Masters in Clinical Mental Health Counseling from a reputable institution like the American International College would provide students with counseling skills such as cognitive therapies and crisis intervention to effectively treat and even prevent mental illness, easing some of the pressure placed on mental health counselors.

Scope of practice

Counselors consult with individual clients, families, and groups. Mental health training includes learning the reasons for mental illness and substance abuse disorders, the various methods of therapy, and a client-centered approach to counseling.


Patient assessment includes conducting interviews, assessing the patient’s mental and biopsychosocial status, and examining their mental health history. Evaluation of the psychological status of the patient involves diagnostic tools such as physical examinations, neurological imaging, and psychological evaluations.

Advances in science and technology have enabled important medical and psychological breakthroughs. Neurological imaging, such as magnetic resonance imaging (MRI), is used to determine whether certain parts of the brain are underdeveloped or injured. Through the assessment of the results of neuroimaging, scientists have managed to determine the effects of irregularities in the brain on individuals’ mental health. Inactivity in certain areas of the brain can indicate conditions such as attention deficit hyperactivity disorder (ADHD), while overactivity in others can indicate depression. The National Institute for Mental Health (NIMH), however, states that brain imaging may not be used in isolation from the traditional method of psychoanalysis.

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Substance abuse

When it comes to treating substance abuse in patients, counselors need to establish the cause of the problem to ensure successful interventions. Counselors use various diagnostic tests to find out whether substance abuse is the root cause of the problem or whether it’s an attempt at coping with some deeper problem. Diagnostic tests include psychoanalysis and assessments of cognitive functioning, intelligence, personality traits, and aptitude.

Counselors conduct interviews with family members and friends and examine the patient’s medical and social history. There may be underlying problems such as ADHD, brain injury, or behavioral disorders, and the method of intervention for substance abuse will be changed accordingly to accommodate alternate treatments.

Treatment plans

A treatment plan is an outline of the client’s personal information, their diagnosis, a record of their financial and social status, and details of the prescribed treatment. It should include feedback and progress reports and document any support the client may have from family and friends.

The treatment plan should include a set of realistic goals and timelines. The tracking of goals serves to encourage clients and boosts their confidence as each of the small goals is met. The tracking process raises opportunities to discuss issues and helps to reinforce goals and objectives.

Treatment plans help the client and counselor keep track of prescribed treatments and progress made, setting out clear lines of responsibility for both parties. A plan helps reduce the risk of waste and potential abuse of the terms agreed upon.

Therapy techniques

Counselors need specific skills to deal with clients across the spectrum of mental illness. They treat clients with empathy and authenticity while displaying good listening and communication skills. They know when to set boundaries and collaborate with the client to find solutions to their problem. Having an inherent interest in people instills a healthy sense of commitment to helping others solve their problems. At the same time, counselors need to practice strict self-control so as not to get too deeply involved with their client’s problems.

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Various counseling techniques may be used, with counselors choosing one or more that suits the symptoms being displayed by the client. Here are a few widely used ones:

Cognitive behavioral therapy (CBT) focuses on the relationship between thoughts, emotions, and behavior. Negative thoughts invoke negative emotions and result in disruptive behavior. By teaching the client to focus on positive thoughts, the counselor can turn the situation around.

Dialectical behavior therapy (DBT) is similar but used when clients experience very strong emotions. DBT encourages patients to accept their lives and behavioral issues and uses mindfulness techniques to help them make changes where required.

Gestalt therapy encourages the client to focus on the present while giving unconditional support and empathy during the process. It allows the client to reach their goals in their own time and manner, independently of any input from the counselor.

Client-centered therapy allows the client to take control of the session with a little guidance from the counselor when necessary. This method allows the client to express themselves freely and to discover their thoughts and emotions without input from the counselor.

Existential therapy allows both the client and counselor to focus on internal and spiritual challenges so that they may achieve an existential, emotional, and psychological understanding of themselves and their surroundings.

The challenges and rewards of mental health counseling

Counseling people who have mental health issues is both challenging and rewarding. The more you learn about people and their problems, the more interesting the job becomes. It is a never-ending learning experience, and counseling can be an extremely rewarding profession when you have the knowledge and skills in place.



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