What Does a Clinical Mental Health Counselor Do, and How Do You Become One?

Jump to:

1. What Is a Clinical Mental Health Counselor?
2. What is the Role of a CMHC?
3. Essential Skills for Clinical Mental Health Counselors
4. Types of Clients Clinical Mental Health Counselors Support
5. Clinical Mental Health Counselor Work Environments
6. How to Become a Clinical Mental Health Counselor
7. About Earning Your MSED Degree Online

Blog Updated on September 23, 2026.

According to Mental Health America’s 2025 report, The State of Mental Health in America, more than 1 in 5 adults — over 60 million people — experienced mental illness in the previous year. After being diagnosed with a mental health disorder, they need care and professional experts to help them manage symptoms and improve their well-being and quality of life. 

Mental health is a challenge for many Americans. In a 2026 Gallup poll, 29.5% of adults reported having a depression diagnosis at least once in their lives, with nearly 20% of the adult population currently being treated for depression. Additionally, 5.5% of adults and 10.1% of youth reported having suicidal thoughts, according to Mental Health America. Left untreated, these and other mental health conditions can be damaging and far-reaching. 

However, understanding the importance of treating these conditions is increasing, reducing harm and helping individuals thrive. Clinical mental health counselors are at the core of this effort, providing invaluable support to those who need it most. It can be a rewarding career for those equipped with an advanced degree in mental health counseling. But exactly what does a clinical mental health counselor do? 

What Is a Clinical Mental Health Counselor? 

Clinical mental health counselors specifically focus on psychopathology, including diagnosing and treating mental health disorders. 

They assist clients using several techniques designed to support mental, emotional, and behavioral health. As licensed professionals, they’re uniquely suited to help clients overcome challenges and develop skills that assist their personal growth. 

Mental health counselors take on many roles, from therapeutic intervention to advocating on patients’ behalf to health care professionals and insurance companies. Counselors may also communicate with families, courts, and law enforcement officials for their clients. 

What Is the Role of a CMHC? 

In the history of mental health counseling, there’s never been a more urgent need for counselors to join the workforce in various capacities. In a recent survey, 26.58% of adults who experienced 14 or more mentally unhealthy days per month reported that they couldn’t find the treatment they needed. Additionally, 77% of adults dealing with a substance use disorder in the past year went without treatment.

Treat Mental Health Issues 

Clinical mental health counselors treat clients for mental health disorders, from generalized anxiety to substance use to depression to OCD. Treatment can occur in individual, family, and group settings. It can involve different therapeutic techniques depending on the individual’s needs and the counselor’s expertise.

Support Individuals During Times of Transition 

Even if someone isn’t experiencing a mental health disorder, times of change, loss, or transition can prompt them to seek professional help. Clinical mental health counselors provide clients with support and opportunities for reflective growth when life feels uncertain or difficult.

Advocate for Positive Environmental, Social, and Occupational Changes for Mental Health 

Clinical mental health counselors may work in the public sphere with local and state officials to create policies that benefit their communities. They also guide individuals through necessary changes that can positively affect their mental health.

Respond to Clients in Distress 

Most clinical mental health counselors respond to urgent situations, from clients who’ve had a traumatic experience to those experiencing depressive episodes. Sometimes counselors go to hospitals, prisons, or courtrooms to advocate for their clients. Counselors also support crisis response, ranging from natural disasters to community trauma.

Essential Skills for Clinical Mental Health Counselors 

Clinical mental health counselors constantly learn and grow to help support their clients. Valuable skills they can cultivate include:

• Communication: Counselors should know how to share complex information, ask good questions, and practice good listening skills. 
• Empathy: Mental health professionals need to balance professional boundaries and empathy. This includes knowing how to separate their personal lives from the difficult circumstances and stories they often face at work. 
• Problem-solving and critical thinking: Each new client brings a new situation with unique challenges and treatment opportunities, and counselors should use their skills to identify treatment options. 

Effective counselors can work to cultivate the right dispositions for therapeutic settings. Qualities such as emotional stability, self-awareness, cooperativeness and professionalism, openness and flexibility, and cultural sensitivity help counselors serve clients in many situations. They also help them meet the demands of the job and enjoy rewarding careers. 

Types of Clients Clinical Mental Health Counselors Support 

What clinical mental health counselors do can vary based on the many specialized populations they serve and the titles they hold. With a master’s degree in clinical mental health counseling, you can seek positions such as group counselor, clinical director, and child and family therapist. Additionally, clinical mental health counselors support a variety of clients, including:

Clients Who Are Veterans 

Clinical mental health professionals offer counseling services to veterans in person at U.S. Department of Veterans Affairs (VA) facilities and online through the VA’s telehealth program. People who’ve served, particularly on active duty, often need support to process difficult experiences, which can include treatment for PTSD, grief, anxiety, and depression. 

Clients With PTSD 

PTSD affects 6 out of 100 people at some point in their lives. This condition develops after a dangerous or scary event. PTSD symptoms are complex, and they often require professional treatment to overcome. Clinical mental health counselors employ various therapeutic techniques to help clients heal from traumatic events and live in the present instead of reliving the past.

Clients With Substance Use Disorders 

The 2025 National Survey on Drug Use and Health found that 44.6 million people over age 12 had experienced substance use disorder in the previous year. From hourly counseling sessions to inpatient treatment and advocacy in the judicial system, clinical mental health counselors can support this population in a variety of ways. 

Clients With Depression and Other Diagnosed Disorders 

Depression and anxiety are central issues in our nation’s mental health crisis. Rates are on the rise for both of these disorders, and therapeutic work is often a core part of treatment. Clinical mental health counselors, such as those trained at St. Bonaventure University, can diagnose and treat depression, anxiety, and other conditions, such as schizophrenia, bipolar disorder, OCD, and mood and eating disorders.

Clinical Mental Health Counselor Work Environments 

Mental health professionals play a vital role in helping people find hope and build resilience. Clinical mental health counselors do this in a wide range of work environments.

Hospitals 

Mental health is inextricably linked to overall health. Hospitals employ counselors to maintain the mind-body connection of each patient. A mental health counselor is also needed during emergencies and life-threatening situations. Behavioral health departments in hospitals typically focus on treating people in both inpatient and outpatient settings. Inpatient programs require patients to stay for more than one day to deal with urgent or complex health concerns. Outpatient behavioral programs include therapy sessions and drug treatments that don’t require overnight stays. 

Universities 

University students encounter stressful environments from their first days on campus. According to a report by the American Foundation for Suicide Prevention, suicide was the second-leading cause of death among people aged 15 to 34. The data demonstrates the need for on-campus mental health counseling. In addition to helping students deal with depression, anxiety, and other disorders, counselors typically participate in campus outreach and education programs. In some cases, this can lead to their involvement with academic research or teaching.

Public Service 

State and federal agencies employ counselors to help those not served by the private sector. The VA is a good example of this type of work. State agencies may employ counselors in educational and hospital environments. Therapists who specialize in developmental disabilities and educational psychology work for state education departments. Mental health counselors can also work on substance use, suicide prevention, and other programs for state health departments. 

Private Practice 

Private practice can range from a single counselor to a group with varying specialties. According to a 2025 report from the American Psychological Association, 64% of psychologists work in private practice settings. While a popular option, private practice can be an adjustment for counselors who have worked in other environments, as it requires balancing counseling and running a business.

Virtual Settings 

Advances in videoconferencing and internet connectivity bring counseling services to patients in the comfort of their own homes. The next generation of mental health counselor positions will likely involve at least some sessions held via video calls. Counselors can also work for online providers such as BetterHelp or Talkspace.

How to Become a Clinical Mental Health Counselor 

Becoming a clinical mental health counselor takes the right education, training, credentials, and disposition. Each state has specific requirements for counselors and mental health care providers.

1. Learn: Educational Requirements 

Education is the first step. Licensing requirements vary by state, but all states require substance use, behavioral disorder, and mental health counselors to have a master’s degree.

Many states require or prefer degrees from programs accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP). These programs require 60 credit hours of education and have been evaluated to ensure that they meet the highest standards of the profession. 

Coursework for master’s in clinical mental health counseling degrees typically includes: 

• Sociocultural foundations of counseling 
• Research and program evaluation 
• Human growth and development 
• Psychopathology and assessment 
• Lifestyle and career development 
• Counseling theory and practice 
• Group dynamics and group therapy 
• Professional ethics and mandated reporting training 

CACREP-accredited programs include all these components. Graduates of programs that aren’t accredited by CACREP will need to have coursework evaluated to determine whether it's equivalent and meets the requirements before applying for licensure.

2. Practice: Training Requirements 

In addition to traditional coursework, working independently as a clinical mental health counselor requires applied experience. All states require counselors to have a master’s degree and a set number of hours of supervised clinical experience; while this number varies, most states require 3,000 hours. During supervised experience, associate counselors work with clients and provide services such as case management. They typically meet weekly with supervisors to discuss their work. In many cases, they must record sessions and review them with supervisors periodically.

3. Certify: License Requirements 

After completing schooling and training, all states require mental health counselors to pass a licensure examination, typically the National Clinical Mental Health Counseling Examination (NCMHCE). The exact title and type of license varies by state.

Some require preliminary licensure as a Licensed Associate Professional Counselor while obtaining supervision hours and completing examinations. Other states offer certification as a Licensed Professional Counselor or Licensed Clinical Professional Counselor. Higher levels of licensure allow counselors to work independently without supervision. 

4. Personify: Disposition Requirements 

Becoming a clinical mental health counselor is about more than training and credentials. Successful mental health counselors should embody a disposition that allows patients to feel supported, respected, and heard. 

In a recent webinar, St. Bonaventure faculty disclosed the characteristics that make a good mental health counseling candidate:

• Commitment: Investment in learning; development of counselor identity; advocacy; professional excellence; civic engagement; collaboration; scholar/practitioner; interpersonal competence
• Openness: Openness to ideas; learning and change; openness to giving and receiving feedback; openness to growth; openness to others; openness to self-development
• Respect: Perceives and honors diversity; appropriate self-care; adherence to the wellness philosophy 
• Integrity: Personal responsibility; personal and professional maturity; honesty; courage; congruence 
• Self-awareness: Integrity; humility; self-reflection and exploration of self; understanding of place in history 

Earn Your Master’s Degree in Clinical Mental Health Counseling Online 

What a clinical mental health counselor does can vary, but counselors all share the common goal of helping people. If you’re passionate about serving your community and working to improve others’ mental health, consider earning an MSED in Clinical Mental Health Counseling. This graduate degree program can prepare you for licensure exams and train you for a counseling career as a skilled and empathetic professional. 

If you’re looking for a qualified, flexible, and affordable program, St. Bonaventure’s online MSED in Clinical Mental Health Counseling may be a good fit. As a student, you’ll learn from experienced faculty members through live videos, demonstrations, and interactive activities designed to help you excel in your counseling career. 

St. Bonaventure’s CACREP-accredited counseling master’s degree program offers the flexibility you need to balance education and your other responsibilities. You’ll gain hands-on experience, receive one-on-one access to faculty, and enjoy dedicated support throughout the program, including assistance with securing an internship placement site. 

Coursework is thoughtfully designed to help you succeed in many counseling settings. With classes that address everything from psychopathology to best business practices, you’ll be fully equipped to sit for your licensure exam and serve your community. 

Learn more about the online MSED in Clinical Mental Health Counseling at St. Bonaventure and start your counseling career today. 

Learn More About SBU’s Online Master's in Clinical Mental Health Counseling

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