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National Clinical Mental Health Counseling Examination (NCMHCE)


The National Board for Certified Counselors (NBCC) is a nationally recognized, independent non-for-profit body dedicated to advancing the field of professional counseling through setting standards and administering certification for counselors across the United States.[1] The NBCC was formed in 1982 in the U.S. and has continued to expand it's reach worldwide.[1] At the present time, over 64,000 counselors worldwide have received at least one credential from the NBCC.[1]

Function of the Test

NCMHCE Study Guide

The National Clinical Mental Health Counseling Examination (NCMHCE) is a specialty certification for clinical mental health counseling professionals which is recognized across the country as a standard for determining clinical competency. Those who pass the exam and meet the experience requirement are awarded the CCMHC (Certified Clinical Mental Health Counselor) credential. While the credential does not automatically confer licensure, passing either the standard NCE (National Counselor Examination) or specialty NCMHCE is a prerequisite in most states for becoming a licensed mental health counselor.[2] Currently 27 states require the NCMHCE or NCE exam in order to obtain a license to practice as a mental health counselor; 7 of these accept only the NCMHCE.[3] Candidates must first be certified as an NCC (National Certified Counselor) to sit for the NCMHCE. Alternatively, both the NCE certification exam and the NCMHCE specialty exam may be taken in tandem.[4] Candidates must hold a master’s degree in counseling, or in a closely related field with a minimum of 60 credit hours counseling coursework to be eligible for the NCMHCE. Experience requirements are the same as for the NCE and include 100 hours of supervision and 3,000 hours of direct client contact in a clinical setting.[5] Each state board sets its own eligibility rules for those who intend to take the exam in order to obtain licensure in the state.[6]

Test Administration

NCMHCE Flashcards

The NBCC administers state licensing examinations for the individual state professional licensing boards. Each board individually determines eligibility rules, and applications are submitted directly with the state board in which a candidate intends to practice. These eligibility rules are enforced by the NBCC during the registration process.[7] Paper and pencil exams are still available and honored in some states, with testing dates offered twice a year in April and October at exam locations in every state.[8] However, most states have moved to computer-based testing. Candidates should check with their state licensing board to determine whether the pencil-and-paper version of the NCMHCE will still be accepted at the time they plan to apply for licensure. Candidates register for the exam through their individual state licensing boards with the exception of licensed counselors applying for US military employment or TRICARE mental health counselor certification. Military candidates must complete a special registration form and send it to NBCC along with proof of state licensure and a non-refundable $195 examination fee ($100 for candidates who hold a current NCC certification).[9] Registration forms and fees are determined by the individual states. Completed registrations are processed by NBCC and once registration is confirmed, candidates schedule their own exam date by phone or online with an AMP (Applied Measurement Professionals) testing center. Testing is offered during the first two weeks of every month at 191 different locations across the country. A candidate who does not pass the exam must re-register and pay in full after a three month waiting period. While NBCC does not limit the number of times a candidate may take the exam, individual licensing boards may impose their own limits.[10] Candidates with disabilities may request special accommodations at the time of registration by completing a “Computer-Based Testing Special Accommodations Request for State Licensure Candidates” form and attaching supporting documentation on letterhead from an appropriate health care professional. Non-native English language speakers may use this form to request additional testing time and use of a standard dictionary for translation, but only if such accommodations were required during their professional education.[11]

Test Format

Test Structure

The NCMHCE deals with three major content areas: Assessment and diagnosis; counseling and psychotherapy; and administration, consultation, and supervision. The test takes the form of 10 clinical health counseling cases. The 10 cases are each divided into five to ten sections that will be formatted either as choosing a single best answer, or choosing multiple options.[7]

Test Environment

Testing for the NCMHCE takes place at Pearson VUE testing centers. There, test-takers are expected to arrive on time for their test. Those who arrive late may not be admitted into the exam. For admission, two forms of identification are required, one of which must be a government-issued photo identification. In the exam room, no personal items are allowed. This includes electronics, calculators, study materials, and other personal items. Exam scores will be reported upon completion.[7]


Each exam contains 10 simulated case studies, 9 of which are scored and one which is for evaluation purposes only. Each case study contains a number of information gathering (IG) and Decision Making sections. IG sections may have more than one correct answer, and each answer is assigned a weight. The highest scoring response in an IG section would be one in which a candidate selected those options that were relevant (correct answer) and did not select those that were not relevant (incorrect answer) to the case. Guessing on these sections can therefore result in a lower score, since a candidate might err on the side of gathering too much irrelevant information. DM sections may either have one correct answer, or multiple correct answers or options. Each section is assigned a “minimum passing level” (MPL) or score, and the MPL for the exam as a whole is a sum of these individual MPLs. At the end of the exam, the raw scores for all of the IG sections and the raw scores for all of the DM sections are added together to achieve an overall raw score. If this score meets or exceeds the MPL for the exam, the candidate passes.[7]

Recent/Future Developments

The US Department of Defense recently issued its final rule on counselor participation in the TRICARE program. The new rule, effective in August 2014, provides reimbursement for TRICARE participants who receive services from independent mental health counselors who hold master’s degrees and either the NCMHC or NCC credential.[12] Effective January, 2022, only graduates of a CACREP (Council for Accreditation of Counseling & Related Educational Programs) will be eligible to apply to sit for NBCC certification exams.[13]


  1. ^ a b c About NBCC 2 July 2018
  2. ^ Understanding National Certification and State Licensure February 16, 2015
  3. ^ Licensure Requirements February 18, 2015
  4. ^ Licencure 4 July 2018
  5. ^ Certification Requirements 4 July 2018
  6. ^ Candidate Handbook for State Credentialing February 18, 2015
  7. ^ a b c d NCMHCE Handbook 2 July 2018
  8. ^ Testing Schedule and Locations 4 July 2018
  9. ^ Registration Form for the National Clinical Mental Health Counseling Examination (NCMHCE) for professional counselors serving the military health systems February 18, 2015
  10. ^ Candidate Handbook for State Credentialing for the National Clinical Mental Health Counseling Examination (NCMHCE) February 18, 2015
  11. ^ Candidate Handbook for State Credentialing for the National Clinical Mental Health Counseling Examination (NCMHCE) February 18, 2015
  12. ^ TRICARE Ruling 2 July 2018
  13. ^ CACREP 2 July 2018

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