Who Are Mental Health Counselors?

Who Are Mental Health Counselors?


By Elizabeth Szlek, LMHC

For The Rome Observer, October 4, 2010


Since a week early in October is generally designated Mental Health Awareness Week, I thought I would take the time to refresh my own memory on the facts of becoming a Mental Health Counselor, or more properly, a Licensed Mental Health Counselor – that’s what those letters after my name above signify!

License or No License- What’s the Difference?

For a quick answer, the difference is tens of thousands of dollars spent on educating oneself, and several years of life! Counselors have only been licensed for five years in New York State, since we were the 48th state to license counselors. Licensed Professional Counselors (LPC’s) have been around for decades in other states, but the iron grip of the other mental health professions, psychiatry, psychology and social work, blocked the admission of counselors to the ranks of the licensed.

Finally, though, reason has prevailed, and at this writing, New York State has thousands of LMHC’s doing all kinds of work across the state. Some counselors work doing assessments, some do psychotherapy, some do treatment planning, some do brief and solution-focused therapy, some work in alcoholism and substance abuse facilities, some are in private practice, others do psycho-educational and prevention programs and crisis management, and others, like me, are Christian counselors. In other words, our training, which is quite extensive, has prepared us to do just about any kind of healing work you can imagine.

By contrast, I always remember the statement of someone who worked in a Domestic Violence shelter for some years. At her own proclamation, she “became” a counselor by doing work with the women in the shelter. Would that it were so easy.

No, the professional counselor holds a 60 credit (as of 2010) Masters degree in counseling, and we have all taken masters-level courses in diagnosis and pathology, group counseling, multicultural counseling, family therapy, counseling theory, theories of personality, testing and assessment, human growth and development, supervised practica and internships, and in my case, the psychology of religion and other courses attuned to the spiritual problems people often develop. THEN, we do a many-month-long supervised internship and finally get our Master’s degree. But wait, there’s more:

After receiving our degree, we need to accomplish 3000 more hours of counseling under supervision. At that point, we can apply for licensure, and if all our ducks are in order , we become licensed! So, no one just “becomes” a counselor in an informal way – it is a highly regulated process, and a true profession.

Comparing Social Workers and Counselors

Of course, there are other mental health professionals who do the same kinds of work counselors do. Psychiatrists are medical doctors, and they are, so far, the only mental health professionals who can prescribe medications. At present, they do very little actual counseling, and receive very little training in this area. Psychiatry today is almost totally dominated by the biological views that deem mental disorders as forms of biological dysfunction, in spite of the fact that no biological markers have been found for ANY mental disorder. They hold to this view, however, with religious fervor, and authorize millions of prescriptions for drugs every year, beginning with patients at age 6 months. I am opposed to this practice, as are many other mental health professionals.

Psychologists are doctors with a Ph.D., not a medical degree. They cannot prescribe drugs, although they are trying to convince various states that they should be able to do this. I think that would be a mistake, and a disaster for those they might put on medications. Many psychologists also do counseling, but they prefer to call it “therapy”, since that sounds more important, somehow.

Then we come to the Masters level mental health workers: Social workers and counselors. Both these professionals have a master’s degree, but the training they get is far from identical. Let’s compare the two for a moment:

Social Workers earn 60 credits for their degree, as do Counselors.

Social Workers have no required clinical education, and have 900 hours of supervised internship. Counselors have many courses in various counseling areas, and have a minimum of 600 hours of supervision. Both professions require an exam for licensure and both are trained in Child Abuse Reporting.

However, when a social worker wishes to receive the designation Clinical Social Worker, they must earn twelve hours of clinical casework, versus the now-60 hours of courses related to counseling. Finally, counselors must acquire 3000 hours of supervised experience in an approved setting to receive their license, and social workers must work for three years and acquire only 960 hour of supervision before getting their licenses.

It seems to me that counselors, with their course work revolving solely around the field of counseling, are much more highly trained in the area of counseling, psychotherapy or therapy, whatever you want to call it, than their supposed peers, social workers.

But, that being said, there is another issue which should be mentioned at this point. Counseling is not a science, but an art. In fact, my degree is a Master of Arts in Counseling. And this is proper. The longer I practice, the more I see that this profession has little to do with science, and EVERYTHING to do with being an artist, in this case, of the soul. Counselors, social workers, psychologists and psychiatrists all deal with problems in living, spiritual problems and problems dealing with finding one’s way in the world. In fact, I have often pointed that psychiatrist is a word meaning “soul doctor”. I think they may have forgotten that fact. So, in reality, how good any mental health professional is depends upon one thing: Can this person connect to their client? Can they understand the movement of the soul, the language of the heart? At the end of everything, this is what needs to be considered, not the degree.

I believe, however, that counselors, with their wealth of training in so many areas of counseling, are far and away the best equipped to handle all kinds of counseling problems. Add to this a strong spiritual base, as in Christian counseling, and you are very likely to find someone who can empathize and bring clients to greater mental and spiritual health.



Elizabeth Szlek is the Director of The Door Counseling Center of Utica. Questions and comments can be directed to her at (315) 768-8900 or at info@thedoorcounseling.com.