[Guest Post] Acing The NCMHCE Examination

[[Please Note: This post was originally written 1/8/2015. Check with your state licensing board to make sure all information is still accurate, as rules change!]]

Graduate school is over - but you still have a lot on your mind! 

You’re wondering where to start first and where to go next. Well, while that is usually an individual decision (because there are a lot of directions you can take) many of you will be interested in getting your licensure as a professional counselor. If so, then you have probably already started to think about the licensure exam! Most of us would like to tackle the exam as soon as possible (though others may decide to wait and take it at a later point!)

Either way, when it’s time to sit down and register for the exam, you probably have forgotten where exactly it is you have to go and which exam it is you need to take. That can be quite stressful! But don't worry. Today, I will be sharing with you everything you need to know to ace the National Clinical Mental Health Counselor Exam.

What exactly is the NCMHCE? 
It’s the National Clinical Mental Health Counselor Examination, and many states require this examination before granting licensure.

What states require the NCMHCE for State licensure? 
As of right now some states require one (the NCMHCE) OR the other (the NCE), in order to obtain a state licensure. Below is a list that shows which states ONLY accept one or the other, right now:

Some states will accept either (NCMHCE) OR (NCE) exam for their licensure. So, essentially, if you are moving from any of the above states to any of the below states, you wouldn’t necessarily have to take another whole exam, you would still be able to use your scores from the NCMHCE. 

Here are the states that will accept either exam:

Now that we have established some of the basics, you may want to note the differences between the words “accept” and “require.” This criterion will be your main determination of which exam you need to take and where to put your focus, if you want to get licensed in any of those states. For example, if you live in Florida (like myself) and decide you want to move to Texas, I would have to take the NCMHCE to be state-licensed in Florida and then also take the NCE to become state-licensed in Texas. However, If I moved to Georgia instead, I would be able to use my scores from the NCMHCE that I used for my Florida licensure. (Yes, very confusing I know! I am right there with you! But you can do it!)

As you’re reading this, you’re probably wondering, what about the National Certification? (NCC) "Can’t I just take one test and be Nationally Certified?" Well...you can... BUT, it’s a certification and not a licensure so, each state will still have individual requirements they need from you to become licensed in their state. Simply put, the NCC alone is not enough to practice legally in your state. That issue is a whole separate topic in itself so, for clarity’s sake, we will just keep our focus on the NCMHCE for now!

When you have decided you want or need to take the NCMHCE, here are a few basics that you need to know:

What is the NCHMHCE like?

• Stimulations that cover a broad area of competencies, rather than simple facts to remember. 
• You will be given 10 clinical cases.
• Each case is divided into 5-8 sections that will be classified as either:
• Information Gathering (IG), or:
• Decision Making (DM)

What does the exam cover?
The exam will assess 3 main areas of your clinical competency:

1. Assessment and Diagnosis:
• Your ability to integrate client assessments, observations, and identification of precipitating problems, and individual/family/relationship problems.
2. Counseling & Psychotherapy:
• Your ability to inform the client about ethical standards, practices, counselor/client roles, treatment plans and evaluation of referrals. 
3. Administration, Consultation & Supervision:
• Will determine how well you maintain case notes, records, and files as well as how you determine if services meet client's needs. Also, will examine how you orally communicate with other professionals as well as your ability to assist clients with obtaining social services. 

What can I expect the exam to look and feel like?

• The exam will assess your clinical problem-solving abilities, which will include your ability to identify, analyze, diagnose and treat clinical problems.
• It will be presented in "real-life scenario" type format such as a paragraph with key information about a client, including information such as age, gender, presenting problem, etc. 
• You will be expected to gather appropriate information (IG from above) which might include missing information that is not provided, but necessary for a true diagnosis. For example: family background, physical health, previous experience in counseling, etc. 
• You will also be expected to make clinical judgments and/or decisions (DM from above) such as what to do with the information you have gathered, know, or have been provided such as making a diagnosis, a referral elsewhere, other social services, etc. 

Is there a right or wrong answer? How will my exam be scored?

• Yes and no. You should know that this is not a fact-based examination and that some questions will have multiple correct solutions. You should select all options that are appropriate for that question. There will also be some questions that are "single best answer" which will provide more than one acceptable option but, only one option is "generally" more acceptable than the other. I know! I know! Trust me, they are really testing your clinical abilities with the NCMHCE and as we all know, real-life scenarios are not black-and-white, and we have to assess each situation individually. That is exactly what this test is designed for. 

So, how can I prepare?

• I, personally, would prepare by allowing yourself to develop professionally first, and gain experience in real-life situations, during your first year of post-graduation licensure. Coming straight out of grad school we have been tested over and over again on factual, black-and-white, right-or-wrong answers! However, that's just not what the NCMHCE is looking for. So, allow yourself some time to adjust to the "grey" area of real-life diagnosing, analyzing and decision-making first. 
• Then, prepare to study! There are numerous resources available but, here are a few that have worked well for others and have been suggested as resources that can help!
• The NBCC website. They supply a good list of study guides that others have found to be useful. Here's the link.
• Dr. Linton's DSM-5 Online Study Prep for the NCMHCE, 6th Edition, which includes online simulations & prep, prior to the actual exam. Many therapists have used this and suggest it as a great way to pass the exam! 
• Click here for access to the main website & other study resources, such as the online subscription service mentioned above. 
• Click here to purchase the Study Guide for the DSM-5 on Amazon.com (Paperback).
• Click here to purchase paperback, Nook, Kindle, or pdf versions from Dr. Linton's website. 
• Dr. Howard Rosenthal's Encyclopedia of Counseling, a.k.a. "the purple book," is a great resource to use complementary to the resources mentioned above, and as a refresher on areas that you need help with. However, this format is primarily designed for passing the NCE. 
• Click here to purchase the Encyclopedia of Counseling package (2009) on Amazon.com.

Whew! Now that we’ve established everything you need to know about the NCMHCE and what to expect, you’ve probably got a lot MORE on your mind than you did before you read this. The most important thing to remember is to take the test at your own pace, when YOU feel most ready for it.

For more information about cost, the DSM-5, how to register and where to go for the exam, visit the National Board of Certified Counselors (www.nbcc.org) and always check with your state to find out which exam they require. Some states will also require “pre-approval” to sit for the NCMHCE through the NBCC first.

If you have any additional resources for studying, or experience you with taking the NCMHCE that you would like to share please feel free to post in the comments below! We always love to hear what has worked and hasn’t for others! 

Jessica Richards is a Registered Mental Health Counselor Intern for the State of Florida. As a graduate of NOVA Southeastern University, she holds a master's degree in Mental Health Counseling. With the help of Stephanie Adams, Jessica established Beginning Counselors of Florida, a support group for beginning counselors leaving grad school and seeking licensure. She is currently serving as Registered Intern Representative for FMHCA. She currently contracts with several community agencies while working on establishing her private practice.