Imagine an illness that affects 1 in 4 people in the U.S. at any given time, that will impact half the population at some point in their lives, yet remains untreated in nearly half of all serious cases, according to the U.S. National Institute of Mental Health. That’s the current state of mental health care in this country.
Constellation Behavioral Health cites a study by the National Alliance on Mental Health estimating untreated mental illness in the U.S. causes $300 billion in lost productivity each year. However, the most damaging impact of mental illness isn’t measured in dollars. It’s measured in the pain and suffering of the millions of people afflicted with a mental disease, as well as their families and communities.
Students interested in pursuing a career in mental health care need to understand the education requirements, skills and experience distinguishing various counseling professions.
- Types of counseling performed
- Job titles and descriptions in each category
- Career opportunities and salaries for various types of counselors
- Education and certification requirements
This article will discuss five of the most common types of counseling careers:
- Substance abuse and behavioral disorder counselor
- Marriage and family counselor
- Crisis counselor
- School and career counselor
- Rehabilitation counselor
Substance Abuse and Behavioral Disorder Counselors
Substance abuse counselors apply various therapeutic techniques to treat people who misuse drugs and alcohol. Behavioral disorder counselors work with people who have mental illnesses and disorders affecting their thinking, emotions and ability to function.
The U.S. Substance Abuse and Mental Health Services Administration defines a substance abuse disorder as recurrent use of alcohol and/or drugs causing “clinically significant impairment,” such as health problems or the inability to meet work, home or school responsibilities. A serious mental illness is defined as a mental, behavioral or emotional problem seriously impairing, interfering with or limiting a person’s ability to function.
Treatments for substance abuse and behavioral disorders typically involve families, groups and community members who work with substance abuse and behavioral disorder counselors to address the underlying causes and contributors to mental illness.
Types of Counseling Performed by Substance Abuse and Behavioral Disorder Counselors
The counseling performed by substance abuse counselors helps people recover from alcoholism and drug addiction. Behavioral disorder counselors treat people who have mental or behavioral problems, such as eating, anxiety and obsessive-compulsive disorders. The counselors work with individuals, couples, families and groups in a variety of settings:
- Mental health centers
- Detox centers
- Halfway houses
- Juvenile detention facilities
- Probation and parole offices
- Corporate employee assistance programs
Substance abuse and behavioral disorder counselors perform many tasks while diagnosing and treating their clients.
- Assess and diagnose people’s mental and physical health, including problematic behaviors and additions, and determine whether they’re ready for treatment
- Develop and implement treatment plans in collaboration with their clients and the clients’ families
- Set goals and help clients gain insight from their treatment
- Help clients identify thoughts, behaviors and situations interfering with their wellness
- Point clients toward other sources of assistance from health professionals and community resources
Substance Abuse and Behavioral Disorder Counselor Careers
Counseling careers for substance abuse and behavioral disorder counselors include licensed professional counselors who have been certified by the National Board for Certified Counselors (NBCC) as a national certified counselor (NCC), certified rehabilitation counselor (CRC) or licensed professional counselor (LPC).
Types of Substance Abuse and Behavioral Disorder Counselor Jobs
According to the U.S. Bureau of Labor Statistics (BLS), these are the most common employers of substance abuse and behavioral disorder counselors:
- Outpatient mental health and substance abuse clinics: 19%
- Individual and family services: 16%
- State, local and private hospitals: 10%
- Residential mental health and substance abuse clinics: 10%
- Government: 9%
Substance addiction counselors often work in residential treatment centers where their clients live for a set period, sometimes several weeks or longer. In these settings, the counselors may have to work evenings, nights and weekends. Substance abuse and behavioral disorder counselors who work for outpatient treatment centers or who have a private practice may work alone or with other counselors and professionals.
Substance Abuse and Behavioral Disorder Counselor Job Requirements
The BLS notes a master’s degree in mental health counseling, psychology, clinical social work or similar areas allows substance abuse and behavioral disorder counselors to offer more services to their clients. Counselors who hold a master’s degree require less supervision and can provide one-on-one sessions.
All states require substance abuse and behavioral disorder counselors in private practice be licensed.
- They must have a master’s degree and 2,000 to 4,000 hours of supervised clinical experience before qualifying to take the state’s licensing exam.
- They must pass the state licensing exam and complete continuing education each year.
Substance Abuse and Behavioral Disorder Counselor Salaries
The BLS estimates that the median annual salary of substance abuse, behavioral disorder and mental health counselors was $46,240 as of May 2019. Those working in government had a median annual salary of $52,720, while counselors employed by outpatient mental health and substance abuse centers earned a median annual salary of $44,750.
Marriage and Family Counselors
An individual’s behavior is influenced by patterns in the person’s family. Marriage and family counselors examine the relationships between partners in a marriage and family members to guide a person’s mental health treatment. Family relationships are emphasized in counseling — even if only one person is being treated.
Types of Counseling Performed by Marriage and Family Counselors
The types of counseling performed by marriage and family counselors include cognitive behavioral therapy whose goal is to replace harmful behaviors with positive, life-enhancing ones. The counseling addresses serious clinical problems, as the American Association for Marriage and Family Therapy (AAMFT) points out:
- Marital problems
- Individual psychological problems
- Parent-child problems
The AAMFT explains that marriage and family counseling is as effective as standard or individual treatments for many mental health problems, and is often more effective than other approaches.
- Adult schizophrenia
- Affective (mood) disorders
- Adult alcoholism and drug abuse
- Children’s conduct disorders
- Adolescent drug abuse
- Anorexia in young adult women
- Childhood autism
- Chronic physical illness in children and adults
- Marital distress
Marriage and family counseling tends to be shorter than other types of counseling, lasting an average of 12 sessions. About half the counseling is done in one-on-one sessions, and the other half is marital/couple and family counseling or a combination of treatment approaches.
Marriage and Family Counselor Careers
Counseling careers for marriage and family therapists require a master’s degree in marriage and family therapy, psychology, or a related mental health field. Counselors in this specialty gain experience by performing clinical work under supervision after earning their degree, often as part of an internship or a residency. The training teaches techniques for family therapy, group therapy, psychotherapy and other therapeutic interventions.
The BLS forecasts that jobs for marriage and family counselors will increase by 22% between 2018 and 2028, which is much faster than the average growth for all employment.
Types of Marriage and Family Counselor Jobs
The types of marriage and family counselor jobs include individual practices and staff positions with health practitioners, outpatient centers and public health agencies. The BLS lists the largest employers of marriage and family counselors:
- Individual and family services: 30%
- Offices of other health practitioners: 20%
- Outpatient care centers: 12%
- State government, excluding hospitals and education: 9%
- Self-employed: 9%
The BLS notes marriage and family counselors who work in private practice are responsible for marketing their services. They deal directly with clients and insurance companies to receive payment for their services, and they collaborate with other community resources, such as support groups and inpatient treatment facilities, as well as with psychologists, social workers and other professionals.
Marriage and Family Counselor Job Requirements
While a master’s degree in counseling or another psychology-related field is the minimum education requirement for marriage and family counselors, many go on and earn a doctorate. Marriage and family counselors must be licensed by the state in which they practice. To gain a license, counselors must complete 2,000 to 4,000 hours of supervised clinical work after receiving their degree.
In addition to passing the state licensing exam, marriage and family therapists must complete continuing education courses annually. The Association of Marital and Family Therapy Regulatory Boards (AMFTRB) offers a handbook for candidates who are planning to take the Marital and Family Therapy National Examination. The examination is designed to help state licensing boards evaluate the knowledge and experience of license applicants.
Marriage and Family Counselor Salaries
The BLS reports the median annual salary for marriage and family therapists was $49,610 as of May 2019. However, those working in state government, excluding schools and hospitals, averaged $72,230 in annual salary.
Crisis counselors, who are also called crisis intervention counselors, help people overcome the debilitating effects of traumatic events of all types, from natural disasters to life changes, such as the death of a loved one. Crisis counseling differs from other forms of counseling in that it’s usually intended to last only a few weeks.
As with other types of counseling, crisis counseling applies observation, assessment, experimentation and other techniques to understand and explain the thoughts, emotions, feelings and behavior of their clients in the aftermath of a crisis. However, the goal of the counseling is to address the specific trauma and its impact on the person.
- Crisis counselors provide emotional support in an attempt to minimize the stress of the triggering event.
- Crisis counselors work with the person to develop coping strategies for the present and future.
- The counselors’ assessment and treatment often focuses on the person’s safety and needs in the immediate situation.
Types of Counseling Performed by Crisis Counselors
The types of counseling performed by crisis counselors include application of various treatment models.
- The initial assessment emphasizes listening to the person and asking questions to determine immediate needs.
- The assessment helps the counselor find the most appropriate coping strategies to apply in the short term and long term.
- While defining the person’s needs, the counselor offers empathy, acceptance and support.
- The counselor educates the person about the situation and how to minimize the damage it inflicts.
- The counselor emphasizes the person’s reactions are normal but temporary and that the person’s old self will eventually return.
Verywell Mind describes three types of crises for which people may seek assistance.
- Developmental crises arise as a person transitions through various stages of life, such as Erik Erikson’s stages of psychosocial development.
- Situational crises occur following sudden traumatic events, such as accidents and natural disasters.
- Existential crises are the result of inner conflicts, such as a person’s spirituality, direction or purpose. For example, a midlife crisis may be engendered by existential anxiety.
Crisis Counselor Careers
Crisis counseling careers differ from other counseling professions since they often entail intervening in situations where people are endangering their own life or that of another. Crisis counselors tend to treat more patients for shorter periods of time than other types of counseling.
Because they need to step in quickly when someone is experiencing trauma due to a crisis, these counselors may work evenings, nights and weekends to offer timely assistance when and where needed.
- The counseling may be performed individually or in group settings. It may also be done on the phone or computer.
- Most counseling is conducted in office settings, but counselors may need to travel as part of their job.
- Counselors may work full time or part time, and their work schedules may be irregular.
PayScale lists the most popular skills for crisis counselors:
- Case management
- Patient counseling
- Diagnosis and treatment planning
Types of Crisis Counseling Jobs
Crisis intervention arose as a separate field of counseling beginning in the mid-20th century. It expanded widely following the Vietnam War, which left many veterans suffering from post-traumatic stress disorder. The field also grew as a result of the women’s movement of the 1970s, which exposed rampant domestic violence, according to Psychology Today. These are among the most common crisis counselor jobs:
- Suicide prevention lines and services
- Crisis hotlines (telephone and internet-based)
- Women’s shelters to treat victims of domestic violence
- Substance abuse and drug addiction clinics
- Community mental health clinics that conduct outreach to homeless patients
Crisis Counselor Job Requirements
Crisis intervention counselors have typically earned at least a bachelor’s degree, although education requirements vary from state to state, as the BLS points out. Counselors who hold a master’s degree are able to offer a wider range of mental health services to their clients, including one-on-one counseling sessions. They also require less direct supervision.
The American Institute of Health Care Professionals provides the Crisis Intervention Certification program that promotes standards of education and practice requirements. The program is available to various professionals:
- Licensed counselors
- Registered nurses
- Licensed social workers
- Licensed health care professionals
- Ordained ministers and clergy
- Others with a working background in emergency and disaster response
Crisis counselors may also be certified through the NBCC.
Crisis Counselor Salaries
The average annual salary range for crisis counselors with crisis intervention skills is $32,000 to $61,000, according to PayScale data from May 2020.
School and Career Counselors
School counselors assist students as they develop the learning and social skills required to succeed in their academic and professional careers, and in life. Career counselors guide people as they explore various careers that interest them. They also help people gain the skills and knowledge their chosen field requires.
Types of Counseling Performed by School and Career Counselors
- Assess students’ academic performance and social skills
- Help students and others identify and overcome social and behavioral problems
- Teach and encourage organizational and time management skills
- Work with students to develop effective study habits
- Encourage students to set academic and career goals
- Collaborate with teachers, administrators and parents to ensure that students are prepared to achieve their goals
- Identify students who may be suffering from abuse or neglect and refer students and parents to support services
Career counselors’ work likewise involves a range of counseling roles.
- Assess their clients’ skills, interests and abilities using aptitude and achievement tests
- Explore their clients’ background to understand realistic goals based on the clients’ education, training and life situation
- Help clients decide on a career or degree program to pursue
- Work with clients to develop job search skills, such as interviewing and networking
- Offer their clients advice on overcoming workplace problems and conflicts
Career counselors work with people at all stages of their careers, whether they’re choosing a profession, planning to advance in their current career or looking to switch careers.
School and Career Counselor Careers
While the majority of school and career counselors are employed in educational settings, many work in health care and with social assistance agencies. The BLS lists the most common employers of school and career counselors:
- Elementary and secondary schools: 44%
- Junior colleges, colleges, universities and professional schools: 35%
- Health care and social assistance: 8%
- Other educational services: 4%
- Self-employed: 3%
Types of School and Career Counselor Jobs
Counseling careers for school counselors are primarily in K-12 educational settings:
Elementary School Counselors
Elementary school counselors emphasize development of specific learning and social skills, such as organization, study habits and decision-making. They discuss students’ progress and challenges with parents and identify any special needs the students may have, whether developmental or academic.
Middle School Counselors
Middle school counselors focus on creating supportive learning environments that maximize academic success. They work with educators, parents and community members to ensure that students develop the academic and social skills they’ll need to reach their goals.
High School Counselors
High school counselors meet with students to help them devise academic and career plans. They help students identify and overcome situations interfering with their academic progress. They educate students about their college and professional training options, including sources for financial aid, internships and apprenticeships.
Career counselors work in diverse educational settings, including colleges, as well as in government agencies and private practice. Among their clients are people with disabilities who need assistance in gaining job skills, often through a private or government agency teaching basic employment skills and connecting clients with community employment resources.
School and Career Counselor Job Requirements
A master’s degree in school counseling or a related field is a requirement for most school counselor positions. School counselors must usually possess a state-issued credential. Employers of career counselors often prefer candidates have a master’s degree in counseling with an emphasis on career development.
To obtain a state-issued credential, school counselors typically require a master’s degree in school counseling, a supervised internship or practicum, and a passing score on a certifying test. Some states also require a teaching license or classroom teaching experience. The American School Counselor Association describes each state’s requirements for earning a school counselor license.
Some states require that career counselors be certified. The NBCC provides information on each state’s certification requirements for career counselors and other categories of counselors.
School and Career Counselor Salaries
As of May 2019, counseling salaries for school and career counselors ranged from a median annual salary of $64,060 for elementary and secondary school counselors (state, local and private) to $40,620 for those working in health care and social assistance. The median annual salary for all school and career counselors was $57,040, according to the BLS.
Rehabilitation counselors work with people who have physical, mental, developmental or emotional disabilities, helping them lead independent lives. They assess their clients’ employment and living situations, anticipate obstacles to their ability to work and live independently, and team with the clients and others to devise strategies to overcome those challenges.
Types of Rehabilitation Counseling
The types of counseling performed by rehabilitation counselors are as varied as the lives, interests and abilities of their clients.
- Evaluate their clients’ skills, health, education and interests and plan treatments for the clients based on their assessment and consultation with other health professionals
- Counsel clients individually and in groups and work with clients to ensure they receive the medical care, job training and other assistance they need
- Work with employers to help them understand the abilities and needs of their clients, including clarification of laws and regulations impacting people with special needs
- Assist their clients as they learn new skills and adapt to their disabilities
- Serve as advocates in their communities for the rights of people with disabilities to work and live independently
Some rehabilitation counselors focus on helping students with disabilities to transition to a career. Others work primarily with veterans to overcome the physical or mental effects of their military service. Another common specialty for rehabilitation counseling jobs is working with older people to help them cope with disabilities that result from illness or injury.
Rehabilitation Counselor Careers
Rehabilitation counselors work for a range of employers, including independent living facilities, schools and government agencies, as well as in private practice. Some rehabilitation counseling careers specialize in dealing with the employment issues that people with disabilities face, while others are vocational rehabilitation counselors whose clients are typically older students and adults.
Types of Rehabilitation Counselor Jobs
The BLS lists the largest employers of rehabilitation counselors as of 2018:
- Community and vocational rehabilitation centers: 30%
- Individual and family services: 18%
- State government, excluding education and hospitals: 13%
- Nursing and residential care facilities: 12%
- Self-employed: 8%
Other employers of rehabilitation counselors include senior citizen facilities and youth guidance organizations. Some employers require rehabilitation counselors to work evenings or weekends. According to PayScale, the most popular skills for rehabilitation counselors, after counseling, are case management, rehabilitation, group therapy and disability support.
Rehabilitation Counselor Job Requirements
According to the BLS, most rehabilitation counselor jobs require a master’s degree in rehabilitation counseling or a related field. In particular, rehabilitation counselors with a master’s degree are able to provide their clients with a wider range of services than those with only a bachelor’s degree.
Every state requires rehabilitation counselors who offer clients consulting services be licensed. Excluded from the licensing requirements are counselors who provide only vocational rehabilitation services or job placement assistance. In addition to passing a state-sanctioned exam, rehabilitation counselors must complete 2,000 to 4,000 hours of supervised clinical work to earn a license. They must also complete continuing education courses each year to maintain their license.
The Commission on Rehabilitation Counselor Certification (CRCC) runs the nationally accredited and internationally recognized Certified Rehabilitation Counselor (CRC) certificate program. The certification is available to graduates of master’s degree programs in rehabilitation counseling or clinical rehabilitation counseling and to people with a master’s or doctorate in a related field that includes specific coursework.
Rehabilitation Counselor Salaries
As of May 2019, the median annual salary for rehabilitation counselors was $35,950, according to the BLS. The median annual salary for rehabilitation counselors employed by state government agencies (excluding education and hospitals) was $51,260.
Counseling Career Resources
Professional counseling organizations provide career guidance and information for job seekers. The advice ranges from how to write a résumé and cover letter to ensuring compliance with standards and practices.
American Counseling Association
- The American Counseling Association’s Career Central has information for job seekers and employers, including information on more than 1,500 jobs and 120 employers. Counseling professionals can post their resumes, apply for jobs directly and sign up for job alerts.
- The ACA Career Tips and Resources page provides sample resumes, cover letters and other documents. It includes links to a dozen counseling job resources.
- The ACA Choosing a Career in Counseling page describes education and licensing requirements for counseling jobs.
American Psychology Association
- The American Psychology Association’s Career Development resources include tips for writing cover letters and curricula vitae, links to sources for grants and funding, and information about academic and nonacademic counseling careers.
- Resources for Job Seekers provide networking tips, video presentations by psychology career experts, and tips for job interviews and negotiating a starting salary.
American Association for Marriage and Family Therapy
- The AAMFT’s Job Connection lists hundreds of jobs for marriage and family counselors as well as dozens of profiles of employers seeking counselors. Like the ACA career site, the AAMFT lets counselors post their résumés, apply for jobs directly and sign up for job alerts.
- The Career Learning Center features videos explaining effective résumé writing, networking techniques and other topics of interest to job seekers.
Choosing a Career in Service to the Community
Counseling careers offer diverse options and many different work environments for people with a passion for helping others learn life skills and overcome health, financial and social obstacles. The outlook is promising for counseling jobs of all types, especially for candidates who possess a master’s degree and have met all licensing requirements for various counseling specialties.
In particular, the renewed emphasis on prevention of health, financial and social problems, rather than responding after the fact, puts the spotlight squarely on mental health and other counselors who now play lead roles in the strategies devised by communities to improve the lives of all their residents.