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Acing the Test: Your Guide to the NCMHCE

September 14, 2016

This article will discuss the National Clinical Mental Health Counseling Examination, how the test works, and provides a sample simulation.

One of the final steps to becoming a licensed mental health counselor is the final examination. Although this hurdle may seem daunting, the proper studying and training can ensure success. This exam will test knowledge from both education and hands-on experience, ensuring that after passing the test, students are able to offer professional services to those in need. This guide will share what the test is, its format and what it covers.

What Is the National Clinical Mental Health Counseling Examination (NCMHCE)

There are two primary licensure exams for clinical mental health counseling, the NCMHCE and the lesser used National Counselor Examination for Licensure and Certification, or NCE. Although the NCE is considered more portable, the NCMHCE is used in more states and by the U.S. military. This guide will focus on the NCMHCE, but check with your state licensure board on which exam is required.

How the Test Works

The NCMHCE focuses on a series of simulations that are meant to replicate what seeing a client would be like in practice. It covers a broad area of competencies and is not based on the recall of isolated facts. This exam measures problem-solving abilities including identifying, analyzing, diagnosing and treating clinical mental health problems.

The exam consists of 10 clinical mental health counseling cases. Each case is divided into five to eight sections that are classified as either information gathering or decision making. During the exam, students are provided with the scenario, including with setting, client information and the problem they present. Then, the student must attempt to identify solutions.

How It’s Scored

Each problem has a given parameter for what is right or wrong, and those point totals are tallied. Each section has a minimum pass level of points, and all of those totals are then tallied. The total raw score on the entire examination then determines whether a student passes or fails. Candidates must achieve a passing score in both the information gathering and decision-making sections to pass the NCMHCE.

Content of the Exam

Each of the 10 simulations has between five and eight sections that test information-gathering or decision-making skills. Information gathering measures the ability to gather clinical data needed to evaluate a situation. Decision-making sections assess the test taker’s ability to solve clinical problems by using data to make judgements and decisions.

Assessment and diagnosis; counseling and therapy; as well as administration, consultation and supervision are all aspects of the mental health counseling field that are included in the NCHMCE.

Assessment and Diagnosis

This content area measures how well the candidate understands what a client is feeling and is able to identify the cause and effects of those feelings. Test takers must be able to integrate their observations of the client from a scenario with the client’s own assessment of their condition. Symptoms will be given and precipitating problems will be involved. This content area also includes the identification of relevant relationship issues with family, friends or self.

Counseling and Psychotherapy

After diagnosing the issue, test takers are presented with a simulation that involves counseling and offering potential psychotherapy. The test will measure how candidates inform the client about ethical standards and practice. It will also test the ability to clarify the counselor’s role in the creation and relation of a treatment plan. Candidates are also measured on referral information provided to a client, if needed.

Administration, Consultation and Supervision

Test takers will also have to identify how they intend on following through with treatment plans. This includes the maintenance of case notes, records and files. The test will also cover how to measure the effects of the services on a client’s needs, including how to maintain professional communications with clients and how to assist them with alternative services.

Because the NCHMCE is so unique, it is helpful to understand what a typical question looks like. The National Board of Certified Counselors offers NCMHCE resources for students looking to better understand what an exam is like.


Tips for Succeeding at the NCMHCE

Because the NCMHCE is a complicated exam with large and complex questions, passing it requires a more intensive approach to preparing for it. This exam requires far more application than fact recall and thus will demand a deeper understanding of the content. Here are a few tips to help study for and take the exam.

Tips for the CMHCE: Think like a counselor, take only the information you need, don't take risks, and keep good study habits.

Think Like a Counselor

The simulation style format of the NCMHCE is designed to make test takers think like a mental health counselor. Instead of focusing on cramming concepts and facts, it’s more important to recall the experience of actually working with clients. Keep in mind that everything in the NCMHCE has one clear diagnosis and assumes a mutual respect between client and counselors. Thus, the test is measuring for ideal questions and treatments, even if those might not be appropriate or applicable in some real-world situations.

Take Only the Information Needed

Many test takers struggle with the information-gathering portion of the exam. In a real practice situation a counselor may ask clients far more than the test suggests, but that is not necessary during the exam. Consider whether the information that is being requested is actually beneficial and whether it will narrow down the diagnosis. Keep in mind the possible diagnoses you are leaning toward and tailor your information gathering to support that.

Guessing Wrong Has Consequences

Although many multiple choice tests recommend choosing an answer even when not confident it is correct, doing so can be detrimental on the NCMHCE. Incorrect selections can cost up to three points, so choosing poorly can have a significantly detrimental effect on the overall score. However, this does not apply to the diagnosis questions, and candidates are encouraged to ask as many questions as needed to get the best diagnoses before proceeding to the treatment questions.

Keep Good Study Habits

Although unusually formatted and extremely rigorous, many of the typical good study habits still apply. Taking practice tests and joining study groups can be helpful to prepare, and taking time during the test is critical. Finally, understand that failure is an option; many people have to take the test two or three times before succeeding.

Get the Right Education

Although the NCMHCE is a difficult exam, taking a master’s program that is geared toward passing the test can help. At Grace College Online, our Master of Arts in Clinical Mental Health Counseling is designed to help students learn the skills needed to become an exceptional mental health counselor, and, by extension, to pass the NCMHCE. Courses are taught by professors with real-world experience, and scenario-based assignments are common. With the right education and experience, the test becomes just another tool in the toolbox of exceptional counselors.