There are many routes to the field of applied mental health. So many, in fact, it can be quite dizzying from the outset. Standing near the end of a BA in psychology or sociology or contemplating a career change later in life, people are confronted with the choice of where to go next. And many undergraduate advisors or school counselors may not have a good, comprehensive grasp of these many routes, what they might entail, and what kind of choices need to be made.
In this article, I’d like to address one specific route with a handful of choices within it: that of becoming an applied mental health practitioner within CACREP-accreditation guidelines (fear not: all of those words will be explained!). Let’s dive into what CACREP is, what specializations they have, and how to choose which one.
What is CACREP?
To start off, let’s discuss what CACREP is, because it’s a very important idea in the world of professional mental health. CACREP is the Council for Accreditation for Counseling and Related Educational Programs. Established in 1981, it was founded to address an area of concern in the field of mental health: how can we agree as to what it takes to educate and prepare a student to become a professional in the field? After all, these students will take on a good deal of responsibility in their work at schools, in clinics, and in consultation rooms. The history of mental health, of course, extends further into the past. But it wasn’t until the mid-20th century that “counselors” and “mental health” really came into being. Before then, practitioners were psychologists and psychiatrists, fields that had been established for many years before that with their own bodies of regulations and councils. Mental health practitioners needed their own. Hence, CACREP.
CACREP is one attempt, among others, of standardizing the training of the clinician. A couple of things CACREP is not: it is not the certification or licensing of individuals; it is not industry-wide regulation; it is not in itself an educational program. Rather, it is a body of regulation which looks at specialized training programs within an institution. For example, the University of Wisconsin cannot in itself be CACREP-accredited; their Clinical Mental Health program, however, can.
A training program has to meet certain requirements set by CACREP to achieve the accreditation. This allows a prospective student to tell what to expect from the training and job outcomes during and after the program is completed. We’ll get into these specifics later. It should also be noted that CACREP does not regulate itself, but is in turn regulated by the Council for Higher Education Accreditation (CHEA), and so is beholden to the demands and requirements of even higher sources.
Below, we will review what is expected from a CACREP-accredited program. The first choice of the prospective student is whether or not they want to attend a program which is within this body of regulation. The decision to do so isn’t required, even if it may seem like it from the outset. I am a practicing psychotherapist in both private practice and a large agency, and I have worked with and consulted with many non-CACREP clinicians who, in my estimation, were very competent and were moving along in the field as well as I was (as a person whose program was CACREP-accredited).
Why Choose CACREP?
A considerable benefit to choosing a CACREP-accredited specialization is that it allows you to transfer credits across schools and state lines with considerable ease. Because CACREP is a nationwide regulatory agency, it doesn’t matter if you’re in Colorado, New Jersey, or Texas. Everyone is taking the same classes. On the other hand, if a program is not regulated by CACREP, and a student tries to transfer to a different program, certain classes may not be accepted, and that student may have to take extra classes to catch up.
Another thing to note is that the importance of CACREP depends on which state you want to live and work in. Some states require that a prospective clinician attend such an institution before they acquire their professional license. You can find an interactive map of these states here. Other states, as found in that link, like Colorado, require some kind of regulatory agency before licensure, but not necessarily CACREP. It can also be helpful to contact your state’s licensing regulatory boards (for instance, in Colorado, we have DORA) to learn more about these specifics.
Choosing a Specialization
We said earlier that CACREP accredits certain specializations within an institution and within the field of mental health practices and related fields. This is where a student has to make their second choice. There are many ways to work within the field of mental health, from psychology to neurology, from social work to school counseling. The field is, in some sense, quite large. But they all address a central concern: the well-being of the minds of others. In standing with this idea, CACREP accredits nine specializations (1). Let’s explore each of them and identify who might be a good fit for each one.
Addiction Counseling
What is it?
Programs accredited for Addiction Counseling prepare and train prospective students to work clinically with individuals experiencing an array of addiction problems, including substance use, gambling, and related behaviors. These programs focus on diagnosis, relapse prevention, and understanding current models of addiction treatment. People who train in Addiction Counseling are often found in residential settings, outpatient agency settings, and private practice.
Who Addiction Counselingis a Good Fit For:
Addiction Counseling can be a challenging career choice for a number of reasons. There should be no illusions about it, but we should also be aware of the immense benefit from working in this field. Relapse rates remain relatively high, and addiction is a huge public policy concern in the United States. But the work is engaged, meaningful, and quite diverse. More and more health centers and departments are addressing addictions from varied, creative, and progressive angles. If you’re a person with grit and determination, and like to work with multidisciplinary teams on challenging problems, you might flourish in Addiction Counseling.
Career Counseling
What is it?
Career Counseling programs train students to help clients assess, evaluate, and refine what they want out of employment. This may include doing evaluations, job searching with that person’s specific needs in mind, or helping the individual interview and prepare their resume. Career Counselors often work in job centers and sometimes in private practice.
Who Career Counselingis a Good Fit For:
Career Counselors can function very much like coaches in the sense that they remain strengths-based and solutions-focused. New research is constantly being produced in this field, so it’s always changing and dynamic, as are the working conditions of the United States. If you’re a person who does well in dynamic conditions with changing social and economic elements but can remain grounded in finding solutions and collaboration, Career Counseling might be a good track for you.
Clinical Mental Health Counseling
What is it?
Programs training students in Clinical Mental Health Counseling focus on preparing future clinicians in dealing with various mental health diagnoses and problems, ranging from mood and anxiety disorders to personality disorders and psychotic disorders (the whole gamut of the DSM). These clinicians often work in clinical settings such as inpatient psychiatric hospitals, outpatient agencies, and private practices. They receive training in diagnosis, assessment, treatment, and individual and group psychotherapy.
Who Clinical Mental Health Counselingis a Good Fit For:
CMHC is a dynamic field with a surprisingly wide sphere of practice, from working in intense and fast-paced psychiatric hospitals and emergency rooms to slow and steady private consulting rooms. There are plenty of spaces to accommodate different kinds of clinicians. If you are interested in psychopathology and mental health concerns, and are drawn to incorporating theoretical models and research into your work with people, the CMHC route might be a good fit for you.
Clinical Rehabilitation Counseling
What is it?
Clinical Rehabilitation Counseling programs prepare students to work with individuals who suffer from cognitive, developmental, physical, and other co-morbid diagnoses, along with psychiatric disorders, to recover from and find strategies to improve their lives. These clinicians are trained in clinical work such as assessment and treatment, and are often found in hospitals and rehabilitation centers.
Who Clinical Rehabilitation Counseling is a Good Fit For:
CRC is dynamic, engaged, and multifaceted. It requires an individual to learn and implement psychiatric-mental health as well as rehabilitation skills and techniques, often addressing patients’ needs in highly complex cases. If you’re the kind of person who jumps at the prospect of solving complex problems with curiosity, confidence, and care in diverse settings, you might find CRC to be energizing and exciting.
Marriage, Couple, and Family Counseling
What is it?
MFT Counseling programs focus on training clinicians to work with family and couple units using various modalities. These individuals often work directly with parents, the entire family, couples, and married couples to identify patterns and systems that aren’t working and help build new pathways of relating with one another. They are often found in treatment centers and private practice.
Who Marriage, Couple, and Family Counseling is a Good Fit For:
Families and couples are incredibly complex. And they are also the bedrock of childhood development and human flourishing in general. MFT’s often find themselves in private practice working with families and couples to address deep systemic and patterned problems. This kind of work requires both sensitivity to complex issues and the ability to hold multiple perspectives at once, as well as being confident and rooted in one’s own knowledge and technique. If you can balance both of these things, the MFT route might be a good fit for you.
Rehabilitation Counseling
What is it?
Similar to Clinical Rehabilitation, Rehabilitation Counseling programs train students to work with individuals who suffer from cognitive or physical disabilities. However, Rehab Counseling does not train individuals as in-depth in the field of psychiatric or co-morbid disorders. As such, these clinicians work mainly with individuals to build independence, agency, and establish support systems to assist in their disabilities. Rehabilitation Counselors often find themselves working in hospitals with patients recovering from accidents or surgeries, or in outpatient settings with individuals with chronic conditions.
Who Rehabilitation Counseling is a Good Fit For:
Rehabilitation Counselors truly do it all: from career and employment exploration to consulting with family members to teaching self-advocacy skills, all centered around the commitment to helping individuals with disabilities or injuries. If you enjoy working with multidisciplinary teams and navigating complex social systems to help individuals, you might be a good fit for a Rehab Counseling program.
School Counseling
What is it?
Programs training individuals in School Counseling prepare students to work in school systems, from kindergarten through 12th grade. These clinicians are trained in individual and group counseling, assessment and safety planning, and dealing with families and parents to assist the child in achieving the best outcomes they can. They also often help students plan for the future, map out college or vocational goals, and help them with day-to-day management of school life.
Who School Counseling is a Good Fit For:
School Counseling takes a certain kind of person. If you don’t like working with kids, for instance, you’d be better off finding another clinical route! If you are relatable, warm, and adaptive to ever-evolving situations and can make emotional contact with children or adolescents, a School Counseling program might be able to draw upon those strengths in unique ways.
College Counseling and Student Affairs
What is it?
If you like the idea of working in education but prefer higher ed, the College Counseling and Student Affairs program might be a good place for you. These programs train students to work in colleges and universities performing very similar roles to School Counselors. The different setting and age-range of students requires slightly different training, but the essence of the work is the same: help students work through mental health, educational, and social obstacles that get in the way of their goals.
Who College Counseling and Student Affairsis a Good Fit For:
If you remember college, you know how confusing it can be at times. College Counselors work on bustling academic campuses and help students navigate the complexities of life in an especially stressful but also exploratory environment. If you are interested in problems of identity formation, exploration, and the adventures of young adulthood, and can remain level-headed and regulated, College Counseling programs might be a good fit for you.
Counselor Education and Supervision
What is it?
Among the programs on this list that are CACREP-accredited, CE&S is the only one at the doctoral level. These programs prepare students to work as teachers and supervisors to counselors at all levels. This training involves becoming familiar with advanced therapeutic techniques and services, the industry of counseling, and theories and practices of education and supervision.
Who Counselor Education and Supervision is a Good Fit For:
If you’re considering CE&S, it means you’re already in the field and have been working for some time doing clinical work. To further your career in different ways, you might even have taught some classes at the Master’s level or supervised younger clinicians. If you’re in this space and want to go even further in university systems and in supervision, this might be a good route for you. It involves a great deal of research and learning during the program, and a strengthening of one’s clinical intuition and expertise, which is something your students will draw inspiration from for the rest of their careers.
Personal Story
I still remember very clearly my decision-making process as to which program to choose. I studied psychology and the humanities in my undergraduate years, knowing that I was drawn to clinical work in some capacity. My brother had gone down a similar path and had completed a Master’s in Marriage and Family Counseling, so I had a good idea of what it might look like. He pressed upon me the importance of a CACREP-accredited degree, as it opens doors and makes it generally easier to go through licensing procedures later on.
So I was already looking for CACREP accreditation tracks from the outset. I also knew I was drawn to psychotherapy and clinical work because of my interests during undergrad. These two preferences narrowed down my choice. I also took into consideration the cost of the program, location, and reputation.
Clinical Mental Health Counseling seemed the best fit for my long-term career goals. I am now on the other side of the program and can say confidently that I made the right decision for me. The focus on diagnosis, treatment, individual, and group psychotherapy prepared me for the various settings I have worked within, from inpatient to intensive outpatient to private practice.
I am also in a strange position, because I went on to acquire a license in addiction counseling from an institution which is not CACREP-accredited. Even though the training program I attended for addiction counseling isn’t within the scope of CACREP, it has not hindered me in my work in the field. I am still able to bill insurance as needed, work with patients in direct clinical capacities, and find employment in the field easily enough.
But there was some trepidation and anxiety about making the right decision for me. If you’re feeling that right now, don’t worry or feel alone–everyone feels that way. It’s helpful to connect with a therapist you trust and respect (a friend, your own therapist, a College Counselor, etc.) who can walk you through their decision-making process and can provide tips, knowing your personal history and goals.
FAQ
It depends. You do not need to attend an accredited program to do clinical or mental health work in most cases (see section above on state differences). But it does make licensing, internships, and other administrative tasks easier. The further you get into the field, the less impact these decisions have, and everyone starts to level out.
Yes and no. Yes, you are ‘locked in’ in that each track is a specialization, providing its own specialized and unique skillsets. No, because it actually varies quite a bit. In a Clinical Mental Health program, you will learn some addiction and family work techniques, but you will not learn about school counseling. An Addiction Counseling track does not cover anything related to Rehabilitation, and so on. So, there may be overlap, but it depends on the track.
Conclusion
Choosing the right CACREP-accreditation track is an important step along the way to becoming the kind of mental health professional you want to become. Each track will prepare you for a very specialized kind of work. While there may be some overlap, there is considerable specialized training in each one. For instance, as a Clinical Mental Health Counselor, I would have to go back to school to do Rehabilitation Counseling, but I could indeed work within colleges with students and with people struggling in their careers. It’s important to consult with the institution’s administration to clarify what each program entails. Additionally, it might be helpful to visit cacrep.org/directory/ to see what’s out there.