North Carolina Professional Counselor — Requirements & Free Practice

• 1. Professional Orientation and Ethical Practice (10.7% of questions) (10.7%)

  • A. Uphold professional ethical standards for rehabilitation counselors and manage risk. [C] — a) Conceptualize and articulate the counseling relationship; b) Adhere to and ensure confidentiality, privileged communication, and privacy; c) Understand how to promote and participate in advocacy and ensure accessibility; d) Maintain professional roles to ensure appropriate service provision; e) Maintain appropriate relationships with other professionals; f) Understand the differing professional relationships in forensic and indirect services; g) Understand the ethical requirements of evaluation, assessment, and interpretation; h) Understand the ethical requirements in the roles of teaching, supervising, and training; i) Understand the ethical implications of research and publication; j) Understand the limits and ethical implications of the use of technology and distance counseling; k) Understand and ensure appropriate business practices; l) Understand and apply ethical decision-making models and processes.
  • B. Understand and apply laws and public policy affecting individuals with disabilities. [R] — a) Summarize and synthesize the impacts of the Rehabilitation Act of 1973.; b) Summarize and synthesize the impacts of Title V of the Rehabilitation Act of 1973 – Sections 501-504.; c) Summarize and synthesize the impacts of the Rehabilitation Act of 1973, as Amended.; d) Understand the impact of SSI/SSDI on employment, independent living and economic self-sufficiency.; e) Understand the impact of veteran benefits (e.g., service-connected disability compensation and non-service-connected pension) on employment, independent living and economic self-sufficiency.; f) Summarize and synthesize the impacts of the Fair Labor Standards Act.; g) Understand the definition of a disability in ADA, the uses of the definition, and how the definition relates to the rights guaranteed by the ADA.; h) Understand the rights guaranteed by the ADA in an employment setting.; i) Understand the definition of a reasonable accommodation as defined by the ADA.; j) Understand the rights guaranteed by the ADA on public transportation.; k) Understand the changes to the definition of disability in the ADAAA, the changes to the interactive process, and the implications for employees and employers.; l) Understand the role of the EEOC in relation to discrimination.; m) Summarize and synthesize the impacts of IDEA.; n) Summarize and synthesize the historical impacts of WIA.; o) Understand the rights and limits guaranteed by FMLA.; p) Understand the confidentiality and technology requirements of HIPAA.; q) Understand the impact of TWWIIA (Ticket to Work) on employment, independent living, and economic self-sufficiency.; r) Understand the impact and implications of WIOA on employment outcomes, independent living, and economic self-sufficiency.
  • C. Advocate for diversity, understand, and apply appropriate services that address multicultural counseling issues. [C]
  • D. Understand and apply appropriate rehabilitation terminology and concepts. [R]
  • E. Understand and identify the differing professional roles, functions, and effective relationships with other providers and professionals. [C]
  • F. Understand the credentialing issues related to the rehabilitation counseling profession and advocate for appropriate solutions. [C]
  • G. Understand the differing organizational structures of rehabilitation counseling practice settings (e.g., public, private-for-profit, and not-for-profit service delivery systems). [R]
  • H. Understand, synthesize, and apply knowledge of historical and philosophical foundations of rehabilitation counseling. [R]
• 2. Counseling Theories, Techniques, and Evidence-Based Practice (11.3% of questions) (11.3%)

  • A. Apply clinical problem-solving and critical-thinking skills. [C]
  • B. Understand rehabilitation techniques for individuals with disabilities. [R]
  • C. Understand individual counseling theories. [C] — a) Integrated/Eclectic; b) Rational-Emotive Behavior Therapy; c) Reality Therapy; d) Person-Centered; e) Psychoanalytic; f) Gestalt; g) Trait-factor/Person Environment Fit; h) Behavioral; i) Cognitive/Behavioral; j) Adlerian; k) Solution-Focused; l) Narrative; m) Feminist; n) Existential
  • D. Utilize individual counseling practices, interventions, and techniques. [C] — a) Systematic Desensitization; b) Behavior Analysis and Therapy; c) Social Skills; d) Time Management; e) Stress Management; f) Restructuring; g) Anger Management; h) Problem Solving Therapy; i) Person-centered practices; j) Mindfulness-based practices
  • E. Understand substance use and treatment. [C]
  • F. Establish and maintain effective working alliances with clients. [C]
  • G. Understand dual diagnosis and co-occurring disorders. [C]
  • H. Understand counseling/training to help clients develop workplace socialization skills. [R]
  • I. Demonstrate motivational interviewing use and skills. [C]
  • J. Facilitate treatment planning for clinical conditions (e.g., depression, anxiety, PTSD). [C]
  • K. Understand human growth and development. [C]
  • L. Apply evidence-based psychosocial/psychiatric rehabilitation interventions in rehabilitation counseling practice. [R]
  • M. Apply evidence-based vocational interventions in rehabilitation counseling practice. [R]
  • N. Apply or facilitate evidence-based counseling/therapy for clients with clinical diagnoses (e.g., depression, anxiety, PTSD). [C]
  • O. Apply or facilitate evidence-based counseling/therapy for clients with substance use disorders. [C]
  • P. Understand theories and techniques of clinical supervision. [C]
  • Q. Recognize and utilize evidence and research-based practices. [C]
• 3. Group and Family Counseling (4.7% of questions) (4.7%)

  • A. Understand family counseling theories. [C]
  • B. Incorporate family counseling practices and interventions. [C]
  • C. Understand group counseling theories. [C]
  • D. Incorporate group counseling practices and interventions. [C]
• 4. Crisis and Trauma Counseling and Interventions (6.0% of questions) (6%)

  • A. Conduct assessment of client risk and development of a safety plan. [C]
  • B. Provide effective rehabilitation counseling services for individuals with polytrauma injuries. [C]
  • C. Understand the impact of crises, disasters, and other trauma-causing events on people with disabilities. [C]
  • D. Use principles of crisis intervention for people with disabilities during crises, disasters, and other trauma-causing events. [C]
  • E. Understand the emergency management system within rehabilitation agencies and in the community. [C]
• 5. Medical and Psychosocial Aspects of Chronic Illness and Disability (9.3% of questions) (9.3%)

  • A. Evaluate the psychosocial and cultural impact of disability. [R] — a) Individual adjustment to disability; b) Human sexuality and disability issues; c) Family or support system adjustment to disability
  • B. Understand medical terminology. [R]
  • C. Apply knowledge of the medical aspects and implications of various disabilities. [R] — a) Mental Functions; b) Sensory Functions and Pain; c) Voice and Speech Functions and Structures; d) Cardiovascular, Hematological, Immunological, and Respiratory Functions and Structures; e) Digestive, Metabolic, and Endocrine Systems and Structures; f) Genitourinary and Reproductive Functions and Structures; g) Neuromusculoskeletal and Movement Related Functions and Structures; h) Skin and Related Functions and Structures; i) Nervous System Structures; j) Eye, Ear, and Related Structures; k) Learning and Applying Knowledge; l) Interpersonal Interactions and Relationships; m) General Tasks and Demands; n) Communication; o) Mobility; p) Self-Care; q) Domestic-Life; r) Major Life Areas; s) Community, Social, and Civic Life
  • D. Review the implications of medications as they apply to individuals with disabilities. [R]
  • E. Address environmental and attitudinal barriers for individuals with disabilities. [R]
• 6. Assessment/Evaluation, Occupational Analysis, and Service Implementation (10.7% of questions) (10.7%)

  • A. Understand the vocational implications of functional limitations associated with disabilities. [R] — a) Mental Functions; b) Sensory Functions and Pain; c) Voice and Speech Functions and Structures; d) Cardiovascular, Hematological, Immunological, and Respiratory Functions and Structures; e) Digestive, Metabolic, and Endocrine Systems and Structures; f) Genitourinary and Reproductive Functions and Structures; g) Neuromusculoskeletal and Movement Related Functions and Structures; h) Skin and Related Functions and Structures; i) Nervous System Structures; j) Eye, Ear, and Related Structures; k) Learning and Applying Knowledge; l) Interpersonal Interactions and Relationships; m) General Tasks and Demands; n) Communication; o) Mobility; p) Self-Care; q) Domestic-Life; r) Major Life Areas; s) Community, Social, and Civic Life
  • B. Access and review resources for the assessment process. [C] — a) Review of case materials for pertinent information; b) Diagnostic and Statistical Manual of Mental Disorders (DSM); c) International Classification of Diseases (ICD)
  • C. Refer or conduct informal assessments. [C] — a) Interviews and initial assessments; b) Situational assessment/job shadowing/community-based work assessment
  • D. Refer or conduct formal assessments. [C] — a) Achievement Tests; b) Aptitude Tests; c) Intelligence Tests; d) Interest Inventories; e) Career, Work Values, and Maturity Tests; f) Personality Tests; g) Psychological/Neuropsychological Tests; h) Adaptive Behavior/Behavioral Observations; i) Mental Health Screeners; j) Learning Styles Tests; k) Ecological/Functional Capacity Evaluations; l) Dexterity Tests; m) Work Samples; n) Non-Cognitive Tests
  • E. Refer or perform Transferable Skills Analysis (e.g., VDARE). [C]
  • F. Interpret assessment results for rehabilitation planning purposes. [C]
  • G. Perform job analysis. [R]
  • H. Assess ergonomic, job accommodation, and assistive technology needs. [R]
  • I. Advise on job modification and restructuring techniques. [R]
  • J. Perform labor market analysis. [R] — a) Occupational and labor market information (e.g., DOT, ORS, O*NET, OOH, other national, regional, or local government labor market sources, private salary surveys); b) Methods and techniques used to conduct labor market surveys
  • K. Use computer-based job matching systems. [C]
• 7. Career Development and Job Placement (9.3% of questions) (9.3%)

  • A. Understand, identify, and apply career development and job placement strategies. [R]
  • B. Understand, identify, and apply job readiness, seeking, and retention skills. [C]
  • C. Understand the unique needs of specialized populations in relation to job development and placement. [R]
  • D. Understand techniques to develop and retain relationships with employers to assist with job development and placement. [R]
  • E. Understand and identify evidence-based employment models and services tailored to individuals with significant disabilities and/or barriers to competitive employment. [R] — i) Supported Employment (SE); ii) Customized Employment (CE); iii) Individual Placement and Support (IPS); iv) Self-Employment
  • F. Understand the unique needs of individuals with a dual diagnosis in the workplace and apply appropriate strategies. [R]
  • G. Understand and apply theories of career development and work adjustment. [C] — a) Trait-Factor/Person Environment Fit theories.; b) Personality theories; c) Developmental/Self-Concept theories; d) Sociological/Self-Concept theories; e) Behavioral theories
  • H. Understand, identify, and facilitate the appropriate use of work conditioning or work hardening resources and strategies. [R]
  • I. Understand the effective use of and risks of social media as a networking tool. [C]
• 8. Business Engagement (7.6% of questions) (7.6%)

  • A. Assist employers with job accommodations for their employees with disabilities (e.g., assistive technology, workspace modifications). [R]
  • B. Provide consultation services and training to employers / businesses concerning disability concepts, best practices, and applicable laws (e.g., hiring, return to work, reasonable accommodations, and retention). [R]
  • C. Partner with employers/businesses to address needs and concerns related to hiring and retaining individuals with disabilities. [R]
  • D. Understand, communicate, and apply business-focused strategies, techniques, and terminology to improve employment outcomes for individuals with disabilities. [R]
  • E. Work with employers to develop pipelines for employing individuals with disabilities using work-based learning and training methods. [R] — a) Apprenticeships; b) Internships; c) On-the-job training (OJT)
  • F. Understand the dual customer role (e.g., employer and person with a disability). [R]
• 9. Community Resources and Partnerships (8.0% of questions) (8%)

  • A. Understand the programs and services available for specific and underserved populations. [R]
  • B. Understand Social Security programs, benefits, work incentives, and disincentives. [R]
  • C. Possess knowledge of funding sources and community resources for rehabilitation services. [R]
  • D. Provide or facilitate skills development and independent living services. [R]
  • E. Provide or facilitate financial literacy training. [R]
  • F. Understand and refer to services available through client advocacy programs (e.g., Client Assistance Program [CAP], legal aid). [R]
  • G. Refer to and partner with one-stop career centers and other community stakeholders. [R]
  • H. Understand and facilitate life care planning and life care planning services. [R]
  • I. Advocate with community partners for full community inclusion for people with disabilities. [R]
  • J. Provide or facilitate counseling on the impact of employment on community services and benefits. [R]
• 10. Case Management (10.0% of questions) (10%)

  • A. Understand and apply the case management process. [C] — a) Case finding; b) Planning; c) Service coordination; d) Referral to and utilization of other disciplines; e) Advocacy
  • B. Complete case recording and documentation. [C]
  • C. Understand and apply negotiation, mediation, and conflict resolution strategies. [C]
  • D. Understand and apply the principles of caseload management. [C]
  • E. Understand and address institutional and social barriers that impede access, equity, and success for clients. [C]
  • F. Apply techniques for working with individuals with limited English proficiency or varied communication methods. [C]
  • G. Understand and apply principles, models, and documentation formats for biopsychosocial case conceptualization and treatment planning. [C]
• 11. Health Care and Disability Management (7.3% of questions) (7.3%)

  • A. Understand and provide appropriate medical intervention resources. [R]
  • B. Understand the diversity of healthcare benefits, delivery systems, and the impact of services on individuals with disabilities. [R]
  • C. Understand and collaborate with health promotion and wellness providers regarding strategies for people with chronic illness and disability. [R]
  • D. Understand different insurance programs (e.g., Medicare, Medicaid, group and individual, short-and long-term disability, personal injury no-fault liability). [R]
  • E. Understand and apply disability prevention and management strategies. [R]
  • F. Understand the variability of workers’ compensation laws and practices. [R]
• 12. Research, Methodology, and Performance Management (5.3% of questions) (5.3%)

  • A. Understand statistics and psychometric concepts related to measurement. [C] — a) Validity; b) Reliability/ Standard Error of Measurement; c) Norms; d) Scaled and Standard Scores; e) Percentiles; f) Distributions/Bell Curve; g) Norm- and Criterion-Referenced Measurement
  • B. Understand research methods (e.g., surveys, case studies) and data analysis. [C]
  • C. Assess research literature related to evidence – based practice. [C] — a) Research databases (e.g., EBSCO, PsycINFO, MEDLINE); b) Ability to select between various levels of evidence-based research (e.g., subject matter experts to the systematic reviews and meta-analyses gold standard)
  • D. Comprehend concepts and principles of organizational development and stakeholder management. [C] — a) Effective management of services and programs, including areas such as administration, finance, benefit systems, and accountability; b) Strategic planning techniques and budget planning
  • E. Understand program evaluation procedures for assessing the effectiveness of rehabilitation services and outcomes. [R]

• 1. Professional Practice and Ethics — This section encompasses counselors’ knowledge, skills, and abilities related to maintaining proper administrative and clinical protocols. (12% of items; 19 scored items) (12%)

  • A. Assess your (the counselor) competency to work with a specific client
  • B. Understand statistical concepts and methods in research
  • C. Practice legal and ethical counseling
  • D. Clarify counselor–client roles
  • E. Discuss client’s rights and responsibilities
  • F. Discuss limits of confidentiality
  • G. Explain counselor agency policies
  • H. Review payment, fees, and insurance benefits
  • I. Explain counseling processes, procedures, risks, and benefits
  • J. Explain uses and limits of social media
  • K. Inform clients about the legal aspects of counseling
  • L. Obtain informed consent
  • M. Discuss confidentiality as it applies to electronic communication
  • N. Establish group rules, expectations, and termination criteria
  • O. Assess competency to provide informed consent
  • P. Monitor the therapeutic relationship and build trust as needed
  • Q. Review client records
  • R. Provide adequate accommodations for clients with disabilities
  • S. Provide information to third parties
  • T. Provide referral sources if counseling services are inadequate/ inappropriate
  • U. Advocate for professional and client issues
  • V. Seek supervision/consultation
  • W. Create and maintain documentation appropriate for each aspect of the counseling process
  • X. Awareness and practice of self-care
• 2. Intake, Assessment, and Diagnosis — This section encompasses counselors’ knowledge, skills, and abilities to effectively conduct client intake, assessment, and diagnosis. (12% of items; 19 scored items) (12%)

  • A. Conduct a biopsychosocial interview
  • B. Conduct a diagnostic interview
  • C. Conduct cultural formulation interview
  • D. Conduct an initial interview
  • E. Determine diagnosis
  • F. Perform a Mental Status Exam (MSE)
  • G. Consider co-occurring diagnoses
  • H. Determine level of care needed
  • I. Determine the appropriate modality of treatment
  • J. Assess the presenting problem and level of distress
  • K. Evaluate an individual’s level of mental health functioning
  • L. Screen clients for appropriate services
  • M. Select, use, and interpret appropriate assessment instruments
  • N. Use formal and informal observations
  • O. Assess for trauma
  • P. Assess substance use
  • Q. Obtain client self-reports
  • R. Evaluate interactional dynamics
  • S. Conduct ongoing assessment for at-risk behaviors (i.e., suicide, homicide, self/other injury, and relationship violence)
  • T. Use pre-test and post-test measures to assess outcomes
  • U. Evaluate counseling effectiveness
• 3. Areas of Clinical Focus — This section encompasses counselors’ knowledge and skills related to areas of clients’ concern(s). (29% of items; 47 scored items) (29%)

  • A. Adjustment related to physical loss/injury/medical condition
  • B. Aging/geriatric concerns
  • C. Behavioral problems
  • D. Bullying
  • E. Caregiving concerns
  • F. Cultural adjustments
  • G. End-of-life issues
  • H. Fear and panic
  • I. Financial issues
  • J. Gender identity development
  • K. Grief/loss
  • L. Hopelessness/depression
  • M. Loneliness/attachment
  • N. Hyper/hypo mental focus
  • O. Intellectual functioning issues
  • P. Insomnia/sleep issues
  • Q. Maladaptive eating behaviors
  • R. Remarriage/recommitment
  • S. Developmental processes/tasks/issues
  • T. Obsessive thoughts/behaviors
  • U. Occupation and career development
  • V. Physical issues related to anxiety
  • W. Physical issues related to depression
  • X. Physical/emotional issues related to trauma
  • Y. Process addictions (pornography, gambling)
  • Z. Racism/discrimination/oppression
  • AA. Religious values conflict
  • AB. Retirement concerns
  • AC. Ruminating and/or intrusive thoughts
  • AD. Separation from primary care givers
  • AE. Sexual functioning concerns
  • AF. Sleeping habits
  • AG. Spiritual/existential concerns
  • AH. Stress management
  • AI. Substance use/addiction issues
  • AJ. Suicidal thoughts/behaviors
  • AK. Terminal illness issues
  • AL. Visual/auditory hallucinations
  • AM. Worry and anxiety
  • AN. Adoption issues
  • AO. Blended family issues
  • AP. Child abuse-related concerns
  • AQ. Child development issues
  • AR. Dating/relationship problems
  • AS. Divorce
  • AT. Family abuse/violence (e.g., physical, sexual, emotional)
  • AU. Interpersonal partner violence concerns
  • AV. Marital/partner communication problems
  • AW. Parenting/co-parenting conflicts
  • AX. Emotional dysregulation
• 4. Treatment Planning — This section encompasses counselors’ knowledge, skills, and abilities to develop an effective course of treatment. (9% of items; 14 scored items) (9%)

  • A. Collaborate with client to establish treatment goals and objectives
  • B. Establish short- and long-term counseling goals consistent with clients’ diagnoses
  • C. Identify barriers affecting client goal attainment
  • D. Identify strengths that improve the likelihood of goal attainment
  • E. Refer to different levels of treatment (e.g., outpatient, inpatient, residential, etc.)
  • F. Refer to others for concurrent treatment
  • G. Guide treatment planning
  • H. Discuss termination process and issues
  • I. Discuss transitions in group membership
  • J. Follow-up after discharge
  • K. Use assessment instrument results to facilitate client decision making
  • L. Review and revise the treatment plan
  • M. Engage clients in review of progress toward treatment goals
  • N. Collaborate with other providers and client support systems (documentation and report writing)
  • O. Discuss with clients the integration and maintenance of therapeutic progress
  • P. Educate client to the value of treatment plan compliance
• 5. Counseling Skills and Interventions — This section encompasses counselors’ knowledge, skills, and abilities to conduct effective counseling. (30% of items; 48 scored items) (30%)

  • A. Align intervention with client’s developmental level
  • B. Align intervention with counseling modality (individual, couple, family, or group)
  • C. Align intervention with client population (e.g., veterans, minorities, disenfranchised, disabled)
  • D. Implement individual counseling in relation to a plan of treatment
  • E. Establish therapeutic alliance
  • F. Apply theory-based counseling intervention(s)
  • G. Address addiction issues
  • H. Address cultural considerations
  • I. Address family composition and cultural considerations
  • J. Evaluate and explain systemic patterns of interaction
  • K. Explore family member interaction
  • L. Explore religious and spiritual values
  • M. Guide clients in the development of skills or strategies for dealing with their problems
  • N. Help clients develop support systems
  • O. Help facilitate clients’ motivation to make the changes they desire
  • P. Improve interactional patterns
  • Q. Provide crisis intervention
  • R. Educate client about transference and defense mechanisms
  • S. Facilitate trust and safety
  • T. Build communication skills
  • U. Develop conflict resolution strategies
  • V. Develop safety plans
  • W. Facilitate systemic change
  • X. Provide distance counseling or telemental health
  • Y. Provide education resources (e.g., stress management, assertiveness training, divorce adjustment)
  • Z. Provide psychoeducation for client
  • AA. Summarize
  • AB. Reframe/redirect
  • AC. Facilitate empathic responses
  • AD. Use self-disclosure
  • AE. Use constructive confrontation
  • AF. Facilitate awareness of here-and-now interactions
  • AG. Facilitate resolution of interpersonal conflict
  • AH. Use linking and blocking in a group context
  • AI. Management of leader–member dynamics
  • AJ. Model giving and receiving of feedback
  • AK. Address impact of extended families
  • AL. Contain and manage intense feelings
  • AM. Explore the influence of family of origin patterns and themes
  • AN. Address the impact of social support network
  • AO. Use “structured” activities
  • AP. Promote and encourage interactions among group members
  • AQ. Promote and encourage interactions with the group leader
  • AR. Use psychoeducation as a part of the group process
  • AS. Explain phases in the group process
  • AT. Identify and discuss group themes and patterns
  • AU. Create intervention based on the stage of group development
  • AV. Challenge harmful group member behaviors
  • AW. Address the potential interaction of members outside of the group
• 6. Core Counseling Attributes — This section encompasses behaviors, traits, and dispositions of effective counselors. (8% of items; 13 scored items) (8%)

  • A. Awareness of self and impact on clients
  • B. Genuineness
  • C. Congruence
  • D. Demonstrate knowledge of and sensitivity to gender orientation and gender issues
  • E. Demonstrate knowledge of and sensitivity to multicultural issues
  • F. Demonstrate conflict tolerance and resolution
  • G. Empathic attunement
  • H. Empathic responding
  • I. Foster the emergence of group therapeutic factors
  • J. Non-judgmental stance
  • K. Positive regard
  • L. Respect and acceptance for diversity
  • M. Use foundational listening, attending, and reflecting skills

• 1. Professional Practice and Ethics — This section encompasses counselors’ knowledge, skills, and abilities related to maintaining proper administrative and clinical protocols. (15% of scored items) (15%)

  • A. Assess your (the counselor) competency to work with a specific client
  • B. Understand statistical concepts and methods in research
  • C. Practice legal and ethical counseling
  • D. Clarify counselor/client roles
  • E. Discuss client’s rights and responsibilities
  • F. Discuss limits of confidentiality
  • G. Explain counselor/agency policies
  • H. Review payment, fees, and insurance benefits
  • I. Explain counseling processes, procedures, risks, and benefits
  • J. Explain uses and limits of social media
  • K. Inform clients about the legal aspects of counseling
  • L. Obtain informed consent
  • M. Discuss confidentiality as it applies to electronic communication
  • N. Establish group rules, expectations, and termination criteria
  • O. Assess competency to provide informed consent
  • P. Monitor the therapeutic relationship and build trust as needed
  • Q. Review client records
  • R. Provide adequate accommodations for clients with disabilities
  • S. Provide information to third parties
  • T. Provide referral sources if counseling services are inadequate/inappropriate
  • U. Advocate for professional and client issues
  • V. Supervision
  • W. Create and maintain documentation appropriate for each aspect of the counseling process
  • X. Awareness and practice of self-care
• 2. Intake, Assessment, and Diagnosis — This section encompasses counselors’ knowledge, skills, and abilities to effectively conduct client intake, assessment, and diagnosis. (25% of scored items) (25%)

  • A. Conduct a biopsychosocial interview
  • B. Conduct a diagnostic interview
  • C. Conduct cultural formulation interview
  • D. Conduct an initial interview
  • E. Determine diagnosis
  • F. Perform a Mental Status Exam (MSE)
  • G. Consider co-occurring diagnoses
  • H. Determine level of care needed
  • I. Determine the appropriate modality of treatment
  • J. Assess the presenting problem and level of distress
  • K. Evaluate an individual’s level of mental health functioning
  • L. Screen clients for appropriate services
  • M. Select, use, and interpret appropriate assessment instruments
  • N. Use formal and informal observations
  • O. Assess for trauma
  • P. Assess substance use
  • Q. Obtain client self-reports
  • R. Evaluate interactional dynamics
  • S. Conduct ongoing assessment for at-risk behaviors (i.e., suicide, homicide, self/other-injury, and relationship violence)
  • T. Use pre-test and post-test measures to assess outcomes
  • U. Evaluate counseling effectiveness
• 4. Treatment Planning — This section encompasses counselors’ knowledge, skills, and abilities to develop an effective course of treatment. (15% of scored items) (15%)

  • A. Collaborate with client to establish treatment goals and objectives
  • B. Establish short- and long-term counseling goals consistent with client’s diagnosis
  • C. Identify barriers affecting client goal attainment
  • D. Identify strengths that improve the likelihood of goal attainment
  • E. Refer to different levels of treatment (e.g., outpatient, inpatient, residential)
  • F. Refer to others for concurrent treatment
  • G. Guide treatment planning
  • H. Discuss termination process and issues
  • I. Discuss transitions in group membership
  • J. Follow up after discharge
  • K. Use assessment instrument results to facilitate client decision-making
  • L. Review and revise the treatment plan
  • M. Engage clients in review of progress toward treatment goals
  • N. Collaborate with other providers and client support systems (documentation and report writing)
  • O. Discuss with clients the integration and maintenance of therapeutic progress
  • P. Educate client to the value of treatment plan compliance
• 5. Counseling Skills and Interventions — This section encompasses counselors’ knowledge, skills, and abilities to conduct effective counseling. (30% of scored items) (30%)

  • A. Align intervention with client’s developmental level
  • B. Align intervention with counseling modality (individual, couple, family, or group)
  • C. Align intervention with client population (e.g., veterans, minorities, disenfranchised, disabled)
  • D. Implement individual counseling in relation to a plan of treatment
  • E. Establish therapeutic alliance
  • F. Apply theory-based counseling intervention(s)
  • G. Address addiction issues
  • H. Address cultural considerations
  • I. Address family composition and cultural considerations
  • J. Evaluate and explain systemic patterns of interaction
  • K. Explore family member interaction
  • L. Explore religious and spiritual values
  • M. Guide clients in the development of skills or strategies for dealing with their problems
  • N. Help clients develop support systems
  • O. Help facilitate clients’ motivation to make the changes they desire
  • P. Improve interactional patterns
  • Q. Provide crisis intervention
  • R. Educate client about transference and defense mechanisms
  • S. Facilitate trust and safety
  • T. Build communication skills
  • U. Develop conflict resolution strategies
  • V. Develop safety plans
  • W. Facilitate systemic change
  • X. Provide distance counseling or telemental health
  • Y. Provide education resources (e.g., stress management, assertiveness training, divorce adjustment)
  • Z. Provide psychoeducation for client
  • AA. Summarize
  • AB. Reframe/redirect
  • AC. Facilitate empathic responses
  • AD. Use self-disclosure
  • AE. Use constructive confrontation
  • AF. Facilitate awareness of here-and-now interactions
  • AG. Facilitate resolution of interpersonal conflict
  • AH. Use linking and blocking in a group context
  • AI. Management of leader–member dynamics
  • AJ. Model giving and receiving of feedback
  • AK. Address impact of extended families
  • AL. Contain and manage intense feelings
  • AM. Explore the influence of family of origin patterns and themes
  • AN. Address the impact of social support network
  • AO. Use “structured” activities
  • AP. Promote and encourage interactions among group members
  • AQ. Promote and encourage interactions with the group leader
  • AR. Use psychoeducation as a part of the group process
  • AS. Explain phases in the group process
  • AT. Identify and discuss group themes and patterns
  • AU. Create intervention based on the stage of group development
  • AV. Challenge harmful group member behaviors
  • AW. Address the potential interaction of members outside of the group
• 6. Core Counseling Attributes — This section encompasses behaviors, traits, and dispositions of effective counselors. (15% of scored items) (15%)

  • A. Awareness of self and impact on clients
  • B. Genuineness
  • C. Congruence
  • D. Demonstrate knowledge of and sensitivity to gender orientation and gender issues
  • E. Demonstrate knowledge of and sensitivity to multicultural issues
  • F. Demonstrate conflict tolerance and resolution
  • G. Empathic attunement
  • H. Empathic responding
  • I. Foster the emergence of group therapeutic factors
  • J. Non-judgmental stance
  • K. Positive regard
  • L. Respect and acceptance for diversity
  • M. Use foundational listening, attending, and reflecting skills

Inferred from the examination name; the authority has not published an examination outline.

• North Carolina General Statutes Chapter 90 — Articles 24 and 24A
• 21 NCAC Chapter 53 — Board of Licensed Clinical Mental Health Counselors
• G.S. 93B-15.1 — Military training, military spouse endorsement and temporary practice permits