Dr. Alyson Carr, LMHC



Figuring out how to approach studying for the NCMHCE can be daunting. Here is a general outline to follow and a detailed study calendar based on a 3-month study timeline.

For testers who have less than 3 months to prepare, just condense the calendar to fit your timeline. For those who wish to spend longer than 3 months preparing, just space out the tasks a little more (or work through the tasks more than once).

  • If you don’t already have it, purchase the DSM-5. And, begin to get familiar with the DSM diagnostic criteria (for each disorder in the DSM, there is a bulleted list that has the heading “diagnostic criteria” - this is what I’m referring to).

There are also a number of tools available to simplify and enhance this part of the study process. Watch this short video that includes 5 steps for mastering the DSM in the way you need to know the material for the NCMHCE.

After you feel confident about your diagnostic criteria knowledge...

  • Purchase the NCMHCE Prep guide that is made by NBCC - it contains 5 simulated cases written by the test makers themselves - for that reason, it is priceless! Don’t open it and complete the simulations until you are close to your test date.

  • Get a subscription to an NCMHCE study site that allows you to complete practice cases - if you aren’t sure which study site you want to invest in, ask your friends or colleagues who have passed what they found to be most helpful. Or, join an NCMHCE support group online or in person and ask group members what worked for them before spending your hard-earned money! Click here to join a free support group for counselors preparing for the NCMHCE.

  • Not every tester wants or needs to do this, but if it’s in your budget, complete an NCMHCE prep workshop with a good reputation. There are many online and in person workshops available - you can learn about these from colleagues and through recommendations in NCMHCE support groups. Click here to learn more and register for the online workshop I offer.

Alyson CarrComment


A conversation with Dr. Alyson Carr on (nearly) all you need to know when preparing to take the National Clinical Mental Health Counseling Examination (NCMHCE).

We discuss why the test is important and useful for counselors, the format of the exam, and concrete ideas to help you prepare.

Click here to listen and view some helpful links!

Alyson Carr

Had such a great time discussing test anxiety as a panelist on the ARE Live Podcast this week!

Check it out if you’re interested in learning a little more about test anxiety in relation to high stakes exams, and a few tips for how to manage test anxiety on the exam day. There is a recording of the Live presentation with slides available on YouTube as well as a Podcast version on iTunes..

“In this episode we sit down with one of our Black Spectacles ARE Prep Coaches and a psychology expert to discuss what test anxiety is, how managing it can improve your exam scores, and specific ways to help overcome it. We’ll be asking for your input on what you’ve found makes you nervous or trips you up, and give you our tips & tricks for staying cool, calm, and collected.

After this episode, you’ll have the opportunity to read a blog post with information from our researchers, and download a variety of useful test taking strategies to help you feel comfortable and relaxed when you take the exam.”

Alyson Carr

DISCLAIMER: I do not work for the National Board for Certified Counselors (NBCC). I have recently received many emails from test takers trying to distinguish between the following acronyms: NCMHCE, NCE, NCC, and CCMHC. This blog post is simply my interpretation of the information provided by NBCC. If you see anything in this post that is inaccurate, please post a comment or send me an email so I can update it accordingly.


National Clinical Mental Health Counseling Examination (NCMHCE): This exam is required for licensure in some states. 

National Counselor Examination for Licensure and Certification (NCE): This exam is required for licensure in some states. 

Depending on which state you live in, you are required to earn a passing score on the NCMHCE and/or the NCE to become licensed. Becoming licensed earns you credentials such as LPC, LCPC, LPCC, LMHC, LPCMH, LCMHC, or LPC-MH.

Click on your state on the State Board Directory and then look at what is displayed on the right side of the page to determine which exam you need to pass to become licensed in your state: http://www.nbcc.org/directory


National Certified Counselor (NCC): A passing score on the NCE or the NCMHCE is one of the requirements for the National Certified Counselor (NCC) certification. 

For more information about NCC application requirements, click here: http://www.nbcc.org/Certification/NationalCertCounselor

Certified Clinical Mental Health Counselor (CCMHC): Many people email asking, "Is the CCMHC an examination?" The acronym CCMHC reflects credentials that correspond to a certification, not an exam. A passing score on the NCMHCE is required for the CCMHC certification. 

For more information about the CCMHC application requirements, click herehttp://www.nbcc.org/Certification/CertifiedClinicalMentalHealthCounselor

One of the benefits of becoming certified is that it demonstrates a commitment to the profession and respective licensing bodies. Some certifications have continuing education requirements for recertification, which further illustrates ones dedication to ongoing learning as it relates to the field.

Hope this helps! 

Alyson Carr

When test takers reach out to me for guidance on how to prepare for the NCMHCE, it is not uncommon for their inquiry to begin with a description of how a bad experience in a CHOOSE ONLY ONE section of the NCMHCE sent them into a downward spiral of extreme anxiety and ultimate failure on the exam.

Let’s talk about the difference between a SELECT AS MANY and a CHOOSE ONLY ONE section on the NCMHCE.

What is a SELECT AS MANY section?

SELECT AS MANY means that you are being asked a question with a number of correct answer selections. For example, let's say there are 10 answer choices and 7 of them are correct: If you select only 4 of the 7 correct answers – you will be allowed to move onto the next section. If you select only 1 answer, and it is incorrect, you will be able to move onto the next section. If you only select 3 wrong answers, you will be able to move onto the next section. To summarize, in a SELECT AS MANY section, you can literally “select as many” answers you think you correct and then you can move onto the next section in your simulation without really knowing if you made all (or any) of the right answer choices.

What is a CHOOSE ONLY ONE section?

CHOOSE ONLY ONE means that you are being asked a question with only ONE correct answer. If you do not select the correct answer on your first try, you must continue making answer selections until you choose the correct answer and can move onto the next section. See how the pressure of needing to select the ONLY correct answer can immediately trigger test anxiety? What adds to this pressure is the realization that not only do you need to select the ONE CORRECT ANSWER, but if you DO NOT select the ONE correct answer on your first try, you will need to continue making selections until you get the right answer. And, what happens when you make wrong answer selections? You lose points. It’s no wonder that nerves take over when a test taker begins a CHOOSE ONLY ONE section.

How to handle the anxiety associated with a CHOOSE ONLY ONE section of DOOM

1.     Remember that you do not have to get every single answer correct in order to pass the NCMHCE – you WILL make incorrect answer selections on test day and you need to be equipped to respond to this stress with a level head that doesn’t compromise your performance.

2.     Remember that you do not need to hit every single case out of the ballpark – your final score on the NCMHCE is an overall cumulative score so if you are doing well in the majority of your simulations, you have some wiggle room in the event you are confronted with a case that really stumps you.

3.     Anticipate being in a CHOOSE ONLY ONE section on test day and build up your emotional resources by working through these kind of sections when you are practicing using CounselingExam.co

Alyson Carr

When taking the PearsonVue version of the NCMHCE, select all of the buttons in a given section first. Then, click "Get Feedback" for all of the buttons you've selected (as opposed to clicking the button, followed by "get feedback," next correct button "get feedback," and so on...).

Approaching your exam this way will prevent you from being distracted by any information you uncover when you click "get feedback." By clicking all of the buttons first, before clicking "get feedback" you increase your chances of staying focused on the most relevant selections before taking in all of the new information you've revealed. 

Alyson Carr