What Is on the National Counselor Exam?

The National Counselor Exam consists of 200 multiple choice items, 160 of which are scored and 40 of which are unscored items used to gather statistics for future exam iterations. Test takers are allowed three hours and 45 minutes to finish the examination. Test takers need to be either graduates of or graduate students at an accredited CACREP counseling program, with courses in 8 categories of work: professional orientation and ethics, career development, social and cultural diversity, counseling and helping relationships, human growth and development, group counseling and work, research and program evaluation, and assessment and testing. There are multiple areas of clinical theory and practice that the test taker is expected to demonstrate competency in, divided between six domains with varying numbers of items associated with each.

Professional Practice and Ethics

19 scored items on the National Counselor Examination concern the specifics of ethics and professionalism as they apply to the counseling field. Issues include informed consent, fees and collection practices, demonstration of an understanding of confidentiality expectations, the boundaries of the counselor-client relationship, and self-assessment in relation to particular kinds of clients. Also, the use of the internet and social media in the modern world causes some thorny issues for counselors, and items concerning the ethical and professional use of social media by counselors may be included.

Intake, Assessment, and Diagnosis

Typically, intake is the first step in a counseling relationship, and 19 scored questions on the National Counselor Exam tests the taker’s knowledge of proper diagnosis and assessment technique. Different kinds of interviews, from diagnostic to biopsychosocial to cultural formation, are covered, as is the trickiness involved in co-occurring diagnoses. Successful takers will also need to know the Mental State Exam (MSE) and substance abuse screening procedure.

Areas of Clinical Focus

The second longest section at 47 scored items, the areas of clinical focus questions deal with the variety of issues that lead clients to seek counseling services. Emotional regulation, divorce, anxiety, depression, sexual functioning concerns, sleeping issues, addiction, grief, and stage-of-life issues are all among the subjects incorporated into these items on the National Counselor Examination. Basically, this covers the different possible conclusions the information gathered in the intake process lead to.

Treatment Planning

Once a client has been diagnosed with a particular clinical issue, the next step in counseling is developing a plan of treatment. 14 scored items stress the importance of a collaborative process between counselor and client, examine when different intensities of treatment (from outpatient to residential) are appropriate, and cover following up on the results of treatment interventions.

Counseling Skills and Interventions

A massive 48 scored items cover the nuts and bolts of practical counseling skills, used to help clients address their issues and find ways forward. Some important concerns focus on appropriate techniques relating to development level, size of counseling setting (single, couples, or group), and cultural population, as these demographics can have a significant effect on how interventions are received. Dealing with substance issues and crises is also covered. The prospective counselor’s ability to build trust and provide education to the client is also tested.

Core Counseling Attributes

There are traits that mark out successful counselors, and those seeking to enter the profession need to know what they are and cultivate them. Subjects include being genuine, listening actively, the many dimensions of empathy, and maintaining a non-judgmental perspective as free from bias as possible. 13 scored questions cover the spectrum of these concerns.