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The History and Development of Clinical Mental Health Counseling

Updated on August 12, 2012

Clinical Mental Health Counseling


This paper examines the development of the clinical mental health counseling field from a historical perspective. Counseling as a profession did not gain identity until 1971. It was at that time that counselors became legally recognized as professional in which counselors provided personal as well as vocational and educational counseling. The recognitions of counseling as a profession separate from psychology developed a need for regulation through credentialing procedures (Gladding & Newsome, 2010). As current trends within the counseling field reflect the changes and evolution of the past, the field of counseling will continue to develop in order to adapt to the diverse needs of society.

Counseling as a profession in the United States first developed in the late 1890s, which was developed from a humanitarian concern to improve lives in communities. Most counselors identified themselves as social reformers and educations and focused on improving the lives of children and young adults (Gladding & Newsome, 2010). Community counseling, which began in the early 1900s, was defined as counseling that took place in settings other than school or universities. During this time, three leaders emerged; Parson, who focused on growth and prevention; Davis, who set up a systematized guidance program in public schools; and Beers, a Yale student who was hospitalized for mental illness and later exposed the deplorable conditions of mental institute in his best-seller, which he used to advocate for better mental health facilities (Gladding & Newsome, 2010). The contributions of Parsons, Beers, and Davis set the pathway for new methods, practices, testing procedures and specialty areas of community counseling that took place within the counseling profession throughout the 1900s. The establishment of CACREP in 1981 allowed master’s programs in community and other agency settings, as well as programs in school counseling and college student personnel, to become eligible to apply for accreditation. In February 2008, 149 community counseling programs and 54 mental health counseling programs were accredited by CACREP. Recent adoptions to the 2009 CACREP standards no longer include specialty areas of community counseling and mental health counseling. The two areas have now merged into one specialty area: clinical mental health counseling (Gladding & Newsome, 2010).

As early as 1960, counseling did not have a strong enough identity as a profession to be recognized legally. In 1971, in an Iowa Law Review Note, counselors became legally recognized as professionals who provided personal as well as vocational and education counseling. The Weldon v. Virginia State Board of Psychologists Examiners of 1974 gave more clear definition to counseling as a profession distinct from psychology. The establishment of CACREP in 1981 provided counselors with professional standards and review procedure from training programs (Gladding & Newsome, 2010). The National Board for Certified Counselors was established by the counseling profession in 1982 in order to certify counselors who have met requirements in training, experience, and performance on the National Counselor Examination for Licensure and Certification. Prior to the 1980s, counselors were not recognized for reimbursement from their-party payors without standards of preparation and practice. Standards for mental health counseling were established by CACREP in 1988. In 1993, using the CACREP standards and the ACA policy as starting points; the AMHCA adopted a set of national standards for mental health counselors who deliver clinical services. National standards in counseling were designed to enable mental health counselors to satisfy the requirements of third-party payers and to pave the way for greater reciprocity among state regulatory bodies (Smith & Robinson, 1995).

Legal and ethical issues, as well as changes in technology and the development of managed care, all played a role in the development of the current trends in the counseling field. The ACA code if ethics and the NBCC code of ethics provide guidelines for modern-day counselors in order to protect the well-being of the clients while providing a set of standards to adhere to. As many counselors will choose to become nationally certified, the NCC allows for a formal agreement from counselors to abide by the NBCC’s Code of Ethics (Gladding & Newsome, 2010). As ethical standards and legal codes, as well as changes in technology, managed care, and assessment and treatment planning trends will continue to evolve to meet the current needs of society, confidentiality, informed consent, competence, and integrity should always reflect the best interest of the client. In today’s managed care environment, clinical mental health counselors offer a full range of services and are qualified to meet the challenges of providing high-quality care in a cost effective manner. Licensure requirements of clinical mental health counselors are equivalent to those of clinical social workers and marriage and family therapists, all of which require a master’s degree for independent status (American Mental Health Counselors Association, 2012).


American Mental Health Counselors Association. (2012). Facts About Clinical Mental Health Counselors. Retrieved July 23, 2012 from

Gladding, S. T., & Newsome, D. W. (2010). Clinical Mental Health Counseling in Community and Agency Settings (3rd ed.). Upper Saddle River, NJ: Merrill.

Smith, H. B. & Robinson, G. P. (1995). Mental Health Counseling: Past, Present, and Future. Journal of Counseling and Development, 74, 158-162


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