top of page

Behavioral Health Practice Licensing & Regulation

All fifty states have at least one regulatory body that oversees the practice of treating mental health conditions, via licensure. The aim of these regulatory authorities is to ensure public safety, and to that end that authority is charged with the responsibility of seeing to it that candidates seeking licensure have demonstrated that s/he has met at least minimum level competencies. The level at which the competency bar is set is the result of an interplay between various entities including national regulatory bodies, authorities that have regulatory and credentialing oversite of training and degree-granting programs, epidemiology, the interests of private and public insurers, and the public.

States' regulatory authorities adopt the view that the greater number of hours devoted to training, the larger number of conditions or pathology (scope of practice) one is qualified to treat. Conversely, the fewer hours time devoted to training, the smaller scope of conditions or pathology one is qualified to treat. When granting a license an agreement is entered into between regulating authority and licensee. The licensee agrees to assuming the burden of responsibility in regulating his/her practice conduct, which includes not mis-representing one's skill level. A weakness in the regulatory responsibilities of licensing boards is their ability to oversee any one provider's scope of practice, and ensuring that the provider is not providing treatment for conditions for which they were not trained.

The minimum degree requirement to be licensed as a counselor is a two-year degree. A provider practicing with a two-year college degree qualifies to practice as a counselor with a narrow scope of practice. That is, the provider is trained to treat a specific diagnosis, or group of diagnoses. examples are the Pastoral Counselor and the Licensed Alcohol and Drug Counselor, or LADC (LAY - dack).

All state authorities grant several licenses kinds to mental health professionals who have demonstrated the ability to meet the state's standard of competent and safe practice. The kind of training one has pursued determines the kind of licenses granted, typically. Some providers who have been granted the doctorate-level degree may opt for a masters-level license as a mental health counselor license, rather than pursuing licensing as a psychologist.


One cannot refer to oneself as a psychologist unless one has been conferred the doctorate degree and has passed the Examination for Professional Practice in Psychology (EPPP), the national licensing examination. Within the state of New Hampshire as elsewhere, the licensed clinical mental health counselor (LCMHC) are individuals who have earned no less than a master’s degree. Some licensed clinical mental health counselor have earned their doctorate but have chosen to not take the EPPP.

Training programs differ in their conceptualization of mental health irregularity. Depending upon the training approach, mental health irregularity will be referred to as disorder, pathology, illness, sickness, disease, syndrome. There are training approaches that view the individual seeking treatment as a "client," while other training approaches adopt the view of the individual seeking treatment as "patient." These descriptors are subject to social, political and economic currents of the day. 

Examples of training approaches or traditions are the alcohol and drug counselor tradition, the pastoral counseling tradition, the social work tradition, the counseling tradition, the clinical psychology tradition, the psychoanalytic tradition. Each treatment approach follows a specific training model and each kind of license reflects the length of degree conferring training. That is, Associates-degree level providers, Bachelors-level provider, Masters-level providers, and Doctoral-level providers. 

bottom of page