What Is Clinical Mental Health Counseling? (And How It Differs From Therapy)

— Originally published October 24, 2024 —

Clinical mental health counseling is care from a licensed counselor who assesses and treats concerns like anxiety, depression and trauma through talk therapy.

Here’s how it compares with therapy, how counselors are licensed in Pennsylvania and what it can help with.

Millions of Americans are living with some degree of mental illness without receiving treatment.

SAMHSA’s 2025 national survey found that just 50.9% of adults who experienced a mental illness received care, leaving almost half without counseling, medication or other treatment [1]. Here in Pennsylvania alone, roughly one in four adults (23.94%) experienced a mental illness in the past year [2].

what is clinical mental health counseling

The scale of the problem is sobering, particularly when we consider how much mental health difficulties can affect a person’s everyday life.

These statistics underscore the importance of having reliable and accessible mental health services, such as individual counseling, to help people cope with the mental health difficulties they may be struggling with. Having someone to talk to, understand what they’re going through and help them find ways forward can be an important part of making everyday life more manageable [3,4].

In this post, let’s take a closer look at what exactly clinical mental health counseling is, as well as some of the various mental health issues that it can help with.

What Is Clinical Mental Health Counseling?

Clinical mental health counseling is a professional practice that focuses on helping individuals, couples and groups understand and manage their mental health difficulties. Counselors work with people experiencing anxiety, depression, mood disorders, problems with substance use and the effects of trauma.[3]

A clinical mental health counselor is the licensed professional who provides this care. In Pennsylvania, that usually means a licensed professional counselor (LPC), or a licensed associate professional counselor (LAPC) working under supervision toward an LPC [7,9].

The American Counseling Association describes counseling as a professional relationship that helps people work toward goals for their mental health, wellbeing, education and careers.[3]

Counselors draw on their training, experience and a range of therapeutic techniques to help clients work through the difficulties they’re facing. These approaches can include cognitive behavioral therapy (CBT), mindfulness exercises and various strategies for managing stress. The techniques used will depend on the person’s needs and the counselor’s training [4].

Is Counseling Different From Therapy?

A common misconception among those who are unfamiliar with the mental health industry is that counseling is not as good as therapy – but this is simply not the case. In fact, there are significant overlaps between counseling and therapy, and counseling is recognized as a form of therapy.

Both approaches draw on evidence-based practices designed to help individuals improve their mental health and well-being [4].

Counseling is sometimes described as short-term support focused on a specific goal, while therapy is associated with longer-term work on emotional patterns or past experiences. However, this isn’t a strict distinction. Both can be brief or ongoing, and a counselor may help with immediate concerns as well as deeper, longstanding difficulties [4,11].

For example, you might go to counseling if you feel anxious about starting a new job. At first, your sessions could help you manage that anxiety and get used to your new responsibilities. If you realize that your fear of making mistakes has also affected past jobs or relationships, you and your counselor can talk about that as well. The same professional can help with both kinds of support.

While both can be effective forms of mental health treatment, the most suitable approach will ultimately depend on your personal needs and goals [4].

Do You Need a Counselor, a Psychologist or a Psychiatrist?

When you’re looking for mental health support, you may come across counselors, psychologists, clinical social workers and psychiatrists. These professionals can help with many of the same concerns, but they have different qualifications and offer different types of care – one distinction being whether or not they can prescribe medication [5,6].

Professional	Typical training	What they do	Prescribe medication in Pennsylvania?
Licensed professional counselor (LPC)	Master’s or doctoral degree in counseling or a related field, plus supervised experience	Assess and treat mental health concerns through counseling and psychotherapy	No
Psychologist	Usually a doctoral degree in psychology, plus supervised training	Provide psychological assessment, testing and psychotherapy within their specialty	No
Licensed clinical social worker (LCSW)	Graduate degree in social work, plus supervised clinical experience	Provide assessment and psychotherapy, considering the person’s relationships and social circumstances	No
Psychiatrist	Medical degree followed by specialist training in psychiatry	Diagnose and treat mental health conditions, prescribe medication and sometimes provide psychotherapy	Yes

In some cases, it’s possible that your care involves more than one professional. You might see a counselor for therapy while a psychiatrist prescribes medication and monitors how it’s working for you. When choosing a provider, it also helps to ask about their experience treating concerns similar to yours, alongside checking their qualifications [5].

Education and Licensing Requirements for Mental Health Counselors in Pennsylvania

Clinical mental health counselors undergo years of education and supervised training to prepare them to support people with their mental health. Pennsylvania’s licensing requirements help ensure that counselors have both the professional knowledge and practical experience needed to provide care.

The usual path to becoming a licensed professional counselor (LPC) in Pennsylvania involves four main steps:

Earn a relevant master’s degree. Counselors study counseling or a closely related field, completing a planned program of graduate study totaling 60 semester hours or 90 quarter hours.
Pass a professional examination. The state accepts several exams, including the National Counselor Examination. Counselors can take the exam while completing their supervised experience.
Build experience under supervision. After earning their master’s degree, applicants must complete 3,000 hours of supervised clinical experience over two to six years. Different experience requirements apply to doctoral applicants.
Obtain their LPC license. Applicants provide the State Board with evidence of their qualifications and complete the remaining requirements, including training in recognizing and reporting child abuse.[7,8]

You may also come across a licensed associate professional counselor, or LAPC. These counselors have completed their graduate education and are gaining supervised experience as they work toward their LPC license. They must have an approved supervision plan, but do not need to pass an exam for the associate license.[9]

Licensed professional counselors can also diagnose mental health conditions within the limits of their education, training, experience and scope of practice. Pennsylvania explicitly recognized this role in Act 76 of 2018.[8]

What Does the Counseling Compact Mean for Pennsylvania?

Pennsylvania joined the Counseling Compact on July 12, 2026, taking a step toward making it easier for eligible counselors to support clients across state lines [12]. However, as of October 31, 2026, the Compact is not yet operating in Pennsylvania [13].

For Pennsylvania clients, this means access to out-of-state counselors through the Compact is still to come. Pennsylvania-based counselors must also wait before applying for Compact privileges; joining does not automatically give them permission to practice in other states [13].

Benefits of Clinical Mental Health Counseling

If you are still on the fence about whether or not to go for mental health counseling, it can be helpful to understand some of the benefits that counseling can offer. These benefits include:

Reduced Symptoms of Mental Health Conditions

Mental health conditions can affect far more than a person’s mood. With depression, poor sleep and low energy can leave someone exhausted before the working day has even begun. Concentrating on a task or keeping up with responsibilities at home may take far more effort than usual, while activities that once brought enjoyment can lose their appeal. These changes can have a considerable impact on someone’s quality of life [10].

Counseling for depression helps people understand these experiences and find ways to address them with professional support. A counselor can help someone recognize harsh judgments they make about themselves, work through difficult emotions and gradually return to activities they have withdrawn from. The aim is to relieve symptoms while helping the person regain confidence in their ability to manage daily life and take part in things that matter to them [4,10].

Yet depression isn’t always apparent to the people around us. Someone may continue working and caring for their family while privately struggling with persistent sadness, exhaustion or a loss of enjoyment. This is sometimes described as high-functioning depression, although it isn’t a formal diagnosis. When someone continues to meet expectations, their difficulties can be overlooked or underestimated. How much a person manages to get done tells us very little about how they feel while doing it, or the support they may need [14].

Improved Relationships

An unfortunate side effect that mental health conditions can often have is strained relationships between an individual and their loved ones. The emotional turmoil and challenges associated with conditions such as anxiety, stress disorders and depression can lead to misunderstandings and communication breakdowns. Loved ones may struggle to understand the struggles that the individual is going through and this can create a cycle of distance and resentment.

Mental health counseling focuses on improving relationships between the affected individual and the people around them. By using strategies for improving communication and rebuilding connections, mental health counseling can help an affected individual foster a supportive environment where they and their loved ones can thrive.

Grief, Trauma and Major Changes

Losing someone close can affect daily life in many ways. Everyday routines might remind you of their absence, and choices you once made together can feel harder to handle alone. Other big changes, like a separation, retirement, or a health diagnosis, can also make you question the future you once pictured [3,4].

Counseling can help you work through these feelings and understand what has changed. With life transition counseling, you can talk about how a change affects you emotionally and get support as you adjust to the loss.

What Can You Expect at Your First Counseling Appointment?

It can be intimidating to talk about your mental health with someone new, especially if you’re not sure how to start. In your first appointment, you and your counselor will talk about what brought you in, how it’s affecting your life, and what you hope to change through counseling. Your counselor might also ask about your health and any past treatment to better understand what support you need [11].

Depending on your concerns, your counselor might use questionnaires as part of the assessment. For example, our Mood Disorder Questionnaire guide explains a tool that helps screen for possible bipolar disorder. The results can point out areas to talk about more, but a screening questionnaire alone can’t give a diagnosis.

Your first appointment is also a chance for you to ask questions. You might want to find out if the counselor has worked with people who have similar concerns, how they approach treatment, and what working together might look like. Their answers can help you decide if you feel comfortable moving forward with them [11]. Before you go, it’s a good idea to check rates, fees, and your insurance benefits so you know what costs to expect.

Find the Right Mental Health Counselor for You

If you’re ready to take the first steps toward improving your mental health or addressing an issue that you’ve been facing, finding the right mental health counselor can make all the difference. A Licensed Professional Counselor can provide the tools, guidance and experience to help you navigate your challenges and lead a more balanced and healthier life.

Fortified Souls is a mental health counseling practice based in Pittsburgh, Pennsylvania, and our team of experienced counselors has decades of combined experience helping individuals with their mental health issues. In addition, we are also a fully remote practice offering telehealth counseling over HIPAA-compliant video conferencing software, ensuring that clients can receive the support they need from the comfort of their own homes.

Our counseling services are also covered by most major health insurance plans in Pennsylvania – including but not limited to United Healthcare, Geisinger, Aetna, Optum and Highmark. Send us a message today to find out more about how we can help with the issues you’re facing or to book your first appointment with us.

Common Questions About Clinical Counseling

Do I need a diagnosis before contacting a counselor?

No. You can contact a counselor because you’re worried about how you feel, struggling with a relationship or finding a change difficult. Assessment can help establish what support is appropriate. You don’t have to decide beforehand whether your experience meets the criteria for a particular condition [3].

How will I know whether counseling is helping?

Agree on goals and revisit them together. Progress might mean handling a difficult conversation differently or finding daily responsibilities more manageable. If sessions aren’t helping, say so. You and your counselor can discuss the approach, whether the goals need to change, or whether another provider would be a better fit [11].

Do I have to talk about experiences I’m not ready to discuss?

No. You can tell your counselor that something feels too difficult to talk about without explaining it in detail. You might begin with how it is affecting your life now. Building trust takes time, and your counselor should work with you on when and how to approach more painful experiences [11].

Will my counselor give me advice or help me make my own decisions?

A counselor can offer guidance and practical suggestions while helping you make your own decisions. They may help you think through a difficult choice, understand what is influencing you or consider options you hadn’t seen before. Your needs, values and circumstances should guide those conversations [3,11].

What happens if I need support between appointments?

Discuss this with your counselor early on, so you know how to contact them and when to expect a response. Together, you can plan for difficult moments, including coping strategies and other sources of support. Your counselor should also explain where to turn for urgent help when they’re unavailable, such as the 988 Suicide & Crisis Lifeline, since routine messages may not be read immediately [4,15].