Topic 2: Taking the LMHC Licensure Exam! {by 2/6}

We will be completing two practice simulation questions of the NCMHCE this week (the exam used for licensure in MA and other states). We briefly touched upon the content of the simulations in our previous class (we will cover the content in significantly more detail this week). Simply share any questions, concerns, anxieties, or thoughts of optimism that you have about taking the exam. Your original post should be posted no later than 2/6. It is okay if your post is relatively “short.” Replies are not required for this blog – I will do my best to address each of your responses in class.


12 Comments (+add yours?)

  1. Rachael Hickey
    Feb 03, 2018 @ 12:12:56

    I am quite nervous about the licensure exam, but after learning what the format is, feel slightly better about it. From the start, our program has focused on case conceptualization and treatment planning using example cases, so I feel that we are likely at an advantage due to the nature of our program. I am concerned that there may be answers that, to be considered “correct,” require a different clinical orientation than CBT (psychodynamic, mindfulness-based, etc.). I am also uncertain of the level of depth we will be required to know various theories and to what extent they will need to be applied to the cases. Depending on the cases presented, I also have some concerns that they may focus on a disorder that I am not as familiar with, which may then greatly impact my ability to accurately conceptualize and treatment plan for that case. On a more technical front, I also have a tendency to run into bizarre glitches with technology, so there is this mostly irrational fear that my computer will crash or something in the middle of the exam.


    • Alec Twigden
      Feb 08, 2018 @ 09:55:04

      I share many of the same thoughts about the exam, especially related to the format. After learning more about the format, although different from what we’re used to, it seems pretty objective and somewhat easy to prepare for. Regarding the therapeutic orientation of the questions, I think that it is pretty common for us to worry about areas of knowledge outside of our CBT orientation but at the same time we may have an advantage since most effective interventions seem to have at least some degree grounding in cognitive and behavioral principles. As for the technology concern, I worry about technology getting in the way but not because of glitches but because I fail to understand something that has consequences for my testing outcome. Taken together, I think we are in good shape for the exam.


  2. Matt Miracle
    Feb 03, 2018 @ 17:31:32

    I’m not too nervous about the exam. I’ve tried out a couple of simulation questions already and I actually like the format. It’s only until one is expected to know obscure assessments or interventions that it gets a little weird. For example, in one of the simulation questions I tried out a correct answer was selecting “bibliotherapy” as a treatment intervention for a depressed client – I didn’t even know what that was until I googled it after. This was put next to other more obvious options I had heard of, like cognitive restructuring, exercise, support groups and to be honest probably wasn’t worth as many points, but it was worth some points. It’s the same with the assessments as well; I would never really consider giving anyone a personality test in a clinical setting, but even though they may not be practical since they tend to be so long, they’re still a valid assessment measure for a depressed client as far as the licensure exam is concerned. Anyway, it seems like the trick is to just try to look at the simulation cases in a completely non-practical way, otherwise you’ll end up tricking yourself into getting less points.


  3. Sarah Henderson
    Feb 04, 2018 @ 19:58:01

    I am pretty optimistic about the exam. I’m fairly good at test taking and feel confident in our program preparing us to succeed. However the test is quite expensive so it would really suck to have to take it more than once. I’m also a bit nervous about the format of the test, but that’s likely only because I haven’t looked into it much so I’m not sure what to expect. I’m also concerned about whether there will be questions about less evidence based practices that we didn’t learn as much about. Furthermore I am slightly concerned about the amount of knowledge we’re expected to have about the different assessments, since there are quite a lot of assessments that are used. I’m also undecided about whether it would be best to take the exam close to graduation so I’ll have the knowledge of the theories still fresh in my head, or if I should take it closer to when I want to be licensed so I’ll have more real world experience. I think I’m leaning towards taking it in December, when I still will have the majority of my grad school knowledge still fresh, but will also have accrued some more experience.


  4. Ana
    Feb 04, 2018 @ 21:08:28

    ONe thing that makes me nervous is the expense of taking the exam. Is it worth paying for study aids and programs as well or study on your own and risk having to pay to retake the exam if you fail? I know that exposure to and practice of the test questions and format is very beneficial when it comes to taking standardized exams. The question is if you don’t take a study program, will it be enough. Honestly the program here I feel really does a great job at teaching conceptualization and such so maybe it would be. Another concern I have when it comes to taking the exam is the timing. If I wait to take I once I have the hours in, it may be much more difficult to go back into book-study mode after spending so much time doing “field” work. However, would it be overwhelming to take it soon after graduating and not have field experience that may help with the exam (if that even would)?


  5. Cora Spillman
    Feb 05, 2018 @ 09:02:06

    My concern is similar to Ana’s- the cost of taking the exam and/or the cost of paying for study aids/classes to help with the exam. As I mentioned in my last blog post, my goal is to take my exam this summer. Since I will be away for two years starting in August, I would like to get the licensure exam over with by August. I have a feeling my two years away will change my thought processes, and likely inhibit my ability to answer the exam questions appropriately. I have heard that experience in the field helps clinicians and their ability to do well on the exam, but I feel the need to get the exam done as soon as possible. Is it possible that I am able to take the exam in August and feel confident that I will pass?


  6. Jeremy Pierce
    Feb 05, 2018 @ 17:49:22

    I feel the same way pretty much every one else does. Right now the cost of the exam kind of sucks but I want to do it while all of this knowledge is fresh in my mind. I personally feel like i would be pretty well prepared for it but would also like to study for it as well. I think the more you can prepare and study for these things the better off you will be. I kind of like the format and what people have told me about how the process and test unfolds as you go. I’d like to do it likely this summer after graduation or very soon after. Ideally i want to get it done before getting hired at a place as it could be a lot all at once.


  7. Andrew Lampi
    Feb 05, 2018 @ 22:05:46

    I am not too nervous about taking the exam itself. I feel as though the writing and case conceptualization focus our program has emphasized in our education leaves us well prepared in the actual write-up component of the exam. I suspect that I would likely wait probably a year before I were to take the test partly to gain more experience creating case conceptualizations for a number of clients. This would primarily be for the purpose of gaining more experience with a variety of problems as well as more practice writing case conceptualizations. There are a couple of factors that I find anxiety provoking however, one being the overall cost of the exam and preparations for the exam. It may not be the exact same case with this licensing exam, but it seems that the trend for standardized tests such as this involves itemization at every corner, meaning that we get stuck with paying for every little service or extra fee that comes with taking the test. I worry about making sure that I budget enough knowing that there may be “hidden” or unknown fees that come with the process. The other anxiety producing factor involves the human factor in this process, and the fact that that can sometimes go awry, even unintentionally. Between missing scores, missed appointments, differences in opinion in scoring, etc., there are a number of intangibles that could come into play that might affect either the score of the exam, or its administration, making retaking the exam a possibility. Though I have no doubt that I (and anyone from this program) would be able to pass the test at some point, the cost of having to take it more than once is just a real downer.


    • Alec Twigden
      Feb 08, 2018 @ 10:19:37

      I agree that we will all pass the exam at one point or another but it would be nice to do so on the first try and without pay for the test twice and perhaps without costly practice programs. I like the idea of waiting a little bit because with experience we will gain more exposure to the field that could give us an edge on certain questions especially as we learn more treatment and assessment options and as we gain experience making decisions about things to ask and follow up on.


  8. Brenden Knight
    Feb 06, 2018 @ 09:33:21

    I share many of the sentiments already expressed by my classmates. In researching the exam, I have learned that the 10 case simulations are “designed to sample a broad area of competencies.” Seeing this information makes me question if the “eclectic therapist” is the ideal test taker. As much as I dread that terminology in a clinical setting (jack of all trades, master of none), I see the value in broad areas of knowledge for the examination. Although I pride myself in an exclusively CBT background, perhaps this clinical focus poses a disadvantage for the examination. In that regard, I worry that I may have to study other approaches (and I would argue less effective approaches!). However, I am appreciative that this program has equipped us with ample experience in case conceptualization and treatment planning. Moreover, I will need to read up on diagnoses and assessment measurements to gain better working knowledge for the examination. Lastly, I am not a fan of standardized tests. My scores on standardized tests in the past (e.g., SAT, AP tests) have never accurately reflected my true abilities, nor predicted my skill potential. I find discomfort knowing that my test score can vary depending on the opinions of the individual(s) scoring my test. The whole process lacks objectivity in my mind. Taking all of my concerns into account, I am fairly nervous about the examination, but simultaneously confident in my clinical and writing abilities.


  9. Alec Twigden
    Feb 06, 2018 @ 11:51:20

    I feel optimistic about taking the exam as long as I prepare well. I think that I have the fundamental skill to succeed on the test with the ability to do case conceptualizations and treatment plans, so I don’t think that I will have any complicated skills to learn however there is a lot a raw information that I will have to learn namely a broader range of diagnoses and their differential diagnoses (which I should learn anyway), learn about more treatments and intervention especially the non CBT but still evidence based (hopefully nothing with poor evidence bases), and a wide range of assessments. I’m sure I will be pretty busy with things to learn while studying. Although I only care to master a single orientation as it seems most practical for myself, I do look forward to being more knowledgeable about (evidence based and valid) treatments and assessments that come from other orientation. However, I will likely feel frustrated if I find myself wasting time learning about interventions that are not empirically supported.


  10. Nima
    Feb 06, 2018 @ 15:35:19

    I’m definitely excited about taking the Licensure Exam. Maybe its just my nerdiness but whenever I take exams I kill them. I’ve never really been that good at video games but I’ve always been really good at exams. So growing up, we’d always play video games, my brothers and friends and I, but like for example my younger brother would always beat me in Madden and NBA and such nonsense. So I gradually lost all my confidence playing video games and if you play me in like Halo or Call of Duty today you’ll know I suck at it. But I’ve in a parallel manner gotten really good at taking academic exams. I don’t know why, its just my niche. So yeah. LIcensure Exam, “watch out ’cause here I come.”


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Adam M. Volungis, PhD, LMHC

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