The Different Types of Counseling Careers and Their Challenges

A 2023 article published by the American Counseling Association opened by saying, “The current state of mental health care in the United States is troubling. Mental health organizations are understaffed. People are unable to access or afford mental health services. Counselors are overwhelmed with high caseloads, and many are leaving the field in search of better pay and work-life balance. And that was before the COVID-19 pandemic, which has only amplified the mental health crisis and provider shortage.”¹

As the need for mental health help continues to grow, so does the demand for counseling professionals in varied settings. Read on to explore several opportunities and challenges that could be part of your future as a counselor.

A broad-based desire to help other people may be the spark that inspires you to pursue a counseling career. Peoples’ mental health needs, however, are as varied and unique as their life experiences, so you’ll quickly see the importance of building precise focus into your practice through specialization options. Consider these possibilities:

Your affinity for young people and a desire to help them thrive can be strong motivators for a career as a school counselor. You’ll help elementary, middle or high school students navigate academic, emotional and social challenges. You’ll also be called upon to provide support services such as career counseling and college-readiness assessments for students, collaboration facilitation between parents and teachers, and crisis intervention.

This can be stressful work with large caseloads, exacerbated by the current shortage of school counselors. The rewards of a school counseling career, however, are often powerful and long-lasting, as students mature and succeed because of your help.

According to Forbes Health, 26% of U.S. adults (slightly more than one in four) experience a mental health disorder diagnosis each year.² Even mild mental health issues can disrupt the stability and quality of a person’s life, so the care of a qualified mental health counselor, who “assesses and treats mental and emotional health disorders, relationship issues and life challenges,”² can be invaluable.

While you may choose to tailor your mental health counseling practice to address particular needs, you’ll likely be trained to help people dealing with a plurality of issues, including anxiety, depression, sexual dysfunction, eating disorders, personality disorders, dementia and adjustment to major life changes, among others.

In addition to the challenges that many professional counselors face (some discussed later in this post), mental health counselors may frequently have to address client resistance. Clients can have many reasons for not wanting to be in therapy. For example:

• Therapy has been court-ordered
• Clients are unable to face events in their lives, such as recent loss or painful diagnosis
• Clients have had negative and/or harmful experiences in therapy

As a mental health counselor, your skill at building rapport and trust, motivating your clients and empathizing with them can help diffuse their resistance and advance their progress in therapy.

Marriage and family therapists (MFTs) are licensed to diagnose and treat mental and emotional disorders within the context of marriage, couples and family systems. Their work expands the traditional therapeutic emphasis on the individual to address the nature and role of people in primary relationship networks such as marriage and the family.

According to the American Association for Marriage and Family Therapy, MFTs typically practice short-term therapy lasting about 12 sessions. Roughly two-thirds of cases are completed within 20 sessions and nearly 90% are completed within 50 sessions. The work is specific and solution-focused, directed toward attainable goals.³

As a marriage and family therapist, you’ll help clients address a wide range of issues, including marital problems, parenting concerns, challenges faced by teens, depression, anxiety, academic and occupational difficulties and stress management.

Your professional challenges will likely include work with clients who distrust therapists and therapy (perhaps attending at the insistence of a partner or spouse), couples who are unwilling to compromise with each other, and those who waited so long to seek help that one or both partners have already decided to leave the relationship.

Also known as addiction counselors, substance abuse counselors are experts in the vicissitudes and underlying causes of addiction.

As a substance abuse counselor, you’ll work with individuals, couples, families and other groups of people struggling with substance use disorders (SUDs). Your clients and/or the people they love may face addiction to alcohol, nicotine, prescription medications, cocaine or heroin, among many other addictive substances. You’ll be called on to:⁴

• Assess clients’ mental and physical health and SUD, the severity of the addiction, client readiness for change, any other mental health conditions and challenges that may affect treatment
• Develop treatment plans to address each substance use disorder; these may involve medical care, therapy, rehabilitation counselors, programs or support groups, among other options
• Make referrals to necessary outside resources such as support groups, medical care or job placement services
• Intervene in crisis and non-crisis situations
• Provide counseling services for individuals or groups of people with substance use disorder and their friends and family members
• Teach family members and friends about SUDs and ways to support their loved one(s) throughout treatment
• Provide case management documentation, which is essential in tracking the progress of treatment and may be required within law enforcement or court systems

Of the 2.8 million U.S. service members deployed to Afghanistan and Iraq since 2001, it is estimated that up to 20% (as many as 560,000 people) experience post-traumatic stress disorder (PTSD) and up to 15% (420,000 people) experience depression.⁵ In addition, veterans and active service members face adjustment disorder, anxiety, bipolar, military sexual trauma, traumatic brain injuries, alcohol and drug problems, schizophrenia and/or suicide.

As a military and veterans counselor, you’ll be positioned to provide vital support to a population in profound need. Working individually and in group settings, you’ll likely perform assessments and psychological tests, teach stress-reduction and coping methods, help veterans make successful transitions to civilian life, and provide counseling for vocational needs as well as emotional stressors including trauma, grief, loss and reconnection with family.

While it can be extremely difficult to hear and absorb the pain that service members and veterans have experienced and continue to face, the rewards of this career can be equally compelling.

The educational and licensure requirements for mental health professionals vary.

• Counselors, social workers and psychologists must hold a master’s degree and licensure to practice in their states
  • Counseling master’s programs are available on campus and online, and they may include specialization options such as clinical mental health counseling, school counseling and military and veterans counseling
• Further, psychologists often complete a doctorate: a PhD, a PsyD or an EdS
• Licensed psychiatrists are medical doctors who are authorized to prescribe medications

According to the United States Bureau of Labor Statistics (BLS), the job outlook for professional counselors is strong. From 2022-2032, the BLS predicts significant job growth for:

• School and career counselors and advisors: 5% (faster than average)⁶
• Marriage and family therapists: 15% (much faster than average)⁷
• Substance abuse, behavioral disorder and mental health counselors: 18% (much faster than average)⁸

As a professional counselor, you’ll have employment opportunities in diverse settings. Depending on your area of specialization, you may work in:

• Private practice (in partnership with other counselors or as your own employer)
• Outpatient or inpatient treatment centers
• Community mental health centers
• State, local or private hospitals
• Government agencies
• Public or private schools, colleges and universities

The national employment site Indeed notes that average annual salaries for therapists without doctorates range from $71,863 to nearly $200,000.⁹ The benefits of most counseling careers are personal as well as professional. As the ZipRecruiter site succinctly puts it, “You will help many people overcome emotional trauma and substance abuse, and assist those with mental health issues. You can help families, veterans, and children going through the worst times of their lives.”¹⁰

Every worthwhile endeavor comes with challenges. Throughout your career path as a counselor, you’ll likely deal with these:

From long hours to high caseloads to emotionally draining sessions, this is a tough job. For your own emotional, mental and physical health, it’s essential that you set boundaries and routines that keep your work and your personal life separate and balanced.

You may experience vicarious trauma or secondary traumatic stress when working with clients who’ve experienced trauma firsthand. The reaction can be similar to PTSD, manifesting as intrusive thoughts or dreams related to a client’s experiences.

A prevalent problem among counselors, burnout is typically due to the intense emotional needs of the job and can be compounded by long work hours and heavy caseloads. Maintaining resilience is critical if you’re going to avoid compassion fatigue or burnout.

Thoughtful counselors understand the critical importance of building a bond of trust and respect with their clients, so what happens if you’re obliged to break it? A client’s intent to cause harm, personally or to other people, can bring questions of ethics and confidentiality to the crisis point.

Restricted and/or limited resources such as funding, materials and staff can deter you from delivering the most effective care and support to your clients.

Insurance companies often strictly limit the number of sessions, modalities of care and types of treatment they cover. They may require in-depth documentation to justify the services you provide. This can be a major time-stress and burden that keeps you from extending the types of care you prefer to offer.

To deliver the best care, you have to keep building competencies and understanding. Staying up to date with new developments and research in the field strengthens your skills as a counselor.

In the William & Mary Online Master of Education (M.Ed.) in Counseling programs, the online learning experience invites you and your peers to collaborate with each other and your expert faculty in an immersive curriculum that aligns coursework with your personal and professional objectives.

Choose one of these paths of study:

• School Counseling concentration
• Clinical Mental Health Counseling (CMHC) concentration
• Military and Veterans Counseling specialization within CMHC

Don’t wait to make a difference. Schedule a call with an admissions outreach advisor today.