What kind of training do I need?

Becoming an MHC requires a master’s degree in counseling, psychology, or a related field. In addition to coursework, they must complete supervised clinical experience, which typically includes internships and 2,000–4,000 hours of postgraduate training. To become licensed, MHCs must pass a national exam such as the National Counselor Examination (NCE) or the National Clinical Mental Health Counseling Examination (NCMHCE). After licensure, they are required to pursue continuing education to maintain their credentials.

Do I have the personality for it?

A good mental health counselor should be empathetic, nonjudgmental, patient, humble, and self-aware, a good listener with strong communication skills, a problem solver, with emotional stamina and resilience, who knows how to maintain firm boundaries.

What can I expect to make?

The average annual salary in the US is approximately $77,130, although there is a range based on location. In the New York area, an hourly salary for fully licensed counselors is around $85.

For those working in private practice, session fees can range from $175 to $275.

TALES FROM THE TRENCHES

RIVKA H. GOLDMAN

Brooklyn, NY

Clinical Mental Health Counselor and Program Director, Sipuk Behavioral Health Clinic, Brooklyn, NY

Graduated From: B.A. Psychology and Masters in Clinical Mental Health Counseling, Touro College

Years in Field: 20

My Typical Day at Work

My weekly schedule is divided between the Sipuk Behavioral Health Clinic, where I am Program Director, and my private practice. From Monday through Thursday, during regular working hours, I oversee the clinical and operational aspects of the clinic. I spend much of my time in meetings with staff — clinicians, supervisors, intake personnel, and other departments — ensuring everything runs smoothly. I also respond to emails, address questions, and provide clinical support as needed. During evenings and weekends, I see clients in my private practice, primarily adult women dealing with relationship issues, complex trauma, or severe mental illnesses like bipolar disorder or schizoaffective disorder. I also work with couples experiencing marital difficulties.

My job at the clinic is highly dynamic. The clinic is a happening place; many days I don’t even have time for a break, so I eat my lunch while working. Even when I’m not physically there, I remain available for emergencies. But when I transition to my private practice, it’s like stepping into a peaceful space where I can focus entirely on my clients. The shift is rejuvenating, and it helps me give my best to those who depend on me for guidance. The therapeutic relationship is unique and powerful; I am honored that my clients entrust me to help them with their innermost struggles.

Both of my roles are intense and utilize my strengths in different ways. I love what I do and am deeply grateful to the Ribbono shel Olam for the opportunity to serve others. I pray daily for the strength and wisdom to continue my work.

How I Chose the Profession

Actually, this field found me. Twenty-six years ago, I was a stay-at-home mom looking for a way to use my spare time meaningfully. I began volunteering with Bikur Cholim of Boro Park’s Crisis Intervention Program and was trained to assist families facing mental health crises. That experience eventually led me to a position as the coordinator for the Eitza/Toshia Chinuch Line and Mentoring Program. Working alongside mental health professionals, I realized the importance of formal education, so I went back to college. The rest, as they say, is history.

How I Chose My Specialty

I have a special place in my heart for individuals struggling with significant mental illness — the people whom others have given up on. I believe in their ability to lead a meaningful life despite their struggles. I also specialize in complex trauma and relationship issues, which are often interconnected. A history of trauma in early development can lead to difficulties in adult relationships. It is very gratifying to help someone work through their trauma and observe the transformation as their current relationships blossom.

What I Love Most About the Field

My work is deeply meaningful. With Hashem’s help, I have made a real difference in people’s lives. The challenges my clients face are not easy, but the growth I witness in them is incredibly rewarding. I’ve learned so much from my clients and have great respect for them.

What I Find Most Challenging

One of the biggest challenges is managing expectations. People sometimes expect therapy to “fix” their problems quickly. However, therapy isn’t a magic solution — it’s a process that takes time and effort.

It can also be challenging not to take home my patients’ pain. I use several techniques to help me with this. In order to remain present during the sessions, I practice grounding and mindfulness. I consult with my mentors to address any countertransference issues that arise. (Countertransference refers to the emotional reactions, attitudes, and biases that a client may trigger in the therapist, reactions that are based on the therapist’s own personal history, unresolved issues, and emotional responses to the client.) It is challenging not to take home my patients’ pain, but it helps me to remember that Hashem is running the world and we cannot and do not see the full picture.

A related challenge is how to maintain a positive outlook on society when you are exposed to so much suffering and trauma. It helps that I’m blessed with an optimistic and trusting nature. I am cognizant of the fact that I am in the trenches, and I try to focus on the resilience I see in my clients.

I’ll Never Forget When

Every client is unique and so is their story. One of the things I love about my work is the privilege of seeing their journeys up close.

For example, I often work with women and couples who are looking to improve their marriages and deepen their relationship with their spouses. It is gratifying to see their satisfaction when they invest in their marriage and grow closer as a result.

The same is true when I work with women who are struggling with depression or other significant mental health issues. Watching them work hard to take small steps to improve their functioning, and seeing how they become more present for their children and feel more positive about themselves, makes all the effort worthwhile.

Something I Wish People Knew About Mental Health Counselors

For a mental health counselor, learning never stops. You must continually work on your own emotional well-being because, as the saying goes, “You can only take your clients as far as you’ve gone….”

How I’ve Seen the Field Change Over the Years

The stigma around mental health treatment has significantly decreased in recent years, though there is still work to be done. Additionally, there are more frum therapists who adhere to daas Torah, which is a positive shift for our community.

My Advice for People Starting Out

This field is not for the faint of heart. It takes a lot of stamina to “hold” the pain of your clients while maintaining your own emotional health. You need to care deeply about your clients but at the same time, keep firm boundaries; you can’t let their struggles overtake you.

In this field, a sense of humility is essential — both in order to realize that you are only a facilitator in your client’s journey and that the real work must come from them, and to understand that there’s a lot that you don’t know, since human beings are complex and each person is a world unto themselves. You need to keep learning and to reach out to those who are more experienced.

I believe that a mental health career is best suited for individuals with significant life experience. Working with clients is emotionally demanding, and younger adults may not have the maturity to handle it. If someone young asked me about going into the field, I would advise them to do a lot of research about what the work entails and speak to their mentors to see if this is something that they are emotionally ready to take on.

JOSHUA ROSENTHAL

Queens, NY

Mental Health Clinician, Rikers Island Correction Facilities (currently retired)

Graduated From: M.A. Mental Health Counseling, Touro College

Years in Field: 12

My Typical Day at Work

The first task of a work day at Rikers Island is to actually enter the island — no simple matter when you’re talking about New York’s largest prison complex. It can take up to an hour just to get through all of the security checkpoints. (After working there for several years, I was able to get special passes which expedited this process.)

There are several jails in the prison complex. I primarily worked at the jail housing the worst kinds of offenders: murderers, drug dealers, armed robbers, and the like. When performing an intake on a new inmate, I would conduct two evaluations: a basic mental health intake and a more in-depth psychosocial eval. Based on these results, we’d assign a tentative diagnosis and determine in which area of the jail he should be placed and how often he should receive counseling.

All inmates receive individual counseling once a month; those who need more serious treatment are placed in the mental observation unit and receive weekly or biweekly individual counseling, in addition to group counseling sessions, where we focus on topics like anger management or listening to authority. Inmates placed in punitive segregation — solitary confinement — for committing crimes while in prison are counseled weekly, or more frequently if needed.

One of my important tasks was to assess if a patient was showing signs of depression and suicidal tendencies, which is quite common in jail. In particular, I would meet with them right after they had a court appearance, as a bad day in court or a bad verdict could send them into depression and potentially make them suicidal. A patient placed on suicide watch must be seen twice a day, and can only be taken off suicide watch with supervisory approval.

In addition to my individual counseling sessions, I would perform daily rounds in the mental observation units and punitive segregation units, during which I would meet with each inmate to get a brief update on how they were doing and, specifically, to determine if they should be placed on suicide watch.

The primary goal of a mental health counselor in the prison system is to ensure the inmate does not harm himself or others while in jail. Beyond that, I would determine what specific issues needed to be worked on (commonly anxiety, depression, anger, and addiction), devise a treatment plan, and, where relevant, help him get accepted into a rehab program. I was also responsible for monitoring their medication compliance and, when I suspected noncompliance, referring him to the psychiatrist.

An essential component of the job is keeping careful session notes. As a therapist in the prison system, your records may be subpoenaed or you may be called to testify in court (I’ve experienced both). In the case where an inmate, for example, commits suicide or otherwise comes to harm, being able to produce detailed notes can save a therapist from a serious lawsuit.

How I Chose the Profession

I spent most of my professional career working as a systems analyst for large corporations. At a certain point, I felt a need to help actual people rather than only faceless corporations, and started volunteering at Ohel’s Beis Ezra home for adults with disabilities. I felt such a strong affinity for this work that, when the bank where I was working underwent a merger and relocated to the Midwest, I used the generous severance package they offered me to go back to school and retrain as a therapist. A psychologist friend told me about the new mental health therapy degree, which was ideal for someone at my stage of life, as I wouldn’t have to spend ten years doing graduate work. The Mental Health Therapy degree is a master’s rather than a doctorate, but involves extensive clinical training.

How I Chose My Specialty

Given my age, I’d assumed I would work with the geriatric population; I certainly never imagined I would end up in the prison system! But when it was time for me to do my internships, my friend, a forensic psychologist, offered me a placement working in the criminal courts, and my second internship was in a drug rehab center. I went on to take additional courses in drug addiction. After receiving a degree, a mental health counselor needs to work for two years before becoming licensed. Today, the field is much more widely recognized, but back then, it was harder to find employers willing to hire you before you were licensed. However, Rikers was desperate for therapists and, with my internship work, it was a natural fit.

What I Love Most About the Field

The gratification you get from helping people. Working with people whose lives and backgrounds are light years away from my own has made me into a much more broad-minded, empathetic person. Initially, I thought I would have a very hard time relating to the inmates. But then you sit across from a convicted drug dealer or murderer and hear his life story and realize that, had you been born into his family and his world, you, too, might have made the same poor choices he did. It makes you into a more compassionate person — and also gives you a much deeper appreciation for the life Hashem gave you.

What I Find Most Challenging

Praying that I’d stay alive; I had a few close calls! The worst incident was when I was sitting with a patient with serious mental issues and he suddenly announced, “I need to kill someone RIGHT NOW.” And I realized that if he decided to act on that urge, there was no one else in the room but me! Fortunately, he broke down into tears instead of allowing his rage to overcome him.

I’ll Never Forget When

I’ve had many interesting patients over the years, but my most memorable was probably the Muslim convert who was a member of ISIS. Indoctrinated by the terrorist group, he had become so numb to murder that when his sister became the victim of abuse, he killed the offender. During our first session, I asked him how he felt about the fact that I was Jewish. He responded that he feels G-d sent him to me to deprogram him about Jews. He ended up becoming one of my biggest fans! In fact, when I once told him that I’d be going on vacation to Israel to visit my children, he said, “If any of my people start up with you, I’ll convert to Judaism and get back at them!”

How I’ve Seen the Field Change Over the Years

The field has become much more accepted today in the mental health arena. Had I been starting out today, I probably would have ended up working in a hospital or nursing home.

My Advice for People Starting Out

If you’re going to enter this field, make sure you’re an open-minded, nonjudgmental kind of person. You don’t know what kind of issues you’ll be dealing with, and you can’t let your own set of values get in the way of relating to people who may be very different from yourself.

DOVID ELEFANT

Sanhedria Murchevet, Jerusalem

Mental Health Counselor and Owner of Private Therapy Practice, Sanhedria Murchevet, Jerusalem

Graduated From: M.A. in Clinical Counseling, Bellevue University; Advanced Training in Couples Counseling, Trauma and Families, Neve Family Institute; and in IFS (Internal Family Systems)

Years in Field: 8

My Typical Day at Work

On a typical day, I see between four and six clients — couples and adult males — in my private practice, where I work in the mornings and evenings. (I learn afternoon seder.) I primarily use the Internal Family Systems model as my therapy approach, and even when I’m not using the actual protocol, it is through the IFS lens that I conceptualize life in general. According to IFS, each person’s system is comprised of multiple sub-personalities, thoughts, feelings, sensations, images, and more — all members of the “internal family,” and by identifying and healing the wounded personalities, we can restore balance and harmony to the entire system. When counseling couples, I use the IFS model as well as EFT — Emotionally Focused Therapy.

My job is to help my clients get to know themselves better. Therapists are not vending machines where you put in money and get all your answers; I operate on the premise that the client has the answers himself — I’m just helping him find them. As I like to tell my clients, “You’re the driver and I’m Waze. You tell me where you need to go and I’ll help guide you there using the best possible route — and reroute when necessary.”

Of course, running a private practice involves administrative tasks as well — scheduling, billing, taxes, and all that. I don’t advertise; my clients come to me through word of mouth and referrals from rabbanim and other therapists. In general, you don’t see therapists advertising, and there’s a reason for that: Who would go to a therapist because they saw his name in an ad? Therapy is built on trust and reputation. For that reason, it can be hard for a new therapist to break into the field. (I have helped guide new therapists based on the advice I received as well as my own experience in the field.)

In addition to my private counseling, I have also been supervising newer therapists for the last couple of years (both privately and through the PATH Center). Throughout the year, I assist in training courses for IFS Levels 1 and 2 (and have done so for EFT as well). While I primarily assist in trainings with Jewish participants, IFS trainings are internationally sought after; earlier this year, I assisted in an IFS Zoom training to a group of people in South Korea! (I served as the assistant for their English-speaking participants.)

How I Chose the Profession

After consulting with my moreh derech, Rav Yitzchak Berkowitz, I decided that it was time for me to leave full-time learning. Looking at my skill sets, I settled on two options — therapy or administration — and decided on therapy, noting its ability to positively impact the lives of so many.

How I Chose My Specialty

While I do have a particular affinity for couples’ counseling, I wouldn’t really describe myself as having a specialty. A therapist must be prepared for whatever challenge walks through his door. I see my specialty as the ability to connect with and understand the client, en route to helping clients understand themselves.

What I Love Most About the Field

To be successful in this field, you must continually work on yourself. Yes, every Jew should work on himself, but this is a job that requires it! As therapists, we’re in a position with a lot of influence. If we want to be there for our clients, we must be aware of what’s going on inside of ourselves. We all have our “stuff”; a therapist must make sure his issues are worked out so that he’s not bringing them to his client.

To that end, like any good therapist, I invest a lot of time in my own trainings and supervisions. Such supervisions include individual and peer supervision (weekly), as well as periodic group supervision and consultation with an IFS lead trainer.

What I Find Most Challenging

Different stages in the field have different challenges. For a new therapist, a big challenge is gaining the trust of referral sources to be able to get clients. New therapists, and at times even veteran therapists, can find themselves questioning whether they’re doing a good enough job, whether they are helping the client enough. A therapist in private practice can find it quite lonely. You sit in your office for hours each day, meeting with individuals who, by definition, you are unable to connect with as a friend. For this reason, it is often important for therapists to have other avenues of social or communal involvement.

Many wonder how a therapist can cope with listening to one client after another share so much pain. Much like a nurse needs to be able to handle seeing blood, it is critical as a therapist to be able to hold your clients’ emotional pain and not be consumed by it. If you can’t, you shouldn’t be in this field.

The Role of Rabbanim

We often talk about training rabbanim to know when to send someone for therapy, but the opposite holds true as well: A therapist must remember that he is not a rav, and to recognize the important role of a rav or rebbi in the growth and healing of the client. At times, a rebbi can do more than a therapist can. I once worked with a client to help him overcome his anxieties around a specific issue.

As his system relaxed, he was finally able to speak with his rebbi about the issue, which was ultimately resolved by doing so.

Something I Wish People Knew About Mental Health Counselors

How much we actually care about our clients. As one of my supervisors responded to a client who accused her of treating her for the money, “You pay me for the forty-five minutes that we meet; the rest of the week that I carry you around with me is free.”

Also, people should know that we’re not magicians. Clients often come in hoping that I’ll wave my wand and give them a magic cure, but it doesn’t work like that. There are some circumstances in life that we can’t change; we can only change the way we handle them.

How I’ve Seen the Field Change Over the Years

As a community, we’ve been de-pathologizing therapy; hearing that someone is in therapy no longer evokes a major gasp. In addition, as rabbanim have become much more knowledgeable about and involved in therapy, there’s a lot more respect for therapists; they’re no longer seen as the troublemakers who are turning everyone against their parents.

My Advice for People Starting Out

In guiding my decision to become a therapist, Rav Berkowitz told me that if I’m going to do this, I must do it right. No shortcuts, no three-month programs. Get a master’s, put in the time and financial investment, and do it the right way. And this is very much in line with the idea that to be a good therapist, you need to work on yourself. If you do a half-hearted job, you’ll be a half-hearted therapist.

I recall, while I was still in training, I was at an event with Rabbi Shimon Russell. I went over to introduce myself as a new therapist in the field. I’ll never forget his reply: “Great! Now get another thirty years of supervision and you’ll be okay.”

(Originally featured in Mishpacha, Issue 1051)