Does Virginia still require the NCMHCE?

Not for licensure. Since July 1, 2024, the Board of Counseling accepts either the NCMHCE or the NCE; before that date the NCMHCE was the only exam allowed. Passing either one lets you become licensed in Virginia.

Why does the NCMHCE matter for TRICARE?

The board states that a licensee must pass the NCMHCE to qualify for reimbursement under TRICARE, the military health program, and that TRICARE will not reimburse a licensee who has passed only the NCE. If you expect to see service members or their families, the NCMHCE is the exam to take.

When do I take the exam in Virginia?

During your residency. All Licensed Residents in Counseling must take and pass the NCMHCE or NCE while in residency, and you do not need board approval to register for either exam.

How long is the Virginia residency?

At least 21 months, with a minimum of 2,000 hours of face-to-face client contact and 200 hours of in-person supervision, no more than half of it in a group. At least 1,000 of the face-to-face hours and 100 of the supervision hours must fall within the two years before you apply.

What degree does Virginia require?

60 semester hours or 90 quarter hours of graduate study in the board’s core coursework, including a supervised internship of at least 600 hours with 240 hours of face-to-face client contact. Programs approved by CACREP or CORE are recognised as meeting the requirement.

What does it cost, and how do I apply?

You first register as a Resident in Counseling ($65), then apply for licensure as a professional counselor by examination ($175). Renewal is $130 a year. Applications are made online, where you can upload supporting documents except transcripts and exam scores.

How to Become an LPC in Virginia

Until July 1, 2024, Virginia licensed professional counselors through one exam only: the National Clinical Mental Health Counseling Examination (NCMHCE). The Board of Counseling now accepts the NCE as well, but its own exam page warns that TRICARE will not reimburse a counselor who has passed only the NCE. Residents take the exam during a residency of at least 21 months and 2,000 face-to-face client hours.

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Does Virginia still require the NCMHCE?: Not for licensure. Since July 1, 2024, the Board of Counseling accepts either the NCMHCE or the NCE; before that date the NCMHCE was the only exam allowed. Passing either one lets you become licensed in Virginia.
Why does the NCMHCE matter for TRICARE?: The board states that a licensee must pass the NCMHCE to qualify for reimbursement under TRICARE, the military health program, and that TRICARE will not reimburse a licensee who has passed only the NCE. If you expect to see service members or their families, the NCMHCE is the exam to take.
When do I take the exam in Virginia?: During your residency. All Licensed Residents in Counseling must take and pass the NCMHCE or NCE while in residency, and you do not need board approval to register for either exam.
How long is the Virginia residency?: At least 21 months, with a minimum of 2,000 hours of face-to-face client contact and 200 hours of in-person supervision, no more than half of it in a group. At least 1,000 of the face-to-face hours and 100 of the supervision hours must fall within the two years before you apply.
What degree does Virginia require?: 60 semester hours or 90 quarter hours of graduate study in the board’s core coursework, including a supervised internship of at least 600 hours with 240 hours of face-to-face client contact. Programs approved by CACREP or CORE are recognised as meeting the requirement.
What does it cost, and how do I apply?: You first register as a Resident in Counseling ($65), then apply for licensure as a professional counselor by examination ($175). Renewal is $130 a year. Applications are made online, where you can upload supporting documents except transcripts and exam scores.

Test yourself: 3 NCMHCE practice questions

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Question 1

As the intake closes, Nikhil asks what the counseling will actually involve and whether it will 'get rid of the thoughts.' To support informed consent for the likely approach, what is most important to convey?

▸ Why B is the answer

Honest informed consent describes the treatment you would actually recommend, including its hard parts. Naming that the work involves facing the feared thoughts and situations while dropping the rituals, that anxiety may rise before it falls, and that it will be paced and collaborative gives him a truthful preview and lets him agree to it with eyes open.

Question 2

Nikhil is relieved that other parents have such thoughts but insists his 'feel real.' Which psychoeducation best fits his obsessive-compulsive picture?

▸ Why C is the answer

The heart of the obsessive-compulsive model is that the thoughts themselves are noise; the problem is the meaning he gives them and the rituals and avoidance he uses to feel safe, which teach his brain the thoughts are dangerous. Teaching him this reframes his own experience and sets up why the treatment targets his response, not the thoughts.

Question 3

You and Nikhil agree to begin structured exposure work. How do you best start building his exposure and response-prevention plan?

▸ Why D is the answer

Exposure and response prevention starts by building a graded hierarchy: name the avoided situations and rituals, rate the fear each provokes, and order them so he can begin somewhere tolerable and drop the matching ritual. Doing it collaboratively secures his buy-in and paces the work to what he can actually sustain, which is what makes exposures stick.

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How to Become an LPC in Virginia

Test yourself: 3 NCMHCE practice questions

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