NCMHCE Practice Test (updated 2023) (2023)

A passing score on the National Clinical Mental Health Counseling Examination (NCMHCE) is required for licensure in some states. It is one of the requirements for both the National Certified Counselor (NCC) and Certified Clinical Mental Health Counselor (CCMHC) certification. Successful completion of the exam and certification demonstrates your commitment to the profession and dedication to continued learning within the field.

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The NCMHCE consists of 11 counseling cases designed to evaluate your capability to make vital clinical decisions that pertain to the health and well-being of figurative mental health clients you may encounter in real-world situations. Each case will include one narrative and 9-15 multiple-choice questions.

The exam is split into three parts:

Component 1: Intake

This part of the exam provides you with basic, introductory client information such as how old they are, whether they are male or female, and what problems they are presenting with. You will also be given the setting, as well as the presenting concerns and diagnosis of the client.

Component 2: Clinical Session I

In this part of the exam, you will work on the presenting concerns with the client by using evidence-based approaches.

Component 3: Clinical Session II

In this part of the exam, you will simply be continuing the work that you began in the last component.

At the beginning of each counseling case, you will be provided with the client’s initial diagnosis. You will then be asked to evaluate how that judgment was initially made. In some instances, you may have to either provide one or more co-occurring diagnoses or monitor the therapeutic relationship and change the diagnosis as it evolves and changes.

(Video) National Clinical Mental Health Counselor Exam | NCMHCE New Format Study Prep

Exam Outline Review

In total, the NCMHCE contains between 130 and 150 questions and has a time limit of 255 minutes (4 hours and 15 minutes).

The questions on the exam cover the following five content domains:

1. Professional Practice and Ethics (10%-20%)

The questions in this domain assess your ability to maintain proper administrative and clinical protocols.

These are some of the specific topics that are covered:

  • Satistical concepts and methods in research
  • Uses and limits of social media
  • Reviwing client records
  • Legal and ethical counseling
  • Advocation of client and professional issues
  • Supervision
  • Obtaining informed consent
  • Reviewing fees, payments, and insurance benefits
  • Confidentiality in the space of electronic communication
  • Provision of information to third parties
  • Counselor and client roles

2. Intake, Assessment, and Diagnosis (20%-30%)

The questions in this domain assess your knowledge and skills regarding the conduction of client intake, assessment, and diagnosis.

These are some of the specific topics that are covered:

  • Conducting a biophysical interview
  • Determining the level of care needed
  • Assessing for trauma
  • Evaluating counseling effectiveness
  • Conducting an initial interview
  • Using formal and informal observations
  • Assessing for substance abuse
  • Evaluation of interactional dynamics
  • Considering co-occurring diagnoses
  • Screening clients for appropriate services
  • Obtaining client self-reports

3. Treatment Planning (10%-20%)

The questions in this domain assess your knowledge and skills regarding the development of an effective course of treatment.

These are some of the specific topics that are covered:

  • Establishing treatment goals and objectives by collaborating with the client
  • Identifying strengths and barriers related to goal attainment
  • Referring to different treatment levels
  • Guiding treatment planning
  • Following up after client discharge
  • Reviewing the treatment plan and making any necessary revisions
  • Integrating and maintaining therapeutic progress

4. Counseling Skills and Interventions (25%-35%)

The questions in this domain assess your knowledge and skills pertaining to effective counseling strategies.

These are some of the specific topics that are covered:

  • Aligning intervention with counseling modalities and with the client’s developmental level
  • Addressing addiction issues
  • Exploring religious values
  • Facilitating trust and safety
  • Developing safety plans and conflict-resolution strategies
  • Providing psychoeducation for the client
  • Modeling appropriate feedback reception
  • Using structured activities
  • Explaining phases in the group process
  • Using self-disclosure
  • Creating an intervention based on the group development stage
  • Challenging harmful group behaviors
  • Addressing the impact of a social support network

5. Core Counseling Attributes (10%-20%)

The questions in this domain assess your overall traits, behaviors, and disposition.

These are some of the specific topics that are covered:

  • Genuineness
  • Empathy
  • Respect for and acceptance of diversity
  • Congruence
  • Positive regards
  • Resolution and tolerance of conflict
  • Foundational listening, reflecting, and attending skills
  • Sensitivity to multicultural issues, as well as gender orientation and gender issues

NCMHCE Practice Test (updated 2023) (1)

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When you decide to register for the examination, you may do so either online (the preferred method) or via a paper registration form. You will be required to pay a $275 fee for the registration, either online with a credit card or with a cashier’s check or money order with a paper registration. These fees are not refundable or transferable and do expire if the NCMHCE exam registration process has not been completed within one year’s time.

You may register to take the NCMHCE exam at any of the 250+ testing centers throughout the United States. Testing dates are typically available in the first two weeks of every month on a first-come-first-served basis without application deadlines, though available testing dates and times will be indicated when you go to register for the examination. Exceptions include recognized holidays.

Once you have completed the registration process, you will have six months to take the examination, or you forfeit both the registration and fees. If you do not successfully pass the exam, you may register to test again after a three-month waiting period. You will be required to pay the associated fees each time you register.

Scheduling Your Exam

You may schedule a testing date to take the NCMHCE exam after you have successfully completed the registration process. Your candidate ID number will be sent via email. This number will be needed in order for you to schedule an appointment to take the exam either through online scheduling (preferred) or on the telephone. You will be asked to confirm your chosen location, date, and time for your examination, in addition to being given a time you will be expected to report to the testing center on test day. Take note of this time. You will not receive any further communications from the test administrators or testing location leading up to your appointment.


You may reschedule your appointment any time up to 24 hours prior. However, there will be a $50 fee to reschedule your appointment if you do so within 7 days of the originally scheduled appointment. In the event that you need or plan to reschedule your appointment but fail to do so at least 24 hours before your scheduled time, arrive more than 15 minutes late for your appointment or fail to report to your designated testing center at your scheduled appointment time for any reason, you will forfeit both your registration and paid fees. To reregister for the examination, you will be required to submit a separate registration and fees.

If the examination needs to be rescheduled due to inclement weather, an emergency, or a power outage, you will be notified by e-mail or telephone with rescheduling procedures. Cancellation is up to the discretion of the respective testing centers and is usually determined based on whether testing center personnel are able to open the facility. In the event of a power failure in the middle of an exam administration, you will be able to restart the exam where you left off before the interruption.

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(Video) NCMHCE Standard Setting Questions Answered

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Test Day

On your testing day, try to arrive at least 15 minutes prior to your scheduled appointment time. You will be required to present two forms of identification, one of which must have a photograph. If you fail to provide appropriate identification and are not admitted to the testing center, it will be written as a missed appointment and result in forfeiture of your examination fee. Know that the name you used on your test registration and the name presented on your current photo ID must match, both must be current, and both should have your signature as you will be required to sign a roster for the testing center administrator to verify your identity. The administrator can accept the following forms of identification, but note that whichever form you use must be current:

  • Driver’s license
  • State ID card
  • Passport
  • Military ID card

Temporary identification, including employment and student ID cards, is not acceptable.

After confirming your identity, you will be directed to a testing carrel. When you begin the examination, you will first be required to agree to the terms of the nondisclosure agreement (NDA) before proceeding to take the NCMHCE examination. It is important to note that you may not bring any personal items into the testing room with you, including cell phones or cameras, and no testing materials may leave the testing location as all questions are copyrighted. All testing materials must be returned to the proctor upon completion of the exam or you will not receive your score report.

Taking the Examination

If you prepared for the NCMHCE exam by taking an NCMHCE practice exam, you should be familiar with the examination screen, which includes two windows:

  • The Scenario Window on the left side of the screen displays the simulation you are currently working on.
  • The Options Window on the right side of the screen displays section you are currently working in. This window will also include instructions, such as how many responses you are to choose.

Once you have submitted a response, you cannot unselect it as your submission reveals information about that selection. To review previous sections and feedback for responses, go to the top right-hand portion of your testing screen. Here, you will be able to view a review screen of your progress on the current case.

Receiving Your Scores

Upon successful completion of the examination, you will be able to receive an unofficial score report from the exam proctor which will indicate a pass or fail. Scores are determined solely based on the individual’s performance on the exam and are not compared to or influenced by the performance of other candidates. You will need to receive a passing score for both the Information Gathering and Decision-Making sections.

Passing scores and additional requirements for licensure are determined by the State Board, so be sure to verify what requirements you will need to meet prior to beginning the registration process.Passing scores will be sent to your state licensure board within 30 days. If you do not pass the exam, you may take it again after a three-month waiting period.

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Online NCMHCE Prep Course

If you want to be fully prepared, Mometrix offers an online NCMHCE Prep Course. The course is designed to provide you with any and every resource you might want while studying. The NCMHCE Course includes:

(Video) NCMHCE Exam Review Assessment Part 1 | Counseling Continuing Education

  • Review Lessons Covering All the Topics
  • 600+ NCMHCE Practice Questions
  • More than 450 Digital Flashcards
  • Over 30 Instructional Videos
  • Money-back Guarantee
  • Free Mobile Access
  • and More!

The NCMHCE Prep Course is designed to help any learner get everything they need to prepare for their NCMHCE exam. Click below to check it out!

NCMHCE Prep Course


How is the NCMHCE scored?

Each section of the exam has a minimum number of points that are needed to be considered as passing. The points for each section are tallied and you are given a raw score for the entire exam.

How much does it cost to take the NCMHCE?

To register to take the NCMHCE, you will be required to pay $275. This fee is nontransferable and nonrefundable.

What does NCMHCE stand for?

NCMHCE stands for National Clinical Mental Health Counseling Examination.

What is the NCMHCE exam?

The NCMHCE exam is a national certification that is required for those who wish to become a Certified Clinical Mental Health Counselor.

How long do you have to take the NCMHCE?

The time limit for the exam is 4 hours and 20 minutes.

NCMHCE Practice Test (updated 2023) (5)

By Peter Rench

Peter Rench joined Mometrix in 2009 and serves as Vice President of Product Development, responsible for overseeing all new product development and quality improvements. Mr. Rench, a National Merit Scholar, graduated magna cum laude with a Bachelor of Science in Mechanical Engineering and a minor in mathematics from Texas A&M University.

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Is the Ncmhce test changing? ›

The NCMHCE State Licensing Exam transitioned to a new Content Outline and Exam Format as of November 7, 2022.

How many people pass the Ncmhce the first time? ›

The format of the NCMHCE is unlike any test you have probably ever taken and, unfortunately, 40 to 45 percent of test-takers fail the exam. So, in short, yes, you do need to study for the NCMHCE. But with such a comprehensive examination, where do you begin?

What percentage of people fail the Ncmhce? ›

You may fail the NCMHCE. In fact, statistically, failing is likely (40-45 percent of people do).

How many times can you fail the Ncmhce? ›

You can take the NCMHCE exam up to three times in two years. However, there is a 90-day waiting period between attempts.

How do Ncmhce decisions get passed? ›

Decision Making can be really difficult for many clinicians who take the NCMHCE.
  1. Read the scenarios to identify the information you need to make a diagnosis. ...
  2. Take the problem at face value in the present context. ...
  3. Avoid responses with extreme/dichotomous words.
Aug 9, 2021

How many simulations are on the Ncmhce exam? ›

Designed to test your clinical problem-solving skills, the NCMHCE is made up of 10 clinical simulations.

Is an 89 passing on NCE? ›


A passing score is usually between 98 and 105, fluctuating slightly with each test administration. There are many forms of the NCE. A typical cutoff for passing is a score in the 90s.

How many simulations are on the Ncmhce? ›

What is the format of the National Clinical Mental Health Counseling Examination (NCMHCE)? There are ten clinical simulations on the NCMHCE. Each section of each simulation problem has been classified according to the examination content outline.

How long did you study for the Ncmhce? ›

Because this exam is unlike most standardized, multiple choice tests, preparation for the NCMHCE should include putting together information and studying 3 to 4 months before your scheduled test date. Taking practice tests will help you. Make it a point to speak to licensed colleagues who have taken the test.

What happens if you don't pass Ncmhce? ›

Candidates who do not take the NCMHCE within the test authorization window must complete a separate registration and fee for reregistration. Candidates who fail the examination may take the examination again after a 3-month (90-day) window.

What happens if you fail the NCE 3 times? ›

If this was your third failed attempt, your application will close. To reapply, you will need to contact our office directly at I passed the NCE, and my account shows that all of my documents have been approved. What is my status?

How many questions do I need to get right on the NCE? ›

There are 200 questions on the NCE exam. The cutoff score to be considered as passing is in the high 90s.

What is the hardest part of being a mental health counselor? ›

Some of the hardest things about working as a counselor include the often painful process of working through problems itself, the slow rate with which change and healing happen, the emotional toll the work takes on a counselor and factors like the abundance of paperwork and comparatively low rates of pay.

Is it better to take the NCE or Ncmhce? ›

Should I take the NCE or the NCMHCE? The choice is completely yours: State counselor licensure boards contract with NBCC to use one or both of these examinations. The NCE is taken most often by final year graduate students, in the pursuit of becoming a National Certified Counselor.

How long does it take to hear back from NBCC? ›

Due to the high volume of applicants, the review can take up to eight weeks. If you have your documents prior to testing, please go ahead and send them to us. Documents are reviewed in the order they are received. You can check the status of your application in Credentialing Gateway.

What percentage of people pass the NCE? ›

What is the NCE Passing Score? No score is known to be considered a passing score. There is somewhat information that NBCC stated that the NBCC informed her that the passing score ranges from 56% to 67%, depending on the kind of test she was taking.

Do you get your NCE score immediately? ›

If your state uses computer-based testing, you will receive an unofficial score report immediately after the exam. For your protection and confidentiality, scores are not released over the telephone. If you did not pass the examination, you may reregister by submitting a new registration form and fee.

How many questions can I get wrong on the NCE? ›

There are many forms of the NCE and typically the cutoff for passing the exam is in the 90s (97, 91, 99, etc.) – out of 160 questions. One hundred questions correct out of 160 is 62.5%. Never has the cutoff for the NCE been higher than 65% correct out of 160 so it is a very passable exam, with your preparation.

Is the Ncmhce multiple choice? ›

Of the 143 total multiple choice questions you will have to answer, only 100 of those will be scored. The other 43 questions are part of field-testing. You will not be told which questions are part of the field-testing, so treat every question as though it is being scored.

Does North Carolina require the NCE or the Ncmhce? ›

All applicants must pass the North Carolina Jurisprudence Exam, provided online. Study material is provided online. Applicants must also pass one of the National Counselor Examination (NCE), the National Clinical Mental Health Counselor Examination (NCMHCE), or the Certified Rehabilitation Counselor Examination (CRC).

Is the NCE changing? ›

Beginning March 10, 2022, NCE will be the only avenue for new business. Partners will need to confirm their readiness prior to March 10 to ensure they're able to transact Teams Essentials and all other Seat-based offers in CSP.

What if you fail the Ncmhce? ›

Candidates who do not take the NCMHCE within the test authorization window must complete a separate registration and fee for reregistration. Candidates who fail the examination may take the examination again after a 3-month (90-day) window.

What percentage of questions do you need to pass the NCE? ›

There are many forms of the NCE and typically the cutoff for passing the exam is in the 90s (97, 91, 99, etc.) – out of 160 questions. One hundred questions correct out of 160 is 62.5%. Never has the cutoff for the NCE been higher than 65% correct out of 160 so it is a very passable exam, with your preparation.

What is the duration of the Ncmhce? ›

The length of time allotted for the National Clinical Mental Health Examination is 3 hours and 15 minutes. The exam consists of 10 simulated clinical mental health counseling cases. Each case study includes 5-10 sections.


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