Differences Between Mental Health Counseling and Rehabilitation Counseling

A brief comparison of mental health counseling and rehabilitation counseling reveals the most significant difference between these two fields: the specific aims of practice.

On the one hand, mental health counselors typically work with clients with mental health needs – depression, anxiety, a personality disorder, and so forth. Their goal is to assist their clients in realizing improved mental health.

On the other hand, rehabilitation counselors usually work with clients who have a disability of some sort, say, a developmental disability or a traumatic brain injury. Their aim is to provide their clients with rehabilitative services that improve their client’s ability to perform activities of daily living, such as going to school or work and living independently.

There are many other differences, too. This guide explores these detailed differences to enable you to determine which field is right for your studies or, alternatively, which type of counselor you might see to make positive changes in your life.

Mental Health Counseling vs Rehabilitation Counseling

Mental Health Counseling Vs. Rehabilitation Counseling

Mental health counseling addresses emotional and mental disorders, aiming to improve overall well-being. Rehabilitation counseling helps individuals with disabilities achieve personal and career goals. While both support well-being, their focus differs: one on mental health, the other on overcoming disability-related challenges.

Differences in Duties

The scope of practice is different between these fields. Mental health counseling tends to be much more targeted. That is, the focus is often on a specific psychological need. Let’s say you are recently divorced and experiencing diminished feelings of self-worth. These feelings, along with the stressors related to divorce (e.g., moving out of your home, splitting time with your children, the stigma of a failed marriage), have led to the development of depression.

This type of issue warrants seeing a mental health counselor. In therapy, your counselor would work with you on the cause of your current mental health struggles – your divorce. Your counselor might employ any number of interventions and treatments to address your current mental health struggles, from cognitive behavioral therapy to journaling to role-playing.

Though the types of activities, as a mental health counselor, you do in therapy might be widely varied, the overall goal is to address the mental health struggles that have grown out of the antecedent event, in this case, the divorce.

As an another example, let’s say a 35-year-old woman may seek a mental health counselor after experiencing prolonged periods of sadness, loss of interest in daily activities, and feelings of hopelessness. The counselor may diagnose her with depression and help her work through her emotions, perhaps suggesting therapeutic techniques, group therapy, or even referring her to a psychiatrist if medication is deemed necessary.

Rehabilitation counseling takes a broader approach, though.

Now, let’s say a person was involved in a car accident and suffered a traumatic brain injury. As a result, they need to relearn certain skills to live independently, such as walking, talking, and feeding themselves. A rehabilitation counselor assists in this process in a variety of ways:

  • Providing case management services
  • Connecting the client with appropriate services (e.g., physical therapy, occupational therapy, and speech therapy)
  • Providing mental health counseling services (e.g., helping the client work through the emotional trauma of their accident)
  • Offering services for the client’s family (e.g., educating the family on their loved one’s condition, providing them with resources to help their loved one recover to the greatest extent possible)
  • Exploring community, educational, or occupational programs that facilitate the client’s reintegration into the community to the extent possible.

In other words, rehabilitation counseling might be considered more holistic than mental health counseling. This isn’t to say that mental health counseling isn’t holistic, but rehabilitation counseling’s focus on mental health, physical health, family support, and so forth often means it has an even greater emphasis on the whole client. The objective is not just to address the disability itself, but to empower these individuals to achieve their personal, career, and independent living goals, despite the challenges they face.

As an another example, let’s assume that a young man who lost his leg in an accident may experience difficulty adjusting to his new reality. A rehabilitation counselor would assist him in navigating these changes, provide emotional support, recommend suitable prosthetics, and even guide him on career choices that align with his current capabilities.

These examples highlight another difference between mental health counseling and rehabilitation counseling – the professional approaches used to assist clients.

Mental health counselors typically rely on traditional psychological interventions like psychotherapy, psychoeducational activities, and targeted behavioral interventions. A good example of this is working with a child with ADHD. The first line of treatment is often behavioral therapy, a common intervention whose goal is to recognize and enhance positive behaviors while reducing or eliminating unwanted behaviors.

On the other hand, a rehabilitation counselor might incorporate behavioral therapy as part of the treatment plan for a client, but they most assuredly use a variety of other techniques to address the myriad of social, emotional, mental, physical, and occupational difficulties their client faces.

For example, let’s assume you are a rehabilitation counselor working with a young adult with ADHD and a developmental disability. You might use behavioral therapy to address the client’s ADHD in addition to vocational training that helps the client learn how to manage their ADHD in a work setting. What’s more, the vocational training would focus on building essential job-related skills that allow the client to work in a setting that is supportive, safe, and commensurate with their skills and abilities.

Differences in Clientele

Another primary difference between these fields is their clientele. As noted in the introduction, mental health counselors usually work with clients with conditions like depression, anxiety, or a personality disorder. Other common issues mental health counselors assist with include childhood disorders, marriage and family issues, and eating disorders.

What mental health counselors usually do not do is provide services for severely mentally ill clients, such as people with psychotic disorders or dissociative disorders. Typically, clients with these types of mental health needs are seen by psychiatrists or psychologists.

Contrast this with the clientele of most rehabilitation counselors. In addition to working with clients with developmental disabilities and traumatic brain injuries, rehabilitation counselors might also work with:

  • Elderly clients who have experienced a physical injury due to a fall
  • Teenage clients with an emotional disability after being sexually assaulted
  • Clients with an intellectual disability, such as Down syndrome or fetal alcohol syndrome

Again, we see the breadth of conditions a rehabilitation counselor might help address.

Differences in Work Environment

Though there are many differences between the type and scope of work between mental health counselors and rehabilitation counselors, there is a lot of overlap in terms of their work environments.

For example, both mental health counselors and rehabilitation counselors might be self-employed in a private practice setting. Both professionals often work in mental health settings, too, like community mental health centers, inpatient treatment facilities, or nursing homes and other care home settings.

Likewise, hospitals and other healthcare facilities often employ both mental health and rehabilitation counselors. Mental health counselors are a valuable asset in healthcare settings because they can provide emergency mental health services, trauma therapy, family support, and so forth. Rehabilitation counselors are critical in this setting as well, thanks to their focus on case management, advocacy, treatment planning, and so on.

Both types of counselors are often found working in the social service sector as well. Government agencies like the Department of Family Services utilize both mental health and rehabilitation counselors to provide services to families in need. Moreover, experienced mental health counselors and rehabilitation counselors might work in collegiate settings, teaching courses and conducting research.

The primary difference in the work environment between these fields is that it’s much more common for rehabilitation counselors to work in a rehabilitation facility. This makes sense, given the goals of rehabilitation counseling and the purpose of rehabilitation centers.

Differences in Education

Both mental health counselors and rehabilitation counselors need at least a master’s degree to work in their respective fields. Likewise, both must obtain the appropriate certification or licensure to practice in their state. Of course, the type of degree, certification, or licensure varies between the two.

Mental health counselors must first complete an undergraduate degree, preferably in psychology or a closely related subject. An undergraduate degree usually takes about four years of full-time study to complete and might include introductory coursework in subjects like:

  • Developmental Psychology
  • Educational Psychology
  • Experimental Psychology
  • Psychological Statistics
  • Physiological Psychology

After completing an undergraduate degree, a master’s degree is in order. Various graduate programs can lead to a career in mental health counseling, though the most common are master of science or master of arts degrees in mental health counseling or clinical mental health counseling. These degrees usually require about three years of studies, including advanced coursework in psychological principles and counseling techniques, such as:

  • Counseling Theory
  • Individual and Group Counseling Techniques
  • Psychopathology
  • Assessment and Diagnosis
  • Counseling Ethics

Furthermore, graduate programs in mental health counseling include practicum and internship experiences that give you real-world, hands-on experience in the field. Typically, practicum experiences focus more on observing professional counselors in their work environment, while internship experiences focus on applying what you’ve learned with actual clients under the supervision of a certified or licensed mental health counselor.

Some mental health counselors – especially those who focus on clinical mental health counseling – continue their education and complete a doctorate. Though a Ph.D. isn’t necessary to work as a clinical mental health counselor, the additional education, training, and research experiences enhance one’s competence as a mental health practitioner.

The educational process for a rehabilitation counselor follows much the same path. Undergraduate studies in psychology, social work, human services, or a closely related field are most common for students wishing to become rehabilitation counselors. But, the training at the graduate level is where these fields diverge.

Rather than earning a graduate degree in mental health counseling, prospective rehabilitation counselors earn a degree in rehabilitation counseling or clinical rehabilitation counseling. These programs often focus on studies in the following areas:

  • Medical Aspects of Disabilities
  • Psychosocial Aspects of Disabilities
  • Foundations of Rehabilitation Counseling
  • Career Counseling
  • Counseling Theories

Though the specific coursework varies somewhat from mental health counseling, rehabilitation counseling graduate programs share the commonality of requiring field experience in the form of practicums and internships. Graduate programs in this field usually take about three years to complete, just like in mental health counseling.

In recent years, graduate degree programs that bridge these two fields have been developed. A degree in Clinical Mental Health and Rehabilitation Counseling incorporates aspects of both fields to prepare you to provide high-level, broad-based interventions in mental health or rehabilitation settings.

Which is Better? Mental Health Counseling or Rehabilitation Counseling?

The question of whether mental health counseling or rehabilitation counseling is better comes down to the issue that needs attention. From an occupational standpoint, mental health counseling is the best bet if you want to focus on assisting clients with social, emotional, and mental health needs. But if you are interested in a broader base of practice that addresses mental, physical, occupational, and other needs, rehabilitation counseling is a better fit.

If you need counseling services, the same principle applies. If you are struggling with a psychological issue and want to achieve better mental health functioning, seeing a mental health counselor is the wisest choice. However, a rehabilitation counselor can provide more appropriate services if you are experiencing mental health issues in the context of medical, developmental, or occupational difficulties.

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