What Is Psychiatric Rehabilitation Counseling and How Does it Intersect with ABA?

Coming back from a debilitating mental disorder is a long road for many patients. Just as with physical injuries, recovery from psychiatric condition can take both years of ongoing therapy and carefully supervised and structured rehabilitation to return to an optimal level of functioning.

Psychiatric rehabilitation counselors are the people who help patients through that long road to recovery.

The use of applied behavior analysis in psychiatric rehabilitation reflects the field’s utility in other types of rehabilitation by applying evidence-based behavioral interventions to acquire or re-acquire life skills and functions. Today, psychiatric rehab counselors use behavioral interventions like motivational interviewing and behavioral activation to help their charges achieve a meaningful and fulfilling return to normal life.

A PR counselor helps patients with their recovery from long-term psychiatric disabilities by monitoring their capabilities, collaborating with other care providers and family members, and facilitating recovery activities.

Counselors are primarily responsible for working directly with clients to assist them in rebuilding their anger management and social skills. They work in both inpatient and outpatient settings, handling patients one-on-one or in group activities.

Patients can run the gamut from those with depression to those with schizophrenia. Some counselors work in hospitals and inpatient psychiatric facilities, while others work in outpatient facilities or with patients in transitional settings like group homes.

You can find PR counselor jobs under other titles, such as:

  • Mental Health Support Specialist
  • Mental Health Support Counselor
  • Psychiatric Rehabilitation Caseworker
  • Psychiatric Rehabilitation Program Direct Care Worker
  • Psychiatric Rehabilitation Specialist
  • Psychiatric Rehabilitation Program Assistant

Psychiatric Rehabilitation Counselor Job Description

PR counselors screen and assess individuals under their care daily to determine their degree of functional impairment and their response to therapy programs. Coming back from a psychiatric illness is full of ups and downs, and counselors are trained to both observe and intervene where necessary for patient support.

You’ll keep records of all patient-related activities, and work with psychiatrists and other therapists to determine and direct long-term rehabilitation plans. You may be primarily responsible for deciding on and putting into action various activities to assist with social skill and interaction development, or you may work at the direction of another therapist or provider to implement the treatment plan.

Some group activities are usually led by PR counselors, helping various patients integrate their recovery with interpersonal skills. You might also design those activities with input from other providers.

Counselors also assist with transition to the outside world for patients coming out of inpatient therapy. You will provide support by helping clients with things like lining up job interviews, applying for housing, or arranging necessary ongoing outpatient support.

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How To Become a Psychiatric Rehabilitation Counselor

A master’s degree, as well as state licensure is the standard requirement for working in psychiatric rehabilitation. The good news is that PR counselors can enter the profession from any number of different backgrounds, including human services or social work, psychology, or counseling.

Most positions will also require a certain amount of supervised experience working in mental health facilities or in a healthcare field.

How to Get the Right Education to Become a Psychiatric Rehabilitation Counselor

Psychiatric rehabilitation counselors generally need to have a master’s  degree to get hired, and most employers prefer degrees in rehabilitation counseling, social work, psychology, or a related human services field.

Typical degrees relevant to this kind of work include:

  • Master of Social Work (MSW)
  • MA/MS in Clinical Counseling
  • MA/MS in Counseling Psychology
  • MS in Clinical Rehabilitation and Mental Health Counseling

Those fields offer the right blend of communication skills, rehabilitation psychology and techniques, and behavioral and developmental education to prepare you to serve the unique needs of recovering psychiatric patients with a combination of tenderness and clinical expertise.

Regardless of the degree you choose to pursue, ensuring that you select a program that is fully accredited by the relevant specialty accreditation body for the field is key. In counseling-related degrees, for example, you’ll want to make sure you pick one accredited by CACREP, the Council for Accreditation of Counseling and Related Educational Programs; for human services, on the other hand, you will want one accredited by the Council for Standards in Human Service Education (CSHSE).

Do You Need a Certification to Become a Psychiatric Rehabilitation Counselor?

Certified Rehabilitation Counselor (CRC) – Many PR counselor jobs require or prefer the Certified Rehabilitation Counselor (CRC) credential through the Commission on Rehabilitation Counselor Certification (CRCC). In some cases you may be allowed to pursue that credential after you are hired.

Qualifying for the credential requires a master’s in counseling or rehabilitation counseling, or a closely related field. Graduating from a CACREP-accredited program (or CORE-accredited if you graduated before July 2017) streamlines the process.

You can still qualify to take the certification exam if your degree wasn’t through a CACREP-accredited program, but your transcripts would need to be reviewed closely to ensure you took the right combination of courses.

Certified Psychiatric Rehabilitation Practitioner (CPRP) – Positions that deal more specifically with psychiatric rehabilitation, the Certified Psychiatric Rehabilitation Practitioner (CPRP) credential from the Psychiatric Rehabilitation Association (PRA) may be the employer’s certification of choice.

The CPRP is a test-based certification that is held by people from a variety of backgrounds and education levels – from medical doctors and psychologists with PhDs to up-and-coming human services professionals with nothing more than a high school diploma or GED.

Whatever your background or education level might be, qualifying for the credential all comes down to passing a test that assesses your competency in seven essential domains.

What State License is Required?

The answer to this question depends on the specific role you take on, whether as a social worker or counselor.

Qualifying for a State-Issued Counselor License – After completing your master’s degree in a counseling related field, you’ll need to complete two years of post-master’s clinical work under the supervision of a licensed clinical mental health counselor and take either a state-developed exam or the National Counselor Examination through the National Board for Certified Counselors, which many states use for licensing purposes.

You can learn more about state licensing requirements to become a mental health counselor here.

Qualifying for a State-Issued Social Work License – To become a clinical social worker in any state so as to be able to provide psychiatric assessments and counseling in the context of rehabilitation social work, you’ll need to earn a master’s degree in social work and then complete at least two years of post-master’s clinical experience. You’ll also need to take the national examination through the Association of Social Work Boards to earn state licensure to practice.

You can learn more about state licensing requirements to become a social worker here.

What About Certification in Applied Behavior Analysis?

With training and skill development often representing a major part of the work of PR counselors, behavioral therapies are a common part of the treatment prescribed to patients. Some counselors are finding it valuable to earn Board Certified Behavior Analyst (BCBA) through the Behavior Analyst Certification Board (BACB).

Though the BCBA has historically been limited to people with a master’s in either ABA specifically or otherwise education or psychology with an ABA concentration, the BACB is removing degree restrictions in the coming years to make the credential available to qualified applicants with master’s degrees in other fields, including counseling and human services.

Starting in 2022, with a master’s in counseling, social work, human services or a related field, you’ll soon be able to satisfy the BCBA education requirements by earning a post-graduate ABA certificate from schools offering the stand-alone Verified Course Sequence (VCS).

Some schools are already starting to enroll students into VCS programs who hold master’s degrees in previously restricted fields.

Typical Salary for Psychiatric Rehabilitation Counselors

Psychiatric rehabilitation counselors fall under two different job categories as monitored by the U.S. Department of Labor’s Bureau of Labor Statistics (BLS), both of them with bright futures for employment. Rehabilitation counselors, the first, are expected to grow at a rate of 10 percent between 2018 and 2028, while psychiatric technicians and aides, the second, will go up 12 percent over the same period. Both are expanding faster than the national average.

Pay rates are also similar, with the median 2021 salary for psychiatric aides coming out at $36,570 per year (or $17.58 per hour) and that of rehab counselors at $38,560 ($18.54 per hour).

For both roles, the employer matters quite a lot for achieving the highest salary levels. State governments paid the best median salaries for psychiatric technicians at $45,170 annually. The best industry for rehab counselors was Insurance Carriers pulling in $51,350  annually.

With more and more demand coming for PR counselors with a strong grounding in behavioral therapies, you can expect both salaries and job opportunities to increase almost anywhere in the country in the coming years, however.

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2021 US Bureau of Labor Statistics salary and employment figures for Rehabilitation Counselors and Psychiatric Technicians reflect national data, not school-specific information. Conditions in your area may vary. Data accessed January 2023.