NCMHCE exam prep
97 full case simulations, 241 domain drills, and 2,400+ exam-style questions with a rationale for every option, organized around the NBCC content outline. Start free — no credit card.
The National Clinical Mental Health Counseling Examination is the case-based licensure exam from the National Board for Certified Counselors (NBCC). You work through 11 clinical case studies (10 scored) with 9–15 questions each — 130–150 items in 225 minutes — making decisions about assessment, diagnosis, treatment planning, and intervention the way a practicing counselor would. Most states require or accept it for LPC, LCPC, LMHC, or LPCC licensure. Read the complete guide →
Largest share (with Domain 6)
Largest share (with Domain 4)
The NCMHCE doesn’t test recall. It tests clinical judgment across an unfolding case. CaseSavvy is built around that.
Each case unfolds the way the real exam does — intake summary, first session, follow-up — with 13 multiple-choice questions written to DSM-5-TR criteria.
Five-question vignettes targeted at a single domain, so you can hammer Assessment or Interventions without sitting through a full case.
10 scored cases, forward-only navigation, and the real clock — so test day feels like something you have already done.
Every option explains why it is right or wrong, in clinical terms. You learn the reasoning the exam rewards, not just the answer key.
See your accuracy across all 9 domains, weighted by how much each one counts on the exam, and drill your weakest areas first.
Content is organized on the new 9-domain NBCC outline (effective July 1, 2027) with a toggle for the current 2025–2026 labels.
Pulled from the free tier, exactly as members see it. Pick an answer to reveal the rationale.
Domain 2B: Assessment
Your client is a 42-year-old man referred by his physician after a full medical workup found no organic cause for chronic muscle tension, headaches, and insomnia. He states, "I keep thinking something is really wrong with me — the doctors just haven't found it yet." He reports constant worry about health, finances, and job performance. You observe psychomotor restlessness and anxious affect. He denies suicidal ideation and substance use.
Which screening instrument is most appropriate to quantify the severity of this client's symptoms?
Domain 4: Provision of Counseling Interventions
You are facilitating an interpersonal skills group. One member consistently talks over others, and you notice another member sigh and cross her arms. The dominant member is in the middle of a lengthy story.
Which group facilitation skill is most appropriate in this moment?
Want more? Four more free practice questions or start the 5 free full cases.
Sample data. Yours fills in from your first case.
Questions answered
142 / 2,466
Unique questions (no retakes)
Overall accuracy
74%
Last 100 questions
Cases completed
18
Full case attempts
1A: Professional Development
~15% (D1) of exam · 17/20 correct
1B: Counselor Self-Awareness
~15% (D1) of exam · 16/20 correct
2A: Intake
~18% (D2) of exam · 14/17 correct
2B: Assessment
~18% (D2) of exam · 12/17 correct
3A: Treatment Planning
~15% (D3) of exam · 14/18 correct
3B: Continuity of Care
~15% (D3) of exam · 14/19 correct
4: Provision of Counseling Interventions
~20% of exam · 12/19 correct · Largest share (with 6)
5: Indirect Client Care
~12% of exam · 13/17 correct
6: Legal and Ethical Compliance
~20% of exam · 13/19 correct · Largest share (with 4)
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Monthly
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Annual
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Exam facts from NBCC sources, clinical topics at exam depth, and practice you can try without an account.
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The National Clinical Mental Health Counseling Examination is a case-based clinical exam administered by the National Board for Certified Counselors (NBCC). It consists of 11 case studies (10 scored, 1 unscored) with 9–15 multiple-choice items each, totaling 130–150 items in 225 minutes. Most states require or accept it for LPC, LCPC, LMHC, or LPCC licensure.
Yes. The free tier includes 5 full case simulations (13 questions each) and 18 domain drills (5 questions each) — 155 practice questions with full clinical rationales. No credit card required and no time limit.
Premium is $29/month or $139/year (about $11.58/month). It unlocks all 97 full cases, 241 domain drills, timed practice exams, and domain performance tracking. Cancel anytime from your dashboard.
Each full case unfolds across an intake summary, a first session, and a follow-up session, with 13 multiple-choice questions written to DSM-5-TR criteria. Timed practice exams use 10 scored cases with forward-only navigation, mirroring the real NCMHCE conditions.
Yes. Content is organized on the 2027 NBCC content outline (effective July 1, 2027), which keeps six domains but splits the first three into subdomains, so CaseSavvy tracks 9 areas, and a built-in toggle shows the current 2025–2026 domain labels. The clinical content applies to both versions.
Cases and questions are drafted with AI assistance from published sources (NBCC handbooks and exam specifications, the ACA Code of Ethics, DSM-5-TR criteria), then checked by automated gates and audited by an independent reviewer that did not write them; anything flagged is repaired and re-audited. Only approved items are published. CaseSavvy is built by David Zimmerman, RN, a nurse and educator; the full process is on the About page.
No credit card required. See exactly where you stand across all 9 domains.
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