Become a Geriatric Counselor – Education & Licensure
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“Our training curriculum is rooted in a cultural, systemic, and justice lens. We adopt a critical-evaluative, anti-racist, and anti-oppression approach when studying counseling theories.”
Kwong-Liem Karl Kwan, PhD, Professor and Former Interim Coordinator of the Gerontological Counseling Program, San Francisco State University
A geriatric counselor is one who works directly with older and aging adults, typically 65 and older but possibly as young as 50. These specialized counselors are also sometimes called gerontological counselors. The name comes from the ancient Greek word “geras,” which means “old age.”
The aging process is normal and is something that everyone experiences, of course, but it is not always an easy one. Aging brings physical and cognitive changes that can impact daily life activities and limit enjoyment. Daily tasks such as shopping, cooking, and cleaning can become challenging for an older person. And not being able to do some things that people dream of doing in their retirement years, like traveling, can bring emotional consequences and isolation.
Not being able to maintain a person’s own independence, whether due to physical or health issues, can elicit emotions such as depression, anger, withdrawal, substance abuse, marital problems, and even some personality disorders. As the older population grows, the need for people who are interested in counseling to become licensed as geriatric counselors to work specifically with older people becomes more important.
According to the 2020 census, more than 55.8 million adults aged 65 and older live in the U.S. But that number is rapidly growing, and by 2050, it is expected to be almost 90 million. Between 2020 and 2030, the number of older adults is projected to increase by almost 18 million. That means one in five Americans will be 65 years old or over by 2030.
The American Mental Health Counselors Association (AMCHA) says that if the rate of mental disorders among older adults doesn’t change within that time period, the number of older adults with mental and/or substance disorders will nearly double from about eight million people to about 14 million people. Without more counselors specialized to work with an aging population, our country’s mental health safety systems are likely to be overwhelmed and unprepared.
The Bureau of Labor Statistics doesn’t track mental health specialists who are specifically trained to work as geriatric counselors, but it is clear that the need for counselors, in general, will grow along with the population. The BLS (2024) forecasts that careers in counseling fields will grow 14 percent nationally from 2023 to 2033, faster than the average for all occupations. The BLS predicts the job outlook for substance abuse counselors to grow at an even higher rate during that same decade at a rate of 19 percent. Demand for rehabilitation counselors is expected to grow at a rate of 2 percent. On the other hand, the job outlook for marriage and family therapists is expected to grow at a rate of 16 percent.
The AMCHA says that mental health for older adults is important because older adults have one of the highest suicide rates in the nation—up to 30 percent more than the general population. Many older adults who die by suicide (up to 75 percent) visited a physician within a month before death. Depression is common in older adults and is also easy to overlook or misdiagnose.
Many individuals who pursue a career as a geriatric counselor obtain a master’s degree in general mental health counseling, which can often lead to a specialty in geriatric counseling, or psychology or psychiatry, which also can lead to specializations of working with an older population. Read on for more detailed information about how to become a geriatric counselor.
Ask An Expert: Kwong-Liem Karl Kwan, PhD
Dr. Kwong-Liem Karl Kwan is a professor and worked as interim coordinator of the gerontological counseling program in the Department of Counseling at San Francisco State University. He earned his PhD from the University of Nebraska at Lincoln. He was a former tenured faculty at Purdue University (1996-2005) and University of Missouri at Columbia (2005-2008), training master-level students in CACREP-accredited mental health and school counseling programs as well as doctoral students in APA-accredited programs in counseling psychology.
Dr. Kwan’s research and clinical interests focus on acculturation, racial salience, ethnic identity and their mental health impact on immigrant and minority adjustment, intergenerational family dynamics, and multicultural counseling relationships.
Dr. Kwan serves as a psychology consultant for the Richmond Area Multi-Services Inc. (RAMS), a non-profit mental health agency serving and advocating for culturally and linguistically diverse communities in San Francisco. He served on the editorial boards of numerous journals, including the Journal of Counseling Psychology, the Asian Journal of Counselling (Hong Kong), the Bulletin of Educational Psychology (Taiwan), and as past editor of the International Forum of The Counseling Psychologist. Dr. Kwan is a member of the American Counseling Association, the Asian American Psychological Association, and a fellow of the American Psychological Association.
CounselingSchools.com: What are some of the core values or philosophies that guide the geriatric counselor and other counseling programs at San Francisco State University?
Dr. Kwan: Overall, our department’s various specializations are driven by CACREP standards and state licensure/credentialing requirements. Our training curriculum is rooted in a cultural, systemic, and justice lens. We adopt a critical-evaluative, anti-racist, and anti-oppression approach when studying counseling theories.
CounselingSchools.com: How do the programs at San Francisco State University balance teaching counseling theory with practical skills training?
Dr. Kwan: Students are required to complete two years of internships at placement agencies specific to the specialization’s clientele populations and settings.
How to Become a Geriatric Counselor
For many people who enter the social work or mental health counseling field, their career and education preparation begins with a bachelor’s degree. During their undergraduate coursework, they begin taking classes related to human development, mental health, and understanding and appreciating diversity.
Volunteer work can also be a big part of becoming a geriatric counselor. Volunteer work in a senior community center, nursing home, or other senior environment can show prospective employers one’s dedication to the field.
Most states do not allow someone to become a Licensed Clinical Mental Health Counselor of any kind without completing a master’s degree that also includes a state-approved amount of supervised clinical work. An internship and supervised field experience along with completing an accredited degree program are prerequisites for licensure in every state, although the specific requirements can vary from state to state.
Many clinical mental health counseling degree programs offer specializations that can lead to specific training such as marriage and family counseling, substance abuse counseling, or geriatric counseling. If a school does not offer a specific geriatric counseling specialization, there is typically an opportunity to gain experience in that area during the internship and field experience, where an environment hosting seniors would be chosen for the student’s experience. Another option is to pursue a general mental health counseling license and follow that up with a certification in geriatric counseling.
Education of a Geriatric Counselor
Specific prerequisites for licensure as a geriatric counselor (and as a counselor in general) vary from state to state. The prospective geriatric counseling student should check with the requirements of the state in which they live or in which they wish to practice to be sure they are choosing a degree track that will meet their needs.
Most states require completion of a master’s degree consisting of at least 60 credits. The organization CACREP, or the Council for Accreditation of Counseling & Related Educational Programs, accredits master’s and doctoral degree programs in counseling and its specialties in the United States and worldwide. CACREP certifies all counseling specialties, including rehabilitation counseling, school counseling, clinical mental health counseling, marriage and family counseling, and addiction counseling.
CACREP approves addiction counseling programs that require students to take a minimum of 60 semester-credit-hours (or 90 quarter-credit-hours) of coursework. CACREP accreditation is important because it asserts that the program meets a broad range of requirements designed to give the students the highest-quality educational experience. It evaluates a school on its overall learning environment, the level of education of core faculty, and the resources available to the students.
Supervised Hour Requirements for Geriatric Counselors
CACREP-certified schools require students to complete a minimum practicum of 100 clock hours of supervised counseling practicum experiences over a minimum 10-week academic term.
Practicum students must complete at least 40 hours of direct service with actual clients. After completing the practicum, students must complete a 600-hour supervised internship consisting of at least 240 hours of direct service. Although this is a minimum for CACREP requirements, some states may have supervised hour requirements for geriatric counselors, so students should check their state’s rules and regulations.
The AMHCA has a Diplomate Specialist in Geriatric Counseling certification. Candidates for this specialist must have completed at least 90 hours of professional development in each area. One completed post-master’s degree graduate semester credit hour is equal to 15 professional development hours.
Applicants must complete at least 100 hours of face-to-face counseling in the specialist area with at least 10 hours of specialist supervision by a licensed mental health professional who has expertise in the area. Successful applicants will be awarded a certificate, and may refer to themselves as a Clinical Mental Health Counseling Specialist or CMHC Specialist (e.g., CMHC Specialist–Geriatric).
Licensure and Certification of Geriatric Counselors
Each state offers its own licensure procedure and requirements. In many states, the licensure and certification of geriatric counselors are handled by a board of health. In most states, the Board only licenses those who hold either a bachelor’s or master’s degree in social work or counseling.
Many states also offer different levels of licensure. An associate license is often the first step in obtaining a clinical license. This is for a student who has recently graduated with their master’s degree, is a master’ s-degree holder currently under supervision, or is transferring their license from another state. Students can qualify to become Licensed Clinical Counselors if they have a certain number of post-degree experience hours and have passed clinical exams.
Those following the master’s degree path who study at a CACREP-accredited school are required to complete licensure requirements set forth by the state licensing board. Each state’s requirements are slightly different, so it is recommended that anyone seeking to enter this field check with the state where they live or wish to practice for specific information.
Geriatric Counselor Licensure Renewal Requirements
Each state will offer its own geriatric counselor licensure renewal requirements. Once licensed, geriatric counselors must take continuing education classes to maintain certification. Each state’s counseling licensure requirements can be slightly different. In general, they consist of educational experiences within the counselor’s core practice area along with refresher courses and experiential courses related to diversity and ethics.
Many states require license renewal every two years. Requirements for continuing education can vary from 20 to 36 hours, or possibly even more. Candidates can earn points through participation in many activities within their field but especially the following methods:
- Attending workshops, in-services, seminars, or conferences
- Attending programs offered by or approved by a geriatric organization
- Giving presentations on geriatric therapy at workshops, seminars, conferences
- Giving guest lectures
- Authoring publications or a geriatric counseling-related book
- Conducting research
- Attending college courses
- Attending self-study independent learning projects
- Achieving a specialty certification
- Association membership participation (such as committee participation)
There is currently no renewal process for AMHCA credentials.
What Do Geriatric Counselors Do?
Geriatric counselors provide physical and psychological assessment services for older adults, along with counseling, direct care, treatment for mental health issues, and assistance with problems interfering with a senior’s quality of life. Since they are often licensed as general mental health counselors first and geriatric counselors following a specialization, they are skilled in identifying and resolving issues common to seniors.
Depending on where the geriatric counselor works, they will face different responsibilities and demands. For instance, seniors residing in long-term care and assisted living facilities will likely have different needs than seniors still independently living at home who may be faced with changes in life due to the death or illness of a spouse, isolation, or other mental health issues. A geriatric counselor can work at a hospital long-term care facility, assisted living facility, senior services agency, or independent practice.
Geriatric counselors can not replace friends or family members, but they can be a trusted resource and provide some assistance that older adults need. A geriatric counselor will be able to assess a senior’s overall quality of life and level of ability, and work with the family members to develop a care plan. After working with a senior, a geriatric counselor can assess changes in a patient’s mental state and keep family members and caregivers updated.
They can advise on the best living arrangements and everyday activities for an individual patient and provide end-of-life counseling to the patient and family members.
There are many life changes that a senior goes through, including the loss of satisfaction of a career, the loss of freedom of being able to drive, health challenges, changing family dynamics, the deaths of loved ones, and even their own anticipated death. A skilled and compassionate geriatric counselor can do a lot to alleviate some of the mental toll of these issues and help provide a better quality of life for those in their “golden years.”
How Much Do Geriatric Counselors Make?
The U.S. Bureau of Labor Statistics doesn’t list employment statistics specifically for geriatric counselors. Those counselors are either included in mental health counselors in general or in “other” counselors. The following numbers represent data from the BLS from May 2023—the latest data available as of November 2024.
Substance Abuse, Behavioral Disorder, and Mental Health Counselors
| United States | |
|---|---|
| Number employed | 397,880 |
| Average annual salary (mean) | $60,080 |
| 10th Percentile | $36,700 |
| 25th Percentile | $44,600 |
| 50th Percentile (Median) | $53,710 |
| 75th Percentile | $70,130 |
| 90th Percentile | $89,920 |
Counselors, All Others
| United States | |
|---|---|
| Number employed | 35,580 |
| Average annual salary (mean) | $52,360 |
| 10th Percentile | $33,300 |
| 25th Percentile | $38,890 |
| 50th Percentile (Median) | $46,130 |
| 75th Percentile | $59,340 |
| 90th percentile | $79,880 |
National Estimates for Community and Social Service Occupations
| United States | |
|---|---|
| Number employed | 2,418,130 |
| Average annual salary (mean) | $58,980 |
| 10th Percentile | $35,570 |
| 25th Percentile | $42,020 |
| 50th Percentile (Median) | $52,000 |
| 75th Percentile | $69,160 |
| 90th percentile | $89,220 |
Geriatric Counselor Professional Associations & Resources
- American Society on Aging (ASA)
- American Geriatrics Society (AGS)
- National Coalition on Mental Health and Aging (NCMHA)
- American Association for Geriatric Psychiatry (AAGP)
- Society of Clinical Geropsychology (SCG)
- GeroCentral
- Administration on Aging (AoA)
- Advocates for African American Elders (AAAE)
- AOA National Family Caregiver Support Program (NFCSP)
- Aging with Dignity
- Alliance for Aging Research
- Alzheimer’s Association
- Alzheimer’s Disease Education and Referral Center (ADEAR)
- American Association for Geriatric Psychiatry (AAGP)
- AARP
- American Bar Association Commission on Law and Aging
- American Federation for Aging Research (AFAR)
- American Foundation for Suicide Prevention (AFSP)
- Anxiety and Depression Association of America (ADAA)
- ARCH National Respite Network and Resource Center
- Center for Research and Education on Aging and Technology Enhancement (CREATE)
- Council of Professional Geropsychology Training Programs (CoPGTP)
- Diverse Elders Coalition (DEC)
- Eldercare Workforce Alliance
- Ethnic Elders Care
- Family Caregiver Alliance (FCA)
- Generations United (GU)
- Gerontological Society of America (GSA)
- Medicare Rights Center
- Michigan Center for Urban African American Aging Research (MCUAAAR)
- National Council on Aging (NCOA)
- National Alliance for Caregiving (NAC)
- National Asian Pacific Center on Aging (NAPCA)
- National Caregivers Library
- National Caucus and Center on Black Aging (NCBA)
- National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP)
- National Center on Elder Abuse (NCEA)
- National Coalition on Mental Health and Aging (NCMHA)
- National Hispanic Council on Aging (NHCOA)
- National Indian Council on Aging (NICOA)
- National Institute on Aging Office of Special Populations
- National Resource Center on Native American Aging (NRCNAA)
- National Association for Professional Gerontologists (NAPG)
- Psychologists in Long Term Care (PLTC)
- Rosalynn Carter Institute for Caregivers (RCI)
- SeniorNet
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- Services and Advocacy for Gay, Lesbian, Bisexual & Transgender Elders (SAGE)
- Stanford Geriatric Education Center (SGEC)
- The National Resource Center on LGBTQ+ Aging
- USAging
- United States Department of Health & Human Services Office of Behavioral Health, Disability, and Aging Policy (BHDAP)
- United States Department of Veterans Affairs (VA)
- National Center for PTSD
- United States Department of Veterans Affairs Veteran Community Partnerships (VCP)
- Well Spouse Association (WSA)
Vanessa Salvia
WriterVanessa Salvia is an Oregon-based freelance writer and editor with a bachelor’s degree in chemistry. As fun as rigorous studies in math and science were, Vanessa took an independent path and developed a prolific career covering lifestyle and healthcare topics for magazines and newspapers, important industries such as concrete construction and building waterproofing, and even hard science. You can get in touch at Sage Media and Marketing.