Counseling Today, Online Exclusives

Why failing the NCMHCE felt so good

By Alyson Carr January 6, 2016

The day I failed the National Clinical Mental Health Counseling Examination (NCMHCE) was the best day of my life. I didn’t know this on the day it happened, of course, because my judgment was clouded by lots of tears, snot and defeat.

You know those classmates or colleagues who seem to easily earn A’s on tests without having to put a whole lot of energy into studying? Yeah, me too, and I’m not one of those people. I’ve always done ExamStudypretty well in school, but I’ve had to work really hard to earn high grades.

Having insight into your strengths and weaknesses as a learner is half the battle when it comes to preparing for examinations because once you have identified your shortcomings, you can target those areas and try to bridge the knowledge or study skill gaps and (hopefully) successfully conquer whatever test is in front of you. After years of being both a student and an educator, I know my learning style and how to target my weaknesses — or so I thought until I became a miserable failure, hyperventilating on the phone to my mother like a child as I broke the news that I hadn’t passed the NCMHCE.

How did I prepare to fail my test, you ask? Diligently. I did a lot of preparation. I worked really hard for that big “F.” I consulted with colleagues who had successfully passed their exams about the materials they had used to prepare, I studied every day for three months, my husband quizzed me in the mornings before work and I performed really well on the practice exams before I went into the real deal.

I was ready. I was ready to pass something for which I had worked so hard. I was ready to finally see the letters LMHC (licensed mental health counselor) after my name. I was ready to reach more people in need. I was ready to experience this rite of passage. Or so I thought until I had to cancel the celebratory dinner planned for after the exam because I obviously wasn’t going to celebrate being such a pathetic loser.

For a while, I thought I failed the exam because I had a panic attack. Sometimes I still like to tell myself that was it. It couldn’t possibly be that I was unprepared or didn’t possess the knowledge required to independently practice — no way, it was just panic, and it was totally out of my control.

In my defense, I did have a panic attack. I saw that I was getting many answers wrong in a row, and I was certain it meant failure. Class, what do we know about self-fulfilling prophecies? If we tell ourselves we are going to fail, we likely will, and that’s exactly what I did.

However, this panic wasn’t reduced to feeling like I was going to have a heart attack because of failing alone. This panic was more dynamic and was perpetuated by realizing the truth — I wasn’t ready.

If I had been more prepared, I would have been able to recover from losing all of those points. If I had been more prepared, I would have had a larger margin for errors. I panicked because any sensible counselor would have entertained the same question I did: If I’m not prepared to pass this exam, am I really the best person to be in a position of counseling clients who deserve the highest quality of care? Pondering this question caused me more emotional distress than failing the exam ever could. I bet a lot of registered interns who have failed ask themselves the same thing.


Feeling grateful for failure

On the day I failed the NCMHCE, I experienced a spectrum of emotions during a 24-hour period. First, I was selfishly discouraged and wondered, “Why me?” Then I was embarrassed and wanted to save face, so I thought about not telling anyone that I had even taken the exam. But I realized that I can’t keep my mouth shut about anything for longer than five seconds, so everyone who encountered me over the prior three months was anticipating my good news about passing. Next, I was mad. I was angry with anyone who had passed a test ever in their lives. I was especially angry with colleagues who seemed to not study at all but managed to pass the exam on their first attempt.

After I got through all of these confusing emotions, I started trying to make sense of things by asking questions such as the one I mentioned previously: “Am I, The Failure, truly delivering the best care to my clients?” By the way, I still don’t know what the answer was to this question at the time. In hindsight, I realize the important thing was that I was asking it in the first place.

Reflecting on this question and client welfare was what motivated me to make a decision. I decided I would throw myself a pity party for one day, then move on with my life and make passing this exam my top priority.

Looking back, I can see that passing the exam wasn’t necessarily my goal. Instead, my goal was to pass and feel like I should have passed. If I had passed on my first attempt, I can say with complete confidence that it would have been the result of pure luck. My clients would not have been getting the caliber of care they deserved because I would have been a licensed professional with a false sense of confidence about my abilities. Taking this into consideration, I became grateful for being a failure because, in my case, being a failure meant not being a phony.

So, I woke up the next day and stuck to my guns about my renewed perspective. I wasn’t going to rehash the pain and suffering associated with failing because I was glad for it. What was done was done, and if a client were in a similar situation, I would pull out every tool in my Counselor Tool Belt to help lead that person to a place where he or she could see the silver lining in all of this.

I wanted to lead by example. I told everyone I failed, including my clients. I wanted them to know that I was human too. I also felt like this piece of professional disclosure was important coming from a registered intern (no, I don’t believe it is unethical if you choose to keep this sort of information to yourself unless you have a contract with an employer outlining terms and expectations in the event you fail).

So, everyone knew I had failed, but more importantly, everyone knew I was determined to overcome the defeat, and that was very empowering. The support from friends, family and colleagues was so warm and loving. And as a result of talking openly about my failure, I learned about others’ experiences with not passing the NCMHCE. Collectively, we embraced emotionally, and I was reminded once again why being in this profession is such a tremendous gift.


The waiting game

Those of us who fail the NCMHCE are forced to sit around for three months sulking in our misery before we are eligible to retake the exam and ultimately amend our stories of the journey toward licensure. I spent those three months confronting the reality that I needed to be more prepared for the test. I needed to feel more prepared for the purposes of alleviating my anxiety, both while studying and so I could manage my panic during my second attempt at the hardest exam I’d ever taken.

I spent more time with the Diagnostic and Statistical Manual of Mental Disorders — a task I don’t think I executed well the first time. I developed some systematic ways of measuring if I was improving and how. I turned preparing for the exam into a second full-time job. I owed this to myself and to the clients who meant so much to me. As it turns out, I also owed this to the baby growing in my belly.

I took my exam for the second time exactly three months after failing the initial attempt. I walked into that testing room committed to not standing in my own way again and prepared to give my second attempt everything I had. I went to the bathroom in between every simulation because taking breaks and going slow is really helpful in terms of managing test anxiety. Going to the bathroom often is also very helpful to a pregnant lady who has a fetus doing back handsprings on her bladder.

When I went into the bathroom, I prayed to every god I knew. I practiced deep breathing. I used imagery techniques to visualize peaceful and tranquil landscapes.

And I talked to my unborn baby: “I want to set an example for you, little one. One day, I want to be able to tell you that I did it right this time. I have already learned so much from you, and you aren’t even here yet, but if there is anything I hope you can learn from me it’s that success tastes so much sweeter when you know you’ve truly earned it. There will be times in your life when you will fail. The experience of picking yourself up afterward will vary depending on the failure. But it’s not the getting knocked down that defines who you are; it’s how you define failure and success and how you conceptualize the complexity of personal growth and development. I pray to this mass-produced picture of a forest in this H&R Block bathroom with customers yelling at accountants about their taxes on the other side of this door that I can give you the same strength you are giving me right now.” I truly used every channel I could to communicate to myself that I could do it this time.


Moment of truth

When I walked out of the testing room through the lobby four hours later to get my results, I saw my husband still waiting for me in the parking lot. He had a good view of the facility from his parking spot, so he had seen me come out of the testing room and walk through the lobby 10 times previously to use the restroom. Each time he had wondered if this was the time. Was I done? Was this it? Had I just drank too much water, or was I done failing again? Had I passed? Was today the day I was going to finally get to drink my celebratory sparkling apple juice?

I walked over to the proctor to get my results. I learned the first time how this process worked from the way the proctor turned my results sheet over and gave me that look of “poor you.” This time, he grabbed my score sheet from the printer and, before handing it to me, looked at it and said, “Wow, great job.”

Alyson Carr proudly shows her NCMHCE results.

Alyson Carr proudly shows her NCMHCE results.

I lunged at this complete stranger, hugged him tightly, thanked him for being the bearer of such relieving news and bolted into the arms of my husband outside, who cried tears of joy and accomplishment with me. I didn’t get the sparkling apple juice, but I did get an ice cream sundae from Dairy Queen. It was the most delicious treat I’ve ever consumed, not because it was exceptionally good ice cream or because I was so hungry that even tire rubber would have tasted incredible at that moment, but because I had achieved something great. Passing was obviously a desirable outcome, but this victory was not about passing — it was about overcoming an obstacle.


A new sense of purpose

As a result of my personal failure, I’ve been inspired and made a career out of helping others pass the NCMHCE. In addition, I’ve dedicated all of my doctoral research to examining the impact of test anxiety on academic performance as it relates to this exam.

The footnotes are this. There are generally two types of highly anxious test takers. The first type fails tests because of test anxiety alone (they have problems retrieving information in the testing situation). The second type fails tests because of test anxiety and poor study skills (they have problems both with encoding the information when they are studying and retrieving the information in the testing situation). I recommend looking into Moshe Naveh-Benjamin’s numerous studies exploring the variables that contribute to the relationship between test anxiety and academic performance if you’re interested in this kind of stuff.

In any case, the bottom line for me is that my failure helped me find myself and a career path that truly makes me happy. Let’s be serious, how many people can say that? If you’re reading this, you’re probably a counselor, so you know from your clients that the answer is “not too many.” Before I became a failure, I was treading water trying to figure out what I was passionate about. For me, failing turned out to be my one-way ticket to a fulfilling job.


Overcoming personal barriers

Everyone has a different demon to fight when it comes to attempting the NCMHCE. For me, I needed to do some serious reflection on what this exam represented to me before I could be successful. An additional distraction during the time I was studying for my second attempt was a high-risk pregnancy and the associated fear that comes with that type of a personal speed bump.

After ending an abusive 25-year marriage, Danielle pursued her master’s degree in mental health counseling when she was 57 years old. Getting back into the swing of studying wasn’t easy for her. She reached out to me after failing the NCMHCE five times and passed on her sixth attempt. She said, “I don’t care how many times it takes me to pass this, I want it, and I will get it.”

Gene’s boss told him that he would be terminated at the end of the month if he didn’t pass on his third attempt. This presented incredible stressors for Gee as the breadwinner for a family of five.

Passing the exam for Connie on her third time meant that she could finally provide services to mothers who had lost young children. This was important to her because her entire career had been inspired by the loss of her 3-year-old daughter in a drowning accident.

Jack was waiting to propose to his girlfriend until after he passed the NCMHCE because he wanted to provide for her and felt like he couldn’t give her the life she wanted until he was licensed.

Jessica became unemployed as a result of failing her exam; Alex gave up going to her kids’ soccer games for three months; George balanced a 60-hour workweek so he could afford study materials while preparing for his fourth attempt.

We all have incredible sources of inspiration, but we also have legitimate barriers (as well as irrelevant excuses) that can stand in the way of our success. With that said, however, we are counselors. We have been there for clients who are up against obstacles we can barely wrap our heads around. We struggle, we suffer and we weep for the clients who have experienced devastation. We are trained to provide support and guidance to those going through struggles. We help people make meaning out of their tragedies, and then we move on to the next thing.

Epictetus said, “When something happens, the only thing in your power is your attitude toward it; you can either accept it or resent it.” The very foundation of cognitive behavior theory is rooted in the idea that it’s not the event itself that causes emotional distress but the meaning we assign to the event. It is easier to look back at this journey once you are at the end of it with a positive attitude, but it is during the treacherous climb to the summit that the valuable internal work takes place. This parallels the counseling process.

You may fail the NCMHCE. In fact, statistically, failing is likely (40-45 percent of people do). Or you may pass. You might not even define scores on a test like this as an effective evaluative tool to measure success. But regardless of your interpretation of these concepts, don’t forget that you are the one invited into the lives of people during their most challenging battles. You are the person who helps them suit up, fight and win.

We should want for ourselves what we want for our clients — the ability to turn our most difficult experiences into an opportunity for self-discovery.




Alyson Carr is a licensed mental health counselor with a doctorate in counselor education from the University of South Florida. Contact her through her website at




Related reading: See Alyson Carr’s article “Preparing for the NCMHCE” at Counseling Today online:




  1. Abraham Sculley

    Amazing post! Thank you for sharing your personal experience/struggle on such an intimate level. This post is very inspiring and I enjoyed it very much!

  2. Rachel

    As a counseling student mid way through my program, it is encouraging to see such a vibrant and positive outlook on this subject! Dealing with disappointment is something we will repeatedly be helping clients with, as well as facing ourselves.

    I am glad to see a clinician openly talking about struggles with achieving professional licensure along with personal strategies to overcome them.

    I really enjoyed your article, wish you continued professional success and hope to see more of your writing!

  3. Michael

    The thing about the NCMHCE is that it is not structured like the testing that we as students are familiar with. I am normally reasonably good as I passed the NBCC exam and others. What I failed to do before taking the NCMHCE exam was to find out anything about it and the standard approach will not work as I found out the hard way. So students & residents need to be made aware that there is substantial differences in the structure and approach to the exam.

  4. niky

    I just recently took the exam and did not pass it. Now is just a waiting game but I had a quick question. Do the simulations change on the second or third time taking the exam? I did really good on the information gathering but missed the decision making part by 13 points. :(

    1. Mazy

      I passed the information gathering and not the decision making also Niky. How can anyone hold all that DSM-5 information in their heads. There is so much.

    2. Mark

      Sae for me, today I missed the DM part by 4 points. I’m not sure if they know but I’m sure the sims will change.

    3. Alyson Carr

      Niky, you really never know what you might see when you go into the exam next time. It’s possible that you will see things that are familiar to you from your previous exam attempts, but it’s also possible everything will be brand new. I recommend over preparing so you have a large margin for error/wiggle room! Best of luck to you!

    4. Alyson Carr

      Niky, it’s possible you will see the same scenarios but it’s just as possible you will see all new cases. Kudos to you for IG! DM is notoriously harder and you actually have to earn a higher score in the DM section than the IG section so it tends to be a really difficult section for most people – you are not alone!

  5. Shalin Oakes

    So I have taken the NCMCE twice once two years ago freaked out and waited till yesterday 8-9-16 to take it again. I am doing really well and actually passing the information gathering section by decision making is where I fail. I.went through the same questions yesterday about whether I was in the right profession.. If God hated me or something I was doing with my I need Xanax .. I am motivated to try again by I don’t know if I should just try the NCE this time around. I haven’t heard of having to face the board yet but I know if I do I will feel like the biggest idiot. I haven’t told anyone I failed but my supervisor and coworkers seemed to be cheering for me so I may have to tell them. Do we have to wait exactly three months?

    1. Alyson Carr

      Shalin, so sorry to hear about your experience. The DM section is notoriously harder to pass than the IG section, but hang in there and keep pushing through. If DM is the area you are having the most difficulty, consider bulking up your DSM-5 diagnostic criteria knowledge.

  6. kristen

    i failed my exam by 2 points in the DM section, any advice on how to better prepare for the DM part? I have purchased and completed a few study programs but not sure what else to do (these study materials were “guaranteed pass”, LIARS)

    1. Alyson Carr

      Kristen, great question. Usually, when test takers are struggling with the DM section they either need to spend a little more time learning the diagnostic criteria in the DSM-5 *OR* they need to learn how the test makers want test takers to *apply* that knowledge. Hope this helps and don’t hesitate to email me directly.

  7. William

    Dr. Carr,

    It’s William from class, long time no see. I have read your post and it’s very informative to understand “Failure”. If we don’t fail from time to time we’ll never grow. It teaches us to adapt and overcome the many obstacles we all face daily. Also this gives the importance of self reflection and the ability to teach ourselves about “Self-Talk”. Thank you for your experiences and knowledge. I hope many people will learn to just “Listen” rather than judge by a cover. Be safe and I hope we get to catch up soon.


  8. myra

    Good morning everyone,
    I came across this post after typing in “can’t pass the ncmhce what to do” weird question but it brought me here. I just took the ncmhce teat a second time and we’ll failed the dm a second time as well. I missed by 13 points and was very disappointed at myself. I went in deep breathing and studied really hard (at least I believed I did) I used the website which really helped and during the practice simulations gave me a passing score, let’s say I was very motivated and believed I was really going to pass it. I left the testing center literally crying. As of today I am a bit confused if I should even Re consider taking the exam again or take the nce. Any suggestions?

    1. Alyson Carr

      I’m so sorry to hear about your experience – it is so discouraging when you give this your best and still don’t get the outcome you were hoping for but PLEASE do not give up. Think about it this way – you will treat many clients throughout your career who are suffering as a result of unfair circumstances – things didn’t go the way they should have but now here they are, in your office, hoping for you to help them. Try to think of this experience as an opportunity for you to become better equipped to treat clients who have been dealt a crumby hand and need someone who understands what it feels like to have to get through it anyway. You can do this – and your clients will be all the better for it.

  9. Mel

    Finally people that understand! Your comments have been great! This is just what I needed as I just failed the DM area by 6 points also for the second time. I can ususally get the diagnosis right, however it’s the differentials that I know I have a hard time with, I look in the DSM and don’t know how we are to memorize them all, The other portion that I fail is the interventions used. I swear I memorized all of the theories but when I choose some of the interventions that go with the theories I get them wrong. It’s so frustrating! How do we work with that?

    1. Alyson Carr

      Mel, remember that “differential diagnoses” are DISORDER specific, not CLIENT specific. So, differential diagnoses correspond to the disorder you are being asked about (for example, “What are the differential diagnoses for Adjustment Disorder?”) – open up your DSM-5 to Adjustment Disorder – skim through that section and you will see a heading called “differential diagnoses” which lists all of the differentials for Adjustment Disorder – this is true for all of the disorders in the DSM-5. Trying to sit down and memorize these from scratch would be DREADFUL and you probably wouldn’t retain a whole lot of information – instead, when you are working through practice simulations and are asked about differentials, simply take a minute to open up your book, read, cheat, and then move on – doing it this way means that you get small doses of differential information AND it’s easier to retain because you’re relating it to an actual case.

      If you’re using, try to “treatment” section of the DSM-5 flip cards – this can be super helpful for interventions/theory stuff. Hope this helps!

  10. Barbara

    I came across Alyson’s article several months ago. I was in the midst of studying for the NCMHCE for the first time and had been studying using a well- known study guide. While it was adequate it felt incomplete. After researching other options I came across and joined for their one month program. I also discovered that they had tutors available! I reached out to Alyson who quickly replied to my inquiry. We developed a weekly tutoring plan via SKYPE. I felt her fee was very reasonable and attribute her support to passing the exam with an awesome grade the first time. I HIGHLY recommend using Alyson’s services. We’re now working together on my private practice start-up. Such a great resource.

    1. Kimberley Ogburn

      Hello . My name is Kimberley Ogburn. I am currently studying for the NCMHCE soon to sit for the exam in November of this year. This will be my fourth time taking the exam. I would very much like to receive help in learning my mistakes so I can finally pass the exam. My email address is dedraette Thank you.

  11. Dina

    Hi Everyone,
    I also was quite frustrated as I studied and did so well on all the simulations and tests and passed with huge margins. Took the NCMHCE for the first time last Saturday expecting to pass for all the work I put in and bombed the DM section by 24 points. I now am going to get help from Alyson as well. I think what also made me frustrated was that others I knew who took the exam said it was just like the simulations on the site I used and if I passed those, I would pass this. None of my simulations were anything like what the real exam was. It was so disappointing. Maybe now with additional help, I will get it right the second time around. I pray. Dina

    1. Heather

      Curious what simulations you used! So frustrating to know that we can be thrown off by things saying we are “ready” when we aren’t!

  12. Crystal

    I feel better that i’m not the only one who struggles with this exam!! I took NCMHCE twice and missed the DM by 4 points both times. Im frustrated and sad because I studied so hard. A couple of my co-workers took the exam for the first time today and passed. I’m happy for them, but I want the same thing. Yes, the DM is the section I’m struggling the most with, but I’m not going to give up…i want those letters behind my name!

  13. kar

    Hello Dr. Carr,

    I recently took the NCMHCE and failed. I got 108 on IG and 109 on DM. So, I missed the test by 4 questions on the DM. I would surmise that this is a very frustrating process and I have questioned my intelligence (tears). I believe that I have what it take to be a good Therapist; but not passing the test has caused me to seriously considering other career options. Your post and the struggles of other people has helped me tremendously… Thank you Kar

  14. Laura

    I’m preparing to take the test next week and it seems like an impossible task. I’m reading these comments and feeling even worse because I, unlike so many here, am NOT mastering the simulations. It sounds bad but I feel like I am a better Clinician than the test. I would do things very differently in practice because its the way I’ve been taught to do things and I believe in it. I am having extreme difficulty with getting out of my own way and learning how the test wants me to take it. I do not feel ready to take this exam next week. But I have put it off for almost a decade and it is time to face the dragon, even if he slays me instead of the other way around. I feel like if I at least face the dragon I’ll know what I’m up against. And this will make it easier to fight it again next time. I don’t want the self fulfilling prophecy, but I also know when I am not ready and I want to be realistic. How your article and these comments has been helpful is that I no longer think it will be the end of the world if/when I fail. I will just have to face the dragon again until I’m slaying it instead of it slaying me. Thank you for being an inspiration.

  15. Millie

    Dear Mrs. Carr,

    This is such a refreshing article and gives me hope. I have taken the LMHC exam twice and failed. The second time I took the exam, three days ago, I realized it was the same exam of 2015. I thought to myself, how am I taking the exam. Bad thought as my anxiety shot off the roof. Needless to say, I got higher scores but still failed the DM. I realized that what failed me was the diagnosis questions and the very tricky questions that when saying “select as many” there is only one right choice, making the exam take away point if you choose other options. This time, I took it better though and plan on taking the exam in exactly three months. I am studying the diagnostics and see what this year brings, considering I need my license.

    Thank you for writing this article.

  16. Mariela

    This article is extremely helpful. Should be the DSM for those including myself who have tried the exam and not passed. I agree with everything posted and the comments. At first I felt hopeless and had a negative attitude towards my results and outcome (what’s the point now) but time has definitely helped and healed and our clients deserve better from us. I would love to receive more information about this topic. Feel free to send me research or any information or tips thank you so much for your dedication to this topic :)

  17. Brae Salmond

    Reading this made me feel a bit better. Even though I didn’t take the NCMHCE, I took the NCE and I did not pass. I feel absolutely how you felt when you failed. I am angry, disappointed and sad and more emotions. I feel as though I am a great counselor. Normally, I do not do well on standardized test because I think it is a horrible way of showing how someone will achieve in their career. Now I have to sit on the sidelines and watch my colleagues move forward while I watch. These next 3 months are going to be a test and I am not ready for it, but I am going to make sure I stay focused and study smarter and not harder this time around.
    Thank you so much for creating this post!

    1. Alyson Carr

      Hey Brae! I’m sorry to hear about your experience with the NCE – both exams are so difficult. Although you didn’t get the results you were expecting on your first attempt, you are so much more ahead of game now than you were before you went into the test simply because you now have a better idea of what to expect. As you said – studying smarter not harder is the way to go. Although the next 3 months may not be easy, try to think of them in terms of what you want them to look like when you reflect on them after you have this milestone behind you. Best of luck on your test in August! :)

  18. Annie

    I took both the NCE and the NCMHCE in order to have the option to work in all 50 states & minimize the loss of time and money. Passed both the first time. Just order the NCE’s study guide. Tells you exactly what to expect.

    1. Alyson Carr

      Congratulations Annie! You were really proactive with taking license portability into consideration – and it sounds like your exam process for both the NCE and NCMHCE were smooth sailing (what a dream!)

      Unfortunately, this isn’t the case for many test takers – as I mentioned in this article, 40-45% of test takers don’t pass the first time. There are so many variables that could contribute to a test taker not passing the exam the first time such as length of time since the they have been in school, rigor of academic program, test anxiety, learning disorder, confusion as a result of english not being ones’ first language, etc,.

      Although the NCE study guide isn’t designed to prepare people for the NCMHCE, it is *such* a great resource for the NCE and for just general practice! Dr. Rosenthal just released his 4th edition of the purple book for the NCE too – very exciting!

      Best of luck to you in your career (that you can take wherever you’d like in the US! hehe:) )

  19. Robert

    Failed five times on the DM section, studied with Dr. Arthurs Materials, Dr. Linton and used Dr Carr define(which were awesome), however this doesnt take away the sting of being a five time failure. I think it is 100% correct when my peers take this test to see it as a challenge to overcome, instead of changing to the NCE. I am not downing the NCE in anyways. I am a retired Soldier who suffered with symptoms of PTSD until I went back to school to get a Masters in Professional Counseling in 2014. I been given the blessing of serving Veterans at the Veterans Affairs and tomorrow I will share with them along with my co-workers that I failed for a fifth time. Thank God for a great wife and kids supporting my efforts, but honestly I cant afford to pay for this test again, but it will happen in August. I can’t afford the on line even though I have been a member basically since 2015. I have taken those guarantee to pass courses but as you can see those guarantee to pass ads or only as good as the paper they are written on. So, I planned to extend my counseling.,com online prescription, use Dr. Carr’s tutoring at least two times and study my butt off. I need help with and I am asking. I consider myself a motivated and somewhat intelligent guy(hell I have five degrees to include to Graduate and have lead Soldiers in combat seven times) why am I failing DM ever time by 8 or 9 points. Dr. Carr and Dr Linnon help, teammates help!!!! Sorry so long, but I cant explain the pain I am feeling today, but this to shall pass. Thanks for the listen and waiting for any positive guidance so I can conquer this Monster in August, 2017.

    1. Jessica

      Hi Robert,

      I hear you, and yes the sting hurts. I just went yesterday for my 3rd exam. I was so confident I was passing this time and felt shocked to see the score that I did not pass by 6 pts on DM. Sure, I felt disappointed, upset, angry, unbelief, doubt, and confusion. I went to sleep crying last night. It felt like a bad break-up. Not a good feeling. Today, I woke up and had to really tell myself, get your SH*T together. I meditated in the morning and knew I would take today off from studying and spend quality love time with my 5 yr old daughter and that’s what I did. I am going to get back into my groove this week and study again to take the test again in 3 months. Why? Because I am going to continue to try and try and try again. A test does not define you. and the work that you do on a daily basis. YOU HAVE LED SOLDIERS IN BATTLE AND HELP / SUPPORT VETERANS NOW. Your work is not done. Continue feeling your blessings. Sometimes our blessings are disguised. When we look back we are able to see/feel/ understand why we had to go through what we did. The fact that you have taken it 5 times shows that you are a warrior. Many successful people have failed numerous times before getting to the success they wanted. When you get your certificate, it will not show how many times you took the exam. You’ve got this!. We’ve got this. Let’s do this. MANY BLESSINGS ON YOUR EXAM.

  20. lorri

    Hello All. I am having problems on the IG section of the test. If anyone could comment on how to improve in that area it would be greatly appreciated.

    1. Alyson Carr

      Lorri, sometimes getting out of your “real life” brain, and thinking in black and white terms can help here. Often, when test takers struggle with the IG section it’s because they are asking questions and exploring things they would as part of their standard real life protocol, but that don’t necessarily align with what the test is looking for. Good luck!

  21. Alison McAllister

    Well as a fellow Alison I am glad that I read this! I am nervous about taking this exam. I do have testing anxiety that I have not learned anything. lol

    1. Alyson Carr

      Don’t forget that you always know more than you think you do, name twin. :) Keep that anxiety in check on test day, don’t let self-doubt compromise your ability to think clearly!

  22. Karen P.

    I am quite frustrated at the timeframe of the exam. I just failed my exam for the 3rd time, having done worse than the other 2 times(even though almost passed 2nd time). Was so much more prepared with Diagnosis than prior times/interventions/ethics. Ran out of time again, as I did the first time. Was told the timeframe was reduced in 2016 to 3 hours instead of the previous 4 hrs. I am concerned with only 3 hours I may never pass the exam. Thoughts anyone?

    1. Alyson Carr

      Have you considered applying for special accommodations that may grant you more time? I would suggest contacting Pearson VUE by phone to ask what steps need to be taken. I have worked with many test-takers who require additional time for a number of reasons (dyslexia, vision impairment, brain injury, ADHD, english is a second language, etc) and Pearson VUE has been informative and accommodating to those that I have worked with. I hope this is all behind you soon – good luck.

  23. Karen P.

    Thank you for your reply. I have contacted NBCC and no accommodations are allowed without documented disability. I do not have one. Just have always been a less than speedy reader, slower test taker, and I am 51. Since it sounds like you passed the exam in 2015 or earlier, do you happen to remember how much extra time you had left when finished? I have read a number of people finishing within 3 hours, 3 hours 15 minutes, 3 hours 30 minutes, and yet NBCC tells me that test takers were not utilizing the 4th hour. I am frustrated and at the cost of $300 each time, not sure if I will retake.
    Love my job though!

  24. John Spinella

    All certification tests are designed for failure. It’s all about the money. When certain certs become popular, seddenly the price goes up. My daughter just took this exam and failed (again) and it’s very discouraging. They always raise the bar, changing the criteria, make study material expensive and intentionally make questions deceptive in order to lower the pass rate. This test has a higher than 45% failure rate and for an occupation that people depend on, that’s high. Now, with state requirements and time not on my daughters side, she will loose her job, have to reapply under supervision, reschedule a rigged test and keep trying. As someone in the IT industry for over 40 years and well versed in certifications and the rigged system, it’s sad to have to watch my daughter go through this.

  25. Chloe Golden

    I am about to take the exam for the first time in a month. I am using and they always indicate when my choice was correct or incorrect. Do you get that indication (I know you don’t get the point value) that you’ve selected one of the correct choices on the actual test?

    1. Karen P.

      When you must pick a decision making question choice(usually one option only) the test will tell you when you have arrived at that one correct answer…by telling you…continue to next screen or simulation. If you have picked incorrectly…simulation will tell you to keep going and…make another selection. Keep in mind when you have to make another selection…you have just lost points you had already gained.
      On information gathering questions…you can continue to keep choosing…but the test will tell you for example…correct selection…noted…intervention used…and will also supply you with additional information at that time. Of course choosing an information gathering choice that is…not suggested…not used…will also subtract points from current score.
      Having been researching study materials…Dr. Arthur shares some strategy within picking choices in information gathering questions…he says that usually half of the choices are correct or +1 half or -1 half. That allows you to move on instead of mulling over choices not clicked on and wasting valuable time. This is the NCMHCE I am speaking of.

  26. Jennifer Leavitt

    If anyone has taken both NCE and NCMHCE, which one felt easier? Just curious.

    1. Karen P.

      The NCE is absolutely easier…much more content, diagnosis, ethical questions, the counseling process from start to finish with actual clients on the NCMHCE, and the timeframe as I mentioned in previous question is too short.

  27. Alison Miller, MSN, RN-BC, CNE

    A wonderful, well-written article about test preparation mindset and coping with failure. I’m going to share this link with my RN students who are prepping for the ANCC Psychiatric Mental Health Exam to become Board Certified. It has much to offer them as they face their fears. Thanks, Alyson!

  28. Samantha King

    I have failed the NCMHCE twice. The first time I FAILED the IG by 6 points and the DM by 23points. The second time I PASSED the IG by 9 points and FAILED the DM by 19 points. I was thinking about taking the NCE this third time around but I was so close this past time when I took the NCMHCE. Thoughts and opinions anyone?? I could really use a boost of confidence…… NCMHCE or NCE this time?? What study guide or tips……

  29. Ashley

    I just took the exam today for the first time and failed it by 2 points on the DM section. I am sad/mad today. I know I need to press on to pass it. Just feeling all the feelings today. I truly feel I was prepared. I have been studying my butt off. My daughter started crying last night because she realized if I didn’t pass today I would need to take it again. In her words through her tears, “we will have to keep going through this until you pass?” I am trying to tell myself that a lot of smart/competent people don’t pass, I am just really sad today.

    1. Monica


      I feel your pain, I failed by a lot more than 2 points and I was crushed. We have to continue to press forward. I just happen to see this article and your post and both inspired me. I was so hurt but yet not well prepared for this test. I know this is what I am supposed to do but another set back I cannot take. I will be better prepared the next time. Good luck to you and keep your head up bc you are not alone.

  30. Mike

    I failed the MAC licensure exam for the 2nd time yesterday and I’m devastated. I shut down, said I’m done and stormed home. I have studied for so long, paid so much money, prayed so hard, I don’t understand! I used Momentrix study guide and there was NOTHING on the test that i studied in that book. Now that i have calmed down, I’m considering taking the test a third time. Does anyone know of study materials that will not only help but actually be on the test?

  31. Sandra

    Hello everyone. I took the exam today and failed the dm section by 2 points. I did not think the test was really hard and was surprised that I failed it. I spent the remainder of my day crying, angry at myself, and being ashamed that I failed it and will now have to wait 3 months before I can retake it. I’m not going to give up and thank all of you for instilling hope in me again and realizing that I am human. Does anyone know if they give you the same exam when retaking it?

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