Therapeutic Mentoring: A Scalable Solution to the Youth Mental Health Crisis
by Alexandra Werntz, PhD
Licensed clinical psychologist
Associate Director, Center for Evidence-Based Mentoring
Director of Research, MentorPRO
We are in the midst of a youth mental health crisis. While 20–30% of young people need mental health support, far too few actually receive it. The challenges are even greater for youth from under-resourced communities and those from ethnic and cultural minority backgrounds, who face significant disparities in access to care compared to their more privileged peers. One major barrier is the difficulty accessing highly-trained professionals—psychologists, psychiatrists, and counselors—who are not only in short supply but often costly and, at times, not culturally aligned with the families they serve. To address this critical gap, we must think creatively about expanding the mental health workforce. Trained and well-supervised therapeutic mentors can be an essential part of the solution, offering meaningful support to youth who might otherwise go without help.
In Dr. Jean Rhodes’ recent Editor’s Blog, Does All That Training Matter?!: New Study Compares Professional Helpers to Paraprofessionals, she describes findings from a new review comparing paraprofessionals to highly-trained helping professionals. The results are relatively consistent with the seminal Durlak (1979) article, suggesting that paraprofessionals can be effective mental health providers in some settings. The new article by Smith and colleagues (2024) found that in community mental health settings, where services are provided to children and adolescents, paraprofessionals demonstrated a significant effect on mental health outcomes.
What is therapeutic mentoring?
Early descriptions of therapeutic mentoring draw from both humanistic and psychoanalytic therapy traditions, emphasizing personal growth, emotional connection, and the importance of the therapeutic relationship. By the 2010s, therapeutic mentoring began to gain recognition, particularly as it became a Medicaid-billable service in some states for youth with behavioral health needs. Massachusetts was an early adopter, driven in part by the Rosie D. v. Romney lawsuit filed in 2001. This case was brought on behalf of Medicaid-eligible children with emotional, behavioral, or psychiatric disabilities who were not receiving essential home-based services. In 2006, the court ruled that Massachusetts had violated the provisions of the federal Medicaid Act by failing to provide these services. As a result, Massachusetts was required to create and implement a plan to expand access to home-based care for youth. This plan included the introduction of several services, including therapeutic mentoring. By 2009, Massachusetts launched its Children’s Behavioral Health Initiative, officially integrating therapeutic mentoring as a Medicaid-billable service when prescribed as part of a youth’s treatment plan.
Dr. Rhodes and I currently teach Therapeutic Mentoring as an undergraduate psychology course at the University of Massachusetts Boston. This is part of a three-course series approved by Massachusetts as a certified Community Health Worker (CHW) program with a specialization in therapeutic mentoring. The program is a component of the broader Transforming Access to Boston Area Mental Health (BAHM) initiative, funded by the Boston Public Health Commission. Upon completing the courses and required supervised hours working directly with youth in Boston, students are eligible for certification as Community Health Workers. Teaching this course has been a unique opportunity to train future therapeutic mentors, refine essential skills and techniques for their practice, and reflect on what is most critical for their professional development.
The evolution of therapeutic mentoring marks an exciting advancement in community-based mental health care, offering a promising approach to support youth. However, despite this progress, significant challenges remain in achieving widespread implementation and consistency. For one, there is no universally accepted definition of therapeutic mentoring, which creates ambiguity about the role itself. Additionally, the absence of a nationally recognized license or certification makes it difficult to establish clear professional standards. Without this role clarity, there is also a lack of standardized training and supervision models, which are essential for ensuring mentors are prepared to deliver high-quality, effective support.
Given the potential of therapeutic mentoring to expand access to mental health services, particularly for marginalized youth populations, a precise definition is crucial for advancing the field of what therapeutic mentoring is and is not. At the Center for Evidence-Based Mentoring, we assert that the term therapeutic mentoring should be used to describe a distinct type of mentoring program that:
1) explicitly focuses on reducing negative mental health symptoms and increasing psychological well-being and thriving among youth;
2) is delivered by paraprofessionals;
3) uses evidence-based practices to target underlying mechanisms of mental health challenges; and
4) is supervised by licensed mental healthcare providers.
New course from the Center for Evidence-Based Mentoring
Dr. Rhodes and I are excited to announce our latest training program in partnership with MentorPRO Academy: The Center for Evidence-Based Mentoring’s Certification in Therapeutic Mentoring. This course will cover the essential skills for therapeutic mentoring: common mental health challenges and their evidence-based interventions, ethics of mentoring, cultural humility and taking a strengths-based approach, basic cognitive behavioral and motivational interviewing skills to support young people, and collaborating with a care team and parents/guardians. This virtual course will meet for an hour each week for 12 weeks. Each session will be a combination of live didactics, interactive role-plays, and in-depth discussions. At the end of the course, learners will have to pass a one-on-one oral exam with me, the instructor, via Zoom to receive the certificate. To our knowledge, this is the first training program of its kind. We are excited to partner with programs and professionals to disseminate this treatment model.
If you are interested in learning more about this training opportunity, please visit our website.
As a licensed clinical psychologist, I am excited about the opportunity to expand access to mental health services while also creating pathways for professional development for those interested in helping professions. One of the challenges clients often face in traditional therapy is staying motivated to apply therapy skills in their daily lives. Even when they remember the skills, factors like low motivation or negative attitudes can interfere with implementation. For example, I often work with youth who struggle to engage in basic self-care activities, such as taking daily walks or reflecting on their thoughts and feelings. This is where therapeutic mentors can make a significant difference: by meeting youth in their homes or communities, therapeutic mentors provide hands-on support and encouragement to help them practice these activities between therapy sessions. This consistent, real-world reinforcement can drastically improve outcomes and may even reduce the number of sessions needed with highly trained professionals.
As a therapist, I wish my job weren’t needed—I wish all youth could thrive without therapy. But until then, therapeutic mentoring offers a powerful way to increase access to care and enhance the effectiveness of mental health support.
