thoughts from a therapist

Quick summary: My intention is to give you a horribly over-simplified definition of all those terms that you may find when you are looking for a mental health worker. I will give you an easy to understand definition of what the difference is between a Psychologist, Psychotherapist, Psychiatrist, Social Worker etc… I must add this disclosure up front – there is no strict definition nor is there any way to accurately state the specific functions of any of these mental health care workers. The specific abilities or specialties of any mental health worker vary greatly depending on their: personality, school they went to, age, education outside of college etc…

 

Mental health care workers are required to attain continuing education credits every year in order to keep their licensure… this means that all people in the field are required to continue their mental health education long after they graduate from university.

 

Mental health care workers all have there own individual interests which encourage them to study material outside of their specialty area.

 

• A psychiatrist could have twenty years of experience and education in teaching mindfulness – there title still remains simply psychiatrist.

 

• A social worker could have thirty years supporting her patients with chronic mental health conditions in staying properly medicated… she may know more about pharmacology (the effects of the medications) than 90% of psychiatrists, but she will still be labeled a social worker.

 

The point is that Mental Health terms in no way tell the full story about a professional.

• It is not my intention to imply that one group has one skill and does not have another skill…

 

Again I am giving you generalizations here…

 

• A Psychiatrist is the only one on the list that is a medical doctor = MD – they are the only ones on the list who prescribe medication.  
  • (All went to med school and most did not go to a counseling program – this has changed – an older psychiatrist might have been required to do both).
  • If a psychiatrist is also a psychotherapist, then the doctor generally had to attain their counseling ability separate from their doctoral degree (they may have a MD and an MA in Counseling for example… this is not horribly common as a psychiatrist will make more money prescribing medication).
  • In is very common for a psychiatrist to work in collaboration with a psychotherapist – research has shown that for some conditions it is most advantageous to have both interventions concurrently.

 

• Psychologists are required to write a thesis for their doctoral degree and generally have significantly more experience with research and University level teaching (conducting research, statistics, assessment etc).
  • A Clinical Psychologist can conduct more assessments and research than others in the field (if you want to have an IQ test or a psychological evaluation done it is best to look for a psychologist).
  • Psychologists have a doctoral degree = PhD or Psyd.
  • The field of psychology is gigantic – not all psychologists are in anyway concerned with psychotherapy.

 

• Social workers abilities are extremely broad – some SW schools focus more on case management and larger community based assistance and some schools focus primarily of psychotherapy.
  • Social workers typically have an advanced education in what I will call social ecology – they understand how society, culture, family, environment, and individuals interact and affect each other.
  • Social workers tend to have the most knowledge related to community resources.

 

• Master’s level therapists abilities are also broad – they all receive training in conducting psychotherapy, but some schools are catered towards very specific vocations (ex. forensic therapy, school counseling, couples counseling etc).
  • Masters level therapist all receive an education in conducting individual psychotherapy (this is not always a requirement for the other fields though many in the other fields have an education in psychotherapy – I know this is horribly confusing).

 

• Marriage and Family therapy – This is a specialty in which a counselor will have an advanced ability to conduct therapy with more than one client in the room – the theories and interventions are slightly different. Most graduate programs still do not require their students to learn about couples and family therapy.

 

• Psychotherapist – anyone who conducts psychotherapy. Not all states regulate the practice of psychotherapy… in such an instance anyone can call themselves a psychotherapist.

 

• Coach – A coach does not yet have a standardized definition – generally coaches are more willing to give advice. There are currently some new schools which are graduating professional coaches… historically coaches did not necessarily have any one specific type of standardized education (anyone can be a coach).

 

• Therapists…counselor… psychotherapist – these terms are interchangeable – they are all the same.

 

• LMFT – Licensed Marriage and Family Therapist
• LPC – Licensed professional counselor
• LSW – Licensed social worker
• LCSW – Licensed clinical social worker 

 

• The licensed therapist/counselor must have a masters degree or higher (PhD or PSYD), and must have completed the requirements of the relevant state’s department or regulatory services.

 

• PhD – Completed a Doctorate program
• PsyD – Completed a Doctorate in Clinical Psychology
• MA or MS – Completed a Masters Degree program
• MD – Completed a doctoral degree in medicine

 

•   (the letters do not indicate what field the degree is in)

 

• Licensure – Most states have a Government run regulatory body which grants licensure to mental health professionals. The intention is good, but the follow through is not always great.
  • The ideal would be for licensure to be achieved as a result of displaying competence – we have not yet arrived at this ideal.
  • There are many professionals who are granted a license simply by completing their degree… others have post degree requirements.
    • For example, in my state a social worker receives a license (LSW) for completing their master’s degree… they may use their license for billing purposes related to psychotherapy. Not all social worker attend school to learn psychotherapy – Social workers are responsible for a significant amount of social assistance tasks.
    •  A Clinical therapist does not receive a license when they complete their Masters degree… they cannot bill insurance or Medicaid for psychotherapy services. All clinical therapists attend school to learn psychotherapy.

• The post degree requirements generally are related to conducting mental health services, but they are not always related to conducting services in a professional’s specialty (ex. it is very common for people to meet their licensure hours related to psychotherapy while working in behavior modification programs). 
• Some universities offer a very good education in conducting mental health services, but they lack accreditation – for graduates from unaccredited school it can be very difficult if not impossible to attain a license though they possess the ability to conduct mental health services.
  • (Most online schools have managed to gain accreditation… many small universities have not = this is largely do to financial constraints.)
• What does a license tell you about a mental health professional? There is no one good answer – you would have to ask.
  • (People have radically different viewpoints on this – there are many that would be furiously against this opinion – they would suggest that licensure adequately measures competence – there is no research to support this.)

 

What about all the other letters like CAC (certified addictions counselor)?

• There are certain programs that a clinician can pay for to receive extra letters at the end of their title – these letters are meant to indicate a specialty.
• Unfortunately, these letters are not very helpful as most specialties still do not have their own special letters… and there are also many people who have a specialty but they did not pay the extra money for the letters (there are professors who ‘wrote the books’ on specialties, but do not have specialty letters).
  • Like licensure, it is a good and necessary idea that has not received adequate follow through from the regulatory agencies.

 

So who is right for you? – read my post on finding a therapist for more helpful information…

Please don’t be discouraged – the letters and labels might not be as helpful as you would like them to be, but almost all mental health professionals are perfectly willing and able to tell you everything that you need to know about how they can best help you.