Therapist vs. Psychologist: What You Need to Know

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There’s a lot of confusion around the different types of mental health providers out there. This can make it hard for a new client to decide if you should work with a therapist versus psychologist, or a psychiatrist. This post will help clarify the most important distinctions.

There is a lot overlap between the mental health professionals. Many of the terms you hear most often don’t solely apply to any specific degree or designation.  For example, the word “counselor” isn’t generally regulated in most states or jurisdictions. This means that all kinds of people might be able to refer to themselves as a counselor. Similarly, many different disciplines use the term “therapist”. Most often, we think of therapists as those who help clients work through life concerns or mental health conditions that impact their daily functioning.

How to Know What Provider You Should Work With (Which Therapist is Right for You?)

Different providers offer many similar services, but many offer specialized services due to their training and experiences. All of the disciplines below may be helpful on your journey towards mental health. They each offer different specializations, or a focus. There is a lot of variability between skill sets of counselors themselves as well. Here is a general rundown of the different types of mental health professionals you might come across:

Licensed Mental Health Counselor

This is a relatively new designation in the mental health field. The term Licensed Mental Health Counselor (LMHC) refers to someone who has completed graduate degree(s) in counseling psychology, focusing on the practice and application of skills for psychotherapy.  Most LMHCs have to complete thousands of hours of post-graduate training in direct supervision. Then they can become independently licensed to practice therapy. This period allows for supervisors to give ongoing feedback about the individual provider’s client care practices. They (like most in this article) must pass a licensing exam and regularly re-certify with their state board of professions. In certain states you might see the terms Licensed Professional Counselor (LPC) or something similar. Titles often varies by state.

Licensed Mental Health Counselor Limited Permit

This provider is someone who has the same education as a LMHC but is not yet able to independently practice therapy without supervision from a LMHC (or higher, like a psychiatrist). Further education and direct supervision, along with passing a licensure exam, is required before a LMHC LP can become a fully independent. Some states have a similar structure with Licensed Professional Counselor and LPC Interns.

Licensed Clinical Social Worker

An LCSW is someone who practices social work services and therapy. LCSWs are very similar to LMHCs. In many states they have similar experience and post-graduate training requirements for licensure. One main difference is that LCSWs often have the option to choose from many different tracks or specializations in graduate programs. Often their focus isn’t solely on becoming a “therapist,” but more of a social services provider overall. They may take courses in community organizing, policy implementation or legal advocacy. LCSWs may have more specialized knowledge in accessing local supportive services like entitlements (social security, disability, entitlements, etc.). However, this differs by program and by person.

Social workers may help their clients with case management services such as filing benefits paperwork, depending on the work setting.

*Note: Some states use the designation LICSW to mean Licensed Independent Social Worker which is similar to the term LCSW.

Licensed Master Social Worker

A LMSW has the same education as a LCSW but can not practice without supervision from an LCSW, similar to LMHC Limited Permit holders. LMSWs need more education and supervision (along with passing another licensure exam) to practice independently as LCSWs.

Psychologist (PhD, PsyD)

Psychologists are doctoral level therapists who have completed even more advanced coursework in psychology and human development. There are also a lot of options for these providers. A PhD level provider may not focus on direct client care (providing therapy). They often work in teaching, counselor education and research. PsyDs (Doctor of Psychology) are doctoral level providers who focus on the application of direct mental health services like therapy. However, they may also conduct, or participate in research.

One big distinguishing factor is that doctoral level providers, like PsyDs, require research projects for completion. They also routinely administer psychological exams for educational testing, placement and forensic processes. If you are looking for someone who can test a child for autism or ADHD, a psychologist would be best due to their testing skills.

Psychiatrist (MD)

Psychiatrists are medical doctors (physicians), with special knowledge about the human body and how to respond to various medical issues. They attend medical school in order to become providers at this level. Some psychiatrists are therapists in that they provide therapy services to some clients. For others, they may only provide medication management services by providing prescriptions for their clients.

(Psychiatric) Nurse Practitioner

PNPs are psychiatric nurses who require graduate level education. They can also diagnose and prescribe medications for clients. Typically, PNPs receive graduate training in nursing and complete an additional certification to treat mental health conditions. They are less common than many of the other providers listed here. However, they are often more readily available than psychiatrists who often have longer wait times.

What does this mean for the type of therapy I may receive?

All of the providers here may provide therapy. Typically masters level providers (LMHCs, LCSWs) have greater availability and focus in providing direct care to their clients. Psychologists, especially PsyDs, also focus on the practice of therapy, but generally exist in lower numbers. Psychiatrists and PNPs don’t often spend a lot of time providing therapy, and often focus on medication management.

All these providers can help you on your journey towards mental health. It’s most important that you find someone who you can connect with. Hopefully, this information provides further insight on what to expect when you’re on your search for a therapist.

If you’d like to work with a Viva therapist on recovering from a relationship misstep, please feel free to reach out to us

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