Five types of mental health therapists & the services they provide

If you’re searching for a mental health provider, chances are you’ve stumbled across a lot of different terms, degrees, licenses, and a lot of different letters after names. These can be downright confusing unless you work in the mental health world. Below is your quick and dirty guide to what all these terms and letters mean, and some things you need to know about each.

Finding the right therapist for you is the difference between getting the results you want and finding yourself frustrated and fed-up.

Doctoral-level providers: psychologists and psychiatrists

There are generally two types of doctoral-level providers specializing in mental health. You may find some others out there from time to time, like doctorally-prepared counselors. Keep in mind that a doctorate degree is the highest level of education that exists, and therefore these individuals will have the most extensive training and are most likely to have sub-specialty areas of practice.

Psychologist: Ph.D. or Psy.D.

In your search, you may have come across potential people to work with who are called “licensed clinical psychologists” or LCPs. Or maybe you were referred specifically to a psychologist. But what is a psychologist? And why would you want to work with one?

A psychologist is someone who has a doctoral degree (that’s the highest degree one can earn) from an organized, accredited university or professional school. A psychologist is not the same thing as a counselor, masters-level clinician, etc. as you’ll see below. To become a psychologist, a person must complete a bachelor’s degree, and then complete an additional 4-6 years of education and practice specializing in mental health, followed by a year of full-time work and training practicing under supervision. Most psychologists also have completed extensive research and have published peer-review journal articles in their sub-specialty topic.Then, depending on the state, they must complete an additional one or two years of supervised practice before they can become a Licensed Clinical Psychologist. Most clinical psychologists also complete an additional 1-2 years of postgraduate training called a postdoctoral fellowship, if they want to become a sub-specialist in a particular area. All together, licensed clinical psychologists have at least 6-10 years of mental health training and education when they begin their careers.

Because psychologists have such lengthy education and practice requirements, many are able to develop competencies above and beyond the standard, basic mental health treatment stuff. Many psychologists are experts in niche areas like sleep, adjusting to disability, evaluating and assessing dementia, etc. For this reason, it’s important not to just pick any psychologist - you’ll want to find one who sub-specializes in your specific concern.

Clinical psychologists can diagnose and treat mental health conditions, but they can also do something else called neuropsychological or psychological evaluation. This means they’re able to use scientifically-valid tests and measures to correctly identify a diagnosis and make recommendations.

I am obviously biased because I am a Licensed Clinical Psychologist, but I recommend that if you have access to one and/or can afford one, you choose a psychologist for your treatment because they have been through the highest level of education and rigor in their training. For instance, if your insurance only covers a certain number of appointments, you may as well see the most highly qualified provider you can. Additionally, if you are paying out of pocket, seeing someone with a lower fee may seem like a better idea, but in reality you may see someone who doesn’t have the skills to address your specific concerns, and it may take more sessions to see the results you wanted. Or, if you have very specific concerns (like you’re feeling depressed and you had a recent stroke) they may not be able to help you at all.

In some states, psychologists prescribe medications for mood, but as of the time of writing, most psychologists do not do that. If you’re interested in medications, scroll down to read about psychiatrists and other medical providers.

Psychiatrist: M.D. or D.O.

But what if you were referred to see a psychiatrist? What the heck is the difference?

A psychiatrist is a physician (a medical doctor) who completes medical school like any other physician, and then completes four years of on-the-job training to specialize in mental health. Because they have a medical degree, psychiatrists can order laboratory tests and generally approach mental health from a medical perspective, meaning they’re going to focus on the physical aspects of mental health problems. Psychiatrists can treat mental health concerns via prescribing medications, and some, depending on their training, do psychotherapy (talk therapy, like what you imagine when you think about going in for therapy). Psychiatrists also can conduct interventions like electroconvulsive therapy, if that is needed. Although you may be able to get medications for mental health from another type of provider, it’s usually recommend you see a psychiatrist if one’s available to you, as other types of medical providers have less training specifically in these classes of medications. Psychiatrists and psychologists often work together. For instance, if you need an evaluation, would like to try medication, and you’d also like psychotherapy, a combination of working with a psychiatrist and psychologist would be a good fit.

As a side note, there are other types of providers who may have doctoral degrees but not identify as a psychologist or a psychiatrist. For instance, some counseling education programs have doctoral-level degrees. Many of these programs identify as “counseling psychology” programs which essentially means they approach the idea of training to become a psychologist through a different model. For your purposes, if you find a doctoral-level counselor you’d like to work with, they should have roughly the same training as a psychologist, but may not have completed research. Just ask, “what degree do you hold?”

Masters-level clinicians

There are multiple types of masters-level clinicians who can do psychotherapy. I’ll go through a few of the most common ones here. In general, these individuals have completed a two-year degree in their field in addition to a bachelor’s degree, and generally don’t have sub-specialty training. However, because they have fewer years of training under their belt, they can be cost-effective. Someone who has a master’s degree and not a doctoral degree might still be a great therapist for you, depending on what you need.

Licensed clinical social workers: LCSW

Social workers are masters-prepared clinicians who may have specialized in either individual treatment, or more macro-level stuff like policy and management. Let’s just focus on the social workers who specialize in individual treatment. These individuals must complete a bachelor’s degree and then spend two years in a combination of classwork and applied training. They generally take at least three specialized classes in psychotherapy, but many may take more. They also must complete between about 200-600 hours of supervised practice before they can receive their license, depending on the state. LCSWs are probably easier to find than doctoral-level providers, because there are more of them. Therefore, an LCSW can be a good fit if you’d like to see someone in person but live in a rural area with limited access to mental health providers. LCSWs focus on treating general mental health conditions, like depression and anxiety. Their training does not extend to sub-specialty areas, but some, over the course of their careers, may develop a sub-specialty area through additional on-the-job training and continuing education. LCSWs cannot prescribe medications.

Marriage and family therapists: LMFT

Marriage and family therapists (MFTs) are masters-prepared clinicians who specialize in treating what’s called the “family system” around someone who has mental health symptoms. They receive specialty training in marital and family therapy techniques, which they can use even if there’s only one person in your family who seems to be having symptoms. You’d be surprised how many factors within a family can actually make one person’s seemingly individual concerns worse. If you want to go to therapy with your spouse or with your whole family, an MFT might be a great fit for you. They usually have two years of training and then must complete supervised clinical experience for another year or two, depending on the state, before earning their license. LMFTs cannot prescribe medications.

Licensed mental health counselors: LMHC or LPC

Mental health counselors are also individuals who have completed a bachelor’s degree plus two additional years of training in mental health treatment. They must have completed six semester hours or ten quarter hours of supervised field experience. Like clinical social workers, they can identify mental health symptoms and treat them using individual psychotherapy. They usually do not have a sub-specialty area, and usually have not conducted research. LMHCs cannot prescribe medications.

So what’s a therapist?

A therapist is a general term that’s given to anyone who is practicing psychotherapy with a valid license. Everyone listed above are considered therapists because they are licensed mental health providers. Your “therapist” might be an LMFT, a psychologist, a psychiatrist, or anyone else with a valid license. Don’t get confused between “counseling” and “therapy.” Some providers will call what they do for you counseling, others will call it therapy. Although there are still some die-hards out there who feel these are different things, most modern, well-trained mental health professionals will pick the technique that best fits your symptoms and presentation. Don’t get caught up in these weird terminology issues - the most important thing is choosing someone with whom you have a good working relationship.

Are there any other options?

Family Doctors: M.D., D.O., P.A. or N.P.

Absolutely! One good option to start with is to see your general family physician, or your primary care provider (PCP). This person can ask you some super-simple, very basic screening questions to help you decide if the symptoms you’re experiencing might warrant further work-up by a mental health professional, and they can give you a referral to see someone. Your PCP can also prescribe some very basic medications, like antidepressants. The benefit of this is that since most people have access to a PCP, medications are widely available, even to those who may not live near a psychiatrist. However, keep in mind that PCPs are not mental health experts, so I usually recommend following up with a psychiatrist plus a therapist even if you get medication from your PCP, in case you want to change medications, or have side effects you didn’t anticipate.

Life coaches

Lastly, I want to touch on the idea of “health coaches” or “life coaches” for a second. Life coaches are unlicensed coaches you can hire who are not regulated by any state or national boards. This means they can say whatever they want about their services, can promise anything, and do not have to adhere to any ethical or legal standards. There may be some really wonderful life coaches out there, and if you find one you’re working with and you’re having amazing results, then great! However, I’d be extremely cautious with these individuals. I once went to dinner with a life coach and he told me about some of the advice he offers his clients. Some of it was harmless but probably not going to be helpful, and some of it was downright dangerous. When it comes to your brain and emotional health, you really don’t want to take chances. Make sure you pick someone with a valid license to practice.

Now, get out there and do the important thing - find the right mental health professional for you, and start treatment. Mental health concerns are not something you “just have to live with” and there’s always hope.

Be well,