If you’ve ever searched for a therapist, chances are you’ve been completely confused by the various acronyms attached to the names of potential clinicians. It’s enough to be cross-eyed.
I wrote about how to find a therapist it fits you well Depending on your the background and needs. I didn’t intentionally go into various licenses in those pieces, because ultimately the most important part of the job is the energy that exists between you and your therapist, not the type of program they’ve completed.
However, credentials are still important.
A reader asked us about this confusing alphabet soup: Can you explain the differences in all the different mental health providers, in terms of qualifications, education levels, capabilities, and why go to one or the other for evaluations, therapy, costs, etc.?
I sure can!
This section will be a primer on the therapeutic credentials you will most commonly encounter in California, but there will be a lot of overlap with other states. So take a look at what training each type of license requires and what each type of therapist can and cannot offer.
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What the Different Therapeutic Credentials Really Mean
Before we get into the nitty-gritty, it’s important to note that therapists have very different levels of experience.
For example, I am an associate clinical social worker; the associate part of my title means that I work toward licensure and provide therapy under the supervision of an experienced clinician. But functionally, it’s the same job, I’m just a little greener than fully credentialed therapists. So if you see an associate in someone’s title, it just means they’ve completed a master’s degree from an accredited program (during which they gained hands-on experience providing therapy or other clinical services) and are working toward the 3,000 or so hours they need to become licensed.
I got through a lot of time with a female therapist when I was younger, and I know many other people who have too. The experience level can really make a difference when it comes to the quality of therapy you receive, but if you feel comfortable with the person and/or want to spend less, don’t let the word associate scare you.
With that said, here is a summary of the credentials:
Psychiatrist (med.): Psychiatrists attend medical school for four years, including a clinical rotation in psychiatry, and then they complete three to four years of psychiatric residency, usually in a hospital. Psychiatrists are the only mental health professionals in California who can prescribe medication.
Psychiatrists traditionally also provided psychotherapy, but this is less common today. The number of psychiatric visits that include psychotherapy lasting more than 30 minutes has been steadily declining since the mid-90s. Now, only 11% to 15% psychiatric visits include complete therapy. Psychiatrists who specialize in therapy tend to treat patients with long-term depression, anxiety and personality disorders, according to the research.
Psychologist (PsiD, PhD): All psychologists have doctorates, which usually involve four to six years of academic preparation, followed by one to two years of full-time supervised therapeutic work. In addition to psychotherapy, psychologists can provide psychological assessments, such as ADHD and autism diagnoses.
Training for PhDs in psychology is broader and has an emphasis on research and theory; those who follow this path most often engage in academic or private practice. PsiD programs are designed to prepare students for the practice of psychology, with concentrations in clinical, counseling, or school psychology. Psychiatrists get more face-to-face experience with patients early in their careers.
Licensed Marriage and Family Therapist (LMFT): LMFTs have a two-year master’s degree in psychology, counseling, or marriage and family therapy. To be licensed in California, they must also complete 3,000 hours of supervised clinical experience (most of which occurs after graduation).
LMFT training emphasizes practical experience, clinical theory, family dynamics, and support for people facing relationship challenges of all kinds. They work with individuals, couples and families.
Licensed Clinical Social Workers (LCSV): LCSVs have two-year master’s degrees that train them in both social work and counseling, and like LMFTs, they must have 3,000 hours of supervised clinical experience to become licensed in the Golden State.
LCSVs are trained to take a person-centered approach in therapy client settings, meaning they are more inclined to recognize that a person’s mental health cannot be separated from their social context (such as their socioeconomic status, age, race, gender, cognitive and physical ability , the community they live in and so on). Because of this systems-level thinking, LCSVs often work in community mental health settings. They can also work with individuals, couples and families in private practice.
Licensed Professional Clinical Counselor (LPCC): LPCCs typically earn a two-year master’s degree in clinical psychology or counseling, which can range in focus from college counseling to therapy in clinical mental health settings or private practice. As LCSVs and LMFTs, they must acquire 3,000 hours of supervised clinical experience.
After licensure, LPCCs have the option of completing additional educational requirements to work with families and couples.
Understanding a potential therapist’s training and experience is important, but it’s only one part of making an informed choice. If you’re torn between PsiD or LMFT, for example, and feel much more comfortable talking to an LMFT, don’t discount that connection just because the other person has a Ph.D. Many clinicians with master’s degrees go on to advanced training in various specialties and modalities, so that should be asked as well.
What are your experiences working with different types of therapists? Write us.
Till next week,
If what you learned from these experts today resonated with you or you’d like to share your experiences with us, please email us and let us know if it’s okay to share your thoughts with the wider group therapy community. Email GroupTherapy@latimes.com comes right into our team. As always, find us on Instagram at @latimesforiourmindwhere to continue this conversation.
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Group therapy is for informational purposes only and is not a substitute for professional mental health advice, diagnosis or treatment. We encourage you to seek the advice of a mental health professional or other qualified health care professional regarding any questions or concerns you may have about your mental health.
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