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The different types of therapist licenses explained

MFT, LCSW, PsyD, PhD - what does it mean when looking for a therapist? Sure, a set of letters after a name lends confidence to anyone who is doing research on potential therapist options, but navigating the various acronyms can make an already-scary process feel down right overwhelming. Finding the right mental health care professional is easier when you understand what these letters mean when it comes to their licensing and credentials. Above all, it’s essential that you find someone that you feel comfortable with - their training is only the beginning.

First of all, it’s important to remember that all these accreditations serve an important purpose. Going to see a therapist is very different than talking to a friend -- the education a therapist receives allows him or her to better engage with clients to understand their full perspectives and pull appropriate tools to address those needs and create lasting change.  

A rigorous licensing process ensures practitioners have the appropriate training to best serve your needs. Plus, it’s important to know that this (or any other) medical professional has been properly evaluated and adheres to your state’s regulations in the field in terms of competency, qualifications, ethics, and business practices. Unfortunately, that’s where things get complicated.  The National Alliance on Mental Health explains that many types of mental health care professionals can help you achieve your therapy goals. They operate under a variety of job titles—including counselor, clinician, therapist or something else—based on the treatment setting. And variations exist state-by-state (the points below are most relevant for California, where reflect is headquartered).   ​ To practice, clinicians must hold a Master’s degree (Master of Science or Master of the Arts) or Doctorate (PhD, PsyD) in a mental health-related field such as psychology, counseling psychology, marriage or family therapy, among others.

Here, the licensure and certification designations can include a variety of additional acronyms to indicate specifics which can vary by specialty and state. Examples of licensure include: LPCC  Licensed Professional Counselor, LMFT Licensed Marriage and Family Therapist, and LCADAC, Licensed Clinical Alcohol & Drug Abuse Counselor.

The most common in California are Marriage and Family Therapist (MFT), Licensed Clinical Social Worker (LCSW), Psychologist (PsyD or PhD), and Psychiatrist (MD).   ​ Confused? We’re here to help, so let’s take a closer look at some of the most common acronyms and what they mean.

Marriage and Family Therapist (MFT, LMFT, AMFT)

Professionals with this designation hold a Master's degree in Marriage and Family Therapy and/or Psychology. While they cannot prescribe medications, many will work with a psychiatrist (M.D.) who does medication management as part of the overall treatment plan.

Those that are licensed (indicated by the titles MFT or LMFT) have also completed a minimum of at least 1,000 (depending on the state) hours of supervised experience, plus passed the state board licensing exams. California requires 3,000 hours of supervised training, which can take 3 to 5 years -- or more!

Licensure is required for an individual to work independently as an MFT. Upon licensure, MFTs have the freedom to establish their own private practices.

You can learn more about California MFT’s through one of the state’s most popular organizations, CAMFT which helps support its more than 32,000 members and educate the overall community.

Licensed Clinical Social Worker (LCSW, ACSW)

A social worker is trained in psychotherapy and helps individuals deal with a variety of mental health and daily living problems to improve overall functioning. A social worker usually has a master's degree in social work and has studied sociology, growth and development, mental health theory and practice, human behavior/social environment, psychology, research methods. There are a wide variety of specializations the Licensed Clinical Social Worker can focus on. These include specialties such as: working with mental health issues, substance abuse, public health, school social work, medical social work, marriage counseling or children and family therapy.

Licensed Professional Clinical Counselor (LPCC)

Licensed Professional Clinical Counselors provide mental health care to millions of Americans and are trained to work with individuals, families, and groups. Their level of training is on par with Licensed Marriage and family counselors and clinical social workers. The first professional clinical counselors became licensed in the state of California in 2012.

"While the LPCC licensure designation is new to the state of California, Licensed Professional Counselors have a long history and account for a majority of licensure types in many other states. We look forward to continuing to educate the public about changing landscape of mental health in the State of California." said Kenneth Edwards, LPCC and Executive Director of the California Association for Licensed Professional Clinical Counselors.

Licensed vs. Associate

Those who have not completed their licensure process and are still working on their 1,000 to 3,000 of training hours are called Associates (designated with the “A” rather than “L” in credentials). Associates can be found in MFT, CSW, PCC and PsyD capacities, among others. Without licensure, a person can only do counseling while under the supervision of other licensed professionals or through a supervising organization.

However, it’s important to note that because of California’s extensive licensing requirements, the quality of care for those working with Associates vs. Licensed therapists may not differ (our founder, Jonathan, actually works with an AMFT under supervision). Studies also show that outcomes do not vary based on years of experience or whether a therapist is an Associate or licensed. Outside of reflect, many associate hourly rates can be equal or greater to some licensed therapists.

PhD and PsyD

PhD degrees are awarded in social work, counselor education, and marriage and family therapy. A Doctor of Philosophy degree in Psychology prepares the mental health care provider to conduct independent research and to provide professional services (consultation, assessment, diagnosis, therapy). To use the title "Psychologist," individuals must have graduated specifically from a Psychology program and meet their state requirements and obtain a license to practice Psychology.

A Doctor of Psychology degree (PsyD) focuses more on clinical practice and less on research. Like a PhD in Psychology, the Doctor of Psychology degree (PsyD) prepares students to practice psychology in a wide range of clinical settings. However, this particular degree requires fewer research and statistics courses and thus takes less time.

Psychologists and psychiatrists hold the highest levels of education and certifications due to the rigorous requirements of the medical field. The American Psychological Association explains that after graduation from college, psychologists spend an average of seven years in graduate education training and research before receiving a doctoral degree.

As part of their professional training, they must complete a supervised clinical internship in a hospital or organized health setting and at least one year of post-doctoral supervised experience before they can practice independently in any health care arena. It's this combination of doctoral-level training and a clinical internship that distinguishes psychologists from many other mental health care providers. Psychologists must be licensed by the state in which they practice. Licensure laws are intended to protect the public by limiting licensure to those persons qualified to practice psychology as defined by state law. In most states, renewal of this license depends upon the demonstration of continued competence and requires continuing education.

MD (Medical Doctor)

Because a psychiatrist is licensed to write prescriptions, they are Medical Doctors who have graduated from medical school and completed a residency program in psychiatric care. Some psychiatrists are board-certified, which means that they have passed written and oral board exams in addition to medical school and psychiatric residency. Many psychiatrists do not offer counseling services and will simply prescribe medication and ongoing medication management and offer referrals to therapists with who they have a working relationship.

Apart from ensuring that your potential therapists are qualified, it’s essential that you ultimately find the right fit with the person who will be helping you manage your mental health. One of the best questions to ask yourself is this: do you feel comfortable opening up with this particular individual? There should be a level of ease, even with difficult or awkward topics. We want you to feel good about your choice, because it’s crucial to your journey.

In the Bay Area? Let reflect help you find a trusted mental health professional by connecting you to our data-driven algorithm to find a local therapist well-suited to your own unique needs. In fact, ninety percent of those who try reflect find a therapist they like - which means that you can take a lot of guesswork out of an otherwise daunting process.

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If you are experiencing an emergency, please dial 911 or go to your local hospital immediately.

reflect connects clients with independent therapists who partner with us, and we provide tools such as scheduling/billing/feedback to simplify and support the process.

We do not provide therapy.


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