Thinking of seeing a therapist, but confused about which type of professional you need? Here's a list to help you sort it out, starting from the top, credentially-speaking. And if you're still not convinced you need a therapist at all, check out this link for our thoughts on that, too.
- MD/Psychiatrist: A psychiatrist is a medical doctor who specializes in mental health. Kinda like how a cardiologist is a medical doctor who specializes in the heart. Psychiatrists used to do "talk therapy." Lately though, it seems most of these good Docs have been relegated to the field of medication management (i.e. prescribing meds, making sure you’re on the right meds, not abusing them, and dealing with a lot of insurance garbage). A typical session with your Psych will last about 15 minutes, 90% of which is spent making sure you’re doing OK on your meds and finding out if you need a refill. Again, highly valuable for that purpose, but not for talking it out.
- PhD/PsyD/Psychologist: Psychologists are doctoral level clinicians. They will have a “Dr.” before their name though they are not MDs. These are super studious types who have completed a doctorate in psychology and gone through a gazillion (more like 3,000) hours of supervision before being granted a license. Whether your psychologist has a Ph.D. or a Psy.D refers to the degree he or she obtained. A PhD used to be all the rage, but some today think of it primarily as a research degree whereas most psychs actually have a clinical focus. Psy.D. stands for "doctor of psychology" and is what is awarded at most schools which are graduating people who go on to become clinical psychologists. The one specialty psychologists have is in administering psychological tests – something you might end up having done if you’re in a contested custody case. But aside from testing, psychologists can work in any of the settings that plain old “counselors” do. In a couple states, psychologists are also allowed to prescribe psychotropic medication (giving you the benefit of medication prescribing + talk therapy in one).
- LPC/LCPC/LPCC/LMHC:These acronyms stand for, respectively, licensed professional counselor, licensed clinical professional counselor, licensed professional clinical counselor, and licensed mental health counselor. These are all licensed by the state. Generally, a person must hold a master’s degree, complete a certain number of post-degree training hours under supervision, and pass an exam. Many of the “counselors” or “therapists” you’ll find (and especially those covered by insurance) are going to be one of these. They are experienced in talk therapy and many have significant experience dealing with divorce. Some will pair with a psychologist for purposes of being able to administer psychological testing.
- LCSW,MSW, LGSW, LMSW, LCSW-C, LISW, LSW (and probably more, as this varies depending on state license, but will always involve an “SW”): These are licensed clinical social workers. They hold a master's level license that is recognized throughout the United States. In broadest terms, LCSW's are clinicians who are trained to look at psychological issues in a more social context, and so you’ll typically find them in an agency setting or a community mental health facility. In recent years, though, many LCSWs have gone into private practice.
- MA, MFT, LMFT, LCMFT: Marriage and Family Therapists. Like the name suggests, their training includes a masters’ program in Marriage and Family Therapy. Those with an “L” have completed licensure requirements which may involve state board exams and supervision hours.
- Registered psychotherapist: Some states have a database that lists people who provide services but do not have formal training in the field (i.e. no credentials). Among these people may be those who call themselves a “life coach” or simply a “therapist.” In my personal experience, these folks can be great – or not. Case in point, I had a male client whose wife saw a “life coach” who convinced her that my client was casting spells on her and that he had the ability to float around the house! Funny as it was, I’m pretty sure he did neither. So, do your homework in advance. If you can’t find the information you’re looking for on the internet, it’s not impolite to ask for the therapist/coach’s credentials before you book an appointment. You have every right to know whether the person you’re considering hiring has any formal training in counseling!
- MA, CCPT, CpastC, NCPC, NCCA: Pastoral Counseling. For those of you who prefer religious or spiritual support, these Godly peeps have completed a master’s program in Pastoral Counseling or Pastoral Therapy. That’s basically some combination of coursework in therapeutic approaches and clinical counseling skills combined with theology, spiritual counseling, and pastoral care/chaplaincy. Note that this degree differentiates a pastoral counselor from a priest, pastor, or clergy person who may provide informal spiritual support, but those are wonderful too. I’ve had quite a few clients seek guidance at their Church and been very happy with what they found.
Phew, that’s the overview. Beyond the title, what matters the most is that you jive well with the person sitting across the sofa from you, not where they went to college, or how many diplomas are on their wall.