Therapist, Counselor, Psychiatrist…. what’s the difference???

There are so many terms floating around in the mental health world and most people tend to use them interchangeably. However, there are some differences between the terms that may be helpful when choosing a mental health professional for yourself or your child. Let me take a few seconds to clear up some of the confusion.

We will start with the most generic term, counselor. A counselor currently refers to a wide variety of positions including your child’s school counselor, a drug and alcohol counselor, or a “marriage counselor”. In general, the word “counselor” can be used for any helping professional and does not require higher education or a professional license. It is a good idea to check out the credentials of your counselor before beginning any therapeutic treatment.

Next we’ll tackle the word therapist. In general, “therapist” refers to a mental health professional who has a Master’s level degree. The most common type of therapist in California is the marriage and family therapist, which is the degree and license I hold. A marriage and family therapist, or MFT, is trained using a systems perspective, which means that they focus on the impact of the surrounding systems (family, school, community, work place, etc…) on the mental health of the client and vice versa. People often think that because of “marriage”and “family”, MFTs can’t or don’t see individuals. This is not the case. MFTs are well trained and qualified to see individuals. I find that the systems (or relational perspective) is extremely helpful in working with individuals because no one experiences mental health issues in a bubble. Our issues are likely impacted by and impacting other people and even if these other people are not in session with us, the MFT relational perspective can address the whole picture.
The next kind of “therapist” is an LCSW or licensed clinical social worker. LCSWs are also masters level therapists. In their graduate program LCSWs are trained more generally. They receive training in therapy but also receive training in other issues such as social policy and advocacy.

Finally, there are psychologists. Psychologists either have a PhD or a PsyD (doctorate in psychology). As noted by the doctorate degree, psychologists attend a doctoral program. Certain doctoral programs have different focuses (clinical psychology, MFT, forensic, etc…). A VERY important distinction is between a psychologist and a school psychologist. School psychologists are not doctoral level and may not be qualified to perform therapy. Please check the credentials of a school psychologist prior to having them provide and therapeutic treatment for your child.

Psychologists, MFT’s, and LCSWs may use the term “psychotherapy“. Psychotherapy is defined as the treatment of psychological disorders or maladjustments by a professional technique. The above professionals can also use the terms “therapy” or “counseling“. to describe these services.

Lastly, we have the source of the most confusion in the mental health world, the Psychiatrist. The reason I left this for last is because psychiatrists are very different from the above mental health professionals. Psychiatrists are medical doctors, or MDs, they have gone through medical school and have chosen psychiatry as their speciality. Many of them also specialize within psychiatry by choosing to focus on adolescents, adults, geriatrics, or an even more specific population. Psychiatrists can also perform psychotherapy, but it is unusual in this day to find one who does due to constraints from managed care companies (a topic for another blog!).

I thought this is where my blog would end, but I feel like I should make one final distinction. Just like in any other profession, there are good therapists and not so good therapists. There are also therapists that will fit who you are and what you need, and ones that will not. Check out your therapist in as many ways as you can. Look at their website, give them a call and chat with them, do whatever you need to do to make sure that you feel comfortable choosing this person as your therapist. Therapy is for you and it is important that you feel comfortable!

I hope this was a helpful little tutorial for you. For more information you can check out AAMFT, CAMFT, APA, and NASWCA.

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