So, you know you want therapy but aren’t quite sure who to choose and how to know if they’re qualified to understand your struggles or support your goals. Hopefully, this will help sort things out!
First off, it’s important to know you’re going to someone who has the foundation in knowledge, ethics, and treatment to serve you best. While education and licensure aren’t a failsafe, they do provide a standard to which your provider can be held and an understanding of what you can expect from your therapist. Alright then, let’s unpack all the professional labels…
Does it matter whether my therapist has a PhD or a Master’s Degree?
No, not really. Psychologists, Counselors, Marriage and Family Therapists (MFTs), and Clinical Social Workers all have the training to provide therapy. All these professionals must complete coursework in knowledge/theory and clinical practice and obtain a ton of clinical experience during grad school. And they all need to acquire further clinical supervision and work experience after graduation to achieve independent licensure, They’re all also required to keep learning through approved continuing education for the rest of their professional. The vast majority of these trainings are open to any kind of therapist as well. Each profession has its own code of ethics, plus all professionals need to follow the rules and statutes set out by their state or province and need to remedy issues – or face more serious consequences if there are issues.
You might have heard the terms “master’s level” and “doctoral-level” used to describe therapists, but this is a misnomer since most master’s-holding therapists have what are considered “terminal degrees” meaning that they hold the highest clinical degree in their field. A master’s holding therapist is not a less expert psychologist; they’re totally different professions that provide some overlapping services. Though some counselors, social workers, and MFTs choose to pursue doctoral studies and obtain a PhD, these degrees typically center on things like advanced theory, supervision and teaching, advocacy within the field, and research generation.
COUNSELORS are trained in human development, mental health struggles and assessment, and a variety of ways to support clients through tough stuff and help them live their best lives. Many people don’t know this, but unlike its sister professions, the field of counseling was born out of career counseling. This still has an impact on the field today and so you might find that counselors have a special orientation toward not just helping people with what hurts (trauma, anxiety, depression, etc.) but also with planning and creating a joyful, meaningful, and sustainable life. A counselor would be a great choice whether you’re looking for support with a mental health struggle, bigger existential issues, or job/life satisfaction and overall growth. Some counselors work in schools or other settings and are not licensed as therapists, and so those who do work in a clinical capacity might be called “professional counselors” or “mental health counselors” by their state regulatory boards.
MARRIAGE AND FAMILY THERAPISTS don’t just work with couples and families struggling with their relationships – they also work with individuals and have training in mental health struggles, assessment, and human development like other therapists. Where things differ really lies in the approach they might use. While MFTs are trained in the “standard” psychotherapy approaches, they are trained to think within the family system. The shorthand is that who you are and where you struggle didn’t just happen in a vacuum so the solutions offered should be broader as well. Your experience is informed by your family, close relationships, and everything related. MFTs do, of course, receive additional training in working with families and couples, so they might be the first professionals you seek out when your relationships need support.
SOCIAL WORKERS have a professional legacy of working with individuals as they navigate tough situations in which the struggles go beyond just the person in front of them. Social workers learn about human development, mental health, and assessment like other therapists. However, they also learn to a greater depth about how issues of poverty and homelessness, medical struggles, disabilities, cultural differences, and other obstacles in life might impact mental health, wellbeing, and outcomes for individuals and families. Some social workers focus more on resources and navigating obstacles than on clinical care. Most states label social workers who are trained as therapists as “clinical social workers” to keep confusion at bay.
PSYCHOLOGISTS are also trained to offer psychotherapy and they typically hold either a Ph.D., Psy.D., or Ed.D. degree. At least in the US, psychologists are required to hold a doctoral degree. Their education includes human development, mental illness framed within a medical model, and therapeutic techniques, but also includes more extensive training in assessment and research methodology. They typically must complete a project or research study to obtain their degree. Like the master’s holding clinicians above, they must have extensive clinical training and experience during and after graduate school to obtain independent licensure and must continue learning for the rest of their career. Some psychologists aren’t licensed to practice therapy but might engage in research or consulting careers, so know that those who are also clinicians can be identified as “licensed psychologists” or “clinical psychologists.”
Not to complicate things, but each of these professional therapists continue training after graduate school to deepen their expertise in various ways of supporting clients! Some social workers take advanced training in diagnostics, psychologists obtain couples counseling skills, counselors might deepen skills around social services and justice, and family therapists might enhance their skillset in helping launch young adults into college or careers. So, your best bet is to look at each individual therapist’s offerings and background to decide who feels like the best fit for your goals. If you reach out to one who might not have the space or expertise to support you, they’ll likely offer ideas of who to call or where to go for what you want or need.
What about PSYCHIATRISTS and PSYCHIATRIC NURSES?
These are licensed medical professionals who have special training in supporting patients with symptoms of mental health concerns. Adding medications can be a supportive option when navigating mental health symptoms, either long-term or short-term. If you are interested in considering medication to support your healing, wellness, or life overall, ask your therapist or primary care physician or nurse to discuss your options and perhaps provide a referral. Other licensed professionals like acupuncturists, naturopaths, dietitians, occupational therapists, and speech pathologists can be supportive as well, depending upon your own needs and preferences. Sometimes, it can be helpful for other professionals supporting you to connect with your therapist, and sometimes it can feel best to preserve separate relationships with whoever supports you on your journey – it’s best to discuss this with your therapist and other providers so you can make the decisions that feel right for you.
So what is the difference between a coach and all of these licensed/registered folks?
Well, we’ve already talked about how therapists support people through a variety of life situations including and beyond mental illness, relationship support, and creating the lives of their dreams. Therapists have the training, professional legacy, and regulatory structures in place to provide you with a variety of effective and transformative options for growth and healing. And other licensed professionals can also help you move in the directions you want with your life and health. You’ve learned above about what goes into becoming a therapist and the many ways therapists can support you. So, what is coaching?
COACHING is a newer and unregulated profession, but that doesn’t mean you can’t benefit from a coach’s help. Coaches can help with specific tasks and skills that might not be cost-effective or within the expertise to focus on in therapy. For example, folks in eating disorder treatment might use the support of a mealtime coach to navigate fears and complete their eating goals. Someone who struggles with executive function can collaborate with a coach to create sustainable ways to manage in life. Someone looking to build their business or brand, create a retirement plan, or tackle a specific goal might consult with a coach to plan how to get it done and find the accountability they might want. Coaches might also be individuals who’ve successfully navigated specific issues in their own lives and want to mentor others struggling in similar ways.
You should know that coaches don’t (and can’t legally) treat trauma or medical or mental health concerns, so if you see one offering this service, you might want to take it as a red flag. Another red flag is when coaches might minimize or discourage therapy or healthcare to elevate their own offerings. A third common red flag in unregulated services is confusing or vague explanations about things like financial commitment, confidentiality, boundaries, or expectations. (Actually, these are concerns in regulated professions as well – trust your gut!)
I really hope this disambiguation has helped make some sense of the counseling alphabet soup so you can feel better prepared to choose a therapist or other professional as you move along your journey. If you’re a resident of Arizona and think therapy might be helpful for you, please don’t hesitate to reach out.