The alphabet soup that follows a therapist’s name can be confusing. 

The letters represent the therapist’s credentials, based on the type of degree or level of education they have. While there are many therapist credentials, the following ones all have key things in common: All have a graduate-level education, passed a series of exams, and completed thousands of clinical hours to receive their state licensure. 

The differences between various credentials are mainly in where they focused during their graduate education and the settings they worked in during their training. But when it comes to how they provide therapy to clients, the differences are subtle, if at all.

Here’s a quick rundown of the four most common types of therapists:

Clinical Social Worker 

Licensed Clinical Social Worker (LCSW) or Licensed Independent Clinical Social Worker (LICSW)

When you hear “social worker,” you might envision someone who works in community care or a hospital connecting people to resources. However, this type of credential is mostly about the approach of their studies — using their social justice lens to understand the impact of society on an individual's mental health. While many do go into social services, many also might focus their work on providing more clinically-focused therapy to support a broad range of mental health conditions.

The same type of therapist can have different credentials because licensing and training requirements vary by state. In California, a licensed social worker will have an LCSW, but in Washington DC, a licensed social worker will have an LICSW credential. 

Marriage and Family Therapist 

Licensed Marriage and Family Therapist (LMFT) or Licensed Marriage and Family Therapist (LCMFT) 

It’s easy to assume that Marriage and Family Therapists only treat, well, married people and families. But this title is really about their educational focus on relational and interpersonal dynamics on the individual, in addition to their training on assessing and treating an individual’s mental health. This can make them ideally suited to treating couples and families, but they also can examine how relationships are impacting an individual client, whether it’s their relationship with family, their friendships, their romantic relationships, or their place in society.

Clinical Counselor

Licensed Professional Clinical Counselor (LPCC), Licensed Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC)

These therapists focus primarily on the needs of patients as individuals to improve mental health. They often practice with a range of therapeutic approaches.

While there are many different types of counselors, such as school counselors or career counselors, these titles in clinical counseling indicate advanced training in identifying and treating cognitive, mental, and emotional issues, and licensing by the state.

As with the other titles, these credentials vary by the state in which they’re licensed. For instance, LMHCs practice in New York and LPCCs practice in California. LPCs are the most common credential, used in 24 states and Washington DC.

Clinical Psychologist 

Doctor of Psychology (PsyD) or Doctor of Philosophy in Psychology (PhD)

Psychologists are trained to understand how the mind and behavior correspond. PsyD training is usually more clinically focused, whereas PhD training is more research focused, but both are able to directly treat clients for a broad range of mental health conditions.

Psychologists also have the ability to do a comprehensive psychological assessment ranging from personality assessments, diagnostic clarification, or intellectual assessment to inform treatment. It’s also one of the credentials that, in some cases, is approved to assess for disability.

While doctorate-level psychologists require more time obtaining their education, there are only some slight differences in the way they may approach therapy with clients when compared to a master's-level therapists. Typically, they will use the same evidence-based therapy modalities – or approaches – in treatment.

Which One Is Right For You?

While the credential can be one aspect in deciding the right therapist for you, there are other aspects that are more important.

• Their specialty areas: Do they have a lot of experience in ADHD and PTSD? Or are they more of a generalist who treats anxiety and depression?

• The approaches they use: Do they use evidence-based modalities? Are they an expert in a specific modality? 

• Their therapeutic style: Are they collaborative? Do they like to use humor? Do they use free-flowing conversation in therapy or structured questions?

• What you’re looking for in your therapist: Do you want to work with a trauma therapist who strictly uses Dialectical Behavior Therapy or someone who uses more of a psychodynamic approach?  

These are the factors that influence the strength of the working relationship between you and your therapist, also known as the “therapeutic alliance.” Studies have shown that the therapeutic alliance has a profound effect on the success of therapy – the ability to build mutual trust, nurture a bond, and agree on treatment goals and plans is critical to a person wanting to stick with therapy and make the changes needed. 

It’s important to work with a therapist who is licensed in your state, but the exact years and level of education may not necessarily make them a better fit for you. Spend your first few sessions talking with your provider, asking them questions, and seeing if you feel supported in your mental health journey.

Looking for a licensed therapist? Octave has over 1,000 therapists who can meet your unique mental health needs.