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:

What Type of Credentials Should a Therapist Have?

Being a therapist is not a straightforward job. They work with people who are allowing themselves to be vulnerable. Trust is crucial even for those who are not in the midst of a mental health crisis. For clients who are suffering from a mental illness, irresponsible or reckless practices would be particularly dangerous.

This is why the right credentials should be non-negotiable when finding a therapist. Although intuitiveness and sensitivity are necessary traits for all therapists to have, they are not enough in and of themselves. Therapy or counseling provided by people without the education and experience can be risky. 

As we’ve mentioned, the types of therapists we will discuss all have a graduate-level education. But what does this mean in practice?

What Graduate-Level Education do Therapists Need?

After completing an undergraduate degree, a person who wishes to become a therapist enrolls in a master’s program. Their master’s degree must be in a relevant field, like counseling, clinical psychology, social work, or marriage and family therapy.

During their advanced degree, therapists in training do courses that cover both theory and practice. They learn about the theoretical frameworks behind various approaches to therapy and the legalities and ethics required in professional practice. They also train in the assessment and diagnosis of clients and the practice of the various therapeutic techniques.

Once the person has attained their master’s degree, they can choose to take their education further by enrolling in a doctoral program – either a Doctor of Psychology (PsyD) or a Doctor of Philosophy in Psychology (PhD).

While both degrees provide the therapist with extensive knowledge and training, their focuses are somewhat different.

• PsyD: This program is primarily focused on clinical practice and provides extensive training in the direct care of patients. The student spends much of their time in internships at hospitals or practices, while completing some academic research.

• PhD: PhD students also receive clinical training and participate in internships. This aspect of the program is balanced with a focus on academic research that contributes to the field. 

It is during a doctoral program that a therapist might specialize further, pursuing areas such as trauma therapy, child psychology, behavioral health, and neuropsychology.

Hands-On Experience

Therapy is not something that can be learned solely in theory. Hands-on experience is required before a therapist is considered fully qualified. This may seem confusing. Doesn’t a person need to be qualified to get that experience in the first place?

This seeming paradox is solved by the practice of therapy under supervision. Therapists in internships provide sessions in hospitals and other settings where their service is needed. Due to the risks inherent in the irresponsible practice of therapy, they are supervised by a professional with expertise both in providing therapy and training therapists.

During their internships, therapists accrue thousands of hours of experience. By the time they are certified to work as independent professionals, they have already put in the time to ensure they’re prepared to provide the best possible treatment.

Another aspect of the therapist’s experience is their own personal work. Many therapists choose to see a therapist of their own. This not only helps them improve their mental health and wellbeing, but also provides the opportunity to experience a seasoned professional at work.

Research and Continued Learning

The field of healthcare is constantly evolving so as to provide new or refined treatments for illnesses. In the mental health space, this means that professionals need to contribute to the progress of the field as well as continue learning long after they have completed their degrees.

Those who qualified with a PhD are often more involved in the academic world and might contribute a higher volume of research papers. Nonetheless, hands-on experience provides insight for therapists of all kinds, as well as plenty of data to work with. In fact, many of the most revolutionary therapeutic approaches began to develop organically in a therapist’s sessions. They then put their observations and experiences to the test, using the scientific method and controlled trials to determine whether they truly helped.

Because the practice of therapy is constantly evolving, even the most experienced therapists need to continue learning. For example, many mindfulness strategies have been developed or refined over the past decade or so. A therapist with thirty years of experience may have had no training in mindfulness during their college years. Professional guidelines and laws on ethics also change with academic and societal progress.

As such, most states require therapists to spend a certain amount of hours engaging in continuing education (CE) in order to maintain their licenses and avoid penalties.

Additional Certifications

Some therapists choose to get additional certifications that enable them to provide a wider gamut of therapeutic strategies. Certifications in mindfulness have become increasingly popular with the emergence of mindfulness in various therapeutic models. This kind of certification can give the therapist the ability to provide mindfulness training to clients who show a particular interest or affinity to it.

Other common examples of additional certifications include those received for training in specialized therapies such as eye movement desensitization and reprocessing (EMDR) for trauma and dialectical behavior therapy (DBT) for treating emotional dysregulation.

Therapists who do not have these additional certifications may be well-versed and experienced in these treatments without having completed specialized courses in them. Many also have an understanding of various tools within these specializations which they incorporate into other therapeutic models.

Credentials Ensure Well-Rounded Therapists

Therapists are required to receive some or all of the certifications mentioned above as this is a career that requires a comprehensive understanding of psychology and its treatments. Every human being is unique and therefore may require a different approach using strategies and tools from multiple therapeutic traditions. It is also not a profession in which a practitioner can afford to become lax with their education.

No matter how many certifications a therapist holds or how much experience they have, it is important to keep in mind that finding the right fit with a therapist is also impacted by an individual’s personality and expectations. In certain cases, past traumas can make it difficult for a person to work with a therapist who, for whatever reason, reminds them of someone from their past. Certifications and experience ensure that a therapist is trustworthy, but human connection is never a perfect science.

Different certifications are expected of different kinds of therapists and the above describes the most common forms of education among therapy professionals. As you can see, therapists need to commit to a long, tough, and continuous process of learning in order to be trusted with this huge responsibility.

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

Types of Therapy Credentials & Counseling Certifications

Clinical Social Worker Credentials

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 masters-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 are 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. 

If you are struggling with a mental health issue, need help in a family or relationship, or hope to grow further in your self-actualization journey, a therapist with the right certifications is a great place to start. Get started with Octave today and find the right therapist for your needs!

It’s important to work with a licensed therapist 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.