What kind of therapist do I need?
A Counseling Road Map
It can be confusing to find a professional to help you when there are so many different kinds of licenses and certifications out there! If you are looking for a therapist or counselor, what do you need to know?
Therapist or Counselor?
These words are often used interchangeably, but they don’t mean exactly the same thing.
Talk therapy in all of its forms can be considered “counseling”. This is a very broad term. So this is where it can get tricky to tell what you’re getting from a specific professional. What is the difference between a Therapist and a Counselor?
For our purposes, we have capitalized Therapist and Counselor in this article to signify that we are talking about these specific titles, though they are not usually capitalized in general usage.
What is a Therapist?
Licensed professionals usually use the word “Therapist” to show that they are licensed by a licensing board in the state where they practice, and they provide mental health diagnosis and treatment, usually through some form of talk therapy. They might have additional trainings and certifications that allow them to specialize on certain types of clients or treatments.
What is a Counselor?
Many professionals use the word “Counselor” because they provide some type of counseling, meaning they talk to you about solving your problems. Unfortunately, the word “Counselor” can mean a lot of different things. It is NOT a title that is regulated by one central organization or state board. As a result, it doesn’t mean much at all. It can sound like someone provides mental health treatment when they might not be qualified to do that at all!
So, if you’re considering hiring a Counselor, you’ll need to do a little more digging.
Therapy Regulation: The Law About Licenses
If you are looking for help with a problem such as anxiety, depression, relationship problems, substance abuse recovery, trauma, postpartum mood or anxiety, complicated grief, (and this list is not exhaustive!), the only people who are legally allowed to provide those therapeutic services are those licensed by the state in which they work. (See below for a list of license types.)
Do I Need a Licensed Therapist?
We always recommend starting with a licensed Therapist to get an initial consult or evaluation. If you meet with a licensed Therapist and find out that you do not have a mental health diagnosis, then a counselor or coach might be the right fit to help you reach your goals. A certified Counselor can be of great help with general life issues, transitions, grief, relationships, and spiritual issues. They might not be able to uncover underlying mental health conditions that contribute to those issues.
Hopefully, a certified Counselor would recognize if issues are beyond their scope of training, and would tell you to consult with a licensed provider before continuing with them.
You can always move down the ladder of qualification, but starting at at a lower rung when you truly need mental health care can create more problems than it solves. Start with a licensed Therapist for accurate diagnosis and recommendations!
The Importance of Licensure
State licensure is an assurance that your therapist/counselor has met certain (comprehensive) qualifications for their education and training. They are likely to understand the complex relationship between your history (especially trauma), biological causes, and therapy approaches they might choose to use, including faith-based ones.
State licensed therapists/counselors are also required to keep up with Continuing Education (CEU) requirements every few years and keep their licenses current. They network with their peers and stay up to speed with evidence-based care standards.
Some Counseling Certifications also require CEUs to stay certified. Look into your Counselor’s requirements to see what they’re required to keep up with, and whether you feel those requirements meet your specific needs.
What is Counselor Certification?
There are many groups and institutions that issue certifications, and sometimes use the word “license”. This is a false and illegal use of the word “license”. A license can only be issued by a state Examining Board, which has a .gov website.
There are many types of certifications, on the other hand. Christian and other organizations especially have created lots of certifications so that counselors and pastors can complete classes and/or an exam and tell people they are certified in something. Individuals can be certified or listed as counselors by the following private organizations:
Christian organizations:
NCCA (Temperament counseling)
AAB Counseling Academy (Claims to offer “Board Certified” temperament therapist credential; this is not a State Board and may be confusing)
ACBC (Nouthetic counseling)
and many more! (Overwhelmed yet?)
This is a diverse list of certifying organizations. We would consider some to be fairly solid, and others on this list to be concerning from a mental health standpoint. Several of these offer certifications for profit - their counselors pay them for proprietary certification materials and memberships. This is not the way to ensure objective standards for training are being met.
Most of these certifications require course work, but classes might be in either Biblical studies or counseling topics. In some certifications, a counselor can claim to be certified, and have never taken a single psychology course. In fact, there is no way to know exactly what their certification means without going to the website of the organization that certified them - which we highly recommend doing! Many times, those websites don’t tell you much about the counseling approach or what you can expect from one of their counselors.
Are Certified Counselors Helpful?
Are all Certified Counselors unqualified to help you, then? Not at all! Some have taken sufficient classes and have enough experience to help, depending on what your problems entail. Do your homework to find out what your Counselor is certified to do, and what their knowledge includes. Working with someone claiming to be a certified counselor could be a great experience…
…but it could also be very damaging.
The Dangers of Unlicensed Counselors
A counselor who is not sufficiently trained to recognize certain mental health conditions, or to understand the effect of trauma on the brain and body, for instance, can actually do more harm than good. Some types of counseling are overly simplistic and will not work for all types of clients and issues.
Some Christian counseling certifications are very narrow, in fact, and equip the counselor to view mental health problems only as the result of a specific sin or demonic activity in the counselee’s life. It’s easy to see how this could lead to more emotional damage, especially if an organic/physiological brain issue is present. Nouthetic counseling and deliverance ministry are examples of these narrow methodologies. We have seen how these approaches have further harmed some of our clients, who later realized they needed treatment that included both mental health AND Christian elements.
If you are considering a Certified Counselor, spend some time online to learn about their certification, what they had to do to get certified, and whether this meets your treatment needs.
Therapist Education/Degree
Whether someone calls themselves a Therapist or Counselor, look for the letters after their name. They should have one of the following degrees:
MA (Master of the Arts) in a psychology or counseling field
MSW (Master of Social Work)
PhD (Doctor of Philosophy) in a psychology or counseling field
PsyD (Doctor of Psychology)
Therapist License
A Therapist should also have a state-issued license listed on their website or profile, wherever you’ve found them. These include:
Licensed Psychologist (occasionally listed as LP)
LPC (Licensed Professional Counselor)
LAC (Licensed Associate Counselor; someone with all of the training and working toward LPC by gaining hours of experience)
LCSW (Licensed Clinical Social Worker)
LMFT (Licensed Marriage and Family Therapist)
LMHC (Licensed Mental Health Counselor)
A licensed/ordained Pastor with a seminary degree may legally provide Pastoral Counseling
When you see a license or title listed on a Therapist’s website, do a quick Google search for that license and the state where you live. Some licenses exist in certain states but not others. Two examples are LMHC and LMFT. You must make sure the professional is licensed to provide their service in your state! If they list a license that isn’t governed or recognized by a licensing board in your state, that is a big red flag.
GoodTherapy.org has a helpful and more comprehensive list of credentials to help in your research.
Now, a Therapist or Counselor who has one of the listed degrees and licenses could also pursue various certifications. That is a great way for a Therapist to enrich their practice and keep up with CEU requirements, in fact. Some Therapists become certified in evidence-based treatment approaches. Some add Christian counseling, grief counseling, postpartum counseling, etc. certifications to their existing mental health qualifications.
Examples of organizations that provide additional certifications to already-licensed therapists to help them specialize include:
PESI (Many types of courses and certifications)
NICABM (Trauma-related certifications)
PSI (Postpartum and perinatal treatment certifications)
EMDR Institute (Trauma treatment method)
and many more
Finding a Therapist or Counselor can be overwhelming. When in doubt, look for a higher level of licensure and education. This helps ensure that you’ll be working with someone who’s qualified to diagnose and treat your problems. Remember, you can always move down the ladder of training and qualification after you have consulted with a licensed professional to diagnose your problems!
Meet the licensed therapists at Grace Behavioral Health.