PsyD? LMFT? Decoding the alphabet soup of therapist credentials

If you’ve ever searched for a therapist, there’s a high likelihood you’ve been completely perplexed by the various acronyms affixed to the names of potential clinicians. It’s enough to make you go cross-eyed.

I’ve written about how to find a therapist that’s a good fit for you depending on your background and needs. In those pieces, I intentionally didn’t go into various licensures, because ultimately, the most important part of the work is the energy that exists between you and your therapist, not the kind of program they graduated from.

That said, credentials still matter.

A reader asked us about this befuddling alphabet soup: “Can you explain the differences in all the different mental health providers, in terms of qualifications, education extent, capabilities and why seek out one or the other for evaluations, therapy, costs, etc?”

I sure can!

This piece will be a primer on the therapist credentials you’ll most commonly run into in California, but there will be a lot of overlap with other states. We’ll look at the kind of training each type of license requires and what each kind of therapist can and can’t offer.

What different therapist credentials actually mean

Before we get into the nitty-gritty, it’s important to consider that therapists have widely varying levels of experience.

For example, I’m an associate clinical social worker; the “associate” part of my title means that I’m working toward licensure and that I’m providing therapy under the supervision of a seasoned clinician. But functionally, it’s the same job — I’m just a little more green than therapists who are fully credentialed. So if you see associate in someone’s title, it just means they’ve completed their master’s degree from an accredited program (during which they’ve gotten hands-on experience providing therapy or other clinical services) and are working toward the 3,000 or so hours they need to become licensed.

I got a lot out of my time with an associate therapist when I was younger, and I know many other people who have too. Level of experience can really make a difference when it comes to the quality of therapy you’re getting, but if you vibe with the person and/or are looking to spend less, don’t let the word “associate” scare you away.

That said, here’s the credential rundown:

Psychiatrist (MD): Psychiatrists go to medical school for four years, including a clinical rotation in psychiatry, and then they complete three to four years of a psychiatric residency, usually at a hospital. Psychiatrists are the only mental health professionals in California who can prescribe medication.

Traditionally, psychiatrists provided psychotherapy as well, but that’s more rare these days. The number of psychiatrist visits involving psychotherapy that last longer than 30 minutes has gone down steadily since the mid-’90s. Now, just 11% to 15% of psychiatry visits include a full therapy session. Psychiatrists who specialize in therapy tend to treat patients with long-lasting depression, anxiety and personality disorders, according to research.

Psychologist (PsyD, PhD): All psychologists have doctorates, which typically involve four to six years of academic preparation and then one to two years of full-time supervised therapy work. In addition to psychotherapy, psychologists can provide psychological assessments, such as ADHD and autism diagnoses.

The training for psychology PhDs is more broad and has an emphasis on research and theory; those who go this route most often pursue academia or private practice. PsyD programs are designed to prepare students for the practice of psychology, with concentrations in clinical work, counseling or school psychology. PsyDs get more face-to-face experience with patients early on in their careers.

Licensed Marriage and Family Therapist (LMFT): LMFTs have a two-year master’s degree in psychology, counseling or marriage and family therapy. In order to get licensed in California, they also must accrue 3,000 hours of supervised clinical experience (most of which happens after graduation).

LMFT training emphasizes hands-on experience, clinical theory, family dynamics and support for people experiencing relationship challenges of all kinds. They work with individuals, couples and families.

Licensed Clinical Social Workers (LCSW): LCSWs have a two-year master’s that trains them in both social work and counseling, and like LMFTs, they must have 3,000 hours of supervised clinical experience to become licensed in the Golden State.

LCSWs are trained to take a person-in-environment approach with therapy clients, meaning they are more inclined to acknowledge that a person’s mental health can’t be separated from their social contexts (like their socioeconomic status, age, race, gender, cognitive and physical ability, the community they live in and so on). Because of this systems-level thinking, LCSWs often work in community mental health settings. They’re also able to work with individuals, couples and families in private practice.

Licensed Professional Clinical Counselor (LPCC): LPCCs typically earn a two-year master’s degree in either clinical psychology or counseling, which can range in focus from college counseling to therapy in clinical mental health settings or private practice. Like LCSWs and LMFTs, they have to get 3,000 hours of supervised clinical experience.

Once licensed, LPCCs have the option to meet additional educational requirements in order to work with families and couples.

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Understanding a potential therapist’s training and background is important, but it’s just one part of making an informed choice. If you’re waffling between a PsyD or an LMFT, for example, and you feel much more comfortable talking to the LMFT, don’t underestimate that connection just because the other person has a doctorate. Many clinicians with master’s degrees pursue advanced training in different specialties and modalities, so that’s something to ask about too.

What have your experiences been working with different kinds of therapists? Drop us a line.

Until next week,

Laura

If what you learned today from these experts spoke to you or you’d like to tell us about your own experiences, please email us and let us know if it is OK to share your thoughts with the larger Group Therapy community. The email GroupTherapy@latimes.com gets right to our team. As always, find us on Instagram at @latimesforyourmind, where we’ll continue this conversation.

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