Alphabet soup - what do all the letters mean? PhD, LCSW, LMHC?
By Categories: Psychotherapy3.5 min read

Making the decision to seek therapy is a big step for most people. It’s important to find the right professional — for you.

How to choose? Some people start by getting referrals from a friend, or from their doctor.

Others look through the provider directory of their health insurance company. Many people just start a Google search. No matter how you approach the situation, you’ll find that mental health professionals hold a variety of titles and degrees, such as Psychologist, Social Worker, Psychiatrist, and Mental Health Counselor. What’s the difference between them?

First of all, you should be aware that the terms “therapist” and “psychotherapist” are unlicensed. That means that anybody can hang a sign on their door and call themselves a psychotherapist.  Psychologists, psychiatrists, and certified social workers, by contrast, require licensure. Practitioners cannot use those titles unless they have completed certain requirements at the state and national levels.

Psychologists spend an average of five to six years in graduate education in psychology after completing an undergraduate degree.  Their doctoral degree is usually a Ph.D or a Psy.D. The course work includes training in assessment, psychotherapy, personality, behavior change, research, and teaching. A one-year full-time supervised clinical internship is required prior to graduation, and usually an additional year of supervised practice is required before licensure. Psychologists have to pass a national examination and must be licensed in the state in which they practice. In states that have prescription privileges for psychologist, they must complete advanced training after licensure. (Note: NY State does not extend prescription privileges to psychologists.) Psychologists are the only mental health professionals who are qualified to perform psychological testing, such as intelligence (IQ) and personality tests.  Clinical psychologists may work in hospital settings, mental health organizations, colleges, or in private practice offices. They treat severe mental illness and personality disorders as well as providing individual therapy for life challenges such as depression, anxiety, relationship issues, work stress and career transitions, addictions, and gender identity issues. They have expertise in mental assessment, diagnosis and treatment, and behavior change.

Psychiatrists are M.D.s. After earning an undergraduate degree, they complete medical school, as well as a residency in their specialty. Their training focuses on the biological aspects of mental illness. Psychiatric residency training may or may not emphasize psychotherapy. Psychiatrists must pass the medical board exams and have to be licensed by the state. Some are also board certified in their specialty. As doctors, psychiatrists can prescribe medication. They often have a more medical approach with regard to treatment and diagnosis.

Social Workers complete an undergraduate degree and a two-year master’s program resulting in the MSW degree. Be aware, however, that only an LCSW (Licensed Clinical Social Worker) is licensed and eligible for private practice. In New York State, social workers must pass a national examination and undergo at least three years of supervision before licensure. Social Workers are more likely to be engaged in work in the social service sector, such as community advocacy, mental health administration, and working with children and families. Some Social Workers continue their education and training at the doctoral level and earn a DSW (Doctor of Social Work) degree.

Mental Health Counselors usually have completed a master’s degree program. Once they have fulfilled the educational requirements and completed therapy training under the supervision of a licensed counselor, they can be certified as licensed professional counselors (LPC or LMHC). Like psychologists and psychiatrists, mental health counselors provide counseling and therapy to patients in an individual or group setting. They are often involved in family counseling, community mental health planning, and substance abuse treatment.

Credentials such as degrees and licenses tell you that a therapist has completed a particular course of study and passed an examination administered by the state. But it is even more important to find somebody you feel comfortable with, and who offers a therapeutic approach that is right for your particular problems or needs. Only you can decide that.

Are you considering therapy?

When you are ready to take the next step, give me a call at 212.666.0332 or send me an email.

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Peggy Thomson, PhD, Therapy in NYC

Peggy Thomson, PhD, is a psychologist based in New York City, providing psychodynamic psychotherapy online and in-person. Find tips, resources and strategies here in her blog.

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