Therapist’s Credentials Explained: What they Mean and if They Matter

At TherapyCloud, we seek to lead the charge in creating a community that allows access to quality and trusted therapists. This also includes educating you as a consumer so you know what to look for and how to find the perfect therapist for your needs. We want you to know what certain words and acronyms mean when you see them using our find a therapist search feature so that you can know who is the best fit for you.

As we explained in our previous blog, “Navigating Therapist Credentials: What to Consider when Choosing a Therapist,” therapists’ credentials are a moving target. They are, admittedly, confusing and overwhelming to not only therapists themselves but to the state and federal governments who award such credentials. There are no nation-wide standards for any therapist credential. And, the credentials of mental health professionals are constantly changing and vary not only by state but by region.

So, while the differences between credentials outweigh the similarities, most of the following credentials have in common the requirement of at least a masters degree, which includes courses focusing primarily on clinical therapeutic practices and modalities. More than anything credential, though, is a goodness of fit. Research shows that it is the relationship developed with the therapist that creates change regardless of their credentials, number of years in the field, or even the formal therapeutic interventions offered.

So, do your research. And, ask questions. To assist you, here are some terms and definitions, in alphabetical order, to help you clarify what matters (or doesn’t) in your search for the perfect therapist for you.  

One other thing to note before you get started reading is that, as we explain on our FAQ page, we recognize the multi-dimensional nature of mental health and value a holistic, interdisciplinary approach to promote the deepest level of well-being possible. Because of this, we know that what is “therapeutic” and supportive of mental health isn’t always formal therapy done by a formal therapist. That is why we have included credentials like peer counselors on this list of “therapist” credentials. Anyone who has relevant credentials to be able to offer support and content to promote mental health is always welcome to join our private, interdisciplinary community! For more information or to recommend a colleague, check out our membership options here. 

Addiction Counselor

Addiction counselors represent a credential that is focused on addiction specifically, whether it is a substance of abuse (e.g. cocaine) or a behavior (e.g. gambling). This credential can represent a formal certification with a governing body like the International Consortium & Reciprocity Consortium (IC&RC), which typically requires training on the topic of addiction, passing an exam, and having continuing education following formally earning the credential. However, this credential is not a formal license with a state.

One challenge (and common criticism) with this credential is that, depending on either the state’s governing body or any overarching governing body, like the IC&RC, managing this credential, addiction counselors may not even be required to have education higher than a high school diploma. And, those practicing as a formal “addiction counselor” may not have yet even had training in addiction or have passed an exam on the topic. While this may be shocking, this strategy and the advent of the “peer support” movement (see description below) has been adopted by entities likeSubstance Abuse and Mental Health Service Administration (SAMHSA) to address the chronic lack of addiction providers influenced by the high rates of burnout and turnover due to the challenging nature of addiction.

So, while “addiction counselors” may not have years of training or a formal license, they are able to offer addiction counseling if they have something like a formal “Development Plan” registered with a credentialing entity. These “Development Plans” acknowledge that the individual does not yet have the training or credentials of an “addiction counselor.” However, such formally documented plans allows them to practice as an addiction counselor while they are working to complete the requirements (e.g. exam, training). Some Universities even offer certifications in addiction or promote their program as training that can contribute to the credentialing of being an “addiction counselor” with certain governing bodies.

Advanced Practice Psychiatric Nurse (APRNs)

This is a lesser-known credential that has many facets and that likely would be seen in a hospital or medical office setting. APRNs can be certified by theAmerican Nurses Credentialing Center (ANCC) in Psychiatric-Mental Health (PMH) - being a “PMH-APRN” - as a Psychiatric-Mental Health Clinical Nurse Specialist (“PMHCNS-BC”), or have the credentials of a Psychiatric-Mental Health Nurse Practitioner (“PMHNP-BC”). As we have discussed is the case with all therapist credentials in our previous blog, this credential varies by state. For example, some APRNs with Clinical Nurse Specialist (CNS) or Nurse Practitioners (NP) credentials in psychiatric mental health nursing are actually considered a nurse practitioner formally. The American Psychiatric Nurses Association further describes that “[f]rom a national perspective, little difference exists between PMH-APRN roles” given that APRNs can offer individual, group, or family psychotherapy and usually have the authority to prescribe psychiatric medication as a PMH-NP in all states grant prescriptive authority.

Professional Counselor

Get ready to be confused. While all Professional Counselors hold a Master’s Degree and are overseen by the American Counseling Association (ACA), there is a lot of variety in names of credentials. Variations of professional counselors credential abbreviations can include “LPC” to designate that they are a “Licensed Professional Counselor”, ”LCPC” to designate that they are a ”Licensed Clinical Professional Counselor”, or “LPCC” to designate that they are a “Licensed Professional Clinical Counselor”. Any professional with two Ls in their credential abbreviation (e.g. “”LLPC”) tends to indicate that they hold a limited license and, therefore, have not yet completed requirements, like hours of supervision, number of years in the field, or the passing of a licensure exam, to be fully independently licensed.

Complications in fully understanding this therapist credential are present firstly because there are two accrediting bodies for Professional Counselors, which includes the Council for the Accreditation of Counseling and Related Educational Program (CACREP) and the Masters in Psychology and Counseling Accreditation Council (MPCAC). Second, the names for the actual Master’s programs can vary even if graduates from various programs graduate with the same eligibility for the same credential. For example, some educational programs offer a “Masters of Arts in Counseling Psychology” (but are also not “Psychologists” formally), some offer a “Clinical Mental Health Counseling” program, and some offer a “Masters of Arts in Counselor Education”. Some educational institutions even blend departments, such as having a “Department of Counselor Education and Counseling Psychology”.

The last complication to this credential is that, while listed separately from the credential of Mental Health Counselor, these credentials are very similar. (See below for more information on this relationship.) For example, some educational institutions state that, after graduating from their Master’s Degree program, you have the ability to become either a Licensed Mental Health Counselor (LMHC) or Licensed Professional Clinical Counselor (LPCC). To make it more confusing, sometimes statistics about therapists will list this group of professionals as either “Professional Counselors” or “Mental Health Counselors.” Either way, this group of therapists, whether we call them “Professional Counselors” or “Mental Health Counselors,” make up an estimated 11% of the behavioral health workforce, which is the second most common credential nationwide (after social workers). 

Marriage and Family Therapists (MFTs)

The American Association for Marriage and Family Therapists (AAMFT) is the member-based organization that oversees this therapist credential. While Marriage and Family Therapists (MFTs) can diagnose mental disorders and provide individual therapy to treat them, they are trained specifically in viewing behavioral problems within the context of the family system. For MFTs, the focus of therapy may be just as much on the well-being of the family as it is on the individual. 

All MFTs have a graduate-level education (a Master's or Doctoral degree), although some states allow those with an equivalent graduate degree (e.g. social work, professionalcounselor/mental health counselor) to apply and earn an additional license as an MFT provided that they complete a certain number of courses foundational to the MFT profession (e.g. family studies, human development, family therapy methodology). Although the AAMFT reports that, since 1970, there has been a 50-fold increase in the number of MFTs nationwide, the Health Resources and Services Administration reports that MFTs make up only 2.7% of the behavioral health workforce. 

Mental Health Counselor

While we go in depth above about the confusing relationship between this therapist credential and the credential of Professional Counselor, it may be easiest to conceptualize them as essentially the same thing. Whether the accrediting body of the therapist’s master’s program is the Council for the Accreditation of Counseling and Related Educational Program (CACREP) or the Masters in Psychology and Counseling Accreditation Council (MPCAC), both this credential and Professional Counselors are trained extensively in mental health disorders, can diagnose, and can offer individual, couples, or family therapy. Some therapists even earned their degree formally in “Counseling” but have a “Clinical Mental Health” concentration, allowing them to adopt this therapist credential once licensed. 

Peer Counselor

While not necessarily holding a formal license to practice therapy and perhaps not even having any formalized training in topics in addiction or mental health, the peer counselor represents a different approach to behavioral health. A peer counselor is an individual who has had personal experience with addiction or mental health symptoms that allows them to share their wisdom with others to help others better their lives. Peer counselors can even be employed by government agencies to offer their services, which may include being on call should a someone enrolled in services need support to prevent a relapse or require support in a time of crisis.

The Substance Abuse and Mental Health Service Administration (SAMHSA) agrees that help treatment outcomes, some boards have developed to even offer official certificationspeer support is an effective intervention for addressing substance abuse disorders and mental health disorders. Because there is evidence to suggest that peer counselors can  for peer supports (e.g. a National Certified Peer Specialist (NCPS), which includes requirements of training hours, supervision hours, letters of recommendation and years of sobriety.

Psychiatric Physician Assistant/Associate

The Association of PAs in Psychiatry (APAP) can offer helpful information to best understand this credential. Because of the massive shortage of Psychiatrists nationwide (see this article from the U.S. Bureau of Labor Statistics to learn more about this shortage), training PAs (who can be called either “Physician Assistants” or “Physician Associates,” depending on the state) in mental health treatment specifically has become a way to provide a better quality of care for a larger number of patients. Similar to a Medical Doctor (M.D.) practicing with multiple healthcare professionals under them (e.g. Physician Assistants/Associates, Registered Nurses, Nurse Practitioners) in a primary care setting, Psychiatric Physician Assistants/Associates extend the care of psychiatrists for those with both medical and mental health diagnoses. While they make up less than 1% of the behavioral health workforce, Psychiatric PAs are viewed as an extension of a Psychiatrist and, therefore, can prescribe medication.

Psychiatrists are formal physicians who have attended medical school and earned a M.D. (Doctor of Medicine) or a D.O. (Doctor of Osteopathic Medicine) degree with a focus in behavioral health. The Health Resources and Services Administration documents that Psychiatrists make up around 5% of those offering behavioral health services nationwide. As the American Psychological Association (APA) points out, specialized training in mental health via a three to four year residency is a key feature of this credential, in addition to being the only credential (other than some Doctoral level Psychologists depending on the state) who can prescribe medication.

Historically, Psychiatrists did it all: diagnosing, writing prescriptions, and offering talk therapy to treat individuals. However, given our current healthcare system’s crisis, the typical length of a visit with a Psychiatrist is 15 minutes, as is the case with a typical physician visit. So, the more-lengthy process of therapy has been transitioned to therapists. And, the focus for Psychiatrists has largely become medication.

Psychologist

While psychologists have earned at least a Master’s Degree that includes education on the topics of mental health, this credential is frequently separated into two distinct areas: clinical interventions and research. This is so much the case that it is not abnormal for psychologists with either a masters or doctoral degree to actually not have had any clinical training as a therapist (if their focus has been on research). 

Regardless of their focus, the foundation of psychologists’ practice tends to be on  assessment and research. As a reflection of this attraction to assessment, while psychologists aren’t the only ones able to complete formal mental health assessments (e.g. ADHD testing, personality disorder assessments, learning disabilities testing), it is likely that those performing such clinical tests will be psychologists. Within the credential of psychologists, there are even further concentrations, like Sports Psychologists, Behavioral Psychologists (think the classical conditioning experiment with Pavlov’s dog), School Psychologists, Child Psychologists, and Forensic Psychologists, to name a few. 

Psychologists also tend to take supervision very seriously. Because of this, licensing bodies at times restrict those with a master’s degree in psychology, which would be equivalent to any other therapist credentials, from ever being able to be officially fully licensed or practice independently. This means that masters-level psychologists may have to seek supervision and perhaps even bill under their doctoral-level psychologist supervisor for the rest of their professional career, no matter how many years they have been in practice. You will know this is the case when a therapist with a limited psychologist license lists the name and license information of their fully licensed supervising psychologist. Psychologists also come in as the third most common behavioral health provider, trailing closely behind the prevalence of Professional Counselors/Mental Health Counselors.‍

Psychotherapist

Given how confusing all therapist credentials are, “Psychotherapist” is the all-inclusive term for someone licensed to provide talk therapy. A “Psychotherapist” could be a social worker, Psychologist, or School Counselor. Overall, however, this term is an indication that they are legally licensed to offer therapy based on their training and credentials, even if the term does not tell you specifically what their credentials are. (This also means that those with certifications and no formal license, like a “peer counselor” or even “addiction counselor” would not fit into this category.)

School Counselor

School Counselors are a unique form of therapist. The American School Counselor Association reports that “School counselors are certified/licensed educators who improve student success for ALL students by implementing a comprehensive school counseling program.” School counselors can be present in elementary, middle, or high schools. 

At a minimum, school counselors have a master’s degree in “School Counseling” specifically, must meet the state certification/licensure standards (as, for some states, this credential is a formal license while in others, it is a certification), must continue to meet continuing education requirements, and are required to abide by The American School Counselor Association’s ethical and professional standards. One thing The American School Counselor makes clear, however, is that “school counselors do not provide long-term mental health therapy”. So, while someone may have a school counselor that helps them with school-based needs, if mental health support is needed in general, a formal therapist external from the school would be appropriate. 

Social Worker

Social Workers are typically divided into two areas of practice: “micro” social work (e.g. providing direct care via services like therapy) and “macro” social work (e.g. being involved in the administrative policies and leadership of organizations). Similar to other credentials, there are additional specialties within this credential, such as school social work or medical/healthcare social work (for which a specific degree may have been obtained). Even considering the various specialties, social work may be the most diverse credential of all the therapist credentials in general given that the social workers not only work as therapists. Social workers can also serve roles as crisis managers and case managers in a wide variety of both behavioral and medical settings. 

Given this diversity of roles, a common myth about social workers is that they only work in child welfare. While it is true that the emphasis on social justice principles sets social work apart from other therapist credentials, social workers make up 70% of those offering mental health services nationwide in all settings. Social workers can diagnose mental health disorders and offer individual, couples, family, or group therapy just like any other therapist.

Social work has a history of offering a Bachelor’s degree license in social work but this is so rare that some states no longer even allow this license to be renewed. Therefore, social workers offering therapy will have a minimum of a master’s degree in social work, although a “macro” social worker has the same legal ability to offer “micro” services based on the incorporation of clinical principles into the education required by the accrediting body (i.e. the Council on Social Work Education) for all social work programs, whether they are “micro” or “macro” in designation. If someone has completed a “micro” program specifically, you will likely see a “Clinical” designation in their credential (e.g.  “LCSW” - “Licensed Clinical Social Worker”). However, some states do not have a formal “Clinical” specifier for social workers credentials. As such, being a “LMSW” (“Licensed Master of Social Work”) may not make clear whether that therapist’s training is in therapy per se.

Regardless of the credential one holds, please note the following disclaimer, which reminds us that this is not an exhaustive list of therapist credentials. Beyond these formal licensure credentials can be other credentials that include extensive specialized training, like a Certified Sex Therapist, Certified Trauma Professional, Certified Play Therapist (for children), or a Certified Integrative Mental Health Professional. Above all, be an educated consumer and do your homework. If you have questions about if a therapist the right fit for you based on their credentials, ask them! Given the diversity of therapist credentials, each therapist will be the expert of their credentials.

Disclaimer:  ‍

Any information provided on the TherapyCloud website is for educational purposes only. The information provided on the TherapyCloud website cannot reflect any and all updates and changes to reflect the current licensure requirements for all U.S. states and territories. Anyone pursuing licensure or education about such licensure must consult with their state’s counseling licensure board to receive the required information regarding licensure requirements and processes.  ‍

This information is not intended to substitute for legal or professional advice. You should consult your own advisors for legal or professional advice. TherapyCloud is not responsible for the consequences of any decisions or actions taken in reliance upon the information and resources provided. Refer to the statutes and regulations of the state in which you are seeking to obtain your license to learn about the specific licensure requirements.  ‍

Sources:

U.S. Bureau of Labor Statistics. 2018 Occupational Outlook Handbook: Community and Social Service Occupations. Available from: www.bls.gov/ooh/community-and-social-service/home.htm‍

U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. Behavioral Health Workforce Projections, 2017-2030. Available from: https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/bh-workforce-projections-fact-sheet.pdf