One of the most confusing parts to becoming a therapist for myself was understanding and choosing which path would be best for me. Put another way: what’s up with all these different licenses? This is an important question because it could determine the trajectory of your career for years to come.
What are the different paths to becoming a therapist?
There are basically three major paths: counseling, marriage and family therapy (MFT), and social work. Depending on which state (or country) you live in, there may be specific licenses that fall within these three paths. Here in Minnesota Licensed Professional Clinical Counselor (LPCC) falls within the counseling path, Licensed Marriage and Family Therapist (LMFT) falls within the marriage and family therapy path, and Licensed Independent Clinical Social Worker (LICSW) falls within the social work path. All three of these paths require a master’s degree.
There are two additional outliers that are somewhat related. The first is the Licensed Psychologist (LP). An LP can complete psychological assessments (i.e. ADHD, learning disorder, neurological assessments etc.) along with providing traditional talk therapy. To become an LP you have to complete a doctorate program which usually takes 5-7 years. The second is a psychiatrist. A psychiatrist can technically provide traditional talk therapy but often they focus primarily and only on prescribing psychiatric mediation. Because psychiatrists are able to prescribe medication, to become one requires going to medical school which can take upward of 10+ years. As both are more specialized and less associated with traditional talk therapy, we’ll focus on the three major paths discussed earlier.
What’s the difference between counselors, MFTs, and social workers?
The fundamental difference between counselors, MFTs, and social workers is found in their theoretical approach to helping people overcome their mental health challenges. To better help understand this, let’s consider the approach each three would take with a mother bringing in her child to be seen.
- Counselors focus primarily on the individual. This means they would consider the symptoms the child is having, their personal psychiatric history (trauma, development, past diagnoses etc.), and then work with the child on things such as individual coping skills.
- MFTs are systemic in theory which means they believe that our context shapes our reality. With the example of the child, they would consider the child within the context of their environment and relationships (particularly their family relationships) and how these connections are contributing to and affecting their ability to overcome their mental health challenges. They might have the child’s mother join sessions in order to observe their relational dynamic and help direct their relationship toward greater health. This might look like teaching communication skills and identifying emotions.
- Social workers are the most systemic of the three. They would not only consider the child’s direct relationships but also consider greater systems they are embedded in, such as the school they attend and the resources available there, their socioeconomic status, and other community supports that might be available to them. Along with providing talk therapy, social workers often help connect clients to external resources around them to help them overcome their mental health challenges. A social worker might help a mother apply for food stamps in order to reduce the stress of not having enough food which would subsequently allow her to have more patience with her hungry child.
While these three paths differ in theoretical approach, they all lead toward being able to provide traditional talk therapy to the public. Although they tend to have a similar pool of job opportunities, they also differ slightly. If you are interested in working in community health facilities such as hospitals or the VA, you might have better luck with a social work license. Additionally, if you know you want to see couples or families as clients, getting an MFT or social work license is your best bet. Some states require counselors (LPCCs) to do additional training in order to work with couples and families.
Helpful Resources
It is crucial to consider your states specific requirements to getting your license. A helpful website I’ve found for this is Counseling Degree Guide. Under the licensure tab you can look up your states specific requirements to attaining whichever license you are considering attaining.
When it comes to understanding what the job market might look like or what you can expect to get compensated for each path, you can check out the U.S. Bureau of Labor Statistics.
Lastly, the video below provides an additional brief overview on how you might determine the best path for you becoming a therapist:
While determining which path might be best for you is a crucial step in the process to you becoming a therapist, as I have said before, know that you are not locked in. You might begin a counseling program and come to find that you have a passion for connecting people with tangible supports – you can switch to social work program. That’s ok. It’s not against the rules. Or maybe your part way through your marriage and family therapy practicum and realize you don’t like working with couples. That’s alright too. There’s always room to make a change. That being said, doing your research and understanding what might be on the other side could save you some time and money getting to where you want to be.