WHO’S WHO
Who Does What: Types of Therapists and Counselors Explained
Types of Therapists and Counselors:
Understanding Mental Health Degrees
Who Does What: Types of Therapists and Counselors Explained
When seeking support for mental health, emotional well-being, or relationship challenges, it can be confusing to navigate the different types of therapists and counselors available. The titles and degrees behind a clinician’s name often raise questions about training, roles, and who does what. This guide breaks down the most common types of therapists and counselors, including time to completion, clinical emphasis, and career outcomes. Mental health professionals differ in training and focus, and resources like the American Psychological Association (APA) or the Bureau of Labor Statistics (BLS) offer helpful distinctions for those exploring career or provider options.
Medical Degree (M.D. or D.O.) – Psychiatrist
- Education & Training: Requires a bachelor’s degree (4 years), medical school (4 years), followed by a
residency in psychiatry (4 years), and potentially a fellowship (1-2 years). - Focus: Psychiatrists are medical doctors who specialize in diagnosing and treating mental health
disorders from a medical/biological perspective. They are the only mental health providers (besides
some nurse practitioners) who can prescribe medication in all 50 states. - Scope of Practice: Evaluate complex psychiatric conditions, prescribe medication, manage medication
plans, and sometimes offer psychotherapy. - Career Settings: Hospitals, private practices, clinics, research institutions, academic medicine.
Psychiatric-Mental Health Nurse Practitioner (PMHNP) or Registered Nurse (RN)
- Education & Training: RN programs typically require 2-4 years. PMHNPs must complete a master’s or
doctoral nursing program (2-4 additional years). - Focus: PMHNPs are advanced practice nurses with clinical training in psychiatric diagnosis and
medication management. RNs often work under supervision and provide patient care and education. - Scope of Practice: PMHNPs can prescribe medications and conduct evaluations. RNs focus on
implementation of treatment plans, patient education, and monitoring. - Career Settings: Hospitals, clinics, psychiatric facilities, primary care offices.
Master’s Degrees (MA, MS, MEd, MSW, MFT, etc.)
Master’s level clinicians are often the front-line providers of psychotherapy and counseling services. Most programs take 2-3 years full time, including supervised clinical practicum.
Master's in Counseling (MA, MS, MEd in Counseling)
- Focus: Individual, group, and sometimes career or school counseling. Emphasis on developmental,
cognitive-behavioral, and humanistic approaches. - Scope: Provides talk therapy, assessments, and treatment planning.
- Common Titles: Licensed Professional Counselor (LPC), Licensed Mental Health Counselor (LMHC).
Master's in Marriage and Family Therapy (MA, MS in MFT)
- Focus: Systemic and relational therapy models focused on couples and families.
- Scope: Works with individuals, couples, and families using systemic frameworks.
- Common Titles: Licensed Marriage and Family Therapist (LMFT).
Master of Social Work (MSW)
- Focus: Combines clinical mental health training with social justice, community resources, and advocacy.
Emphasis on person-in-environment perspective. - Scope: Clinical therapy, case management, and resource coordination.
- Common Titles: Licensed Clinical Social Worker (LCSW), LMSW.
Master’s in Psychology (MS or MA in Psychology)
- Focus: Varies by program. May lead to roles in counseling, research, testing, or academic settings.
Some are pre-doctoral. - Scope: Often does not lead directly to licensure unless part of a licensure-track program.
Educational Specialist (EdS) or Master's in School Psychology
- Focus: Mental health and educational support services within school settings. Training in psychological
assessment, intervention, consultation, and prevention for school-aged children. - Scope: School psychologists work with students, parents, and teachers to support learning, behavior,
and mental health. They conduct psychoeducational evaluations and help develop IEPs (Individualized
Education Plans). - Common Titles: School Psychologist (often certified by the state department of education, sometimes nationally certified—NCSP).
Doctorate Degrees
Doctoral programs are the most advanced education paths for mental health professionals. These programs can take 4-7 years post-bachelor’s.
Doctor of Philosophy (PhD in Psychology or related field)
- Focus: Research, academic, or clinical work. PhDs emphasize both the science and practice of psychology.
- Scope: Provides therapy, conducts psychological testing, and may work in academia or research.
- Common Titles: Clinical Psychologist, Counseling Psychologist, or School Psychologist.
Doctor of Psychology (PsyD)
- Focus: Practice-focused degree with less emphasis on research than a PhD.
- Scope: Similar clinical roles to a PhD. Heavy training in assessment and intervention.
Doctor of Marriage and Family Therapy (DMFT or PhD in MFT)
- Focus: Advanced systemic therapy training with a focus on leadership, supervision, or academia.
- Scope: Clinical work with couples and families, program development, or teaching.
Doctor of Social Work (DSW)
- Focus: Advanced practice, policy, and leadership in social work.
- Scope: May work in administration, advocacy, or advanced clinical roles.
Which Type of Provider is Right for You?
- Need Medication? Seek a psychiatrist or PMHNP.
- Looking for Therapy? A master’s or doctoral level therapist such as an LPC, LMFT, LCSW, or psychologist may be right.
- Prefer Relationship or Family Focused Work? Look for an LMFT or PhD/DMFT in marriage and family therapy.
- Looking for Trauma-Informed or Social Justice Approaches? Consider an LCSW or clinician with specific trauma or DEI training.
- Want Testing or Formal Assessments? A psychologist (PhD or PsyD) typically offers those services.
- Need Support in School Settings? A school psychologist specializes in working with children, parents,
and teachers to support academic and emotional success.
Understanding types of therapists and counselors and who does what in the mental health world can help reduce the intimidation factor and support you in choosing someone aligned with your needs. No one path is better than another—just different. The key is finding the person, and the approach, that helps you feel understood, empowered, and safe.
