What kind of counselor is this? - therapist character builds

You may be asking yourself, Jeanette, why are there so many letters behind your name? This is ridiculous. What’s the difference?

I’m glad you hypothetically asked, inquisitive person on the internet!

The different types of clinicians you can work with for your mental health can be confusing for sure. All mental health professionals are rock stars that can help you with a variety of different goals, but the difference lies in the “character build” so to speak. The same way you can build an RPG character to focus on stealth, to be a tank, or to rely on magic abilities vs. melee skills. Different types of mental health clinicians focus their skill training on different approaches. The following are some explanations of some of the different types.

*DISCLAIMER: This is specific to the clinicians and credentials I’m aware of in Texas and is by NO means an exhaustive list. It’s always best to ask anyone you would like to work with what their particular training and credentials are to see if they will be a good fit for your needs!

COUNSELORS/THERAPISTS

With some exceptions, those in the Counselor/Therapist category have a Master’s degree or higher and specialized training with certain populations. They tend to focus on individual, group, family, or couples therapy and are not able to prescribe medications.

Counseling Practicum/Internship Students: currently in their graduate programs and working on their first field experiences. These students are often supervised by university professors as well as a clinical supervisor in their internship sites. Many people work with student counselors through community agencies or university counseling centers.

LPC - Licensed Professional Counselor: Master’s level clinicians who have completed their graduate program, have passed a national exam, have been approved by the state to practice counseling, and have completed at least 3000 supervised hours over the course of at least 18 months. Their scope of practice can cover all mental health issues, though some LPCs focus in particular areas and may not be comfortable treating specific issues. For example, an LPC can specialize in substance abuse, but not feel they have the scope to treat eating disorders.

An LPC-A - Licensed Professional Counselor Associate is someone in the process of completing their 3000 hours/18+ months of supervised post-graduate clinical experience.

An LPC-S - Licensed Professional Counselor Supervisor is someone who has completed a PhD in Counselor Education and Supervision or a Masters level clinician who has had at least 5 years of experience and who has passed a 40 hour supervision course.

LMFT - Licensed Marriage and Family Therapist: Master’s level clinicians who have completed a graduate program specific to marriage and family therapy, have passed a national exam, have been approved by the state to provide therapy, and have completed at least 3000 supervised clinical hours. 750 of those supervised hours must specifically be clinical work with families or couples rather than individual counseling. Their scope of practice can cover all mental health issues, though LMFTs tend to focus on working with couples or families rather than individuals. An LMFT-A - Licensed Marriage and Family Therapy Associate is someone who is in the process of completing their post-graduate supervised hours.

LMSW - Licensed Master Social Worker: these Master’s level workers often focus on the case management side of support for clients. These graduate programs do provide some training on counseling/therapy techniques, but often focus more on case management, community organization and program development, systems work and advocacy. They may connect you with resources, provide overall support and guidance in setting and achieving goals, and provide education, to better manage a wide range of physical and mental health needs.

LCSW - Licensed Clinical Social Worker: after completing their Master’s level program in social work, these people go on to focus on clinical work and often provide individual and group therapy in addition to the case management services that LMSWs do. LCSWs must have completed at least 2 years of supervised clinical work.

LCDC - Licensed Chemical Dependency Counselor: these counselors must complete at least a 2 year Associates degree in the behavioral health field, pass a licensure examination, and must complete at least 4000 supervised clinical hours with clients that have chemical dependency. LCDCs are, however, only able to provide services specific to substance abuse and chemical dependency. They are not authorized/trained to provide mental health services for any other diagnoses beyond this scope. (Unless they are dual licensed!)

Pastoral Counselor: These can be ministers, priests, or chaplains that provide spiritually focused counseling through their congregation and do not necessarily need to have any license to practice in mental health. They may be required to complete ministry or religiously specific education through a university, seminary, or theological school. Some pastoral counselors, however, also go through requirements to become licensed clinicians such as an LPC or LMFT.

School Counselor: Can be an LPC, but does not necessarily need that license. School Counselors are required to complete a Masters degree in a counseling field, complete an approved Educator Preparation Program, and have at least 2 years of classroom teaching experience. They provide counseling services, you guessed it, in school settings rather than their own practices.

NCC - National Certified Counselor: Along with meeting state requirements to practice counseling/psychotherapy, an NCC has also met more stringent training requirements at a national level. They must often complete substantially more ongoing training each year to keep this credential.

There are also various specific trainings that counselors may complete in order to provide specialized treatment services such as Play Therapy, Art Therapy, Sand-Tray, EMDR, etc.

CLINICAL PSYCHOLOGISTS

These clinicians are typically required to have a Doctorate in Psychology and you may see PsyD or PhD behind their names. From my experience and those I’ve worked with, psychologists often focus on assessment, evaluation, and testing more-so than individual therapy, though it can be a service provided by a psychologist. They are not able to prescribe medications. You may see the following acronyms used by Psychologists.

LP - Licensed Psychologist

LSSP - Licensed Specialist in School Psychology

NCSP - Nationally Certified School Psychologist

PSYCHIATRISTS

These clinicians are required to have medical Doctorates and you will see MD in their credentials. They have completed medical school and have decided to focus on psychiatry as their specialty. These clinicians are able to prescribe and manage medications with their clients. They tend to have more of a medical focus in their practice and, when they do offer therapy services, are typically less frequent than other types of counselors (once a month vs. once a week is common). You may also see a Psychiatric Nurse or APN - Advanced Practice Nurse for mental health support and medication management through this medical focus.

At the end of the day, the most important thing is that you feel safe, respected, and comfortable working with your counselor. While certain licenses or credentials may give you a better idea of the scope of a clinician’s practice, it’s important that they are someone who you can work collaboratively with to reach your mental health goals!

If you are ever confused or unsure about how a clinician may be able to help you, please ask! We are all here to help you complete your mental health quests and level up your confidence, coping skills, and awareness.