2016-08-30

There are dozens of types of therapists and counselors, each with a different method, speciality, salary or degree. If you are interested in working with a psychotherapist, this guide will offer all the information you need to find the professional who best fits your challenges, lifestyle, budget and preferences. It is also helpful for aspiring therapists who want to learn about possible career paths.

What Does “Type” Mean in the Context of Therapists?

There are several factors that determine exactly what a therapist’s “type” is (we explore all of them thoroughly in the rest of the guide):

Type of Psychotherapy They Practice

Type of Degree or License

Type of Specialized or Additional Credential

Issues or Disorders They Specialize in Treating

Whether They Use Mediums Such as Art and Music

Willingness to Give Advice

Practicing In an Office, Online or Both

If They Practice in an Office, Is It a Group or Individual Office?

Health Insurance Policies

Works with Individuals, Couples, Families or a Combination

Works Only with Adults, Only with Children, Only with Seniors or a Combination

Specializes in Seeing Clients of Certain Races, Income Levels, Religious Backgrounds and Sexual Orientations

The Locations in Which They Practice

There is no consensus or standard definition of what “type” means in the context of counselors. “Type” can refer to any one of the aforementioned factors.

Nonetheless, therapists and clients mostly use “type” to refer to the type of psychotherapy the therapist practices or their degree, license or credentials. This is because many therapists most prominently feature therapeutic approach and education in their personal brand and marketing. They also often perceive it as a more important part of their professional identity.

You’ll see many listings and bylines that look something like this:



Or this:



Some therapists stress their therapeutic approach on Google and their personal website:



Why All Parts of a Therapist’s Type Are Equally Important

It’s natural for therapists to stress their credentials and approach more than other parts of their type. “Health Insurance Flexible Therapist” doesn’t sound as appealing as “CBT therapist,” even if clients find the therapist by searching health insurance directories.

The unintended negative consequence of stressing education and type of psychotherapy more than other factors is it leads some clients and therapists to believe the other factors don’t matter as much. The factors actually vary in importance depending on what the client is looking for and what the therapist wants to offer during treatment.

Some clients search for counselors based on health insurance or the ability to practice online. To them, the type of psychotherapy and credentials are an afterthought.

Then there are clients who want a therapist with the same race or similar life experiences. They, too, don’t care as much about education level and therapeutic approach.

There are also therapists who believe the type of degree does not significantly impact the quality of therapy.

“I believe any mental health professional who has experience counseling can help people with the same effectiveness as another degree, such as LMFT, LPC, PhD, LCSW and LMHC,” said Talkspace therapist Karissa Brennan, LMHC.

All of the factors that make a therapist’s type are important. Keep reading to learn about them in depth and see how they impact both the client and therapist.

The Type of Psychotherapy/Therapeutic Approach

The type of psychotherapy or therapeutic approach affects a therapist’s career path but makes little difference in the quality of treatment they can provide. It is important to clients, though.

Some clients might find a purely cognitive behavioral approach too cold or believe psychodynamic methods are outdated. It’s crucial for the therapist and client to think about how the therapeutic approach will mesh with their personalities, preferences and goals.

Most therapists say they specialize in or use a certain approach rather than claiming they are a practitioner of it. There is a difference between someone who calls himself a psychoanalyst and someone who says he uses psychoanalysis in therapy. The former is less likely to blend psychoanalysis with other approaches.

Therapists Who Use an Integrated Approach Or Don’t Use a Specific Approach

Most therapists integrate therapeutic approaches or do not specify an approach. They adapt their methods for each client.

These therapists are best for clients who want to explore a range of issues or are not sure what they want from therapy.

Cognitive and Cognitive Behavioral Therapists [CBT]

Additional Education and Credentials: at least one year of clinical experience, working with more than 10 clients, certification in CBT

Cognitive behavioral therapists focus more on directly treating the negative thinking that is causing the client to behave in maladaptive ways or suffer from anxiety and depression. They don’t spend as much time exploring the client’s past and relationships.

Someone could call him or herself a cognitive behavioral therapist without training at a CBT institute after their master’s degree. Like most therapeutic approaches, there is no license for CBT.

A therapist who trains at a CBT institute and earns a CBT certification after their graduate education is likely to provide better CBT than one who did not. Nonetheless, the additional education is not a guarantee the client and therapist will form a stronger therapeutic relationship and be a better fit.

Dialectical Behavior Therapist [DBT]

Additional Education and Credentials: DBT certification

Therapists specialize in DBT primarily to treat clients with borderline personality disorder [BPD] and other severe mental health conditions. Because BPD is rare compared to other mental health conditions, there are relatively few dialectical behavior therapists.

Psychodynamic Therapist or Psychoanalyst

Additional Education and Credentials: certifications from various institutes

Psychoanalysts or therapists who practice the psychodynamic approach focus on unconscious processes and past experiences that impact present behavior.

There are therapists who practice several other types of psychotherapy, but most of them do not specify the approach as a prominent part of their professional identity. Here are some examples:

Client-Centered Therapist

Existential Therapist

Gestalt Therapist

Humanistic Therapist

Interpersonal Therapist

Rational Emotive Behavioral Therapist

Relational Therapist

Education, Degree and License

The type of education and licenses therapists receive affects their career and salary more than their clients. Therapists with more education usually charge more or are more involved in academia and research. The quality of therapy they offer is not significantly different.

Note: Most types of licensed therapists have a graduate degree or higher level education from an accredited institution. License requirements vary by state.

Licensed Clinical Social Worker [LCSW] or Licensed Master Social Worker [LMSW]

Salary Range: $40-70,000 (varies by state and employment situation)

Common Places of Practice: offices, schools, rehabilitation centers, hospitals

License Requirements: board-approved supervisor and supervised hours, two years of full-time work, board-certified exam

Like all therapists, LCSWs help people improve their mental health and relationships. LCSWs fall within the field of social work, so they tend to be more affordable and work with people in disadvantaged populations more often than other therapists. The difference between LCSWs and LMSWs is LCSWs have more clinical experience and have passed a clinical licensing exam.

There are also LCSW-Rs, who have at least six years of clinical supervision experience and can seek reimbursement from insurance companies.

(Licensed) Mental Health Counselor [LMHC or MHC], Licensed Professional Counselor [LPC] or Licensed Clinical Professional Counselor [LCPC] depending on state

Salary Range: $34-67,000

Common Places of Practice: offices, clinics, hospitals, courts, client’s homes

License Requirements: board-approved supervisor and supervised hours, two years of full-time work, board-certified exam

A LMCH, LPC, etc. is similar to a LCSW. One of the key differences is the ability to perform assessments, Brennan said, including the Wechsler Intelligence Scale for Children [WISC], an assessment designed to help parents understand intellectual disabilities their child may be experiencing.

(Licensed) Marriage and Family Therapist [LMFT or MFT]

Salary Range: $30-78,000

Common Places of Practice: offices

License Requirements: two years of clinical experience with supervision, national exam

LMFTs are therapists who specialize in seeing couples and families. They might occasionally work with family members individually, but the mental health issues will still be in the context of family and relationships. The therapy is designed to be short-term, typically lasting 12 sessions.

Doctor of Psychology [Psy.D.]

Salary Range: $55-129,000

Common Places of Practice: offices, academic and research facilities

License Requirements: Ph.D., years of supervised clinical training, Examination of Professional Practice of Psychology

Psy.D.s have more overall education and experience than therapists with a master’s degree. Because of this, they can charge more and make more money.

They also have more career options outside of working with clients. These include business psychology, forensic psychology and organizational psychology.

This doesn’t mean Psy.D.s are better at working with clients, though. Most doctoral programs divide their focus between treating clients and research.

Psy.D.s are, however, usually more equipped to treat clients with severe mental illnesses such as borderline personality disorder. Their extended education allows them more time to study and specialize in such disorders.

Ph.D. in Psychology

Salary Range: $46-136,000

Common Places of Practice: offices, academic and research facilities

License Requirements: Ph.D., years of supervised clinical training, various exams

Ph.D.s in Psychology primarily focus on research and often become academic faculty so they can continue their research and teach. They also have the options Psy.D.s have.

Many don’t work with clients. Those who do work with clients usually don’t spend the majority of their time doing so.

There are, however, some who open their own private practice. This requires a Ph.D. in Psychology and is one of the biggest benefits to earning one. There are also many Ph.D.s in Psychology who spend most of their time working with clients but do not open their own practice.

Psychiatrist

Salary Range: $59-193,000

Common Places of Practice: offices, hospitals, universities

License Requirements: medical degree [M.D.], four-year residency program with at least three years spent in psychiatry, various exams

Psychiatrists prescribe medication and help clients manage regimens and dosages. They typically do not spend a lot of time providing talk therapy. They are more like mental health doctors than therapists.

There are some psychiatrists, however, who work with therapists to treat clients or provide talk therapy and medication to the same clients.

Less Common Licenses

You won’t see these licenses often, but it is worth recognizing them. Here they are:

Licensed Professional Counselor-Supervisor [LCP-S] — Think of this as a more experienced LPC who supervises other therapists. Many therapists supervise their peers but don’t bother to stress their supervision duties as part of their professional identity. To become a supervisor, a therapist must take additional courses and earn a certification (requirements vary by state).

Licensed Creative Arts Therapist [LCAT] — A LCAT must earn a master’s degree in art therapy, music therapy or another art-related therapy. They also need to pass exams and complete additional training that varies by state.

Additional Credentials, Certifications and Licenses

In addition to the minimum education and licensure therapists need to practice, they can earn credentials to set themselves apart. These credentials can involve learning new skills, applying current skills in new environments, specializing in types of treatments or in working with certain types of clients. They allow therapists to charge more and diversify their career.

Distance Credentialed Counselor [DCC]

Distance Credentialed Counselors train to provide psychotherapy via distance mediums, including phone, text, audio messaging, video messaging and live video chat. DCCs need to take several exams to earn the certification.

“The DCC credential helped me by teaching me how to manage risky situations, such as working with someone who is being abused, who is suicidal or is self-harming,” said Talkspace therapist Karissa Brennan, DCC. “Also, it taught me practical tips, such as where to place the video windows on the computer screen so it appears I am making eye contact with the person on the other end while still observing their facial expressions and what’s going on in the background, and where to place lighting to ensure I have a warm, inviting presence.”

Therapists who do not have this credential can still provide high-quality online therapy comparable to a DCC. Nonetheless, being a DCC can only help.

Certified Alcohol and Drug Counselor [CADC] or Licensed Clinical Alcohol and Drug Counselor [LCADC]

Both CADCs and LCADCs specialize in working with clients who have alcohol or drug problems, addiction issues or substance use disorders. The difference — depending on state — is LCADCs can conduct unsupervised practice and supervise both CADCs and other counselors. On the other hand, CADCs cannot supervise other counselors.

LCADCs have a thorough understanding of how drugs affect brain functioning, the causes of addiction, risk factors for addictions and compulsive behaviors, according to Talkspace therapist Katherine Glick, LPC, LCADC. This experience can help clients more quickly identity causes of addiction and implement treatment plans based on research and neurology. It also helps the therapist be more empathetic and compassionate regarding addiction issues.

Here are a few more additional certifications and credentials therapists can earn:

National Certified Counselor [NCC] — This credential sets a therapist apart because most therapists are only certified on a state level.

National Certified School Counselor [NCSC] — NCSCs specialize in working with student clients, usually on campus.

Certified Clinical Mental Health Counselor [CCMHC] — This certification provides extra general counseling training.

Master Addiction Counselor [MAC] — This certification provides extra addiction counseling training.

Military and Family Life Counselor [MFLC] — MFLCs work with military personnel and their families to address issues they tend to have, including crisis intervention, grief, reuniting, occupational stress and much more.

Pastoral Counselor — Pastoral Counselors specialize in integrating spiritual and mental health issues in the context of a religious identity or community. Some of them work in places of worship such as churches and synagogues.

Disorders and Issues

The Issue of Branding and Qualification: “Couples Therapists,” “Sex Therapists” and More

Most therapists have plenty of experience studying and treating both depression and anxiety, the two most common mental health issues. There are also many who specialize in treating less common mental health conditions such as post-traumatic stress disorder [PTSD] and borderline personality disorder [BPD].

Therapists who specialize in treating disorders usually do not brand themselves in an obvious way. A therapist who exclusively sees clients with PTSD will most likely not call himself a “PTSD Therapist.”

It’s more common for therapists to brand themselves based on issues such as relationships and sex. There are thousands of “Couples Therapists” and “Sex Therapists.”

Couples therapists might exclusively see couples or have far more experience working with couples. Then there are sex therapists, who might exclusively discuss issues of sex or extensively studied sex before receiving their license.

The only problem with this branding is it doesn’t necessarily mean anything in terms of licensing. There is no license to practice “sex therapy” or “couples therapy.” There are, however, certifications for couples therapy and sex therapy, including ones from the Gottman Institute and American Association of Sexuality Educators, Counselors and Therapists.

Therapists who want to brand themselves this way come to a crossroads. They can pursue the relevant certifications before branding themselves and seeking clients based on this brand. This path is less likely to result in malpractice lawsuits. It also allows therapists to charge more.

The second option is branding themselves with a speciality in an issue and not pursuing the certifications. This is legal if they have a license to practice psychotherapy, but it is an ethical grey area.

Clients might work with therapists like this and achieve amazing results without worrying or caring about certifications. On the other hand, there is the risk of clients feeling mislead or cheated. Both clients and therapists need to decide how important the certifications are.

A Quick List of Specializations in Mental Illnesses

Below are some mental illnesses therapists specialize in treating. Therapists can specialize in them by focusing their education, earning certifications and taking work or clinical opportunities related to specific illnesses. Clients can search for these therapists by using Google, various therapy or insurance databases and online therapy networks (more on that later).

Anorexia Nervosa

Anxiety

Attachment Disorder

Binge Eating Disorder

Bipolar Disorder

Body Dysmorphic Disorder

Borderline Personality Disorder

Bulimia Nervosa

Depression

Narcissistic Personality Disorder

Obsessive Compulsive Disorder [OCD]

Panic Disorder

Schizoaffective Disorder

Schizophrenia

Social Anxiety Disorder

A Quick List of Issues Therapists Specialize in Treating

Academic Life (School Counselors)

Addiction (Addiction Counselors)

Aging (Geriatric Counselors)

Divorce (Divorce Counselors)

Existential Crises

Family (Family Therapist)

Grief (Grief Counselor or Grief Therapist)

Multicultural Issues (Multicultural Therapist)

Relationships (Couples Therapists and Relational Therapists)

Sex (Sex Therapists)

Social Media

Sports (Sports Therapists)

Stress

Trauma (Trauma Counselor or Therapist)

Work Life

Remember, a therapist can specialize in an issue and have a certification for it without being licensed in it. A therapist could specialize in family issues and have relevant certifications, for example, but he or she might not be a Licensed Marriage and Family Therapist [LMFT].

This therapist might offer care that is comparable to an LMFT. It’s up to therapists and clients to decide what they are more comfortable with.

Using Mediums Such as Music and Art

There are therapists who use art forms to supplement their practice. Then there are Art Therapists, Music Therapists and others who earn a specific degree. These therapists use the medium as an essential part of their therapy.

Registered Art Therapist [ATR] and Board Certified Registered Art Therapist [ATR-BC]

Salary Range: $30-80,000

Education Requirements: master’s degree, supervised experience, certification in art therapy, national exam

Art therapists help clients use visual art to explore and resolve mental health issues. They still talk with clients, but they encourage them to use art if words aren’t sufficing. An ATR-BC is likely to have more experience and provide better care than an ATR.

Registered Dance Movement Therapist [R-DMT] or Board-Certified Dance Movement Therapist [BC-DMT]

Salary Range: $60-95,000

Education Requirements: graduate degree from American Dance Therapy Association [ADTA]-approved program, certification via ADTA-approved alternate education, experience working with children

Both R-DMTs and BC-DMTs use dance as a medium to help clients improve emotional, cognitive and physical wellbeing. The difference is BC-DMTs have a higher level of qualification, allowing them to charge more and supervise other dance therapists.

Music Therapist-Board Certified [MT-BC]

Salary Range: $40-50,000

Education Requirements: MT-BC credential, national examination, undergraduate degree

Music therapists use music to help clients achieve therapeutic goals. They also encourage clients to express emotions and thoughts via music.

The Type of Advice They Give and Whether They Give It

Therapists define advice in several ways. Then there are therapists who don’t give any advice. Here is a quick summary of the types:

Therapists who define advice as telling clients what to do

Therapists who define advice as offering their thoughts or opinions on an issue

For each of these definitions, there are therapists who offer advice or refuse to offer it. You can explore the issue thoroughly by reading this article: “Do Therapists Give Advice (And Should They)?”

Practicing Only in an Office, Only Online or Doing Both

Most therapists only practice in an office or see clients online in addition to practicing in an office. The therapists who do both usually work with the online clients to supplement their income.

There are much fewer therapists who only work online or brand themselves as “online therapists.” They do not necessarily provide better online therapy than therapists who practice online and in an office. Nonetheless, a therapist with online training or the aforementioned DCC credential is likely to provide better online care than someone without that extra experience.

If They Practice in an Office, Is It a Group or Individual Practice?

The vast majority of therapists practice alone. They are not affiliated with a group practice, company or firm. Because there are more of them, they are easy to find and will satisfy most of the type requirements we mention.

Group practices are less common and harder to find. You can search for them by Googling “group psychotherapy practices in [insert your city].” You might encounter them during other types of searches as well.

Because there are less of them, it might be hard to find a group practice that fits your needs and preferences. If you do find one, however, the benefits are amazing. Therapist Kristen Martinez, co-founder of Seattle-based group psychotherapy practice Pacific NorthWell, outlined a few of them:

Benefits for Therapists

Easier collaboration with or supervision of other therapists

It’s easier to work with psychiatrists and other mental health professionals if they are in the same office

Referrals from therapists within the group practice

Easier to specialize in a specific population or approach

Stronger support system and professional community

Administrative staff handles the business aspects of therapy, allowing therapists more time to focus on their calling

Benefits for Clients

Some group practices have psychiatrists, therapists and other mental health professionals under the same roof, allowing clients to more easily and efficiently coordinate multiple types of treatment and care

Only Takes Health Insurance, Doesn’t Take It or Is Flexible

Some therapists are able to make more money by working with health insurance companies. They think the time spent negotiating rates with insurance companies and dealing with opaque bureaucracies is worth it. Some of them get into a routine and end up only working with health insurance companies.

Other therapists might prefer insurance but are willing to take clients without it. They might need clients too badly to be stingy about it or realize there are cases where they can make more money without health insurance.

When a therapist doesn’t take health insurance for any clients, it is usually because he or she can make more money by working directly with the client. The therapist might also feel the time it takes to communicate and negotiate with health insurance companies is too great a cost. The bureaucracy can be frustrating to the point of turning therapists off from it entirely.

Working with Individuals, Couples, Families or a Combination

Most therapists only work with individuals or see individuals and couples. There are a relatively small number who only work with couples or families. Even LMFTs usually see a combination of individuals, couples and families.

A LMFT is likely to provide better therapy to couples and individuals than a therapist who has spent the majority of his or her time with individuals. Nonetheless, couples and families should consider the other types in this article rather than assuming any LMFT will be better than another type of therapist.

Age: Adults, Children and Seniors

The vast majority of therapists work with adults of all ages. There are, however, many who work only with children, only with seniors or with children and adults of all ages.

Child Therapist, Child Psychologist, Child Counselor or Child Pediatric Therapist

Child therapists are licensed therapists who studied child psychology during their education, have experience with children in a clinical setting or earned a certification relevant to child therapy, including a certification in play therapy.

There are therapists who specialize in working with seniors, but they usually do not brand themselves the way child therapists do. You won’t see “Geriatric Counselor” as often as “Child Psychologist.”

Specializing in Seeing Clients of Certain Races, Income Levels, Religious Backgrounds and Sexual Orientations

There are thousands of therapists who specialize in treating clients of a certain race, income level, religious background or sexual orientation. The problem is some are easier to find than others. There are more certifications and additional credentials available for specializing in sexual orientation than there are for race, income level or religious background.

“LGBT therapists” are relatively easy to find because most people are comfortable with that kind of branding language. There are additional certifications for specializing in sexual orientation such as the LGBT-Affirmative Psychotherapy Online Certification Program.

The branding and credentialing issue is more difficult for therapists who specialize in seeing other kinds of populations. A black therapist who only takes black clients would not call himself a “Black Therapist” or “Therapist Who Specializes in Black Clients.” Therapists can have experience treating and studying certain races, religions and income levels, but there are few relevant credentials or certifications available.

This makes the marketing work harder for the therapist and the search more time-consuming for the client. The search becomes even more difficult after factoring the difference between finding a therapist who belongs to a certain population versus one who specializes in treating that population (or both).

If you search for a therapist based on specializing in a population, the results will be a mixture of therapists who belong and don’t belong to that population. There is no way to manually filter these results. Again, this is less of an issue with LGBT therapists.

Therapists who belong to and specialize in treating a certain population are not necessarily better than those who specialize but do not belong. Some clients want a therapist who can relate to them on a personal level. Other clients feel this connection will make the therapist too close to the issue/community and likely to judge rather than being objective.

Practicing in Various Locations

The location psychotherapists practice in usually depends on the other “type” factors in this article. An online therapist often works from home, a therapist who specializes in severe mental illnesses might only work in a psychiatric hospital and an addiction counselor could have an office in a rehabilitation center.

Below is a quick list of the common locations psychotherapists work in. Each location lists the type of therapists who are more likely to work there.

Private Office or Group Practice Office: any type

Psychiatric Hospital: therapists specializing in severe mental illnesses such as BPD, psychiatrists

Hospital: grief counselors, psychiatrists

Schools and Universities: school counselors, psychiatrists, child therapists

Rehabilitation Center: addiction counselors, CADCs, LCADCs

LGBT Center: LGBT therapists

Churches: pastoral counselor

Synagogues: religious counselor

Mosques: religious counselor

Federally Qualified Health Centers [FQHCs]: any type

Military Facilities: Military and Family Life Counselor [MFLC], pastoral counselors

Using the Types of Therapists To Find the Right One for You

If you are an aspiring therapist, this article will help you focus your career path. You can see how mixing and matching each factor in “type” can assist you in finding new clients, diversifying your skillset, making more money and being more fulfilled in your work.

For clients this guide will help you consider the factors in determining which type of psychotherapist is the best fit. Then you can search based on what you decide.

Note: At Talkspace our consultation therapists and matching algorithms can consider most of these factors for you. It might save you a lot of time and stress.

The post The Different Types of Therapists and Counselors: The Complete Guide appeared first on Talkspace Online Therapy Blog.

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