Decreasing barriers to care –
After working in the therapy field for years with various clinical professionals, I’m sharing the differences between the types of psychology titles out there so you can find the right one for your mental health needs.
So you are thinking of starting therapy…
The idea may have sparked from a conversation you had with a friend, or from a TikTok video you watched, or maybe an article you read. Whatever it was, you now find yourself ready to nurture your mental health and look for a therapist. If this is you, please know how incredible that is, because there is so much to overcome in order to get to just that point.
I mean, lets be real, most people don’t actually want to go to therapy. Even therapists themselves avoid getting their own personal therapy. Before we make that first dreaded Google search, there are many internal hurdles that stop us.
Some people were raised with a family value of not airing your dirty laundry to anyone outside of the home; let alone some stranger-therapist-person. Some people think of going to therapy as some kind of admission of their own personal failure (“I should be able to deal with this on my own; now I have to pay some shrink to tell me that there’s something wrong with me.”)
The truth is that going to therapy is not an act of failure, but an act of self-preservation. It is a place to learn more tools to take on all the sludge that life throws at us. Considering the level of taboo and stigma that still surrounds the idea of therapy, you providing yourself that resource and care is an impressive feat.
Unfortunately, even with the infinite wells of information online at our fingertips, the mental health field still remains overwhelmingly tough and frustrating to navigate. The first barrier to accessing mental health support is that most of us don’t know the differences between the types of therapy providers. How do we know where to start our search if we do not know who we are even looking for?
When first searching for therapy, your thoughts may have sounded like:
“What do I need? Who would I go to for that? Do I need a psychiatrist? Or a person with a license? Or a Ph.D? Wait – what do all of these other letters mean?!? Is one better than the other? There are so many. And too many letters. This is so confusing. Yeah-no. Nope. NOPE, this is too much. I’m done. DONE. Gonna go back to pretending I’m fine and just hope nothing bad happens.”
If that is you, please know that you aren’t alone. The confusion around what kind of provider to choose is so overwhelming that most people give up and avoid ever trying to look again. Even clinicians in the field get frazzled by all the titles of providers out there.
Where to begin
For a start – keep in mind that titles of AMFT, ACSW, LMFT, LCSW, Psy.D, and Psychiatrists are all qualified to assess, diagnose, and treat the full range of mental and emotional disorders found in the Diagnostic and Statistical Manual (DSM) of mental disorders.
If you are still thinking “Okay thanks, but what are all of those titles though?!?” feel free to look below for a breakdown of the common types of mental health support:
A Life Coach is simply a human using their guidance and experiences to help another human. Some people find this more culturally acceptable than enrolling in therapy. Any of the providers listed below this one can also become Life Coaches, and commonly do so. However, unlike the other providers listed below, becoming a Life Coach requires no education, accreditation, license, or legal/ethical mandates. I am going to caution that this means a Life Coach without any other accreditations does not have a medical state board holding them legally liable if they harm you mentally, emotionally, sexually, physically, financially, or for the amount of time you spent in services.
Associate Marriage and Family Therapist (AMFT) & Associate Clinical Social Worker (ACSW)
An AMFT/ACSW has a Masters Level Degree (6+ years of college) in providing mental health clinical treatment. They consult weekly with their Licensed supervisor on how to provide best quality care to their clients. Required to take a state board Law and Ethics exam to ensure they do not harm clients. They commonly work in government agencies, non-profits, schools, and hospital settings to earn a minimum of 3,000 hours treating clients before they can qualify to take the state Licensing exam.
Licensed Marriage and Family Therapist (LMFT) & Licensed Clinical Social Worker (LCSW)
An LMFT/LCSW has a Masters Level Degree (6+ years of college) in mental health clinical treatment; passed their Law & Ethics Exam; earned a minimum of 3,000 hours (average of 2-4 years) of treatment experience; and passed rigorous Licensing exam (tests their knowledge of all mental disorders + treatments + state laws + state ethics) to ensure they do not harm clients. Provide talk therapy and behavior interventions in clinical treatment of 1x/week sessions with clients. An LCSW’s degree has more of a lens on social justice and community resources, and an LMFT’s degree has more of a lens on social support/relationships. They commonly work in hospitals, mental health facilities, government agencies, and private practice.
A psychologist has a doctorate level degree (8+ years of college) focused on either mental health clinical treatment (Psy.D.) or research (Ph.D.). Psychologists conduct psychotherapy, psychometric assessment, and psychological testing. Many of them are also licensed (see LMFT/LCSW qualifications above). They commonly work in schools, hospitals, government agencies, and private practice. Note that their doctorate is not a medical degree, and therefore Psychologists cannot prescribe medication – only Medical Doctors or Psychiatrists can prescribe psychotropic medication.
Medical Doctor/General Physician
At first, it may be confusing to see a general medical doctor on this list as they cannot provide mental health treatment. However, doctors are a person’s most likely first access point to gaining mental health care. Across many cultures, people tend to trust their primary care physician to ask about mental health questions before turning to a therapist. Doctors/Physicians have a medical degree (8+ years of college) and medical license. They are a very helpful resource as physical health and mental/emotional health are closely connected. Doctors can prescribe medications for the most common mental disorders in the U.S. of anxiety and depression. Doctors can refer their patient to a psychiatrist for further assessment of psychotropic medication. Finally, Doctors have the ability to rule out if a patient’s physical ailments are sneakily presenting as mental health symptoms.
As a therapist, I always ask my clients during our initial assessment if they have had a physical exam within the previous year. This is to make sure that I am not spending the client’s time (and money!!!) trying to treat mental health symptoms that are actually caused by a physical ailment; which would therefore be better addressed through physical treatment than mental health therapy.
A Psychiatrist has a doctorate medical or osteopathic degree (8+ years of college), then another 3+ years of post-degree psychiatric residency, and then obtained a medical license. Psychiatrists can prescribe any psychotropic medication, teach clients about how their physical health and mental health symptoms are connected, and can provide mental health therapy treatment. Psychiatrists usually only see clients for appointments 1x/month. Psychiatrists can help refer the client to a therapist if weekly mental health therapy sessions to go along with medication support would be helpful. Therapists will follow the psychiatrist’s plan for treating a client as psychotropics are very powerful; psychotropic medications have the ability to kill clients if not taken and weaned off as precisely directed by the psychiatrist.
By reading this, you have already saved yourself time, money, and energy knowing the type of clinician to look for from the start. Woohoo! Now you can embark on Google searches and directories like Psychology Today with confidence in knowing what to look for.
Wishing you wellness and fulfillment!