Certified, Licensed, and Self Proclaimed “Experts” — The Difference Between “Coaching,” “Therapy,” “Counseling,” and “Consulting”
Nowadays there are many professionals out there offering different kinds of services that seem to be very similar. You have life coaches, therapists, drug and alcohol counselors, recovery coaches, psychologists, psychiatrists, social workers, and the list goes on and on. It can be hard to sift through it all, so I wanted to take a bit of time to explain some of the legal and technical definitions of these things, as well as some of what they do. Additionally, I will cover some of my personal opinions about what they SHOULD do, and more importantly should NOT do.
Licensed and Certified Professionals
The following is a list of some of these professional licenses and terms, as well as what it takes to become one, and what that particular title means, from most to least educated.
Psychiatrist — A psychiatrist is a medical doctor (or doctor of osteopathy) who has specialized in mental health and psychiatric disorders. They can prescribe medication, and provide any kind of counseling, therapy, and mental health treatment. They have the widest scope of practice and are allowed to supervise any other mental health professional.
They need to have a bachelor’s degree, four years of medical school (minimum), three years of residency (minimum) specializing in psychiatry, and need to have passed a half dozen or so certifying exams throughout their school and residency. They must maintain a level of continuing education and have a license in good standing by the state in which they are practicing medicine. This is 11+ years of schooling and training, with 7+ years focused on the job they are going to be doing.
Psychologist — A psychologist is an individual with a doctorate in psychology (either Ph.D. or Psy.D.) as well as a license to practice psychology in the state where they practice. A psychologist is licensed to provide mental health treatment (excluding medication) and can supervise any mental health professional with an equal or lesser license.
A psychologist goes through a bachelor’s degree, a master’s degree, a doctoral degree, and a minimum number of supervised internship, as well as 4+ certifying and licensing exams throughout their schooling. This means a licensed psychologist has gone through 8+ years of school and training with at least 4+ focused on mental health. A psychologist is required to maintain their license and complete a certain number of hours of continuing education per year.
Psychotherapist — A psychotherapist (or “therapist”) is someone who has a master’s degree in some form of psychology and mental health, as well as has a license in the state in which they practice. There are a few different types of therapists, and a few different people who can call themselves therapists. In California there are three primary master’s level licenses to practice psychotherapy; Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW), and Licensed Professional Clinical Counselor (LPCC).
These all have gone through a minimum of a bachelor’s degree, a master’s degree, and a year or more of supervised internship. This is a 7+ years of schooling and training, with 3+ years of specific training to practice, as well as licensing exams. A therapist is required to maintain their license and complete a certain number of hours of continuing education per year. They all have a similar scope of practice with different emphases in school.
Licensed Marriage Family Therapist — A master’s level licensed mental health professional that has focused their study in school on therapy and has extra education in group process and family dynamics.
Licensed Clinical Social Worker — A master’s level licensed mental health professional that has focused their study in school on public health and has extra education in community resources and case management.
Licensed Professional Clinical Counselor — A master’s level licensed mental health professional that has focused their study on counseling and has extra education on individual therapeutic techniques.
School Psychologist/Therapist/Counselor — These are generally master’s level licensed professionals that have their scope of practice limited to educational settings.
Addiction and other Mental Health Counselors — Usually associates degree (or lower) certified counselors that have taken a certifying exam and legally MUST work under a licensed professional. They are usually very limited in scope of practice, and can only treat limited populations, with limited types of psychotherapy.
Registered Interns/Associates — Individuals who have completed their Masters degree and are in the process of collecting their hours of supervision before taking their licensing exams.
These are the primary licenses and certifications that you will find in mental health. These are the ones in California, though most states are fairly similar. Usually if you are practicing in different states you need to have your licenses in each state. These licensing and certifying boards and bodies are set up to maintain consistent minimum standards of education, training, and competency for people calling themselves by these terms. While not every person in practice who is certified or licensed is the same, anyone who has these licenses is at least complying with minimum standards.
No matter what the specific license or title, what really makes a good or great clinician is their experience, talents, and what they have learned since getting out of school. Some people are great educators, some people are warm and excellent empathizers, some people hare incredibly talented in different models. This all comes from a clinicians talents and experience in the field.
Non-Licensed or Certified Professionals
Even though there are many licenses and certifications in the mental health field, there are people who practice things close to it, or use different titles, so they don’t have to meet these minimum requirements. There are “coaches,” “consultants,” and “mentors” to name a few. None of these “professionals” needs any training, licensing, or certification, and are not required to meet any professional standards.
They have no ethic’s boards they are beholden to, they have no repercussions for malpractice (except lawsuits), and there are no standards of care they are required to adhere to. I could call myself a “life coach” or “recovery coach” just because I want to. No one can tell me I can’t, and having this title does not mean I have any knowledge or experience.
This is not to say that some of these individuals are not excellent at what they do, and provide great help to people in need. This is simply saying that there are no standards, and so often times you have no idea going in what you are getting out of these “professionals.”
There are also limitations on what these individuals are allowed to do. They may not perform any kind of therapy, treat any mental illnesses, or provide any legal advice. These would all be considered practicing without a license and is illegal. People’s lives can be on the line in mental health treatment, which is why licenses and certifications were put into place, to insure that people providing treatment to at risk individuals are at least minimally competent and providing appropriate care.
When Should You See Different Types of Clinicians
This is a simple and complicated question to answer. I believe that if you have an issue that is beyond simple discomfort, say addiction, PTSD, or any mental health issue, you should see an appropriate certified or licensed professional. When you injure your shoulder and need surgery, you see a surgeon, and then a physical therapist, and then maybe once you are back to mostly healed you can go back to your coach for sport specific training.
Even when all you need is a little coaching or consulting, often times the licensed professionals are even more skilled than the self-proclaimed “coaches” because they have the experience, training, and education required to know exactly what they are doing. Some of the best personal trainers and strength coaches are actually certified physical therapists who have a master’s degree and a license.
The moral of this entire discussion is simple, anyone can claim they are going to help you with your problems, but some professionals are required to have proved that they at least are minimally competent. If you are really struggling, find a licensed or certified professional. Even if you just want a tune-up, if you want the best help possible, you may want to find a licensed professional as well.
If you have any comments, questions, concerns, please comment below or contact us here at Coherence Associates Inc. at info@coherenceassociates.com. If you would like to speak to a licensed professional give us a call at (760) 942–8663.
Jeremy Larsen
Coherence Associates Inc.
www.coherenceassociates.com