Counselor, therapist, psychologist—is there a difference?
If you’re seeking therapy for the first time, the number of different terms might be overwhelming. Should you see a psychotherapist or a social worker? A counselor or a coach? A psychiatrist or a psychologist?
Some of these names are more or less synonyms, while others have very defined meanings. It helps to know what each type of therapist can offer you, so you can find the right fit for you.
What’s a Psychologist?
A psychologist is an official term for someone who has their doctorate in psychology. Some psychologists work in research only, but many work as therapists to provide mental health support for clients.
A psychologist has the following characteristics:
- Has earned a doctorate in psychology
- Can provide treatment through talk therapy with clients
- Cannot prescribe medications, but may refer you to someone who can
- Must be licensed to practice within one particular state
What’s a Psychiatrist?
A psychiatrist is a medical physician who has completed their residency in psychiatry. Residency is a period of training after medical school in which the graduate is a “doctor in training” in their desired field of work—in this case, psychiatry.
A psychiatrist has the following characteristics:
- Has earned their medical degree
- Has completed psychiatric residency
- Diagnoses and treats mental health conditions
- May perform laboratory testing for diagnostics
- Can perform treatments like electroconvulsive therapy
- Prescribes medication for mental health conditions
- Can offer psychotherapy (but many do not)
- Tend to meet clients for shorter sessions to help monitor and manage medication efficacy
“If you’re seeing a psychiatrist and on medication, it is encouraged to also see a therapist,” says Cara Maksimow, LCSW. This provides a more well-rounded approach and tends to improve medication efficacy.
Therapists + Social Workers
Therapist is a tricky word because it sometimes serves as a catch-all term. Since psychologists, psychiatrists, and social workers can all offer therapy, they could all fairly refer to themselves as therapists. Their patients are also likely to just call them “their therapist.”
That said, if someone is a therapist but does not have a doctorate in psychology or a medical degree, it often means they are a licensed clinical social worker, or LCSW.
LCSWs often have the following characteristics:
- Earned a master’s degree in psychology, social work, or counseling
- Completed post-masters training in a clinical setting under professional supervision
- Passed a licensing exam in order to practice in their state
Counselors + Coaches
Some terms you might hear less frequently are counselors and coaches (such as a “life coach” or “therapeutic coach”).
Counselor is yet another catch-all term that has less defined meaning. “A lot of social workers call themselves counselors,” says Maksimow. “As an LCSW, I say I’m a counselor, therapist, [or] psychotherapist.” For this reason, if someone calls themselves a counselor, you can assume they meet the criteria listed above for LCSWs.
Coach is not a regulated term, and they are not considered medical providers. As such, “a coach is not able to be reimbursed through any medical or mental health benefits,” says Maksimow. In other words, your insurance won’t cover your sessions with them.
“However, a coach can be really helpful. A coach can help you work on setting goals, learn strategies, [or] help you problem solve,” says Maksimow.
No matter which type of therapist you see, find out what to expect at your first therapy session here.
Cara Maksimow is a licensed clinical social worker in New Jersey. She is the founder of Maximize Wellness Counseling and Coaching.
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So Cara, you're a licensed clinical social worker,
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and a psychotherapist.
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What's the difference between a psychologist,
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a psychiatrist, and a therapist?
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There are distinctions.
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So a psychologist is someone who's got their doctorate
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in psychology, so they've gone to school for a PhD.
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They can do talk therapy,
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diagnose and treat through a therapeutic relationship.
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But a psychologist cannot prescribe medications
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and a psychologist also has to be licensed
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to practice therapy in that state which requires
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an exam and a certain level of clinical hours.
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A psychiatrist is a medical doctor who's completed
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and then done residency in psychiatric training.
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A psychiatrist can diagnose and treat,
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and treat with medication, and prescribe meds.
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A psychiatrist also is not always gonna do psychotherapy.
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They can. It's not really the most cost effective.
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Most of the time, they'll do a full assessment, evaluation,
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prescribe the medication if needed,
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and then meet with a client or a patient
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for medication management,
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so maybe short appointments every couple of months.
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If you're seeing a psychiatrist and on medication,
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it is encouraged to also see a therapist.
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Now a therapist is usually master's level.
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Like, I am a LCSW,
which is licensed clinical social worker,
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so it's a master's level training
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in either psychology, social work, counseling,
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and post-masters, depending on the state,
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I know New Jersey is about 2,000 hours of clinical work
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while being supervised regularly,
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and then passing a licensing exam
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in order to practice in that state.
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So that's, I hope that answers your question.
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Two other terms I want to ask you about:
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Counselor and coach, and both of those
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sometimes have therapeutic offerings, too, right?
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Yes, so a counselor is another,
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a lot of social workers call themselves counselors.
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As an LCSW, I say I'm a counselor,
a therapist, psychotherapist.
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So it's usually a master's level training and licensing.
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A coach is not considered a medical provider.
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However, a coach can be really helpful.
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A coach can help you work on setting goals,
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help you learn strategies,
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help you problem solve,
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but you're not able to then submit any of the claims
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or be reimbursed as a medical provider
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because coaching is not,
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it's not regulated in most states.
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So anyone can technically call themselves a coach,
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whereas you can't call yourself a social worker
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or an LCSW unless you're licensed with the state.
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Same thing with psychologists,
so it's an unregulated area
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that's not considered reimbursable through health care,
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but can be really effective depending on
what your needs are.
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So it sounds like there's a lot of choices
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and if you are wanting to get some mental health help,
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how do you go about finding someone
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who's gonna be right for you.
Do you just google them?
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Do you ask a friend? What do you recommend?
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There's a lot of different ways.
Asking a friend is always helpful.
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There are some websites, like PsychologyToday.com
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is one of the most common websites where you can
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look up your zip code and look for a therapist
or a psychiatrist,
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and therapists can either be psychologists
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or master's level counselors or therapists.
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They're pretty interchangeable on that site,
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and you can read through and look.
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That's always a good place to start,
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and your medical doctor could also recommend someone,
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and a psychiatrist could recommend someone,
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but if you're seeing a psychiatrist for medication,
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you probably also want to be seeing a therapist as well,
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so they go hand in hand.
- Clinical social work. Washington, DC: National Association of Social Workers. (Accessed on July 17, 2020)
- How to choose a psychologist. Washington, DC: American Psychological Association, 2019. (Accessed on July 17, 2020)
- What is psychiatry? Washington, DC: American Psychiatric Association. (Accessed on July 17, 2020)