Anyone who provides clinical counseling services can call themselves a therapist. That’s because the word ‘therapist’ can be legally used to describe many counseling professionals, from psychiatrists to social workers and even pastors. People tend to think of clinical psychologists as the only mental health professionals who can use talk therapy to treat people with serious and severe mental illnesses, but clinical counselors like marriage and family therapists are also qualified to treat conditions like bipolar disorder and schizophrenia.
The gap between what clinical psychologists do and what other therapists do isn’t actually very wide. Counseling psychologists and other therapists both can legally treat people individually and in group therapy sessions. They both diagnose and treat mental illness, give people tools to address challenging personal issues, and help patients of all kinds thrive in their lives.
In other words, don’t assume that you have to become a psychologist because you want to spend your career working with sick patients or in a hospital setting. Licensed clinical therapists of all types work with people coping with everything from post-traumatic stress disorder (PTSD) to substance abuse to extremely severe mental and emotional challenges, and many roads can lead to a career in clinical therapy.
In this article about clinical psychologists vs. therapists, we’ll cover:
Psychologists are mental health professionals with advanced psychology degrees. Most practicing clinical psychologists have either a PhD or a PsyD, though some states allow psychologists to work one-on-one with clients with a master’s degree in psychology. Clinical psychologists typically operate under the assumption that people are capable of learning to think about themselves and their lives differently and, as a result, overcome disruptive thoughts and negative behaviors. Just like other types of therapists, licensed psychologists use different techniques when working with clients and embrace different psychotherapeutic philosophies.
Clinical psychologists with doctoral degrees can also transition into research where they might study how human minds and animal minds work and into teaching positions in higher education.
There are a couple of significant practical considerations:
- A Bachelor’s or Master’s degree in social work
- A license to practice or required social work certification
Credentials vary among careers, states, and territories. Licenses include:
- Certified Social Worker (CSW)
- Clinical Social Work Associate (CSWA)
- Licensed Advanced Practice Social Worker (LAPSW)
- Licensed Advanced Social Worker (LASW)
- Licensed Baccalaureate Social Worker (LBSW)
- Licensed Clinical Social Worker (LCSW)
- Licensed Graduate Social Worker (LGSW)
- Licensed Independent Clinical Social Worker (LICSW)
- Licensed Mental Health Professional (LMHP)
- Licensed Master Social Worker (LMSW)
Most of these licenses require a Master’s or Doctorate, along with additional coursework or clinical internships. ( )
A survey of 2017 social work graduates by the National Social Work Workforce Study found that social workers with Master’s degrees and Doctorates made substantially more than those with no advanced degree. ( )
- People with MSW degrees made $13,000-plus more than those with only BSW degrees
- MSWs make more in large cities or urban clusters
- People with doctorates earned $20,000 to $25,000 more than people with only MSW degrees
|University and Program Name
Clinical therapists usually are licensed mental health professionals, but depending on where you live, someone calling themselves a therapist may or may not be clinically trained and licensed. The rules and regulations about what a therapist is and isn’t vary widely by state, and only some states treat ‘therapist’ as a protected designation. In those that don’t, nutritionists, hypnotists, meditation guides, life coaches, and other professionals can legally call themselves therapists.
In this article, when we refer to therapists, we mean masters-level and doctoral-level mental health counselors who are trained in psychotherapy and licensed by the state. They generally fall into one of the following categories:
The difference between these professionals isn’t clear cut. Clinical psychologists, mental health counselors, and clinical social workers are all “helper professionals.” They’re all able to provide one-on-one psychotherapy once they complete years of advanced training and clinical fieldwork and get a license. They all work with clients to improve their mental and emotional health, social skills, and overall well-being. And they’re all qualified to work in settings like:
These groups can be both large and small and include non-profit and grassroots organizations.
Federal agencies include the Veterans Administration (VA), Social Security Administration (SSA), and the Department of Justice (DOJ); but smaller local government agencies are included as well.
Social work in these settings may include end-of-life work, abuse counseling, child abuse services, and more.
Social services are required at home and during deployment for military personnel and their families.
Nursing home care is a unique specialization that requires treatment with both residents and in communication with family members outside the facility.
Religion in social work creates a unique blend of science and spirituality, and work within religious institutions will strike a particular mix.
Prison social work is as varied as the community it serves, and is a critical resource for both youth and adult populations.
Some private companies offer counseling in-house, providing employees with an added level of care during and after work hours.
Social work in private practice is a traditional setting, but even private practices can share space, clients, and even treat in a virtual setting.
Much like private companies, sports leagues benefit from providing counseling to players and the larger employee base in-house.
Both public and private schools employ school psychologists for students and their families, functioning within their own specific guidelines.
Clinics treating substance abuse disorders provide a specialized and targeted approach to best treat patients in a clinical setting.
They sometimes, but not always, use different approaches. Social workers may work with clients to make significant environmental changes as part of treatment. Licensed counselors may see more clients who are going through emotionally fraught life changes like divorce or unemployment. Psychologists probably see more clients with serious mental health issues, but many people looking for improved quality of life also seek out the help of clinical psychologists.
So, the biggest differences between social workers, psychologists, and counselors aren’t functional. They’re all therapists providing mental health care, after all. The big differences involve training and pay—both of which we’ll address below. What attracts professionals to one branch of therapy over another isn’t typically money, however, but how they feel about the most common approaches different types of therapists use. Social worker M. Levy, for instance, began her career studying psychology, but felt it ignored the larger systems that can impact or even cause mental illness.
“I was delighted to hear that social workers don’t just work with individual clients, but the people and systems around them, too. In a multidisciplinary care team, social workers are the ‘context people,’ often tasked to explain how poverty can prevent a person from recovering from a psychological disorder, or how domestic violence may deter healthy childhood development… I felt that social work could give me what psychology had lacked.”
The answer is a confusing sometimes. As noted, there are states in which clinical psychologists can become practicing therapists with a master’s degree—the same level of degree other therapists must have to practice. In most states, however, clinical psychologists must have a doctorate (either a PsyD or PhD) from an American Psychological Association (APA)-accredited program, plus one to two years of supervised clinical experience for licensure and to practice counseling psychology.
The training psychologists receive includes coursework in theories and practice of psychotherapy, psychological assessment and diagnosis, and other subject matter related to the clinical practice of psychology. Most doctorate-level psychology programs require students to complete a practicum experience, an internship, and a dissertation or capstone project. It can take three to seven years to earn a doctorate in psychology.
Other types of therapists apply for state licensing specific to the type of therapy they offer and are often required to earn two-year degrees specific to their profession:
Includes Licensed Professional Clinical Counselor (LPCC), Licensed Professional Counselor (LPC), National Counselor Examination (NCE), National Board for Certified Counselors (NBCC), Licensed Mental Health Counselor (LMHC); typically they have either a master’s degree in counseling or a master’s degree in clinical psychology.
Includes Master of Social Work (MSW), Licensed Graduate Social Worker (LGSW), Licensed Clinical Social Worker (LCSW), Licensed Master Social Worker (LMSW), Licensed Certified Social Worker-Clinical (LCSW-C), Licensed Independent Social Worker (LISW), Licensed Social Worker (LSW); most often they have a social work master’s.
They will either have a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) with a psychiatric focus.
Includes Master of Arts in Counseling, Marriage and Family Therapist (MFT), Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Marriage and Family Therapist (LCMFT); they can earn a master’s degree program in marriage and family therapy.
They usually have a master’s degree in mental health couseling or a graduate degree in marriage and family therapy.
All the above practitioners are required to complete hundreds of supervised clinical internship hours before they can become licensed by the state—regardless of which license they apply for.
Programs in the same discipline can vary so widely from school to school that it’s difficult to compare and contrast programs for different therapeutic approaches. The counseling programs at some colleges and universities can cover a lot of the same ground covered by psychology programs. Ditto for social work degrees with a clinical focus. And the number of and intensity of clinical training hours can vary between programs in the same discipline.
It’s best not to make assumptions about the classes in or the requirements of any given psychology or counseling program, but you can generally assume that:
Psychology programs typically focus more on identifying, diagnosing, and treating serious mental illnesses. The curriculum may touch on more medical concepts and even psychopharmacology.
This type of program may include coursework in psychotherapy techniques, but doesn’t expose students to psychological theory. Students in counseling programs sometimes spend more time learning how to help people deal with and move past change-of-life issues.
Social work programs train students to provide psychotherapy and other counseling services, but the curriculum tends to be broader. Aspiring LCSWs will also learn case management and concepts related to mezzo level social work and macro-level social work.
Again, the answer to this question is sometimes. All licensed clinical therapists (whether psychologists, counselors, or social workers) can treat circumstance-specific issues and serious mental health disorders in clients. Psychologists, however, are more likely to work with clients with chronic or hard to treat mental illnesses, while counselors may see people who just need someone to talk to more often than clinical psychologists do. Licensed clinical social workers can treat mental, emotional, and behavioral disorders, but they are more likely to look at what’s happening in someone’s head in the context of what’s happening around them.
In other words, clinical psychologists and therapists can work with the same patients and may use different therapeutic approaches, but they might not. Most therapists use talk therapy, cognitive behavioral therapy, holistic therapy, and other common forms of psychotherapy when working with clients.
Clinical psychologists typically make a lot more than other types of therapists. The average clinical therapist salary is about $98,000, which is tens of thousands more than licensed mental health counselors and clinical social workers usually make.
It’s not entirely clear why clinical psychologists out-earn their colleagues in other branches of therapy, but it probably has something to do with the fact that psychologists spend more time in school and are required to earn a more advanced degree if they want to provide therapy. Clinical therapists can also work in higher-paying positions as an industrial-organizational psychologist, engineering psychologist, or an administrative hospital psychologist.
According to PayScale, the average salary for a clinical therapist is $49,461 per year—but that figure doesn’t mean much. Some workplaces pay more than others, and where in the US a therapist works may have a larger impact on pay than job title. A licensed clinical social worker in a healthcare setting might make just $57,630. If they open their own private counseling practice, they might make a lot more. A mental health counselor in a residential facility could make only $40,560 even though they’re treating similar clients. On the other hand, a marriage and family therapist in Provo, Utah could make $85,000 or more.
Absolutely not. Clinical psychologists study longer, are often more respected, and make more money, but that doesn’t mean they are more qualified to treat clients. All licensed counselors study and train for years to help people cope with trauma and mental illness. If you’re thinking about becoming a clinical therapist, but you’re not sure what kind you’d like to be, money and prestige shouldn’t factor too much into your decision.
No matter what branch of therapy you choose, you’ll probably enjoy career fulfillment and a better than average work-life balance (marriage and family therapist is on US News & World Report’s list of the 100 best jobs). You’ll probably make enough to live comfortably, and your services probably will always be in demand.
Your decision to become a clinical psychologist or to focus on another type of therapy should be based on your thoughts and feelings about the approaches and philosophies involved. If you’re drawn to the hard science behind psychology, then you’ll power through a doctorate program and enjoy every minute. If you’re most interested in how people can achieve mental and emotional wellness in different family systems, marriage and family therapy might be more your speed. There is no wrong path if you want to make helping people your career because there’s room for many approaches in therapy.
As commenter Ted Mick put it in a post about different types of therapist degrees, “All types of clinical therapists have a different focus—which is fortunate for everyone who needs a qualified and competent ‘therapist’–and for us as professionals, also. Fortunately, if we work together, we can provide comprehensive care for those who require our services.”
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