A friend who is not a therapist looked at my LinkedIn profile and saw all the letters after my name and said, “whoooooa, alphabet soup!” Basically noting to me that the letters were impressive, but incomprehensible. While it is important that you seek a therapist who is licensed, it can be hard to understand what those licenses are and what the letters mean. Worse, they’re different state to state so finding a lexicon that’ll explain them is pretty difficult. I’m not going to get into alllll the different licenses that exist, since I don’t know them, but I can tell about some basic distinctions that you can look out for and what they mean. I’m not including pastors and other religious titles because I can’t possibly be inclusive to all the religions that exist either.
When in doubt, write into Google, “What does _(insert acronym)___ certification mean?”
Let’s look at my credentials first, since they are pretty alphabet soup-y. I write my title as Colleen Steppa, MSW, MBA, LICSW, LCSW-T. The first two are my degrees, and the second two are the two licenses I hold in the two states I am licensed in. Professionals should list their credentials in this order – Academic, License, then additional certifications. Let’s start with academic acronyms.
Typically someone who has a Bachelor’s degree will not have letters behind their name, but sometimes they may use letters that start with “B” to denote their license. “BSW” means “Bachelor of Social Work,” for example, and in Minnesota someone at this level can have a license as a social worker, though they can’t work independently as a therapist. Other common “B” degrees are “BA” for “Bachelor of Arts” and “BS” for “Bachelor of Science.” Most of the time, someone with a Bachelor’s degree alone cannot work as an independent therapist because a Master’s or Doctorate are required for this. So what we remember here is that typically, when we see a “B,” that usually means “Bachelor’s degree.”
Additionally, there exist “A” degrees, for “Associates,” but again most people who have an Associate’s degree do not put these letters behind their name, and cannot work as therapists independently (i.e. they need to be under the supervision of someone with a Master’s or Doctorate degree). In Minnesota, a person with an Associate’s degree can obtain a license as an Alcohol/Drug Counselor, so there are licenses that can exist at this level, but you would typically see them write only their license acronym after the name, and not the degree. I don’t know why! It’s just like that.
I know there’s a whole debate in my field about people with less-than-a-Master’s feeling shut out, so I just want to say that someone with an AA or a BA isn’t a bad therapist, stupid, lazy, or anything. Many people spend years on the job learning and have phenomenal practice wisdom that isn’t reflected in their title, and unfortunately because of the emphasis on degrees they tend to get paid less than people who have a Master’s or higher. There’s also students who are obtaining their degrees who can be authorized to practice therapy under supervision, and a lot of them are great. Everyone who is now a Master or Doctor of something was once a trainee, and going to trainees is a wonderful option if you can’t afford someone who’s fully licensed. I have to say that personally, for myself, I would want a therapist who is at least currently enrolled in a Master’s program, or has worked in the field for a number of years and had training specifically in ethics and therapy interventions. I say this because I know when I’d earned only a Bachelor’s I didn’t know anything about ethics or techniques and though I was not a therapist at the time, I would have done horribly if I was.
I feel that there is also something common with addiction counseling, that there are a lot of titles that are quasi-therapeutic and shouldn’t be a replacement for actual therapy. Peer mentoring or sponsorship is great and I love the fact that people can get support from others who have gone through similar experiences, but sometimes a peer can’t see their own issues getting in the way of that support. If you are looking for support for addiction recovery, I would really suggest you see someone who is licensed for therapy in addition to using resources like peer support or mentoring.
Degrees that start with “M” tend to stand for “Master’s degree,” which includes degrees like these: MSW – Master of Social Work, MFT – Master’s of Marriage and Family Therapy (also in some states may be MFCC – Master of Family & Children Counseling), MA – Master of Arts, MS – Master of Science, and the list goes on. These are going to differ depending on what state you live, there are TONS of Master’s programs that exist and it can be hard to compare. I notice that in a lot of states there are acronyms for master’s programs containing some combination of “M,” “F,” “T,” and “C,” which tend to stand for “Marriage”, “Family”, “Therapy/Therapist”, “Counseling/Counselor,” “Couples,” or “Children.”
A common assumption is that people who have one of these Marriage/Family/Children type degrees typically work better with couples, families, or kids, which I don’t think is true by default. I will say that they likely had more classes devoted to these topics, but their actual experience can differ because someone’s degree says nothing about what jobs they may have held or additional training they’ve done pre- or post-grad. People with any independent social work/therapy/counseling/psychology license can do children’s, couples, or family therapy, if they have training in this modality. It’s confusing, I know. Basically, on this one, I would look at the therapist’s website or bio and see what they’ve written about their experience with families/kids/couples and training they’ve done. Someone who has studied social work (BSW, MSW, or DSW) will likely have studied more about systems, institutions, and historical/societal context as well, but that likewise doesn’t mean that only a person with these degrees is capable of understanding these things as they pertain to therapy. And just as a sidenote – a title of “social worker” does not mean that the person works only in Child Protective Services! Social workers do lots of other things and we aren’t all evil, I swear.
Now those starting with or having a “D” tend to stand for “Doctoral degree.” The “D” degrees can get confusing because someone may have a Doctorate and be able to use the title “Dr.” in front of their name, but not actually be a medical doctor. Psychiatrists (M.D., for “Medical Doctor”) are medical doctors who have studied mental health as well as the rest of the body and are able to prescribe medication. In some cases, psychiatrists may not actually do therapy at all and only handle medication, working in conjunction with a therapist who has an MFT, MSW, or other degree type. There are also Psychiatric Pharmacists, or “PharmD” who can prescribe medication and are able to do therapy like a Psychiatrist, but they may be in a role where they just prescribe. If you need psychiatric (mood-altering, like Zoloft, Prozac, Percocet, etc.) medication, you can often get it from your regular M.D. or sometimes a nurse practitioner, but it’s usually a good idea to be in some kind of therapy if you are using meds so that you can work on parts of your life that may make your illness better or worse.
Other types of Doctoral degrees that a therapist may have are a “Psy.D.” which is a “Doctorate of Psychology” and would give them the title “Psychologist.” Some Psy.D.’s design standardized tests, conduct assessments, profile criminals, or work as therapists – there are lots of job possibilities with this degree type. There are also Doctors of Counseling, Doctors of Social Work, and Doctors of Marriage and Family Therapy. I don’t know as much about these particular degrees, but I assume they each delve deeper into their respective fields and the person who obtains these degrees likely has to write a dissertation or do research on a particular topic to earn their degree. I am going to guess that they’ll often be more specialized in one specific type of therapy or client problem that they’ve spent years on.
Finally, getting to licenses. Licenses are easy to spot in therapy because they usually start with “L,” and they follow the educational title. Some licenses are temporary and may have an “M” or a “G” in them, standing for “Master’s” or “Graduate.” This is because some licenses (like mine) can be obtained immediately after graduation from a Master’s program, but are meant to be temporary as the person is completing supervised practice requirements. Yes, we have to do a lot to get licensed, *sigh*. Typically licenses include some number of years in “supervised practice” which means the therapist is doing therapy but also meeting regularly with a supervisor to review their notes and talk about cases to ensure they learn correctly. Usually there is also a test to be completed at some point of licensing. Someone with an “LGSW” or an “LMSW” is a Master’s of Social Work graduate in the limbo years after they’ve earned their Master’s degree but are still completing licensing requirements. Likewise there are “LMFT”s (Licensed Marriage and Family Therapist), “LPCCs” (Licensed Professional Clinical Counselor) and many, many other “L” licenses that I don’t know about. There are also licenses, like I mentioned above, that can be obtained with a Bachelor’s or an Associate’s degree, though they are less common.
In addition to all of this, there is a neverending sea of new certifications that are coming out all the time. The best way to get rich as a therapist is to invent a new type of therapy and make other therapists pay thousands of dollars to get certified, so people do that. Types of common certifications can be a subject for a future post, since there are plenty. A smart therapist will list their certifications in plain(ish) English on their profile on Psychology Today or their website as well as what types of people they typically work with.