What Type of Therapist Should I Work With?
Welcome to my new series for therapy seekers!
Over the next several weeks, we’ll be exploring the ins and outs of therapy— I’m talking license types, therapy modalities, niches/specializations, and so much more— so that you can find the right therapist for you or your teen daughter.
If you’ve ever been searching for a therapist and wondered what all those letters mean after their name, I want you to know that you’re not alone. It’s confusing. And, since licensure rules and types vary by state, it’s also not uniform (did I mention it’s confusing?).
In today’s blog post, I break down the different licensure types you might come across in your online search or your social media algorithms. My hope is that, by this end of this post, you’ll feel more confident navigating the alphabet soup of mental health therapists.
Let’s Talk About Licensure
In the United States, all licensed mental health therapists are required to obtain a graduate degree, often from an accredited program that ensures their degree meets educational standards. The degree type determines the licensure that a therapist is eligible for and there are often internship or practicum hours required to graduate. In my Master of Social Work program at the University of Texas at Arlington, I was required to complete 900 hours of unpaid practicum hours (which is a whole other conversation, honestly).
Associate Therapists
After graduation, associate therapists have to earn on average 3000+ clinically supervised hours in no less than two years and pass a national clinical exam before they can become independently licensed mental health therapists. Some common examples of associate licensure, which varies by state, are:
Licensed Master Social Worker (LMSW) or Social Work Licensure Candidate (SWLC)
Licensed Associate Counselor (LAC) or Licensed Professional Counselor Associate (LPC-A)
Licensed Marriage and Family Therapist Associate (LMFTA)
Independently Licensed Therapists
Once a therapist becomes independently licensed, they no longer need a clinical supervisor signing off on their documentation or evaluating their work. Independent licensure also varies by state, and here are the most common ones:
Licensed Clinical Social Worker (LCSW) or Licensed Independent Clinical Social Worker (LICSW)
Licensed Marriage and Family Therapist (LMFT)
Licensed Professional Counselor (LPC) or Licensed Clinical Professional Counselor (LCPC)
Clinical Psychologist - Doctor of Philosophy (PhD) or Doctor of Psychology (PsyD)
Independent licensure is the highest level of licensure available for therapists in their state for both Masters-level therapists and Doctoral-level therapists. The majority of therapists are Masters-level, however all Clinical Psychologists are Doctoral-level.
Frequently Asked Questions about Licensure:
What’s the difference between an associate therapist and an independently licensed therapist?
Both types of therapists hold a graduate degree, however an associate therapist is still earning their clinically supervised hours (often 3000+ hours over a period of no less than 2 years) while an independently licensed therapist (e.g. LCSW) has already completed their requirements.
Independently licensed therapists typically have more trainings and experience as a therapist compared to associates since they’re further into their careers.
What are the pros & cons of working with an associate therapist?
Pros:
Often more affordable than independently licensed therapists (which can great if you’re on a tight budget)
Their clinical supervisor is responsible for evaluating their work and documentation to ensure they’re meeting legal and ethical requirements
You have their clinical supervisor’s contact info and can address any concerns with them as needed
Helps make therapy more accessible, especially in more rural areas
Cons:
Some states and insurance carriers restrict associates from accepting insurance, so many are private pay only
Clinical supervisors have access to associate’s notes and will sometimes need to be present in a session or watch a recording of it (with client permission, of course!), which some clients may feel uncomfortable with
Often generalists instead of specialists while they’re earning their hours
When should I choose an independently licensed therapist over an associate therapist?
Everyone has to be a beginner at some point, and therapists are no exception. But there may be times when you want to work with a therapist who has a certain amount of experience or specializes in working with someone just like you or your teen daughter, in which case an independently licensed therapist may be a better option.
What questions should I ask a therapist during our free phone consultation?
If the therapist you’re interested in offers a free 15 or 20 minute phone consultation like I do in my practice, I recommend coming prepared with at least 3-5 questions that will help you decide if this therapist is the right fit for you or your teen daughter. Here are some examples of questions you can ask:
My teen daughter is highly intelligent and gets good grades, but she’s so hard on herself when she doesn’t get a perfect score or when she makes a mistake. Is this something you can help with?
I’ve struggled with anxiety for most of my life, but lately it’s gotten worse and nothing I’m trying is helping. How do you typically treat anxiety in your work with clients? What modalities do you use?
I saw that you offer Christian counseling on your website. What does that look like in your practice?
My teen daughter doesn’t get home from school until almost 5:00 pm. Do you offer later appointment times?
I’ve tried therapy in the past, but I would just talk in circles and never really get anywhere. What’s your approach to therapy? Are you more direct?
You don’t have to have all your questions figured out to get started with a therapist, just an idea of what you’re looking for. With the right therapist, you’ll feel seen, valued, and hopeful about the path towards healing. You should never feel pressured into starting therapy and it’s always okay to ask for time to think things over.
That’s it for today, folks! Come back next week for a breakdown of common therapeutic modalities and how to determine which ones are right for you.
And if you have any therapy-related questions that you’d like me to cover in future blog posts, you can text me at (214) 702-1785 or send me an email at hello@storiedsoulstherapy.com.
Hi, I’m so glad you’re here!
I’m Madilynn Szoboszlay, LCSW and founder/CEO of Storied Souls Therapy.
I specialize in working with high-achieving and highly sensitive (HSP) women and teen girls across Texas, Arizona, and Montana navigate anxiety, burnout, and perfectionism to feel more confident and grounded in their own skin.
Interested in working together?
Schedule a free 15-minute phone consultation with me to see if I’m the right therapist for you or your teen daughter.
Please note: This post is for educational purposes and is not a substitute for professional mental health care. Use of this site does not create a therapist-client relationship.