Alphabet Soup in Mental Health: A Breakdown of Licensures

Social Worker, Psychologist, Counselor, Therapist, Pastoral Counselor, Biblical Counselor or Coach? When seeking mental healthcare, the options for training background and approach are endless. The advantage of this is no matter what you are seeking help for or how you would like to approach the problem, there is most likely a helper aligned with your needs. The downside? It can be hard to understand the nuanced differences in approaches to care. As you choose the care that aligns with your needs, be sure to note licensed vs not. Licensure ensures a mental health professional has gone through extensive training, passed state board exams, and meets ongoing requirements for ethical and competent care. Coaches, some Pastoral, and Biblical counselors are roles that can be valuable in specific contexts, especially for spiritual guidance or personal development. However, they are typically not regulated by the state and do not have the clinical training to treat mental health diagnoses. While some professionals market themselves as "board certified" it is important to do your research and understand what organization has certified them and what the requirements are to obtain certification.

1. Licensed Professional Counselor (LPC / LPCC / LCPC)

Training: Master's degree in counseling or a related field (e.g., Clinical Mental Health Counseling). Scope: Trained to assess, diagnose, and treat mental health conditions using talk therapy. May take advanced trainings post-graduation to specialize in conditions or treatment modalities. Focus: Individual, group, couples, and family therapy. Use a variety of evidence-based modalities for treatment such as cognitive behavioral therapy, dialectical behavioral therapy, EMDR, Adlerian therapy, etc. Prescribing Meds? ❌ No Notes: Titles vary by state—e.g., LPCC (KY), LCPC (MD), LPC (TX, many others).

2. Licensed Clinical Social Worker (LCSW / LICSW / LISW)

Training: Master of Social Work (MSW) with clinical training. Scope: Similar to LPCs—can diagnose and treat mental illness, often with a systems-based and advocacy lens. May take advanced trainings post-graduation to specialize in conditions or treatment modalities. Focus: Therapy plus case management, advocacy, and coordination of community resources. Prescribing Meds? ❌ No Notes: More likely to work in community agencies, hospitals, and policy-oriented roles in addition to therapy.

3. Psychologist (PhD / PsyD)

Training: Doctorate in psychology (PhD = research-focused; PsyD = clinically focused). Scope: Advanced training in diagnosis, testing, and evidence-based treatment. Focus: Therapy, psychological testing (e.g., for ADHD, PTSD, IQ), and research. Prescribing Meds? ❌ No (except in a few states with special certification) Notes: Often seen as experts for complex cases or formal assessments.

4. Psychiatrist (MD / DO)

Training: Medical degree (MD or DO) with residency in psychiatry. Scope: Full medical training allows diagnosis of mental illness and physical health conditions. Focus: Primarily medication management, though some provide psychotherapy. Prescribing Meds? ✅ Yes Notes: Typically work in hospitals, private practices, or medication-focused clinics.

5. Licensed Marriage and Family Therapist (LMFT)

Training: Master’s degree in Marriage and Family Therapy or related field. Scope: Specializes in relational and systemic dynamics—primarily works with couples and families. May take advanced trainings post-graduation to specialize in conditions or treatment modalities. Focus: Addresses communication, conflict, trauma, and life transitions within the context of relationships. Prescribing Meds? ❌ No Notes: While they can work with individuals, their training emphasizes interpersonal systems and relational healing.

6. Pastoral Counselor

Training: Varies widely—may include a degree in theology, divinity, or counseling. Some are licensed; others are not. Scope: Integrates spiritual/religious beliefs with counseling practices. Focus: Often addresses life transitions, grief, marriage, and spiritual concerns. Prescribing Meds? ❌ No Notes: May or may not have formal mental health training, depending on credentials.

7. Coach (Life Coach, Wellness Coach, Executive Coach, etc.)

Training: Varies widely—can range from certification programs to no formal training at all. Scope: Focuses on goal setting, motivation, performance, and personal development. Focus: Present and future-oriented—coaching does not diagnose or treat mental illness. Prescribing Meds? ❌ No Licensed? ❌ No (Not regulated as a clinical profession) Notes: Coaching can be powerful for achieving life or career goals but should not replace therapy for mental health concerns.

8. Biblical Counselor

Training: Typically, not licensed by state mental health boards; training often through church-based or Christian counseling programs. Scope: Uses Scripture as the foundation for counseling; should not incorporate clinical mental health practices. Focus: Discipleship, sin, and spiritual solutions to life’s problems. Prescribing Meds? ❌ No Notes: Not considered mental health professionals in a clinical sense and not regulated.