I am a therapeutic counselor, but when I tell people that I am a "MFT" I am often met with a blank stare. Many people seek mental health-psychological/emotional/behavioral/relational support, but they get confused about which professional to choose for help. In terms of providers, services and their credentials, just how does one decide if they need a psychiatrist or a therapist and what do those letters after the name actually mean?
While it is true that there are many professionals who offer counseling services based on having a Master's or Doctoral-Level degree in psychology, it is not true that all providers have the same level of training or qualifications. In an effort to reduce some of the confusion, the primary "counseling" professions with some brief definitions are listed for your consideration.
MFT - Marriage and Family Therapist
Family Nature
MFT is sometimes written as LMFT, but the "L" is optional. It's illegal for unlicensed persons to use the MFT or LMFT designation. Professionally, an MFT is a Clinical Psychotherapist, licensed by the California Board of Behavioral Sciences (otherwise known as BBS), working in private practice or in an agency or hospital, to help individuals, couples, families, or groups deal effectively with psychological and relational difficulties. These professionals have a Master's degree and/or a Doctoral degree, and additional clinical (hands on) training in relationship dynamics and family systems.
Taken from the California Association of Marriage and Family Therapists (CAMFT) website:
"Marriage and Family Therapists (MFTs) are relationship specialists who treat persons involved in interpersonal relationships. They are trained to assess, diagnose and treat individuals, couples, families and groups to achieve more adequate, satisfying and productive marriage, family and social adjustment. The practice also includes premarital counseling, child counseling, divorce or separation counseling and other relationship counseling. Marriage and Family Therapists are psychotherapists and healing arts practitioners licensed by the State of California. Requirements for licensure include a related doctoral or two-year master's degree, passage of a comprehensive written and oral examination and at least 3,000 hours of supervised experience."
Basically, people who are involved in relationships of any kind-- can come to an MFT for help in understanding the dynamics of a relationship, their role in the relationship, what kind of issues from the past are affecting the relationship, how to enhance the relationship, or how to heal from a previously traumatic relationship, etc. MFTs work with couples, families, and individuals to improve the experience of being in relationships.
LCSW - Licensed Clinical Social Worker
LCSWs work in private practice or in an agency or hospital to help individuals, couples, families, or groups deal effectively with psychological and relational difficulties. These professionals have additional training in social work that allows them to understand social programs and governmental systems that could be of use to clients.
MSW - Masters in Social Work (an unlicensed provider)
MSWs work in agencies or hospitals to provide guidance to individuals and families through the government system. We often refer to MSWs simply as "social workers." These professionals are the backbone of the social programs in this country, and have been trained to navigate "the system" in order to ensure that individuals in need get all the support and assistance available to them through the government.
LPC - Licensed Professional Counselor (Not recognized by the California Board of Behavioral Sciences)
LPCs work in private practice or other agencies to provide counseling to individuals, couples, families, or groups. This designation is a common certification in other states, but is not recognized in the state of California because it does not currently meet the same academic and clinical standards required by other mental health professionals.
Clinical Psychologist (Ph.D.-Doctor of Philosophy or Psy.D.-Doctor of Psychology)
PhDs or PsyDs work in private practice or in an agency or hospital to help individuals, couples, families, or groups deal effectively with psychological and relational difficulties. These professionals have additional academic (book) training (a doctorate) that often means specialized study in a particular area.
If licensed, the Ph.D. or Psy.D. designation certifies them to administer psychological testing in addition to working one-on-one. These professionals may have both the doctoral degree and meet the clinical requirements for Psychologist licensure, or they may only have the "book" academic degree. Furthermore, the PhD degree may be in another area of study (e.g., anthropology, philosophy, history, English, etc.), therefore potential clients should always inquire about specific training and education.
Psychiatrist (M.D.-Medical Doctor)
Working from a "medical model" perspective, psychiatrists work in private practice or in an agency or hospital to help individuals with psychological difficulties by diagnosing the "mental disorder" and incorporating medication (psychotropic drugs) as a part of the overall treatment plan. Psychiatrists are the ONLY mental health professionals that can legally prescribe medication.
With minimal "counseling," many psychiatrists will prescribe medication and schedule re-checks to review how the medication is working to control the symptoms of the mental disorder. It is safe to say that most psychiatrists will work collaboratively with psychotherapists (who have more training in counseling theories), and will themselves only counsel the patient on the use of the medication (e.g., discuss dosage, side effects, other medication options); leaving the therapist to handle the psychological aspects of the patient's treatment. Some psychiatrists will not give medication unless the patient is also in counseling with a licensed therapist, and others will give the medication without question.
Some additional notes related to professional practices and services for children:
As a point of controversy among many therapeutic professionals, medical doctors, with little to no specialized training in psychology or counseling theories, will commonly write prescriptions for psychotropic drugs for their patients. This is especially true of pediatricians (common with Family Physicians too), primarily prescribing medication for ADHD (Attention Deficit Hyperactive Disorder), anti-anxiety medication and anti-depressants, because very few psychiatrists specialize in the treatment of children.
More often than not, those psychiatrists that do focus their practice on children, primarily work with severe mental illness or other pervasive developmental disorders, and do not take on clients with minimal needs or focus on prevention/early intervention unless medication is going to be prescribed.
Although all therapeutic providers are required to work a minimum number of hours with children for licensure, many do not "specialize" or focus their practice on children, and many do not receive much clinical training for children beyond their academic (book) training. Most providers will limit their practice to certain populations (e.g., couples, individuals, elderly, families, children, adolescents, etc.), and/or particular issues (e.g., family issues, addictions, sexuality, conflict resolution, brain injury, depression, Bipolar disorders, etc.), but some do not specify. Fortunately, the legal and ethical guidelines of the profession prohibit providers from working outside their area of competency and training, requiring providers to refer clients/patients to another provider who is trained to better meet the need.
What is a MFT - A LCSW - A PsyD?
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