Behavioral health therapy vs counseling

Deborah C. Escalante

If you are considering a career as a mental health professional, it can be exciting (and potentially overwhelming) to learn of the many job titles and career paths available to pursue. While the variety of jobs increases your chances of aligning your career and interests, understanding the differences among available roles can make choosing the “right” path a daunting task. 

Three of the most common job titles in the mental health industry are counselor, therapist, and psychologist. But what is the difference between these job titles? Are counselors, therapists, and psychologists really that different from one another, or are they more similar than different?

While there is overlap between these three careers, there are specific differences which you should understand before embarking on a career in the field. Here, we explore those differences. 

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What is a counselor?

The term counselor is used to broadly refer to a professional trained in the fields of psychology, counseling, social work, or a range of medical fields such as nursing. Mental health counselors, specifically, are those professionals working in a mental health capacity. 

Mental health counselors perform many functions and responsibilities. Their duties include conducting patient evaluations, providing education and informational resources to their clients, and making suggestions that the client or patient can use to solve the problem they are seeking counseling to address. Often, mental health counselors will specialize in addressing a particular issue, such as substance abuse, sexual abuse, marriage and relationships, or family counseling, among others.

What is a therapist?

A therapist is an individual that has been professionally trained to provide some form of therapy to a patient or client that addresses either mental or physical disorder. Examples of therapy used in the context of physical medicine can include physical therapists and occupational therapists. In the context of mental health, the terms mental health therapist and psychotherapist are common.

As with counselors, therapists will often specialize in addressing particular client issues, such as marriage and family issues, substance abuse, etc. 

The Difference Between Therapists and Counselors

If the two definitions above sound very similar, it’s because they are. Mental health counselors and therapists occupy the same professional space, treating the same issues within the same patient populations. Even within the industry, you can find the terms used interchangeably in some contexts.

However, the key difference between counselors and therapists lies in the approach to treatment that they take.

As a practice, counseling often addresses specific problems, challenges, or behaviors in a patient’s life in a very practical way. A counselor working with a patient who suffers from anxiety might, for example, provide the patient with different tactics that they can use to ward off a pending panic attack. Or they might give an alcoholic patient a set series of steps to follow when they feel a craving coming on. In this regard, there is a certain problem-solving approach inherent in counseling.

Therapists work to help their patients address similar issues, and often provide the same advice that counselors might. However, a key difference is that therapists often seek to go deeper by helping the patient understand the how and why behind a challenge. For example, what scenarios tend to bring on an alcoholic craving and why; what situations are more likely to trigger a panic attack and why? What is the root of these issues? They seek to identify the source of these issues through a combination of talk therapy and other frameworks.

As such, counseling is often (though not always) a short-term approach, arming the patient with tools they can put into action immediately to begin living a more healthy life. Therapy, on the other hand, is often a longer-term process that can last months or even years as the therapist and client seek out the root of the issues being addressed to make lasting change.

Despite these differences, there is significant overlap between therapists and counselors, and they will often borrow from each other’s playbook. Additionally, both therapists and counselors will typically be master’s level clinicians licensed by the state in which they practice. A Master of Science in Counseling Psychology is a commonly held degree, and common licenses include Licenced Mental Health Counselors (LHMCs) and Licensed Professional Counselors (LPCs). Licensed Clinical Social Workers (LCSWs) may also hold the title of counselor or therapist. 

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What is a psychologist?

Another common job title within mental health counseling is that of a psychologist. Whereas therapists and counselors may be considered more alike than different, the difference is more pronounced for psychologists.

A psychologist is similar to mental health counselors and therapists in that they also work to improve their patients’ mental and emotional health. The techniques and frameworks that they use tend to differ, however. Additionally, psychologists are more likely than counselors to treat patients with severe mental disorders. With this in mind, becoming a counseling psychologist will typically require a higher level of education, such as earning a PhD in Counseling Psychology.

Choosing The Right Career For Your Future

If you’re considering entering the mental health field, it’s important to understand the various available job functions so you can choose a career path that aligns with your interests and goals. While there are many different variations of the titles discussed above, the most common will be counselor, therapist, and psychologist. Though these are related in many ways, the differences are also significant and can substantially change the trajectory of your career. 

Jumpstart your career today by learning more about the skills and experience needed to succeed in counseling psychology.

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The terms “counselor” and “therapist” are often used interchangeably. But these two types of professionals aren’t technically the same.

The differences come down to education, training, and licensing standards.

Overall, both counselors and therapists help clients work through their mental health and life challenges. The key differences between the two are:

  • degree requirements
  • specific kinds of training and supervision
  • licenses and certifications

For the most part, the choice is about finding a mental health professional whose services are a good fit with your goals. You’ll also want to choose someone you feel comfortable talking to.

There are also practical considerations like cost, insurance coverage, and how many sessions are needed for a particular treatment approach.

Whether you select a therapist or a counselor, it’s important to seek a professional who’s licensed and regulated in your state.

Learn more about the key differences between counselors and therapists to help clarify your search for the right treatment program.

What are the differences between a counselor and a therapist?

The terms “counselor” and “therapist” are sometimes used casually to refer to mental health professionals who offer counseling or therapy. Sometimes you might switch between one word or the other, without really thinking about it.

However, in specific terms, “counselor” and “therapist” refer to two separate categories of mental health professionals. Some of their skills and interests may overlap, but their training and licensing are not the same.

When assessing the difference between the two for your own mental health treatment, what’s important is finding the appropriate professional that provides services that support your individual needs.

When it comes to counselling and therapy, make sure you look for a licensed professional. For example, even though life coaching may resemble talk therapy, it’s not licensed or regulated. Unlike licensed counselors or therapists, life coaches do not have any training requirements or professional standards.

Counseling treatments

According to the American Mental Health Counselors Association, licenced clinical mental health counselors take a holistic approach to mental health. This approach focuses on your overall well-being as a person.

Licenced clinical mental health counselors also take a strengths-based approach. This means that treatments are focused on your unique strengths and abilities.

The American Counseling Association notes that counselling is often goals-focused. You may come to counselling to work on goals for your mental health, overall wellness, or career or education milestones.

Treatment areas include:

  • individual, couples, family, and group therapy
  • trauma
  • marital or relationship issues
  • alcohol or substance use
  • struggles with anger or low self-esteem
  • loss or grief
  • anxiety
  • depression
  • multiple issues, such as PTSD with subtance use

Typically, a counselor focuses on present day problems that may be affecting your overall mental health and well-being. They can assess your mental health and help you work on reducing symptoms and feeling better.

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Some believe that counselling treatments may not go as deeply into how issues from previous relationships, past experiences, or deep-seated trauma may have contributed to your current mental health state.

However, different counselors may use different frameworks. If you’re considering working with a counselor, ask them about their approach to counselling. This way, you’ll know what to expect, and can decide if it’s a good fit.

Therapy treatments

Like counselors, therapists focus on treatments that can benefit your overall mental health and well-being. Therapy sessions can happen:

  • one-on-one (individual therapy)
  • with your partner or family
  • in a group setting

The kinds of conditions treated by therapists are often the same as those treated by counselors. According to the National Institute of Mental Health, conditions treated with therapy include:

  • stress
  • grief or loss
  • relationship or family issues
  • depression
  • anxiety
  • bipolar disorder
  • PTSD
  • other mental health conditions

Both therapists and counselors may be trained in specialized forms of talk therapy. This involves verbalizing your problems to help work through solutions that may also involve changes to your thinking and behaviors. Cognitive behavioral therapy (CBT) is one option.

The goal of therapy is to relieve your symptoms and help you improve your quality of life. But it’s important to ask a therapist what kinds of techniques and approaches they will use to help. This can help you find the right strategy for your needs.

Some say that therapists focus on human behavior and research to a greater degree than counselors do. But this may have more to do with an individual’s training and approach than with overall differences between the professions.

Certain therapists with higher-level training may work with more complex issues than counselors. But the specializations can overlap significantly.

Counselor and therapist specialties

You may notice that therapists and counselors specialize in similar treatment areas, including:

  • child and adolescent therapies
  • therapies for individuals, groups, couples, or families
  • behavioral therapies
  • substance use treatment
  • support for anxiety or depression
  • therapy for loss or grief

What qualifications does each type of specialist have?

Both counselors and therapists are trained in their area of specialty. They hold licenses or certifications as required by their state.

To practice therapy, a psychotherapist must be licensed in the state they’re in. To obtain such a license, the therapist must take and pass an exam administered by their state.

The process for counselors is typically similar. To work as a professional counselor, state licensing is also required. All states require counselors to pass an exam before they can receive a license.

You can ask a therapist or counselor about what kind of license they hold.

It’s important to consider such requirements, as well as the educational level of each mental health professional in relation to your treatment needs. A reputable professional will have either a master’s or doctorate level education combined with a license in order to provide their services.

Counselor qualifications

To treat patients in a clinical setting, counselors have a minimum of a master’s degree in counselling. As part of their education, a counselor will take courses related to their specialty, including therapy techniques.

Counselors also have to gain a certain amount of experience before they can be licensed. This practical training happens under the supervision and guidance of a more senior counselor. Usually, a counselor needs to do 2,000 to 3,000 hours of supervised experience before they qualify for licensing.

During the supervision period, a counselor can typically offer mental health services. But they won’t have their full license yet.

Both counselors and therapists may choose to pursue additional certifications, such as those related to addiction or marriage counseling.

You might have come across the term “counseling psychologist.” This is a different type of professional who can offer mental health services. Counseling psychologists have doctorate level degrees in psychology. They are licensed as psychologists, not counselors.

Therapist qualifications

Therapists are required to have a master’s degree in a subject relevant to psychotherapy. These degrees include:

  • Master of Social Work (MSW)
  • Master of Arts in Marriage and Family Therapy
  • Master of Arts in Psychology
  • Master of Arts in Counselling Psychology

Some therapists also obtain doctoral level education.

Like counselors, therapists also need to gain experience before they can qualify for a licence. During this time, a trainee therapist will be supervised and receive guidance on developing their skills.

For Marriage and Family Therapists, the period of supervision is usually about two years long. Therapists with a MSW degree will typically have 2 to 3 years of supervised experience before qualifying for licensing. If you’re thinking of working with a therapist, feel free to ask them about their specific education and training.

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Therapists can usually offer services while they’re in the supervision period. After the supervision period is successfully completed, therapists need to pass a licensing exam in their state.

Some psychologists or psychiatrists who offer therapy may refer to themselves as therapists. But becoming a licensed psychologist or psychiatrist requires different education and training. Psychologists need a doctoral degree such as a PhD or PsyD. Psychiatrists attend medical school to earn a MD or DO degree, and often have additional training in mental health topics.

Who should I see?

Choosing between a counselor or a therapist depends on your treatment needs.

Therapists as well as counselors may offer services in their own private practices. But these professionals may also work in:

  • group practices
  • schools
  • universities
  • assisted living facilities
  • clinics
  • social services

Therapists and counselors can work with individuals in one-on-one sessions as well as with couples, families, and groups. Some also specialize in working with children through a technique called play therapy.

Here are some tips on how to choose a professional based on what treatment outcomes you’re looking for.

Looking for ways to support your mental health and well-being? Try Healthline’s FindCare tool to connect with mental health professionals nearby or virtually so you can get the care you need.

Short vs. long-term treatment

You might be seeking help to deal with short-term concerns that don’t stem from a long-term mental health condition. Or, you might be looking for treatments that can delve into a long-standing situation such as:

  • anger issues
  • anxiety
  • depression
  • trauma
  • addiction

For example, a marriage counselor or therapist can help couples work toward resolving disruptive short-term problems for a healthier relationship.

In the longer term, one of these professionals can also help you discover the underlying causes of these issues, along with negative past experiences that may apply to the situation.

Making the decision depends on:

  • your goals
  • your clinician’s approach
  • the cost of therapy and the time available to devote to it

Education and background

Beyond their different treatment areas, you may also consider a prospective mental health professional’s education and background.

For example, if you’re seeking help for depression or family-related issues, you may want to choose a professional with expertise in this area rather than one who specializes in couples therapy.

Finding a professional who understands where you’re coming from can help make mental health treatment feel more comfortable. For example, some therapists or counselors have training or experience to specialize in working with:

  • people with certain life experiences, such as trauma or abuse
  • people of color
  • people with diverse sexual and gender identities

Be wary of any professional who advertises therapy or counseling services but doesn’t possess the necessary education, training, or licensing.

Budget and location

Your budget and location are other considerations.

If you have insurance, you may want to start by calling your insurance company to ask about your mental health coverage and receive a list of in-network professionals to help you lower the cost of your treatment.

If you’re in school, both school and university-level mental health services may offer free sessions for students while also having the convenience of offices on campus.

A clinic or community health center may offer options at a reduced cost for therapists and counselors.

Online and remote options

There’s also the option of therapy apps that offer the ability to host online sessions anytime.

These apps typically offer sessions for free or at a lower cost, with many apps only requiring a one-time purchase or monthly subscription fee that may be lower than the cost of regular counseling or therapy sessions.

Need a diagnosis?

It’s important to note that, while many counselors and therapists are trained to help assess and treat issues related to mental health, most don’t make formal diagnoses.

If you’re seeking a mental health diagnosis, you may consider seeing a psychiatrist or clinical psychologist.

The takeaway

Both counselors and therapists are treatment-based mental health professionals who can help you work through a variety of issues to achieve a better quality of life.

Keep in mind that, while the terms “counselor” and “therapist” may be discussed interchangeably and do have some overlap, there are still some differences between these two professionals in terms of how they are trained and licensed.

First, narrow your search to a few different professionals and ask for free consultations with each. At this point, you may also inquire about their education and training. You can then continue forward with your preferred counselor or therapist that you feel most comfortable with.

Also, keep in mind that you may work with more than one counselor or therapist over the course of your treatment.

This may help you access a wide range of specialists who can address every dimension of your desired mental health outcomes.

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