A Guide On How To Become A Psychotherapist

What does a psychotherapist do?

Psychology is defined as the study of the mind and behavior, and within this discipline, there are many branches and specialties, giving you plenty of career options. Forensic, educational, and neuropsychologists are all types of specialized psychologists, many of which require an advanced degree to practice. Outside of conducting research, some psychological study, such as psychiatry and psychotherapy, is dedicated to helping people find treatment for mental health and behavioral disorders.

Psychotherapy differs from psychiatry, though both psychotherapists and psychiatrists are health care professionals who have similar goals and require a background in psychology. They may both be viable career paths for you depending on your goals.

A psychiatrist is a medical doctor who can prescribe medications to treat mental conditions. A psychotherapist can employ various techniques to help patients overcome unhealthy behaviors, or concerns such as depression and anxiety. Psychiatrists do not always offer psychotherapy practice or counseling services for mental health.

Based on a client's situation and goals, a psychotherapist may take notes and use those in conjunction with their training and knowledge to create a treatment plan best suited to their patient. However, they will not be able to prescribe medication unless they are also a licensed psychiatrist.

Many psychotherapists and psychiatrists work as part of hospitals, government organizations, or nonprofits, but many also choose to set up their own practices, so if you are interested in pursuing psychotherapy, you have a variety of career options. According to the U.S. Bureau of Labor Statistics, the median annual pay for psychotherapists in 2021 was over $80,000. 

Educational requirements to be a psychotherapist

To become a licensed psychotherapist, extensive coursework is required from accredited universities. Initially, an individual may be required to receive a bachelor's degree in psychology, a degree in counseling, or a degree in a related field, like social work, which can take approximately four years. Students may need to have a strong undergraduate GPA as they work toward their bachelor’s degree to enter a reputable master’s program, the next step in the path to becoming a mental health counselor or social worker.

A master's degree in clinical psychology, social work, family therapy, or related fields can be a prerequisite to becoming licensed in most states. You can choose to enter a more structured master’s degree program with a set schedule that will enable you to graduate sooner. However, if attending graduate school full-time isn’t an option, you can also take a variety of continuing education courses at your own pace to earn your master’s degree. There may be plenty of degree options as you work toward a career in psychology and mental health.

States also license clinicians who have a doctoral degree. A doctorate is not the same as a medical degree, which is required to become a psychiatrist.

During your graduate studies, which may take about two years for a master's and longer for a doctorate, you may be expected to work clinical hours under the supervision of an instructor. The clinical hours required can vary per person, allowing students and recent graduates to practice their analytical skills and gain therapeutic experience before working independently as mental health counselors, social workers, behavioral therapists, family therapists, or in whichever field they prefer. 

Licensing and having the proper credentials are crucial because they can provide your clients with confidence that you are experienced and that they are in trusted, knowledgeable hands. Additionally, you cannot legally practice therapy without a license. 

Types of psychotherapy to practice 

Psychotherapy can be an umbrella term to describe a host of therapy modalities and specialties, including the following:  

Interpersonal therapy

Interpersonal therapy may focus on the relationships between a client and their loved ones. This type of psychotherapy may be rewarding for those experiencing relationship issues, including losing a relationship, divorce, or conflict with others. People can also learn about communication skills, attachment theory, and more through relationship therapy. In this type of counseling, a therapist (often a specialized marriage and family therapist or social worker) may support clients in exploring and changing existing unwanted relationship patterns. 

Often, the goal of interpersonal therapy may be teaching the client interpersonal effectiveness skills, which may also teach them independent skills. Although interpersonal therapy deals with relationships between others, it is often conducted on an individual level. People can also participate in this therapy through couples counseling or group therapy options. 

Psychodynamic therapy

Psychodynamic therapy is one of the earliest forms of talk therapy, often considered to be inspired by practices developed by Sigmund Freud and Carl Jung. Because of its association with Freud, this therapy has its roots in psychoanalysis. Psychoanalytic therapy often aims to bring the unconscious into conscious awareness and help clients find relief from common mental health conditions and symptoms. 

For example, someone may have repressed fears rooted in past experiences. Psychodynamics can be defined as the human potential for dynamic self-alteration and self-correction, which may be able to address symptoms of a behavioral disorder. By becoming aware of fears, fears may be worked through and lessened.

Although historically significant, psychodynamic therapy has been criticized for lacking scientific credibility and empirical evidence. Nonetheless, it may benefit those looking to understand unconscious thoughts and urges. 

Cognitive-behavioral therapy (CBT) 

Cognitive-behavioral therapy (CBT) is another form of psychotherapy that addresses how clients think and their underlying beliefs about themselves. CBT can help people learn the connections between thoughts, feelings, and actions, while modifying them into healthier behaviors better suited to a situation or conflict. 

Aaron T. Beck, who developed cognitive therapy, suggested that our thoughts affect our feelings. This form of psychotherapy is sometimes also known as Beckian therapy because of its founder.

CBT is one of the most widely used therapies and can be effective for many mental health conditions and symptoms, such as anxiety, depression, or stress. It may also take a practical and hands-on approach to modify how clients think or feel about specific conflicts, situations, and stressors. Some professionals even consider CBT to be the "gold standard" of psychotherapies. 

Exposure-response therapy (ERP) is a form of cognitive therapy that helps desensitize people to their fears by exposing them to stimuli until a fear response is reduced. Other types of cognitive therapies may be rooted in CBT, as well.

Transference-focused therapy

Created by Otto Kernberg, the transference-focused psychotherapy method is designed for those with personality disorders, especially borderline personality disorder (BPD).

This therapy was derived from psychoanalysis and is based on the concept that ideas in a person’s brain have been built up over their lifetime, but these ideas are not always conscious, rational, or accurate. According to Frank Yeomans, a doctor specializing in TFP, these internalized perceptions of oneself and the world can lead to distorted thinking. These distortions may result in drastic mood changes, reduced self-esteem, and negatively impacted relationships with others.

The goal of transference-focused psychotherapy sessions is to allow the patient to live out internalized thoughts and images through the therapist while the therapist helps guide them to more stable and realistic perceptions and experiences with the self and the world.

Equine-assisted therapy

Equine-assisted therapy is a specialized form of psychotherapy that uses horses to address many mental health conditions and behavioral concerns.

Horses are considered by many to be sensitive to human emotions. Connecting with a horse, learning to feel safe with an animal, and using horseback riding as a form of exercise can help individuals feel in control of their emotions and symptoms. 

In a study involving 13 veterans with PTSD, positive outcomes were shown in an equine-assisted program. The individuals reported "increased sociability, reduced feeling of isolation, an increased sense of trust and hope, and a need to serve others."

Despite being experimental, equine-assisted psychotherapy may be a rewarding experience for a client, horse, and therapist. 

Finding counseling options 

Anyone interested in going through the steps to become a therapist and those who are already providers may benefit from visiting with a therapist. Many therapists may have their own providers, and those looking to become a counselor may benefit from the insight of others in the field. 

If you face barriers to treatment such as distance, cost, or availability, you can try online therapy, which may be a more casual method of receiving support. Online therapy can be conducted anywhere you have an internet connection, often making it more convenient and affordable for clients and therapists. Therapists working through an online platform may not have to worry about paying to rent out an office space, allowing them to maintain lower rates for clients. 

Online CBT, a branch of psychotherapy, is becoming increasingly popular. The National Center for Health Research analyzed dozens of studies conducted on internet-based CBT, finding that online CBT can be as effective as in-person therapy for treating various mental health concerns, including anxiety, depression, and PTSD. If you're interested in trying this form of counseling, consider signing up with a platform like BetterHelp, which offers a growing database of licensed therapists.