Your guide: How to become a therapist

Medically reviewed by Laura Angers Maddox
Updated January 8, 2024by BetterHelp Editorial Team

The US Bureau of Labor Statistics shows that the growth of the counseling industry and counseling psychology jobs from 2021 to 2031 is expected to be at a rate of 22%, showcasing the opportunity for individuals looking to start a career as a therapist. Becoming a counselor or a licensed therapist can take around six to eight years of higher education, so understanding how to get started may benefit you as you plan your ideal future career in mental health counseling.

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What is a therapist? 

“Therapist” is a broad term that defines all mental health professionals offering clinical mental health counseling or therapy and treatment through strategies such as talk therapy, art therapy,  cognitive behavioral therapy, or another form of mental healthcare within the scope of mental health careers and career paths. There are generally a few broad categories of mental health therapists, including the following: 

  • LCPC: Licensed Clinical Professional Counselor
  • MD: Medical Doctor (reserved for psychiatrists) 
  • Ph.D.: Doctor of Philosophy
  • PsyD: Doctor of Psychology
  • LMHC: Licensed Mental Health Counselor
  • LCMHC: Licensed Clinical Mental Health Counselor
  • MFCC: Marriage, Family, and Child Counselor
  • LMFT: Licensed Marriage and Family Therapist 
  • LCSW: Licensed Clinical Social Worker 
  • LPC: Licensed Professional Counselor

Each license title may have different educational and licensure requirements and career experiences, although all of the licenses above require a master’s degree program and a graduate degree. Often, counselors and social workers complete a graduate degree program with a master’s level degree, whereas psychologists may have a doctoral degree in psychology. The process can differ on how to become a therapist from state to state as well. 

What are the main differences between a therapist and a counselor? 

Counselors and therapists may use both terms to describe themselves. Both professionals complete advanced graduate degree programs and use their expertise in behavioral sciences and strong communication skills to serve their communities and often work in the same types of modalities. They can diagnose behavioral disorders, help manage symptoms of disorders, improve communication skills, and help clients build self-awareness. However, if a therapist is a psychologist with a doctorate, they may have some differences from a counselor in how much they’re paid, the duties they have in their practice, or their abilities in the psychological industry. 

Many psychologists do not work as therapists but in a niche field like neuropsychology, forensic psychology, or research. Some may go on to be philosophers or professors at a university. Psychologists who offer therapy and have a license to practice are called clinical psychologists.

The therapist's job description

There are several types of mental health professions you can choose from after attending school and receiving your degree. Understanding the job description of how to become a therapist may help you decide if the job suits your goals. 

There are often strict requirements in the US to practice as a therapist to ensure ethical standards are met and that therapy is high quality with standardized training and measured outcomes. This means that therapists require licensure in order to practice. Licensed therapists have a unique responsibility. These professionals are often tasked with understanding the human condition and formulating a compassionate and effective treatment plan for clients experiencing mental health issues, distressing symptoms, and challenging life events. 

A therapist can diagnose and treat various mental illnesses and specialize in many modalities. For example, you could become a marriage and family therapist, or you could specialize in helping people who struggle with substance misuse. There are many types of therapy, and you may need to have additional education or experience to practice a specific one.

Therapists meet with clients in person or online either through non-public practice or mental health centers. Sessions with a therapist are often tailored to the individual’s needs, with routine follow-ups and adjustments whenever necessary. According to Indeed, the average salary for a clinical psychologist in 2023 is $108,710 annually. Some types of therapy, such as marriage and family therapy, may pay more or less money than other types of therapy. For example, family therapists make a median annual wage of $56,570, according to the Bureau of Labor Statistics. Knowing information such as this may drive your decision on whether to become a family therapist or another kind of mental health professional.

Therapist duties and responsibilities

There are various responsibilities you might confront as a therapist, including the following: 

  • Implementing integrated behavioral health principles, procedures, and philosophies
  • Following ethical guidelines outlined by the American Psychological Association (APA) 
  • Providing intervention, education, and counseling services  
  • Observing and assessing client's symptoms
  • Offering clinically appropriate treatments based on assessment and diagnosis
  • Documenting therapeutic outcomes, diagnoses, and treatment options
  • Participating in structured case consultations and supervised conferences
  • Engaging in staff development opportunities to ensure professional growth
  • Earning and maintaining licenses, certifications, and program performance courses

As a therapist, you may also try to keep a flexible schedule, offer community resources to clients, and keep your practice safe and client-centered. 

Types of therapists

While many therapists and professional counselors may work with a wide variety of patients, there are many career options and different areas that a therapist may specialize in after completing a master’s program including: 

  • Marriage and family therapists – these therapists specialize in marriage and family therapy or counseling and work with couples and their families to improve communication and interpersonal relationships. Family therapists may offer family therapy done as a group. 

  • Child therapists – a child therapist specializes in working with young children and may use strategies that are more developmentally appropriate. 

  • Addiction therapists—these therapists work with individuals experiencing substance abuse. Substance abuse issues impact many aspects of a person’s life and an addiction therapist can provide strategies for managing addiction.

  • School-based therapists – some therapists practice therapy in a school setting and provide in-school counseling to meet the mental health needs of students. A school-based therapist may need to collaborate with other professionals to provide support, such as occupational therapy or speech-language pathology, when providing strategies to reduce symptoms of mental health disorders. For schools with autism-specific programs, school-based therapists may be trained in using applied behavior analysis with students.

What are the educational and career requirements to become a therapist? 

According to the American Counseling Association, a master’s degree or higher is required to become a therapist within the US. Many providers start as a psychology major, receiving an undergraduate degree in sociology, psychology, or human sciences. In graduate school, for master’s programs, you can take a clinical social work or clinical psychology path. After graduate school, you might decide to get a PsyD or Ph.D. for further learning. 

After school, you may be required to complete an internship experience by working under supervision in a clinical setting for a certain number of supervised clinical hours to be able to receive your license. Many employers looking for counselors may also want to see a year or two of experience in a professional mental health services environment to ensure you have the skills needed to adequately help patients. Therapists and certified counselors can work in one-on-one practice, as contractors, or through a clinic as employees.

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How to receive a license to practice

The requirements for licensure to become a licensed therapist vary by each state within the US. After graduating from graduate school with a master’s degree in counseling and participating in the specific number of supervised clinical experience hours required for a license, you can register to take the exam with your state psychology, counseling, or social work board. The exam will be a test with questions on common mental health topics, treatment modalities, and psychology. After passing your state board exam, you will receive your license in the mail. Some boards may require more than one exam or license. Some counselors may elect to pursue a national board certification by completing the National Counselor Examination.

Five paths for professional therapists

Once you have completed your clinical experience hours, all testing requirements, and received your license in the mail, you can select the therapist career that best fits your licensing, specialty, or career goals. Below are five options. 

Clinical social worker

Clinical social workers are counselors trained in social work. These providers often have a master’s degree in social work (MSW). Social workers often provide therapy, community resources, case management, and referral. 

A variety of mental health counselors 

Mental health counselors can work in various specialties and require a master’s degree or higher. These providers often provide talk therapy. A few types of counselors include the following: 

  • School counselors
  • Career counselors
  • Pre-marital counselors
  • Couples counselors
  • Group counselors
  • Individual counselors

Psychiatric nurse practitioner 

Psychiatric nurse practitioners obtain a nursing degree before working in psychiatric nursing. Afterward, they may take additional courses in psychiatric training to be able to offer mental health care in medical settings like hospitals and inpatient mental health centers. 

Clinical psychologist 

A clinical psychology degree is a doctoral credential requiring significant mental health and therapeutic methodologies training. Professionals in this field may focus more on providing mental health support, diagnosis, and analysis instead of working in research or education. 

Psychiatrist (MD)

To become a psychiatrist, you must attend medical school after you receive your bachelor’s degree. Many individuals complete a pre-med bachelor’s degree with a minor in psychology. Medical school is an additional four years and requires an internship as a psychiatric assistant. After medical school, psychiatrists are assigned to a residency which may last one to two years. They may also receive complete training in psychiatric medications and specific therapeutic modalities. The full path takes around 12 years. 

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What attributes should a therapist or mental health counselor have? 

It may benefit professionals to be engaging, professional, approachable, and organized in their practice. Critical thinking skills can also be valuable. Networking with other professionals, completing higher learning courses, and keeping your license up-to-date can help you provide research-backed comprehensive treatment to your clients. Becoming a therapist is a serious commitment, so taking your job seriously and understanding the importance of ethical care can also be crucial. 

Career and educational mental health counseling options 

If you’re looking for support as you consider your educational or career path, talking to a professional might benefit you. Licensed therapists have gone through the process of becoming therapists and can counsel you as you start your journey. You can try online counseling if you’re looking for a convenient and affordable way to find this type of support. 

Through a platform like BetterHelp, you can indicate your preference for a career counselor or another type of provider and get matched with one of 30,000 therapists. In addition, you can receive resources like worksheets, educational documents, and journal prompts as you work through your goals. You do not have to have a mental health diagnosis to try therapy. One study showed that online career counseling interventions could help college students make more confident career decisions

Takeaway

There are many types of psychotherapists and many options when looking to work in the mental health field. To get started, consider speaking to a career counselor or provider to discuss your goals and worries and start adapting a plan that fits your educational and career values.

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