Counselor vs Therapist: Which Mental Health Specialist Should I See?

Key Points

• Mental health professionals use a range of titles because they often have different education, licensing, and training backgrounds.
• The differences between “counselor” and “therapist” are small, and the terms are often used interchangeably.
• Above all, making sure your therapist is licensed and has specialized treatment experience for your condition is key to getting the help you need.

Searching for someone to treat your mental health condition or help you cope with major life changes is a daunting task. But parsing through various titles and credentials adds another layer to what’s already an overwhelming process. Maybe your search is taking longer than planned, or you feel like giving up. 

Knowing the difference between counselors, therapists, and other types of mental health professionals—so you can find the specific form of therapy you need—is the first step to finding help and treating your symptoms. 

“If someone has received a diagnosis and they already know what condition they’re living with, or if they suspect they have something like OCD, bipolar disorder, or major depression, the key is to search for a professional that has specific experience treating that condition,” says Taylor Newendorp, MA, LCPC, Network Clinical Training Director at NOCD. 

What is a counselor?

Counselors are defined as people who are trained to give personal, social, or psychological guidance. The term is overarching and encompasses many types of professional advice—career counselors, school guidance counselors, and camp counselors are just a few examples.

In a mental health capacity, counselors specialize in addressing issues like substance use, relationship conflicts, or emotional challenges. Their responsibilities include conducting patient evaluations, educating patients on mental health conditions, and recommending problem-solving tools for things like panic attacks or alcohol use disorder. Counseling is typically goal-oriented and focuses on minimizing symptoms.

What is a therapist?

A therapist is an individual who specializes in treating a mental, emotional, or physical challenge. Physical therapists, for example, help with rehabilitation of the body after injuries, while family therapists help people resolve conflicts between siblings, spouses, or parents. Much like counselors, therapists who focus on mental health conditions help address symptoms, often working with patients for extended periods of time as they develop strategies for managing emotional or behavioral challenges.

Key differences between therapists and counselors

Patients and mental health professionals regularly use the terms “therapist” and “counselor” to describe the same role. While that’s okay when discussing the mental health profession in broad terms, it can be helpful to be aware of the treatment methods and education history behind counseling and therapy, so you can find help that suits you best.

Counseling treatments

According to the American Mental Health Counselors Association, counselors are trained to be “holistic and strength-based in working with individuals, couples, families, and groups” and “focus on treating both the symptoms and causes of mental and emotional concerns.” 

Treatment usually involves helping people come up with real-life solutions to the problems and challenges they face in every area of life. That might look like resolving a conflict with your partner or finding ways to soothe your anxiety at work.

Counseling services include:

• Assessment and diagnosis
• Treatment planning 
• Trauma-informed care
• Solution-focused therapy
• Substance use treatment
• Treatment for overlapping mental health disorders
• Crisis management

Therapy treatments

According to the National Institute of Mental Health, therapists focus on helping patients gain relief from symptoms, maintain or enhance daily functioning, and improve quality of life.

Therapists typically target their treatment methods to the disorder or combination of challenges that a patient may have. Those can include long-term stress, changes in sleep or appetite, mental health disorders like obsessive-compulsive disorder (OCD) or bipolar disorder, and family conflicts.

Therapy services include:

• Developing awareness of harmful thought patterns
• Identifying ways to cope with stress 
• Creating problem-solving strategies
• Teaching social and communication skills
• Using mindfulness and relaxation techniques
• Exposure therapy
• Emotional support for exploring troubling issues

What’s the main thing to look for when choosing a mental health professional?

The definitions of “counselor” and “therapist” frequently overlap, and the titles are used interchangeably in the mental health space. That’s because fully licensed mental health professionals, all of whom are qualified to diagnose and treat mental health conditions, go by a few different titles based on their education history. 

The most common include:

•  Licensed Marriage and Family Therapist (LMFT)
•  Licensed Clinical Professional Counselor (LCPC)
•  Licensed Clinical Social Worker (LCSW) 

To make matters more confusing, some LMFTs refer to themselves as “family counselors” and some LCSWs call themselves therapists. “The distinction matters less than ensuring the series of letters after your mental health professional’s name includes the letter ‘L,’ because that means they’re licensed,” Newendorp says.

“You want someone who is licensed, because it’s how you know they’ve had a thorough background check and verified that they have a graduate degree,” Newendorp says. “To obtain licensure you have to obtain a certain amount of direct clinical experience—3,000 hours in most states—meaning licensed professionals have a couple of years of experience under their belt following their graduate degree.”

In addition, it’s important to seek out a mental health professional who can deliver specialized treatment to help with the issue you’re dealing with. “In our field there are lots of different treatment modalities,” Newendorp says. Modalities in the mental health profession are different ways of addressing symptoms. “Simply put, if you’re living with something like OCD, you want to be looking at a therapist’s experience to know if they have a background in exposure and response prevention therapy (ERP), which is the best evidence-based therapy for OCD,” he explains. “The same goes for a condition like bipolar disorder: if someone doesn’t understand it or doesn’t use evidence-based therapy, they might not be able to help treat your condition as effectively.”

You can verify whether the therapist or counselor you’re researching is qualified to provide specialized treatment by asking if they’ve received post-graduate training from a large, accredited organization. “For example, the International OCD Foundation typically provides ERP training, while the Anxiety and Depression Association of America focuses on treatment for anxiety disorders,” Newendorp says. It’s also worthwhile to ask how long they’ve been treating the condition you’re interested in learning about. 

Other mental health professionals you might be considering

Apart from counselors and therapists, there are other professionals you’ll commonly encounter in the world of mental health. Those include psychologists, coaches, psychiatrists, and social workers. Here’s a look at the differences between some of them:

Therapist vs. Psychologist: What’s the difference? 

The primary difference between therapists and psychologists is education. A psychologist has a doctoral degree, usually a PhD or a PsyD. Therapists, on the other hand, obtain master’s degrees before becoming licensed. While psychologists can perform many of the same roles as a therapist, their extensive education means they’re also qualified to perform research and work in labs.

Therapist vs. Coach: What’s the difference? 

The title of “coach” requires no formal education, training, or licensure. For that reason, anyone can call themselves a coach. In general, coaches offer career or fitness advice, but they may also claim to treat mental health conditions. “If they can’t produce a license number for you, I would question that,” Newendorp says. “There are people who might be ‘life coaches’ who haven’t had training, direct clinical experience, or formal education.”

Therapists vs. Psychiatrists: What’s the difference?

A psychiatrist is a doctor that’s attended medical school and is qualified to diagnose mental health conditions, prescribe medication, and provide talk therapy. Therapists, on the other hand, don’t go to medical school and cannot prescribe medications to their patients. It’s not uncommon for patients to receive drug treatments from a psychiatrist, and get additional help for their symptoms from a therapist.

Bottom line

Meeting with a licensed professional to treat a specific mental health condition, or when you need extra support, can help you build emotional resilience and develop better coping strategies. The key to a positive therapy experience is finding a professional who has the right qualifications and is someone you feel comfortable around. That starts with reaching out and asking questions.

“Overall, I’m a big proponent of people advocating for themselves,” Newendorp says. “Whatever it is you’re struggling with, if you’re looking for help and you find a couple of people that look like a good fit, it’s in your best interest to reach out and ask them more pressing questions.”

If you have an anxiety disorder, it might make sense to ask potential therapists to tell you more about cognitive behavioral therapy (CBT) and how they use it. If you’ve been diagnosed with OCD, ask them to tell you how long they’ve been working with OCD and what they understand about ERP. “There are plenty of people that will attend a one-hour course and start to advertise for it, and that’s not enough,” Newendorp says.

Newendorp also recommends avoiding professionals who say they specialize and treat every possible disorder. “Even if someone had received training in all those areas, there’s still a chance they don’t have the in-depth, specialized background they need because their history is too broad,” he says. 

Still, there are plenty of mental health professionals who are both licensed and have specialized training for your condition. The key is to ask questions and be honest about the kind of help you’re looking for. While the search can be daunting at first, finding the person who can give you the tools to address your symptoms is well worth the hard work.