What's The Difference Between A Therapist & A Counselor?

There's a lot of terminology in the mental health space.

Aug 11, 2022 - 21:02

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What's The Difference Between A Therapist & A Counselor?

August 11, 2022 — 11:20 AM

When talking about therapy, the terms “counselor” and “therapist” are often used interchangeably to refer to mental health professionals. There are, however, a few key differences between counselors and therapists. Here’s how to choose between the two and know whether you should work with a counselor vs. a therapist.

How is a therapist defined?

A therapist is a licensed mental health professional who is trained in using therapeutic interventions to help people learn how to cope with mental illness or otherwise support their mental well-being. Therapy, or psychotherapy, is a specific type of treatment intended to heal or relieve a psychological or mental health issue.

“Therapists are trained to help people who are struggling with mental illness, such as depression, anxiety, or PTSD. They diagnose, assess, and provide treatment of mental disorders,” Christine R. Melendres, LCSW, a licensed clinical social worker and therapist, recently told mbg. She adds that therapists can also help clients with crisis intervention, grief counseling, or processing and healing from past hurts and traumas.

How is a counselor defined?

While a therapist typically works with people who are struggling with mental illness or who are looking to process their past, a counselor is more present and future-oriented, according to GinaMarie Guarino, LMHC, a licensed mental health counselor at Psychpoint. Counselors tend to focus more on coping skills and stress management to help their clients have a healthier lifestyle, according to Guarino.

“Counselors typically provide short-term, solution-focused strategies to address behaviors that include exploring stressors, coping skills, and environmental factors contributing to behaviors which are negatively impacting one's life,” says Angeleena Francis, LMHC, a licensed mental health counselor, therapist, and executive director at AMFM Healthcare in Washington.

It’s also important to note that “counselor” is a general term used in many different fields, such as a guidance counselor (at school), a career counselor (at work), a spiritual counselor (in religious contexts and communities), and beyond. These are different and separate from a mental health counselor, who is legally required to hold a license. Additionally, in different countries, these words mean different things–for example, a counselor in Canada is the equivalent of a therapist in the US.

Key differences between the two.

There are definite similarities between counselors and therapists, and they also work with many of the same types of people and treat many of the same types of issues. However, it’s important to note key differences.

1. Counselors and therapists may have different approaches.

While they certainly borrow from each other’s playbooks, counselors and therapists may have different approaches. According to Francis, therapy often addresses underlying mental health issues such as negative core beliefs, unresolved trauma or grief, and cognitive distortions. “Therapy brings awareness of unconscious beliefs that impact the view of self and interactions with those around us,” Francis tells mbg.

On the other hand, counseling often focuses on current behavioral patterns and creates tangible strategies to address these. Because of this, counseling can also be used as a component in addition to therapy (and vice versa).

Notably though, there’s a lot of overlap between how many therapists and counselors practice. Many licensed counselors are also trained in therapeutic methods and incorporate them into their practice, and many therapists are trained in modalities that are based in the here and now, coping with present emotions, and present and future behaviors. In general, it’s far more effective to ask your potential therapist or counselor about how they practice therapy or counseling than to guess based on the title alone.

2. Therapists and counselors may have different credentials.

Therapists have very specific credentials and are legally required to hold a license to practice therapy in their state. “A licensed therapist has obtained a masters or doctorate level education in either clinical psychology, mental health counseling, social work, marriage and family therapy, or similar field,” Francis explains, “[and] has also completed requirements for state licensure, including 2-3 years of practicing under the supervision of a licensed and state-approved supervisor, as well as passing a state approved exam.”

Likewise, according to the American Counseling Association, professional counselors are also required by law in every state to be licensed in order to legally practice. While the specifics vary by state, licensure usually will require some kind of graduate education, passing an exam, and training under a licensed supervisor as well. Notably, in some states, licensed counselors are also legally allowed to practice therapy and can legally refer to themselves as therapists. (This is why it gets confusing, and often the terms can be used interchangeably)

That said, Francis notes there are some exceptions in which some types of counselors may be allowed to practice without state licensure. Groups commonly exempt from licensure might include students in graduate programs working under supervision, members of the clergy in the performance of their religious duties in connection with a religious denomination, and employees of federal, state, and local agencies acting in an official capacity.

Again, it’s far more effective to ask your potential practitioner about their education and credentials than to assume based on the title alone.

3. Counseling and therapy sometimes have different treatment durations.

Therapy addresses mental health diagnoses and focuses on the individual’s process, whereas counseling focuses on obtaining a measurable outcome or goal. This is why, according Francis, therapy is typically long-term, where-as counseling often is short term. (Again, these are generalizations – there are tons of therapeutic approaches that are short-term and plenty of counselors who have long-term clients.)

“Therapeutic goals include emotional regulation, improved interpersonal relationships, ability to connect with others, and stabilized mood,” says Francis. “Counseling goals include identifying triggers and coping skills, abstaining from substances, creating healthy lifestyle habits, and action plans such as steps to reach a goal, evaluating barriers, and creating strategies to address barriers.”

Of course, these are generalizations and not true universally–some therapists may support clients on the latter set of goals, and some counselors may work with folks on the former.

Choosing the right expert for you.

In order to find a provider to best fit your needs, consider your goals. According to Guarino, if your goal includes processing pains and resentments of the past or learning how to cope with a mental health condition, you may want to consider seeking a therapist. You may also consider seeking services from a therapist if you are in need of treatment for a diagnosed mental health condition.

If your goal is to learn skills to cope with current and future-oriented life stressors, relationship issues, or self-esteem, you may want to consult with a counselor – or a therapist who works with more present-moment modalities. If you’re working through a period of grief and typically feel balanced in your mental health, you also might want to seek a counselor for this shorter-term need. (Often, counselors will have a speciality – e.g. grief counselor, addiction counselor, etc.)

Francis recommends asking yourself questions to get clear on what’s best for your needs. For example:

What are my goals? What is going well in my life and where are my challenges? How much time/effort am I able to commit to counseling or therapy? What support systems do I have, and am I willing to include them in the healing process? Am I willing to be vulnerable to obtain the changes I seek?

1. Look for someone who specializes in your issues.

In general, if you have a particular mental health condition you’d like to work with, Francis recommends seeking a licensed provider (therapist or counselor) with expertise, including advanced training and experience working with that specific diagnosis or population. You may also want to research the specific therapeutic modalities that apply to your issues and seek a provider who uses that method. (Here’s our guide to the different types of therapy, and online therapy can also be an option.)

2. Ask the practitioner a lot of questions.

While choosing your therapist or counselor, Francis suggests asking as many questions as you need to feel comfortable with your choice. Some questions for your provider might include:

What are your qualifications, including licensure, certification, additional training, specialized interventions, population served, and experience with specific issues? What is your recommended frequency and duration of therapy/counseling based on initial assessment? What is your medication philosophy? (i.e., How do they view medication as an intervention in conjunction with therapeutic interventions). What additional crisis resources are available? What are your policies on confidentiality, record keeping, and limits to confidentiality? What is the protocol for interaction if we see one another outside of session? How much does each session cost? Do you accept insurance?

3. Find someone you feel truly comfortable with.

When trying to find a therapist or counselor, remember that a good fit and comfort-level is important above all.

Psychotherapist Rachel Wright, LMFT, recommends doing free consultation calls with three different providers to see how each feels, how they work, and how you click. “Finding a therapist is like dating in the way that you sometimes have to go on a bunch of first dates (aka consults) to find one you want to continue dating (seeing as your therapist or counselor),” she explains.

And as Guarino notes, “If you do not feel comfortable with your provider after one or two sessions, consider asking for a referral for a different provider or returning to your search for a provider that best fits your needs.”

4. Commit to the process.

Regardless of if you’re entering into therapy, counseling, or even coaching, it is important to honestly self-assess your overall readiness for counseling or therapy. You’ve got to really want to do the work or to change, for any modality to be truly effective.

“You must also keep in mind that change, progress, and growth will not happen immediately,” Guarino adds. “It will take time to see results, so do not get discouraged if you do not feel better right away.”

Achieving goals in counseling and therapy takes time and commitment. Remember to have patience with the process and with yourself.

Though there are clear differences between a counselor and a therapist, both types of practitioners share methods and take inspiration from each other's processes. Many practitioners use aspects of both modalities, and there is a lot of overlap.

Focus on how comfortable you feel around the practitioner, your overall connection and rapport, and if you could see yourself being consistently vulnerable and honest with this person. Also, keep in mind that if you choose a certain counselor or therapist and it doesn’t end up working out, you can always transition to a new practitioner.

Lastly, remember: Healing isn’t linear. Try to stay open-minded and gentle with yourself throughout the process of connecting with the right practitioner for your needs at the time.