Counseling Vs. Therapy: Understanding the Differences

What Is a Counselor?

A counselor is a health professional who has training in the areas of counseling, psychology, social work, or nursing.¹ They often focus on bettering the individual by setting goals for achieving changes. Services provided may include evaluations, psychoeducation, or short- and long-term goal setting.¹ Most counselors work primarily with individuals unless they have received formal training to work with couples, families, or groups.

Here are a few different types of counselors:

• Marriage and couples counselor
• Family counselor
• Career or vocational counselor
• Rehabilitation counselor
• Mental health counselor
• School counselor
• Pastoral counselor
• Substance abuse counselor
• Addiction counselor

What Is a Therapist?

A therapist is a health professional with training to treat mental or physical disorders.² ‘Therapist’ is sometimes used interchangeably with ‘psychotherapist’, referring to a mental health professional designated to treat mental, emotional, or behavioral disorders.³ Services provided may include diagnostic assessment, addressing emotional or cognitive dysfunctions, or traditional talk therapy.³

Here are a few common types of therapists:

• Marriage and family therapist
• Cognitive behavioral therapist
• Psychodynamic therapist
• Play therapist
• Dialectical behavioral therapist
• ABA therapist
• Sex therapist 
• Drama therapist
• Art therapist 

What Is the Difference Between Counseling & Therapy?

The major differences between a counselor and therapist relate to training, licensure, and modalities of treatment. Although the terms ‘counselor’ and ‘therapist’ are often used interchangeably, there are notable differences in training between the two professions. There are also variations in degree, licensure, and training requirements based on the state of licensure. Both professions are required to have at least a graduate-level degree.

For example, Licensed Clinical Mental Health Counselors (LCMHC) often focus on an individual’s short and long-term goals, providing holistic strategies for reaching self-actualization. Licensed Marriage and Family Therapists (LMFT) may focus on relational and systemic approaches to therapy, assisting individuals with strengthening support systems and communication abilities. Both professions may borrow strategies, techniques, and modalities of treatment from one another to provide the best care for clientele.

Here are five differences between counseling and therapy:

1. Education

There are differences between a counselor and a therapist around acquired education. Both professions require, at minimum, a master’s level degree, clinical and supervision hours, and passing a licensure exam. Both professions may receive training in general areas needed for either profession, such as addiction, grief, diagnosis, crisis management, multicultural approaches, or trauma intervention. Therapists sometimes receive more training around diagnosis of mental health conditions than certain types of counselors. Differences in training will also vary by school, and it is important to be informed about the type of program your therapist or counselor graduated from.

In order to qualify as a licensed counselor, an individual must:

• Obtain a master’s or doctoral-level degree in counseling
• Meet supervision hour requirements (specifics vary by state)
• Meet clinical hour requirements (specifics vary by state)
• Pass a licensure exam
• Keep up with continuing education credits (most states)

In order to qualify as a licensed therapist, an individual must:

• Obtain a master’s degree or doctoral-level degree in a psychotherapy-related field
• Meet supervision hour requirements (specifics vary by state)
• Meet individual and relational clinical hour requirements (specifics vary by state)
• Pass a licensure exam
• Keep up with continuing education credits (most states)

2. Experience in Modality

Certain professionals may have more experience in individual, couple, or family modalities. Licensed Marriage and Family Therapists are specifically trained to view issues from a systemic and relational lens. They are also required to earn relational hours or experience with couples, families, and groups before receiving licensure. Choosing an LMFT means that therapy will often focus on improving the quality of relationships in your life.

Whereas LMFTs focus on client relationships, Licensed Clinical Mental Health Counselors are generally experts at helping individuals set goals and improve individualized mental health outcomes. LCMHCs may also choose to obtain additional training in treating couples and families. Differences between counseling and therapy may affect the type of interventions provided during treatment.

3. Experience in Presenting Concern

Certain professionals may have more experience in treating your presenting concern. A career counselor is a wonderful choice for someone looking to enhance professional goals but not process their childhood traumas. A sex therapist is a great option for someone who wants to focus on treating sexual dysfunctions or enhancing intimacy with their partner(s).

4. Expected Length of Treatment

Certain approaches to counseling or therapy can take varying lengths of time. You may decide the difference between seeing a counselor or therapist depending on the amount of time you want to spend in therapy. There is a general consensus that counselors may provide shorter lengths of treatment due to their focus on present-day goals and achievable outcomes.

Some people believe therapists provide longer treatments, often processing childhood issues, familial relationships, and communication dysfunctions. However, this is not always the case. For example, solution-focused brief therapists provide therapy that may last anywhere from 1-8 sessions and focus on short-term achievable outcomes.

5. Additional Certifications or Theories

Counselors and therapists may have differences in the types of additional certifications they hold or theories they draw from. Depending on the type of training they received in school and desired specialties, counselors and therapists may choose to pursue additional trainings or certifications. Common choices for additional certifications often center around presenting concerns, such as communication issues for couples.

Some common trainings for couples interventions include:

• Gottman method couples therapy 
• Emotionally focused couples therapy
• Imago relationship therapy
• Couples and sex therapy (CSST)

Counselors and therapists can use models or interventions from various therapies and theories. However, it is important to receive therapies from a trained professional when appropriate. For example, many counselors may use art-based interventions with clients. However, a client who is looking to use art therapy to process trauma should seek the expertise of a trained art therapist, who will have received formal training in a graduate program focused on art-based interventions and likely sought additional certification from the Art Therapy Credentials Board.

Which Mental Health Professional is Right for Me?

It is important to choose a professional who has received the training and education to provide appropriate services for you. Although counselors and therapists receive formal training in their respective professions, certain professionals may have more experience than others. There are also practical concerns to consider, such as location and cost.

Some things to consider when choosing a therapist include:

• Preferred modality for therapy
• Type of therapy or counseling offered
• Areas of specialty
• Racial-ethnic or gender provider matching
• Additional certifications
• Insurance coverage or self-pay costs
• Expected length of treatment.

It is equally important to find a professional that you match with on a personal level. It may take a few phone calls or sessions to find a relatable professional, but studies show that the therapeutic alliance is one of the most important factors in the process of change.⁴

How to Find a Counselor or Therapist

Finding the right counselor or therapist is sometimes a daunting process. Some first steps include searching for a provider with training in your presenting issue, calling insurance to know your benefits, and asking potential providers if they offer free initial phone consultations.  Some people may find it helpful to use an online therapist directory or online therapy platform to explore their options in providers.

Always know that the power to choose the right provider lies with you. Even if you do an initial intake session with a provider and sign the informed consent, you have the power to request discharge and ask for additional referrals. Finding the right match in a counselor or therapist is an important step in your process for change.

Here are a few tips for how to find the right counselor or therapist for you:

• Ask if they provide a free initial phone consultation. This consultation gives you time to ask questions about their approach to therapy, background, and other practical matters like cost, location, and areas of specialty.
• Look for a counselor or therapist who has obtained a degree from a Council for Accreditation of Counseling and Related Educational Program (CACREP) certified school. This certification has specific requirements for top-tier education standards for both counselors and therapists.
• Consider your presenting concern and filter your search for therapists and counselors accordingly.
• Some clients of color prefer a racial-ethnic match in provider for therapy. Finding a therapist who matches your race or ethnicity can provide an extra level of emotional safety.
• Some clients who identify as LGBTQIA+ may want to find a therapist who is a member of the LGBTQIA+ community or who identifies as an ally. Similar to finding a Black therapist or finding a LatinX therapist, which can also offer a layer of emotional safety.
• If a therapist or counselor tells you they are unable to accept new clients, you can ask them if they have anyone in their network they might recommend for your particular concern.
• If you are looking to utilize insurance, you can go through your insurance provider to find therapists or counselors who are in-network and then filter by their specialties.

In My Experience

As a Licensed Marriage and Family Therapist Associate, I received formalized training to provide psychotherapy from a relational and systemic lens. I believe that both counselors and therapists have specific strengths, and both professions provide important services for people in need. I also believe that certain strengths lie within certain professions, and it is important for professionals to understand where one role ends and another begins. For example, if a client were to approach me about career counseling, I would feel confident in referring a client to a career counselor who had received training in the appropriate assessments and goal-setting strategies for this particular need.

As someone who works from a family systems background, I work with all clients from a systemic perspective, no matter the modality. Whether an individual, couple, family, or group is my client, I am constantly aware of the systems that affect their issues. These systems can present as microsystems, such as the family environment, or even macrosystems, such as social and cultural values.⁵ These complex interactions between systems affect the way clients conceptualize and heal their problems. As a systems thinker, I know my strengths lie in providing relational therapies, which directly target the communication patterns of my clients with the systems around them. My experience with clients has shown me firsthand that change happens through our relationship with others.