Counselor Definition and Terms

Therapist Definition and Modalities

Techniques and Modalities of Counseling
Formats of Group Therapy

Links to Credentials:
LCDC, Chemical Dependency Counselor
LMFT, LMFTA, Marriage and Family Therapist
LPC,LMHC, CCMHC, Professional Counselor or Mental Health Counselor
MD, Psychiatrist
APN, Psychiatric Nurse
PhD, PsyD; LP, LPA, PLP, define Psychologist
LRC, OTR, Rehabilitation Counselor, Occupational Therapist
LCSW, LMSW, LICSW, LSW, LSW-A, CSWA, LBSW Social Worker
LSSP, LEP, School Psychologist, Educational Psychologist

Counselor Definition, Therapist Definition: According to Texas Department of State Health Services, counseling means assisting one or more clients through a therapeutic relationship, using a combination of mental health and human development principles, methods, and techniques, including the use of psychotherapy, to achieve the mental, emotional, physical, social, moral, educational, spiritual, or career-related development and adjustment of the client throughout the client's life. That’s a lot of ground to cover!

Because many of us aren't quite clear on the differences between psychiatrists, psychologists, counselors and social workers, we offer a rough field guide here.

Chemical Dependency Counselor (LCDC)

A licensed chemical dependency counselor (LCDC) is licensed only to provide chemical dependency counseling services to drug-users, family members of drug-users or any other person involved in a significant relationship with an active substance abuse issue. Providers must pass a state licensing exam and have comparable educational and clinical experience in the chemical dependency field. The must also maintain annual continuing education credits. The license does not qualify an individual to provide services outside the scope of chemical dependency, meaning that LCDCs are not qualified to treat individuals with a mental health disorder or provide family counseling to individuals whose presenting problems do not include chemical dependency.

Marriage and Family Therapist(LMFT)

Marriage and family therapists, (LMFTs), receive a master’s or doctoral degree specializing in family and interpersonal dynamics. They treat individuals in the context of family relationships, addressing issues from anger and resentment to intimacy and communication skills. Treatment with a marriage and family therapist is typically brief (20 sessions or less) and solution-focused. Since 1970, the number of practitioners has increased substantially, and the number of states licensing marriage and family therapists. (American Association of Marriage and Family Therapists)

Pastoral Counselor (LPC, LMFT)

Pastoral counselors listed on this site are ministers who have graduate training in religion and behavioral science and are licensed as Professional Counselors or Marriage and Family Therapists. They offer therapy to individuals, couples, families, and groups and their approach is shaped by their religion. They also provide consultation and leadership in personal, family, and spiritual growth.

Professional Counselor, Mental Health Counselor (LPC, LPC-Intern, LMHC, CCMHC)

A Licensed Professional Counselor, Licensed Mental Health Counselor, or Certified Clinical Mental Health Counselor holds a master’s degree in a relevant field, such as counseling, psychology, or substance abuse treatment. To become certified they must complete 3000 clock hours of counseling under a supervisor and pass a state licensure exam. An LPC-Intern has completed a master’s degree and is in the midst of completing their hours under supervision. They often treat people dealing with problems such as depression and anxiety, grief, work-related issues, communication, relationship stress, and addiction or eating disorders. Some specialize in a certain area such as child counseling, internet addictions or trauma. All LPCs are regulated by the State Board of Examiners of Professional Counselors.

Psychiatrist (MD)
Psychiatrists are medical doctors who, after completing medical school, receive an additional four years of specialized mental health training. Psychiatrists treat the full range of emotional and mental disorders, and are licensed to prescribe medication. Psychiatrists sometimes use psychotropic medication in conjunction with psychotherapy to treat psychiatric disorders. (American Psychiatric Association) Some psychiatrists only address medication management.

Psychiatric Nurse (APN)

The Advanced Practice Nurse (APN) in Mental Health has a master’s degree or higher from an accredited school of nursing and has passed a national exam. Services include psychiatric evaluation, psychotherapy, and patient education. Additional education and authorization by the Board of Nursing Examiners permits some APNs to also prescribe psychoactive medications.

Psychologist (PhD, PsyD; LP, LPA, PLP)

Psychology has two doctoral degrees: a PhD a doctor of philosophy, and a PsyD, doctor of psychology. Ph.D. programs in clinical psychology emphasize theory and research methods and prepare students for either academic work or careers as practitioners. The Psy.D., which was created in the late 1960s to address a shortage of practitioners, emphasizes training in therapy and counseling. Psychologists with either degree can practice psychotherapy but are required to complete several years of supervised practice before becoming licensed. (American Psychological Association)

Psychologists practicing under a PhD or PsyD have a doctoral degree in psychology that meets the requirements of the Psychologists’ Certification and Licensing Act. They have also passed the National Psychology Licensing Examination, the State Board’s Oral Exam on ethics and professional conduct, and have two years of supervised experience (one pre-doctoral internship and one postdoctoral year) from a licensed psychologist that satisfies the requirements of the Board. Psychologists perform a wide range of evaluation and treatment interventions with children, adults, couples, families, groups, and organizations. Services include therapy, diagnostic evaluations, psychological and neuropsychological testing, career counseling, forensic evaluations, behavioral health consultations, and organizational consulting.

Licensed Psychological Associates (LPA) and Provisionally Licensed Psychologists (PLP) are trained at the masters or doctoral level and can provide a full range of psychological services under the supervision of a fully licensed psychologist, including individual and group therapy and psychological assessment. All psychologists are regulated by the State Board of Examiners of Psychologists.

Rehabilitation Counselor (LRC), Occupational Therapist

Rehabilitation counselors help people deal with the personal, social, and vocational effects of disabilities. They counsel people with disabilities resulting from birth defects, illness or disease, accidents, or other causes. They evaluate the strengths and limitations of individuals, provide personal and vocational counseling, and arrange for medical care, vocational training, and job placement. Rehabilitation counselors interview both individuals with disabilities and their families, evaluate school and medical reports, and confer with physicians, psychologists, occupational therapists, and employers to determine the capabilities and skills of the individual. They develop rehabilitation programs by conferring with clients; these programs often include training to help clients develop job skills. Rehabilitation counselors also work toward increasing the client’s capacity to live independently.

Occupational therapists help patients improve their ability to perform tasks in living and working environments. They work with individuals who suffer from a mentally, physically, developmentally, or emotionally disabling condition. Occupational therapists use treatments to develop, recover, or maintain the daily living and work skills of their patients. The therapist helps clients not only to improve their basic motor functions and reasoning abilities, but also to compensate for permanent loss of function. The goal is to help clients have independent, productive, and satisfying lives.

Occupational therapists help clients to perform all types of activities, from using a computer to caring for daily needs such as dressing, cooking, and eating. Physical exercises may be used to increase strength and dexterity, while other activities may be chosen to improve visual acuity or the ability to discern patterns. For example, a client with short-term memory loss might be encouraged to make lists to aid recall, and a person with coordination problems might be assigned exercises to improve hand-eye coordination. Occupational therapists also use computer programs to help clients improve decision-making, abstract-reasoning, problem-solving, and perceptual skills, as well as memory, sequencing, and coordination””all of which are important for independent living.(http://www.bls.gov/oco/ocos067.htm)

Social Worker (LCSW, LMSW, LICSW, LSW, LSW-A, CSWA, LBSW)

A social worker usually has a master's degree in social work and has studied sociology, growth and development, mental health theory and practice, human behavior/social environment, psychology, research methods. In terms of counseling, social workers help individuals deal with a variety of mental health and daily living problems to improve overall functioning. (http://www.medterms.com/script/main/art.asp?articlekey=15160) While many work in private practice, social workers often work in schools, hospitals, community clinics and government agencies. (National Association of Social Workers) The social work perspective is one of strengths-based practice, meaning that the practitioner will help look for and encourage building upon a client’s strengths. A social worker also as a broad view of the client, keeping in mind the family, community and culture of each person.

“LCSW” stands for Licensed Clinical Social Worker or Licensed Certified Social Worker, and "LICSW" stands for Licensed Independent Clinical Soical Worker. A professional with this designation has completed a certain number of post-graduate hours of clinical work under supervision, has passed a state licensing exam, and is current on annual continuing education requirements. “LMSW” stands for Licensed Master of Social Work, "CSWA", stands for Clinical Social Work Associate, "LSW-A" stands for Licensed Social Work Associate. A practitioner with any ofthese designations has completed a master’s program, taken a licensing exam, and is in the midst of accruing their required number of hours of clinical work under an approved professional’s supervision. "LSW" stands for Licensed Soical Worker and "LBSW" stands for Licensed Bachelor of Social Work. Someone with either of these licenses may practice social work in an agency setting, but not in private practice without supervision. All social workers are regulated by the State Board of Examiners of Social Workers.

Specialist in School Psychology, Educational Psychologist (LSSP, LEP)

School psychologists have specialized training in both psychology and education and must have completed a graduate degree in psychology from a regionally accredited academic institution with graduate level coursework in specific domains related to educational psychology. In addition, LSSPs must have completed a certain number of supervised hours of internship or experience, some of which must be in a public school. They team with educators, parents, and other mental health professionals to ensure that every child learns in a safe, healthy and supportive environment.

Specific Techniques and Modalities in Counseling

Art therapy

Art therapy uses art media and the creative arts process in psychotherapy. Registered Art Therapists (ATRs) are board certified through a national exam.

Biofeedback

Biofeedback is the use of electronic equipment to reflect the physical state of the individual while the person learns techniques to regulate the body's systems and to reduce unwanted symptoms. It teaches physical awareness, and voluntary control over the body's systems. This is referred to as self-regulation. Biofeedback is a painless and non-invasive therapy which should be performed by a trained biofeedback therapist, preferably one with certification credentials. Biofeedback is used for the treatment of stress, chronic pain, Raynaud's Disorder, anxiety, TMJ jaw pain, high blood pressure, tension, muscle pain, addiction, phobias, migraine headaches, Attention Deficit Disorder, panic attacks, tension headache, Fibromyalgia, Irritable Bowel Syndrome, and many other disorders. There are many types of biofeedback. (http://www.coe.unt.edu/cdhe/Biofeedback1.htm) See this site for more information.

Brief Therapy

Brief therapy is short-term (usually 10 to 20 sessions) and focused on helping a person to resolve or effectively manage a specific problem or challenge, or to make a desired change. The therapy is typically solution-oriented, and sessions are more geared towards here-and-now aspects of the problem than on exploration of historical material. Goal setting is the hallmark of this approach, and the therapist is more active in sessions than is typically the case in traditional psychotherapy. Most often, those who practice brief therapy take a cognitive, behavioral, or cognitive-behavioral approach to treatment. (http://www.cognitive-therapy-associates.com/therapy/brief-therapy.php)

DBT (Dialectical Behavior Therapy)

Dialectical Behavior Therapy is an approach that has been developed for a type of personality that has extreme shifts in emotional state and behavioral instability called Borderline Personality Disorder (BPD). In addition, those with BPD may have tendencies toward self-injurious or suicidal behaviors, and have difficulty stopping themselves from acting upon these impulses. Simultaneous emphasis on acceptance and the need for change are at the core of this approach, and specific behavioral skills are learned and practiced to improve impulse control, emotional regulation, interpersonal interactions and overall functioning. The goal is to replace old, harmful ways of thinking, feeling and behaving with new, healthier ones. (http://www.cognitive-therapy-associates.com/therapy/dialectical-behavior-therapy.php) See this site for more information.

EMDR (Eye Movement Desensitization and Reprocessing)

Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapeutic technique used by licensed mental health practitioners who are trained in this protocol to facilitate the recovery of those suffering from aftereffects of traumatic events. In this technique, the therapist guides the person in right/left eye movement or other right/left brain stimulation as he or she recounts the event. Also, the person gets to choose their actions rather than feeling powerless over his or her reactions. The goal is to release blocked emotional experience (memories and distress) as well as successful integration of the event, resulting in symptom relief and healing. (http://www.cognitive-therapy-associates.com/therapy/emdr.php) See this site for more information.

Forensic services

If a practitioner offers “forensic services” they are willing to apply their knowledge and training in mental health to the investigation and establishment of facts or evidence in a court of law.

Hypnosis

Hypnosis is a method whereby a hypnotist seemingly induces a trance or trance-like state in a willing subject. Hypnotherapy is the use of hypnosis for therapeutic purposes, and should only be employed in this manner by a licensed professional. The main ingredients of this approach include: (1) deep relaxation, (2) intense concentration, and (3) high suggestibility on the part of the subject. During hypnosis, the hypnotist uses techniques that foster a very relaxed state in which defenses or resistance is lowered. Then, suggestions are given that are related to the purpose of the procedure, or the subject's mind or imagination is explored in order to gain insight or access to memories (though accuracy is not enhanced). Contrary to popular myth, a person will not engage in any behavior that is against his or her will, either during the procedure or afterwards. That is, the person is not controlled by the hypnotist; both the hypnotist and the subject simply behave in accordance with their own expectations of the situation, and each play a learned role. Also, an "altered state of consciousness" is not actually achieved, but rather it is akin to the twilight state between sleeping and waking. (http://www.cognitive-therapy-associates.com/therapy/ericksonian-hypnotherapy.php)

Imago Therapy

In Imago therapy, couples are taught structured dialogues to change their relationship from a power struggle to one of mature love with mutual commitment, awareness, safety and comfort. (http://www.psychomed.net/clp/Imago.html) See this site for more information.

Neurofeedback

Neurofeedback is a form of biofeedback which uses electrical signals from the brain detected by electrodes that are placed on the scalp. It is a completely painless and non-invasive exercise in which the person's mental activity in the form of frequency bands or individual frequencies (brainwaves) are "fed back" to him or her via a computer. A coach trains the person how to change the activity of one's brain in a desired way, and thus new behaviors are learned. This way, the person gains better control over his or her symptoms. Neurofeedback has been used to help those with Attention Deficit Disorder (ADD). It has also been used to treat problems that are stress-related, such as chronic pain, headaches, insomnia, depression and addictions. (http://www.cognitive-therapy-associates.com/therapy/neurofeedback.php)

Play Therapy

Play therapy is an approach typically used with children between ages 3 to 8. It is the medium by which a child can express, or play out, internal conflicts and distress regarding a variety of problems. Younger children in particular do not have the cognitive development or verbal skills to discuss issues and communicate directly with words as adults do. Also, in play, children feel more empowered by interacting voluntarily, on their terms, in a modality that is natural, familiar and comfortable for them. Within a playroom containing a range of carefully selected toys and materials, children are the directors and rule makers in their symbolic world. Play therapy provides a safe, accepting environment for children to express their needs and feelings, practice social skills, and reenact conflicts for the purpose of preparing them to deal with upsetting issues or traumatic events. In addition, it affords children an opportunity to find and experiment with alternative solutions to problems, as well as to learn how to cope better. Parents are an integral part of the process, and the therapist shares observations with them, as well as provides guidance regarding ways in which parents can foster their child’s progress. (http://www.cognitive-therapy-associates.com/therapy/play-therapy.php)

Psychodrama

A psychotherapeutic technique in which people are assigned roles to be played spontaneously within a dramatic context devised by a therapist in order to understand the behavior of people with whom they have difficult interactions. (http://www.answers.com/topic/psychodrama)

Systems Centered Therapy (SCT)

According to Systems-centered theory (SCT) living human systems survive, develop, and transform from simple to complex through a developing ability to recognize differences and integrate them. SCT explains how living human systems contain their energy within functional boundaries and direct it towards their goals: the primary goals of survival and development and the secondary goals of environment mastery. Systems-centered training teaches how to understand and influence living human systems and how to take up one’s role as an agent of change, both for the self and for other living human systems. SCT members learn through experience rather than explaining. (http://www.systemscentered.com/index.asp?page=/Theory/index)

Format of Groups

Time-limited

This type of group closes to new members after the first couple of sessions, runs for a set period of time.

Psycho-Educational

This type of group is focused on educating the members about a certain topic such as divorce, grief, or terminal illness. There may be some internal or interpersonal processing involved.

Open Process Group

Process group therapy is defined as a method of treating existing presenting problems using the interaction between a mental health professional and two or more group members to promote positive emotional or behavioral change. An “open” group is ongoing and receives new members as there is room; there will be a certain focus of the group, whether it is a topic, experience, or type of therapy.

Support Group

Support groups are focused on a certain experience that all the members share and the goal is to foster support for one another in light of that experience. In general, this type of group may or may not be run by a licensed counselor.

Process and Art / Movement / Writing / Yoga

These are all “expressive group therapy” formats. Through active expression, inner-strengths are discovered that can help the client deal with past experiences and cope with present life situations in more beneficial ways.

The mental health profession has many types of certifications, each with unique education, training, approach, and licensing requirements. All of the practitioners listed on this site are licensed in their own area of education and training. Types of licenses may be important if you're looking for a therapist who can prescribe medication or who is expert in a particular problem like drug addiction. But in general, effective therapy is mostly about finding a therapist who works well with you.