What Does a Career in Therapy Look Like?
Are you ready to discover your college program?
A June 2020 study from the Centers for Disease Control and Prevention (CDC) found that 40% of U.S. adults reported “elevated adverse mental health conditions associated with COVID-19.” Dips in mental health, increased substance abuse, and growing thoughts of suicide are all cited. The hardest hit include young adults, racial/ethnic minorities, and essential workers.
Now more than ever, U.S. counseling therapists are needed to support Americans of all races/ethnicities, cultures, gender expressions, sexual orientations, and disabilities as they work through pandemic- and post-pandemic-related mental health challenges. Therapists can help clients work through feeling uncertainty, grief, loneliness, burnout, and confusion to build healthier habits and empowered lives.
Below, we explain how to hone personal and professional skills needed for a career in therapy and how to choose the right program for your career goals. We also interviewed a practicing therapist, who shares her experiences and insights about the job.
What Do Therapists Do?
Therapists meet with patients regularly, typically in person or over video. They learn about their patients’ mental health and personal histories, assess their well-being, offer coping strategies, develop treatment plans, and document patient progress. Therapists are not legally certified to prescribe medication.
Therapists may specialize in working with specific demographics, like children, or they may work with individuals, couples, and families. Common specializations for therapists include:
- Marriage and family therapy
- Cognitive behavioral therapy
- Child therapy
- Dialectical behavior therapy
- Psychodynamic therapy or psychoanalysis
Therapists can incorporate a variety of approaches and methods into their work, depending on the needs of patients. The most common methods are:
- Cognitive behavioral therapy (CBT)
- Behavioral therapy
- Humanistic/client-centered counseling
- Psychodynamic therapy
- Schema therapy
Therapists also employ these tools and techniques to understand and support their patients.
- Diaries
- Imagery
- Talk therapy
- Systematic desensitization
- Role-playing
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Where Do Therapists Work?
Therapists are usually employed in a private practice office, healthcare setting, or school. Therapists who have private practices often take on the responsibilities of a small business owner, which requires its own skill sets, like accounting and marketing.
Because of the COVID-19 pandemic, teletherapy is on the rise. Teletherapy providers offer therapy appointments via video, phone, and/or text. Therapists may even choose to work in a hybrid setting, accepting clients both in person and online.
Therapists can work during the day or at night, or some combination of both. Depending on their clientele, some therapists have on-call or emergency alert hours.
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Skills
Therapists need strong emotional and interpersonal skills, as well as the ability to compartmentalize. Key soft skills include sensitivity, awareness, nonjudgment, and openness to diverse cultures, races, gender expressions, and sexual orientations. Therapists regularly practice active listening and may need to act quickly in high-stress situations.
In addition, therapists — especially those working in private practice — must have good business management skills and ethics, including confidentiality.
Career Information
The most highly compensated therapy positions tend to be in clinical, counseling, and school settings. In general, marriage and family therapists earn $10,000 per year more than the average American worker. Those working in counseling, social work, and substance abuse or behavioral disorder counseling enjoy salaries just slightly above the national average.
| Career | Median Salary (2023) | Projected Job Growth (2023-2033) |
|---|---|---|
| Counselors and Social Workers | $53,710 | 19% |
| Substance Abuse, Behavioral Disorder, and Mental Health Counselors | $53,710 | 19% |
| Marriage and Family Therapists | $58,510 | 16% |
| Clinical, Counseling, and School Psychologists | $92,740 | 7% |
How to Become a Therapist
Individuals wanting to become a therapist should expect 5-8 years of higher education, including a bachelor’s degree, a master’s degree, clinical supervision hours, examination(s) for licensing and certification, and continued education to maintain licensure. Some roles, such as psychologist, require a Ph.D.
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Education
Specific education requirements to become a therapist vary across states, but the most common education path is as follows.
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Licensure and Certification
To become a practicing counseling therapist in the U.S., state licensure is required. Licenses and their exams vary by state, and they also depend on the type of therapy you want to practice. The following counseling titles are the most common.
- Licensed Professional Counselor (LPC)
- Licensed Mental Health Counselor (LMHC)
- Licensed Clinical Professional Counselor (LCPC)
- Licensed Professional Clinical Counselor of Mental Health (LPCC)
- Licensed Clinical Mental Health Counselor (LCMHC)
- Licensed Mental Health Practitioner (LMHP)
- Licensed Marriage and Family Therapist (LMFT or MFT)
After students complete a master’s degree in therapy or counseling from an accredited school and earn their clinical supervision hours, they must undergo the following process.
Background Check
Counselor Examination
Depending on the state in which you want to practice, you will need to pass one or both of these exams:
- The National Counselor Examination for Licensure and Certification (NCE)
- National Clinical Mental Health Counselor Examination (NCMHCE)
Both are available through the National Board for Certified Counselors (NBCC).
If you are planning to work with individuals with physical, mental, developmental, and/or emotional disabilities, some states may also require that you pass the Certified Rehabilitation Counselor Examination (CRC).
Purchase Liability Insurance
Additional Certifications for Specialties
Depending on your specialization, you may need to earn additional certifications.
Here are a few of the credentials and certifications that therapists can pursue to set themselves apart.
- Distance Credentialed Counselor (DCC)
- Certified Alcohol and Drug Counselor (CADC)
- Master Addiction Counselor (MAC)
- Military and Family Life Counselor (MFLC)
- Music Therapist – Board Certified (MT-BC)
NBCC offers certifications in becoming a Certified Clinical Mental Health Counselor (CCMHC), Masters Addictions Counselor (MAC), and National Certified School Counselor (NCSCS). To hold one of these specialty certifications, you must also be designated as a National Certified Counselor (NCC).
Continued Education
In order to renew licensing and credentials, most states require therapists to continue earning education credits. Usually these credits must be earned every 2-4 years, though exact time frames vary by state and credential.
What to Look for in a Program
Follow these tips to make informed decisions about the program you decide to pursue.
Accreditation Matters
Whatever your field, be sure to look for a program that is fully accredited for that profession. Programmatic accrediting agencies in the counseling and mental health fields include:
- American Psychological Association
- Council for Accreditation of Counseling and Related Educational Programs
- Council on Rehabilitation Education
- Masters in Psychology and Counseling Accreditation Council
Review your state’s licensing requirements to be sure your target program qualifies.
Scheduling
- If you are interested in online college programs, ask yourself which schedule works best for your lifestyle: a synchronous schedule (classes meeting at a set time on a regular schedule) or an asynchronous schedule (completing coursework on your own time). For example, will you have to balance part- or full-time work with your degree? If so, an asynchronous course may work better for you.
Curriculum
- If you already have a firm idea of what type of therapist career path you want to pursue, look through the curriculum of each program in which you are interested. This will help you determine which one best matches the skills and experience that you need for your chosen career.
Location
- Consider the location of the program. Again, many therapy programs tailor their courses to the licensing exams used in their state, so if you live somewhere else, those classes may not be the ones you need.
Other Important Questions to Ask Yourself
Is this a regionally accredited school?- Will your desired program meet state licensing standards for your prospective career?
- How do costs compare across programs? Are any of your target schools unreasonably expensive when compared to your salary prospects after graduation?
- What is the transfer credit policy for this program?
- What is the background of the faculty? Do they specialize in the areas where you would like to take your therapy career? Is there a potential for mentorship?
Similar Careers
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Social Worker
Social workers are similar to therapists, but they focus more on connecting clients — who may be oppressed or living in poverty — with resources in their communities. However, licensed clinical social workers can open private practices to deliver therapy, and they can accept Medicare insurance. They can also more easily access jobs with the federal government than licensed counselors can.
Social workers must earn a bachelor’s degree and graduate degree (master of social work or licensed clinical social worker), complete supervised clinical work, and pass the Association of Social Work (ASWB) exam.
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Psychiatrist
Psychiatrists resemble therapists in that they provide mental healthcare for clients. The difference is that psychiatrists have medical backgrounds, allowing them to consider the physical aspects of mental health in addition to psychological aspects. They can also offer diagnoses and prescribe medication. Unlike therapists, psychiatrists must earn a medical doctorate and complete a psychiatry residency.
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Physical Therapist
Physical therapists are not mental healthcare providers. Instead, physical therapists diagnose and treat individuals with physical pain, functional impairments, and limited mobility. Similar to counseling therapists, they can assess and help patients, but they only address physical or fitness issues — not mental health.
Physical therapists must earn a doctorate in physical therapy (DPT) from an accredited institution, pass the National Physical Therapy Examination (NPTE), and meet state-specific licensure requirements before practicing.
Ask An Expert
To understand what a career as a therapist looks like, we interviewed an expert. Read about her experience and advice below.
Karol Ward, L.C.S.W. is a licensed psychotherapist and confidence-building coach who helps her clients cultivate inner confidence in the areas of personal growth, business visibility, and communication. She is the author of “Worried Sick: Break Free From Chronic Worry to Achieve Mental & Physical Health” and “Find Your Inner Voice: Using Instinct and Intuition Through the Body-Mind Connection.”
Ward is an award-winning speaker and delivered a popular TEDx Talk on the power of the body-mind connection at TEDx TimeSquare. She is regularly featured in the Wall Street Journal and her new book, “The Confident Practitioner,” goes on sale in June 2021. www.karolward.com
Why Become a Therapist?
If helping others resolve emotional struggles appeals to you, becoming a therapist may be a rewarding career. This career requires an interest in human nature and a passion for helping others.
How To Get Hired
What Is a Normal Day Like for a Therapist?
Therapist Professional Organizations
American Counseling Association
Founded in 1952, ACA is a nonprofit, professional, and educational organization that supports the counseling profession. It is the world’s largest association representing professional counselors.American Mental Health Counselors Association
AMHCA is dedicated to supporting clinical mental health counselors through collaboration, advocacy, research, ethical practice, and professional development. It also publishes AMHCA Standards on a rolling basis to address needs between the public and the profession.American Psychological Association
The APA is the top scientific and professional organization for psychologists in the United States, with membership including researchers, educators, clinicians, consultants, and students. It is dedicated to using psychology to make positive impacts on society, educating the public on psychology, and serving as an authoritative voice for psychology.American Association for Marriage and Family Therapy
AAMFT is the professional association for more than 50,000 marriage and family therapists in the U.S., Canada, and abroad. It promotes research, inclusivity within the profession, and awareness of changing social trends.
Rayelle Davis is a nationally board certified counselor and a licensed clinical professional counselor. As a nontraditional student, she earned an associate degree in psychology at Allegany College of Maryland and a bachelor’s degree in psychology at the online University of Maryland Global Campus. Davis earned her master’s degree in counseling education with a concentration in marriage, couples, and family therapy from Duquesne University. She has taught several undergraduate psychology courses. She is currently a doctoral student and teaching assistant at Duquesne University and practices psychotherapy in Maryland.
Header Image Credit: SDI Productions | Getty Images
