What to Know About Being a Licensed Mental Health Practitioner

by Meg Embry

Updated May 23, 2023 • 6 min read

Gen Z is struggling with their mental health more than any other generation. And millennials (those perennial economic underdogs) aren't doing so great, either.

So it's no surprise that these two generations are the most likely to report seeking help for their mental health. And their willingness to talk about it — especially on social media — is destigmatizing mental disorders and normalizing therapy for everyone.

Now, millennials and Gen Z are becoming professional therapists themselves. Nearly half of U.S. therapists are ages 40 or younger.

But what exactly does it mean to be a therapist? And what do you need to know before becoming one?

Therapy as a Career

The term "therapist" is a catch-all for any kind of therapeutic professional. But not all therapists are the sort that scribble in a notebook while you lie on a fainting couch. In fact, some therapy careers focus exclusively on physical function and well-being:

Therapy Careers Focused on Physical Function and Well-Being

  • Exercise therapy
  • Nutritional therapy
  • Healthcare therapy

Mental health therapists treat emotional and mental disorders. There are at least a dozen therapy specializations within the mental health field alone, and many approaches to treatment within each specialization.

Most mental health professions require a master’s degree, and some require a Ph.D.

Mental Health Therapy Careers



  • Psychiatric nurse practitioner
  • Psychiatric mental health nurse practitioner
  • Licensed creative arts therapist
  • Certified music therapist

Ph.D. or Psy.D.

The job outlook for mental health therapists across specializations is strong. Employment of marriage and family therapists, for example, is expected to grow 22% by 2029.

Since the pandemic, demand for therapy has exploded as rates of depression and anxiety have soared. New remote treatment options have led to an unmanageable increase in patients for a lot of practitioners.

Even in such overwhelming times, mental health professionals say their career feels more like a calling.

"In this job, you are doing sacred work that will always be much greater than you," explained psychotherapist Allison Chawla.

"It is a privilege that cannot be put into words," agreed Janine Ilsley, LMSW.

But many therapists also reported challenges and difficulties they didn't feel prepared for. Here are some things therapists wish they knew before becoming therapists.

You’ll Need Boundaries — and Therapy

“Things are going to go a lot smoother for you if you already have healthy practices in your own life. This means being able to say no to additional tasks, knowing what you can handle, and having good stress relief practices in place. You need to have strong boundaries. Being a therapist can consume you if you’re not careful.”

— Tara Haidinger, MS, LPC, CCTSF, CCTSI, Aegis Counseling PLLC

“If you are interested in a particular modality of therapy, see a clinician who works in that modality to make sure it is something you believe is truly therapeutic. A common question you get as a practitioner is whether you have been in therapy before. Make sure you can answer that honestly.”

— Courtney Douds, LCSW, Talk Therapy

“Sometimes clients share experiences that hit close to home and activate an old wound. Seeing my own therapist to process triggers is necessary for my success.”

— Laura Fonseca, MSW, LCSW, Cornerstone Therapy Services

It Isn’t Personal

“I have had clients quit therapy, yell at me, or become upset at me. Young and naive me would think, ‘what did I do wrong?’ I didn’t do anything wrong. Clients come to therapy with poor relationship patterns and maladaptive thinking. When they encounter the compassion and empathy a therapist brings to the session, it becomes uncomfortable and scary for them. Their reactions are not necessarily your responsibility.”

— Timothy Kelly, LCSW, Propagate Hope Counseling

Some Problems Are Too Big to Tackle

“Sometimes it feels like a losing battle. For every person who makes positive changes, there are so many more who need therapy and can't access it. Sometimes it feels like you're not even making a dent.”

— Tara Haidinger, MS, LPC, CCTSF, CCTSI, Aegis Counseling PLLC

“We work mostly on the level of individual change. But it is impossible to solve the ills of capitalism, racism, transphobia, or other systemic issues from the consultation room. You can only help patients find their own paths to desire, creativity, activism, or other forms of liberation.”

— Courtney Douds, LCSW, Talk Therapy

The Learning Never Ends

“I wish I knew that continuing education is a must — not just for maintaining licensure, but for providing appropriate care for the clients who would become a part of my caseload.”

Sally Berkowitz, LPC

“It’s so important to be picky about finding quality field work! I received powerful advice to take one of your clinical intern years to explore working with a population that you don’t naturally gravitate toward. Get experience outside your comfort zone. Be selective and advocate for yourself.”

— Jennifer Gran Schliessman, LCSW and Psychotherapist

“We learn theory, intervention, life span, addiction, trauma, and so much more. Yet there is very little focus on legislative advocacy and how it informs practice. Legislative advocacy helps us to engage legislators on mental health policies and funding. More education is needed in this area.”

— Dr. Nakpangi Thomas, LPC, TITC-CT

Business Acumen Is Required

“I wish I had realized how much business knowledge I would need. While most therapists enter the field to help people, you may also have to support a family. That means learning how to run a private practice. And if what you really want is to run a business, you might be better off doing something else.”

— Rabbi Shlomo Slatkin, LCPC, The Marriage Restoration Project

“I wish my graduate program had included business courses. I have had to learn how to do booking, hiring, marketing, and managing through trial and error. That is an expensive way to learn.”

— Cheri Timko, MS, Synergy Coaching

The Money Doesn't Always Cut It

“I wish I had understood just how heavy the student debt load would be and how difficult it would be to pay it off. I love my career, but the debt load of a doctoral education has not matched the salary.”

— Shamin Ladhani, Psy.D., Ascension Healthcare

“Becoming a therapist will not afford you the quality lifestyle you imagine. Be intentional about creating additional streams of income within the profession.”

— Crystal Currie, LCMHC, NCC, BC-TMH, Life Skills and Counseling

“I wish I had understood that I would need at least a Master's degree and a lot of experience before making any money in this field. If I had, I probably would have taken a different route to helping people.”

— Cheri Timko, MS, Synergy Coaching

You Will Get Therapist-Zoned

“I wish I had known how people would react to me socially when they find out what I do for a living. Sadly, most people assume I am analyzing or judging them. But when I am not in the chair, I just want genuine connections like everyone else. Those who don’t know me well assume I am always in therapist-mode. Be prepared for people not to feel at ease around you.”

— Allison Chawla, MA, LMSW, CC, Clinical Social Worker and Therapist

“People will judge you. Once they find out you are a therapist, they will automatically assume you are trying to diagnose them.”

— Crystal Currie, LCMHC, NCC, BC-TMH, Life Skills and Counseling

Portrait of Meg Embry

Meg Embry

Meg Embry is a Colorado-based writer for TheBestSchools.org covering higher education. She is an award-winning journalist who has lived and worked in Canada, the Netherlands, and the United States.

Header Image Credit: selimaksan, ferrantraite | Getty Images

Learn more, do more.

More topic-relevant resources to expand your knowledge.

Popular with our students.

Highly informative resources to keep your education journey on track.

Take the next step toward your future with online learning.

Discover schools with the programs and courses you’re interested in, and start learning today.

woman in an office