Alphabet Soup: Decoding Mental Health Credentials

Trying to find a reputable mental health professional can feel daunting. There are so many clinicians out there, and it’s important to find a good one. Many choose to start their search on the Internet—hooray, a good start! Looking through search results, though, may feel confusing. Most of the names have letters behind them, but what do all those letters mean? How can a savvy consumer of mental health services use them to choose a counselor or therapist?

Here’s a brief guide to some of the common credentials in mental health licensing in the United States. Please note some of these credentials relate to the state licensing and certification standards for practicing professionals, and therefore may vary somewhat from state to state. In most states, however, there is some similarity in qualifications required for licensure. If you are interested in knowing the minimal level of qualification for practice in your state, an Internet search for your state and the specific credential you are interested in can typically yield this information. You can also contact your state’s licensing board directly for more information.

• Registered psychotherapist: In an attempt to provide some level of regulation for people offering services who are often not otherwise credentialed, some states have introduced a database that lists people the state recognizes as providing services, but does not recognize as having formal training or credentials in the field. This often includes those who might call themselves a “life coach” or simply a “psychotherapist.”
• CAC: A certified addictions counselor has some level of training in the specific dynamics of addiction. Credentials necessary to achieve this certification vary by state, but may be minimal. For example, in Colorado, CAC I and CAC II require a high school diploma or GED, while a CAC III (the highest level) requires a bachelor’s degree.

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  MA: This is a fairly universal designation indicating that the person using this credential has a master of arts degree. If used to indicate professional competence in psychology, it should be in a field related to psychology. Typically, a master’s degree of any variety reflects two years of post-bachelor’s study.
• MS: Another indicator of a degree held—in this case, a master of science.
• MEd: Indicates a master’s degree in education.
• MC: Indicates a master’s degree in counseling.
• LPC/LCPC/LPCC/LMHC: These acronyms denote, respectively, licensed professional counselor, licensed clinical professional counselor, licensed professional clinical counselor, and licensed mental health counselor, as licensed by the state. Generally, a completed master’s degree, post-degree training hours under supervision, and completion of a licensure exam are required to obtain this license.
• LAC: Indicates in some states that the holder has been licensed as an addictions counselor and holds specialized training in this field. Depending on the state, it may require a completed master’s degree.
• NCC: Indicates that the holder has successfully completed a master’s degree, post-degree supervision, and the national counselor examination. This is a nationwide credential and is consistent from state to state.
• LMFT: Indicates that the professional is a licensed marriage and family therapist.
• LCSW: Indicates that the professional is a licensed clinical social worker.
• EMDR: Some (but not all) professionals who have completed training in and are qualified to offer eye movement desensitization and reprocessing therapy are choosing to append this credential to their names. The EMDR Institute, Inc. requires that clinicians be graduates of or students in a psychology-related, graduate-level training program to undergo this training.
• EdD: Indicates that the holder has completed a doctorate in education degree.
• PsyD: Indicates that the holder has completed a doctorate in psychology degree. Typically, the focus in a PsyD program emphasizes less research than in a PhD program and likely has a less stringent requirement for original research by the student.
• PhD: Indicates that the holder has completed a doctorate of philosophy degree. If used to indicate professional competence as a mental health professional, the degree should be in the field of psychology. Typically, a doctoral degree reflects a minimum of four or five years of post-bachelor’s study; the national average for completion of a PhD is seven years of study.
• MD: Indicates that the individual completed medical school and holds a doctorate in medicine. If offering mental health services, this person should have completed a residency in psychiatry and be a board-certified psychiatrist. Most psychiatrists prescribe medication as part of their practice; some limit themselves to medication-related issues, and some also offer therapy. A psychiatrist has completed four years of post-bachelor’s study in medical school and a residency of at least four years.
• LP: Some choose to append this to their name to indicate their status as a licensed psychologist, though it is not standard and many licensed psychologists do not. Licensed psychologists have completed a doctoral degree that adheres to training standards (which include a minimum one-year full-time internship in clinical practice), have completed a competency-based licensure exam, have completed extensive post-doctoral training under supervision, and have accordingly been licensed by the state. In most states, the term “psychologist” is legally protected and reserved for those having completed these requirements. In addition to counseling offered by other types of professionals, psychologists typically offer psychological testing and assessment services.
• ABPP: This indicates that the holder has been board certified to practice in a specialty by the American Board of Professional Psychology. This requires the professional, who must be a licensed psychologist, to have completed an accredited doctoral degree, have passed a licensure exam, have accrued extensive post-doctoral training under supervision, have become licensed by a state, and to have completed additional specialty-specific practice and examinations as directed by his or her specialty board. This is a national certifying body, and this credential is the same in every state.

Professionals who are licensed as counselors, physicians, or psychologists may be licensed in more than one state, and often are required by the state(s) in which they are licensed to maintain current knowledge and practice by accruing a certain number of continuing education hours every year. Choosing a licensed clinician allows the consumer to be assured that this person has met minimum requirements for education and practice, has demonstrated familiarity with the standards for ethical practice, and is held to these standards to maintain licensure.

One red flag to be aware of is a clinician whose licensure status is not commensurate with his or her level of education. For example, if John Doe, MA is listed as a “registered psychotherapist,” this does not reflect the licensure status for a master’s-level clinician, which would be LPC/LCPC/LPCC/LMHC, depending on the state. Or, if John Doe, PhD is listed as an LPC, this does not reflect the licensure status for a doctoral-level clinician, but for a master’s-level clinician.

There could be many reasons for such a discrepancy, many of which are nonproblematic and some of which are. If the discrepancy is short-lived, it may simply reflect the transitional period during which a recent graduate accrues post-degree hours under supervision. However, it may reflect something more concerning—for example, the individual is not eligible for licensure commensurate with the degree for some reason. Perhaps John Doe’s degree is actually in biology, but he decided to change careers. Since his degree is not relevant and does not reflect training in the field, it does not make him eligible for licensure. Or perhaps John Doe’s PhD was obtained from a nonaccredited online university and did not meet minimum standards for licensure, so he’s practicing under a license reflecting his master’s-level training. Such a discrepancy may be nothing to worry about, but if it is noticed, the savvy consumer may wish to inquire about it.

Whichever clinician you decide to contact, be aware that asking him or her questions about professional training, clinical background, experience, and licensure status is a reasonable step to take in being an informed and conscientious consumer of mental health services. Wise clinicians will encourage this type of consumer advocacy and gladly answer your questions, as we want to help you make a match with the best professional for you. We know that a good fit is a critical element in successful therapy outcomes.

Best of luck in your search!

* Editor’s Note: The above list is not nor is it meant to be an exhaustive list of all mental health credentials and degrees. Credentials, degrees, and licensing requirements can vary from state to state and country to country. On September 17, 2014 the GoodTherapy.org editorial team edited the above list to include LCSW, which was not included on the author’s original list.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.