Is There a Difference Between a Therapist and a Counselor?

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A clinical mental health counselor leads a group therapy session.

The difference between the terms “therapy” and “counseling” can be a point of confusion for clients seeking mental health treatment — as well as for students exploring graduate-level programs and careers.

Much of the confusion arises because licensed practitioners, clients, and the general public frequently use the words “therapy” and “counseling” interchangeably, as well as “therapist” and “counselor.” For instance, a couple may seek marriage therapy from a licensed counselor and their son may refer to his mental health counselor as his therapist.

But there is a key distinction to be aware of. In a mental health sense, “therapy” and “counseling” are largely synonymous. But in a professional sense, they are not.

Therapy is considered a type of mental health practice when specifically done by a professional counselor, clinical social worker or psychologist. However, therapy is not a profession; it is not possible to have a career as a therapist from a mental health perspective.

Counseling is a mental health profession. Someone who aspires to provide therapeutic treatments and counseling services can pursue a career in counseling. With a Master of Arts in Counseling (MAC) and the appropriate professional licensure, it’s possible to find a job as a clinical mental health counselor.

Similarities between counseling and therapeutic practices

Although there is no such thing as a career in therapy, counseling and therapy are considered interchangeable in a clinical sense. In practice, both are collaborative processes between a client and a licensed mental health practitioner, such as a clinical mental health counselor, psychologist or clinical social worker.

In each of these roles, practitioners may utilize research-based counseling strategies and therapeutic practices to help clients embrace new behavioral habits that support their well-being. A professional counselor’s clinical practice relies on theoretical perspectives as well as scientifically validated techniques. In evaluating, diagnosing and treating clients, counselors may utilize dialogue, testing, practical exercises, interventions or any combination of psychological assessments and therapies.

Therefore, it is not uncommon for clients of a professional counselor to experience both counseling and therapy. Whichever strategies they may employ, a counselor’s intent is to help their clients address and change harmful behavior and thought patterns to promote mental and emotional health.

A clinical mental health counselor speaks with a client.Clinical mental health counseling as a profession

Although mental health professionals regularly apply therapeutic practices and counseling strategies, therapy and counseling differ in the professional sense. “Therapy” is not a profession, but “counseling” is.

Clinical mental health counselors “help clients identify goals and potential solutions to problems which cause emotional turmoil; seek to improve communication and coping skills; strengthen self-esteem; and promote behavior change and optimal mental health,” according to the American Counseling Association (ACA).

This work tends to be collaborative, goal-driven and solution-oriented. A clinical mental health counselor may start by assessing a client’s current mental, physical and emotional condition to recommend treatment goals and plans. They will help identify the behaviors, thought patterns and situations that will help — or hinder — progress. Counselors may recommend coping mechanisms and recovery plans, provide educational resources to family members or assist a client with rebuilding aspects of their career or personal life.

If you pursue a career in clinical mental health counseling, you may work with clients on:

  • Addiction
  • Anger
  • Anxiety
  • Behavioral disorders
  • Crisis intervention
  • Depression
  • Grief and loss
  • Mental illnesses
  • Relationships
  • Stress
  • Suicidal impulses
  • Trauma

The biggest factors impacting your career will be your area of specialization, research background, theoretical approach and extent of clinical practice. Aspiring counselors can find opportunities in a variety of settings, including private practice, corporations, community clinics, outpatient care centers, and nonprofits and government organizations. With the right certification, clinical mental health counselors can work with individual clients, couples, families or groups seeking treatment. It’s also possible to work with a specific demographic, such as veterans, students or senior citizens.

As a clinical mental health counselor, you will have the opportunity to employ both therapeutic and counseling methods in your practice. In this profession, you can draw on a wide variety of techniques such as cognitive-behavioral therapy, person-centered or humanistic therapy. For instance, you may start a session by engaging a client in therapeutic exercises like questioning and exploration — or you could start by counseling your client to try concrete, solution-oriented strategies.

Although some practitioners lead with one technique, others take an integrated approach and adapt their methods based on each client’s needs. They may choose to focus on mental illness prevention or to help clients who suffer from mental illnesses and disorders — or a combination of these strategies.

However, professional counselors and other mental health practitioners are not able to prescribe medication. This responsibility is reserved for psychiatrists who hold medical doctorate (M.D.) degrees although a few states allow certain psychologists to prescribe psychotropic medication.

Other careers related to counseling

According to the U.S. Bureau of Labor Statistics (BLS), the following counseling areas of specialization exist within the broader category of “Community and Social Services” occupations.

Substance abuse counselors and behavioral disorder counselors work with clients who struggle with drug addiction, alcoholism, eating disorders and other behavioral challenges. They offer treatment strategies to combat these disorders and destructive behaviors, supporting clients through the process of recovery or positive behavioral change. Their work may also involve helping clients manage mental and emotional difficulties and rebuild aspects of their personal or professional lives.

Rehabilitation counselors work with clients who have developmental, physical, or psychological disabilities. They do not address the physical aspects of a disability; rather, their work focuses on the personal, emotional, social and psychological effects of living with a disability. Often, rehabilitation counselors help clients adjust to their disability, develop independent living strategies and navigate the workplace.

Marriage and family counselors support clients through marital challenges, divorce, and other difficult life experiences and relationship challenges. They routinely apply cognitive-behavioral therapy in their work, encouraging clients to discuss their feelings and experiences. Moreover, they typically take a goal-oriented approach in helping their clients identify and work toward solutions to their relationship problems.

School and career counselors support students, emerging professionals and adults already established in a career. They help their clients work through a variety of issues related to personal, academic and work life, from college admissions to a potential career change.

The following careers incorporate therapeutic and counseling practices as well.

Clinical social workers undertake many of the same responsibilities as clinical mental health counselors. According to the National Association of Social Workers (NASW), “clinical social work is a specialty practice area of social work which focuses on the assessment, diagnosis, treatment, and prevention of mental illness, emotional, and other behavioral disturbances.”  Compared to counselors, social workers may be more engaged in advocacy, community welfare, and reform. An aspiring clinical social worker can prepare with a master’s degree in social work, rather than in counseling.

Psychologists are, unlike the rest of these “Social Services” professionals, categorized under the occupational umbrella of “Life, Physical and Social Sciences.” According to the BLS, psychologists are scientists who “study cognitive, emotional and social processes and behavior by observing, interpreting and recording how individuals relate to one another and to their environments.” In this field, professionals may work as research, counseling or clinical psychologists. However, such a career calls for a doctoral degree, such as a Doctor of Psychology (Psy.D.) degree or a Ph.D. in psychology. Aspiring professionals should be aware that clinical mental health counselors can typically provide the same services as counseling psychologists, but often at a lower cost to clients and insurance companies.

Post-graduate education for aspiring counselors

Throughout the U.S., a master’s degree and supervised clinical experience are required for licensure. To become a counselor, you can pursue an accredited graduate degree program with a focus on your chosen counseling specialty.

Bradley University’s online Master of Arts in Counseling program involves 60 credit hours of coursework, two one-week-long residencies on campus, two internships and one practicum. Bradley’s MAC students can choose to specialize in either Clinical Mental Health Counseling or Professional School Counseling.

Core MAC courses — including Theories and Techniques of Counseling, Counseling: Ethics and the Law, and Counseling Diverse Populations — provide a strong theoretical and practical foundation. Additionally, courses like Loss and Grief Counseling, Crisis Intervention and Substance Abuse Counseling prepare students to approach a range of client needs.

Licensing requirements for professional counselors

The professional title of “counselor” is regulated in some states. Clinical mental health practitioners require licensure and board approval to enter private practice — that is, to work directly with clients. Licensing requirements for clinical mental health counselors vary from state to state. In general, you will be required to hold relevant degrees from accredited universities, complete an approved internship or practicum and pass a state-approved exam.

One such assessment is the National Counselor Examination (NCE) developed by the National Board for Certified Counselors (NBCC). The MAC program at Bradley University provides a direct path to licensure, helping students prepare for the NCE and facilitating a smooth transition into the professional world.

Here are just a few of the licenses a mental health counselor may hold:

  • National Certified Counselor (NCC)
  • Licensed Mental Health Counselor (LMHC)
  • Licensed Professional Counselor (LPC)

Different coursework and experiences are required for each one. If there is a certain specialty you’re interested in pursuing, start by researching the educational requirements for the relevant license so you can direct your postgraduate studies accordingly.

All clinical mental health counselors abide by the same ethical and professional standards. For instance, all licensed counselors are expected to maintain a high degree of confidentiality and professionalism with their clients. They are also required to keep their license active through continuing education and other professional development activities. Many choose to do this by joining a professional organization such as the American Mental Health Counselors Association (AMHCA). The AMHCA’s code of ethics, standards and annual conferences help mental health professionals stay abreast of the latest industry developments and best practices.

Job growth in clinical mental health counseling

There is a bright future ahead for counseling students, as the field is expected to see significant growth over the next few years. For clinical mental health counselors, the job market is projected to grow at a rate of 22 percent between 2018 and 2028, according to the BLS. This is significantly faster than the 5 percent average growth expected across all occupations.

The BLS attributes this boom to a growing demand for mental health services. Greater public awareness and utilization of such services have led more organizations and people to seek out the expertise of professional counselors. Master’s-prepared counselors can increasingly find employment in schools, social service centers, and hospitals, as well as religious institutions, correctional centers, and military veterans’ organizations.

The median annual salary for clinical mental health counselors was $44,630 in 2018. Actual earnings vary based on location, specialty, experience level, and many other factors.

Earn your MAC at Bradley University

If you aspire to a career in mental health counseling, consider a counseling degree from Bradley University. Want to help people address their mental and emotional health concerns through a combination of therapeutic and counseling approaches? A master’s degree in counseling may be your next step. With a MAC and the correct licensure, you may be able to practice within a wide range of possible settings to help clients achieve emotional and mental well-being. Wherever you land within the professional field of mental health, your work is sure to have a positive, long-lasting impact on the clients you engage with.

If a career in clinical mental health counseling seems right for you, or if you would like to learn more about your educational and career options, contact an enrollment advisor at Bradley University to learn more about the online MAC program.


Recommended Readings:

What Is The Difference Between a Master’s in Counseling and Master’s in Social Work?

Help Americans Manage Post-election Stress with a Master of Counseling

Bradley University Online Counseling Program



American Counseling Association

American Mental Health Counselors Association

BLS — Marriage and Family Therapists

BLS — School and Career Counselors

BLS — Social Workers

BLS — Substance Abuse, Behavioral Disorder and Mental Health Counselors

BLS — Rehabilitation Counselors

BLS — Psychologists

National Board for Certified Counselors

National Association of Social Workers