Counseling, Therapy, and Psychology: What’s the Difference?
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Reviewed by: Jennifer Litner, LMFT, CST Timothy J. Legg, Ph.D., Psy.D., CRNP, ACRN, CPH
Careers in counseling, therapy, and psychology each hold different education requirements, licensure standards, and potential salaries. For example, counselors might not need as much education as psychologists, and therapists might work with different patient populations than counselors.
Each position also offers different job responsibilities. For example, psychologists are more likely to be tasked with providing psychotherapy than counselors. Because counselors, therapists, and psychologists possess different responsibilities, anyone interested in the field may prefer one job over the others.
Generally speaking, someone willing to complete up to a Ph.D. or PSy.D. and take on the responsibility of treating mental illnesses might want to become a psychologist. Those interested in a bachelor’s or master’s degree might prefer becoming a therapist or counselor.
This guide explores the differences for each position, including required education, information on licensure, and potential career outcomes.
What is the Difference Between a Psychologist, a Counselor, and a Therapist?
The differences between psychologists, counselors, and therapists come down to the skills, necessary education, job responsibilities, and other requirements to secure positions in the field. While the three occupations share some similarities, they each come with varying expectations and job titles.
Counselors, therapists, and psychologists must possess excellent communication, listening, and interpersonal skills. Counselors work with individuals or groups, and many professionals draw from a variety of experiences to connect with patients.
Therapists receive training to connect with clients. A therapist usually chooses a field of specialization, such as marriage or family therapy, and guides clients to help them overcome personal issues.
Psychologists require strong analytical and observational skills. These professionals conduct research, diagnose disorders, and supervise interns. Unlike psychologists, psychiatrists receive medical training and can prescribe medication, although psychologists can prescribe medication in Iowa, Idaho, Illinois, New Mexico, and Louisiana, as well as in the Public Health Service, the Indian Health Service, the U.S. military, and Guam. Generally speaking, psychologists have more in common with therapists and counselors than psychiatrists.
Many counselors require a bachelor’s degree, although some certifications as counselors may not even require an associate’s degree. For instance, some states license or certify addictions counselors with an associates degree, or a combination of college credits, professional seminars, and years of experience working in addictions. Addictions and behavioral disorder counselors working in private practice must be licensed and therefore must have a master’s degree. Mental health counselors must also earn master’s degrees in order to gain licensure.
Therapists should earn at least a master’s degree. At this level, students choose a field of specialty while completing their master’s degrees. After earning a four-year bachelor’s degree, each aspiring professional must complete a 2-3 year master’s and supervised clinical work.
Each psychologist needs a doctoral degree, and most professionals complete a 3-4 year Ph.D., Ed.D., or Psy.D. Doctoral degrees in psychology require a bachelor’s and master’s in psychology, along with some professional experience. This degree also requires supervised clinical work and most states require around two years of clinical supervision before the individual would be eligible for licensure.
Counselors typically provide guidance to their clients. Because counseling is a broad field, the way counselors approach patient care widely varies, though counselors usually stay within their fields of expertise.
Therapists often need licenses to practice, so therapists only see patients that fall under their area of expertise. Many therapists use a specific theoretical orientation to guide their practice, such as cognitive behavioral therapy, which allows clients to take their negative thoughts and replace them with positivity. Other commonly used clinical models include psychodynamic, attachment theory, family systems, and IFS.
Psychologists possess the highest level of education and only see specific cases in their field of expertise. These professionals may also adopt a specific theoretical orientation such as cognitive behavioral therapy or psychoanalysis to treat their patients.
Requirements and Certifications
Counselors may require a license whereas therapists and psychologists all require licenses, with few exceptions. While some counselors do not gain licensure, many professionals complete a bachelor’s degree and supervised experience to meet state licensing or national certifying agency requirements.
A therapist must obtain a master’s degree in a specific field, and that field dictates which license and certification the therapist pursues. Therapists also complete supervised experience through internships or residencies.
A psychologist needs at least a master’s degree, although most states will not issue a psychologist license to anyone without a doctoral degree. Most states require licensure for practitioners to use the title “psychologist.” In addition to 1-2 years of supervised experience, a psychologist can earn advanced certification and typically must complete continuing education to maintain their license.
Which Mental Health Profession is Right for Me?
Choosing between a career as a counselor, therapist, or psychologist may depend on your intended level of education, ideal professional role, and salary goals. Higher levels of education often lead to more lucrative positions. Of the three positions, counselors earn the lowest median salaries ($44,630), while psychologists earn the highest ($79,010).
Counselors find employment in many different settings to work closely with a diverse set of clients. Therapists work in a wide variety of settings and occasionally work with other therapists. Psychologists may work in a wide variety of settings as well, including group practices or integrated health systems. Many therapists and psychologists venture into private practice, as well.
As mental health becomes an increasingly important concern, the need for mental health experts increases, too. The Bureau of Labor Statistics (BLS) projects a faster-than-average 22% job growth rate for counselors and therapists from 2018-28, which is much faster than average growth. BLS data indicates a projected 14% job growth rate for psychologists over the same time frame.
Students interested in prescribing medication and drugs should become a psychiatrist. Psychiatrists share many similarities with psychologists, though the two also have several significant differences. Regardless of which career you choose, all three options can lead to rewarding careers making a difference in people’s lives.
Interview With a Psychologist
Dr. Jaime Zuckerman is a Philadelphia-based clinical psychologist in private practice, specializing in adults with anxiety, depression, and those adjusting to medical illnesses. Dr. Zuckerman received her undergraduate degree from The Ohio State University and her doctorate in clinical psychology from La Salle University. She completed her internship and postdoctoral fellowship at LIJ Medical Center in New York. After returning to Pennsylvania, she took a position as head psychologist at the Coatesville, Virginia, for the acute medical, nursing, and hospice units.
She was also actively involved in an internship training program. In 2009, Dr. Zuckerman accepted the position as Director of Psychology at The Center for Neuroscience in Media, Pennsylvania, where she remained for several years until entering private practice full time. In addition to her practice, Dr. Zuckerman offers seminars and support groups for the Epilepsy Foundation of Eastern Pennsylvania and frequently presents at their conferences.
What drew you to a career as a psychologist?
First, I had always been interested in how the body worked. Even as a young child, I was always fascinated with the pictures in my father’s medical textbooks. Eventually, when I got to high school, I took an intro to psychology course as an elective and began to take a real interest in the brain and its role in emotions, cognition, and behaviors.
I’m fascinated by the fact that electrical impulses in our heads were solely responsible for every action, every thought, and every decision we made. I also became very interested in behaviorism and how modifying even the smallest of reinforcement schedules could drastically alter behavior. I loved the idea that there was a way to explain and modify what seemed like intangible variables, such as emotions and thoughts.
I also felt an innate obligation to help others. For as long as I can remember, I have held the belief that if you are in a position to help others, you do so. And what better way to combine my two interests of brain-based behavior and helping others than to become a clinical psychologist?
Why did you choose this path over similar care roles, such as a counselor or therapist?
I chose the path of earning a doctorate in clinical psychology because I wanted the flexibility to work across different domains within the field. It enabled me to teach, see patients and work in various types of institutions. Furthermore, I wanted to develop more of a specialized approach in the empirically supported treatment of adults, specifically in cognitive behavior therapy and acceptance and commitment therapy.
The extended clinical training of the two year-long practicums, the year-long predoctoral internship, and the year-long postdoc experiences were of great interest to me. In addition to the clinical experience offered by a doctoral program, I wanted to take part in research opportunities, as well. It was important to me that I become an educated consumer of empirical research in the field and I contributed to it, too.
What are some of your most significant day-to-day challenges?
First, social media has inevitably affected the practice of psychology. In fact, and this is especially true for my millennial patients, social media is an integral part of their interpersonal experiences. To understand their experiences, I must remain aware of the ever-changing social media landscape. Second, social media has drastically changed the way psychologists market themselves.
Whether it’s a practice’s website or an informational Instagram page, psychologists’ presence on social media has become somewhat commonplace. And while I do believe that such a platform can be extremely beneficial, it remains a grey area. Currently, there are no hard rules about social media presence, other than to not engage with your patients on these platforms. Finding that healthy and appropriate balance is something that I have found to be a day-to-day challenge.
Juggling different roles also presents a challenge. In addition to working as a clinical psychologist, I am also a mother of three little children all under the age of seven. The coordination of schedules, homework, doctor appointments, playdates, and carpools keep my head swimming — and that is before I add in seeing patients. I sometimes struggle with the constant switching of hats from psychologist to mom, but with time management strategies and leaving room for self-care and a lot of support, it can be truly rewarding.
What do you find most rewarding about a career as a psychologist?
By far, the most rewarding thing about my career as a psychologist is seeing my patients improve. There is nothing better than a patient who once had crippling social anxiety begin dating, or a person with severe depression re-enrolling in school and finishing their semester with a 4.0. Seeing a patient with low self-esteem and toxic relational patterns finally understand and change their behaviors is such a satisfying thing to observe. Also, it is extremely gratifying when patients who have been in therapy with me for some time permanently incorporate our therapeutic language into their everyday problem-solving.
What advice would you give prospective students considering pursuing a career as a psychologist?
First, make sure you thoroughly research the programs that interest you. Are they APA-accredited? Ask current and former students about their experiences and opinions. This will give you a better feel for the culture of the program itself. Ask about the programs’ available practicum sites. Most importantly, ask about their predoctoral internship match rates. Do more than just read their online material.
Second, while you don’t necessarily need to know the nuances of your specialty at this point in your journey, it may be helpful to narrow down a few criteria. For example, do you want to steer more towards academia, clinical application, or both? There is a common misconception that all Psy.D. programs are purely clinical and that Ph.D. programs are solely research. This is not always the case.
My Psy.D. program included a significant amount of required research. Make sure to narrow down the general population you wish to work with (i.e., children vs. adults) as this can help to determine the program you choose.
Know that the next 5-7 years are a major commitment. I watched many of my friends take lucrative jobs, get married, and have children while I was still studying in graduate school. I would be lying if I didn’t say I felt like I put my life on hold. But, in the end, I realized I had not. It’s just that my path to get where I wanted to be was a bit longer than theirs, and there is nothing wrong with that. It is a long journey, but a rewarding one in the end. In the words of my mentor, “If it were easy, everyone would do it.”
Careers for Mental Health Professionals
Before committing to a specific level of education, anyone interested in becoming a mental health professional should review some of the common career outcomes. Keep in mind that these career options and salaries vary based on a combination of education, experience, location, and licensure.
Substance Abuse Counselor
This common position for counselors sees professionals working closely with individuals who suffer from drug addiction, mental health issues, or other behavioral problems. Substance abuse counselors work in residential treatment centers, outpatient treatment centers, and detention centers.
Licensed mental health counselors work in clinics, hospitals, and patients’ homes. Some may also work in private practice, depending on scope of practice laws in their states. These counselors earn a license to work with patients that suffer from depression, substance abuse, anxiety, or any number of other issues affecting mental health.
These counselors help students with academic and social concerns. Counselors work with students to develop career goals, identify potential issues affecting success in school, and help students develop new habits.
Marriage and family therapists work individually and in group settings to help members of a family or relationship. This includes evaluating family roles and assessing family dynamics to determine if they are adaptive or maladaptive and supporting a family to change patterns that may not be supportive to the family system. Some of these therapists choose to open private practices.
Psychologists work to understand the thoughts, feelings, and behavior of patients through a variety of psychotherapeutic approaches. Some specializations for psychologists include counseling, clinical, forensic, developmental, and rehabilitation. Specific duties and salaries vary depending on which specialty the psychologist chooses.
These specialized psychologists create exercises, interviews, and surveys for corporations. Industrial-organizational psychologists work with management, interview focus groups, and analyze research. Most industrial-organizational psychologists work in a team. Currently, there are no licensure requirements for industrial/organizational psychologists. If they are providing psychotherapy services members of the organization, then they must be licensed.
Counselors and therapists share many similarities, and some professionals use the terms interchangeably. However, licensure or certification influences whether a counselor is or is not a therapist. For example, a licensed professional counselor is not a therapist. Similarly, not all therapists can be considered counselors.
Can I provide therapy as a counselor?
Yes — as long as the therapy is within your field of expertise and you are licensed to do so. Most counselors do not perform therapy, though. Generally speaking, a counselor provides advice for clients after evaluating them over time. Counselors may refer clients to therapists or psychologists.
Is there a difference between counseling and therapy?
Counselors typically offer counsel and advice, while therapists typically perform psychotherapy. Again, this is greatly influenced by state licensure and scope of practice laws. Therapy takes place over a longer period and tends to focus on more complex issues, while counseling tends to take place on a short-term basis and tends to address a more focused issue.
Can psychologists, counselors, or therapists prescribe medication?
In most cases, psychologists, counselors, and therapists cannot prescribe medication. Prescriptive authority depends on the state and usually requires certification and education. Some psychologists with a doctoral degree may be able to prescribe medications, but prescriptive authority typically remains reserved for psychiatrists and psychiatric/mental health nurse practitioners.
What degree do I need to become a counselor?
Not all types of counselors need degrees, though required education ranges from a high school diploma to a master’s degree. Your ideal position influences the required education. For example, school counselors typically need a master’s degree. Some substance abuse counselors only have a high school diploma.
Jennifer Litner, LMFT, CST
Jennifer Litner is a licensed marriage and family therapist and certified sex therapist working in private practice in Chicago. She earned her MS in marriage and family therapy from Northwestern University and her master of education in human sexuality studies at Widener University. She is a clinical fellow of the American Association for Marriage and Family Therapy and a certified member of the American Association for Sexuality Educators, Counselors, and Therapists. At Jennifer’s practice, Embrace Sexual Wellness, she helps people address their intimate concerns such as changes in sexual desire, coping with illness, loss or lack of intimacy, sexual pain or discomfort, and sexual identity.
Timothy J. Legg, Ph.D., Psy.D., CRNP, ACRN, CPH Hospice and Palliative Medicine, Geriatrics, Addiction Medicine, Psychiatry
Dr. Timothy Legg is board-certified as both a geriatric and psychiatric mental health nurse practitioner and is also a licensed psychologist. He graduated from Touro College in New York with a doctorate in health sciences research and education and from California Southern University in Irvine, CA, with a doctorate in clinical psychology. He’s currently a university professor and clinician in private practice. He’s certified in addiction counseling, public health, health education, and is also an AIDS-certified registered nurse.
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