What the Heck IS a Therapist?


When people ask what I do, the conversation usually goes like this:

“What do you do?”

“I am a therapist”

“A physical therapist?”

“No, a counselor,”

“Ohhh, a school counselor?”

“Well I am certified as one, but I am a mental health counselor.”

The sound of  crickets and a look of confusion…

Usually people process for a second and run away.

“I don’t want to be analyzeeeeedddddd,” they’ll scream off into the distance.

Some people think that that I am a Child Psychologist. I am not. I do a lot of work with kids and adolescents, but not exclusively. I would be curious to know the correlation between the people that think that I am child therapist and their own resistance to counseling. You know, like… “I’m safe from his judgment and scrutiny because I am an adult and he is a child psychologist.” I wonder if they are subconsciously trying to distance themselves and their issues; I digress.

A lot of people think that I am some other sort of psychologist. I am not. I am also not a psychiatrist, a social worker, or a witch doctor. There appears to be a lot of confusion about the different folks that have therapist on their shingle. I will try to clear it up.

Mental health people that might call themselves therapist: a primer

Let me say that I am speaking very generally, based on my experience, personal biases and desire to entertain. If you are an exception to one of the generalities presented below, or take offense to the way I use your profession as a springboard to a funny, take me to lunch (your treat) and you can tell me I’m wrong.


To be a psychiatrist a person must go to medical school. In med school you have to dissect dead people and that’s gross. I think it is psychiatrists we envision in plush offices where the client lays down on the couch and talks about their mother. Psychiatrists who see patients clinically are usually trained in longer duration kinds of therapies. Howard Stern talks often about his psychiatrist and the years that they have been seeing each other. I’d love to challenge Howard’s need for that. I know many psychiatrists that only diagnose and prescribe meds and don’t do much therapy. Psychiatrists have to wear jackets with patch elbows and smoke pipes. I couldn’t dissect a person and I think pipes come off pretentious. I couldn’t be a psychiatrist.

Another mental image materializes for me that is shared between psychiatrists and the next group on the list: psychologists. The image is of a psych-ward with a bunch of bat-s#*t-crazies running around hitting them selves in the heads with a bed pan. The action takes place while the doctor scribbles notes on a pad. I am not comfortable around bat-s#*t-crazy people –they can be a lot of fun, but they’re unpredictable, so this would never be me!


Psychologists have PhD’s or PsyD’s and there are two kinds: clinical and research. The clinical folks do therapy, the research folks do experiments. Research psychology degrees don’t train people to see clients therapeutically. A PhD requires extra schooling and a dissertation. That dissertation makes a person super knowledgeable about one specific subject. Generally that subject has a laser sharp focus and doesn’t equate to helping clients directly. For instance, my googling machine just returned the following title when asked to find “psychology dissertation”: An Examination of Multicultural Competency of Northern New England School Psychologists. After this dissertation, the author probably knows a lot more about New England school psychologists than anyone really needs to know!

Many psychologists do testing, assessments and diagnosis but refer out to someone else for therapy. I said many, not all; calm yourself if you are a clinical psychologist. I have known some that are great therapists.

For the most part the MD’s and PhD’s make way better jack than I do. I do think about it from time to time, but a PhD would be a butt-load of extra school and money. I have applications in at a couple of universities, but I can’t seem to hit “submit.” Someday it may be me, but ehhhh…

Social Workers

Some social workers do therapy. By my estimation, they are touchy-feely kind of people. If not touchy-feely, then social workers are certainly warm and fuzzy folks. I have met a lot of social workers, I have even supervised some and they are good people. Even though we are similar professionally, we keep a comfortable distance. They are kind of like Canadians: they are super nice, but just a bit off. I am not particularly touchy feely or warm and fuzzy so this would never be me!

Let me just apologize now to all Canadians and social workers, I went our on a limb for the sake of humor; I am a terrible person.

Counselor (LPC’s, also LMFT’s – super similar)

An LPC (Licensed Professional Counselor), is the highest license for counselors in the State of Texas. In order to earn an LPC, an individual must earn a Master’s Degree in counseling and then pass the National Counseling Examination. After applying for an intern/temporary license, one must work with clients for 3000 hours under a trained supervisor to gain their full license. LPCs are trained and licensed to treat all manner of mental health issues. I am an LPC – actually an LPC-S, which means I am board certified to “supervise,” or train counselors, as well. The little “S,” can be applied for after 3 years of full licensure and some additional training. I’m also an LCDC (Chemical Dependency Counselor License) and hold a School Counselor Certificate in the State of Texas. The chemical dependency degree is a lower level license. If one only has an LCDC, they can not treat mental health disorders, only substance abuse issues. My School Counselor certification is to balance the hole in my ego wall because my I have an odd number of degrees and licenses hanging there. I having raging OCD as it related to symmetry, don’t judge me.

LPC’s do alright financially compared to some folks – not many, but some. Counselors and social workers are the low men on the totem pole financially as compared to Psychiatrists and Psychologists. My experience has been that my clients see one of the big wigs for a diagnosis and meds if needed and then get referred to me for the actual therapy. Again… generalization; if the reader sees any of the mentioned providers and it moves you forward that is great. All roads lead to Rome, a friend reminded me the other day.

I hope this clears up therapists a little bit. There are all kinds of us, we have achieved our place in the world through various methods, experiences and education, but all with a similar goal: to evoke mind control over the masses until the revolution begins. I kid… we want to help folks have a good experience in life. If you need one of us, find one of us. If you don’t like the one you find, if it isn’t a good fit, then find another. Next time I might just talk about what therapy is…

As a side note, I love you and you look great in this light.




Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s