Types of Therapists in Ohio & Virginia

Choosing a therapist can be a daunting experience. You pull up Google or Psychology Today to investigate options and get lost in an alphabet soup. PhD’s, MSW’s, LISW’s, LCSW’s, PsyD’s, and more! There are also similar-sounding terms such as psychologists, psychiatrists, therapists, and counselors. Despite working in the field for nearly two decades, I still get confused at times! I’m providing today’s brief explainer to clarify some of the similarities and differences amongst providers. Please note that my explanation covers therapists in Ohio & Virginia; while many ideas hold true elsewhere, laws and regulations vary across states!

‘Talk therapy’ versus medication

A major distinction is between ‘talk therapy’ versus medication. I am a licensed clinical psychologist (PhD), and given the similarity of this title to ‘psychiatrist,’ I often get calls from people understandably confusing the two. Clinical psychologists, along with other mental health specialists, provide talk support that many people call ‘therapy’ or ‘counseling.’ In contrast, psychiatrists are medical doctors who also have specialized mental health training. While some psychiatrists may offer (usually brief) talk therapy as well, they typically focus on medications. For many problems there are effective treatments using either or both modes simultaneously (e.g., seeing a talk therapist and a psychiatrist at the same time for depression). Don’t be led astray by assumptions about talk therapy vs. medication; for instance, both directly change the brain’s functioning.

The ‘umbrella’ of therapists in Ohio & Virginia

When it comes to talk therapy, distinctions become even more confusing. It is time for us to separate out everyday language from more technical professional meanings.

Counselors vs. Therapists vs. Psychologists

In everyday language, counseling and therapy are used interchangeably to mean mental health support. In other words, there are many types of providers who fit beneath broad ‘umbrella’ terms such as counselors or therapists. I tend to use such everyday language myself – for instance, throughout this post, I’ve been using the everyday meaning of ‘therapist.’

However, in a technical sense, the terms are not the same. On average, counselors, therapists, and psychologists tend to have different educational backgrounds, regulatory requirements, and methods of approaching treatment that may impact your experience. Of course, there is great variation among each type of professional as well, so the general trends will not apply to every provider you meet.

Commonalities and differences across providers

In general, all counselors, therapists, and psychologists tend to have training in how to impact your general well-being. In providing support, all seek to be:

Empathetic
Active listeners
Good communicators
Ethical

Counselors, therapists, and psychologists also tend to overlap in their techniques and theories. No one provider type has a monopoly on mindfulness, cognitive-behavioral therapy, or other common approaches, although certain approaches seem to be more frequent among some provider types.

In addition to commonalities, providers have important differences. The largest involves the degree of training before beginning practice. Educationally, counselors usually require at least a bachelor’s degree. Therapists typically require a master’s degree after their bachelor’s, and psychologists require a doctoral degree above and beyond their master’s. While I want to emphasize the diversity of educational paths that counselors, therapists, and psychologists may travel, providers can differ by as much as 5-7 years or more in their training and supervised experiences.

Another important difference involves regulatory requirements. Most types of counselors and therapists need to obtain a license, but not all. In Ohio & Virginia, the term “psychologist” is legally protected and regulated by state boards of psychology. There is a high bar for claiming that one is a psychologist. For instance, when I became licensed in Ohio, I needed to prove not only that I had completed my (7-year-long!) Ph.D., but also that I had successfully completed a year-long internship practicing therapy, several thousand supervised clinical hours, a national psychology practice exam, and an oral exam testing knowledge of relevant Ohio legal code. To maintain my license, I complete continuing education each year and maintain my activities in line with the standards of the board. Again, most counselors and therapists have their own regulatory and continuing education requirements; just be aware that the number and rigor of requirements may differ.

A final distinction involves the methods that providers use in therapy. The story is once again one of overlap; any two psychologists may differ just as much as one provider type differs from another. That said, in general counselors tend to have training relatively more focused on practical methods and suggestions for specific issues. Therapists tend to incorporate a greater emphasis on mental diagnoses, with increased conceptualization of the underlying problems. Finally, psychologists are skilled in diagnosis, identifying the root causes of mental health disturbances, and applying research evidence to clinical work. Psychologists will bring extensive theoretical grounding to their work and are relatively more likely to work with severe mental illness.

Finding the right provider

All of these distinctions mean little if you can’t find someone to support YOUR needs. Finding therapists in Ohio & Virginia deserves its own post, but here are several important things to look for:

Interpersonal fit: Do you feel comfortable and supported? Will you be able to discuss difficult topics with this person?
Attention to science: We are fortunate to live in a time where we have ever-improving knowledge about which approaches are more likely, on average, to work for particular issues. Your therapist should not blindly apply scientific findings without individualizing your care, but ask: is your therapist in touch with evidence about what works?
Cultural responsiveness: You have a unique combination of values, identities, preferences, and experiences that make you “you.” A good therapist will work as a team to understand you and design an individualized treatment plan.
Credentialing/Experience: Regardless of the type of therapist, is there an indication that they are trustworthy and have sufficient training and competence to help you?

Hopefully after reading this explainer you feel more empowered to determine who is a good fit for you. The right provider for you may be a counselor, therapist, psychologist, psychiatrist, or someone else! Indeed, my most trusted colleagues come from a variety of mental health backgrounds. As you seek a provider, please ask them the questions that will allow you to find the person.