The Roles Different Mental Health Professionals Play
I am a hardcore fan of “Grey’s Anatomy” and “Private Practice.” However, one of the things I cannot stand about these shows is the way they portray all mental health professionals the same way. They will show psychiatrists offering hour-long psychotherapy sessions, while social workers will come in and tell clients what medications to take—it’s messed up.
However, I think this lack of understanding is a common misconception for everyday people as well. Many people don’t realize that not all providers offer the same services. I also think that some providers end up overstepping their roles and doing things beyond their scope of practice. But, if people don’t understand what different mental health professionals can and cannot do, how are they supposed to know that they aren’t receiving the correct treatment from the best possible provider?
From social workers to psychiatrists, here are all the different mental health professionals and what they can and cannot provide.
Social workers can hold many jobs once they obtain their degree and license, but a significant number of them end up offering clinical services such as individual therapy. If properly licensed, social workers can also provide family or couples counseling, substance use treatment, grief counseling, and career planning services.
Social workers often work in more acute settings, such as psychiatric hospitals. They perform intake assessments, help with discharge planning, and lead group therapy. Sometimes social workers also serve as case managers for individuals with severe and persistent mental illnesses.
Despite all the things social workers can do, only Licensed Clinical Social Workers (LCSW) with a master’s degree or higher can provide most clinical mental health services. Licensed Baccalaureate Social Workers (LBSW) can only provide case management services, whereas Licensed Master Social Workers (LMSW) can do some other clinical services and assist with therapy if they are under the supervision of a Licensed Clinical Social Worker (LCSW).
Regardless of what type of license they hold, social workers are never permitted to prescribe medications. They also cannot perform or interpret data from psychological tests. In most cases, social workers will provide some sort of diagnosis label to individuals for insurance purposes, but they will likely refer you out if you need more in-depth psychological testing.
Licensed Professional Counselors (LPC)
Licensed professional counselors are masters-level mental health providers who can provide a variety of psychotherapy services to people. LPCs can offer individual therapy, group therapy, family therapy, and psychoeducational classes for people. They often work in outpatient offices, but can sometimes work in a hospital setting.
Like social workers, licensed professional counselors cannot prescribe or administer medications. They also cannot perform psychological testing.
Unlike social workers, LPCs are not typically licensed to serve as case managers. They cannot perform a lot of the documentation and paperwork that social workers complete. Instead, their training is more focused on counseling services.
Marriage And Family Therapists (LMFT)
Licensed marriage and family therapists go through similar schooling as licensed professional counselors. However, they typically focus more on working with family units for short durations of time versus offering individual or long-term therapy. Instead of focusing on diagnoses and treatment, most LMFTs use solution-focused therapy to address specific, attainable goals. Once these goals are achieved, the sessions typically conclude.
Although their name implies that they strictly offer family therapy and couples counseling, LMFTs do offer individual therapy to clients when appropriate. However, this is usually only offered when the issues the individual is dealing with are connected to their family or marriage in some way.
Licensed marriage and family therapists cannot offer psychological testing. They also cannot provide medications. LMFTs do not serve as case managers, nor do they typically work with people who need more acute psychiatric services.
Psychologists undergo the most rigorous training before obtaining their license. These individuals typically hold either a PhD in Psychology or a PsyD (Doctor of Psychology).
Psychologists can offer a variety of therapeutic services to their clients, including individual therapy, career counseling, group therapy, marriage counseling, family therapy, and grief counseling.
Unlike all of the masters-level providers on this list, psychologists can provide psychological testing and interpret the data from these tests to provide a comprehensive diagnosis. Psychologists use a variety of diagnostic tools and their own observations over the course of hours or even weeks to make a diagnosis. This testing can be incredibly valuable for clients who have symptoms that could fall in the bucket of several diagnoses.
However, psychologists cannot prescribe medications and should not offer medication suggestions to their clients. Also, those with just a bachelor’s or master’s degree in psychology cannot offer any type of counseling services and are not considered psychologists.
Psychiatrists are medical doctors who have completed focused training in diagnosing and treating mental health conditions through the use of medications. Because they are medical doctors, psychiatrists can perform physical exams, order blood work, and interpret data from MRIs or similar brain scans. Sometimes Psychiatric Nurse Practitioners (NP) will also work alongside psychiatrists to provide some of these services as well.
The most important thing psychiatrists do is manage medications for their clients. They prescribe medications and make changes as needed based on how the medications help with symptoms. They also monitor patients for side effects or issues psychiatric medications can cause.
However, these doctors do not undergo the rigorous training in psychotherapy that social workers, counselors, or psychologists do. This means that psychiatrists are not equipped to provide psychotherapy (talk therapy) in the way that social workers, counselors, or psychologists do.
There’s a common misconception that a life coach is the same thing as a therapist. However, that isn’t at all the case. In fact, you don’t even need any sort of license to become a life coach in many states.
Life coaches can be very helpful for individuals who need guidance on an aspect of their life such as their career, interpersonal relationships, or spirituality. However, life coaches can’t aid in mental health treatment, and they should never assign diagnostic labels to their clients.
Peer Support Specialists
If you ever go to a residential treatment facility or attend a day program for psychosocial rehabilitation, you may encounter peer support specialists along the way. These individuals can hold credentials such as Certified Peer Recovery Specialist (CPRS) or Certified Addiction Peer Recovery Coach (CAPRC), but they may not.
Peer support specialists are trained to help lead group activities, complete regular check-ins with clients, and monitor progress. They can also use motivational interviewing and goal-setting strategies with their clients to help them on their path to recovery.
However, peer support specialists are not trained to offer therapy services. They cannot diagnose clients, nor can they prescribe medications. This is because peer support specialists do not need a college degree — they just need to complete the required training based on the certification their employer requires them to get.
Over the past two decades, I have seen nearly every mental health professional on this list. What I’ve learned is that, although their roles are clearly defined by licensing boards and employers, some professionals have a harder time staying in their lane than others. I think it’s important for anyone seeking mental health treatment to understand how each type of provider can help them and how they cannot. This ensures that you receive the care you deserve so you can build a life worth living.
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