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How to Become a Therapist

Updated on April 29, 2012
Sue B. profile image

I am a mother, a social worker, a dream interpreter, and a writer.

Thinking about becoming a therapist or counselor but aren't sure how to get there? There are many more fields of study than psychology that could result in a job in which you are licensed or certified to counsel others about their problems. Some regulations vary from state to state. Below is a brief overview of the various academic programs and licensing options available to become a therapist.

Becoming a Social Worker

In New York State and many other states in the US, a Social Worker is allowed to act as a psychotherapist under the following conditions:

  • Completion of an accredited graduate program resulting in a Master's in Social Work (MSW)
  • Passing state certification/licensure tests*

* In almost all states use the Association of Social Work Boards (ASWB) examinations for licensure. ASWB provides two tests:

  1. "Masters" In most states, this allows the social worker to perform various social work tasks as well as provide psychotherapy under supervision of a Clinical Social Worker, Licensed Psychologist or Psychiatrist. In New York State, this is an LMSW.
  2. "Clinical" In most states, this allows the social worker to perform everything an LMSW would be able to do plus provide psychotherapy without supervision. Medicare requires all social workers possess the clinical license as well as many insurance companies. In New York State, this is an LCSW. In order to take the Clinical test, each state sets requirements. Most states set 2 years of supervised experience in a qualifying setting (ranging from mental health clinics, inpatient treatment to private practice under a PLLC). New York State requires a minimum of 3 years of supervised experience and at least 2,000 client contact hours after the social worker completed their master's degree. These requirements change and may vary from state to state. It is important to check with your state's Education Department for the exact requirements.
  3. The "R" number: The R number is something a social worker can apply for after providing 3 years of supervised clinical experience after becoming a clinical social worker. Not all social workers decide to pursue the R number. The R number requires insurance companies to reimburse the social worker for mental health services performed and allows the social worker the freedom to perform services without supervision within a private practice.

Although social workers are able to begin providing psychotherapy after fulfilling a master's degree (60 credits after bachelor's), social workers are not able to provide psychotherapy independently within a private practice for at least 3 years and social workers do not achieve the capacity to bill all insurance companies the way other psychotherapists do until at least 6 years.

Becoming a Mental Health Counselor

Licensed Mental Health Counselors are permitted to provide psychotherapy services.

In order for an individual to become licensed, they must meet the following requirements (in NYS although other states are similar):

Education: They must possess a Master's or Doctorate degree in Mental Health Counseling or similar degree with at least 60 hours of the following:

  • human growth and development;
  • social and cultural foundations of counseling;
  • counseling theory and practice;
  • psychopathology;
  • group dynamics;
  • lifestyle and career development;
  • assessment and appraisal of individuals, couples, families and groups;
  • research and program evaluation;
  • professional orientation and ethics;
  • foundations of Mental Health Counseling and consultation;
  • clinical instruction; and
  • include a minimum one year supervised internship or practicum in Mental Health Counseling where one year means at least 600 clock hours

This is a bit more flexible in terms of education requirements than many other fields of study.

Becoming a Certified Rehabilitation Counselor

Rehabilitation counselors are the only professional counselors educated and trained specifically to serve individuals with disabilities.

Rehabilitation counselors are able to become certified rehabilitation counselors (CRC). The CRC allows the rehabilitation counselor to

Eligibility Requirements for the CRC have changed recently and have expanded the amount of people eligible to sit for this exam. The past, only people with a Master's degree in rehabilitation counseling with 600 clock hours of supervised experience were eligible. Now criteria is expanded to include some exceptions to related graduate or doctorate degrees, months of experience, etc.

Although gaining more recognition, CRCs are not able to have private practices and must be employed by an approved setting such as an outpatient or inpatient rehabilitation program. CRCs are able to bill private insurance through these facilities.

Becoming a Psychologist

Psychologists are permitted to provide psychotherapy once they are licensed. Licensed Psychologists must have a Doctorate in Psychology and 2 years full-time supervised experience before they sit for the Examination for Professional Practice in Psychology (EPPP) developed by the Association of State and Provincial Psychology Boards (ASPPB).In New York State, 1 full-time year is defined as 1750 clock hours.

A licensed psychologist can either have a PsyD (Doctor of Psychology) or a PhD.

  • PsyD: is intended to prepare graduates for careers as practicing psychologists-- applied work in therapy. This degree emphasizes training in therapeutic techniques and many supervised experiences with less of an emphasis on research than in PhD programs.
  • PhD: is a research degree in psychology. PhD programs are designed to create psychologists who can understand, apply and conduct research. PhD graduates are trained to create research-based knowledge. It is this research-based knowledge that all other professions within this article reference and utilize to inform their psychotherapy practices.

In addition to providing psychotherapy, psychologists also provide psychological testing and counseling. Due to the emphasis on psychological testing in many psychologist jobs, professionals interested in pursuing a career in psychotherapy are often turned off by this particular profession. Yet many others find the emphasis on empirical data to be a strength in psychology and instrumental in diagnosis and treatment- especially when working with children and developmental disabilities.

Becoming a Psychiatrist

Did you know that psychiatrists are doctors? They possess either an MD (Doctor of Medicine) or a DO (Doctor in osteopathic medicine). When most people think of a psychotherapist, they think of psychiatrists, a comfy couch and hours of psychoanalysis over many years. The field has changed a great deal.

Although many psychiatrists provide psychotherapy, most psychiatrists act as staff psychiatrists, providing consultation, psychotropic medication management and diagnosis. Sometimes psychiatrists are hired to review the work of others providing psychotherapy such as social workers.

Here are the brief description of steps to become a psychiatrist:

  1. During your Bachelor's Degree, you will need to be pre-med. It is best to discuss this with a guidance counselor who is aware you would like to be a psychiatrist.
  2. You will need to apply to medical schools. This can be rather competitive. Medical School is typically completed in 4 years.
  3. Obtain a medical license in the state you are practicing in by passing either the USMLE or COMLEX licensing exams. Many states require postgraduate training prior to licensure. New York State requires a minimum of one year postgraduate training.
  4. To be able to prescribe medication, you must register with the Drug Enforcement Administration. Although this may not be necessary for psychotherapy, it is necessary for most if not all of the psychiatry jobs available.
  5. After these steps are completed, you can apply for a residency program. Psychiatry residency programs are 4 years long. Not only are your rotations in the field of psychiatry, but also other areas of the medical field such as internal medicine, emergency care, etc.

Although psychiatrists make the most money, have the most flexibility and are able to open a private practice, it takes a psychiatrist about 13 years of education and experience to practice independently.

Becoming a Psychiatric Nurse Practitioner

Psychiatric Nurse Practitioners are Advanced Practice Registered Nurses (APRN) with a Master's degree (60 credits) in psychiatric/mental health nursing. Most states require licensing prior to practicing as a psychotherapist.

APRN's are able to write prescriptions once they are licensed similar to a psychiatrist.

Educational Requirements: (source Office of the Professions NYS Education Department)

A. Completion of a nurse practitioner educational program registered by the New York State Education Department as qualifying for certification, or a program determined by the Department to be equivalent to a registered program, which is designed and conducted to prepare graduates to practice as nurse practitioners.

B. Certification as a nurse practitioner by one of the following national certifying organizations:

and either





Do you live the US and you are not sure how to pursue one of these occupations within your state? Write a comment with a question and I will find the information for you.

Which type of discipline tends to have the most effective psychotherapists?

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