Written by Alexa Boubalos, RN.
Whether you are seeking out an initial mental health evaluation, committing to a course of psychotherapy, or considering psychiatric medication options, deciding what kind of clinician to see (or, which combination of clinicians) can be daunting. LMFT, LCSW, PsyD, PhD, PMHNP, MD – what do all of these letters after their names mean? And . . . what exactly is being conveyed by one set of credentials versus another? For example, who provides talk therapy, who prescribes medication, and who does some combination of the two?
Below is a basic dictionary of mental health professionals. Note that this is not an exhaustive list and that the descriptions provided represent typical definitions but exceptions may apply.
Individual providers may have participated in specific, continuing education training beyond their original degree to specialize in a topic that may serve your needs well. For example, this might include a sub-specialty in family-based treatment for adolescents with eating disorders, or a focus on dual diagnosis for adults with co-occurring bulimia nervosa and substance use disorders. Be sure to ask questions to determine your clinician’s familiarity with and comfort with treating the type of symptoms you are experiencing.
LCSW – Licensed Clinical Social Workers
LCSWs are skilled therapists, case managers, and patient advocates. They hold a graduate degree in social work which typically takes two to three years to complete. Upon graduation, LCSWs pursue additional clinical training, including supervised clinical hours, to become eligible for licensure. Social workers work in a variety of treatment settings from hospitals, child protective services, case management services, residential treatment centers, and private practice. In structured treatment settings, such as inpatient or residential programs, LCSWs meet with patients’ families to help enhance their understanding of the condition, to develop a treatment plan following discharge from the structured program, and to help individuals and their families discuss and problem-solve ways in which psychological symptoms play out in the home/family environment. In private practice, LCSWs may provide psychotherapy on either an individual or family basis.
LMFT – Licensed Marriage and Family Therapists
LMFTs receive a two to three-year-long master’s degree in Marriage and Family Therapy. Similarly to social workers, they receive extensive clinical training which requires them to complete supervised clinical hours. Once they have completed both their degree and clinical hours, they can take the boards to become licensed to practice therapy. LMFTs, similarly to LCSWs work in private practice or in treatment centers, but they tend to provide exclusively couples or marital counseling.
PsyD – Doctor of Psychology
PsyDs are psychotherapists who have completed a 4-5 year doctoral degree in psychology including pre- and post-graduate supervised clinical hours to sit for licensure. These clinical psychologists typically receive extensive training in the delivery of a range of psychotherapies and have often in the course of their training worked with multiple patient populations across a number of treatment settings from counseling centers to intensive outpatient programs to inpatient units. PsyDs are usually experienced in conducting individual, group, couples, and family therapy, though they may ultimately choose to specialize in one modality.
PhD – Doctor of Philosophy in Psychology
PhDs in Psychology are experts of research in psychology and are also trained to teach at the university level if they so choose. People working towards a PhD in psychology choose at the onset to specialize in a particular domain including clinical psychology, developmental psychology, experimental psychology, neuroscience, social psychology, etc. Those who specialize in clinical psychology receiving training in conducting original research related to mental disorders; they simultaneously receive extensive training in the delivery of different psychotherapies for a range of patient populations. During and after their graduate training, they complete supervised clinical hours to be eligible to sit for licensure. As part of their education, PhDs get experience with many modalities of therapy including individual, group, and family therapy. Individuals with PhDs and a clinical psychology focus may choose to work in academic medical centers or in university psychology departments carrying out research. And/or, they might select to focus on providing clinical services in any number of public or private settings.
PMHNP – Psychiatric-Mental Health Nurse Practitioner
These practitioners have typically received a Bachelor of Science in Nursing (BSN) plus either a Master’s of Science in Nursing (MSN) OR DNP (Doctor of Nursing Practice) with Nurse Practitioner Licensure. Nurse practitioners can choose the psychiatric-mental health specialty to become a board-certified psychiatric mental health nurse practitioner. Upon graduation and passing board examinations, PMHNPs can both practice therapy and prescribe psychotropic medications.
MD – Medical Doctor
MDs complete four years of medical school, where they receive general training in science, medicine, and clinical practice across all areas of medicine (including, but not limited to emergency medicine, general surgery, psychiatry, pediatrics, internal medicine, etc.). Psychiatrists are physicians who have selected to specialize in psychiatry, completing four years of residency in psychiatry, including some elements of internal medicine and neurology following medical school. Psychiatrists receive training in the use of psychiatric medications as well as psychotherapy to treat mental disorders. Following training, psychiatrists may choose to provide clinical services in any number of public or private settings including academic medical centers carrying out research, intensive hospital-based treatment programs overseeing acute clinical care, or in private practice. Psychiatrists in private practice may provide psychotherapy and medication, or medication only, depending on the patient’s needs and the constellation of the treatment team (if required).
Please find additional information about clinical degrees, licensure, and specialized board and other certifications here. To learn more about professionals involved in the treatment of people with feeding and eating disorders, listen to our group’s podcasts about who’s who on an eating disorder treatment team and treatment settings/levels of care, and read further about distinctions between a dietitian and a nutritionist.