Therapist vs counselor vs psychologist: What’s the difference?

Understanding Mental Health Professional Roles

Mental health professionals are trained, licensed specialists dedicated to helping people improve and maintain their emotional well-being. This broad category encompasses therapists, psychologists, counselors, psychotherapists, psychiatrists, and psychiatric nurse practitioners—each bringing unique qualifications and approaches to mental health care.

“A mental health professional is really someone whose goal is to help stabilize and improve a person’s mental health,” explains Tim Hirschman, LPC, vice president of clinical operations at Thriveworks.

Now let’s break down what each of these professionals does and how they might be able to help you.

Therapist

The terms “therapist” and “counselor” are often used interchangeably, and anyone with the licenses below can call themselves either one. However, people who use the title “therapist” typically take a deeper, more theory-based approach to treatment.

Defining what makes someone a “therapist” can get confusing because each state has its own licensing requirements and titles. Here are the most common licenses you’ll see:

• Licensed Mental Health Counselor (LMHC)
• Licensed Independent Clinical Social Worker (LICSW/LCSW)
• Licensed Professional Counselor (LPC)
• Licensed Clinical Professional Counselor (LCPC)
• Licensed Professional Clinical Counselor of Mental Health (LPCC)
• Licensed Clinical Mental Health Counselor (LCMHC)
• Licensed Mental Health Practitioner (LMHP)
• Licensed Marriage and Family Therapist (LMFT)

In most states, you need a master’s degree in counseling, psychology, or social work to get licensed as a mental health provider. For licensed marriage and family therapists (LMFT), practitioners typically complete additional specialized training in family systems and relationships.

Best for: Long-standing mental health challenges. For example, if you’ve struggled with depression since high school and still experience symptoms even when your job, relationships, and personal life are going well, working with a therapist might be the right choice.

Counselor

While “counselor” and “therapist” are interchangeable terms with the same licensing requirements, people who identify as counselors typically focus more on current, situational challenges rather than deep-rooted patterns.

“Therapists and psychotherapists tend to be very theoretical in their approach, and they tend to dig deeper to find out the root cause of a problem,” Hirschman explains. “A counselor, on the other hand, is someone that helps a client address day-to-day problems.”

Best for: Situational difficulties and recent life changes. For example, if you’re feeling depressed and inadequate after starting a new job—but this isn’t something you’ve experienced before—a counselor might be the right fit. They often work short-term to help process difficult emotions around life changes and develop better coping strategies and self-care routines.

Psychotherapist

Psychotherapists have the same training and licensing as counselors and therapists, but they use the term “psychotherapist” to emphasize their specific approach to mental health treatment.

“There is a very grey line between therapists and psychotherapists, but a psychotherapist is often very specific in the way that they implement care,” Hirschman says. “A psychotherapist is actually using psychotherapy to help with addressing deep-set issues and concerns, whereas a therapist will use a variety of treatment approaches.” (Think: cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), eye movement desensitization and reprocessing (EMDR), and more.)

When you hear “psychotherapy,” you might picture classic Freudian analysis—lying on a couch, talking about childhood memories while a therapist takes notes nearby. While Freud was indeed a psychotherapist, modern psychotherapy looks very different. The term actually encompasses any form of talk therapy designed to help you work through behavioral, emotional, or mental challenges.

Best for: When you want someone who specializes in specific, evidence-based talk therapy methods rather than a more general approach. Psychotherapists are particularly helpful for addressing deep-rooted patterns and long-standing emotional concerns through structured therapeutic techniques.

Psychologist

“A psychologist is a doctorally prepared therapist or counselor,” explains Kate Hanselman, a psychiatric nurse practitioner at Thriveworks. That means they’ve completed the highest level of education in their field, earning either a PhD or PsyD degree, and are licensed by their state to practice.

What sets psychologists apart is their advanced training in research and clinical assessment. “They usually have a research background and a better understanding of clinical evaluation and testing, so they can do a full psychological evaluation, which a regular counselor can’t do,” Hanselman says. In fact, psychologists are the only mental health providers who can conduct comprehensive psychological evaluations and provide formal diagnoses.

This specialized expertise becomes especially valuable in certain situations. If you need an official diagnosis for legal proceedings or when there’s uncertainty about what condition you might have, a psychologist’s assessment skills are crucial. For example, if a counselor suspects you might have a complex condition like autism, they’ll likely refer you to a psychologist who specializes in those types of evaluations.

Best for: When you need comprehensive psychological testing, a formal diagnosis, or evaluation for legal purposes. Psychologists can also provide therapy like counselors and therapists, but some focus exclusively on testing and assessment.

Psychiatrist

“A psychiatrist is a medical doctor who went all the way through med school and then specialized in psychiatry,” Hanselman explains. “So they’re a generalist doctor with a psychiatry specialty.”

What makes psychiatrists unique among mental health professionals is their ability to prescribe medication—they’re one of only two types of providers who can do this (see below for the other). Because they completed medical school, they have the medical training to understand how psychiatric medications interact with your body and other medications you might be taking.

Psychiatric Nurse Practitioners (PMHNP)

The other mental health professional who can prescribe medication is a psychiatric mental health nurse practitioner. PMHNPs hold either a master’s degree in nursing practice (NP) or a doctorate of nursing practice (DNP), with specialized training in psychiatric medications and clinical skills.

“While I learned how to prescribe a variety of medications, like antibiotics or blood pressure medications, most of my coursework and training focused on psychiatric clinical practice and prescribing,” Hanselman reflects. This focused training makes psychiatric medication management their primary area of expertise.

Best for: When you need medication as part of your mental health treatment. Some psychiatrists and psychiatric nurse practitioners provide therapy services alongside prescribing, though many focus primarily on medication management and work with other providers who handle the therapy portion of your care.

Psychologist vs Therapist: Education and Practice Differences

There are two key differences between a psychologist and therapist. First, psychologists hold doctoral degrees (PhD or PsyD) while therapists typically have master’s degrees. This educational difference translates into different capabilities: While both can diagnose, only psychologists can conduct comprehensive psychological assessments to support an official diagnosis, which is often required by schools or courts.

The second difference is more about focus than ability. Both psychologists who provide treatment and therapists can specialize in specific therapeutic approaches, mental health conditions, or particular populations—like young adults navigating their twenties or women going through menopause. However, psychologists often bring a more research-based perspective to their work due to their doctoral training.

Counselor vs Therapist: Licensing and Scope of Practice

From a licensing standpoint, “therapist” and “counselor” are essentially interchangeable terms. Both require state licensure and have the same scope of practice. The difference is more about how we typically think of their approaches to treatment.

Counselors are often associated with helping people work through short-term, situational challenges, like navigating a rough patch in a relationship or processing the immediate grief after losing a loved one. Therapists, on the other hand, tend to focus on longer-term patterns and deeper-rooted issues, such as grief that persists more than a year after a loss or anxiety that began in high school and continues into someone’s thirties.

It’s worth noting that these distinctions aren’t hard rules. Many professionals use both terms depending on the context, and their actual approach depends more on their training and specialization than the title they choose.

Psychotherapist vs Psychologist: Understanding the Distinctions

The main difference comes down to education level and scope of practice. “Psychologist” specifically refers to someone with a doctoral degree (PhD or PsyD) in psychology who can diagnose mental health conditions and conduct psychological assessments.

“Psychotherapist,” on the other hand, describes someone’s treatment approach rather than their education level. A psychotherapist specializes in talk therapy methods to help clients, but they could have either a doctoral degree (like a psychologist) or a master’s degree (like a licensed therapist or counselor). What defines them is their focus on using specific psychotherapy techniques rather than their educational background.

Psychiatrist vs Other Mental Health Professionals

The key difference between psychiatrists and other mental health professionals is their medical training and prescribing authority. Psychiatrists are uniquely qualified to prescribe psychiatric medications—a capability they share only with psychiatric nurse practitioners. While Psychiatrists and PMHNPs can provide therapy, it is often in a shorter duration within a mediation visit.

Hanselman often recommends a collaborative treatment approach: working with both a psychiatrist (or psychiatric NP) for medication management and another mental health professional for therapy. “It’s helpful to have two clinicians who have two sets of eyes on you, and then they can work together to give you really robust support,” she says.

This team approach allows each provider to focus on their area of expertise while ensuring you get comprehensive care that addresses both the biological and psychological aspects of your mental health.

Which Mental Health Professional Is Right for You?

Choosing the right mental health provider goes beyond just looking at license types. The most important factors are finding someone who understands your specific symptoms and life stage and uses therapeutic approaches that feel comfortable to you.

“A client should be less concerned about choosing between a therapist or counselor and more focused on whether a mental health professional specializes in the area they are struggling with,” Hirschman says.

What to Look for When Researching Providers

Most mental health professionals will have detailed information on their website or therapy platforms that covers:

• The types of mental health conditions they treat
• Age groups they work with (teens, adults, seniors)
• Their specific areas of expertise
• Availability and scheduling options
• Therapeutic approaches they use
• Insurance networks they accept
• Out-of-pocket costs

Making the Final Decision

Once you’ve identified a few candidates who seem like a good match for your needs and budget, “take advantage of the free 15-minute phone consultation most therapists will offer and ask them questions,” Hanselman says.

Key questions to ask:

• What are your specialties?
• What kind of clients work really well with you?
• How will I know if we’re a good fit?

Remember, good therapists want to ensure you’re matched with the right provider. “Therapists are ethically bound by our states and our practices’ code of ethics to help you, and sometimes that means telling you this won’t be a great fit,” Hanselman says. When that happens, they’ll typically provide a referral to someone better suited for your needs.

You Don’t Need All the Answers to Start

Finally, don’t let uncertainty hold you back from seeking help. Therapy works whether you have a clear understanding of what’s wrong or you’re still figuring things out.

“Sometimes people self-sabotage, thinking that they have to have the answer or that they shouldn’t seek help because they don’t know what’s wrong,” Hirschman says. “I really want clients to know that they deserve to have help and they deserve to have a life where they feel like their mental health is not a limiting factor, no matter where they are in their mental health journey.”

Frequently Asked Questions About Mental Health Professionals

Q: What’s the main difference between a psychologist and therapist?

A: Psychologists have doctoral degrees and can provide official diagnoses, while therapists have master’s degrees and cannot offer testing. Both can provide therapy, but only psychologists can conduct comprehensive psychological assessments.

Q: Is a counselor the same as a therapist?

A: Yes, counselor and therapist are interchangeable terms for licensed mental health professionals. The difference is typically in approach: counselors often focus on short-term, situational issues like job loss, while therapists address longer-term patterns like persistent PTSD symptoms.

Q: What’s the difference between a psychotherapist and psychologist?

A: A psychotherapist is any mental health professional who specializes in psychotherapy, an approach rooted in talking with clients about their emotional or behavioral struggles. A psychologist has a doctoral degree, can diagnose mental health conditions, and offers psychological testing, in addition to providing treatment, which may involve psychotherapy.

Q: Can a psychologist prescribe medication?

A: No, psychologists cannot prescribe medication because they are not medical doctors. Only psychiatrists and psychiatric nurse practitioners can prescribe medication for mental health conditions.

Q: Do I need a referral to see a psychiatrist?

A: Typically no, you don’t need a referral to see a psychiatrist. However, check with your insurance provider, as some require a referral from your primary care doctor or another mental health professional for coverage.

Q: Should I see a therapist, counselor, or psychologist for anxiety? What about depression?

A: All three can legally treat and diagnose anxiety and depression. Choose based on your specific needs: Therapists often see patients with more severe or long-term symptoms, while counselors usually specialize in those experiencing emotional turmoil related to a specific event or life phase. Psychologists are the only mental health professionals who can provide testing to support an official diagnosis, which is often required by schools or courts.