General Information about Clinical Paths
Please watch this video.
This video:
- introduces the concept of clinical practice (therapist/counselor)
- explores the diverse employment settings and potential career paths
- highlights the collaborative nature of mental health care by showcasing various professionals with different educational backgrounds working together in clinical settings
Overview of License Options
To legally practice therapy in the U.S., professionals must hold a state-issued license that reflects their training, scope of practice, and ethical responsibilities. Licensure ensures accountability, protects clients, and defines what services each provider can offer. The chart below outlines common licensure paths to help you compare options and consider which path aligns with your interests and goals.
| License |
Job Title(s) in Clinical Settings |
Degree |
Can Diagnose? |
Can Prescribe Medication? |
Focus |
| Licensed Professional Counselor (LPC)/ Licensed Mental Health Counselor (LMHC) |
Therapist, Counselor |
MA or MS |
✅ Yes (varies by state) |
❌ No |
Talk therapy, life challenges |
| Licensed Clinical Social Worker (LCSW) |
Therapist, Clinical Social Worker |
MSW |
✅ Yes (varies by state) |
❌ No |
Talk therapy, case management, advocacy |
| Licensed Marriage and Family Therapist (LMFT) |
Marriage and Family Therapist |
MA or MS |
✅ Yes (varies by state) |
❌ No |
Relationship dynamics, couples/family talk therapy |
| Licensed Psychologist |
Psychologist, Clinical Psychologist, Therapist |
PhD or PsyD |
✅ Yes |
❌ No (except in a few states with extra training) |
Talk therapy, assessment |
| Medical License + Board Certification |
Psychiatrist |
MD or DO |
✅ Yes |
✅ Yes |
Medical treatment, medication management |
The “Can Diagnose?” column varies by state for licenses like LPC, LMHC, LCSW, and LMFT because each state sets its own scope-of-practice laws for mental health professionals. Here’s why that matters:
- 🏛️ State Statutes Define Diagnostic Authority: Some states explicitly grant diagnostic privileges to these professionals in their licensing laws, while others do not. In states where diagnosis isn’t authorized, counselors or therapists may need to refer clients to psychologists or psychiatrists for formal diagnoses.
- 📍 Examples of Variation:
- In New York, LMHCs and LMFTs can apply for a separate diagnostic privilege if they meet additional training and experience requirements.
- In other states, LPCs and LCSWs may be allowed to diagnose based on their clinical training and licensure, but this authority is not always clearly outlined in law.
- 🧾 Why It Matters: Diagnostic ability affects treatment planning, insurance reimbursement, and interdisciplinary collaboration. Students considering these paths should review their state’s licensing board to understand what each credential allows.
