Ph.D.s – M.D.s – Psy.D.s
There could easily be three to four hundred thousand therapists in the United States. Some are licensed, some are not; some have Ph.Ds, some do not; some have Master’s degrees, some do not; some are RNs most are not; some are psychiatrists, some are psychologists, some have an Ed.D., and some are MFCC’s, (or MFT’s, as they are so designated in some states). So, just who are all these people, and does it really matter? Well, yes, it does matter. What you are about to read will shed some light on these distinctions, and enable you to understand the differences between all of these degrees and licenses.
Let’s begin by examining a rather bewildering fact: A doctorate is not a doctorate is not a doctorate. What this means is that there are many different such degrees. There is the Ph.D., which by itself is not very explanatory. In other words, in what field of study is the degree? It may be in counseling, clinical psychology, psychology, school psychology, or something quite esoteric that may not easily be recognized as a degree related to the practice of psychotherapy. It may also be in medicine, or an M.D.
The Ph.D. is distinguished from the M.D. degree by at least one distinct element: medical school. The M.D. or physician has typically gone to medical school, and the Ph.D. or psychologist has not attended medical school. Instead, the psychologist has attended (usually) a graduate course of study lasting a minimum of 4 years, plus pre-doctoral and post-doctoral internships, each lasting (usually) 2 years or more.
Basically, psychiatrists have little formal training in the theory and practice of psychotherapy, unless they have sought post-graduate training at a psychoanalytic institute. In short, the picture looks like this: If you are not going to receive medication, you should avoid the expense of the psychiatrist ($250.00-$500.00 per hour). If psychotherapy is what you want, then an individual with a Ph.D. and a license to practice psychotherapy is a good bet since they will be fully trained in psychotherapy. It doesn’t mean that you will be comfortable with the person, just that they are supposed to know what they are doing.
There is also the Psy.D. degree, or doctor of psychology. The main difference between the Psy.D. and Ph.D (Doctor of Philosophy) is that in many cases, the Psy.D. requirements do not include the research toward and the writing of a dissertation. A dissertation is required for the completion of a Ph.D. The Psy.D. is often thought of as a more practically oriented degree, that is, more slanted toward the practice of psychotherapy than the Ph.D. degree. The Ph.D. is often viewed as the degree with a research slant. Both, however, require a great deal of course work related to the assessment and treatment of mental disorders. Both the Psy.D. and the Ph.D. are nationally accepted as degrees prerequisite to the licensure of a psychologist.
M.A.s – MFCCs – LCSWs – LMFC – MFTI – MFCI – LPC
In California and most, if not all, other states, there are also those counselors or therapists who practice with a license known as the MFCC (Marriage, Family and Child Counseling license), or LMFC (Licensed Marriage Family Counselor, or LMFT (Licensed Marriage and Family Therapist)., or MFT. So, what we have here is a situation where the following all mean literally the same thing: MFCC, LMFC and LMFT and MFT all indicate that some one is licensed to practice as a Marriage, Family and Child Counselor.
In all the states (I believe) which offer such a license, a Master’s level (M.A. or M.S.) degree is the maximum education required. As a consumer, it is important to understand that the difference between the Master’s level and the Doctoral level of education is significant. There simply is more required for the doctorate degree, and the difference between the two is significant.
First of all, the doctoral degree requires at least another two years of clinical experience and supervision beyond that required by the M.A. Second, there is considerably more course work required for the Ph.D. Most students will tell you that the single most valuable element of their training was their clinical supervision. This is the time spent presenting clinical case material to a senior or more experienced clinician and receiving feedback about the way the supervisee has functioned as a therapist. It is the clinical experience which provides real-time experience seeing clients, and during this experience a remarkable amount of learning occurs. It is extremely important that an individual has had extensive clinical supervision both prior to and following the completion of the degree.
The LCSW or Licensed Clinical Social Worker is also a Master’s level degree. The degree involved in this case is the M.A. in Social Work. In the past, the social work degree consisted of course work related to social work, but also had a very strong clinical component. This element was comprised of heavily steeped psychoanalytic courses and general psychodynamic theory. Those trained in clinical social work who have had adequate clinical experience and supervision are typically well trained therapists. The Licensed Social Worker or LCSW has been around for several decades, and is a very well-respected professional license.
The MFCC license has not been in existence as long as the LCSW, and for that reason alone is probably not as well-respected. However, as mentioned earlier, those licensed with the MFCC who also have Ph.D’s or Psy.D’s are trained equivalently to psychologists if they have also completed their postdoctoral internship and supervision, and are eligible for the psychology license.
Also worth noting is the DSW, or Doctor of Social Work. Apparently, those who possess the DSW are also, when licensed, LCSW’s, that is, Licensed Clinical Social Workers. It is not a common degree or one you are likely to find when searching for a therapist, but it is nevertheless a well respected degree.]
LPC – Licensed Professional Counselor
All 50 states now have what is known as the LPC, or, Licensed Professional Counselor. In the state of South Carolina, for example, individuals who possess a masters degree in coursework specific to counseling, and who have accumulated 1500 hours of Clinical Supervision, may be granted the designation LPC after passing the National Counselors’ Examination (NCE).
The LPC, I am told, is equivalent to the MFCC or LMFT license that exists in several other states, such as California and Nevada. Some third party payers reimburse LPCs.
MFCI or MFTI–The Interns
Next we come to the MFCI or MFTI, that is, the Marriage, Family and Child Intern or Marriage and Family Therapy Intern, each being different designations for virtually the same thing. These are individuals who have a Master’s degree and are presumably fulfilling the requirements for licensure as a Marriage, Family, and Child Counselor. They are seeing clients or working in one type of clinical setting or another, with their clinical work being supervised by a senior, licensed person, hopefully well seasoned in all the subtleties of clinical work.
One last word about the differences between advanced degrees is appropriate. With respect to the general requirements of both Master’s and Doctorate degree programs, in most if not all cases the Doctorate programs require that a candidate receive some minimum amount of psychotherapy. Some MA programs require therapy, some do not. If You know of any Ph.D. or MA programs that DO NOT require therapy, please e-mail me. The point, however, is: Unless a therapist, irrespective of degree held, has participated in his or her own medium to long term intensive psychotherapy, his or her effectiveness, in my opinion, is compromised.
Be aware that regardless of the license or certification, requirements for certification and licensure vary from state to state. Each state tends to have their own specific academic and experiential prerequisites in order for an applicant to obtain their particular license or certification.