Alphabet Soup
Accreditation, Boards, and Credentials
A common question I’ve received when asking people what they wish were clearer about the world of psychotherapy is some iteration of, “Why do therapists have different letters after their names?” I realize how confusing it is to see so many different (and so many similar) combinations of letters. Because of this, I go with the least congested collection of letters that still represent my credentialing in my own marketing. I don’t believe this is the only correct way of displaying credentials, but it’s what feels most accurate while being most approachable to me. This won’t be a total breakdown of letters and credentialing, but I hope to provide a working knowledge to understand what it means to the casual observer.
Let’s start with my name and current credentials as an example to break down.
Travis Kessell, MA, LPC
Most often, I simply advertise as Travis Kessell, LPC. My email signature and official communications contain MA, but I chose the path of least resistance (amount of characters to type) for day-to-day representation.
Schooling
The first designation you’ll see after the name is a person’s graduate degree. Mine is a Master of Arts. Other common ones you’ll find are MS (Master of Science), MEd (Master of Education), or MSSW (Master of Science in Social Work). These are not exhaustive examples, but whatever the lettering, it communicates the same thing: the person whose name the letters follow has completed a master’s degree that meets the requirements to become a licensed counselor in their state.
Some states have different requirements for their degrees, but more and more, states have adopted credentialing from an organization called CACREP as the standard for degrees. CACREP is not setting licensure requirements, but many states, including Virginia, have set CACREP accreditation as the minimum standard. If a person is pre-licensed or licensed in your state, they have completed a master’s-level degree as required to provide professional counseling.
Some therapists will have PhD or PsyD after their names. A doctorate is not required to practice as a licensed counselor in any state I am aware of, however, it is required to become a licensed psychologist. This is a further level of education and licensing and is different from being solely a licensed therapist. If you see these designations after someone’s name they have conferred a doctoral-level degree. They are only a licensed psychologist if they advertise themselves as such in addition to having the degree designation. Some licensed counselors complete doctoral degrees but do not become licensed psychologists, or they have completed a doctoral degree unrelated to the educational requirements to do so.
A note on the Counselor-in-Training designation. This person is in school and has not completed a master’s degree. You’ll most often encounter this designation when working with a therapist who is interning as part of their master’s degree. Licensing
The second designation of note you’ll see after a person’s degree is their license type. I am a Licensed Professional Counselor (LPC) in Virginia, but you may also Licensed Marriage and Family Therapist (LMFT), or Licensed Clinical Social Worker (LCSW). These are the common designations in Virginia, but each is a separate license with separate requirements to complete. LPCs and LMFTs are very similar in education and residency requirements in VA but are different licenses. An LCSW has completed a different course of study, though they are still qualified to provide many of the same mental health services. You may see other licensure designations depending on your state or the state in which a therapist holds a license. For example, in Maryland, the designation equivalent to my license is Licensed Clinical Professional Counselor (LCPC). The requirements in Maryland are slightly different than in Virginia, but a person with this designation is a licensed counselor.
There are efforts underway to unify counseling licenses across the United States, but it is a complicated endeavor. In early 2024, the Counseling Compact will come into effect allowing licensed therapists who join to cross state lines among states who have signed the compact. Until then, each state has guidelines and requirements that vary.
Certifications
Common letters you’ll see after a license type will indicate specific certifications a therapist has. I currently do not have certifications after my name, but I am in the process of gaining my Dialectical Behavior Therapy certification (as soon as I submit my paperwork…). This means I’ve met the requirements in training and can advertise myself as a therapist specifically trained in this modality. Other common ones may be Cognitive Behavioral Therapy (CBT) or Eye Movement Desensitization and Reprocessing (EMDR). Knowing some of these can help narrow the search for a therapist who has specialized training.
A Final (Controversial) Note
One of the most common designations you’ll see after a license is National Certified Counselor (NCC). In no way am I disparaging therapists who seek this credential. They have worked hard and are entitled to pursue it should they so desire, but in the spirit of this Substack serving to demystify psychotherapy I want to address what this means.
The National Board for Certified Counselors (NBCC) provides the NCC certification. This certification, however, does not require additional training beyond what most states now require for licensure. Licensed therapists of all kinds are required to take a state-level exam before receiving their license. Currently, most states utilize education and exam thresholds that meet or exceed the requirements to receive the NCC designation. It is important to note that the NCC designation does not on its own, and in most cases, indicate a more qualified therapist. If a therapist is fully licensed (no longer under required supervision), it is highly likely they also meet the NCC requirements even if they have not chosen to pursue this designation.
Again, therapists have worked hard to become licensed, and receiving this certification may be part of verifying that endeavor. But it must be noted the presence or absence of NCC after someone’s name does not indicate any more or less than having a state license about their qualifications.
I hope this, in part, has made the hodgepodge of our credentials a little less so.