The terminology in the world of mental health professionals can be quite confusing. To take a few examples, licensed social workers (LCSW) don’t necessarily do social work, and licensed marriage and family therapists (LMFT) often work with individual clients. This guide aims to clarify who can do what, in terms of mental health, and how they are regulated.

For more specifics on what therapists can and can’t do, and are required to do, also see our guide What are the Legal and Ethical Requirements for Therapists in California?

1. Therapy vs Counseling vs Coaching

What is the difference between therapy, counseling, and coaching?

Therapy (specifically psychotherapy) and psychological counseling both involve helping a client work through and resolve emotional and psychological issues. Therapy often involves deeper work, dealing with more challenging mental conditions and disorders (diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, or DSM).

Coaching is a goal-oriented process that focuses on helping individuals set and achieve specific personal or professional goals. Coaches do not diagnose or treat mental health issues or disorders. See more at our Guide to Laws about Life Coaches.

How is therapy and counseling defined?

Therapy (specifically psychotherapy) refers to a professional relationship between a trained mental health professional (psychotherapist) and a client (individual, couple, or group). The primary goal of therapy is to improve mental and emotional well-being, resolve psychological issues, and promote personal growth and development.

Therapy sessions typically involve talking and exploring thoughts, feelings, behaviors, and experiences to gain insight into challenges and develop coping strategies. The specific techniques and approaches used in therapy can vary depending on the therapist’s training and the needs of the client. It is essential for therapists to adhere to ethical guidelines and maintain client confidentiality to ensure a safe and supportive therapeutic environment.

Psychological counseling has significant overlap with therapy, and is often used interchangeably. Other types of counseling are quite different, including school counseling, college counseling, and career counseling. These may require specific credentials and/or licenses.

2. Practicing Therapy or Counseling

Who can practice therapy or counseling in California?

There are five license types of professionals who may practice psychotherapy or psychological counseling in California: clinical psychologists (PhD or PsyD degree), psychiatrists (MD or DO degree), and master’s level psychotherapists (Masters degree – includes LMFT, LPCC, LCSW). All of these five types may also be referred to as therapists.

• Licensed Psychologists aka Licensed Clinical Psychologists: Licensed Psychologists must have a doctoral degree (either PhD or a PsyD), and obtain a license from the California Board of Psychology. They are trained in the assessment, diagnosis, and treatment of mental and emotional disorders. Psychologists may provide therapy to individuals, couples, families, and groups; they also offer comprehensive psychological testing. Clearing Up Some Myths About Psychologists in California: What You Need to Know
• Licensed Marriage and Family Therapists (LMFT): LMFTs must have a master’s degree in psychology or related field and obtain a license from the California Board of Behavioral Sciences (BBS). They specialize in providing therapy for individuals, couples, and families, often to address relationship and family issues. They may treat mental health issues and disorders and practice all accepted therapeutic techniques.¹California Business and Professions Code 4980.02 Clearing Up Some Myths About LMFTs in California: What You Need to Know
• Licensed Professional Clinical Counselors (LPCC): LPCCs must have a master’s degree in psychology or related field, and obtain a license from the California Board of Behavioral Sciences. They provide counseling and psychotherapy services for individuals, couples, families, and groups.²California Business and Professions Code 4999.20 Clearing Up Some Myths About LPCCs in California: What You Need to Know
• Licensed Clinical Social Workers (LCSW): LCSWs must have a master’s degree in social work, and obtain a license from the California Board of Behavioral Sciences. They offer therapeutic services and counseling to individuals, couples, families, and groups, and may treat mental health disorders and practice all accepted therapeutic techniques. They are also equipped to connect clients with community resources.
• Psychiatrists (M.D. or D.O.): Psychiatrists are medical doctors with a medical degree, specializing in mental health, and are licensed by the Medical Board of California. They can prescribe medication to treat mental health disorders. Psychiatrists may also provide psychotherapy, but many of them do not do so.

What is an associate marriage and family therapist, associate  professional clinical counselor, associate clinical social worker, or psychological associate?

An associate marriage and family therapist (AMFT), associate professional clinical counselor (APCC), associate clinical social worker (ACSW), or psychological associate are professionals who are not yet licensed but typically have completed their education and have completed some training. Their work must be supervised by a licensed professional in their field.

Who can diagnose someone with a mental disorder?

All licensed mental health professionals – clinical psychologists, psychiatrists, LMFTs, LPCCs, and LCSWs – may diagnose or assess a patient as having a mental disorder or affliction, such as generalized anxiety disorder, bipolar disorder, or any other condition included in the Diagnostic and Statistical Manual of Mental Disorders (known as the DSM). That said, the diagnosis must be within their scope of competence and training. So, for example, typically an autism diagnosis is made only by clinical psychologists, who often have the necessary training on this condition.

Who can administer psychological tests and assessments?

Clinical psychologists and psychiatrists have the most expansive authority to conduct, score, and interpret psychological tests, including intelligence tests, neuropsychological testing, and personality tests. This is part of their core training and competency.

LMFTs can engage in psychological testing within the context of an ongoing psychotherapy relationship.³Van de Kamp, J. K. (1984). Do marriage, family and child counselors have the statutory authority to construct, administer, and interpret psychological tests? California Attorney General opinion no. 83-810, June 28, 1984.

LPCCs are explicitly prohibited from administering “projective techniques in the assessment of personality, individually administered intelligence tests, neuropsychological testing, or utilization of a battery of three or more tests to determine the presence of psychosis, dementia, amnesia, cognitive impairment, or criminal behavior.”⁴California Business and Professions Code 4999.20(c)

Who can prescribe psychiatric medications?

Only licensed physicians (M.D. or D.O.) may prescribe medications, such as Xanax, Paxil, Zoloft, Celexa, Cymbalta, etc. Often these are prescribed by a psychiatrist, but general medical practitioners may also prescribe these.

Who can practice sex therapy?

In order to be a certified sex therapist under the American Association of Sexuality Educators, Counselors, and Therapists (AASECT), you must be licensed as one of the above professionals (LMFT, LCSW, etc), and complete the required sex therapy training.

Who can market themselves as or call themselves a therapist or counselor?

The titles of “therapist,” “counselor,” and “social worker” are generally not legally restricted to licensed professionals, as long as it is made clear that the person is not licensed. However, the term “psychotherapist” is protected by law, and must only be used by a licensed mental health professional. In addition, the following titles are also restricted to licensed professionals: “Marriage and Family Therapist” (MFT), “Professional Clinical Counselor” (PCC), “Clinical Social Worker” (CSW), “psychologist.”⁵Caldwell, B. E. (2024). Basics of California Law for LMFTs, LPCCs, and LCSWs (11th ed.). High Pass
Education.

3. Other forms of therapy and related practices

Certain practices may include the word “therapy” or may be related to psychotherapy, but are not the same. These practices require different credentials or licenses, if they require any.

Who can practice hypnotherapy or hypnosis?

Anyone may practice hypnotherapy, hypnosis or hypnotic techniques. There is no license to be a hypnotist or hypnotherapist. See our Guide to California Laws about Hypnotherapy and Hypnosis.

Who can teach or guide meditations?

Anyone may practice teaching or guiding meditations, so long as they do not hold themselves out as a psychotherapist or as doing any sort of psychological treatment (unless licensed). There is no license to be a meditation teacher or guide, although there are various optional certifications by private organizations.

Who can practice music therapy?

To perform music therapy services in California, no special license or permit is required. However, to call yourself a “certified” or “board certified” music therapist, you must have a credential from the Certification Board for Music Therapists.

4. Coaching

What can life coaches do for clients? Do they need a license?

See more at our Guide to Laws about Life Coaches.

Further Resources

For more specifics on what therapists can and can’t do, and are required to do, also see our guide What are the Legal and Ethical Requirements for Therapists in California?

Clearing Up Some Myths About LMFTs in California: What You Need to Know

Clearing Up Some Myths About Psychologists in California: What You Need to Know

Clearing Up Some Myths About LPCCs in California: What You Need to Know

Guide to Laws about Mental Health in California

Guide to Laws about Health in California

Guide to Professional Licenses in California

Guide to Laws about Life and Wellness Coaches in California

Guide to the Laws and Regulations for California Therapists in Private Practice