Counselor or Therapist: What’s Best for Me?

Understanding your mental health care options

More and more people seek mental health care every year. With diverse options available, many find it difficult to know where to start. What kind of mental health care provider should you see? How do you know what type of care is right for you?

A counselor or therapist is a good place to start for those seeking treatment for a mental health problem or for people just looking to talk through life’s bumps and bruises with someone. While both of these types of caregivers work directly with patients to address their concerns and needs, their professions vary in crucial ways. Learning the difference between a counselor and a therapist can help you make a more informed decision about the type of care that’s best for you.

Mental health care definitions

Before examining the similarities and differences between therapists and counselors, some context is needed to understand who these providers are and what they do. Both therapists and psychologists are considered mental health care providers. Mental health care, as defined by the American Psychological Association (APA), is “a category of health care service and delivery provided by several fields involved in psychological assessment and intervention (psychology, psychiatry, neurology, social work, etc.). This type of care includes but is not limited to psychological screening and testing, psychotherapy and family therapy, and neuropsychological rehabilitation.”

Therapists and counselors are health care professionals trained to provide this type of service.

The APA defines a counselor as “an individual professionally trained in counseling, psychology, social work, or nursing who specializes in one or more counseling areas, such as vocational, rehabilitation, educational, substance abuse, marriage, relationship, or family counseling. A counselor provides professional evaluations, information, and suggestions designed to enhance the client’s ability to solve problems, make decisions, and effect desired changes in attitude and behavior.”

A therapist is defined as “an individual who has been trained in and practices one or more types of therapy to treat mental or physical disorders or diseases.”

Similarities between counselors and therapists

Both counselors and therapists have years of experience and training that allow them to help patients manage stressful life events, behavioral or emotional concerns, and relationship issues. Depending on their training, both counselors and therapists can provide “talk therapy” services, a form of mental health care that involves communication and engagement between provider and patient to discuss mental health challenges and how to overcome them.

Counselors and therapists work in a variety of settings. Many health care providers work in private practice, working with patients individually or in small groups in a clinical setting. Other patients may receive mental health services in the workplace, educational settings (like a university student center or high school), or larger support groups.

Counselors and therapists must undergo rigorous education and clinical training to conduct mental health care services. While specific educational and experiential requirements vary from state to state, most states require both counselors and therapists to, at minimum, have:

• Obtained a Master’s degree with correlating coursework
• Log thousands of hours (usually 1,500-3,000) of supervised clinical practice working directly with patients
• Pass a nationally recognized licensing exam (like the National Clinical Mental Health Counselor Exam)

What is a counselor?

Counselors are mental health care providers who work with patients to manage and address thought processes or behavioral patterns. These challenges may include anxiety, depression, stress, trauma, relationship issues, grief, self-esteem struggles, and more. Mental health counselors employ various therapeutic interventions to help their clients navigate their difficulties, develop coping strategies, and achieve personal growth and well-being. They create a safe and non-judgmental space for clients to openly express their thoughts and feelings and work collaboratively to identify underlying issues and set achievable goals. Mental health counselors can work in various settings, such as private practices, community mental health centers, schools, hospitals, and corporate environments. They play a crucial role in promoting mental wellness, fostering resilience, and facilitating positive changes in individuals' lives through empathy, active listening, and evidence-based therapeutic approaches.

Counseling is often goal-based. Patients in counseling work with their providers to find specific management tools to achieve life goals. This is often a highly practical therapy. For example, a patient with public-speaking anxiety may receive specific coping mechanisms or practice tools from their counselor before public speaking engagements.

You might see a counselor for concerns such as:

• Stress management
• Relationship issues (couples counseling, family therapy)
• Low self-esteem and self-worth
• Career and academic concerns
• Adjustment difficulties (life transitions, relocation, cultural adaptation)
• LGBTQ+ support
• Body image issues
• Communication skills and conflict resolution
• Personal growth and self-improvement
• Work-related stress and burnout
• Sexual and intimacy concerns

What is a therapist?

Therapists are professionals in the field of mental health care, engaging directly with individuals, groups, and institutions to address a spectrum of mental health conditions and disturbances. To attain licensure, a therapist is required to hold a minimum of a Master’s degree, possess clinical expertise, and secure certification through the successful completion of a nationally acknowledged examination. Their role involves collaborating with clients to enhance mental well-being, recognize and modify specific behavioral or cognitive patterns, and develop effective stress-coping strategies. Additionally, therapists are equipped with the training and experience to diagnose and treat various mental health disorders such as depression, anxiety, and obsessive-compulsive disorder.

Therapists generally use a form of talk therapy. Talk therapy is used interchangeably with psychotherapy to characterize a therapeutic practice conducted through personal communication and interaction with a patient. This practice is tailored to meet the needs of the individual.

You might see a therapist for concerns such as:

• Depression and mood disorders
• Anxiety
• Eating disorders
• Trauma-related disorders (like post-traumatic stress disorder)
• Obsessive-compulsive disorder
• Substance abuse disorders
• Marriage and family therapy
• Emotional distress
• Self-esteem issues
• Relationship difficulties
• Stress management
• LGBTQ+ identity support
• Anger management
• Personality disorders
• Cultural or spiritual concerns
• General counseling

This is not a complete list of all concerns for which a licensed therapist can provide therapeutic services, although they are among the most common.

Who should I see?

The primary difference between therapists and counselors is the specific issues they treat and how they treat them.

Counselors often focus on providing guidance, support, and psychoeducation to clients dealing with specific life challenges, transitions, and personal development. They may offer more practical advice and strategies for addressing day-to-day issues. They may use a problem-solving and guidance-oriented approach. They might employ career assessments, decision-making strategies, and stress management techniques.

Conversely, therapists work more with clients managing mental health, behavioral, or personality disorders. Therapists tend to work with clients on a deeper level, addressing psychological and emotional issues, mental health disorders, and facilitating personal growth. They often utilize various therapeutic modalities to help clients explore and process their thoughts, feelings, and behaviors. Therapists use a broader range of therapeutic techniques and interventions to delve into clients' underlying emotional and psychological issues. They might use psychoanalytic, cognitive-behavioral, humanistic, or other approaches.

Simply put, counselors will work with clients to overcome a problem or concern. Therapists will work with clients to address why that concern is occurring in the first place while addressing the underlying causes of behavioral or emotional challenges.

How Sesame can help

Mental health is crucial to your overall health and well-being. Whether you are working on a specific goal or want to talk through recent challenges in your life, mental health care can help you tackle life’s challenges in a holistic and productive way. Patients with mental health disorders can use these services to manage their condition and learn positive coping skills. Ready to talk to a provider today? Book an online mental health consult on Sesame to discuss your concerns and ask any questions you may have.