An argument is regularly brought forward, especially in California, that there aren’t any differences, whether nuanced or noticeable, between professions in mental health. So why are there different licenses if anyone with a master’s in mental health can run assessments, diagnostics, and treatment, through psychotherapy, for the full array of mental and emotional disorders in the Diagnostic and Statistical manual?
Dr. Todd Grande provides a useful video overview- check it out below:
Which Type of Psychotherapist is the Best? | Counselors, Social Workers, Psychologists, or MFTs
Licensing And Supervision Differences
The argument is brought forth by therapists trained and supervised by experts from other professions. One can get a license as an LMFT (Licensed Marriage and Family Therapist) or LPCC (Licensed Professional Clinical Counselor) without the supervision of an expert in the same profession.
In California, clinical social workers must have some pre-licensed experience under the supervision of LCSWs (Licensed Clinical Social Workers). We would, however, argue that the supervision of individuals outside their profession isn’t ideal in order to become a member of that profession. The training of social workers, the texts they read and their way into the social work field isn’t typically known by LMFTs. While mental health professions at the master’s level do perform the same functions, they don’t share similar underlying philosophies.
More recently, professions have tried to be defined for the sake of licensure. Until 2009, LMFTs and LPCCs both had states where their professions weren’t licensed. That year, Montana, LMFTs, and California, LPCCs, passed laws that saw the completion of 50 states of licensure for each profession. Before that, both institutions argued for distant licensure in both states, since they have different histories, skill sets, and bodies of knowledge.
To comprehend the difference, we should start at the problem. Take for example John, a 38-year-old married man who works in a book store. He’s in need of therapeutic help for his anxiety. The different health professions would ask the same question, why is John suffering from anxiety? Their starting points would however differ.
What is Clinical Supervision Like?
Differences In Approach
Trying to understand the perspective of the psychologists would be helpful, though this article isn’t focused on them. An examination of John’s inner world would reveal the cause of his dysfunction. A Freudian would examine his childhood while a behaviorist would zoom in on John as an individual and examine his present. Pathology would furthermore be the focus of traditional psychology.
Professional Clinical Counseling
Professional clinical counseling emerged from school and career counseling. Even though their focus is on mental health, LPCCs are more likely to view John’s struggle as an individual with a developmental issue. Examinations will be carried out to determine his social and psychological development, and treatment will narrow in on helping John to improve his overall development and wellness, including treating the mental illness.
Clinical Social Work
Clinical social workers focus on creating connections between people and the resources they need to function optimally. The resources may be internal, like personal skills and strengths which John may not have utilized efficiently, or external, like community resources and support groups. In a traditional sense, LCSWs will tend to see John’s struggle as resource linked, and will try and expose John to the resources he needs to control and overcome his anxiety.
Marriage And Family Therapy
LMFTs look at behavior from a social and relational perspective. Maybe John’s anxiety is a consequence of tension experienced in his workplace or in the relationships he is in. Perhaps the anxiety he is experiencing is even adaptive when looked at from this perspective, as he may receive support from his wife or boss when he exhibits his anxiety outwardly. Ultimately, a belief amongst LMFTs is that no behavior can exist in a social vacuum, and they will work with John and his family members and instrumental people in his life, if need be, in the effort to make his anxiety nonexistent.
Areas Of Overlap
As is visible, we cannot say that one approach to the problem is superior to the other. They are different. Taking this into account, it matters a great deal how new professionals are trained, supervised and socialized into each of their respective professions.
The points of view highlighted above are purist in nature, but even by observing them from that perspective, we come to understand that there are significant overlaps between the two philosophies when dealing with problems. Take for example dealing with adjustment issues amongst children; the LMFTS and the LPCCS share a lot of common ground in their work.
Both fields have been influenced by the workings of the other. Psychologists are a good example. Community psychologists are greatly influenced and have a lot in common with LCSWs in the approach they take. The work of family psychologists is greatly similar to that of the LMFTs, and Counselling psychologists take up a lot form the LPCCs. The benefit of cross-pollination is felt through all the professions, which leads to the effectiveness of communication with one another and the assessment of clients more thoroughly.
If we use the LMFTs as an example, however, we only need to look at their core competencies in order to identify where the overlap ends. By simply perusing through the expected skillsets LMFTs should be equipped with, they can be broken down, roughly and equally, into three categories;
- The tasks all professionals in mental health should be equipped to do, and all would go about it the same way; for example, suicide assessment.
- The tasks all professionals in mental health should be equipped to do, but the LMFTs would perform in a differing conceptual framework; for example, the general assessment of mental health; MFTs would take a rational mindset approach.
- The tasks LMFTs should be able to do that other mental health professionals are not unable to do, like systematic case conceptualization.
We have just used LMFTs as an example, and this is not to say that they are superior to other professionals or to imply that they have greater job function. The lists of core competencies for both the LCSWs and LPCCs can be broken down into similar proportions. As much as these professionals all do many similar things like assessment, diagnostics, and treatment of mental health disorders, a great disservice is done when it is suggested that they are all one and the same.
Sources
- What Are the Differences Between Mental Health Counseling and Licensed Clinical Social Work?
- The ABCs of Mental Health: Ph.D.? M.D.? LCSW? LPC?
- Social Work vs. Counseling – What is the Difference?
- Counseling vs Social Work