Therapists must qualify for one of the professions legally allowed to provide psychotherapy in their state. This generally includes psychologists and counselors, marriage and family therapists and social workers. Requirements vary from state to state, but generally include graduate education, supervised experience, examinations and credentialing. For professions like nurse practitioners and psychiatrists, who are allowed to practice therapy but frequently do not, other patterns may apply.
Therapists are required to complete graduate education in the specific therapy field in which they will practice. For master's level clinicians, this is generally a 48 to 60 semester hour master's degree, including up to 900 hours of internship or practicum. In the case of counselors or marriage and family therapists, the coursework is generally clinical, whereas only 20 percent is required to be clinical for social workers. For psychologists, the required education is a Ph.D. in psychology or the more clinically-focused Psy.D., including a one-year internship.
Except for entry-level social workers who always operate under supervision, therapists go through a period of supervised experience before becoming a fully qualified therapist. This experience allows the new therapist to receive feedback on their work and guidance in their development as therapists. Master's level clinicians usually fulfill a requirement of 1,500 to 2,000 client contact hours within the context of a 3,000-hour post-graduate supervised experience that takes two to three years. Psychologists are generally required to fulfill the equivalent of a two-year residency.
Some states require common exams of all therapists. Beyond these core exams, a therapist has to pass state or national exams in their field. Even when national exams are utilized, these are not standardized and a therapist may have to take new exams if they move or want to practice in another state. The requirements for psychologists and social workers are more standardized, whereas the requirements for counselors is the most diverse.
Credentials are required of all fully qualified therapists, such as a Licensed Mental Health Counselor, Licensed Marriage and Family Therapist, Licensed Professional Counselor or Licensed Clinical Social Worker. While each license allows a person to be a therapist, each has its own focus. Understanding the state's requirements allows the prospective therapist to prepare for specific licensing.