If you’ve ever tried to find support for your mental or relational health, you’ve probably met a wall of titles, credentials, and alphabet soup. LMHC. LCSW. LPC. NCC. CST. RLT. It’s enough to make you want to shut your laptop and take a nap.
Let’s demystify it—you deserve to know who you’re trusting with your story.
1. Therapist vs. Counselor: What’s the Actual Difference?
Here’s the truth:
Most people use “therapist” and “counselor” interchangeably—and in many states, they mean the same thing.
Both terms usually refer to licensed mental health professionals trained to help people with emotional, relational, behavioral, and psychological concerns.
But there is a subtle distinction:
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Counselors often focus on specific problems, skills, or life situations (communication, anxiety management, transitions, etc.).
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Therapists may lean more into deeper emotional patterns, trauma, the past, attachment, and long-term change.
In real life? … We all do a blend. The title often depends on where you’re licensed, not how you practice.
2. Coaches: A Different Lane (Important!)
Coaches are valuable but different.
A coach works with:
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Motivation
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Accountability
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Life skills
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Goals
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Structure
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Growth
What coaches don’t do:
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Treat mental health disorders
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Provide clinical diagnosis
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Work with trauma, abuse, or deep emotional wounds
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Offer therapy or clinical interventions
Coaching is not therapy.
And therapy is not coaching.
Think of coaching like personal training for your goals.
Think of therapy like medical care for your emotional and relational health.
Both can be powerful. They just have very different responsibilities, training backgrounds, and scopes of practice.
3. “Registered Interns” vs. “Student Interns”
These two often confuse people the most, so let’s break it down:
Registered Intern (sometimes called: “Associate,” “Pre-licensed clinician”)
This is someone who:
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Has finished their master’s degree
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Is working toward licensure
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Practices under supervision from a licensed professional
They can provide therapy while they’re accumulating hours and experience.
They usually charge a lower rate because they’re still in the licensure process.
Think of them as licensed-therapist-in-training—but with a degree already in hand.
Student Intern
This is someone who:
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Is currently in graduate school
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Is completing required clinical training
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Works under close supervision
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Cannot practice independently
They’re learning the field, gaining hands-on experience, and supported by their school, their supervisor, and the practice where they train.
They often offer the most affordable way to access therapy.
4. All Those Letters: What Do They Actually Mean?
The letters behind a name often tell you two things:
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Type of license
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Specialized training or certifications
Let’s decode the most common ones you’ll see:
Licenses (state-regulated)
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LMHC / LPC / LPCC — Licensed Mental Health Counselor / Professional Counselor
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LCSW — Licensed Clinical Social Worker
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LMFT — Licensed Marriage & Family Therapist
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PsyD – Psychologist
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PhD — Doctoral-level clinician
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MD / DO — Psychiatrist (medical doctor who can prescribe medication)
These letters mean the person passed exams, completed supervised hours, and is legally authorized to practice therapy in their state.
Certifications & Trainings (specialized)
These are add-ons that show advanced training. Examples:
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CST — Certified Sex Therapist
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RLT — Relational Life Therapy
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EMDR — Eye Movement Desensitization & Reprocessing
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IFS-trained — Internal Family Systems
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Gottman-trained — Gottman Relationship Method
These letters mean the therapist invested extra time and training in a specific modality. They’re not licenses—they’re specialties.
5. So… Who Should You Work With?
Here’s the simplest guide I can give:
Work with a licensed therapist if:
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You want to heal trauma
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You’re navigating anxiety, depression, or emotional challenges
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You need support with relationships, attachment, conflict patterns
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You want long-term internal change
Work with a registered intern if:
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You want therapy at a lower rate
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You like someone who’s learning the newest research and approaches
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You don’t mind them consulting with a supervisor (a good thing!)
Work with a student intern if:
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Cost is a barrier
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You’re comfortable with someone earlier in training
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You want very supported, supervised care
Work with a coach if:
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You want accountability, structure, or motivation
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You want to reach goals
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You’re not seeking treatment for trauma or mental health concerns
No option is “better”—they’re just different.
It’s about matching your needs with the right level of support.
6. Why This Matters
Your mental and relational health is sacred.
Understanding who you’re working with ensures you get safe, qualified care—not confusion, not guesswork, not surprises.
Professional titles shouldn’t feel like a secret language.
Hopefully, now they don’t.
