Being a therapist can be an extremely gratifying career. You spend your days validating, supporting, and helping people make meaningful differences in their lives.
You may feel overwhelmed when you first start exploring your different career options. As you have probably realized, therapists have different specialties and niches. They work with all kinds of populations and in many different settings.
Here are some of the most popular types of therapists and what you can expect in that type of work.
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Common Therapist Degrees
In the United States, licensed therapists must have at least a master’s degree to practice. In addition to their degree, they also need to complete postgraduate education and pass state board exams.
Therapists may hold the following titles:
Licensed Clinical Social Worker (LCSW): LCSWs often examine how larger societal systems impact individual functioning. They often provide liaison support between clients and community-based resources. They may work with vulnerable populations such as children in foster care systems, homeless people, and people in prison. However, many of them also work as therapists in settings like nonprofit facilities, community mental health, and private practice.
Licensed Marriage and Family Therapist (LMFT): MFTs work within a systemic framework in treating individuals, families, and couples. Instead of viewing problems individually, they take relationship dynamics into account. They may work in a variety of settings, including community mental health centers, hospitals, schools, and private practice.
Licensed Professional Clinical Counselor: (LPCC): LPCCs focus on treating the needs of clients with the emphasis on improving individual mental health. However, they may also work with families, couples, and groups. LPCCs work within many settings, such as rehabs, crisis centers, schools, hospitals, and private practice.
Licensed Psychologist: Licensed psychologists are doctoral-level practitioners who also help clients improve their emotional health. Some psychologists can prescribe medication (although this varies state by state). Psychologists can also conduct psychological assessments and testing for their clients. Licensed psychologists are employed in schools, healthcare facilities, government agencies, and private practice.
Advanced Practice Registered Nurse (APRN): APRNs can assess, diagnose, and treat mental illnesses. In some states, they can also prescribe medication. In addition to offering clinical treatment, APRNs play a profound role in psychoeducation and maintaining preventative healthcare. APRNs often work in healthcare settings, but they may also have their own practices.
Psychiatrist: Psychiatrists are medical doctors who can prescribe psychiatric medication and provide therapy. In general, psychiatrists undergo the most schooling and training, as they must obtain an undergraduate degree, finish medical school, and complete a four-year residency. Psychiatrists typically work in healthcare settings, although many also own their own practices.
Common Therapist Specialties
Therapists work with people with all kinds of presenting problems and mental health needs. In this work, you will never quite have the same day! That said, here are some common areas of focus therapists may choose to specialize in.
Children and Adolescents
Children can experience trauma, behavioral issues, or challenging family dynamics that affect their well-being. Unfortunately, many people overlook these problems and assume that children are naturally resilient. Child-based therapists help children understand their feelings and cope with distress appropriately. Sometimes, these therapists also work with family members to provide parenting support. These therapists primarily work in child-based settings. These can include schools, mental health clinics, hospitals, the child’s home, and private practice offices.
Over 21 million Americans struggle with addiction. Addiction therapists help clients recover from substance use disorders and behavioral compulsions. They implement concepts rooted in psychoeducation, alternative coping skills, relapse prevention, and building positive support.
Addiction therapists often work in hospital-based settings, drug or alcohol rehab centers, state-funded facilities, or private practice.
Trauma therapists help clients understand, identify, and heal from trauma. Trauma is a broad concept that includes emotional, sexual, or physical abuse. Trauma may also result from medical emergencies, natural disasters, or witnessing severe hardships. Trauma therapists may offer acute support after a crisis. However, many of them also help clients who experienced a trauma that occurred many years ago. They often use interventions rooted in mindfulness, reframing, and desensitization to help clients cope.
Depression affects millions of people worldwide. When left untreated, the symptoms can become downright debilitating. Depression therapists help clients struggling with mild apathy to severe suicidal ideation. They often utilize interventions rooted in changing negative patterns, increasing self-esteem, implementing healthy coping strategies, and building a positive support system.
Anxiety disorders are the most common conditions in the United States, affecting nearly 20% of the population. Anxiety disorders include generalized anxiety, panic disorder, social anxiety disorder, and specific phobias. Therapists specializing in anxiety help clients understand their triggers, reduce stress, and implement healthy coping skills.
Grief and Loss
Grief and loss therapists help clients process and heal from loss. People grieve death, but they also grieve losing jobs, moving, losing friends or family, or losing parts of their identity. Grief therapists help clients reconcile these complicated feelings in a safe and supportive environment. Some of these therapists also facilitate bereavement groups.
Therapists can help clients struggling with relationship issues, such as infidelity, trust, sexual dysfunctions, and divorce. Some therapists work exclusively with couples by improving communication and restoring a sense of intimacy. Others provide individual support for clients without their partners present.
Many clients come to therapy because they lack healthy self-esteem. This can be the case even without a specific mental health condition. Therapists can help clients understand the issues impacting their self-esteem. They also empower people to make decisions that positively impact their well-being.
Life transitions can include graduating school, starting a new job, entering a new relationship, starting a family, or relocating. While these changes can be exciting, they can also be stressful and taxing. Therapists can help provide support during this time. In addition, they help clients cope with the related stress and uncertainty associated with their change.
Many clients enter therapy because they simply want to understand themselves better. Maybe they want a deeper awareness of who they are or why they do what they do. This desire can coincide with having a mental health condition, but it’s also sometimes just a part of being human. Therapists help clients understand their motives, patterns, and values, which supports people to feel more authentic in their everyday lives.
Common Therapeutic Orientations
Most therapists adhere to a specific theoretical orientation to guide their interventions and treatment plans. A theoretical orientation refers to how a therapist perceives human behavior. Some therapists utilize a variety of orientations in their practice- this is typically known as having an eclectic framework.
Cognitive-behavioral therapy (CBT) is one of the most well-known types of treatment. CBT examines the relationship between feelings, thoughts, and behavior. The notion is that negative thinking patterns often lead to uncomfortable emotions and poor responses. Challenging problematic thoughts can, therefore, help people feel better.
Psychodynamic therapy focuses on how past experiences and relationships contribute to current functioning. Psychodynamic therapy explores concepts rooted in family dynamics and early childhood. This work can cultivate insight and help clients understand their motives. Over time, that process can lead to a healthier emotional well-being.
Narrative therapists focus on identifying and rewriting the stories clients tell themselves. The idea is that stories give meaning and shape how people live. Rewriting problematic stories can help empower clients and observe themselves more accurately. Externalizing certain issues also allows people to give themselves space between themselves and their unwanted behaviors.
Humanistic therapy focuses on themes of unconditional positive regard and honoring true authenticity. Humanistic therapists operate from the mindset that people are inherently good and entirely competent to make the right decisions. They believe showing clients genuine respect- while also teaching concepts of self-acceptance and self-compassion- can help them heal.
Solution-focused therapists aim to provide immediate relief for clients. Instead of examining past patterns, they help people look forward to identifying the changes they want to make. They will then support people in recognizing the potential barriers (whether real or perceived) that might impact progress.
Expressive therapists integrate alternative interventions over talk therapy. These therapists may use play, art, psychodrama, dance, or other movements to help clients understand their emotions. Some of them also use animals, such as dogs or horses, to promote companionship and safety.
How Do You Decide Which Type of Therapist You Should Be?
Even if you know all the similarities and differences in this field, you may struggle with deciding how to structure your career. First, it should be noted that there isn’t a perfect choice. Every therapist is different, and what one practitioner loves may seem dull or uninspiring to you.
In addition, therapy is a fluid field. You aren’t locked into any specific preference. Many therapists start their practice working with one type of population only to discover they prefer another kind.
However, if you feel stuck, here are some pointers to consider.
Expose Yourself to Different Kinds of Therapy
It’s normal to feel uncertain about where you want to work when you’re early in your career. You may benefit from working with a variety of clients during this time. Consider looking for an internship or job at a community mental health clinic. This setting tends to generate clients with many different backgrounds, and you will ideally get a better understanding of your therapeutic preferences.
Consider Which Clients Interest You the Most
What clients seem the most exciting to work with? If you’re already working in the field, where do you feel the most passion or motivation? Paying attention to those trends may give you insight into where your specialties and focus lie.
Seek Specialized Training
If a specific model or population interests you, consider taking advanced training in it. You will gain a deeper insight into how the treatment works, and you will leave feeling more confident applying it. This is also a great strategy if you aren’t sure if a certain approach is for you. After taking the training, you may realize that it’s not your preference, and that’s okay, too!
Get to Know Other Therapists
Networking is an important part of this job. However, it’s also important to acquaint yourself with like-minded therapists working in settings that interest you. It may be worth connecting with a few providers to pick their brain to see what they like and dislike about their jobs.
Be Open to Change and Growth
Your niche or preference may come to you after several years of working in the field. That’s normal for many industries, including therapy! It’s important to stay open and curious about your career. Don’t assume you know your exact path. Certain client interactions or career experiences may surprise you!
There’s no doubt that becoming a therapist is exciting and rewarding. You are on the frontlines of helping people, and your work makes a meaningful difference in bettering our society.
However, the work, at times, can also feel overwhelming and complicated. This is especially true if you are in the beginning stages, or if you are considering changing jobs.
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