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LMHC vs LCSW, masters questions

Discussion in 'Psychology [Psy.D. / Ph.D.]' started by lakewood, Apr 22, 2007.

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  1. lakewood

    lakewood

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    These questions got no response on the doctoral forum... maybe I will have better luck here?

    Can someone tell me the pros and cons of becoming a LMHC? How does this differ from a LCSW? How does a general masters in clinical psychology differ?
  2. pingouin

    pingouin just chillin' Administrator SDN Senior Moderator

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    my state doesn't have an LMHC (that I've ever seen, anyway), so I'm not familiar with that.

    what kind of degree would one have to sit for that exam? MA Counseling? MEd Counseling? Is it similar to an LPC/LCPC?
  3. lakewood

    lakewood

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    I have encountered it while looking into the Boston University masters program in mental health and behavioral medicine. As far as I know, this is a very unique program (not sure if there are any quite like it). I have not looked into masters degrees much in the past, and quite frankly, the various credentials seem like a random jumble of letters to me (obviously exaggerating, but you get the point). So I am now trying to learn what it's all about. The BU program is intriguing because of its uniqueness, and it offers potential licensure as a LMHC.

    However, I don't really know the limitations of a license in counseling, or of any masters-level degree for that matter, since I have primarily looked into doctoral programs in the past. I would really appreciate if someone would tell me, though.

    According to the program's web site:

  4. lakewood

    lakewood

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    Also, according to the handout I have for their open house:

    So what are the pros and cons of being licensed for mental health counseling?

    The program is rather pricey, so I also wonder, how might the job prospects for this credential be as well as general salary trends?
  5. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty Moderator Emeritus

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    I've seen: LMHC, SW, LSW, LCSW, etc. I 'think' LCSW is towards the top end for credit requirements, but I couldn't really tell you which would be better. I"m guessing the LCSW would also address SW needs (duh), which is probably where some of the credits go, but again....this is more speculation than fact.

    -t
  6. lakewood

    lakewood

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    I am thinking that anything ending in "SW" is different than anything ending in "MHC". I would imagine a social work credential would be a separate field than a mental health credential... perhaps a LMHC is just the masters level of the same track as a PhD in counseling psychology?

    But I don't know. I still don't understand the differences between masters degrees in psychology, clinical psychology, counseling, and social work. Which programs yield which certifications, licenses, and opportunities? Does ANYbody here know?
  7. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty Moderator Emeritus

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    LMHC is a terminating degree (meant for licensure). It is not on the same track as a PhD.

    -t
  8. pingouin

    pingouin just chillin' Administrator SDN Senior Moderator

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    ok, going to answer these as best as I can.. with the caveat that I know nothing about MA licensure in general. I did go to their website, as well as BU's, so here's what I can glean-

    (and as I'm finishing this up, I realize it's becoming alphabet soup, so if anyone's getting confused, please ask!)

    exactly. The MA LMHC seems to be the equivalent of the LPC/LCPC in other states. Both are governed via the National Board of Certified Counselors (NBCC).



    From the looks of their curriculum, it doesn't look too drastically different than most of the counseling programs in my area. A more medical emphasis, sure.. but it seems like it's the equivalent of doing a general Masters in Counseling with all medically-related electives. Which is intriguing, I agree. It just makes me wonder if there are similar electives at other programs which may not be so pricey. Kind of a create-your-own if you will..

    You asked a question essentially about scope/definition of practice for masters-level. From the MA website, here are the two primary masters-level licensure definitions of practice:

    As you can see, they're pretty similar. I was surprised to see "organizations and communities" mentioned in the LMHC but not the LICSW as that's typically a social work-y thing, but then I realized that those things would not fall under "clinical" social work. Rather, there's a whole set of social workers with no interest in clinical/mental health work whatsoever who are wonderful at that stuff. Also interesting to see the medical exclusion under the LICSW definition.. makes me wonder who was doing something they shouldn't have been doing. :laugh: (I've never seen that before in a definition, and I've reviewed several states' licensing regs as I've considered moving states.)

    I freely admit to strong bias toward the MSW.. interestingly, I've never met a social worker who said they wished they had done counseling instead.. but I've met several counselors who wish they would have chosen the social work route. Their reasons have been primarily due to job accessibility and security. (see below)

    yes on both counts. SWs have their own regulatory boards in most states.

    First things first:

    The degrees are: BSSW/BSW, MSW
    The licenses are: LSW/LBSW, LCSW/LICSW

    and for counseling
    no BS-level degree in counseling, no licensure available
    Degrees: MA Counseling, Masters in Counseling, MEd Counseling, various others
    Licenses: LPC, LCPC, LMHC (apparently)

    In my (again, very biased) opinion, the MSW is a bit more of a known quantity, as the Council on Social Work Education accredits the programs and mandates a core curriculum. And one of the requirements of licensure in every state I've looked into has been that the degree be from a CSWE-accredited school. Plus, the ONLY degree which can obtain a LCSW/LICSW is a MSW. So as a general rule, if you're hiring a MSW and/or LCSW, you know what their background is. (Of course, electives, practica, and work experience are important as well.) It is my understanding- and if someone knows differently, please feel free to correct me- that the curricula at counseling schools tend to vary more as there are multiple similar degrees- MEd Counseling, MA Counseling, MCounseling, etc- which all sit for the LPC/LMHC exams. So there's a lot more variability going on, and an employer may not know exactly what they're getting. It's debatable whether that's of any actual importance as they are so similar, but.....

    I would propose that this difference is part of the reasons why Medicare will reimburse LCSWs but not LPCs/LMHCs at this point. My theory is that because of the more cohesive background, the NASW has been able to advocate more strongly to get things passed while the NBCC is trying to pull together folks from several fields and hasn't gotten it done yet. They are working on it, though, but it's been several years.

    This issue does come into play occasionally.. couple of anecdotes- I was working for a CMHC where a LPC in my department was running DBT groups and one of my clients would have really done well with that. Except she had Medicare and no ability to pay for the services out of pocket, so she couldn't go. Same agency- the state cut the budget for mental health services, leading to a slash in our funding. There was talk of laying off someone in our department (adult psychotherapy). I had the least seniority, but they were going to keep me (LCSW) and cut the person ahead of me (LPC) because I could generate revenue from the same resources as her, PLUS Medicare.

    Complaints from some of my counseling friends include the Medicare thing, but also that they can ONLY do counseling jobs, whereas the MSW allows me to transition to do medical SW, or organizational, administration, advocacy, adoption, children/families... etc etc etc. So there have been several positions they wanted to apply for and were not able to do so.

    Something to consider.

    I've got other soapboxes sitting around, but I have to get up in 6 hours. :)
  9. pingouin

    pingouin just chillin' Administrator SDN Senior Moderator

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    a link to make the alphabet soup slightly more understandable. maybe.
  10. lakewood

    lakewood

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    First of all, thanks for all of the info!

    Secondly,

    The information I have received from BU states that the program prepares students "as an independent private practitioner eligible for insurance reimbursement."

    Would this not include Medicare, then?
  11. pingouin

    pingouin just chillin' Administrator SDN Senior Moderator

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    most private insurances, yes. Medicare, no. not right now, anyway.
  12. Womanonajourney

    Womanonajourney

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    I am currently finishing up my BSW and considering switching from SW and pursuing a graduate degree in Community & Agency Counseling or Rehabilitation Counseling? Who has better job prospects---more marketability? Does where you graduate from really matter, for instance The University of Texas-Austin's School of SW is ranked #10. . .my current school has not been ranked in years and even then it was only in the top 50s but the university itself is high ranking and well recognized. Please help!!:confused:
  13. pingouin

    pingouin just chillin' Administrator SDN Senior Moderator

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    Rehab counseling is probably more limiting, setting you up for jobs with vocational rehabilitation and similar agencies and very little other stuff in my experience. I supervised a rehab couns masters student once at a community mental health agency, and she did NOT have the educational background to be working there.

    Regarding prestige, I don't really think it matters a whole lot as far as getting jobs later. It's usually not asked about by either employers or clients. Just make sure the program is accredited by the appropriate body, or it could make licensure a pain later on.

    There was an interesting article in Social Work a few months ago in which they looked at the importance and validity of rankings. When they switched around who was doing the rankings (ie, USN&WR vs a bunch of SW deans), they got VERY different results. It's pretty much all subjective. As with medicine, the USN&WR social work rankings should be taken with a grain of salt.
  14. iawv

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    Hi, All:

    Thought I'd chime in on this one. There are undergrad programs in counseling (I have one). Before we begin putting down the training of counselors, I think we need to put things in perspective. Counselor licensure is the newest of the mental health professions (it only started in the 1970's). We've made a huge amount of progress since those times. We have licensure in every state but two---and this will change soon. Counselors aren't eligible to bill for Medicare because of the lobbying efforts of social workers and psychologists to stop this from happening. It is all about limiting who can provide services (i.e., territorialism), not the quality of training. Family therapists have in the past fought the same fights! I believe this will change.

    Speaking as a counselor educator, our training is as rigorous as other mental health professions. Let's put an end to this rumor because it is very tiring---social workers are not better trained than counselors. Anectotal accounts mean nothing (I could provide several personal observations about the poor training of social workers). However, I believe that it is time to stop this territorialism (i.e., our profession is better than yours) and focus on providing good mental health services....with which ever degree you may possess.

    Dr. Jim




  15. pingouin

    pingouin just chillin' Administrator SDN Senior Moderator

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    Great post, Dr. Jim. Did not know about the bachelors in counseling- do you have a link for similar programs? I'm also curious what a bachelors-level counselor would do.. scope of practice, et al.

    Please note that other than my comment on rehab counseling, I never made any references to masters-level counselors having inferior training to social workers. Didn't do that because I don't think that. My comments were directed at post-grad practice issues. Due to the reasons you cite regarding counseling (younger profession, lobbying issues), I believe there are some logistical issues as to why it's easier (not better) to be a social worker. Within mental health, social workers and counselors are typically working side by side in the same positions. However, when one ventures outside of mental health, it is more difficult for a counselor to find employment. It is in large part the difference between the 2-years MH education counseling programs and the 1-yr generalist/1-yr counseling clinical social work programs. If I am not mistaken there are some other differences in training such as required field placement experience, however I'll defer to you on what is required of a counselor.

    Regarding my rehab counseling comments, my student was not qualified to work in mental health because her training was in disability, health and vocational issues, and mental health played only a fraction of her training. The degree from that school did not allow their students to sit for the LPC, therefore it was an inappropriate placement to have she and her two classmates doing individual and family therapy outside of a rehab setting. Again, this is not a knock on rehab counselors, as they are wonderful at what they do (and require a lot of patience to do it). It's questionable in my mind whether that training is appropriate for clinical mental health work. In the same vein, I wouldn't want a social worker who trained in administration or community planning doing therapy, either. Just having a MSW does not make one qualified to do therapy. Having a masters in counseling does, though. :)
  16. mftPsychSoc

    mftPsychSoc

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    From the posts I've read it sounds like the MSW(LCSW) is much more marketable than an MA in counseling(LMHC/LPC). Is this generally the same for LCSW vs LMFT's as well? Also, when it comes to the job market, is this trend apparent? And out of curiosity are there instances of LCSW going for training in MFT or MHC to get additional licensure as LMHC's or LMFT's?

    I'm interested to find this info out b/c I'm thinking of pursuing an MFT or MHC program, and don't want pursue MHC or MFT with blinders on, and not research any MSW programs(especially if I can get additional licensure in MHC/MFT later).
  17. pingouin

    pingouin just chillin' Administrator SDN Senior Moderator

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    I would support that the MSW is the most flexible of the masters-level degrees. The majority of the positions I've ever held or applied for were for LCSW or LPC. There aren't a lot of LMFT's in my area, so I *think* they're considered equivalent but don't know much about them. It was my understanding that some LMFTs run into problems finding positions where the majority of clients are individuals, because their training focuses on the MFT end of things. Please, someone correct me if I'm wrong on that.

    Where I've seen the specific MSW requirements are for positions which are not *specifially* designated as mental health. As an example, one of the hospital systems I work for uses MSWs and MA/Couns for their behavioral health intake assessors, and for some of the therapists on the behavioral health units. However, on the medical floors- doing psychosocial assessments- it has to be social workers- no counselors, no MFTs. I believe this has to do with accreditation and Medicare issues. At the other hospital, I do forensic child abuse evaluations in the ER- again, MUST be a social worker- my boss is not able to hire a counselor. Clinically, there's no reason a counselor couldn't learn to do those assessments- it's because of the degree.

    Regarding additional training, I could do a post-masters MFT certification if I chose to, but I'd rather repeatedly gouge my eyes out with a fork than do couples counseling. There would be no need to get another license, however. It'd be pretty redundant.
  18. michalita

    michalita New Member

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    :eek:

    Ow. Just envisioning the fork-in-the-eye thing. Ow.
  19. pingouin

    pingouin just chillin' Administrator SDN Senior Moderator

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    that's what it's like for me sitting across from a couple- ow. no thank you. go to someone else who wants to do that.

    I'll keep my bipolar borderline not-quite-teenager-not-quite-adults, thankyouverymuch. :)
  20. PsyKardinal

    PsyKardinal

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    I am an LPCintern (just recently completed my 3000 hours of internship). My experience has been that as to the job market in the Dallas/Ft Worth area and most of Texas that the LPC and LCSW are fairly neck and neck. In a hospital setting the SWs have an advantage when it comes to medicare. Medicare will not reimburse for the LPC. In an outpatient basis were more therapy is conducted vs referral and assessment I have seen that most places aim to hire the LPC. Granted take this for what it is worth, just my experience. As to LMFT you are limited in the MFT role and therefore you have a smaller share of the market place to find work.

    As pingouin stated having an LPC or LCSW and then seeking further certification in MFT would be redundant. An LPC or LCSW can do the MFT stuff. My best advice is two fold. Look to the state you want to practice in and determine which has the broadest scope of practice, then look at the philosophies that are incorporated in LPC or LCSW and go with what fits to you the best. In the long run I think that you will find either LPC or LCSW will be a wonderfully difficult challenge that culminates in being able to help others and fulfillng your career aspirations.

    Good Luck

    Jeff
  21. mftPsychSoc

    mftPsychSoc

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    Thanks for the input, and if I do end up choosing MFT, (or just generally working with couples/families) hopefully I won't resort to self mutilation of the eyes:D.

    Some of the wacky comments I read, put together with some really good info and pointers always seems to keep drawing me back for more. And to think i found sdn on accident!:laugh:
  22. michalita

    michalita New Member

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    I agree with PsyKardinal.

    In the northeast, the LICSW is quite a bit "stronger" than the LMHC, mostly because it has a longer tradition there. I believe Pingouin lives in the same state as you, so you can take her advice with that in perspective. I have heard that the LPC is pretty strong in Texas (like PsyKardinal said) but when it comes to NY or MA, the MSW/LICSW has a bit more momentum behind it.
  23. michalita

    michalita New Member

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    Hmm, that's the population that's driving me a bit, er, crazy right now :p Mostly because I need way more training to learn how to more effectively work with them, but regardless... I actually enjoy working with them when I feel like I'm being effective (isn't that a given??)

    :laugh:
  24. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty Moderator Emeritus

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    I have a soft-spot for borderlines.....so more work for me!
    Last edited: Dec 5, 2010
  25. Steven James

    Steven James

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    An LCSW is a licensed clinical social worker. A LMHC is the newest addition to the field of mental health. They are highly similar and can do most of the same things with few exceptions. One thing to keep in mind is that because the LMHC lincense is so new, there are fewer in number in the field. During residency training for licence, a MHC in training can be supervised by a LCSW or a LMHC. However, I am not sure if a LMSW can receive supervision from a LMHC in order to obtain the LCSW. LCSW's are more widely known in th MH field, thus this license can receive less resistance when applying for job.
  26. nashvegas

    nashvegas

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    What I have found is LCSW is probably the best in comparing it with the other. LCSW you have more options job wise, but also more insurance copies will cover and handle. That is just the differences I have learned and found.
  27. nashvegas

    nashvegas

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    Also, just as someone else mentioned on here. It is true that for your LCSW you have to be supervised by someone who has their LCSW. With the LMHC you can be supervised by an LCSW, Phd, or almost any other clinical license
  28. PizzaButt

    PizzaButt New Member

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    I am interested to hear what people would say the philosophies are for the master's in counseling vs. MSW. I am leaning toward counseling but also wonder whether the MSW would be better because it seems to be the more flexible degree.
  29. hoggercore

    hoggercore

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    I got my bachelors degree in counseling psychology from Keene State College in Keene, NH. It basically allowed me to work for non-profits and as an in-home therapist. There are other creative roles I was able to play but it basically led me to living paycheck to paycheck. Not a lot of money in the field really (no matter which direction you go - lets be honest).

    I then got my MSW from Smith College in Northampton, MA. I got the MSW instead of going for the LMHC because I felt that 1. The school was really focused on psychotherapy and I wanted to focus on that, 2. Having an LICSW (Licensed Independent Clinical Social Worker) after your name warrents a lot of credibility (for example LICSW's are now able to file Section 12s - that is the form needed to hospitilize someone against their will - prior to this only MDs were able to perform this action). A LMHC cannot perform this function. Just the same, both an LICSW and an LMHC might have the same educational equivalency. 3. the MSW was way more diverse than was the LMHC. Jobs seem to be more readily available for an MSW (LCSW and LICSW) than are LMHCs. 4. I have seen professors at Universities with only a LICSW teaching classes but not with LMHC (not sure if that's just a coincidence or if LMHCs are able to teach at a graduate level).

    If you want to do any mental health work, I'd suggest going with the MSW simply for the diversity of the field.

    And as for going for a degree in Clinical Psychology, I would advise looking into the classes required for an MSW degree and a Clinical Psychology degree. See how they compare. My guess is that there might be more of a focus on psychotherapy as a whole with Clinical Psychology, but that there will be more training on services and diversity sensitivity with an MSW. With that, I have to believe though that over all there will be more varied jobs available to the MSW than the MA.
  30. hoggercore

    hoggercore

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    To obtain your hours needed for your LICSW, you have to log supervision while you're an MSW or and LCSW from an LICSW ONLY. Hours from an LMHC do not count...or they're not supposed to anyway...

  31. CuriousWeasel

    CuriousWeasel

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    I am finishing my M.S in Mental Health Counseling (LMHC) this spring after onslaughts of classes ranging from Cognitive Assessment Administration all the way down to starting a successful practice...not to mention countless hours of residency. I have to say that if anyone says my education is inferior or less then an SW I would say you are debating a mute point.
    Both degrees, any mental health based degree actually, are all great and we are just trained in different aspects of mental health. We need to understand that the "elders" of our professions are fighting a turf war that we newer professionals should step out of for it only causes bitter rivalry and clients in the end suffer.
    As for the ability to do different things with what degree it is completely open. Lets say you are becoming a MSW, I am sorry but my training in psychotherapy is a lot more comprehensive. This is the same as a MSW's ability to help advocate for clients using resources is better then my training. We are trained differently, however, this is not to say that either one cannot be trained to gain competency in the others proficiencies or that one profession is better then another. You are only bound to what you will not or what you think you cannot learn. I want to be able to prescribe at times, my training does not let me do this and nor would I be trained to do so, thus instead of trying to fight I am going after my masters to Med School to gain competency so I can add this to my therapy bag. You are only bound to what you will not do or what you think your limitations are in a degree.​
  32. BSWdavid

    BSWdavid

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    A lot depends on what program you attend as quality isn't universal regardless of whether it is social work or counseling. There are some excellent clinical swk programs that focus almost exclusively on psychotherapy, and there are others that don't. Similarly, while counseling programs tend to focus more directly on counseling, this doesn't mean that the program produces better therapists. Choose the program with the best reputation, and don't focus as much on whether it is a swk or counseling program. The licenses are quite similar in regards to scope of practice.
  33. Shayforte

    Shayforte

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    I also have been contemplating whether to get my master's in Social Work or "Mental Health Counseling in Schools and Communities". I am currently working on my undergrad in Rehabilitation Counseling at Penn State, and would like to stay here for Grad School. The problem is, Penn State doesn't offer a master's program for Social Work. The master's in mental health counseling in schools and communities would lead to a LPC and then I could get an addictions studies certificate... ultimately I want to work as a drug and alcohol counselor in a high school.

    Which would be best, A master's in social work leading to a LMSW, or the master's in mental health counseling in schools and communities along with an addictions studies certificate?
  34. mfema

    mfema

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    I'm applying now to MSW programs. My recommendation is that you take the GRE (take a prep course, regardless of how strong you think you will do) and apply to the program at your school and other local programs that offer the MSW. Not knowing your age, if you are ever thinking about doing teaching or research then consider a Ph.D, Psy.D. I'm older and I have no intent on doing either. Make the decision between the MSW and the Penn State Master's only if you get into both programs. If you only get into one or the other, the decision is made.

    For my two cents, I'd recommend you talk to a local counselor and also a local LCSW about career outlooks, regrets, recommendations, and insurance panels.

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