How to Become a Therapist: From High School to Full Licensure
Take a moment to recall your high school career day. There are doctors, firefighters, police officers, politicians, and every other profession under the sun. You’ve got a general idea of what you want to do for a living. You like helping people, but you get squeamish at the sight of blood. You’ve got great listening skills and are emotionally warm, but you’re unsure if you want to become a teacher. The job “Therapist” keeps getting thrown around a lot. Your friends and family can easily see you in a stylish cardigan, taking notes, and helping people have healthier lives. The idea appeals to you, but it’s left you with a question: “How does one become a therapist?”
Anyone that you ask bombards you with college questions, asking if you’ll get your PhD (do you need that for this job?), if you’ll work with kids, what kind of therapist you’ll want to be, etc., etc. It’s enough to make your head spin. Everyone has a lot of questions for you, but none seem to be able to answer your fundamental question of the process of becoming a therapist.
When I was seven years old, I made the decision to become a therapist. This life changing decision came after watching far too much Law & Order and a general desire to know why people did the things they did. From every career day forward, whenever anyone asked what I wanted to be, I always said the same thing: I want to be a therapist. However, I didn’t know how to be a therapist, what a therapist really did, or all the education that was required to become a licensed therapist. I went into my education blind and I really wished that I had someone to help me. The path from high school to college, to LPC-A, to fully licensed can be extremely overwhelming. So, here’s a handy guide, designed to help you navigate through the process. By the end of this guide, you’ll have a clear roadmap to becoming a licensed therapist and know exactly what steps to take next.
Is Becoming a Therapist Right for You?
A therapist counseling a client
A lot of people interested in becoming a therapist, enter into the field with the general idea of “I just have to listen to people” and to an extent, you do, but you will be doing so much more. You’ll be doing research into the latest clinical techniques, you’ll be attending conferences, handling documentation, making medication decisions, taking courses to keep up with your education and that’s just scraping the surface on the day to day tasks. With clinical work, things will become more intense. People come to therapy because they need help. The extent of help that they need won’t become apparent until after the intake and then a few sessions. You’ll learn how to process vicarious trauma, be stunned at the level of cruelty that people experience, and learn how to manage symptoms from depression, anxiety, suicide ideation. The work is hard, but the rewards are astounding. You’ll get to see people make genuine progress in their lives, manage their emotions that once ruined their lives, and engage in daily intellectual stimulation. Being a therapist can be a deeply emotionally rewarding career, but you will need to have the right personality traits in order to thrive in this field. Below, I’ve got a list of general traits that will help you determine if this is the career for you.
You can be empathic without losing yourself in your client’s personal issues
You have a genuine interest in the lived human experience.
You are comfortable with not knowing and uncertainty.
You are willing to examine your own emotions, thoughts, and motivations.
You are okay with slow progress
You can set and maintain boundaries
If you’re still questioning if becoming a therapist is for you, then here is a list of traits that this career path might not be for you.
You’re uncomfortable with people crying
You prefer to have a black and white worldview.
You struggle with receiving feedback
You don’t want to go to therapy
Here are a few questions that will help you decide if this career is for you.
Do I have a support system in place?
Am I okay with being a lifelong learner?
Am I okay with not having all the answers?
Am I okay with having a modest starting income?
If you can answer all of these questions with a resounding yes, then congratulations, you have what it takes to become a therapist. But a therapist is just one part of the overall mental health world. While this article focuses solely on becoming a therapist, it’s important to know the other important types of mental health professionals that you will be interacting with. In any path that you will choose, you will need at a minimum a bachelor’s degree in either psychology, sociology, or a related field.
Licensed Professional Counselor
Education: Masters in Counseling/Clinical Mental Health
Settings: Private practice, community mental health, universities, and schools
Career Focus: Individual, couples, family, group therapy
Licensed Clinical Social Worker (LCSW)
Educational: Masters in social work
Settings: Private practice, community mental health, universities, and schools
Career Focus: Policy and advocacy and with a strong emphasis on developing interpersonal and life skills
Licensed Marriage and Family Therapist (LMFT)
Education: Masters in marriage and family therapy
Settings: Private practice, agencies, clinics
Career Focus: Specialized training in couples and family systems
Psychologist (PhD/PsyD)
Education: Masters in marriage and family therapy
Settings: Private practice, agencies, clinics
Career Focus: Specialized training in couples and family systems
Psychiatrist (MD/DO)
Education: Masters in marriage and family therapy
Settings: Private practice, agencies, clinics
Career Focus: Specialized training in couples and family systems
To break it down even further and help you determine your career path: If you want to do clinical testing, become a psychologist. Are you interested in policy and making changes in existing systems? Become a social worker. Do you primarily want to do therapy? Become an LPC/LMFT. Are you interested in medication and healthcare? Become a psychiatrist. I’ll provide a deeper dive into each career pathway, but it is helpful to know the difference and to be aware of the general expectations for each profession.
For therapists, better known as a Licensed Clinical Counselor, the path is fairly straightforward. You’ll need to graduate from high school and enter into a bachelor’s degree program. To finish your bachelor’s degree at an accelerated rate, some high schools offer dual credit with a linked college. Taking these classes during high school will not only lower your overall college cost, but it will save you time in pursuing your overall career goals. Despite what some may say, it is impossible to become a licensed therapist, psychiatrist, psychologist, or social worker without the appropriate education level. To improve your chances of getting into your desired graduate school, you will want to focus on volunteering with vulnerable populations, building relationships with your professors, and getting involved in research opportunities.
Once you have completed your bachelor’s degree, you are then able to start your master's program. Each masters program is not created equal and not everyone will thrive in the same environment. Online programs have grown in popularity since COVID-19 and have remained as a vital entry way for adults who work full time and do not have the flexibility for in-person classes. However, some people will need the structure of in-person classes and have the focus of developing their relationships with others in their classes. Important items to look for in a quality program include, but are not limited to: CACREP, faculty research focus, full-time/part-time option, financial aid package, practicum and internship sites for training and utilizing your clinical skills on a specific population, in addition to preparing you for licensure exams like the NCE (National Counselor Examination).
A young woman studies for the NCE exam
During your masters program, you will learn the basics of counseling theory, basic and advance counseling skills, how to take documentation, and be given the opportunity to explore specializations. After the two years of your masters program, should you choose to focus on it full time, you will then spend your third year of the program in a practicum and internship. This is where you will choose a counseling site (most students will need to find their own sites. Your masters program is not obligated to help you land a site. You will need to do this on your own.)
Your practicum and internship is where you will begin to utilize the skills that you have learned in your program. You will officially see clients in, hopefully, a warm and supportive environment. This is, in my opinion, where a majority of the personal and professional development occurs. Studying counseling is far different than actually counseling. You will get to experience the stressful but educational moment of a person needing you and you having to be a stable force in the room. Throughout your practicum and internship, you will earn direct and indirect hours. These hours are required in order to graduate and will be required to have appropriate documentation by your faculty or your site supervisor. I strongly recommend that every student keeps a back-up of their hours and has their hours signed on a weekly basis. You will need to protect your hours because if you don’t have your hours in place, you will not be able to apply to your state licensure board without them.
Once you have completed your masters program, you will officially be a therapist...sort of. Your license will be LPC-A which stands for Licensed Professional Counselor Associate. This licensure shows that you have completed the necessary education to perform your duties as a therapist and that you are completing your direct and indirect hours for full licensure. Being an LPC-A is very similar to being a practicum/internship student. You are required to keep track of your direct and indirect hours which you will need to have for applying for full licensure. Until you have completed your hours for full licensure, you will be practicing counseling under the supervision of a Licensed Professional Counselor Supervisor. While the states have a varying amount of direct and indirect hours to accrue for full licensure, most will spend a minimum of two years learning and expanding their skill set, expanding their clinical interests, and exploring career options.
After two years of hard work and dedication, then you will finally become a fully licensed therapist. Your career then becomes your own and you are able to practice, explore, and develop your clinical skills as you see fit.