Licensed vs. Unlicensed

Lately I have found myself answering questions from clients about the difference between a licensed counselor and one who is not licensed. This is actually a good question, as many people do not know what is involved to become licensed. So, I thought it might help if I outlined what I have been sharing with these clients. (Licensure requirements differ from state to state, and I highly recommend contacting your state licensing board for specific requirements for your state.)

Hours of training Licensed professionals (LPs) are required to complete more supervised training hours during their degree process, and then are required to complete 2000 to 4000 hours of supervised counseling before being awarded a full, unrestricted license. (The amount varies by state.) This is similar to the process doctors go through before becoming eligible to legally practice medicine (albeit nowhere near as long). Once a therapist has become fully licensed, you can be assured that therapist has performed thousands of hours of counseling under the supervision of a state board-approved (in most states) supervisor. That person knows what they are doing…and if they don’t, they have an extensive network they can turn to for guidance, referrals and direction.

Supervision hours In most states, licensed professionals are required to be supervised for an extended period of time prior to being issued an unrestricted license. And although this supervision is not required once a full license is issued, most licensed professionals continue their association with their supervisors and the network they built up during that time as a source of support, referrals and professional resources.

Specific training in mental health disorders LPs have undergone specific training in mental health disorders, which is required by most (if not all) state licensing boards. Just about anyone can call themselves a “counselor” with little to no training (and many do!). The licensing process requires the LP to have received extensive education and training in identifying, diagnosing and treating all known mental health disorders. All state licensing boards also require LPs to take and pass at least one national exam in order to show proficiency in the identification, treatment and diagnosis of mental health disorders. LPs also have extensive training and education in evidence-based theories and therapy treatments. This means an LP is knowledgeable in treatment processes that have been empirically proven to be effective. This increases the client’s chance of a successful therapeutic course.

Confidentiality protection LPs are held under the laws outlined in The Health Insurance Portability and Accountability Act of 1996 (HIPAA). This means clients have legal recourse that can be taken if a breach of confidentiality happens, whether on purpose or by accident. This protects client confidentiality further by providing protection of confidential information beyond simply the word of the therapist/counselor. An unlicensed professional may be able to testify against you in a court of law without your permission or knowledge, whereas a licensed professional is bound by both ethics and HIPAA to not only notify you of potential release of confidential information (not just to the legal system, but any release of information), but they must also have your prior permission to do so. Should a release of information occur without your prior knowledge or permission, there are several avenues that can be pursued, including HIPAA, the state licensing board and the state’s board of ethics. These avenues are not available in the case of an unlicensed counselor.

Regulated by the state LPs are regulated by their state licensing board, which includes approval of supervision, adhering to ethical standards, and maintaining continuing education. Many boards require their contact information be made available to clients prior to beginning counseling for the purpose of directly filing complaints against the LP, such as breach of confidentiality or ethics.

Insurance possibilities LPs are eligible to be placed on many insurance boards and be reimbursed for insurance payments. While current statistics show that about half of licensed mental health professionals choose not to participate in insurance, this is by choice. Finding an LP who accepts insurance can make counseling easier to afford.

Continuing education LPs are required to participate in regular continuing education as set forth by their state licensing boards. This ensures the LP remains up to date on current trends and research in their field.

Liability insurance LPs are required to carry liability insurance, which not only protects them from malpractice, but gives clients yet another level of protection against any mistreatment.

Certificates Some unlicensed counselors will advertise or indicate they have acquired certificates in certain areas of fields of mental health. These certificates are a great way of indicating continued education and training in their specialty or fields of interest. However, they are not equivalent to a license. There is no regulating body associated with the certificates, and no required continuing education to maintain the certificate. Certificates are a good way of verifying the person you have chosen to see for counseling has or is working towards expertise in their fields.

There are many unlicensed counselors available who are very talented and gifted in what they do. A license does not guarantee the counselor/therapist is better than an unlicensed one. What the license does do, however, is offer protection, for both the client and the counselor/therapist. In the event something goes wrong or the client is mistreated, the client has governing bodies to turn to for help. It can also assure a potential client that the therapist has extensive training and education in the mental health field. It indicates this person has undergone the requirements of their state to qualify to be licensed. A license is just one aspect to factor in when considering a counselor/therapist.