Differences Between a Mental Health Counselor and a Marriage and Family Therapist

In daily conversations, people often use the terms “counselor” and “therapist” interchangeably. In some instances, more specific terms, like “mental health counselor” and “marriage and family therapist,” might also be used interchangeably.

And while there are many similarities between counselors and therapists, there are also many differences that make them distinct specializations.

This guide discusses the characteristics of mental health counseling and marriage and family therapy careers, including their primary differences, required education, typical job duties, and more.

If you are interested in a career in one of these helping professions, this guide can help you differentiate between the two.

Key Differences: Mental Health Counselor Vs. Marriage and Family Therapist

The differences between mental health counselors and marriage and family therapists go far beyond the different job titles. As outlined below, these mental health professionals have different job duties, different educational paths, and in some cases, different clientele.

Likewise, though mental health counselors and marriage and family therapists might occasionally work in the same setting, there are some differences in work environments as well.

Job Duties

There is a lot of crossover in terms of the job duties for these two professions. Yet, it’s worth looking at their duties in detail to understand the subtle differences between them. Below are some common duties you can expect to perform as a mental health counselor or a marriage and family therapist.

Mental Health Counselor Job Duties

  • Assess clients for behavioral, mental, or emotional disorders
  • Devise treatment plans to address clients’ presenting problems
  • Review treatment plans with clients and caregivers
  • Implement therapeutic treatments that help address clients’ needs
  • Provide feedback to clients regarding their progress
  • Maintain detailed records of sessions with clients
  • Refer clients to other mental health professionals as appropriate
  • Create a discharge plan and implement it when the client is ready to cease counseling

So, what might these job duties look like in real life?

Let’s assume you are a mental health counselor who works in a community mental health setting. Let’s also assume you have a new client, Tina, who you believe to be depressed. Your first step would be to conduct an intake session during which you get to know Tina. You will collect basic information (e.g., age, family history) and begin to discuss Tina’s problems as she sees them.

The next step might be to administer an instrument like the Beck Depression Inventory to help you determine if Tina is clinically depressed. You would also consult the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision (DSM-5-TR), for guidance on the specific criteria she must meet for a mood disorder diagnosis.

Assuming Tina meets those criteria, you would develop a treatment plan – say, five sessions of cognitive behavioral therapy – to address Tina’s depression. You would help Tina change her thought processes throughout treatment to help bring about behavioral change. You would d offer encouragement and guidance while providing critical feedback when necessary.

However, if Tina’s condition required the input of a specialist (e.g., a psychiatrist who could prescribe antidepressants), you would refer her to a physician to do so. Likewise, if Tina shows signs of improving and no longer needs counseling, you would develop a transition plan to help her continue her positive growth on her own.

Marriage and Family Therapist Job Duties

  • Work with couples and families that are experiencing difficulties in life (e.g., divorce, death in the family)
  • Teach clients strategies and skills for better communication, building trust, and decision-making
  • Mediate between clients during therapy as needed
  • Meet with individual members of families as needed
  • Connect clients with community resources and refer them to other mental health professionals as appropriate
  • Maintain detailed records of sessions with clients

Again, how do these job duties play out in real life?

Let’s assume you have begun working with a couple named Rob and Pam, who are having difficulties communicating. As a result, they frequently fight, have misunderstandings, and have developed strong feelings of resentment toward one another.

You might address the communication issue by modeling appropriate ways to communicate. For example, you might play the part of Pam in a role-playing exercise with Rob. Doing so can help you identify breakdowns in Rob’s communication strategies while also modeling appropriate responses for Pam.

In some situations, you might have to mediate between Rob and Pam as they discuss their problems in therapy. You might even request that they bring their children to therapy for some group sessions so that everyone’s needs are identified and met.

But let’s say Rob and Pam’s difficulties go deeper than simple communication breakdowns. Perhaps you identify that they need some parental training. In that case, you might refer them to a local mental health clinic for parenting classes taught by clinicians who specialize in building parenting skills.

Work Environment

Mental health counselors and marriage and family therapists often work in very similar environments. For example, the Bureau of Labor Statistics (BLS) notes that mental health counselors and marriage and family therapists often work in:

  • Government settings (e.g., Department of Health and Human Services)
  • Outpatient mental health centers
  • Individual and family services
  • Hospitals or the offices of health professionals

Many mental health counselors and marriage and family therapists also work in private practice.

However, one difference in the work environments of these professions is that mental health counselors are commonly employed in residential treatment centers.

For example, as a mental health counselor, you might specialize in working with clients who have a substance abuse problem and provide your services in an inpatient drug and alcohol treatment center. Marriage and family therapists are not typically employed in these settings.

The same is true of inpatient treatment centers for severely mentally disturbed individuals. For example, a mental health counselor is much more likely to specialize in working with institutionalized clients with a psychotic disorder than a marriage and family therapist.

Education

On the one hand, mental health counselors and marriage and family therapists have similar education requirements in that a graduate degree or higher is required. Similarly, both must be licensed by the state in which they practice. However, there are some differences that make the educational journey for these careers a little bit different.

Mental Health Counselor Education Requirements

Generally speaking, to become a mental health counselor, you must satisfy the following requirements to be licensed:

  • Graduate from an accredited mental health counseling program
  • Complete post-graduate supervised clinical work
  • Pass a licensure exam
  • Pay applicable state licensure fees

However, since licensure requirements vary from state to state, the specific education requirements for licensure might vary. It’s important to check with your state’s licensure board for specific details.

National certification bodies, like the National Board for Certified Counselors (NBCC), outline much more specific educational criteria that apply to counselors in all states. For example, to become a National Certified Counselor (NCC), you must:

  • Have a master’s degree, an educational specialist degree, a certificate of advanced study, or a doctoral degree in mental health counseling. The credential must be from a CACREP-accredited program.
    • Alternatively, you can graduate from a counseling program at institutionally-accredited schools, provided the program includes at least 48 semester credits (72 quarter credits) of graduate-level coursework and a supervised field experience in counseling that’s at least six semester credits (10 quarter credits).
  • Complete coursework in the following areas:
    • Helping Relationships in Counseling
    • Career Counseling and Lifestyle Development
    • Research and Program Evaluation
    • Human Growth and Development Theories in Counseling
    • Social and Cultural Foundations in Counseling
    • Group Counseling Theories and Processes
    • Professional Orientation to Counseling
  • Participate in a minimum of 100 hours of counseling supervision over two or more years.
  • Submit an endorsement from a professional colleague who graduated from a master’s program in a mental health field.
  • Complete 3,000 or more hours of post-graduate counseling work over two or more years.
  • Adhere to NBCC’s ethical policies.
  • Pass the National Counselor Examination or the National Clinical Mental Health Counseling Examination

Marriage and Family Therapy Educational Requirements

To become a marriage and family therapists, you must meet the following broad criteria for licensure in most states:

  • Have a master’s degree from an accredited institution
  • Complete 2,000-4,000 hours of supervised post-graduate clinical work
  • Pass a licensure exam
  • Pay an application fee

Again, these requirements vary somewhat from state to state. More stringent requirements must be met for certification. For example, to become a Clinical Fellow with the American Association of Marriage and Family Therapists (AAMFT), you must:

  • Be a member of AAMFT
  • Have a master’s degree or higher in marriage and family therapy or a related field
  • The degree program must include coursework in the following:
    • Human Development
    • Professional Ethics
    • Marriage and Family Therapy
    • Marriage and Family Studies
    • Research
  • Complete a 300-hour supervised practicum during your degree program (if your program doesn’t require this many hours, you can finish the remainder after you graduate)
  • Complete at least two years of professional marriage and family therapy work, including 1,000 client contact hours with 200 hours of supervision. All work must be supervised by an AAMFT supervisor.

Which One is Better? Mental Health Counselor or Marriage and Family Therapist?

Ultimately, whether mental health counseling or marriage and family therapy is best depends on the individual and the situation. Think of it like this – a Jeep and a Ferrari have a lot in common, yet their utility is very different. If you want to go off-roading, the Jeep is the better choice. If you want to drive fast on the Autobahn, the Ferrari is the much better selection.

If your passion is helping people with wide-ranging mental health issues like depression, work-related stress, or personality disorders, mental health counseling is a better career path. The broad-based approach of mental health counseling enables you to work with many different types of clients with many different needs.

On the other hand, if the family unit is of more interest to you, marriage and family counseling is likely the better option. Though marriage and family therapists can work with clients on many mental health issues, focusing on the dyadic relationship and family dynamics makes it a better option for people who want to work with couples and families.

These are just two examples, but you get the point – the best approach to helping others is the one that best suits their particular needs at that specific moment in time. In many cases, that might mean that marriage and family therapy is the best approach right now, but mental health counseling might be a better approach down the road. Sometimes, clients even participate in both at the same time!

Are Marriage Counselors and Marriage Therapists the Same?

From a broad view, marriage counselors and therapists are extremely similar. For example, both have similar goals to help clients resolve problems in their lives and improve their mental health. As another example, marriage counselors and therapists might use similar techniques (e.g., role-playing, communication exercises) to help couples work through their issues.

Having said that, the biggest difference between marriage counselors and therapists is that counseling usually refers to short-term interventions. In contrast, therapy usually refers to treatments that last anywhere from several weeks to several years.

For example, a marriage counselor might meet with a couple for three sessions to teach them parenting techniques for a child on the autism spectrum. Conversely, a marriage therapist might meet with a couple for six months to help them work through trust issues after one person cheats on the other.

Ultimately, though, counselors and therapists are guided by the principle of using their expertise to improve the lives of others. The pathway to improved mental health might look different, but counselors and therapists are well-equipped to attend to the needs of their clients just the same.

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