Licensed marriage and family therapists (LMFTs) and licensed clinical social workers (LCSWs) are required to have an advanced education, be licensed to practice, and provide comprehensive psychological treatments to their clients. In many cases, an LMFT and LCSW might even work with very similar clientele.
But beyond this baseline of similarities are far more differences that make these professions distinct areas of practice. This guide offers a detailed look at these and other differences so you better understand what these mental health workers can provide you with if you need psychological treatment.
Likewise, this guide outlines the differences between LMFTs and LCSWs if you wish to pursue one of these areas of study.
LMFT Vs LCSW
LMFTs specialize in family and relationship counseling. LCSWs provide a broader range of services, including individual therapy, crisis intervention, and case management. Both require advanced degrees and state licensing but focus on different aspects of mental health and support.
Differences in Job Duties
While both LMFTs and LCSWs strive to help their clients work through psychological difficulties, they do so in different ways and with different goals.
An LMFT has a relatively narrow focus on the dynamics between couples and families. As such, they spend the majority of their time working with couples and families to improve the functioning of the family unit. So, for example, an LMFT might use role-playing techniques that encourage family members to express their feelings and be open to others’ points of view to improve communication among family members.
Let’s consider another example: a family whose dynamics are out of balance because of an overbearing father. In this situation, the LMFT might provide individual counseling to the father to help identify why he feels the need to be controlling and explore ways to let go of that need to be in control all the time.
Likewise, an LMFT might provide psychoeducational training to the rest of the family that teaches them how to address the father’s controlling behavior in a supportive, loving, and helpful manner.
Contrast these family-specific examples with the broader purpose of an LCSW. Where the goals of marriage and family therapy might be to improve the family dynamic and the psychological functioning of family members, the goal of social work is typically to improve the broader multi-system functioning of a client.
So, assume you are having difficulty finding a job. As a result, you feel down on yourself and perhaps even depressed. In this situation, you might see an LCSW for psychological treatment for your depression. But they might also provide job training and connect you with local resources for overcoming employment difficulties.
Moreover, a social worker might help you search for jobs, help you prepare a resume and cover letter, or administer an interest inventory to help you narrow down the field of potential career pursuits that fit you best. At the same time, they might refer you to a psychotherapist for more intensive psychological treatment of your depression and any underlying issues that have contributed to your depression.
As an another example, let’s say, you are a single parent of two children, struggling with balancing work, childcare, and mounting bills. Lately, you have been feeling overwhelmed, and your oldest child has been having behavioral issues at school. Upon meeting with an LCSW, they would provide a judgment-free zone where you can voice your concerns and stresses. They would offer coping strategies to manage your stress and may suggest therapy sessions for your child to address behavioral challenges.
Additionally, the LCSW could guide you towards local resources for financial assistance, parenting classes, or afterschool programs, ensuring that both you and your family receive holistic support.
Now, recognizing the family dynamics at play, you decided to also consult an LMFT. The LMFT in this case would focus on strengthening the bonds between you and your children, improving communication, and addressing any child-parent tensions. They’d offer family therapy sessions, providing tools and techniques for conflict resolution and fostering understanding.
With the combined expertise of the LCSW and LMFT, a family is better equipped to face challenges holistically.
Differences in Work Environment
The work environments for LMFTs and LCSWs are often quite similar. In many cases, you will find LMFTs and LCSWs working in private practice (e.g., as self-employed therapists), community mental health settings, rehabilitation facilities, and hospitals. Many government agencies (e.g., Health and Human Services, Family Services) also employ LMFTs and LCSWs.
Having said that, a primary difference between LMFTs and LCSWs is that LCSWs have a broader range of work environments. A good example of this is that detention facilities often employ LCSWs to provide psychological services to prisoners. LMFTs, on the other hand, typically don’t work in that environment.
Moreover, the social services component of social work means that LCSWs often work for aid organizations, like food pantries and homeless shelters. This isn’t to say that an LMFT can’t work in these settings; it’s just more common for LCSWs, who tend to provide more holistic services and collaborate with other professionals and organizations on a more frequent basis.
LCSWs commonly work in school settings as well, usually with special needs children. An LCSW might provide psychological treatment for the child in addition to advocating on the child’s behalf in the school setting, collaborating with parents and guardians to obtain proper services for the child, and helping train teachers to work more effectively with special needs kids.
Differences in Education
As noted earlier, LMFTs and LCSWs both require an advanced education and a license to practice. In both cases, the educational journey begins with a bachelor’s degree, which often requires four years of full-time study.
Usually, future LMFTs major in marriage and family counseling or psychology, though child development, social services, social work, or even communications are worthy areas of study as well. Most graduate-level programs that prepare you for a career as an LMFT do not require a specific undergraduate degree, though you might have to complete prerequisite courses if your undergraduate studies aren’t closely related to psychology.
An LCSW, on the other hand, most commonly majors in social work at the bachelor’s degree level. Doing so makes the transition to a master of social work program far easier. Again, if your undergraduate studies are in another field, you will likely have to complete prerequisite courses before beginning the master’s program in earnest.
In either case, pursuing a graduate degree in one of these fields will probably take two to three years of study. Many classes overlap between these degrees and often include coursework in psychological assessment, diagnosis, and treatment.
Moreover, both types of graduate programs include a significant field experience requirement, usually in the form of at least one practicum and one long-term supervised internship.
Where graduate programs in marriage and family therapy and social work diverge, though, is in the scope of study. Prospective marriage and family therapists have a narrower focus of study on treating psychological problems in the couples and family context. Prospective social workers further prepare for providing services to individuals and groups in clinical and non-clinical settings, collaborating with social services and other government agencies, and advocacy.
Once LMFTs and LCSWs complete the required education for their respective careers, a period of supervised professional practice is required. The specific requirements of supervision vary between the two careers and also vary from one state to the next. However, in both cases, it’s a common requirement to complete 2,000 or more supervised post-graduate hours over the course of a year or more before a full license is granted.
Can LMFT Diagnose Personality Disorders?
Yes. Part of an LMFT’s scope of practice is to assess, diagnose, and treat mental disorders of all kinds, not just personality disorders.
What LMFTs cannot do is prescribe medications or diagnose physiological conditions. Typically, if an LMFT feels like medication is a viable option for one of their clients, they will work with a psychiatrist or other medical professional who can prescribe medications. This is done to ensure their client has access to the necessary medicines to help treat their personality disorders or other mental health conditions.
Is Being an LMFT Stressful?
Though an LMFT’s job is often highly rewarding, it can also cause significant work-related stress. Helping guide couples and families through difficult times requires a lot of focus and resolve, but exploring deep emotional wounds, psychological illnesses, trauma, and the like, with one’s clients can be extremely emotionally taxing.
One of the keys to being an effective LMFT while also minimizing the amount of stress you feel is to have professional colleagues you can consult and decompress with. For example, let’s suppose you are working with a family that has experienced trauma in the past and struggles to trust one another as a result. But you are finding it difficult to break through these barriers with the family, and you are beginning to feel the pressure of stagnant sessions in which little to no progress is made.
By consulting with a colleague and sharing your experience, you can achieve a couple of very important things. First, talking through your process with your clients can help you alleviate some stress by “blowing off steam” with someone who thoroughly understands what it’s like to be a therapist. And second, venting your frustrations might lead to a productive discussion in which your colleague has advice or insights that can help you and your clients get unstuck.
Of course, there are other ways of dealing with work-related stress. The standard advice to eat right, get plenty of rest, and avoid substances that interfere with your functioning (e.g., caffeine, nicotine, and other drugs) applies here. So too does the advice to get regular exercise.
So, while this is definitely a stressful job, there are ways to overcome that stress in a healthy and productive way. You just have to be willing to take the necessary steps to do so, much like you ask your clients to do!
Which is Better? LMFT or LCSW?
If you are instead contemplating whether you wish to become an LMFT or LCSW, the answer to “which is better” really comes down to your specific interests and skills.
On the one hand, if working with couples and families piques your interests, pursuing a career as an LMFT might be the better of the two options. Likewise, if focusing mostly on assessing and treating mental health disorders and the effect those disorders have on relationships, becoming an LMFT makes a lot of sense.
Then again, if your interests are in providing a wider range of services to your clients by working with local and state agencies, non-profits, and other organizations, a career as an LCSW might be more rewarding. You might also consider a career as a social worker if you’re especially interested in social justice and serving clients that historically have been marginalized.
As with any major life decision, the path you take depends in large part on taking the time to reflect on the kind of professional you want to be. Once you do that, you can set out to get the necessary education and training to fulfill your career goals.
How Much Does an LMFT and LCSW Earn?
As of September 2023, the average annual salary for an LMFT and LCSW is $93,100 and $92,145 respectively. Top earning LMFTs and LCSWs earn over $150,000 per year.
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