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Clinical and Counseling
— and Licensure


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Page Contents: General Psychology / Clinical Psychology / Counseling—and Counseling Psychology / Coaching / Licensure (MD, RPN, LCSW, MFT, Psychologist) / What does “ABD” mean? / Additional Resources


YOU MIGHT ASK  the simple question, “What is the difference between clinical psychology and counseling psychology?” The answer, however, is not at all simple because psychology can be applied in many different ways. Some persons who study psychology end up practicing as counselors, some practice as psychotherapists, and some practice as psychologists. To make it even more complicated, some psychologists use techniques of psychotherapy and some use techniques of counseling. So let’s try to disentangle some of these elements.

Introduction: General Psychology

We humans are social creatures, and most of our behavior takes place in a social context. Accordingly, the science of Sociology studies our social—or collective—behavior. But each of us, as an individual, is motivated not just by social rituals but also by mind and free will. Therefore, if you want to focus on community social functioning as it is affected by medical care and mental health functioning, you would study the field of Social Work.

Now, if you want to understand how the mind works biologically—that is, if you want to understand the mechanics, so to speak, of the nervous system—you would study the field of medicine called Neurology or the branch of psychology called Biological Psychology.

You could also study the physiology of sensation and perception, and that could take you into the associated field of General Psychology. Those who take this path usually end up in academic psychology (also called Experimental Psychology), teaching or conducting research. This research can be applied to everyday life in an almost infinite variety of ways. On example would be the application of human factors research to the design of machines to make them more “user friendly.”

And then, of course, all this knowledge can be applied clinically.

Is a psychotherapist just a “paid friend” 
or an “emotional prostitute”?


Clinical Psychology—a (very) short history

Textbooks often use the phrase “the science of behavior” as a definition of psychology. Well, behavior is a very broad concept that can include all sorts of influences, both rational and irrational. Systematically studied as a rational science, the study of individual behavior began in the study of human and animal perception under the influence of such men as Willhelm Wundt, the “founder of modern scientific psychology.” 

Lightner WitmerThe practical application of this psychological knowledge began when those principles of animal and human perception were first applied in the field of education by Lightner Witmer [1] when he inaugurated the first psychological clinic in 1896; as this initial practical application of psychology grew, it expanded its clinical applications to the treatment of various mental health disorders.

The word clinic derives from the Latin clinicus, a bed-ridden person or a physician who attends patients sick in bed. A clinic, therefore, is a place where sick patients are treated. So, in the literal sense, Clinical Psychology is concerned with the work of treating “sick” patients. In the broader, contemporary sense, however, clinical psychology involves teaching about, research about, or treatment of persons with any of the common mental health disorders. (Today, we understand that someone with a phobia, for example, is not literally “sick in bed.”)

As clinical psychology grew, it became strongly influenced by the treatment principles of psychoanalysis which place a large emphasis on unconscious functioning. Although the whole story is quite complicated, the various forms of clinical treatment that emerged in the mid-20th century through the associations with, and reactions against, psychoanalysis resulted in what we now collectively call psychotherapy.


If you’re wondering, “What does a psychologist do?” see Reasons to Consult a Psychologist for a sampling of the many sorts of treatment issues in clinical psychology.


Usually, the degrees associated with clinical psychology are the traditional Ph.D. (Doctor of Philosophy) —which involves training in both clinical treatment and research—and the newer Psy.D. (Doctor of Psychology)—which emphasizes clinical training and minimizes training in research.

Getting a graduate degree in clinical psychology, however, is only part of the story. If a person wants to provide clinical services (such as psychotherapy) to the public as an independent practitioner (as opposed to teaching or conducting research), the person must receive a license. Persons with doctorates in clinical psychology usually become licensed as Psychologists. Persons with master’s degrees in clinical psychology usually become licensed as Marriage and Family Therapists. (See below, under Licensure.)


If you’re wondering, “How does someone become a psychologist?” see To Become a Psychologist for a description of the process required to earn a doctorate in clinical psychology and then become licensed as a psychologist.



Counseling—and Counseling Psychology

The concept of counseling (in British English it is spelled counselling) has actually been around for ages, and it reflects the need for one person to seek out help or advice from another person. Counseling as a professional occupation, therefore, derives not from the clinic but from more social settings. It focuses on helping persons resolve problems or role issues related to work or school or family matters. In this setting, the counselor is a “problem solver” who through direct advice or non-directive guidance helps the client make rational decisions.

Here are some general characteristics of counseling.

It is concerned with “normal” problems rather than mental health problems.

It is concerned with role functioning, with choices to be made, and with actions to be taken.

It is more concerned with present events than with past events.

It is more concerned with conscious, rational thinking than with unconscious functioning.

Counseling has traditionally been associated with the field of education (M.S. or M.S.E. or Ed.D.), although some counselors may have bachelor’s or master’s degrees in psychology. In addition, many psychology programs offer degrees, most usually the Ph.D., in Counseling Psychology, a branch of psychology specifically concerned with the practice of counseling. Moreover, many counseling psychologists receive training in vocational psychology, an aspect of psychology that, through personal guidance and vocational testing, helps individuals discover a fulfilling and productive work life.

Even though counseling programs usually teach the various theories of psychotherapy, training and supervision in the practice of psychotherapy usually is not part of the education for counseling; accordingly, personal psychotherapy is usually not an academic requirement. In general, whereas psychotherapy tends to involve a complex change in basic character and often works with unconscious conflicts, counseling tends to be more limited and more concerned with the immediate situation. Still, many counselors disagree among themselves about the distinction between counseling and psychotherapy; some training programs in counseling psychology, for example, may put a large emphasis on psychotherapy.

A person with a doctoral degree in counseling may become licensed as a Psychologist; a person with a master’s degree in counseling may, in some states, become licensed as a Licensed Professional Counselor. (See below, under Licensure.)



Since you might find persons advertising themselves as providers of coaching, I will give a brief description of this relatively new practice.

Coaching, like counseling, is meant to help “healthy” clients, but instead of helping them solve problems, coaching focuses on helping persons utilize their abilities more effectively than they have previously. Advertising jargon would call this “achieving your full potential.”

Here are some general characteristics of coaching.

Appointments are usually conducted by telephone.

It can focus on personal work, but it is usually used in business settings with executives.

It tends to help persons achieve personal and business goals.

Although specialized training may be needed, no specific degree is required and no license is needed to practice coaching.



In the U.S., all states have licensing laws as a way to guarantee to the consumer a minimal standard of education and training that must be met by practitioners who sell their services to the public in independent practice. These laws vary from state to state, so see below in Additional Resources for links (categorized by type of practice) to the various regulating boards.

There are many settings, however, in which a person with any of various degrees might work as a “counselor” or “psychotherapist” without a license:

Drug and alcohol counselors and residential treatment counselors who work for large agencies, or in hospitals, are examples. Many of these persons have only bachelor’s degrees. In these cases, “counselor” is a job title, not a license to practice independently.

There are some states in the U.S. in which a person with a master’s degree in education or psychology may practice counseling or psychotherapy without a license.

A validly ordained Catholic priest who is actively serving his Ordinary (bishop or provincial) can practice counseling as a part of his pastoral functions. Some Protestant ministers and Rabbis can also provide counseling within the context of religious duties. Also, any one of these persons who has received an advanced degree in psychology or education and who has received supervised clinical training in psychotherapy may ethically practice psychotherapy within the pastoral role.

Many states in the U.S. allow individuals to practice counseling with a license.

Licensed Professional Counselor (LPC). An individual with a master’s or doctoral degree in counseling or a counseling-related field from an accredited college or university, and who has acquired the requisite hours of supervised practice, may become licensed as an LPC in certain states.

Then, there are many different licenses under which individuals may practice psychotherapy.

Psychiatrist. A psychiatrist has an MD degree and is licensed (in California by the Medical Board of California); by virtue of his or her license to practice medicine, he or she can perform psychotherapy (or psychoanalysis, with the proper training from a psychoanalytic institute).

Psychiatric Nurse. A psychiatric nurse (RPN), by virtue of his or her license to practice nursing, can perform psychotherapy (with proper training) in some settings, but not independently (except for an Advanced Psychiatric Nurse).

Psychiatric Technician. These persons (licensed in California by the Board of Vocational Nursing & Psychiatric Technicians) must practice under supervision in settings such as hospitals, correctional facilities, and residential care facilities; they cannot practice independently.

Social Worker. A person who has a master’s degree in social work (MSW), and who has acquired the requisite hours of supervised practice, may become licensed as a Licensed Clinical Social Worker (LCSW) and practice independently as a psychotherapist. In California, LCSWs are licensed by the Board of Behavioral Sciences. (Also, in California, an Associate Clinical Social Worker (ASW) can perform psychotherapy while working under the supervision of an LCSW in order to accrue supervised experience before becoming licensed.)


According to California regulations, “LCSWs are authorized to employ psychotherapeutic techniques, among other services, with individuals, couples, families, and groups to improve the clients’ quality of life.” (What does quality of life mean? In practice, it can be stretched to mean anything. So be careful.)


Marriage and Family Therapist. There are states, such as California, in which a person who has received a master’s degree in clinical psychology, and who has acquired the requisite hours of supervised practice, may become licensed as a Marriage and Family Therapist (MFT)—and most MFTs usually call themselves psychotherapists as well. In California, MFTs are licensed by the Board of Behavioral Sciences. (Also, in California, an MFT Intern can perform psychotherapy while working under the supervision of an MFT in order to accrue supervised experience before becoming licensed.)


According to California regulations, “MFTs are authorized to employ psychotherapeutic techniques with individuals, couples, families, and groups to improve the clients’ interpersonal functions.” The intent of the law was to provide an alternative to psychologists, so that less educated, and therefore less expensive, service providers might work with non-psychiatric interpersonal issues. But when everyone—even a person with a psychiaric disorder—has interpersonal functions, some MFTs can stretch the laws to do anything they want. Consequently, because such practitioners charge less for their services than psychologists, they are routinely paid to treat psychiatric issues they are not qualitied to treat. And managed care companies are quite happy to stretch their profits thereby. So be careful.


You might occasionally find a psychotherapist who has a Ph.D. degree but only an MFT license, as in Jane Doe, Ph.D., MFT. Such a case can be deceptive and calls for caution, for two reasons.


This person might have a Ph.D. in a field totally unrelated to psychology, such as anthropology, while the degree allowing the MFT license is only an M.A. in psychology.


This person might have the Ph.D. in psychology but was unwilling—or unable—to pass the Psychologist licensing examinations and so took the easier MFT exam.

Psychologist. The title Psychologist (in the U.S.) is usually protected by state law; that is, a person with a degree in psychology can’t be called a “psychologist” unless licensed as a psychologist by a state. In California, psychologists are licensed by the Board of Psychology.

Yet when states license psychologists they generally don’t care if the person has a degree in clinical psychology or counseling psychology or education. So in most states a person with a psychologist license can legally do clinical work or counseling work, regardless of training or type of degree. In California the degree must be a doctorate, but in some states a person with a masters degree can be licensed as a psychologist.


In California, both a Registered Psychologist and a Psychological Assistant are specific forms of registration by which an unlicensed person can perform limited psychological functions to accrue hours of supervised professional experience.
A registered psychologist can be registered only at a nonprofit community agency and must possess (a) a doctoral degree which qualifies for psychology licensure and (b) at least 1500 hours of qualifying supervised professional experience.
A psychological assistant need not have any experience but must have at least a qualifying master’s degree in psychology; a psychological assistant can be employed and supervised by a licensed psychologist (or a board-certified psychiatrist) in a private setting.
For more information about registered psychologists and psychological assistants, see the website of the
California Board of Psychology.




Because of all the confusion described above, it is not at all uncommon for counselors, psychotherapists, and even psychologists to attempt to treat problems for which they have not been specifically—or adequately—trained.

As a consumer, therefore, you should know (a) what degree, (b) what license (if any!), (c) what training, and (d) what sort of personal psychotherapy your psychotherapist or counselor (or whatever) has received.

You should also understand that psychotherapy and counseling, because of their different origins and purposes, have different ethics.


What does “ABD” mean?

In essence, it means “A Big Deception.” Well, seriously, it really stands for “All But (the) Dissertation,” and it refers to the fact that someone who is trying to earn a Ph.D. has completed “all” [2] the coursework but has not yet written the doctoral dissertation—a large piece of original research—that is required to complete the degree.

Of course, many persons have difficulty completing a dissertation, for a variety of reasons, and it’s not necessarily a sign of academic failure to be struggling to complete a degree. Still, an incomplete degree is no degree, and there can be no respectable reason to pretend otherwise.

Nevertheless, some psychotherapists-in-training feel so insecure about having an incomplete degree that they will make business cards with ABD after their names, to mislead their clients, as if the ABD were a title. But those three letters, despite having the appearance of something official, are neither a degree nor a license.

So, when someone cannot just accept incompleteness honestly, but feels driven to hide it by using “ABD,” then it’s all a big deception meant to obscure academic failure.

And that leads to a chilling thought. When a psychotherapist-in-training is caught up in unconscious victimization and entitlement, what chance do his or her clients have to learn how to live honest lives?



1. McReynolds, P. (1987). Lightner Witmer: Little-known founder of clinical psychology. American Psychologist, 42, 849–858.
2. Actually, the dissertation is part of the coursework for a Ph.D., so unless the dissertation has been completed, the student has not completed all the coursework.


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Additional Resources
Biological Psychology:
Psychology Jumping Stand: Biological Psychology
The Coaching & Mentoring Network
College of Executive Coaching
American Counseling Association
American Association of State Counseling Boards
Canadian Counselling Association
National Board of Certified Counselors
Experimental Psychology:
Experimental Psychology Society
History of Clinical Psychology:
Classics in the History of Psychology
Classics in the History of Psychology — Witmer (1907) —read one of Witmer’s papers.
History of Clinical Psychology
History of Psychology Archives
Marriage and Family Therapy (MFT):
American Association for Marriage and Family Therapy  provides information and resources for marriage and family therapy.
California Board of Behavioral Sciences  oversees licensing of MFTs, LCSWs, and LPCs in California.
Directory of State MFT Licensing Boards  provides the regulated titles and addresses of state boards regulating marriage and family therapists.
American Academy of Neurology
Pastoral Counseling:
The American Association of Pastoral Counseling  provides information about pastoral counseling.
Psychiatric Nursing:
Board of Vocational Nursing & Psychiatric Technicians  oversees licensing of nurses in California.
Psychiatric Technicians:
Board of Vocational Nursing & Psychiatric Technicians  oversees licensing of psychiatric technicians in California.
The American Psychiatric Association  represents all member psychiatrists, and its site provides extensive information about psychiatry.
The Medical Board of California  oversees licensing of physicians in California.
Academy for the Study of the Psychoanalytic Arts  —“To advance the study of psychoanalytic epistemology, theory, practice, ethics, and education within a psychological framework consisting of philosophy, the arts, and the anthropic sciences as opposed to biology, medicine, and the natural sciences.”
The American Psychoanalytic Association  represents all member psychoanalysts.
The Lacanian School of Psychoanalysis  in the San Francisco Bay area, offers training in Lacanian psychoanalysis.
Psychoanalysis  by Wolfgang Albrecht, in Berlin; provides links to pages with information related to Psychoanalysis.
The San Francisco Psychoanalytic Institute  is a psychoanalytic training institute in San Francisco.
The San Francisco Society for Lacanian Studies  provides information about training in Lacanian psychoanalysis.
Lacan Related Papers  provides links to numerous Lacan-related papers.
Lacanian Links  provides links to Lacanian sites and is an extensive resource for Lacanian articles and papers.
Association of State and Provincial Psychology Boards  —Roster for U.S. and Canada. Find your state’s Board of Psychology to learn its requirements for licensure as a psychologist.
The California Board of Psychology
CALIFORNIA BUSINESS AND PROFESSIONS CODE 2900-2918 —the “Psychology Licensing Law”
The California Psychological Association MCEP Accrediting Agency  provides information about continuing education for psychologists in California.
Divisions of the American Psychological Association  lists the various divisions of the APA and will give you an idea of the many varied applications of psychology.
Social Work:
California Board of Behavioral Sciences  oversees licensing of MFTs, LCSWs, and LPCs in California.
Clinical Social Work Federation, Inc.  is maintained for clinical social workers and those with an interest in their services.
Related pages within A Guide to Psychology and its Practice:
Other Applications of Psychology
Questions and Answers about Psychotherapy
Reasons to Visit a Psychologist
To Become a Psychologist
Types of Psychological Treatment
INDEX of all subjects on this website
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Therefore, if my work has been informative and helpful to you, please send a donation in appreciation, even if it’s only a few dollars, to help offset my costs in making this website available to everyone without advertising.

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Raymond Lloyd Richmond, Ph.D.
San Francisco
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Psychology is a complex subject, and many issues are interrelated. And so, even though you may find a topic of interest on one particular page, an exploration of the other pages will deepen your understanding of the human mind and heart.

Psychological Practice
To Become a Psychologist
Choosing a Psychologist
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Honesty in Psychological Treatment
Legal Issues
The Limits of Psychology
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Other Applications of Psychology
Psychology: Clinical and Counseling
Psychology and Psychiatry
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Termination of Psychotherapy
Types of Psychological Treatment
Clinical Issues
Becoming a Nonsmoker
Depression and Suicide
Diagnosis in Clinical Psychology
Dream Interpretation
Fear of Flying: Information
Hypnosis and “Negative” Hypnosis
Medical Factors Affecting Psychology
Medication Issues
Psychological Testing
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Reasons to Consult a Psychologist
Repressed Memories
The Psychology of “Stress”
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Types of Psychological Treatment
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Throughout this website, my goal is simply to help you realize that although life can be painful, unfair, and brutal, it doesn’t have to be misery.
The practice of good clinical psychology involves something—call it comfort—which does not mean sympathy or soothing, and it certainly doesn’t mean to have your pain “taken away.” It really means to be urged on to take up the cup of your destiny, with courage and honesty.








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A Guide to Psychology and its Practice



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