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Understanding the Letters After a New York Therapist's Name
· Couch Commons
What LCSW, LMHC and LMFT mean in New York: the education, exam and supervised experience each license requires, what each may do, and the rules all three share.
When choosing a therapist in New York, you may see different acronyms after their name, such as LCSW, LMHC, or LMFT. These letters indicate the specific license the professional holds, which determines their education, training, and scope of practice. Understanding these distinctions can help you find the right fit for your mental health needs.
LCSW: Licensed Clinical Social Worker
The title LCSW stands for Licensed Clinical Social Worker. In New York State, only licensed social work professionals may legally use this title. To become an LCSW, a professional must complete a Master of Social Work (M.S.W.) degree that includes clinical courses. They must also have three years of post-degree supervised experience in clinical social work and pass a clinical licensing examination.
LCSWs are qualified providers of psychotherapy services. They may provide all social work services, including clinical services such as:
- Diagnosis of mental, emotional, behavioral, developmental, and addictive disorders
- Development of treatment plans
- Provision of psychotherapy
One specific detail to note is that an LCSW’s registration certificate may start with the letter "R" to designate eligibility for insurance purposes. This is a designation on the certificate itself, not a letter added to the professional's name.
LMHC: Licensed Mental Health Counselor
The title LMHC stands for Licensed Mental Health Counselor. Only licensed mental health counselors, and certain others exempt under the licensing law, may practice this profession. However, none of these exempt individuals may use the title of licensed mental health counselor unless they are also licensed.
To become an LMHC, a professional must have a master's or higher degree in counseling (or equivalent). This degree must include required coursework in mental health counseling theory and practice, assessment, psychopathology, ethical practice, and a supervised internship. Additionally, they must pass a State-approved exam and complete at least 3,000 hours of post-degree clinical experience under the supervision of a qualified, licensed mental health professional. Note: These requirements apply to all LMHCs except those licensed under special provisions established in law for those already practicing when the new law came into effect, who meet other standards specified in law and regulation.
It is important to know that licensed mental health counselors may not prescribe or administer drugs or use any invasive procedure, such as surgery, therapeutic ultrasound, or electroconvulsive therapy.
LMFT: Licensed Marriage and Family Therapist
The title LMFT stands for Licensed Marriage and Family Therapist. Similar to LMHCs, only licensed marriage and family therapists, and certain others exempt under the licensing law, may practice this profession. Exempt individuals may not use the titles of licensed marriage and family therapist, licensed marriage therapist, or licensed family therapist unless they are also licensed.
To become an LMFT, a professional must have a master's or higher degree in marriage and family therapy (or equivalent). Required coursework includes marriage and family theory and practice, assessment, ethical practice, and a supervised internship. They must also pass a State-approved exam and complete at least 1,500 client contact hours of clinical experience under the supervision of a qualified, licensed mental health professional. Note: These requirements apply to all LMFTs except those licensed under special provisions established in law for those already practicing when the new law came into effect, who meet other standards specified in law and regulation.
Like LMHCs, licensed marriage and family therapists may not prescribe or administer drugs or use any invasive procedure, such as surgery, therapeutic ultrasound, or electroconvulsive therapy.
Common Requirements for All Three Licenses
While the education and experience requirements differ, all three licenses share several common regulatory requirements in New York:
- Registration Certificate: All three types of professionals must display a current New York registration certificate that lists the licensee's name, address, and dates of the registration period.
- Reregistration: All three must reregister every three years to practice in New York.
- Record Keeping: All three must keep client or patient records for six years or until the client or patient turns 22, whichever is longer.
Additionally, for LMHCs and LMFTs specifically, there is a requirement regarding serious mental illnesses. In cases of sustained treatment of serious mental illnesses—such as schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, panic disorder, obsessive-compulsive disorder, attention-deficit hyperactivity disorder, and autism—the patient must be evaluated by a physician. The consultation requirement differs by license:
- For LMHCs, the physician shall consult with the mental health counselor regarding the illness and advise whether any medical care is needed.
- For LMFTs, the marriage and family therapist must consult with the physician regarding the illness, and the physician must advise whether any medical care is needed.
It is also worth noting that individuals who have completed the education requirements for LMHC and LMFT may hold a limited permit to practice while completing the exam and/or experience required for full licensure. During this time, they practice under supervision at a specific site.
Frequently asked questions
What is the difference between LCSW, LMHC, and LMFT?
The main differences lie in their educational backgrounds and specific training hours. LCSWs hold a Master of Social Work and require three years of supervised experience. LMHCs hold a master's in counseling and require 3,000 hours of supervised experience. LMFTs hold a master's in marriage and family therapy and require 1,500 client contact hours of supervised experience. Note: These credential requirements have exceptions for practitioners licensed under earlier special provisions.
Can an LMHC or LMFT prescribe medication?
No. Licensed mental health counselors (LMHCs) and licensed marriage and family therapists (LMFTs) may not prescribe or administer drugs. They also may not use invasive procedures such as surgery, therapeutic ultrasound, or electroconvulsive therapy.
What does the "R" on an LCSW's certificate mean?
An LCSW’s registration certificate may start with the letter "R" to designate eligibility for insurance purposes. This is a specific designation on the registration certificate itself.
How often do these therapists need to reregister?
All three types of professionals—LCSWs, LMHCs, and LMFTs—must reregister every three years to practice in New York.
Do these therapists keep my records for a specific amount of time?
Yes. All three types of professionals must keep client or patient records for six years or until the client or patient turns 22, whichever is longer.
Who consults with the physician during treatment for serious mental illness?
The role depends on the license. For LMHCs, the physician consults with the counselor. For LMFTs, the therapist consults with the physician. In both cases, the physician advises whether medical care is needed.