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Merriam Saunders: Psychiatrist, Psychologist, Clinician? Getting the Terms Straight.



Part of our mission at A Novel Mind is to help writers as they represent mental health & neurodivergence in their work, and to help readers recognize whether an author has done a decent job. If you’ve ever wondered what the difference is between all the mental health helping clinicians, and what their acronyms really stand for, this is the post for you.


Psychiatrist: is a medical doctor, so their fancy acronym will be MD. They are the only therapists who can prescribe medication. Sometimes they practice therapy, but often they are strictly psychopharmacologists concerned with medical treatments. Typically, psychiatrists will meet patients at ongoing intervals for medication management to make necessary adjustments.


Psychologists have a Ph.D or Psy.D trailing their name and so can be called Dr.—but cannot prescribe medication. They are specially trained to do psychological testing, like the kind that could be used in a court of law. Forensic psychologists are specially trained to work with police. Some psychologists only do testing, and some do therapy.


LMFT (Licensed Marriage & Family Therapists), LPCC (Professional Clinical Counselors), LCSW (Clinical Social Workers) are just a few of the confusing acronyms (like the one behind my name!) for licensed Masters-level clinicians. They are not called Dr. and frequently refer to their patients as “clients”. It is these psychotherapists that one will most encounter doing the typical talk therapy in a movie or book scene. Every state has their own acronym, so double-check you are correctly referring to your therapist’s title in the state where your story is set.


School Counselor: there are generally two types of School Counselors, but this varies state to state, so if you’re writing about a school in California, school counseling might look different than if your scene is set in Wisconsin. Some school counselors strictly help with academics and college admission prep and not mental health. Those who work with mental health, typically focus on how it impacts academics. They usually have a Masters degree and often have an additional credential from their state to work in a school setting.


School Psychologist: A School Psychologist is typically responsible for doing psychological and academic testing for students suspected of learning disabilities, restricted to the school setting. They cannot practice privately. In some schools, they may also counsel, but typically they focus mostly on testing.


A word about BCBA:


BCBA: A Board Certified Behavior Analyst uses ABA (Applied Behavior Analysis) to work (mostly but not exclusively) with neurodivergent children. It’s important to know that many in the autistic community who have undergone ABA or have tried it for their children find it abusive.


BCBAs are NOT licensed as such, and the daily “treatment” is generally not done by them, but by a “para,” who has a Bachelor’s degree (not specific to ABA), limited training, and carries out a behavior plan written by the BCBA (who typically has a Masters degree). If you include someone like this in your writing, tread lightly and research well.


Some people get confused by the terms "licensed," vs. "credentialed" (or “certified”). To put it bluntly, a credential is to a license, like a prep cook is to a master chef. A license is administered by the government under extremely strict protocols and standards, mandatory ongoing training, and its holder is subject to state and federal laws that, if broken, could result in hefty fines and jail time.


A credential, on the other hand, is usually given by a self-regulated non-government organization that independently decides on a set of steps one needs to follow to get a credential from that organization. (Note: this is not the case for CPA – Certified Public Accountant, which is a license.)


So, you could start the Snail Racing of America organization and offer a credential in Snail Racing for anyone who took your class and paid the fee. And, suddenly, that person is signing their name Jane Doe, ASRC (American Snail Racing Credential) as if it’s a real thing. And if Jane’s actions caused harm to a snail because of an ethical violation…she would not face prosecution under any state laws…because there aren’t any. (Can you tell this is a thorn in my side? It mostly has to do with Life Coaches, sorry…)


I hope this has been helpful in clarifying the very large umbrella that is psychotherapy!


 

Merriam Saunders is a writer and Licensed Marriage and Family Therapist with a passion for helping people with ADHD, Learning Differences, and Autism. She is the author of the companion picture books, My Whirling, Twirling Motor, and My Wandering, Dreaming Mind, and the middle grade novel, Trouble With a Tiny T.

She is also the co-founder of A Novel Mind.