When I first started looking for help for my child, I had an advantage many parents don’t, a professional background that at least gave me a basic map of the mental health system and the people who work within it. I understood the difference between a therapist and a psychiatrist. I understood, roughly, who did what.
And I still struggled to figure out what kind of mental health professional I needed for my family.
I found myself hovering over a name in a directory, wondering whether someone with a PhD would be more qualified than someone with an MSW. Whether the degree predicted something about how good they would be. Whether I was keeping the right people on my “wish lists” of therapists and providers.
Over the years, we’ve worked with a lot of different mental health providers, different credentials, different training backgrounds, and different approaches. And what I can tell you is: the degree does not predict how good a therapist is. The fit matters way more in the long run. The experience with your child’s specific challenges matters. The license matters. The letters after the name, less so.
If you don’t have a background in this field and you’re staring at a list of credentials that looks like alphabet soup and wondering what any of it means, you are not alone in that confusion. Let me try to break it down.
Therapists and Counselors: This Is Probably Where You Start
When most people say they want to find someone for their child “to talk to,” they’re usually looking for a therapist. Therapists and counselors are most often trained to provide what’s called talk therapy. This often includes sitting with your child, building a relationship, and working through what’s going on, whether that’s anxiety, depression, trauma, school stress, family changes, or something that may not have a name yet.
Talk therapy is the most common approach, but therapy for children and teens can take a lot of different forms (for example, play therapy, art therapy, and others), depending on your child’s age, personality, and what they’re working through. A good therapist will tell you what approach they use and why.
One thing I want to emphasize is that you do not need a diagnosis before starting therapy. You don’t need to know exactly what is wrong, or even which type of provider is the right fit, before you make that first call. A good therapist will help you figure out the next steps from wherever you are. If your child is struggling, that’s enough of a reason to reach out.
Here’s where it gets confusing: there are a lot of different credentials that fall under this umbrella. You might see LPC (Licensed Professional Counselor), LCSW or LICSW (Licensed Clinical Social Worker/Licensed Independent Clinical Social Worker), MSW (Masters in Social Work), LMFT (Licensed Marriage and Family Therapist), or others depending on your state. These professionals have different training backgrounds and different licenses, but many of them do essentially the same kind of work when it comes to therapy for children and adolescents.
If you see a credential you don’t recognize and you’re wondering whether this person is qualified to help your child, it’s worth doing a little digging. Each license type has a governing board and usually a website where you can learn more about what that credential requires. I’ve linked to some resources below that can help you sort through this. The key thing to know is that a licensed therapist — regardless of the specific letters after their name — has completed graduate-level training and clinical supervision. The license matters. The specific letters are worth understanding, but shouldn’t be a barrier to getting started.
I share all of this because many people are familiar with the term “psychologist” and may start searching only for those with a PhD. But the truth is, many other wonderful mental health providers can support your child and your family who do not have a PhD — and in fact, most don’t.
A note on telehealth: many families are now finding providers through virtual platforms. These are real options worth exploring. The same credential rules apply; a therapist working through a telehealth platform is still a licensed clinician, and you can and should look at their credentials the same way you would for anyone you find through a traditional directory.
A Word About Non-Licensed Providers
As you search, you may come across people offering support for children and teens who are not licensed mental health clinicians, such as teen life coaches, wellness coaches, parent coaches, and similar practitioners. Some of these individuals are thoughtful and well-intentioned, and coaching can serve a purpose in certain contexts.
That said, it is my strong opinion that when a child is struggling with mental health challenges, anxiety, depression, trauma, behavioral concerns, professional credentials, and licensure matter. A licensed clinician has completed graduate-level training, passed licensing exams, completed supervised clinical hours, and is accountable to a licensing board. Someone who describes themselves as a “coach” does not necessarily have those requirements. When your child’s well-being is at stake, it’s worth knowing who you’re working with. If you are unsure whether someone you’re considering is licensed, you can look them up through your state’s licensing board.
Psychologists: When You Need More Than Therapy
A psychologist (PhD or PsyD) has doctoral-level training, which means more years of education and typically more specialized clinical training than a master’s-level therapist. Psychologists can provide therapy, and many do. But what really sets them apart is their ability to do psychological testing and assessment. Assessments often include comprehensive evaluations that can identify whether your child has ADHD, a learning disability, an anxiety disorder, or something else that needs a name before it can be properly treated.
If your child has already been in therapy and something still isn’t adding up, if their therapist is wondering about an underlying diagnosis, or if the school is pushing for an evaluation, a psychologist is often who you’d see next. They can also provide therapy alongside or after that evaluation, or you can stick with the therapist you are already working with.
From my own experience: for many families, the path starts with a therapist. The therapist does the ongoing work. If a diagnostic evaluation becomes important, a psychologist comes into the picture. These providers often work together as the foundation of your child’s support team.
Psychiatrists: When Medication Is Needed
A psychiatrist is a medical doctor (MD) who specializes in mental health. This distinction matters: psychiatrists can prescribe medication. Therapists and psychologists, in most states, cannot.
What surprises a lot of parents is that many psychiatrists don’t actually do ongoing therapy. They do evaluations, medication management, and follow-up appointments focused on how a medication is working. The therapy piece often stays with a therapist or psychologist, while the psychiatrist manages any medication your child might need.
If you’re wondering whether your child needs a psychiatrist, the most straightforward answer is: if medication is on the table, yes. That might be because therapy alone hasn’t been enough, because a diagnosis like ADHD or severe depression is involved, or because a prescriber is needed to evaluate whether medication to support your child makes sense. Not every psychiatrist is trained to treat kids, so I highly recommend finding a child and adolescent psychiatrist (it is a specific subspecialty in the field) to make sure you work with someone who understands the nuances of supporting children and adolescents.
One thing I’d say gently from our own experience: it is my opinion that if the question of psychiatric medication comes up, I’d encourage you to find an actual child and adolescent psychiatrist rather than relying on a pediatrician to prescribe. Pediatricians are wonderful, and they’re a great starting point for many things. But psychiatric medication for children is genuinely specialized, and a psychiatrist who works with kids has the training and the ongoing relationship to do this safely. We learned this the hard way, and it’s something I wish someone had told us earlier.
Your Pediatrician, PCP, and School Counselor: Good Places to Start — But Not the Finish Line
Pediatricians and school counselors are often the first people parents turn to when something feels off, and that’s not a bad instinct. A good pediatrician will do a basic screening, take your concerns seriously, and point you toward the right resources. Many have referral networks and can help you figure out where to start. School counselors can also play a valuable role, checking in on your child, flagging concerns, and sometimes helping facilitate a connection to outside support.
What neither of them is equipped to do is provide ongoing clinical therapy or, in many cases, manage psychiatric medication. I think of them as a gateway, helpful for getting your bearings and making that first connection, but not a substitute for a licensed mental health provider. If your child’s pediatrician or school counselor has raised concerns, take that seriously and use it as a starting point to find someone who can provide ongoing clinical care.
And if your child is resistant to the idea of seeing someone, which is very common, I talked about that in last week’s post, and there are some concrete approaches that can help. Visit How to talk to your child about therapy.
So Who Does My Child Need to See?
I want to be honest that there’s no one-size fits all answer. But here’s a general picture of how it often unfolds: most families start with a therapist. If a deeper evaluation is needed, a psychologist comes in. If medication becomes part of the conversation, a psychiatrist gets involved. These providers often work in parallel, and your child’s therapist and psychiatrist may communicate directly about what they’re seeing.
The thing I most want you to take away from this is that you have more options than you might have thought. A therapist with a credential you’ve never heard of might be exactly the right person. In many cases, you don’t need someone with the most advanced degree; you need someone who is qualified, licensed, and a good fit for your child. Starting with a therapist is almost never the wrong move. And this opens up a lot of doors in your search, because if you narrow yourself only to psychologists, it may take longer to find someone who is accepting new patients or takes your insurance. Our experience has been that insurance may be more apt to cover support from someone with an MSW, LCSW, LICSW, or similar credentials, and there are simply more of those professionals working in the field than psychologists.
Next week, we’ll get into the practical side of the search itself, how to use insurance, what in-network actually means, and how to work through the frustrating reality of provider availability. It’s a lot, but it’s navigable.
– Laurie
Additional Resources
- National Alliance on Mental Illness – Types of Mental Health Professionals
- Psychology Today’s therapist finder with credential filters
- American Association for Marriage and Family Therapy – credential info
- American Psychological Association – find a psychologist
- American Academy of Child & Adolescent Psychiatry – find a psychiatrist