Licensed Mental Health Counselor (LMHC) vs. Licensed Marriage and Family Therapist (LMFT)

According to the National Center for Health Statistics, in 2019 19.2% of adults in the United States had received mental health treatment during the past 12 months. With such a significant need for treatment, numerous counseling specializations have emerged that focus on clients’ specific treatment needs.

If you want to focus your counseling career on helping clients individually or in their relationships, you might consider comparing clinical mental health counseling vs marriage and family therapy. More specifically:

  • Clinical mental health counselors - also known as licensed mental health counselors (LMHC) or licensed professional counselors (LPC) - focus on the needs of individuals, families, and groups.
  • Licensed marriage and family therapists (LMFTs) address the needs of people specifically within the context of marriage, couple, and family systems.
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In broad terms, clinical mental health counselors focus on their clients, while licensed marriage and family therapists focus on their clients’ relationships.

    LMHCs can choose to direct their skills in different ways. For example, they can:

    • Diagnose and treat mental and emotional disorders
    • Work to prevent disorders
    • Conduct research to identify new treatment approaches

    These clinical mental health counselors offer a variety of treatments, such as cognitive-behavioral therapy (CBT) and interpersonal therapy.

    In contrast to a clinical mental health counselor, an LMFT specifically focuses on the roles that clients play in important relationships in their lives, such as with their spouses or other family members.

    Working within that context, marriage and family therapists offer services such as:

    • Child and adult psychotherapy
    • Couples therapy
    • Group therapy

    Online Programs to Consider


    Many higher education institutions offer online programs to prepare students for clinical mental health counseling and marriage and family therapy. LMHCs and LMFTs typically earn master’s or doctoral degrees. The website of CACREP, an accreditation organization for graduate degree programs in counseling, offers a tool to search for accredited programs.
    You also can find more information about online degree programs below.

    What Is an LMHC?

    Most clinical mental health counselors conduct therapy with clients to treat various issues such as anxiety, depression, or stress. Therefore, strong communication skills are critical. They need to be able to assess their clients’ needs and select appropriate treatment plans. They also must be able to recognize when to refer clients to other professionals such as psychologists or psychiatrists.
    Clinical mental health counselors (LMHC) can choose to focus on working with specific populations such as the elderly or children. They also can be found working in a variety of settings. Schools, government agencies, correctional institutions, residential care facilities, and private practice settings are just a few of the settings where clinical mental health counselors can practice.
    Providing therapy may be the entry point for clinical mental health counselors, but it is not necessarily what they will do forever. For example, some eventually move into teaching, consulting, or conducting research.


    What Is an LMFT?


    Licensed Marriage and family therapists (LMFT)s provide services to address a range of issues, such as substance abuse, depression, or child/adolescent challenges, and how those issues affect relationships.
    They can work with individuals, families, and couples in relationships, and they provide services such as diagnosis and treatment, psychotherapy, and group therapy.
    Strong communication skills and an aptitude for understanding individual viewpoints, conflict resolution, instruction, and leadership are also important. Most marriage and family therapy is short term, with an average duration of 12 sessions.
    While marriage and family therapists can work in private practice, they also can provide their services in a variety of other settings, such as mental health centers and hospitals.

    What Does an LMHC Do?

    A Licensed Mental Health Counselor (LMHC), also known as a Licensed Professional Counselor (LPC), plays a crucial role in addressing the mental health needs of individuals, families, and groups. Their primary responsibilities include diagnosing and treating a wide range of mental and emotional disorders. LMHCs employ various therapeutic techniques, such as cognitive-behavioral therapy (CBT) and interpersonal therapy, to help clients navigate their challenges.

    In addition to treatment, LMHCs actively work on preventing mental health disorders by employing early intervention strategies. They also contribute to the field through research, constantly seeking new and effective treatment methods. This holistic approach enables LMHCs to provide comprehensive care tailored to the specific needs of their clients, fostering mental wellbeing and resilience.

    What Does an LMFT Do?

    A Licensed Marriage and Family Therapist (LMFT) specializes in helping individuals, couples, and families navigate and improve their interpersonal relationships. LMFTs focus on the dynamics within these relationships, understanding how each person's behavior impacts the group. They offer a range of therapeutic services, including child and adult psychotherapy, couples therapy, and group therapy, to address issues such as communication problems, marital conflicts, and family dysfunction.

    LMFTs work to understand the unique dynamics of each relationship, providing tailored interventions that promote healthier interactions and stronger bonds. Through their specialized approach, LMFTs help clients develop the skills and understanding necessary for sustaining fulfilling and supportive relationships.

    How to Become an LMHC

    To become a Licensed Mental Health Counselor (LMHC), one must typically follow these steps:

    1. Educational Requirements: Earn a master’s degree in counseling or a closely related field from an accredited institution.
    2. Supervised Clinical Experience: Complete post-graduate supervised clinical experience, which varies by state but often includes several thousand hours of supervised practice.
    3. Licensing Examination: Pass a state-recognized counseling exam, such as the National Counselor Examination (NCE) or the National Clinical Mental Health Counseling Examination (NCMHCE).
    4. Ongoing Education: Obtain licensure and fulfill ongoing continuing education requirements to maintain the LMHC credential.

    How to Become an LMFT

    To become a Licensed Marriage and Family Therapist (LMFT), one must usually undertake the following steps:

    1. Educational Requirements: Obtain a master’s or doctoral degree in marriage and family therapy from a program accredited by the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) or a related field.
    2. Supervised Clinical Experience: Gain post-graduate supervised clinical experience, typically requiring several thousand hours, focusing on marriage and family therapy.
    3. Licensing Examination: Pass a state-specific licensing examination, often the Examination in Marital and Family Therapy.
    4. Continuing Education: Maintain the license through ongoing continuing education and adhere to professional ethical standards.

    Learn More: How to Become a MFT

    Tips for Deciding Between an LMFT and an LMHC

    Choosing between becoming a Licensed Marriage and Family Therapist (LMFT) and a Licensed Mental Health Counselor (LMHC) depends on your career goals and interests. Here are some tips to help you decide:

    • Assess Your Interest in Relationship Dynamics: If you are more intrigued by the complexities of relationships and family systems, LMFT might be the right path. LMHC is ideal if you are interested in a broader range of mental health issues affecting individuals and groups.
    • Consider the Types of Clients You Want to Work With: LMFTs often work with couples and families, while LMHCs typically see a wider range of clients, including individuals with various mental health issues.
    • Evaluate Your Educational and Career Goals: Look into the specific educational pathways and licensure requirements for each profession. Consider the type of work setting you prefer, such as private practice, hospitals, or community agencies.
    • Seek Professional Guidance: Talk to current LMFTs and LMHCs, attend career workshops, and consult with academic advisors to gain insights into each profession.
    • Reflect on Long-term Career Objectives: Consider how each role aligns with your long-term career aspirations, including opportunities for specialization, advancement, and impact.

    Remember, both paths offer rewarding opportunities to make a significant difference in people's lives.

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    Benefits of the LMHC and LMFT Roles


    If you are choosing between working in clinical mental health counseling or marriage and family therapy, consideration of their respective benefits can be worthwhile.
    Benefits of an LMHC
    Perhaps most important, becoming a clinical mental health counselor offers the opportunity to help others improve their lives, which can be extremely rewarding. In addition, for people who prefer working one-on-one with clients, becoming an LMHC allows them to focus on individuals. LMHCs are also often surprised to find that providing therapy enables them to learn more about themselves.


    The employment outlook for clinical mental health counselors is bright. The U.S. Bureau of Labor Statistics (BLS) projects that employment of substance abuse, behavioral disorder, and mental health counselors will increase by 18% from 2022 to 2032, which is much faster than the average growth rate for all occupations.


    Benefits of an LMFT

    LMFTs find the opportunity to help others improve their relationships to be highly rewarding. They also have the chance to work independently with clients of all backgrounds. In addition, LMFTs discover that the practice of providing therapy can benefit their own growth and assist them in dealing with issues in their personal relationships.


    As with LPCs, the employment forecast for LMFTs is good. The U.S. Bureau of Labor Statistics (BLS) projects that employment of marriage and family therapists will grow 15 percent from 2022 to 2032, which is much faster than the average growth rate for all occupations. This updated projection reflects a continued strong demand for professionals in the field of marriage and family therapy.


    Educational Requirements


    Whether you work in clinical mental health counseling or marriage and family therapy, you will need to have the appropriate academic credentials. To become an LMHC, most individuals earn a master’s or doctoral degree.

    Likewise, most individuals who become LMFTs earn a master’s or doctoral degree, or participate in postgraduate clinical training programs.


    Classes to Take

    Graduate degree programs that lead to becoming a clinical mental health counselor or a licensed marriage and family therapist offer classes that can equip individuals with the skills necessary for success.
    Classes That Train LMHCs
    Examples of classes within a mental health counseling degree program include:

    Counseling theory classes that enable students to develop their personal models of counseling

    Assessment and appraisal classes that train students on testing instruments, test administration and scoring, and common individual and group tests

    Counseling internships through which students gain supervised experience in applying the principles and techniques of a particular specialization

    Elective classes in areas such as grief counseling or play therapy

    Classes That Train LMFTs


    Examples of classes that graduate degree programs offer to train LMFTs include:

    Classes that focus on psychotherapy involving adolescents and their families

    Classes on diagnosis and treatment planning in family and cultural contexts

    Classes oriented toward group and family processes and strategies for preventing interpersonal and system dysfunction

    Practicum classes through which students gain supervised experience providing services to individuals, couples, and families

    Ask the Expert: Clinical Mental Health Counseling vs Marriage and Family Therapy Degree Paths
    Is there a certain track within a counseling program that you should follow to become an LPC or LMFT?
    “State licensing bureaus have specific documentation required for each of these types of licensure, requiring specific courses focused on each of these specialty areas. MA programs also have some similarities in the coursework between these two disciplines, and some differences, primarily associated with the number of courses specific to marriage and family systems theories.
    The LPC and LCPC licensure will have a focus on clinical mental health issues. Both MA programs would address mental health services as related to couples, families, and individuals. The LMFT track would increase the number of family/couples courses, while the LPC and LCPC courses focus on clinical mental health services across age groups and focus on understanding how to provide individual therapy sessions.”
    — Dr. Julie Smirl, Assistant Professor in Bradley University’s Online Masters of Counseling Program

    LMHC and LMFT Licensure

    Licensure requirements for LPCs and LMFTs are established at the state level. While specific licensure requirements can vary by state, the general requirements across states share many similarities.

    LMHC Licensing Requirements

    State requirements for LMHC licensure usually include:

    • Completion of a master’s or doctoral program from an accredited higher education institution
    • At least 3,000 hours of supervised clinical experience during a two-year period
    • A passing result on the National Counselor Examination (NCE) or another examination recognized by the state licensing entity
    • Compliance with the state licensing entity’s requirements in areas such as ethics and continuing education

    LMFT Licensing Requirements

    State requirements for family and marriage counseling licensure usually include:

    • Completion of a master’s or doctoral program from an accredited higher education institution
    • At least two years of supervised clinical experience 
    • A passing result on the examination set forth by the Association of Marital and Family Therapy Regulatory Boards or another examination recognized by the state licensing entity
    • Compliance with the state licensing entity’s requirements in areas such as ethics and continuing education

    Careers Available to You 

    Career choices for LPCs are numerous. For example, they can choose to work in private practice, residential treatment centers, schools, nonprofit organizations, government entities, prisons, or hospitals. LMHCs are even beginning to provide services through telemedicine. As of May 2022, the median annual pay for substance abuse, behavioral disorder, and mental health counselors was $49,710, according to the U.S. Bureau of Labor Statistics.

    LMFTs also have a wealth of career options. In addition to working in private practice, they can pursue careers in places such as outpatient and inpatient centers, schools, social service agencies, treatment centers, residential care facilities, legal and correctional systems, or employee assistance programs. As of May 2022, the BLS reports that the median annual pay for marriage and family therapists is $56,570.

    Consider Pursuing a Career as an LMHC or LMFT

    If you value the rewards of helping people and improving their lives, then pursuing a career in clinical mental health counseling or marriage and family therapy could be a good choice for you. Both clinical mental health counselors and licensed marriage and family therapists have the opportunity to work in a variety of environments with people from different backgrounds. They also perform work that has a beneficial effect on society.

    While becoming an LMHC or an LMFT takes effort, educational opportunities are available and employment prospects are promising. In pursuing the path of an LMHC or an LMFT, you may find the career that you were meant to have. 

    Interested in learning more about becoming a LMHC or LMFT? Check out our degree pages below:

LMHC vs. LMFT FAQ

Do licensed marriage and family therapists and licensed mental health counselors require the same degrees?
While both LMFTs and LMHCs typically require a master’s degree, the focus of their degrees may differ. LMFTs generally need a degree specifically in marriage and family therapy, whereas LMHCs need a degree in counseling or a related field.

Do LMHC and LMFT have the same licensing process?
The licensure process for LMHCs and LMFTs varies by state, but both require a master’s degree, a period of supervised clinical experience, and passing a state-recognized examination.

How are counselors and therapists different?
The terms are often used interchangeably, but in the context of LMHCs and LMFTs, the difference lies in their focus. LMHCs address a wide range of mental health issues, while LMFTs specialize in relationship dynamics within families and couples.

What career opportunities are available for LMHCs and LMFTs?
LMHCs can work in various settings, including private practice, hospitals, and community agencies, focusing on individual mental health. LMFTs often work in private practice, relationship counseling centers, and social service agencies, focusing on family and relationship therapy.

Can LMHCs and LMFTs offer the same types of therapy?
Both can offer similar therapeutic techniques like CBT, but their application and focus will differ. LMHCs apply these techniques broadly to individual mental health issues, whereas LMFTs use them to address relationship and family dynamics.

 

Explore More Licensure Comparisons:

 

Sources:

American Association for Marriage and Family Therapy, About Marriage and Family Therapists

American Association for Marriage and Family Therapy, Marriage and Family Therapist: The Family-Friendly Mental Health Professionals

American Counseling Association, Who Are Licensed Professional Counselors

CACREP, Find a Program

CACREP, What Is CACREP?

Career Trend, “What Are the Advantages and Disadvantages of Being a Mental Health Counselor?”

Counseling Today, “Choosing Your Path Wisely”

Houston Chronicle, “Good Skills for Being a Family Counselor”

Houston Chronicle, “The Rewards of Being a Therapist”

Houston Chronicle, “Where Can Licensed Professional Counselors Work?”

Licensed Professional Counselors Board of Examiners, Rules, Standards and Procedures

National Center for Health Statistics, “Mental Health Treatment Among Adults: United States, 2019”

Our Lady of the Lake University Academic Catalog, Counseling: Clinical Mental Health Counseling, MA

Our Lady of the Lake University Academic Catalog, Psychology Specialization: Marriage and Family Therapy Concentration, MS

Psychology Today, “Marriage and Family Therapy”

Public Health Online, About: LPC (Licensed Professional Counselor)

U.S. Bureau of Labor Statistics, Marriage and Family Therapists

U.S. Bureau of Labor Statistics, Substance Abuse, Behavioral Disorder, and Mental Health Counselors

Work Force Health

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