Therapists often carry a soup of different initials after their name and it's easy to get lost in them. (I didn't understand them until I was applying to counseling graduate school, despite having had therapy for years.) This article helps demystify those letters.

Research shows that the letters after a therapist’s name aren’t as crucial as the relationship you build with them. Your goal should be finding someone you fit with.

Why are they there?

There are a couple of reasons for those initials. Many states require that therapists identify their credentials as part of the state licensing process. State licensure ensures that your counselor has gone through a regulated training program and can lose their license if a board determines there have been ethical or legal violations.

For credentials above and beyond state requirements, such as AASECT (a sex counselor certification), counselors may display them proudly to signal competency in a specific area. However, as a consumer, it’s wise to investigate what those certifications mean. Don’t assume they guarantee competency without some due diligence.

Initials you might see

In Washington state, a credential ending in “A” often means “Associate,” indicating a newly licensed professional who may still be under supervision. Good news: Research shows they are just as effective as fully licensed therapists!

If you’re curious about different professions, check out my guide on the differences between coaches, counselors, marriage and family therapists, social workers, psychologists, psychiatrists, and psychiatric nurses.

Common initials in the state of Washington:

• LCSW and LCSWA: Licensed social worker and licensed social worker associate. Washington state issues this credential to social workers who work in healthcare settings.
• LICSW and LICSWA: Licensed and independent clinical social worker. Washington State issues this credential to social workers who practice independently.
• LMFT and LMFTA: Licensed Marriage and Family Counselor and LMFT Associate. Washington State issues this credential.
• LMHC and LMHCA: Licensed Mental Health Counselor and LMHC Associate. Washington State issues this credential. (Other states often use LPC instead of this for Licensed Professional Counselor)
• NCC: National Certified Counselor, an optional certificate issued from the National Board of Certified Counselors organization. In Washington state, this has similar requirements to an LMHC.
• PysD: Psychologist, typically through a Clinical Psychology degree program.
• PhD: Depends; it means a doctoral level degree in something. It’s often used to designate a PhD Psychologist, but PhD programs exist for many things, including areas like counselor education.