FAQ: What Are the Differences Between Mental Health Counseling and Licensed Clinical Social Work?

Answer: Counseling and social work are distinct but related professions in the health and human services sector. Licensed Professional Counselors (LPCs) and Licensed Clinical Social Workers (LCSWs) are trained to provide mental health services to individuals, groups, and communities. However, the focus of this training differs, as does the scope of the professional responsibilities associated with the two fields. While LPCs and LCSWs both provide psychotherapeutic services, social work encompasses additional responsibilities in healthcare assistance, social services, job placement, and other areas that generally fall outside the purview of counseling.

Clinical Counseling vs. Clinical Social Work

Counselors and social workers are part of a network of interrelated, interdisciplinary professionals who serve in the heath and human services sector, providing support and assistance to people in need. While their roles may overlap, the training they receive in master’s programs in order to attain state licensure differs significantly. In addition, counselors and social workers have distinct professional identities, and different strategies for improving the overall welfare of the clients they serve.

Defining Counseling and Social Work

The American Counseling Association (ACA) defines counseling as “a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals.” Social work, as outlined by the National Association of Social Workers (NASW), touches on some of the same goals, but includes additional responsibilities that set it apart from counseling. These include: “helping people obtain tangible services; counseling and psychotherapy with individuals, families, and groups; helping communities or groups provide or improve social and health services; and participating in legislative processes.”

The Council for the Accreditation of Counseling & Related Educational Programs (CACREP), an independent accrediting body for master’s and doctoral counselor training programs, outlines the scope of professional counseling education programs in its eight common core areas for counseling. Similarly, the Council on Social Work Education (CSWE), which accredits undergraduate and master’s programs in social work, maintains a list of nine social work competencies, which are detailed in its 2015 Educational Policy and Accreditation Standards for Baccalaureate and Master’s Social Work Programs. While there are similarities in counseling and social work competency areas, there are differences in emphasis that reflect the distinctions between the two fields, as detailed in the table below:

Psychotherapy in Counseling and Clinical Social Work

Counseling and social work intersect most strikingly in the area of psychotherapy. Professional counselors (LPCs) and clinical social workers (LCSWs) are trained to provide therapy based on accepted theories of psychology and human development. Both are qualified and empowered to assess an individual’s mental health. And professionals from both fields provide psychotherapeutic treatment to address emotional and behavioral problems that may be rooted in family dysfunction, substance abuse, personality disorders, physical impairment, and a variety of other factors.

In counseling, the primary focus is on alleviating the immediate causes and symptoms of stress, anxiety, depression, and other mental conditions that impair an individual’s ability to function properly. LPCs use psychotherapy as the main means to achieving this outcome. Social workers seek to achieve similar outcomes through psychotherapy. However, social workers also actively seek to secure additional social and healthcare services for clients through state and federal programs like Medicaid, Section 8 Housing Choice Vouchers, and the Supplemental Nutritional Assistance Program (SNAP), and through community-based organizations.

Training in Counseling vs. Social Work

Instruction in professional counseling and in clinical social work can begin at the undergraduate level. However, a master’s level degree or higher is required for both counselors and social workers seeking state licensure to practice professionally. Many of the key differences and subtle distinctions between counseling and social work become apparent when comparing curricula from advanced degrees in counseling and social work.

Master’s in Counseling vs. Master’s in Social Work

Master’s in counseling programs provide foundational instruction in theories of human psychology and development. Students learn to apply this knowledge to the use of psychotherapy in a variety of clinical settings, with individuals, couples, families, and other social groups. Other core areas of instruction include the laws and ethics pertaining to counseling, research methods in the field of counseling, and the identification and treatment of common forms of psychopathology. In addition, master’s in counseling programs typically offer elective coursework or concentrations in areas like marriage and family therapy; substance abuse and addiction treatment; rehabilitation counseling; child and adolescent counseling; school counseling; and other specializations.

Master’s in social work programs use a similar grounding in theories of psychology as well as theories of sociology and social development to foster an understanding of human behavior in the context of social environments, social pressures, and population demographics. Students learn to apply this knowledge in clinical and community settings, with individuals, families, and groups. A master’s in social work curriculum also typically includes coursework in social welfare policy; applied research in the field of social work; and client advocacy. In addition, there may be electives that cover specialized topics like conflict management; clinical practice with specific populations (children, couples, the elderly, minority groups, LGBT clients, the military); and managing cases that involve criminal justice and/or mental health issues like grief, trauma, substance abuse, and family violence.

Counseling Practicums and Internships vs. Social Work Field Education

Master’s in counseling and master’s in social work programs both incorporate an experiential or applied learning component. In counseling, students typically complete a formal practicum (generally 100 hours) during which they work in a supervised clinical setting and have direct client contact. In addition, most master’s in counseling programs include at least 600 clinical internship hours. These practicum and internship experiences take place in settings like teaching hospitals and clinics or, in the case of school counseling, educational institutions.

In social work, students in MSW programs are required to complete a designated number of hours of field education or fieldwork. The CSWE recommends that MSW programs include at least 900 hours of field instruction, during which students engage in supervised work with clients in need of social services and/or mental health counseling. Field instruction typically takes place at a social service agency, or in a hospital, school, prison, or other institution with a social work department.

Accreditation of Master’s in Counseling and Master’s in Social Work Programs

There are several independent bodies that assess and accredit master’s in counseling programs. The largest and most widely recognized accreditation body is CACREP, which recently merged with the Council on Rehabilitation Education (CORE), the former accrediting body for master’s in rehabilitation counseling programs. The Masters in Psychology and Counseling Accreditation Council (MPCAC) offers an alternative accreditation to master’s in counseling programs. And there are two other organizations that offer accreditation to specialized counseling programs: the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE), and the National Addiction Studies Accreditation Commission (NASAC). In contrast, there is only one governing organization that accredits master’s in social work programs, the CSWE.

Licensing in Counseling vs. Clinical Social Work

Licensing for professional counselors and clinical social workers runs along parallel but separate paths. Each state sets its own licensing requirements for counselors, which can include different types of licenses for clinical counselors, school counselors, rehabilitation counselors, and substance abuse counselors. States also set their own licensing requirements for social workers.

In counseling, a master’s degree from an approved program is required for licensure, and applicants must also complete a designated number of post-graduate clinical internship hours (typically between 1,000-3,000 or more). In social work, many states have a tiered system that allows graduates from bachelor’s in social work programs to attain licensure. However, clinical social workers who intend to provide direct client services in their own private practice must attain LCSW status, which requires a CSWE-accredited master’s in social work degree and the completion of a designated number of supervised clinical hours (typically at least 3,000 supervised clinical hours).

Once the educational and training prerequisites for licensure have been met, states then require LPCs and LCSWs to pass an exam. In counseling, the two most commonly used exams are the National Counselor Examination for Licensure and Certification (NCE) and the National Clinical Mental Health Counseling Examination (NCMHCE). In clinical social work, most states use the Association of Social Work Boards (ASWB) exam for advanced generalist or clinical social work. LPCs and LCSWs with a valid state license are then qualified to work in a broad range of clinical counseling and social work settings, including private practice.

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