Decoding counselor alphabet soup: LPC, LPCC, LMHC, and more

Used under licenseAround the US, most mental health professions have the same titles. A Psychologist in New York is likely to be pretty much the same, in terms of what they do, as a Psychologist in California, Montana, or anywhere else. Same for Licensed Clinical Social Workers (LCSWs) and Licensed Marriage and Family Therapists (LMFTs). In other words, you can recognize the job by its title. If you’re a counselor, on the other hand, you may have any one of several different titles. Among them:

  • Licensed Professional Counselor (LPC) – This is the license title used in 24 US states and the District of Columbia as of 2016, according to this data from the American Counseling Association.
  • Licensed Mental Health Counselor (LMHC) – This is used in seven states, the largest of which is New York.
  • Licensed Clinical Professional Counselor (LCPC) – This is used in seven states, the largest of which is Illinois.
  • Licensed Professional Clinical Counselor (LPCC) – This is used in six states, the largest of which is California.
  • Licensed Clinical Mental Health Counselor (LCMHC) – This is used in New Hampshire, Rhode Island, Utah, and Vermont.
  • Other variations – The remaining states (Nebraska and Delaware) use slight variations, both of which contain the words “mental health.”

What’s up with that? Do those titles mean different things? We’re here to break it down for you.

The biggest difference

The terms “Clinical” and “Mental health” in some titles delineate that the license is specifically a mental health license. When the title includes the terms “Clinical” or “Mental health,” that usually means that everyone with that title can assess, diagnose, and treat mental illness. As such, all of the titles except LPC can be reasonably grouped together.

The title “Licensed Professional Counselor” is more broad. LPCs usually have training in mental illness, but LPCs may also focus on career counseling, rehabilitation counseling, and other forms of counseling that do not directly involve the diagnosis or treatment of mental illness. And indeed, in states where the counselor license operates under the broad LPC title, the protected scope of practice is often broad as well. An LPC license may be necessary to perform any kind of counseling, whether related to mental health or not.

In states that have more narrowly-focused “clinical” or “mental health” titles, these other counseling activities may not require licensure at all. (Individual state laws vary in this regard.) California is a good example: While LPCCs are required to have received training in career counseling, you don’t need to be an LPCC here to do career counseling. The scope of practice linked to the LPCC license is specific to mental health, and anyone — licensed or not — can call themselves a career counselor.

So which title is best?

From a policy perspective, there are good arguments on all sides of that question. A broad LPC license might offer greater public protection, in that even consumers of non-mental-health counseling have a licensure board they can complain to if the LPC behaves unprofessionally. On the other hand, a more narrowly-focused LPCC, LCPC, or LMHC license leads to more consistency in what the people working under that title actually do. Advocating for insurance reimbursement, for example, may be easier when counselors are operating under a more narrow mental health focus.

There can be some license portability headaches if you go from a state with one kind of counselor licensure (broad versus narrow) to the other, but those can happen no matter which direction you’re moving. And the ACA has been working closely with NBCC to improve portability, including through the use of interstate compacts.

So, it’s best to understand these differences as just that: differences. None of these titles is inherently better than any other. And truth be told, those differences are pretty minor, all things considered. All counselors, regardless of specific state license title, tend to share counseling’s training and philosophy. That underlying identity — “Counselor” — is what clients are likely to care about most.