How to Become a Mental Health Therapist

The well-known shortage of therapists is likely to persist: 

The U.S. Health Resources & Services Administration (HRSA) predict the behavioral health workforce shortage to continue and worsen through 2036 (HRSA, 2024)

Using the latest available data, the National Alliance on Mental Illness (NAMI) highlights that over 50% of all people in the U.S. do not seek treatment for mental illness.

There are more people seeking mental health care than are healthcare workers trained to provide therapy.

Becoming a therapist takes years and can be an unclear process.

The terms therapist, counselor, clinician, and clinical social worker typically refer to a mental healthcare worker who:

• Earned a graduate degree in a counseling or related field
• Provides direct clinical services
• Holds a counseling license (or pursuing licensure) by a professional state board

Direct clinical services refer to: 

• Counseling (psychotherapy), behavioral health consultation, and crisis care, to name a few.

Therapist Job Expectations

Therapists provide counseling services to children, teens, adults, and seniors.

Counseling services may include individual therapy, group therapy, or couples therapy.

Before (or during) graduate school, neophyte therapists are encouraged to identify a specific “population” to work with such as:

Women, men, refugees, people who have experienced trauma, teenagers, LGBTQ+ community, couples, or survivors of abuse.

Therapists typically schedule 5-8 client sessions a day (8 is a lot!) with each session meeting for 50- or 60-minutes.

Most therapists use 10-minutes of the hour to complete documentation, billing, making referrals, read the latest research, and follow-up on any aspects of the session.

Other aspects of a therapist’s work day include trying to drink enough water, strategically time bathroom breaks, stretch in between sessions, and/or engage in a little social media scrolling.

The Role of Therapists During Sessions:

• Evaluate client safety and progress
• Deliver evidence-based treatments to target identified symptoms
• Build rapport and be fully present with another human
• Develop a plan to address therapeutic goals in following sessions

Common Employers of Mental Healthcare Workers:

• Community Mental and Behavioral Health Agencies
• Hospitals, Primary Care Offices
• Schools
• Private Counseling Practices
• College or University Counseling Centers
• Tribal Health Agencies
• Government or Non-Profit Organizations

How to Become a Therapist

1. Earn a High School Diploma or GED

Consider dual enrollment if you (or your child) is still in high school.

There is no “right” or “wrong” age to start any degree.

2. Earn a Bachelor’s Degree

Complete an undergraduate program in counseling, psychology, social work, or related field.

Many people are not aware that being a therapist requires at least a master’s degree; so expect going to graduate school following completing a degree.

College is expensive: consider community college and take transferrable courses, apply for grants and scholarships, and develop a schedule that allows you to work while in school.

3. Apply to Graduate Programs and Take the GRE

People may enter graduate school following undergrad and other people may return to graduate school years later.

If you are considering relocating to a new area or state, can you imagine enjoying living in that city / town / climate / cultural region / local environment?

4. Complete a Master’s or Doctorate Degree in Psychology or Related Field from an Accredited University

Choose a field of study that genuinely interests you.

It helps to consider a few programs and apply to the one(s) that feels like the best fit for you and your desired career path.

If you’re entering a counseling field, it is extremely likely the program will require practicum and internship experiences (which are typically unpaid).

5. Study and Take the Examination for Licensure

If you wish to be a Counselor you'll prepare for the National Counselor’s Examination (NCE).

Those seeking to be a Psychologist or Psychological Associate prepare for the Examination for Professional Practice in Psychology (EPPP)

Association of Social Work Board Exam (ASWB) is for Social Workers, and there are others. 

6. Complete Professional Licensure Requirements Guided by Your State’s Licensing Board

Each state has different licensing requirements: always check the statutes in the state where you ultimately want to practice.

This period typically takes at least two years where you are employed as a therapist under supervision of a board-approved supervisor.

7. Apply for a License and Submit Necessary Documents to the Appropriate Professional Licensing Board

Plan to save multiple copies (and formats) of documents such as syllabi, internship logs, and supervisor evaluation forms throughout graduate school and the pre-licensure process.

8. Maintain your Professional License 

Licensed professionals in healthcare fields are expected to follow ethical guidelines, such as staying up to date on the latest research and delivering appropriate care.

Other aspects of maintaining a professional license include professional board membership fees and completing continuing education courses as dictated by each licensing board. 

About the Author

Hello! My name is Nicole Zegiestowsky (she/her) and I am a pre-licensed therapist in Alaska. 

I graduated with my Master’s in Clinical Psychology from the University of Alaska, Anchorage and transitioned into private practice. In private practice I am able to work with my ideal clients and provide accessible online individual and group therapy to adults.

Learn more about my training and services

References:

HRSA, 2024

https://data.hrsa.gov/topics/health-workforce/workforce-projections

NAMI 

https://www.nami.org/about-mental-illness/mental-health-by-the-numbers/.