Mental health as a helping field has evolved rapidly over the course of history. In fact, mental health therapy has its roots in social work and career counseling. There are many terms that have emerged, like therapist, counselor, psychologist, psychiatrist, LPC, LMFT, and many others. But what is the difference between all of these titles? And exactly what is an LMFT?
What is an LMFT: The Technical Definition of LMFT
LMFT stands for licensed marital and family therapist. The title is also referred to as a marriage and family therapist and a couples and family therapist (CFT). The American Association for Marriage and Family Therapy (AAMFT) is the biggest U.S. professional organization designed to be a resource for LMFTs. They represent at least 50,000 CFTs worldwide. According to them, the definition of LMFT is mental health professionals trained in therapy techniques and family systems geared toward working with couples, individuals, and families on issues related to mental health. This LMFT definition is not all-encompassing, but it gives a good idea of what an LMFT is.
What does an LMFT do?
An LMFT uses psychotherapy techniques and an understanding of family systems to help individuals, couples, and families navigate challenging situations and dysfunctional learned behaviors. Relationships are the realm of CFTs, and these therapists work with clients on a number of challenging issues, like divorce, communication problems, trauma, grief, pre-marital counseling, depression, anxiety, mental health analysis and diagnosis, addiction, couples disagreements, relational dysfunction, and many other areas. While LMFTs have traditionally been labeled as marriage and family therapists, not all of their clients are married, which is why the term “couples and family therapist” is increasingly being used.
LMFTs may also act as advocates for their clients. Unfortunately, in modern society, there are often systemic roadblocks to clients in achieving wellness, particularly with minority clients. An LMFT can help connect clients with resources, navigate the confusing system, or speak up on behalf of their clients. For example, a client struggling to find employment may benefit from the counselor’s connections.
Furthermore, mental health is increasingly becoming a holistic endeavor, with counselors working with a system of healthcare providers to oversee the biopsychosocial well-being of their clients.
What is the difference between an LMFT and an LPC?
We have talked about what an LMFT does, but what is the difference between an LMFT and an LPC? First of all, LPC stands for a Licensed Professional Counselor. This is the term for someone who has received a license in clinical mental health counseling after meeting the licensing standards in their state. It differs from an LMFT in that an MFT has chosen to specialize in couples and family therapy and uses theories and techniques specifically designed for use in challenges related to couples, families, and relationships. An LPC might work on these issues, but they have pursued a different license that does not require graduate-level coursework specifically about family systems and couples counseling. Furthermore, while both an LMFT and LPC candidate must complete clinical practice hours working with clients both while in school and during a post-graduate supervision period, the LMFT candidate must gain a certain amount of clinical hours working with clients on issues related to family, couples, or relationships.
How to become an LMFT
In order to become a Licensed Marriage and Family Therapist, there are a number of requirements candidates must satisfy, and these requirements differ in every state. While the specifics differ, overall, all candidates must complete the same steps. Firstly, candidates must attend an academic training program that has a curriculum designed to satisfy minimum course requirements and the earning of a minimum number of hours doing supervised clinical experience. This experience earned as a student is called a practicum or internship. States specify that these programs, which can be graduate-level or Ph.D. programs, must be accredited by a regionally recognized accrediting agency. These agencies examine the curriculum and judge whether or not it satisfies the training requirements needed to make effective counselors.
After graduating, candidates enter their residency in the training period. While some states require that the candidate pass a national licensing exam prior to beginning this residency period, in general, most do not. Some states also require that candidates apply for a training license before they can accrue hours during the residency. Regardless of these specific requirements, the candidate will work as a paid employee in a clinic with an approved supervisor. The supervisor doesn’t have to work at the clinic where the candidate works, but the supervisor should meet the minimum qualifications to be approved. Candidates will need to earn a minimum amount of hours working with clients, making treatment plans, and being supervised over the course of at least two years.
If the candidate has not already taken their exam at this point, they should make sure to do so. Candidates need permission from the state board that regulates licensure in order to register for the test. Generally, this means sending in the application for licensure and waiting to hear back from the Board. Once the candidate has been approved, they will pay a fee for the national licensing exam and another fee to the testing administrator when they actually register for a specific testing day. The test will likely be the National Marriage and Family Therapy Examination, though candidates may also be required to take an oral exam.
Once candidates pass, it’s time to wait, since the application was already sent prior to the exam. When candidates send the application, they should do so along with transcripts, an application fee, any responses to specific questions, proof of completion of the post-graduate supervision, and other supplemental materials. Many states also require candidates to complete fingerprinted background checks.
The pros and cons of becoming an LMFT
There are many reasons to become an LMFT, and there are also many reasons why someone would prefer to pursue a different field. Here are a few pros and cons.
-Helping people: Many people are attracted to the field because it places them in a position to help others. While challenging, the job of a counselor has the potential to meet people where they are in the most real way, sitting with people in their pain and being a partner with their clients in finding ways to overcome challenges and live better lives.
-Potential to be your own boss: There are so many options for those entering the counseling field. Many counselors work as salaried employees as a part of a clinic with many counselors. Others work for hospitals or for agencies that connect counselors to clients. Still, others become independent therapists, beginning their own clinics solo or with other counselors. Furthermore, counselors are often in control of their own schedules and billing, which, while a potential con for some, is an incredibly freeing prospect for others.
-A rewarding challenge: being a counselor means working with clients to create goals and a treatment plan, and that means continuously refining the approach to tailor it specifically to each client. That is a unique challenge, which means doing research and collaborating with other counselors as well as with the client. This is a great field for those who want a challenge in their work and want to be able to see the fruits of their labors.
-A growing industry: The mental health industry is one that has grown quickly and is expected to continue to grow in the future. The MFT field is projected to grow by 16% nationwide by 2030, according to the Bureau of Labor Statistics. This increase is likely due to the increased awareness toward mental health because of social media and the Covid19 pandemic, the increased access to mental health services from advances in technology, and the greater demand for counselors since the pandemic. The number of LMFTs in the U.S. was 54,800 in 2021. The average salary in that same year was $59,660, but this differs by state. An LMFTs projected salary ranges from anywhere between $37,050 and $96,520. This differs not only by state but also by the type of employment (small or large clinics).
-Telework: Similar to being able to take control of your schedule, advances in technology have made it possible for counselors to operate either partially or fully online. This is a fantastic opportunity for those who must balance other priorities or who prefer working from home.
-Burnout: While rewarding, there is a high burnout rate amongst mental health counselors. LMFTs need to have clear boundaries with themselves, their clients, and others in order to keep themselves in a healthy place. Many counselors even have their own therapists, both because it helps them be better counselors and because it is another means of taking care of themselves so they can continue to be effective counselors.
-Unpredictable pay: In many cases, counselors get paid per client they see, so if they are having trouble filling up their schedule or if clients are canceling sessions, it could mean that the LMFTs pay differs from week to week, causing potential stress over finances.
-Erratic schedule: Similarly, unless counselors keep strict boundaries on their hours, they may find that they have a sporadic schedule because their ability to gain clients depends a lot on time and whether or not their clients are available. That means counselors often schedule sessions whenever their clients are able in order to fill up their own schedules to pay the bills.
-The route to licensure: We have already discussed the long road candidates must take to becoming fully licensed, but LMFTs have to continue to maintain their license through continued education like classes and seminars and meet other qualifications, as well as pay a yearly fee.
-Jumping through hoops: Unfortunately, LMFTs’ jobs require a lot of paperwork to keep up with the tax, insurance, and legal requirements of working with clients and confidential information. In order to take out insurance, LMFTs must keep notes on client progress and information, which must also be formatted in such a way that it meet insurance requirements. Furthermore, owning one’s own business means keeping track of finances related to taxation, and counselors must also make sure that every aspect of their business is compliant with the Health Insurance Portability and Accountability Act (HIPAA).
The bottom line
These are just a few reasons to become an LMFT. While there are many challenges to becoming a couple and family counselor, most of those who choose to pursue licensure and work as a counselor do so because the work is rewarding. If you are looking to pursue this career, make sure you check the requirements in your state.