Counselor or Therapist?

Counselor or therapist? Does your troubled teen need counseling? Or, would therapy be better? Keep reading to learn differences between a counselor and therapist, evaluate your teens issues, decide what help your teen needs, then decide on a counselor or therapist.

In considering whether a struggling teen might benefit from a counselor on the one hand or a therapist on the other, we need to start by understanding what each of these job descriptions means. This article will discuss the roles of counselors and therapists to help clarify when each may be useful.


Counselor has several different meanings. First it can simply mean, “a person who gives counsel or advice.” In this sense, any person can be a counselor: your grandmother, the grocery store clerk, the mailman. Second, counselor is sometimes used as a euphemism by people who do not want to advertise that they are seeing a licensed psychologist or other certified therapist, perhaps because they’re embarrassed, or simply because it’s not the other person’s business.

The vocation-specific use of the word counselor refers to a professional licensed by the state, who has met state requirements for education and training, as well as any other license qualifications (such as an exam or work experience). There are educational and school counselors, vocational counselors, rehabilitation counselors, mental health counselors, substance abuse and behavioral disorder counselors, and marriage and family therapists (note the different word), who, nevertheless, are grouped as counselors.

Educational and school counselors work in school settings or for organizations that help match students with educational choices (such as boarding schools). They help students with issues that arise in their academic, personal, and social development, as well as providing career counseling, as appropriate to their age. If a school-age child develops a behavioral issue or seems to be having a difficult time, the school counselor is likely the first person who will step in to see what kind of help might be provided.

Vocational counselors, also called career counselors, pick up from school counselors once a child graduates from school. They are available for people at any time of life who are considering or reconsidering the place they might take in the workforce.

Rehabilitation counselors assist people in coming to terms with and overcoming (when possible) the effects of physical and emotional disabilities that result from a variety of causes.

Mental health counselors work, often teamed with mental health specialists such as psychologists and psychiatrists, to address mental and emotional health issues, including common issues such as low self-esteem, depression, stress, anxiety, and grief. Substance abuse and behavioral disorder counselors focus specifically on issues with addiction and other problems with alcohol and drugs, as well as eating disorders and gambling. Marriage and family therapists apply specific techniques and principles to help individuals, couples, and families deal with crises and problematic dynamics as a whole. They focus more holistically and externally, and often leave individual treatment and internal conflicts to be dealt with by the individual with a psychologist or psychiatrist.


When people consider the choice between a counselor and a therapist, they usually meant the job of counselor as defined above (school counselor, mental health counselor, etc.) and a psychologist, a job popularly referred to as a “therapist.” A clinical, counseling, or school psychologist will have a specialized graduate degree, possibly a doctoral degree, but they are not medical doctors.

Psychologists treat mild to severe psychological disorders, but do not prescribe medication except in New Mexico and Louisiana. While school psychologists are licensed by the state and work with children within a school setting, students may also see clinical or counseling psychologists outside of school, in an office, for example.

Counselors vs. Therapists

The differences between counselors and therapists include their training, their focus, and the point at which they become engaged in a problem. Usually when a school has an indication that a student is troubled, a meeting with the student’s counselor is arranged, and this person helps determine what type of further assistance is most appropriate. This could be continued meetings with the counselor, interactions with the school psychologist, or some other staff member, consultant, or outside source.

If you are seeking help on your own, it may still be worth asking at the school for advice: they may be able to recommend who would be in the best position for your particular situation. They may also be able to steer you away from people who would not be a good match for your family and child, and this in itself can be invaluable information.


Related Article: Choosing a Counselor >>