Family Therapist Overview

Mental health counselors and marriage and family therapists help people manage and overcome mental and emotional disorders and problems with their family and other relationships. They listen to clients and ask questions to help the clients understand their problems and develop strategies to improve their lives.

Mental health counselors and marriage and family therapists typically do the following:

• Diagnose and treat mental and emotional disorders, such as anxiety and depression
• Encourage clients to discuss their emotions and experiences
• Help clients process their reactions and adjust to difficult changes in their life, such as divorce and layoffs
• Guide clients through the process of making decisions about their future
• Help clients develop strategies and skills to change their behavior and to cope with difficult situations
• Refer clients to other resources or services in the community, such as support groups or inpatient treatment facilities

Mental health counselors and marriage and family therapists use a variety of techniques and tools to help their clients. Many apply cognitive behavioral therapy, a goal-oriented approach that helps clients understand harmful thoughts, feelings, and beliefs and teaches how to replace them with positive, life-enhancing ones. Furthermore, mental health counselors use cognitive behavioral therapy to teach clients to eliminate unwanted and damaging behaviors and to replace them with more productive ones.

Although some disorders can be overcome, others need to be managed. With the latter, mental health counselors and marriage and family therapists help the client develop strategies and skills to minimize the effects of their disorders or illnesses.

Many mental health counselors and marriage and family therapists work in private practice. They must spend time marketing their practice to prospective clients and working with insurance companies and clients to get payment for their services.

Mental health counselors provide treatment to individuals, families, couples, and groups. Some work with specific populations, such as the elderly, college students, or children. Mental health counselors deal with a variety of issues, including anxiety, depression, grief, low self-esteem, stress, and suicidal impulses. They also help with mental and emotional health issues and relationship problems. 

Marriage and family therapists work with individuals, couples, and families. Unlike other types of mental health professionals, they bring a family-centered perspective to treatment, even when treating individuals. They evaluate family roles and development, to understand how clients’ families affect their mental health. They treat the clients’ relationships, not just the clients themselves. They address issues, such as low self-esteem, stress, addiction, and substance abuse.

Mental health counselors and marriage and family therapists coordinate patient treatment with other professionals, such as psychiatrists and social workers.

Mental health counselors and marriage and family therapists are typically required to have a master’s degree and a license to practice.

To become a mental health counselor or a marriage and family therapist, applicants typically need a master’s degree in psychology, clinical mental health counseling, marriage and family therapy, or a related mental health field. A bachelor’s degree in most fields is acceptable to enter a master’s program.

Counseling programs prepare students to recognize symptoms of mental and emotional disorders and to use effective counseling strategies. Marriage and family therapy programs teach students about how marriages, families, and relationships function and how these relationships can affect mental and emotional disorders.

Many employers prefer to hire counselors who have graduated from programs accredited by the Council for Accreditation of Counseling & Related Educational Programs.

Candidates gain hands-on experience through postdegree supervised clinical work, sometimes referred to as an internship or residency. In training, they learn to provide family therapy, group therapy, psychotherapy, and other therapeutic interventions, under the supervision of a licensed counselor.

All states require mental health counselors and marriage and family therapists to be licensed in the state in which they practice. Licensure requires a master’s degree and 2,000 to 4,000 hours of postdegree supervised clinical experience, sometimes referred to as an internship or residency. In addition, counselors and therapists must pass a state-recognized exam and complete annual continuing education classes.

Contact information for state boards regulating mental health counselors is available through the National Board for Certified Counselors.

Contact and licensing information for marriage and family therapists is available through the Association of Marital and Family Therapy Regulatory Boards.

Compassion. Counselors and therapists often work with people who are dealing with stressful and difficult situations, so they must be compassionate and empathize with their clients.

Interpersonal skills. Being able to work with different types of people is essential for counselors and therapists. They spend most of their time working directly with clients and other professionals and must be able to encourage good relationships.

Listening skills. Good listening skills are essential for mental health counselors and marriage and family therapists, both of whom need to give their full attention to their clients to understand their problems, values, and goals.

Organizational skills. Good organizational skills are especially important for counselors and therapists in private practice, who must keep track of payments and work with insurance companies.

Speaking skills. Mental health counselors and marriage and family therapists need to be able to communicate with clients effectively. They must express ideas and information in a way that clients can understand easily.