What Is the Difference between an Intern and a Fully-Licensed Therapist?

Tina Gilbertson, MA, LPC: There are two main differences and one big similarity between interns and licensed therapists.The first difference is that interns haven’t completed all the requirements for licensure. They may still be in school, or they may have graduated, but it takes time to meet all the criteria required by most licensing boards. Therefore, they’re less experienced in doing therapy than their licensed colleagues. But experience is just one tool in a therapist’s toolkit, and arguably not the most important one.

The second difference is that internships come to an end, and you might not be able to continue seeing your therapist once his or her internship is over. When matched with an intern, always ask how long they’ll be there, and what your options will be if you’re still working together when they leave. Of course, your work with a licensed therapist can also come to an end if they leave their place of employment, move away, or retire. So that difference, too, may be moot.

Here’s the big similarity: Both interns and licensed therapists are human beings. As such, both groups are identical in their inherent ability to do good therapy. Every therapist, whether just staring out, close to retirement, or somewhere in between, has a unique life story and set of personal qualities that they bring to their relationship with you.

An intern with self-awareness, integrity, and deep compassion will do better work than a fully-licensed colleague with more experience who doesn’t have those qualities.

When choosing a therapist, look first at the human being, not the paper credentials. Ask yourself, “How do I feel when I’m with this person?” If you feel respected, understood, and valued, you’re in good company—licensed or not.

Blake Griffin Edwards, MSMFT, LMFT: When I was an intern, I reviewed nearly every case not only with a site supervisor but also with a practicum supervisor and a practicum consultation group. I was also in the thick of serious studies that kept my therapeutic vision more or less clear. These pieces of support, when combined, provided invaluable scaffolding for the therapeutic work I was facilitating in-session.Most of my clients could have cared less what letters were behind my name.

Interns, of course, do face many more hours of required professional training and supervision on their road ahead. If you wish to better understand the requirements for an intern to become a fully-licensed therapist, look at the website for your state’s licensing board for professional counselors, marriage and family therapists, clinical social workers, and the like. Requirements vary from state to state.

Here, for me, is where the rubber meets the road:

The best therapists continue to seek regular consultation long after they have secured an independent license. There may be a clear threshold for the issuance of credentials by governmental entities, but there is no magical threshold a therapist crosses in the course of their development as clinicians. It is written, “As iron sharpens iron, so one man sharpens another.” This is, therefore, true of therapists.

Let’s talk pros and cons. Out with the bad news first: One cannot master the art of helping people through difficult emotional, mental, and relational difficulties in a matter of a few months or years. For many—I’ll include myself here—it takes decades. Now the good news: Beneficial therapeutic help doesn’t require a masterful therapist, just a good one.

The common elements of effective therapy, regardless of methodology or the prior experience of a therapist, are genuine care and concern, optimism and change-centered language, and constructive and co-created therapeutic goals. Whether interning or fully licensed, a good therapist will provide these.

Justin Lioi, LCSW: All of us therapists, no matter what our degrees are now or how many years of experience we’ve racked up, were all interns once. If you’re at a clinic and the worker you meet is an intern, there are some things you should know.Interns are currently in training, which means they will only be at the agency for a limited amount of time. They are in the midst of studying human behavior and may be focusing on different types of therapy in their studies. They will be monitored closely by a supervisor. This means they may check in with that person during sessions.

A licensed therapist has graduated with a degree in mental health, has been in the field for several years, and has passed an exam. The type of degree, time in the field, and the kind of test all vary depending on the type of therapist. This should all be explained to you when you first meet.

While working with a seasoned clinician may sound like a better way to go, there are some strong positives of working with an intern. Because they are new to the field they bring a lot of energy to the work—a different kind of energy than someone who’s been in the field for several years. Since they are in school they are actively studying the most recent developments in mental health and psychology—maybe even taking classes with experts in the field. That they are actively working with a seasoned clinician as their supervisor means that you will essentially have two therapists for the “price” of one.

Working with an intern or a licensed counselor both have their benefits and with either you should ask any questions that will put you more at ease.