I’ve gotten these questions as a therapist from several pending clients in many different situations over the years:

• Are you an expert on this issue?
• Have you worked with this before?
• Are you just a regular professional therapist?
• I’m not sure if you could help, can you?

It is a good question to ask. And a question coming from a pragmatic, caring heart, as you want yourself or someone you love, not to waste time but to experience healing and growth. So, in this article, I want to provide some introduction to what you can probably expect your therapist to know and how likely they are to help.

Therapist Training

Let’s first talk about the knowledge and training a therapist gains from the ground up, and what you can generally come to accept as standard for your experience across the board.

There are three basic differentiations for therapists by experience and training, like the levels in carpentry, which look like

• Apprentice
• Journeyman
• Master carpenter

Therapist training levels are:

• Trainee: like an apprentice learning the trade, supervised often by professors
• Associate therapist: like a journeyman gaining experience, full-time practitioners, gaining supervision by professional therapists, often still pre-licensed
• Licensed therapist: like a master carpenter, working under own license

This is the marriage and family therapy model of training classification, whereas other counseling professionals, like clinical counselors, social workers, and psychologists, may have slightly different education and classification than MFTs.

Like any profession, you can have brilliant and skilled technicians or not-so-brilliant or skilled practitioners at any level of training. But let’s start with trainees and ask the questions: Are you an expert, have you seen this, and can you help?

As a trained therapist trainee, one has received a variety of education and training around areas as diverse as child psychology and the study of aging along the lifespan, abnormal psychology regarding the study of all types of mental illnesses, and the study of what makes romantic partnerships and personal lives thrive and blossom versus fail.

All trainees have been reared in a number of different theories and philosophies, looking at what causes problems in human functioning. They are also trained in vehicles of change for the betterment of quality of life and the factors in therapy that are conducive to that growth.

You can have appointments with trainees and work with them, generally for lower fees than associates or licensed therapists, and specific benefits can range from their recent academic scholarship and research, the supervisors who really invest in their maturation, and so you have two brains working behind your care.

Trainees are often tremendously gifted individuals by nature who apply some of the common factors beautifully, as well as begin to grow more knowledge of certain specialized treatments.

Below are some of the common factors that describe what therapy looks like in every office and are generally considered factors that contribute to many healing outcomes:

Common Factors

Support

• Catharsis
• Identification with therapist
• Mitigation of isolation
• Positive relationship
• Reassurance
• Release of tension
• Structure
• Therapeutic alliance
• Active participation of both therapist and client
• Therapist expertise
• Therapist warmth, respect, empathy, acceptance, genuineness
• Trust

Learning

• Advice
• Affective experience
• Assimilating problematic experiences
• Cognitive learning
• Corrective emotional experience
• Feedback
• Insight
• Rationale
• Exploration of the internal frame of reference
• Changing expectations of personal effectiveness

Action

• Behavioral regulation
• Cognitive mastery
• Encouragement to face fears
• Taking risks
• Mastery efforts
• Modeling
• Practice
• Reality testing
• Experiencing success
• Working through

Therapists at all levels will be trained to apply these modes of thinking, feeling, relating, teaching, and modeling, which means most interactions, when things fit, are examples of dealing with an expert in modeling and shaping changed thinking, feeling, communicating, and behaving at some level.

Trainings And Credentials

Therapists at all levels can receive specialized training (as permitted by the presenters). In fact, I took training this last year for an evidence-based couples therapy approach that had me surrounded by psychologists with PhD’s, licensed MFTs, associates, trainees just beginning to see clients for the first time, many saying keenly insightful things.

Some training and methods can teach you theories that are evidence-based (meaning research studies have proven effective in achieving positive outcomes) or can have you trained in subject matter as general as child psychology or as specific as trauma-focused therapy with veterans.

Other training can lead to certification and credentials such as CSAT (Certified Sex Addiction Therapist), Addiction certified through organizations like National Certified Addiction Counselor, NAADAC, EMDR certified, or Gottman method certified, and those who pursue them often spend years and thousands of dollars on those specialties.

That shows a passion and a commitment to that subpopulation, which is a good sign if you’re a client (and probably means you’ll need to pay more for their services).

The next level of general training every therapist must progress to is that of an associate therapist. After a trainee graduates from their graduate program and has seen hundreds of hours of clients by then, they then apply for an associate number to begin seeing clients under the tutelage of a supervisor in a professional and paid relationship.

Therapists in this stage gain even more hours and end up with upwards of 1200 face-to-face session hours with a supervisor coaching them before and after, and countless more hours learning the trade, amounting to at least 3000 hours of training. Associates, on top of education, amass a lot of real training in the field.

Many of these associate therapists work in agencies or private practices under the license of their supervisor, so they are well monitored and guided by those supervising licensed therapists. During this time, they must acquire training in telehealth, ethics, suicide, and risk assessment, and often do many hours of extra training in these topics.

For example, the agencies I worked with during my associate period trained me intensively in Dialectical Behavior Therapy, which is a model that largely helps clients who are dysregulated internally regulate, make effective choices, and increase mindfulness and flexibility.

I also was taught Trauma Focused Cognitive Behavioral therapy, which taught a method of working with traumatized children to assist them to grow in the ability to deshame themselves, notice their feelings and sensations, and process trauma in a suitable way that left them more able to continue with their lives. Then, with this trauma, I was able to implement the tools and techniques of those models and then be shaped and molded by my supervisors into a more adept practitioner with those tools.

What is the scope of competence versus the scope of practice?

Terms you may hear from a therapist are.

“That is not in my scope of practice.”

This means the therapist, and any therapist at any level or professional title, would not be equipped to deal with. To exaggerate, filing your taxes, giving you legal advice, or telling you how to reconstruct your porch would be out of a therapist’s scope of practice. However, it is harder to identify discrepancies would be giving medical advice, or usually prescribing medication (unless the therapist is a psychiatrist

What is within the scope of practice is trained listening, encouragement, discernment, interpersonal skill building, self-regulation skill building, insight development, crisis management, mindfulness, and thought process change toward truthfulness

“That is within my scope of competence!”

This means the topic that you are bringing to the therapist is one that the therapist is well versed in and trained or experienced in more than the average therapist. For example, all therapists are trained to assist family members in healthier discussions, etc., but some therapists have a greater scope of competence than others, maybe to assist a family member dealing with a son with severe mental illness, which a different therapist might not be as competent in handling

The last level of training is being licensed in your therapy field, such as a licensed marriage and family therapist (LMFT), licensed clinical social worker (LCSW), or licensed professional clinical counselor (LPCC). After completing the required hours and your associate phase, a therapist of any sort is now granted the privilege, in distinction from the professional boards of their state and or professional organizations, to conduct therapy on their own.

If the famous anthropologist Malcolm Gladwell is close to the truth about 10,000 hours of practice making someone an expert in something, then including the associate time of 3000 hours plus many hours of undergraduate and graduate education, any licensed therapist is pretty close or at least halfway to being an expert, or at least a skilled professional at handling mental, emotional, and social issues adeptly for the client.

And many issues overlap, and initial reasons for coming to therapy can often lead both the therapist and the client to see that there are other underlying things to be worked on. Therapists who engaged in different ways of becoming experienced can often see problem areas where they can apply what they know from different angles, whether it be a more researched approach, common sense, or general intuition and skillfulness at the therapist’s springs.

I, for example, have been shaped through training in different methods, life experience, overall years of clinical experience, outside interests in readings, psychological concepts, and how much time in my faith, reading the Bible, listening to sermons, and community, which speaks to the human experience.

So perhaps I may have a potential client who says their child with high functioning autism is really struggling and isolating due to social pressures in junior college as a forty-year-old attempting to be more self-sufficient.

I’ve never worked with a forty-year-old with autism, and I’m not considered an expert who has had countless training sessions and hours of experience. However, I know the client will need emotional regulation, some interpersonal skills, some acceptance and understanding of where to push to accept limits, and family support, just through general awareness and experience

Hopefully, I’ve been able to show the spectrum of the kind of helpful care you will receive and things that you can look for and ask for to gain greater clarity. Overall, seeing anyone at any level in this field, it is likely you will be meeting with someone knowledgeable who can provide adequate supervision of your care.