If you are considering a career in mental healthcare, several fulfilling paths are available to you.

A licensed mental health counselor (LMHC) and a licensed marriage and family therapist (LMFT) are just two types of mental health professionals that help individuals and families lead productive and fulfilling lives.

While each practice can make a profound impact on patients, you may be wondering, what is the difference between LMHC and LMFT?

In this guide, we will dive deeper into what sets each licensure apart, and how they affect therapy practice and career development.

What is a Licensed Mental Health Counselor?

A licensed mental health counselor provides mental health services to individuals, with a focus on diagnosing and treating emotional, behavioral, and mental health disorders. LMHCs play a critical role in the mental health field by offering accessible and effective support to clients for issues like:

• Depression and anxiety
• Substance abuse 
• Post-traumatic stress disorder (PTSD)
• Relationship issues
• Stress, grief, or life transitions

A licensed professional counselor takes a client-centered approach in any clinical setting, with a focus on understanding an individual's mental health through a wide range of therapeutic methods such as:

• Cognitive behavioral therapy (CBT) – CBT aims to help patients manage mental health issues by identifying and challenging unhelpful thought patterns with practical strategies to change their behaviors.¹
• Solution-focused therapy (SFT) – SFT is a goal-oriented approach to therapy that emphasizes identifying and building on a client's strengths and resources to resolve current problems.²

What is a Licensed Marriage and Family Therapist?

A licensed marriage and family therapist helps couples and families resolve emotional, psychological, and relational conflicts and explores how family dynamics can impact mental health.³

LMFTs are trained to approach therapy through the lens of systems theory, which emphasizes the interconnectedness of individuals and their environments, particularly their relationships and family dynamics.⁴

This perspective is foundational to how LMFTs understand and address psychological and relational challenges. In addition, their practice can include various styles of therapy such as:

• Family systems therapy – A form of therapy that treats the family as one unit—when something affects one member it affects all members, and likewise, the strength and stability of the family unit can provide support when one member needs help.⁵
• Structural therapy – Structural therapy focuses on interactions between family members, such as how they communicate.⁶ An LMFT may help restructure elements within the dynamic that cause dysfunction, such as boundaries, hierarchy, or reactions to life changes.
• Narrative therapy – Narrative therapy takes a story-telling approach that helps patients and families view themselves as separate from their problems and encourages them to reshape their personal stories in empowering ways.⁷

LMHC vs. LMFT: The Scope of Practice

So, what is the difference between LMHC and LMFT? While both licenses equip therapists to provide essential mental health support, their scope of practice differs based on their training, clinical focus, and approach to treatment.

For example, an LMHC may take a broad approach to their practice, working with individuals across diverse client populations with varying mental health issues. On the other hand, an LMFT will employ a more specialized approach that focuses on solution-oriented modalities for families.

Individual Therapy vs. Family Therapy

As we mentioned above, LMHCs and LMFTs serve different client populations. While there can be some overlap, their training and focus influence the clients they typically work with and the issues they address through two different types of therapy:

• Individual therapy – LMHCs specialize in addressing the mental health concerns of individuals, helping clients manage personal challenges.⁸ They work with clients across all life stages (from children and adolescents to adults and seniors), adapting therapeutic techniques to suit developmental contexts.⁹
• Family therapy – LMFTs use family therapy techniques to treat clients within the context of their relationships and broader family systems, emphasizing the interconnectedness of relational dynamics.¹⁰ Sessions often involve multiple members of a system, such as couples, families, or even intergenerational groups, to explore patterns, improve communication, and positively impact the health of the system as a whole.

Treatment Focus and Client Impact

For LMHCs, treatment plans often prioritize understanding the internal processes of their patients, such as thoughts, emotions, and behaviors. They employ evidence-based methods like Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT) to:

• Improve symptom management
• Build lasting life skills
• Achieve personal goals
• Foster overall mental well-being

Alternatively, an LMFT often works with multiple members of a system, using techniques like structural family therapy to improve communication and resolve conflicts. Treatment emphasizes:

• Shifting unhealthy patterns within relationships
• Resolving interpersonal conflicts
• Supporting the individual and collective well-being of the system

Educational Requirements and Pathways

Whether you’re considering a career as an LMHC or an LMFT, specific educational paths and licensing requirements are needed. Some of these requirements can overlap, such as:

• Obtaining a bachelor’s degree 
• Obtaining a master’s degree
• Passing a licensing exam 
• Gaining supervised clinical experience

However, these requirements do differ in key ways. For instance, where an LMHC might obtain a master’s degree in clinical mental health counseling, an LMFT will typically pursue a master’s degree in marriage and family therapy.

The number of clinical hours required to complete supervised clinical training may vary as well. Although it varies by state, LMHCs must typically complete up to 3,000 hours of supervised clinical experience.¹¹ An LMFT must complete about 2,000–4,000 hours of supervised clinical experience, with a portion of these hours dedicated to working with families and couples.¹²

After supervised clinical experience is complete, prospective students must pass nationally administered exams specific to their licensure. Both pathways also require students to complete related educational programs that align with their chosen area of licensure.

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Licensing Exams: What You Need to Know

The licensure exams for LMHCs and LMFTs are tailored to assess the competencies required for each profession, reflecting their unique areas of specialization.

For example, LMHC exams reflect the profession’s emphasis on addressing individual mental health needs. It tests for proficiency in understanding psychological disorders, formulating treatment plans, and applying therapeutic interventions for personal growth and symptom management.¹³

The LMFT exam highlights the profession’s focus on relational and systemic dynamics. It assesses the ability to work with multiple clients in a system and emphasizes communication, boundary setting, and resolving conflicts within families or relationships.¹⁴

Similarly, LMHCs and LMFTs must pass two separate tests distinct to their areas of specialization (keep in mind that prospective applicants must first receive permission from the state they wish to practice in before sitting for the exam):¹⁵

• National Clinical Mental Health Counseling Examination (NCMHCE) - The NCMHCE is the most common exam for LMHC licensure. It assesses a candidate’s ability to evaluate, diagnose, and treat mental health issues using clinical case studies.¹⁶
• Association of Marital and Family Therapy Regulatory Boards (AMFTRB) Exam - The AMFTRB is the primary exam for LMFT licensure. It includes case scenarios that involve couples, families, or intergenerational systems, requiring candidates to identify patterns, relational dysfunctions, and appropriate therapeutic techniques.¹⁷

Should You Be Double-Licensed?

Both individual therapy and family therapy are valuable (and often complementary) approaches to addressing the complex nature of mental health and relationships. To that end, being licensed in both fields can present unique advantages for your practice and patient outcomes.

For instance, you may be able to:

• Serve a broader client base – So, can you be double licensed in LMHC and LMFT? Yes, you can. With a double license, you can treat a broader client base that includes individuals, couples, and families struggling with common mental health issues or relational dynamics.
• Enhance your expertise – Dual licensure can also expand your expertise and deepen your knowledge of patient problems and treatment plans.
• Take a holistic approach – Double licensure can expand your scope of practice to include several therapeutic techniques.

That said, a double license can pose some challenges, like meeting the education, clinical, and examination requirements for both licenses. Holding dual licensure may also require addressing complex client needs using a variety of approaches.

How to Decide Between LMHC, LMFT, or Double Licensure

Choosing between LMHC and LMFT (or pursuing double licensure) involves careful consideration of your career goals, interests, and the populations you want to serve. Evaluating your mental health professional aspirations and long-term goals can help you make an informed decision.

Consider Your Therapeutic Approach

To decide which licensure is right for you, consider your therapeutic approach—each approach will guide your interaction with the client to achieve their goals and desired outcomes.

Do you feel drawn to evidence-based practices like CBT to help individuals address personal challenges? Or are you interested in how therapeutic approaches like family systems therapy can resolve issues within relationships or families?

Consider how each licensure aligns with your interests and career aspirations.

Long-Term Career Aspirations

If you want to focus on individual mental health, an LMHC license may be the best fit. It offers the flexibility to work with diverse populations in various settings. However, if you want to specialize in relational dynamics, you might prefer to pursue an LMFT license.

For those seeking broader opportunities or leadership roles, consider dual licensure to expand your scope of practice and versatility in the field.

Practical Advice for Pursuing Dual Licensure

For students pursuing dual mental health degrees, planning and organization are essential to balancing the academic, clinical, and licensing requirements. To determine if dual licensure is the right fit for you, consider:

• Researching programs that offer dual-degree options
• Choosing curricula that align with the requirements for both fields
• Prioritizing internships or practicum placements that provide diverse experiences to meet the requirements for both licensures
• Consulting with academic advisors and licensing boards early to ensure that your coursework and supervised clinical hours align with state-specific standards for dual licensure

Ready to Help Others?

LMHCs often focus on individual mental health concerns, while LMFTs specialize in addressing relational and family dynamics—but both can positively affect the mental health and well-being of patients across a diverse client base.

Whether you choose to pursue one (or both) paths, consider partnering with Alliant International University. With our Master's in Marital and Family Therapy and Master's in Clinical Counseling programs, we help students build their educational foundation and equip them with the skills and knowledge they need to make a lasting impact in their respective fields.

Apply today to learn more.

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