How to Become a Therapist (US)
How to Become a Therapist (US)

How to Become a Therapist (US)

In recent years, people have become increasingly aware of the importance of mental health. More and more of us are seeking help from therapists and other mental health experts.

But, what exactly is a therapist, what do they do, and what are the skills and qualifications required?

What Is a Therapist and What Do They Do?

A therapist is a relatively broad term that can describe someone who is qualified to work as a mental health professional.

Therapists are able to offer assistance to individuals, couples or groups.

They will often work in private practices, although they can also work in school, clinical or workplace settings.

How Much Do Therapists Earn?

Your earning potential as a therapist will vary considerably depending on your level of experience and the specialization you choose.

Average salaries for therapists in the US, listed by specialty are:

  • Psychotherapist – $85,000
  • Behavioural therapist – $40,000
  • CBT therapist – $52,000
  • Recreational therapist – $58,000
  • Occupational therapist – $84,000
  • Family therapist – $49,000
  • Child therapist – $120,000
  • Art therapist – $47,000

How Long Does It Take to Become a Therapist?

The length of time that it takes to become a fully qualified therapist can vary.

For most people, it will take 7–15 years to complete all of the training required post-high school.

This is because some specializations require longer studying time and more extensive training.

If you know what specialization you would like to pursue, it is important to understand how long the relevant courses might take and how many clinical hours might be required to qualify.

All therapists will find that they require a bachelor's and master's degree before moving on to their specialist training.

Some examples of the length of time you could expect to study and train after completing a bachelor's degree are:

  • Psychotherapist – 2–5 years
  • Behavioural therapist – 2–5 years
  • CBT therapist – 1–2 years
  • Recreational therapist – 1–5 years
  • Occupational therapist – 2–3 years
  • Family therapist – 2–3 years
  • Child therapist – 6–8 years
  • Art therapist – 2–3 years

What to Expect When Training as a Therapist

The training will vary depending on the specialization you choose, but there are some similarities between the potential options.

Knowing the process that you need to follow will help you to take the right steps at the right time.

Check State Requirements

Each state will have different requirements for their licensed therapists.

It is important to fully understand the requirements of the state you are planning on practicing in.

In many situations, the training needed to become a therapist is the same from state to state. However, different states may specify that certain courses are required.

It is also possible that the number of clinical hours required may vary, although this is more likely to vary due to specialty rather than state requirements.

The final consideration is that licensing rules can vary.

Some states will have an annual license fee, whereas others require therapists to renew their license every two years.

There may also be rules regarding continued learning attached to your license.

Know Your Specialization

Before you begin your studies, it is a good idea to research different specializations.

If you have some idea as to how you would like to specialize, this can help you to decide the best courses to take.

Bachelor's Degree

Almost all states will require therapists to hold a bachelor's degree.

Although it doesn't always have to be in a subject related to therapy, it can be useful to study something which can be useful later in your studies.

Master's or Doctorate Degree

Once you have completed your bachelor's degree, you will usually be required to complete a master's degree.

This will often be a course related to the specialty you have chosen.

The more specialized therapist roles also require individuals to gain a doctorate in their chosen specialization.

Clinical Work

No matter which specialization you choose, you will need to complete a set number of clinical hours to work directly with patients.

The exact number of hours required varies across specializations, and different states may also have different requirements.

Be sure to check the rules for your state and specialization of choice.


Once you have completed your studies and clinical hours, you will need to apply for licensing. In most states, this will require you to submit evidence of your qualifications and clinical work.

It is also likely that you will have to sit a standardized test to show your knowledge. For most people, this will require study and preparation to pass.

Some states will also have separate exams for ethics and mental health laws.

There are likely to be fees associated with gaining your license.

For most states, these will be paid annually, although some states require therapists to pay their license fee every two years.

After Licensing

For most people, their license will come with an agreement to continue learning throughout their careers.

This is to ensure that therapists keep up to date with changes in practices and ethics regulations relating to their state.

How to Become a Therapist: by Therapist Specialization

As previously mentioned, the exact educational requirements will vary depending on the specialization that you choose.


  • Bachelor's degree in psychology or a similar field
  • Master's degree in psychotherapy
  • 1,500–3,000 clinical hours
  • Licensing exam

Behavioural Therapist

  • Bachelor's degree in psychology or similar field
  • Master's degree in either psychology or counseling
  • 2,000–4,000 clinical hours
  • Licensing exam

CBT Therapist

  • Bachelor's degree in psychology or similar
  • Master's degree in psychotherapy
  • Complete state-required clinical hours
  • Licensing exam

Recreational Therapist

  • Bachelor's degree in recreational therapy or similar
  • Apply for National Council for Therapeutic Recreation Certification (NCTRC)
  • Take the certification exam and fulfill licensing requirements for your state

Occupational Therapist

  • Bachelor's degree in a course that includes coursework in psychology or similar
  • Master's degree in occupational therapy
  • Register with the National Board for Certification in Occupational Therapy (NBCOT)
  • Take occupational licensing exams

Family Therapist

  • Bachelor's degree in psychology or similar
  • Master's degree in counseling, family therapy or similar
  • Complete the number of clinical hours required by your state
  • Take a licensing exam

Child Therapist

  • Bachelor's degree in psychology or similar field
  • Master's degree in child psychology, clinical psychology or child development
  • Complete clinical hours required by your state. This is usually 2,000–3,000 hours
  • Take a licensing exam
  • Consider a PhD

Art Therapist

  • Bachelor's degree which includes some study of psychology
  • Master's degree in art therapy
  • Complete the required number of clinical hours for your state, usually 700–1,000 hours
  • Apply for licensing with the relevant body for your state
How To Become a Therapist (US)
How To Become a Therapist (US)

Skills to Master

Most of the skills that you will need as a therapist will be taught as part of your training.

It is useful, however, to possess some skills before starting.

These will help you to be the best therapist that you possibly can be and enable you to connect with your clients in a way that makes them feel comfortable and heard.


It is important to have empathy for your patients.

They may come to you with issues that you find impossible to relate to, but they should feel as though their thoughts, feelings and concerns are understood.

Without empathy, your patients may feel as though they are being judged. This can have a negative impact on their ability to make progress.

Listening Skills

One of the most valuable skills for a therapist is the ability to listen.

Patients will come to you to talk about difficult subjects, their emotions and issues that they are having. They need to feel listened to and valued.

Reading Body Language

Alongside the ability to listen to your patients, it is also helpful to be able to read body language. Sometimes, people will say one thing while they mean another.

Being able to interpret someone's body language can help you deduce what they might be feeling, even when they cannot tell you.


Communication is vital as a therapist.

Whether you need to know the right questions to ask or explain treatment plans to your patients, it is important that you can communicate clearly.

Critical Thinking

You will need to evaluate patients' symptoms to form a diagnosis and treatment plan. Critical thinking is vital for this as it will allow you to look at all of the individual parts as well as the patient as a whole.

The Ability to Set Boundaries

While it is important for your patients to feel listened to and understood, it is also vital for you to be able to set boundaries.

This means that although your patients will be able to feel as though you understand them, they will also know that you are their therapist and not their friend.

Setting boundaries also helps to ensure that you are fulfilling all of the appropriate ethical practices, such as not becoming romantically attached to a patient.

How Is a Therapist Different from a Psychologist, Psychiatrist or Counselor?

Although they all work with individuals to improve their mental health, there are some differences between therapists, psychologists, psychiatrists and counselors, which should be considered before choosing which path to take.

What Is a Psychologist, Psychiatrist or Counselor?


Psychologists study the mind and human behavior to understand why individuals act the way they do.

They then apply this knowledge to their patients to find ways to treat psychological and societal problems.


A psychiatrist is a medical professional who specializes in mental health and the treatment of patients with mental health problems.

They use their medical knowledge to treat their patients.

Unlike other mental health professionals, psychiatrists can prescribe medication as part of a treatment plan.


Counselors predominantly use talking therapies combined with regular appointments to help patients with emotional and behavioral issues.

The main difference between a therapist and a counselor is the level of training and licensing required to practice.

What Training Does a Psychologist, Psychiatrist or Counselor Need?

Because the areas a psychologist, psychiatrist or counselor might work in are slightly different, the level of education and training required may also differ.


Training will vary depending on the specialist area that a psychologist chooses to work within.

They will usually require a master's degree in their chosen field as well as a doctorate.


The exact level of training and licensing will vary depending on the state’s requirements that an individual is working in. Often, it will include a degree in medicine.

Once they have completed their medical training, psychiatrists are required to register and license with the state that they plan to work in.


Before applying for licensing, counselors are required to complete both bachelor's and master's degrees as well as a number of clinical hours that are specified by their state.

Final Thoughts

As a therapist, you can make a significant difference in the lives of your patients.

Whether it is providing a listening ear to a child who has a difficult home life or helping an adult deal with a traumatic experience, the value of a therapist should never be underestimated.

If you are considering therapy as a career path, it is vital to know the steps you will need to take and when to take them.

This will mean that you are prepared and organized before starting your studies.

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