LCSW vs. Psychologist

June 29, 2021 | By Scott Wilson

Both LCSW therapists and psychologists help people overcome problems like depression or addiction but operate under different licenses and come from different schools of thought. LCSWs hold master’s degrees and work with individuals and groups to solve mental health and social problems, marshalling skills in both therapy and the traditional practical solutions that social services provide. Similarly, psychologists work with individuals or groups to handle mental health problems, but hold doctorates and use advanced psychotherapeutic techniques without the social services component

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Psychologists vs Social Workers: Different Philosophy and Approach to Professional Practice

You can see how the philosophy of a social worker vs psychologist grows out of different kinds of priorities for human services. Those origins subtly shape the approach that clinical social workers and clinical psychologists take. This affects both the cases they take and the methods they use in providing treatment.

Psychology is the study of the mind and its functions. As a science, it looks inward toward mental processes where social work looks outward at social structures and pressures. Psychologists aren’t blind to sociological effects, but their treatment methods usually focus on what the individual patient can control—their own thoughts and behaviors.

Psychology is the study of the mind and its functions. Social work is about social systems. Both are important in behavior and happiness.

Social work is more about systems. Clinical social workers can and do look at mental states and behavioral issues on the individual level, but they tend to base their diagnosis and treatment in broader contexts of social structures and supports. They aim for holistic solutions that assist both individuals and communities.

That broader focus on addressing systemic issues puts LCSWs into contact with more social services systems and more community groups, too. They engage in political lobbying and activism in an effort to change chronic issues that may reach way beyond the individual level.

Psychologists also recognize those big systemic problems, but their role is to help each patient figure out their own solution.

The Different Capabilities of Social Workers vs Psychologists

With specializations like clinical neuropsychology on tap, it’s easy to see why psychologists end up treating more complex and severe mental conditions than social workers.

The ability of a psychologist to really plumb the depths of the human brain make them a better choice for handling issues that are more rooted in individual mental processes. Complex mental health problems like schizophrenia and borderline personality disorder are tough to diagnose and fix. The specialized training a psychologist gets makes them the right kind of expert to handle such issues.

In instances where the root causes of mental health issues are wrapped up with personal circumstance or bigger social issues, though, an LCSW can offer better solutions. The best solution for treating depression in a homeless person, for example, might be to find them housing. Dealing with chronic addiction issues might benefit from not just talk therapy but also placement in a methadone treatment program. Clinical social workers have the mindset and the training to offer that kind of broad-spectrum treatment.

An LCSW working in juvenile healthcare might get a referral from a doctor who suspects that a student suffering from ulcers is developing the condition in response to problems at home. The doctor isn’t equipped to investigate the psychological or cultural roots of those issues and doesn’t have the right toolset to treat them if they are the ultimate cause of the medical condition.

The LCSW, however, has the training to evaluate the student for mental health problems like bulimia, OCD, or anorexia. They also have the experience and training to spot potential problems within the family like bullying or abuse. Finally, they have a broad set of tools to fall back on to resolve whatever the root issues is—whether it is counseling the student directly, making a placement in an after-school program, or arranging for child welfare supervision from the state.

Social workers have a big toolbox for dealing with all kinds of behavioral, psychosocial, and just flat-out random issues that life throws at people. They are the ideal tool for scoping out and solving practical problems that keep people from having happier, more fulfilling lives.

What is an LCSW?

What does LCSW stand for? It stands for Licensed Clinical Social Worker. Each state sets out licensing requirements for the LCSW, or for an equivalent license. Not every state defines the job exactly the same. In some places, you might find different titles for the same tasks, such as LICSW, meaning Licensed Independent Social Worker. You can also find other similar titles like:

LGSW – Licensed Graduate Social Worker
LMSW – Licensed Master Social Worker
LISW – Licensed Independent Social Worker
LSCSW – Licensed Specialist Clinical Social Worker

And some states use the term LCSW, but call it a Licensed Certified Social Worker instead, a job that does not allow clinical therapy work… unless you earn an LCSW-C, or Licensed Certified Social Worker-Clinical.

Whatever the exact abbreviation that is used to describe their license, clinical social workers are both trained and authorized to offer direct therapy to clients.

Those counseling capabilities come on top of the typical social worker skillsets – client advocacy, coordinating care, and organizing services.

The Different Types of LCSW Practice

The National Association of Social Workers (NASW) lists sixteen different types of social worker practice. Not all of these require an LCSW. Social work is roughly divided into direct, macro, and clinical practice levels.

Direct – Social workers who work directly with clients, but not necessarily in a therapeutic role. Examples include some kinds of hospital social workers and child welfare workers.
Macro – Social workers who function in an oversight or support role. For example, managing a large home health service would fall into a macro role, or working in a non-profit advocacy group.
Clinical – Social workers with an LCSW or equivalent who work directly with clients to provide therapy among other services.

The exact licensure required in each of these kinds of work can vary from state to state, however. But you can find LCSWs involved in any of these types of practice:

Aging – Geriatric social work can involve getting needed services to elderly patients who can no longer care for themselves, or need counseling and assistance in the kinds of major life transitions that happen as we age.
Child Welfare – Social workers are critical in taking care of vulnerable youth populations, making sure that at-risk kids have the kind of support and resources they need to grow up strong and healthy, and offering a safe, friendly ear for the numerous problems that come along with growing up.
Developmental Disabilities – Individuals of all ages who have developmental disabilities need both advocacy and assistance in all different aspects of life and learning. Social workers help secure the assistance that is needed and help these individuals fit into lifestyles that are fulfilling and meaningful.
Health Care – Health issues often come along with social and economic problems. Social workers in health care offer counseling for getting through these rough patches together with resources and referrals for getting patients back on their feet after recovery.
Justice and Corrections – America has one of the highest rates of incarceration in the world, matched by a sky-high recidivism rate. Social workers in this area attempt to cut the cycle of prison and re-offending through counseling, job placement assistance, and programs to help ex-cons return to productive places in society.
Mental Health and Clinical Social Work – This is the sort of core areas for LCSW work. Social workers are one of the largest resources for mental health assistance in the United States and some of the easiest to access for underprivileged individuals in need of therapy.
Mental Health and Substance Abuse Social Work – Closely related to general mental health social work, but more specialized, many social workers are on the front lines of dealing with the more than 30 million Americans that the National Center for Drug Abuse Statistics have identified as drug abusers.
Occupational and Employee Assistance Program Social Work – The average American spends just over 34 hours a week at work according to the Bureau of Labor Statistics. A job allows them to get insurance, food, and put a roof over their heads. It’s a pretty big deal. Social workers in this specialty work with people to help them have happier and more productive jobs. They also work to help those out of work get assistance and find a new job as soon possible.
Public Welfare – This area is a kind of catch-all for the types of issues that impact patients but may not fit neatly into other kinds of practice areas. Poverty, racial, religious, and gender discrimination, and other large-scale societal problems can be issues for public welfare.
School Social Work – Bullying, educational access issues, and abuse problems are dealt with by school social workers. Like the title says, they primarily work in school systems, but they also can spend plenty of time on the street with home visits, coordinating after-school programs, or working with other juvenile social services agencies.

How History Shaped the Role of the Clinical Social Worker

If you want to understand the differences between psychologists vs social workers, it helps to understand how each job came to be in the first place.

For social workers, the role grew out of the work of philanthropists and volunteer societies trying to address the mass dislocation and poverty that came out of the Industrial Revolution. By the late 1800s, the slums of modern industrial cities had become horrific scenes of poverty and hunger.

Christian societies and organizations like the New York Charity Organization Society put together relief efforts, including paid staff who went to investigate and assist. Those first social workers were called Friendly Visitors.

At the political level, those organizations lobbied for government assistance, which arrived with the wealth of the Roaring Twenties and became more critical through the Great Depression.

Those collective responses to major societal shifts are part of what helps define the work of clinical social workers even today. Their perspective and reactions are rooted in the history of the profession to take on big problems and look for practical solutions.

Rough living conditions in turn-of-the-century industrial cities sparked the origins of the social work movement.

Earning the MSW You Need to Become an LCSW

Any kind of clinical social worker needs to have not only an advanced education, but also plenty of real-world experience and demonstrated knowledge in the field. The process of earning an LCSW can take four or more years after getting a four-year bachelor’s degree.

That four-year degree is both a requirement and just a jumping off point. The traditional LCSW degree is the Master of Social Work (MSW). This is a two-year graduate degree that includes both theoretical and practical approaches to social work.

The typical curriculum in an MSW degree program will include courses in:

Social Justice – Social justice issues are at the core of how modern social work came to be. You learn how and why these issues come about, from over-incarceration to healthcare inequities. Then you learn how to attack them both on an individual level and as a society.
The History of Social Welfare – Part of understanding how things are today requires learning the trends that brought us here. You’ll go all the way back to the Industrial Revolution and the roots of charitable assistance and work forward through wars, the Depression, and racial intolerance.
Sociology and Community Building – The “social” in social work shares the same root as sociology. You’ll study how societies are formed and organized and how both rules and attitudes affect the lives of individuals. You’ll get practical instruction in how to build community consensus and organize people to pull together for a better society.
Advocacy and Leadership – Social workers are expected to step up and lead throughout their careers, so an MSW comes with courses in leadership and advocacy work. You’ll learn the role and limits of political lobbying as well as the art of applying pressure to agencies and officials to get results for your clients.
Clinical Practice – This is the part of the MSW program that will most closely resemble the coursework that psychologists go through. You learn behavioral principles and the basis of human thought. Mental health conditions and their common treatments are taught, along with assessment methods and standard testing techniques.
Field Placement – All that training in all those subjects gives you a solid basis for practicing as a social worker. But the real secret to the MSW is the practicum and internship placements that are required. These put you out in the field, under the supervision of experienced instructors and active social workers. You will put your skills to the test against real-world situations and with real individual clients, polishing off your theoretical understanding with practical experience.

There are different types of concentrations available in different MSW programs. Each different concentration will include both the core classes for the MSW and unique coursework that prepares you for that specialty. Additionally, you may find that your basic courses emphasize approaches and applications that line up with your specialty. For example, a concentration in school social work may mean more time spent on juvenile development and problems like bullying instead of Alzheimers or other geriatric concerns.

A master’s thesis or capstone project is the part of an MSW degree that brings together all your learning and experience in a final wrap-up that shows what you have learned and how you plan to practice as an LCSW.

MSW programs also require either a thesis paper or a capstone project. A thesis paper, usually between 40 and 80 pages of scholarly writing based on a unique research project that you take on under faculty supervision, is the traditional cherry on top of a master’s degree. But the practical nature of social work has taken many MSW programs in the direction of a capstone project instead. These projects are more action-oriented, with less focus on writing and more on practical implementations of your ideas.

It’s also important to pick an MSW program that has been accredited by the Council on Social Work Education (CSWE). In many states, your eligibility for licensure will depend on that accreditation, since state boards look to CSWE for quality assurance. Their long experience in real-world social work demands and in evaluating colleges that teach the required curriculum gives the organization real authority in determining which schools offer a serious degree in the field and which ones don’t.

It’s also possible to get your LCSW with a Social Work Doctorate (DSW), but the advanced study in those programs is often more appropriate for leadership or teaching positions rather than LCSW therapist work.

The Experience and Exams Required to Earn the LCSW

Earning an MSW is just the start when becoming an LCSW. Every state has additional requirements for the LCSW, meaning that graduation with an MSW is just the start.

Extensive Post-Graduate Field Experience

Although the MSW includes practicum and internship experience, that’s just the tip of the iceberg. In practically every state, getting a clinical social worker license also requires 3,000 hours or more of supervised post-graduate field experience. Usually, supervision will come from a current LCSW, but in some states any other mental health professional may fill in, including psychologists.

The supervised hours have to consist of a certain amount of direct one-to-one oversight, but this is a period where you are also expected to start standing up your own clinical skills. That means consultation and chart reviews will make up most of the hours.

In some states, you have to get an intermediate license in order to practice even under supervision. Usually holding an MSW is enough to meet requirements for that credential.

Testing Requirements for LCSW Licensure

LCSW therapists also have to pass a test to earn their license. Every state relies on the Association of Social Work Boards (ASWB) for the exams for LCSW licenses.

ASWB offers five different exams, but the Clinical test is the one required for the LCSW. It costs $270 and consists of 170 multiple choice questions that you must complete within four hours. The questions cover both clinical knowledge and your practical skills in treatment.

Most states also have a state-specific test that covers ethics and regulations that cover LCSW practice authority in that state. You’ll usually also have to pass a criminal background check and may have to submit professional references.

Specialty Credentials for LCSW Therapists

LCSWs can also become certified in their specialty areas by the National Association of Social Workers. With a certain amount of on-the-job experience and specific training in that area, clinical social workers can get a certification in:

Addictions/Clinical
Clinical
Education
Gerontology
Health Care
Hospice & Palliative
Military
Youth & Family

Certifications aren’t state requirements and most jobs in the field don’t demand you have one. But they can give your job prospects a boost over the competition and assure clients that you have the right kind of expertise for dealing with their needs.

The Education and Expertise That Makes a Psychologist Different From a Clinical Social Worker

Psychologists are also licensed by the states, and just as states are responsible for answering the question “what is a LCSW?,” they are also responsible for defining what a licensed psychologist is.

Just like social workers, there are many kinds of psychologists who don’t need a license because they aren’t in clinical practice.

Clinical psychologists provide psychotherapeutic services to patients and draw from many different schools of treatment, ranging from psychoanalysis to behavioral therapy.

Going back to the student with the stomach ache from the example above – if the doctor referred him to a psychologist instead of an LCSW, the focus would be on exploring the roots of the stress and finding ways to assist the student in managing it. The psychologist might use cognitive behavioral therapy to adjust the perspective of the patient on the stressors affecting him. Long sessions of traditional talk therapy would help him better understand the causes and provide the mental toolset to minimize the trauma leading to the physical symptoms.

Psychologists are all about what’s going on in the head and have fewer tools for finding practical solutions to some of the immediate day to day problems that arise from poverty.

Psychological practice specialties are just as broad and wide-ranging as social work. The American Psychological Association maintains a list of recognized specialties, subspecialties, and proficiencies in the field. There are 18 specialties and 3 subspecialties, even more than the 16 social work practice areas listed by NASW.

Also like social workers, there are many kinds of psychology practice that don’t fall into the bucket of clinical services. Psychologists can work in criminal investigations, study and advise corporate management practices, or look at large-scale social psychological phenomena, all without ever seeing a patient.

Unlike NASW’s categories, however, there may be some clinical component in every one of the APA list of specialties.

The History of Psychology Still Influences Professional Practice Today

Psychology came out of the even older discipline of philosophy. All that thinking about thinking primed a German professor named Gustav Fechner to set up some experiments about how thoughts are created and acted on.

A fellow of his, Wilhelm Wundt, founded the first laboratory dedicated to psychological research in Leipzig in 1879 and suddenly the ball was rolling through Europe, with luminaries like Pavlov, Ebbinghaus, and Freud branched out into important applications of psychology like conditioning, memory, and psychoanalysis.

Psychologists through the ages have consistently been motivated by scientific study and experimentation with mental processes. That focus on what is happening within the mind is in contrast to the LCSW emphasis on broader societal concerns. But there are branches of psychology that study group dynamics and social psychology as well as individual mental processes.

All of those threads equip modern psychologists with a full toolbox of techniques and proven principles that are still relevant in treating patients today.

Wilhelm Wundt began the scientific investigation of the mind that continues in today’s psychology profession

The Doctorate You Need to Become a Licensed Psychologist

Becoming a psychologist is a much longer and more intensive process than becoming an LCSW.

For starters, psychology licensure requires a doctoral degree. That PhD or PsyD program can take up to seven years to complete, a much more significant commitment in both time and money than the MSW.

But that also offers a much more in-depth education in psychological principles and practices. The course of study in an APA-accredited psychology doctoral program will include coursework in:

Psychological Foundations – The fundamental scientific understanding of how the mind works and how human mental processes develop across the lifespan. These courses also study neuroanatomy and fill in some of the long history of the field of psychology. From there, you’ll look at the family tree of psychological theories and how they shape modern psychology treatment practices.
Evaluation and Assessment – Plumbing the depths of a brain going sideways is as much an art as a science. Psychology programs put a lot of time into training you how to test cognition and personality to establish mental well-being. You’ll also learn abnormal psychology and how to diagnose problems that you do find.
Standards and Ethics – When exploring the deepest thoughts of patients, a lot of sensitivity is required. Psychology comes along with a rigorous code of ethics and high standards for patient privacy and meeting legal requirements. Every doctoral program devotes time to your ethical obligations and dealing with tricky questions that come up in everyday practice.
Clinical Practice and Psychological Interventions – The gritty core of a PsyD program is learning how to treat patients with mental conditions. You’ll study case conceptualization, treatment planning, creating differential diagnoses, and learn how to measure progress. Classes teach you standards of reporting and how to work with multi-disciplinary care teams. Specialized coursework will develop your clinical skills in line with your future specialization, and may cover areas like juvenile, adult, and geriatric practice as well as group and individual therapy.
Research – Particularly in PhD programs, but part of all psychology doctorates, research trains future psychologists in both finding new statistically relevant data to base treatments on, and to interpret other findings in the field. The qualitative and quantitative training that is part of these programs creates the scientific basis for effective psychological treatments.
Practicum – The in-person practice of psychology has a heavy emphasis in every doctoral program. It’s likely you’ll spend over 1,000 hours of time in a practicum or internship in most programs. The exact setting and kind of experience will depend on the program and the specialization you choose.

Concentrations in different types of psychology practice are common in PsyD and PhD programs. Your choice in specialization will affect your entire experience, not just your practicum placements. The coursework, research engagements, and your dissertation topic will all be heavily influenced by concentration.

The Psychology Doctoral Dissertation is a Key Feature of a Psychologist’s Education

One big difference between a psychology doctorate and an LCSW degree is the dissertation. A master’s in social work will often include a thesis paper, which is a substantial bit of original work that expands the knowledge of the field in a focused subject. But a doctoral dissertation is a whole different level.

You’re required to produce a 40-50 page paper that includes both unique ideas and original supporting research. Then you defend that paper in front of a committee of professors and experts, who ensure it’s the best possible representation of your ideas and findings.

The dissertation project can take up to two years of your entire doctoral program by itself and is considered a publication-worthy expression of your thoughts and learning. Although some PsyD degrees now offer an alternative capstone project option, dissertations are still the norm in psychology degrees.

What is The Difference Between a PsyD and a PhD in Psychology?

Just to set the record straight, you can become licensed as a clinical psychologist with either of these types of psychology doctoral degrees. But you might be wondering what the actual difference is if you are considering them as an alternative to the LCSW degree path.

The PsyD, or Doctor of Psychology, is a newer option. It is focused on the practice of clinical psychology. That means it leans more on practicum, diagnostic, and treatment teaching. It incorporates research and theory, but mostly in support of genuine practice in the field.

The PhD, or Doctor of Philosophy in Psychology, is a more traditional, research-oriented degree that is weighted toward preparing psychologists for academic positions. That means more theoretical work and investigation, with an emphasis on both conducting research and writing it up. Clinical aspects of treatment are a part of the program, but less so than with a PsyD.

Just as CSWE accreditation is important for LCSWs, picking a psychology program with specialty accreditation from the American Psychological Association is important for psychologists. The APA Committee on Accreditation is the gold standard in evaluating the competency and quality of psychology degree programs. State psychology licensing boards rely on that evaluation just as social work licensing boards do when evaluating your educational credentials.

The Experience and Exams Required to Become a Psychologist

An LCSW is a licensed position, whereas psychologist can describe anyone in the field, whether they need a license to practice or not. The licensure process for clinical psychologists is very similar to what is LCSW-required, however.

Post-Graduate Field Experience Hones Clinical Psychologist Skills for Licensure

Just LCSW licensing, psychologist licenses require a mountain of post-graduate supervised practice experience. Also like the LCSW, the exact standards for supervision and the hours required differ between states. But for the most part, you can expect to have to rack up between one and two years of professional experience, on top of an internship placement, to meet these requirements.

The meat of that experience will come through hours of direct client contact. You’ll be expected to spend time doing the same kind of clinical counseling that you will use in practice, with the oversight of experienced practicing psychologists honing your practical therapy skills.

Rigorous Testing to Establish Knowledge and Skill Levels

There is a national-standard test in psychology licensing, too. Developed by the Association of State and Provincial Psychology Boards, the Examination for Professional Practice in Psychology (EPPP) is a two-part exam that gives over both core knowledge and treatment skills.

The EPPP has multiple question formats from multiple-choice to scenario-based questions, and covers eight domains of knowledge and six different areas of practical skills. It’s a rigorous exam in keeping with the high demands for expertise in psychological practice.

Many states also have a jurisprudence exam that will test you on legal and ethical requirements based on the laws of that state. Others use an oral exam that also tests competency on top of ethical standards. And, due to the sensitive nature of psychotherapy counseling, you’ll have to pass a criminal background check before your license will be issued.

The Salary and Career Potential of Psychologists vs Social Workers

LCSW vs psychologist is a tough comparison when looking at salary and job prospects. The two have some overlap in terms of what they can do and the kind of patients they treat, but with very different paths to licensure and different job duties, a head-to-head competition isn’t really apples to apples.

Psychologists spend a lot more time in school and years getting all the required clinical practice in before becoming licensed. You better believe that pays off for them in the end.

According to the Bureau of Labor Statistics, the median salary for all psychologists in 2020 hit $82,180 per year. But that really undercounts the best comparison to clinical social worker jobs, which would be clinical psychologists. They fall into the psychologists, all other, category, and the median salary there is $105,780. The top ten percent of all psychologists pull in more than $137,590 per year.

Social workers generally earn a median of $51,760, but, again, that includes many who don’t have the advanced LCSW license. Clinical social workers are also in the social workers, all other, category, and their median pay is $64,210 per year. The top ten percent earn over $85,820.

Of course, most social workers don’t get into the business for high salaries. The real pay comes from helping people and driving social change.

Social workers also have an advantage when it comes to the rate of job growth too. BLS estimates the profession will grow by 13 percent between 2019 and 2029, much faster than the average rate of growth. That’s an additional 90,700 jobs over the decade.

Psychologists, on the other hand, will see only 5,700 positions added over the same period, a very typical 3 percent growth rate.

No matter what direction you decide to go, there are many opportunities to do well by doing good work as either a social worker or psychologist.

The choice may come down to your personality and your preferences: engaging in an exploration of the mind and mental processes, or of society and the social contract.

Both jobs are important, and both are demanding. And the fact is, the human services community is going to continue to need both compassionate and capable psychologists and social workers.

Understanding the philosophies and approaches that differentiate a Licensed Clinical Social Worker from a psychologist is a critical first step when it comes to determining which career to pursue. If you want to become an LCSW, the next step is finding the online MSW program that’s a best fit for you. If you’re considering a career as a psychologist, it’s important to learn more about earning a degree in psychology.

May 2020 Bureau of Labor Statistics salary and job growth figures for Social Workers and Psychologists represents national data, not school-specific information. Conditions in your area may vary.

Data Accessed June 2021.