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Differences: LCSW, MFT, LPCC, PhD, PsyD, ‘MFTI’, ‘AMFT’, ‘Associates,’ ‘Coaches’

In California, when someone seeks psychotherapy, there are various types of professionals to choose from who are licensed to provide these services. These are: 1) psychiatrists (a type of MD with special training and specialization); 2) psychologists (Ph.D. or Psy.D); 3) Licensed Clinical Social Workers (MSW); 4) Marriage and Family Therapists (MA or MS), and 5) Licensed Professional Clinical Counselors (LPCC).


Psychiatrists are specialty types of doctors (MDs) and they are the only types of mental health professionals who legally can prescribe medication in California. While some psychiatrists provide psychotherapy, many today do what is called “medication monitoring,” which includes providing prescriptions and monitoring patients to assess their response to the medication and to assist in addressing any side-effects. I frequently collaborate with psychiatrists and we work closely together to help clients achieve symptom relief. Even though any MD can prescribe medications for psychiatric disorders, I prefer to refer you to a trusted, gay or “gay-friendly” psychiatrist because of their specialized expertise in prescribing the right medication at the right dosage for your situation.


Licensed psychologists get a Ph.D. or a Psy.D. degree.  They also provide psychotherapy, and many provide psychological testing as well, which can be helpful in diagnosis of such disorders as adult Attention Deficit Disorder and some neurological problems.  Psychologists also traditionally contribute much to the academic literature and body of research, and associations such as the American Psychological Association have meaningful gay-advocacy programs.


The MFT license is a phenomenon unique to California, and is the most populous mental health discipline in the state, with many variations on training and quality.  It has undergone many name changes over time. It was formerly the MFCC (Marriage, Family, and Child Counselor). Some of its members use the official “MFT” suffix, while others use the unofficial “LMFT” suffix (perhaps to align more in the public’s perception with LCSWs). The MFT license has less rigorous requirements to obtain compared to the other licenses for mental health professionals. The precursor degree, an MA or MS in psychology or counseling, can be offered by major universities, but is frequently offered by small, private, for-profit trade schools, with often less formal academic standards and less standardized curricula.  Some of these schools require no competitive admissions process, and are not accredited by any major academic or mental health organization body outside of themselves. Because they are the most populous clinical discipline in the state, the majority of complaints filed with the California Board of Behavioral Sciences (a division of the California Department of Consumer Affairs) are related to this discipline.


The “MFTI” is an acronym that is sometime still used, but is outdated.  Practitioners who have graduated their graduate school program but are not yet licensed practice under the supervision of a licensed provider until they accumulate the required number and type of clinical experience hours to be eligible to sit for the state licensing exams.  The “I” used to stand for “intern,” but the proper name is now called “associate.” The newer acronym is “AMFT.”  The “MFTI” is not the acronym of a clinical license, nor is the “AMFT,” and should not be used without spelling out the “associate” as well.  Some of these practitioners open practices and advertise immediately after receiving their degree, obscuring their status as unlicensed associates, perhaps misleading the public that the acronym implies a type of clinical license when it is not. The California Board of Behavioral Sciences has issued a strong requirement that all non-licensed registered interns/associates of all disciplines make clear by notation in all advertising, websites, business cards, stationery, and other promotional materials that they are indeed associates, who must be supervised by licensed practitioners, and the name, title, and license number of their supervisor must be included in these materials, but this requirement is often ignored.

“Life Coaches”

This discipline is completely unregulated and therefore is the most risky.  In recent years, a number of entrepreneurs have appointed themselves “life coaches” and sprung up on the scene, especially online.  While these people claim that they are “certified” by something or other “coaching federation,” which has no legal oversight, they are often charging similar fees as therapists, when far too often they have no graduate degree, no license, and sometimes not even a Bachelor’s degree.  Unlike all  licenses to do counseling/therapy, there is no state board to oversee these “life coaches.”  They undergo no required academic standards, no rigorous exams, no supervision, and no ongoing professional education to be in practice.  There is no recourse against abuse or malpractice to clients.  There are some coaches whom some people have found to be very helpful, much as other non-professional practitioners like psychics or shamans can be, but I would be very leery of such services from people who have been unwilling to undergo the efforts and sacrifices of many years of formal academic training, thousands of hours of clinical supervision, exams, continuing education, investment, oversight, and rigorous screening standards that all forms of licensed psychotherapists must undergo in every state.    Despite claims from some of these coaches that they “focus on the future” while psychotherapists merely “re-hash the rubble of the past,” psychotherapists DO counseling or coaching to focus on a better future for their clients as well — especially in techniques that focus on the present, such as Cognitive-Behavioral Therapy, Problem-Solving Therapy, Motivational Interviewing, Acceptance and Commitment Therapy, Dialectical Behavioral Therapy, or Positive Psychology.  Receiving life, business, executive, or relationship coaching services from a Master’s or Doctoral level, experienced, licensed psychotherapist is much safer for the client and the community.


My license to practice psychotherapy is the LCSW (Licensed Clinical Social Worker), with special additional training as a psychiatric social worker, which qualifies me to discuss medications and their use in more depth, but not as precisely as an MD psychiatrist who can prescribe. I also am an AASECT Certified Sex Therapist (which is another credential that includes academic work and supervised practice before certification, of about eighteen months), and hold a certification from a year-long training program in Consensual Non-Monogamy (CNM) and Polyamorous Relationships/Families from the Sexual Health Alliance.  Surprisingly, in the United States, the majority of psychotherapy and counseling services are provided by clinical social workers, not psychologists as might be expected. I was licensed as an LCSW on my first attempt in 1997 (LCS#18290, verifiable at, after completing my undergraduate degree, my graduate degree, and then 3,200 hours of professional, supervised clinical experience in not less than 24 months of work, supervised weekly by an LCSW, and rigorous written and oral exams (with an approximately 30% pass rate).

After receiving a B.A. from UCLA in 1987 and a number of years working in industrial psychology, I received my MSW (Master of Social Work) degree in 1994 (with a specialization in Mental Health and a special sub-specialization certificate in treating Psychiatric Disorders) from the University of Southern California (USC) Suzanne Dworak-Peck School of Social Work, accredited by the Council of Social Work Education (CSWE) and at that time one of the top 5 schools of social work in the United States. It was here that I started my specialization in working with gay men, gay male psychology, gay mental health, HIV mental health, and community research and advocacy.  I am retired faculty from there, having achieved the rank of Adjunct Associate Professor, having taught courses in LGBT Psycho-Social-Political Issues, Evidence-Based Practice in Psychotherapy Techniques, and Couples Therapy.

While many well-meaning, progressive, heterosexual psychotherapists claim to work with LGBT and/or HIV issues, or even gay male therapists who are not specialists, can provide valuable service, working with me gives you the added benefit of working with someone who is a long-term specialist who actually lives within these communities as a part of them.  I am gay and HIV-positive, 24/7, which means that I sometimes draw on my professional training in the gay and poz areas of study, research, and expertise, and other times I am drawing on my personal experiences and examples to help you in these areas.  After over 32 years of living successfully with HIV myself, and 38 years of living as an “out” gay man in Los Angeles and  West Hollywood, there is much “material” to draw on!

Benefits of Working with Me:

Some of the benefits of working with me, as opposed to some other practitioners in our community, include the length, breadth, and depth of my experience.  These include:

– 30 years of continuous professional experience providing psychotherapy, counseling, and coaching specifically to a gay men’s specialty, as well as secondary specialties in helping people living with HIV or psychiatric disorders

– Specialized training in working with psychiatric disorders, including Depression, Bipolar Disorder, Panic Disorder, Obsessive-Compulsive Disorder, Attention Deficit Disorder, and other conditions that require close and effective collaboration with psychiatrists and medication treatment

– Extensive experience working with gay men who have substance dependence or addictions, helping hundreds of people overcome dysfunctional relationships to crystal methamphetamine, cocaine, heroin, marijuana, sex, gambling, shoplifting, eating, and work

– Graduation from two major accredited academic institutions (BA – UCLA and MSW – USC), not a trade or professional school

– Experience in the private practice, public sector, and community agency settings, where I have held both clinical and non-profit organization executive positions

– 38 years of familiarity of working, playing, and living in the West Hollywood gay community as my home

– “Walking the talk” of living a thriving professional and personal life with a high degree of gratitude and personal/commercial success

– Prior experience in “corporate America” and industrial psychology for effective executive and career coaching services

– Thousands of hours of experience helping gay men with very similar problems, and countless “success stories” on how problems much like yours have been solved in the past

– Dozens of publications and speaking engagements given locally and nationally, hundreds of blog articles, and over 100 podcast episodes of “Gay Therapy LA with Ken Howard, LCSW, CST” heard by over 8,000 per month in over 40 countries of the world.

– Continuous involvement in contributions to our gay and/or HIV community through volunteer work, donations, consulting, and other contributions


All of this background gives me a history, experience, skill set and perspective that I can then apply to help you with your specific situation and help you resolve the challenges you face today.


If you have questions about my services, email me directly at, or text me at 310-339-5778 for more information or to make your first appointment.