Teen Counselor vs. Therapist vs. Psychologist


In this post, we go over the difference between a teen mental health counselor, therapist, and psychologist.

The Steadily Worsening U.S. Public Mental Health Crisis

According to the latest provisional data from the Centers of Disease Control & Prevention (CDC), the situation is already worsening further now that the impact of the pandemic is close to being fully realized.

From March to October of 2020, children’s visits to the emergency room for mental health conditions increased by 31% for those aged 12-17 years old, and 24% for children aged 5-11 years old compared to the same period in 2019.


Teen Counselors, Therapists & Psychologists


There are many types of behavioral therapy that can prove beneficial in the treatment of a teenage mental health disorder or a behavioral issue, and the most widely used of these is one-to-one psychotherapy, known commonly as “talk therapy.”

According to the U.S. National Institute on Health, “psychotherapy” is a term for “a variety of treatment techniques that aim to help a person identify and change troubling emotions, thoughts, and behavior.”

Most psychotherapy sessions take place with a licensed, trained mental health professional and the patient, either meeting one-on-one or with other patients in a group setting.

For the parents, guardians and caregivers of a teenager with a mental health or behavioral disorder, it can be confusing as to which type of “licensed, trained mental health professional” they should choose for the treatment of the child.

According to the U.S. Bureau of Labor Statistics, the most common options for this professional in the U.S. are either a teen counselor, a teen therapist, or a teen psychologist. However, their list also includes psychiatrists, social workers and advanced psychiatric nurses.

The issue of choice is often further confused by the different state legislations across the U.S. for the licensing and certification of these types of mental health professionals.

What is a Teen Counselor?

Licensed counselors are usually required to have a bachelor’s degree (although individual states do vary), and should typically have 2-3 years of graduate training in counseling methods, with specialty areas including marriage and family counseling, school counseling, community counseling, and substance abuse counseling.

All states in the U.S. require counselors to be licensed by the National Board for Certified Counselors (NBCC), which officially grants the title of National Certified Counselor (NCC) on the successful completion of the licensure examination.

What is a Teen Therapist?

The actual term of “therapist” is a very broad one, and can be applied to anyone who provides any form of therapy, from acupuncture to aromatherapy, and from psychotherapy to physical therapy (and pretty much every therapy in between).

However, a “teen therapist” usually applies to a mental health or behavioral therapist working at an in-patient mental health care facility, hospital, clinic, or private practice.

To become qualified as a teen therapist usually requires a bachelor’s degree (as a minimum), a master’s degree (often required), or a doctorate (sometimes required). Again, this varies from state to state.

State licensure is required in every state for various types of counselors, as well as all clinical social workers and psychologists.

Parents looking to hire a teen therapist for their child should find out about the licensure requirements for the U.S. state they live in.

What is a Teen Psychologist?

Psychologists typically offer one-to-one (individual) or group therapy treatment sessions for their patients, and there are various areas each can specialize in, such as teen psychology..

There are a number of distinct levels within the distinction of a psychologist:

  • Ph.D. psychologists have undergone five years of graduate training in psychology, and
  • PsyD psychologists have the same training as those with a Ph.D., but there is less emphasis on research and experimental methods

Most states also require 1-2 years of supervised experience after graduation to be fully licensed to practice. In most states, unlike medical physicians like your family doctor, psychologists do not have prescribing privileges.

Additionally, psychiatrists, licensed clinical social workers, and advanced psychiatric nurses all have the professional capability to provide teen psychotherapy.

Growin’ Up: Worsening Mental Health in U.S. Teenagers


In December, 2021, the U.S. Surgeon General, Vice Admiral Vivek H. Murthy, M.D., M.B.A, in a rare public advisory, warned of a “devastating” mental health crisis among American teens:

Every child’s path to adulthood – reaching developmental and emotional milestones, learning healthy social skills, and dealing with problems – is different and difficult. Many face added challenges along the way, often beyond their control.

It is now abundantly clear that the coronavirus pandemic, with its social distancing, school closures, imposed isolation, and online classes, has simply worsened this already critical situation.

The Decline in U.S. Teenage Mental Health During the Pandemic

Since the pandemic began, psychological distress, such as symptoms of anxiety, depression, and other mental health disorders, among U.S. youth has increased, and it’s not just in the U.S. either.

A global study of around 80,000 youth worldwide found that symptoms of depression and anxiety doubled during the pandemic, with around 25% of youth experiencing depressive symptoms and 20% experiencing those associated with anxiety.

Here in the U.S., in early 2021, emergency department visits for suspected suicide attempts were a massive 51% higher for adolescent girls, and 4% higher for adolescent boys compared to the same time period in early 2019.

U.S. Teenage Mental Health: Facts & Stats

According to Mental Health America (MHA), in 2020, nearly 1 million adolescents, aged 11-17 years old, took a clinically validated mental health screen through the MHA Online Screening program. This was a huge 628% increase over those who took the screen just one year before – in 2019.

Not only are more adolescents looking for mental health treatment, throughout the course of the pandemic so far, those aged 11-17 have been more likely than any other age demographic to score for both moderate to severe symptoms of anxiety and depression.

As an example of the huge demand for treatment and therapy services for children and teens in the U.S., a pediatrician in Glasgow, Kentucky, Dr. Melissa Dennison, recently stated to the New York Times:

If I’ve got this child, and they’re cutting and saying they’re going to kill themselves, I’ll say, ‘Well, I’ll see them today.’”

If I call a child psychiatrist, they say, ‘I’ll see them in a month.’”

Furthermore, the MHA found that:

  • 84% of 11-17-year-olds who took an anxiety screen in 2020 scored with moderate to severe anxiety symptoms, and
  • 91% of 11-17-year-olds who took the PHQ-9 for depression scored with symptoms of moderate to severe depression;
  • These rates were, respectively, 7% and 9% higher than the rates for anxiety and depression among adults over 18

However, it’s not just anxiety and depression that’s affecting U.S. teenagers.

U.S. Teens: Self-Harm, Suicidal Ideation & Suicide Attempts


During 2020, the first year of the pandemic, the proportion of mental health-related emergency department (ED) visits among adolescents aged 12–17 years increased significantly by 31% compared with 2019.

However, in May 2020, the CDC further found that ED visits for suspected suicide attempts were beginning to increase among same-age adolescents, and far more girls presented in the ED than boys.

What is Self-Harm?

The act of “self-harm” (also known as “self-injury”) can be defined as “self-poisoning or self-injury, irrespective of the apparent purpose of the acta British Psychological Society definition accepted by the U.S. National Institute of Health.

The medical term of “self-harm” is considered to be a broad one, and could be applied to the actions of many people at some point in their lives.

An individual episode of self-harm could be an attempt to end life. However, the majority of these acts of self-harm are performed with any suicidal intent whatsoever.

In the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (known as DSM-5 / 5th. Ed.) self-harm is now listed as a medical disorder, and termed “Nonsuicidal Self-Injury (NSSI) disorder” (NSSI).

Prevalence of Self-Harm in the U.S.

According to Mental Health America, the most common methods of self-harm (NSSI) are:

  • Skin cutting (70-90%)
  • Head banging or hitting (21-44%), and
  • Burning (15-35%)

Other forms of self-harm include:

  • Excessive scratching to the point of drawing blood
  • Punching self or objects
  • Infecting oneself
  • Inserting objects into body openings
  • Drinking harmful liquids, eg. bleach or detergent, and
  • Purposely breaking bones

Most individuals who engage in NSSI hurt themselves in more than one way.

Research indicates that self-injury occurs in around 4% of American adults.

However, rates are higher among adolescents, who are at an increased risk for self-injury, with around 15% of U.S. teenagers reporting some form of self-injury. Some studies show a greater prevalence of NSSI among college students, ranging from 17-35%.

What is Suicidal Ideation?

“Suicidal ideation” (also known as thoughts of suicide or suicidal ideas / SI) is a broad medical term describing “a range of contemplations, wishes, and preoccupations with death and suicide.”

However, there is no universally accepted definition of SI, which results in immense difficulty for medical professionals, such as researchers, clinicians, and educators.

DSM-5 does refer to suicidal ideation, stating that the term may be assigned as a principal diagnosis if the clinician has confirmed that there is no underlying mental disorder.

Prevalence of Suicidal Ideation, Suicide Planning & Suicide Attempts in the U.S.

Among U.S. adolescents (aged 12 to 17 years), according to the U.S. 2020 National Survey of Drug Use & Health (NSDUH):

  • 12.0% (or 3.0 million people) had serious thoughts of suicide
  • 5.3% (or 1.3 million people) made a suicide plan, and
  • 2.5% (or 629,000 people) attempted suicide in the past year

Furthermore, during the month-period from February 21 to March 20, 2021, ED visits for a suspected suicide attempt were 50.6% higher among girls in the same age group than during the same period in 2019.

Among boys, also aged 12-17 years, ED visits for a suspected suicide attempt increased by just 3.7% – highlighting the clear disparity in the type and level of pressures facing both female and male adolescents.

Common Mental Health Disorders Affecting U.S. Teenagers


Mental health disorders that now commonly affect American teens include anxiety disorders, depression (known medically as major depressive disorder), and ADHD (abbreviated from attention deficit hyperactivity disorder).

Sadly, mental illness is common in teenagers, with around 1 in 6 teens (aged 12-18 years) suffering from at least one diagnosed mental health disorder.

According to several studies:

  • High school students with significant symptoms of depression are more than twice as likely to drop out compared to their peers, and
  • Students aged 6-17 with mental, emotional or behavioral concerns are 3 times more likely to repeat a grade.

However, that is not the full story.

In addition, the prevalence of self-harm (or self-injury), thoughts of suicide (known as suicidal ideation) and actual suicide attempts, many successful, have increased steadily along with the increases in mental health disorders during the last decade, and so contributed greatly in creating the current public mental health crisis among American youth.

U.S. Teens: Anxiety Disorders, Depression & ADHD

1. Anxiety Disorders

Anxiety disorders, such as generalized anxiety disorder (GAD), social anxiety disorder, panic disorders and phobias are the most prevalent mental health disorders among teenagers in the U.S.

Although each type of anxiety disorder has its own unique range of symptoms, they do share one thing in common – they are all characterized by a persistent, excessive fear or worry in situations that, in reality, are not threatening.

Sufferers of an anxiety disorder normally experience one or more of the following symptoms:

Emotional Symptoms:

Physical Symptoms:

  • Feelings of apprehension or dread
  • Sweating, tremors and twitches
  • Feeling tense or jumpy
  • Headaches, fatigue and insomnia
  • Restlessness or irritability
  • Upset stomach, frequent urination or diarrhea
  • Anticipating the worst and being watchful for signs of danger
  • Pounding or racing heart and shortness of breath

2. Major Depressive Disorder (MDD)


Major depressive disorder – more commonly known as depression, and often abbreviated to MDD – involves severe and recurrent periods of highly negative changes in mood, thought processes (such as negative thoughts and feelings of hopelessness), and motivation lasting for a minimum of two weeks. These are known as major depressive episodes (MDE).

MDD is considered medically as a severe mental illness, and it can present several different symptoms, depending on the person with the disorder. However, for most sufferers, it changes how they function day-to-day, and typically last for longer than 2 weeks.

Common symptoms of MDD can include:

  • Changes in sleep
  • Hopelessness or guilty thoughts
  • Changes in appetite
  • Physical aches and pains
  • Lack of concentration
  • Suicidal thoughts
  • Loss of energy
  • Changes in movement (less activity or agitation)
  • Lack of interest in activities

3. Attention Deficit Hyperactivity Disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) is a developmental disorder normally seen in children and adolescents, and defined by the following behaviors:

  • Inattention, such as trouble staying on task and actively listening
  • Disorganization, such as losing things / materials, and
  • Hyperactivity-impulsivity, such as fidgeting, and difficulty in staying seated or waiting

According to the CDC, millions of U.S. children have been diagnosed with ADHD. Using data from a 2016 parental survey, the CDC estimated the number of children diagnosed with the condition is 6.1 million (9.4%). This number includes:

  • 388,000 children aged 2–5 years
  • 2.4 million children aged 6–11 years
  • 3.3 million children aged 12–17 years

Furthermore, boys are more than twice as likely to be diagnosed with ADHD than girls (12.9% compared to 5.6%).

Teenage Mental Health & Substance Use


It has long been established by medical and addiction experts that mental health issues often result in issues with the use and abuse of substances – and this is just as true for children and teenagers as it is for adults.

What is Co-Occurring Disorder?

Known as “co-occurring disorder” – or “dual diagnosis” – the simultaneous prevalence of a mental health disorder and a substance use disorder (SUD) is far more common than you may think.

In fact, drug abuse and mental disorders, like depression and anxiety, are commonly found together in teens, and co-occurring disorders occur in more than half of all teens who abuse drugs.

The most common way this happens is when an individual with an undiagnosed and untreated mental health disorder uses psychoactive substances to “self-medicate” their mental health symptoms.

However, it works in reverse, too, when substance abuse leads to the development of a mental health disorder, most commonly either depression or anxiety.

In addition to common mental health disorders among teens [provided above], other mental health disorders and severe behavioral disorders, such as a SUD or eating disorders, eg. anorexia nervosa and bulimia are also highly prevalent.

Your Teen’s Psychotherapy: Who Should You Choose & Why?


All of these mental health professionals [listed and described above], such as counselors, psychologists and teen therapists, are fully competent in providing talk therapy and other psychotherapies to teenagers with a mental health or behavioral disorder.

However, it is best to follow the steps provided below to ensure the mental health or behavioral disorder you believe your teen is suffering with is an accurate and professional diagnosis, and the therapist that you choose is sufficiently licensed, accredited and qualified to do so.

1. Consult Your Family Physician

Your primary care physician can help you determine what kind of mental health professional you need, and can give you a referral. Although your family doctor may provide a preliminary diagnosis of your child’s disorder or issue, it is always best to follow their advice, and be provided with a clinical diagnosis from a mental health / behavioral specialist.

2. Your Teenager’s Mental Health Diagnosis

The diagnosis and the advice provided to you by the specialist will help you to understand the type of therapy that is required for your teen. Indeed, the specialist may well provide a referral to a psychologist or counselor from the same hospital / clinic, or recommend a program of care at a mental health facility who works with your health insurer.

3. Teenage Psychotherapy: Licensure, Accreditation & Professional Qualification

To ensure the mental health professional who is providing talk therapy sessions and other psychotherapeutic treatments is suitably legally qualified to do so, consult your U.S. state government’s website to determine the requirement for the practice of psychotherapy where you live.

Avery’s House: Teen Behavioral Treatment in Arizona

One of the most successful therapy avenues available to the parents of a teen with a mental health or behavioral disorder is an accredited adolescent treatment program provided by a hospital or clinic specializing in mental health and behavioral issues.

Avery’s House, located in Apache Junction, near Mesa, Arizona, is a behavioral health facility with highly specialized behavioral health professionals who work with adolescents (aged 11-18 years) to evaluate, diagnose, and stabilize a variety of teen mental health conditions, such as:

  • Depression
  • Bipolar Disorder
  • Anxiety Disorders
  • PTSD
  • ADHD
  • Attention Difficulties
  • Mood Swings / Anger
  • Self-Esteem Issues
  • Difficulty With Family & Friends
  • Suicidal & Self-Harm Thoughts
  • Bullying & Victimization
  • Substance Use Disorders

Call 855-506-1906 today and speak to one of our representatives.

Please Note: We do not work with aggressive and violent behaviors, extreme substance use with criminal background, adjudicated teens, fire starters, severe sexual dysfunction or any other extreme diagnosis.

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