What Is Scope of Practice for Therapists?

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In mental health care, “scope of practice” refers to the knowledge, skills, and experience needed for the provision of effective therapy and counseling services to clients, as well as the mental health diagnoses and conditions clinicians are trained and experienced in diagnosing and treating.

Scope of Practice

The term "scope of practice" refers to the areas in which a therapist specializes in.

Although most graduate programs include generalized training, each therapist will have different methods they draw from more than others and diagnoses with which they are more comfortable working. A therapist must understand the limits to their scope to ensure that clients receive quality care.

How Does a Therapist Choose Their Scope of Practice?

People have different strengths, and many therapists will find that they connect well with a specific type of client. For example, someone with a very stoic personality might have difficulty connecting with young children or engaging in play therapy interventions.

Similarly, many adult clients might have difficulty connecting with a therapist who is very playful or “child-like” in their demeanor.

Some therapists specialize in diagnoses or mental health symptoms that they have personally experienced. Although each experience is unique, they might feel they are better able to empathize with the client’s experience because they have been there themselves.

Therapists might specialize in working with clients to whom they are demographically similar because they connect well with this population. Many clients might also request a therapist who shares part of their identity. For example, LGBTQ+ individuals might prefer a therapist who is part of the LGBTQ+ community as well.

Some therapists choose a scope of practice because they see an unserved population in their community and want to help. They create a niche for themselves helping that group.

The setting that a therapist works in might also determine their scope of practice. A therapist working in a prison setting, for example, will specialize in working with people who are incarcerated.

Types of Scopes of Practice

A therapist’s scope of practice includes the presenting issues and diagnoses they are experienced in treating, the age range with which they work, and the modalities and interventions they have trained in. A therapist can expand their scope of practice by getting training and experience in additional areas.

Sometimes, a therapist might specialize in a very narrow and specific area that requires extensive training and expertise. EMDR, for example, is a very specialized intervention often used with survivors of trauma and requires training, supervision, and continuing education. A therapist who gains this certification will often focus much of their practice on clients who need this intervention.

A therapist may also decide to specialize in a particular diagnosis. For example, many therapists get minimal training in working with eating disorders, and so a therapist with extensive training in this might choose to accept most or all clients with eating disorders.

Other therapists have more broad scopes of practice. A therapist working in a rural clinic might specialize in issues common in rural populations, like farmers and ranchers. That therapist will also need to be familiar with a wide variety of diagnoses and symptoms since they might be one of the very few mental health providers in the area. In many parts of the United States, therapists in small communities are the only provider in the area.

A therapist’s scope of practice might change throughout their career. They might become more specialized in an area that plays to their strengths, or they might develop skills that allow them to treat a wider range of clients.

Why Is a Therapist's Scope of Practice Important?

You would not go to a dermatologist if your kidneys were failing. You need a provider who has the right training to understand your symptoms and treat your issue. Therapy is the same way.

If a therapist does not have the proper training to treat your diagnosis or symptoms, they could potentially do more harm than good by taking you on as a client. If they do not possess up-to-date knowledge about best practices in this area, this will impact their ability to provide you with the quality care that you deserve.

Sometimes, a therapist will limit their scope of practice based on their personal needs. A therapist who is being treated for their own trauma might be aware that they cannot competently treat clients who have experienced a similar trauma without their own triggers coming up. A therapist going through a difficult divorce might not feel competent to treat couples.

The therapist’s scope of practice is intended to protect clients and make sure that they receive appropriate care.

What Do Therapists Do When A Client Is Outside Their Scope of Practice?

If a therapist knows that a client’s presenting problem is outside of their scope of practice, they have an ethical responsibility to refer that client to a more appropriate provider. This is a requirement detailed in the ethical codes of psychologists, counselors, clinical social workers, and marriage and family therapists, and the requirement exists to protect clients from substandard care.

Therapists have information about other providers in their area. If a therapist receives a referral that is outside their scope of practice, they can provide the client with information about a provider with training or specialization that might better meet that client’s needs.

If a client’s presenting issues are similar to a therapist’s specialty but still outside their scope of practice, the therapist might choose to get additional continuing education, supervision, or consultation. If they are able to develop the competency to treat that client, they can pursue these resources and take the referral. This frequently occurs when a therapist is the only provider in the client’s geographic area, and there are limited referral options.

Finding the Right Therapist

It is difficult to take the first step and reach out to a therapist for treatment, and it can be disheartening if that therapist indicates that they are unable to provide care for you. Know that the therapist is offering that referral in order to ensure that you get the best possible care. They should give you information about other providers who might be a better fit for your needs.

Therapists typically list their specialties on their websites. You can use this information to determine whether a therapist might be able to treat your presenting issues. Directories also list therapists and what diagnoses they treat as well as what modalities or interventions they use in treatment. You can filter your search to find a therapist who has the training you need.

Your primary physician may have information about therapists in your area as well. General practitioners often have a referral list including information about each therapist’s specialization.

When seeking treatment, it is essential to work with a therapist who can meet your unique needs and has the training and expertise to treat your concerns.

6 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Grus CL, Skillings JL. Scope of practice considerations related to master’s training and psychological practice. Professional Psychology: Research and Practice. 2018;49(5-6):311-313. doi:10.1037/pro0000198

  3. American Psychological Association. Ethical Principles of Psychologists and Codes of Conduct.

  4. American Counselors Association. 2014 ACA Code of Ethics.

  5. National Association of Social Workers. Read the Code of Ethics.

  6. American Association for Marriage and Family Therapy. Code of Ethics.

By Amy Marschall, PsyD
Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. She is certified in TF-CBT and telemental health.