A free guide from Cima Find Care

How to choose a therapist in Texas

The letters after a name tell you what someone is trained and licensed to do. This guide explains them, shows you how to check a Texas license in a minute, and gives you the questions to ask on a first call so you can find someone who fits.

Updated October 25, 2026. General information, not medical, legal or insurance advice.

If you need help now: call 911 in an emergency. In a mental health or substance use crisis, call or text 988, any time. SAMHSA's National Helpline, 1-800-662-4357, is free, confidential and open 24/7 for treatment referrals.

What the credentials mean

In Texas, the license title tells you someone's training and whether they can work on their own. "Associate" means a licensed clinician who's finished their degree and is now working under a board-approved supervisor. That's normal and allowed.

Credential	What it means	Licensed by
LPC Licensed Professional Counselor	A graduate degree in counseling or a related field, supervised experience and a national exam. Treats mental health concerns with counseling, on their own. An LPC-S is also an approved supervisor.	Texas State Board of Examiners of Professional Counselors (BHEC)
LPC Associate	Has the degree and passed the exam, and is completing at least 3,000 hours of supervised work over at least 18 months. Can counsel only under an LPC-S, and must tell you who that supervisor is.	Same board (BHEC)
LCSW Licensed Clinical Social Worker	A master's or doctorate in social work, at least 3,000 hours of supervised clinical work over at least 24 months, and a clinical exam. Provides therapy on their own.	Texas State Board of Social Worker Examiners (BHEC)
LMSW Licensed Master Social Worker	A master's degree in social work. Can provide therapy only through an agency, as an employee or contractor, and under clinical supervision, often while working toward the LCSW.	Same board (BHEC)
LMFT Licensed Marriage and Family Therapist	Graduate training in marriage and family therapy and at least 3,000 hours of supervised work. Sees couples, families and individuals, with a focus on relationships. An LMFT Associate practices only under an LMFT-S supervisor.	Texas State Board of Examiners of Marriage and Family Therapists (BHEC)
Psychologist Licensed Psychologist	A doctoral degree in psychology, an internship and supervised experience. Provides therapy and psychological testing. A Licensed Psychological Associate (LPA) has a master's degree in psychology.	Texas State Board of Examiners of Psychologists (BHEC)
LCDC Licensed Chemical Dependency Counselor	Focuses on substance use: assessment, counseling and recovery. HHSC says an LCDC isn't qualified to treat a mental health disorder, or to give family counseling for problems that don't involve substance use. Some clinicians hold an LCDC and another license.	Texas Health and Human Services Commission (HHSC)
Psychiatrist	A medical doctor (MD or DO) who specialized in psychiatry. Diagnoses mental health conditions and prescribes medication; some also provide therapy.	Texas Medical Board
Psychiatric nurse practitioner PMHNP, an APRN	An advanced practice registered nurse with graduate training in psychiatric and mental health care. Diagnoses and prescribes medication under a prescriptive authority agreement with a physician.	Texas Board of Nursing

BHEC is the Texas Behavioral Health Executive Council. It runs the four boards for counselors, social workers, marriage and family therapists and psychologists. LCDCs are licensed separately, by HHSC.

Who can prescribe medication

In Texas, these clinicians can prescribe psychiatric medication:

Psychiatrists and other physicians, including your primary care doctor.
Psychiatric nurse practitioners and other APRNs, under a prescriptive authority agreement with a physician.
Physician assistants, under a physician's delegation.

Counselors, social workers, marriage and family therapists, LCDCs and psychologists don't prescribe in Texas. A few states let psychologists with extra training prescribe; Texas isn't one of them. Many people see a therapist for talk therapy and a prescriber for medication, and with your permission the two can work together.

If you take an ADHD stimulant: many are Schedule II controlled substances. Texas lets nurse practitioners and physician assistants prescribe Schedule II drugs only in limited settings, such as hospitals and hospice care, so at a regular clinic a physician writes them. If you need one, ask the practice who will prescribe it before you book.

How to check a license

It's free and takes a minute. Look for an active status, a name that matches, and any disciplinary actions.

If they're a...	Check with
LPC, LPC Associate, LCSW, LMSW, LMFT, LMFT Associate, psychologist or LPA	Texas Behavioral Health Executive Council: "Verify a License" at bhec.texas.gov
LCDC or counselor intern	HHSC's Online Licensing Services: choose "License Search". No account needed. Start from HHSC's LCDC page.
Psychiatric nurse practitioner	Texas Board of Nursing: Verify License. APRN results show prescriptive authority.
Psychiatrist or physician assistant	Texas Medical Board: Look Up a License. Profiles show education and any board actions.
A substance use program	HHSC's online licensing search for chemical dependency treatment facilities

If you're seeing an associate, look up the supervisor too. Cima Find Care shows each listed provider's license and the date it was checked (how listings work), but your own check costs nothing.

Video visits in Texas

Video visits can widen your choices, especially outside big cities. One rule matters most: the clinician must be licensed in the state where you are during the session, not the state where they are.

If you're in Texas, even just visiting, the clinician needs a Texas license or another legal way to practice here. Texas doesn't offer temporary licenses for counselors or social workers.
If you travel or move out of state, your Texas therapist may not be able to see you there. That depends on the other state's rules, so ask before a trip.
Tell your therapist where you are at the start of each session, and agree on what to do if the call drops or you're in crisis.
Ask your plan whether video visits are covered the same way as office visits.

Where to look

Your insurance plan's directory. Then confirm with the provider that they're in network for your plan and taking new clients.
A directory. Search Texas providers by insurance, city, focus and language.
People who know you: your primary care doctor, a school counselor, or your employer's Employee Assistance Program.
Low-cost care: community health centers and your local mental health authority (call 2-1-1).

Before the first visit, read how to use your insurance for therapy in Texas. It lists what to ask your plan. More plain-language guides are on our guides page.

Questions for a first call

A short phone or video call before you book is normal. The National Institute of Mental Health suggests one so you can see how treatment would work and whether you feel comfortable. Ask:

Are you licensed in Texas, and which license do you hold? If you're an associate, who's your supervisor?
Have you worked with people dealing with what I'm dealing with, and with people my age?
What kind of therapy do you use, such as cognitive behavioral therapy (CBT), and why would it help me?
How will we set goals and know if it's working? About how long do you expect it to take?
If I might need medication, how do you work with a prescriber?
What stays private, and when would you have to share something?
Do you take my insurance? What's your fee, do you have a sliding scale, and what's your cancellation policy?
Do you see clients by video, in person or both? When do you have openings?
What should I do if I'm in crisis between sessions?

For a child or teen, also ask how parents will be involved.

Signs it's a good fit

You feel heard and respected, and comfortable being honest. NIMH notes that treatment works best when you have a good relationship with your clinician.
They explain their approach in plain words and set goals with you.
They're clear about fees, insurance and privacy from the start.
They respect your culture, faith, identity and language.
Over time, you notice progress, or they talk openly with you about changing course.

It's okay to switch. NIMH says you may need to try a few providers before you find the one that works for you. A good therapist will help you find a better fit if it isn't them. A therapist should never pressure you or cross personal or sexual boundaries. If that happens, you can file a complaint with their licensing board.

When weekly therapy isn't enough

Sometimes one session a week isn't enough support. Talk to your therapist about more help if your symptoms keep getting worse, you're struggling to get through work or school, or your drinking or drug use is growing. Options include intensive outpatient programs (IOP), a few hours several days a week, and partial hospitalization (PHP), most of the day. Our guide to IOP vs PHP vs weekly therapy explains who each one fits and what insurance needs.

If you're thinking about suicide or you're not safe, don't wait for your next session. Call or text 988, or call 911 in an emergency.

Questions people ask

What's the difference between a counselor, a social worker and a psychologist?

All three can provide therapy in Texas. Counselors (LPCs) train in counseling, clinical social workers (LCSWs) in social work, and psychologists hold a doctorate and can also do psychological testing. Their experience with your concern, and how well you connect, matter as much as the letters.

Is it okay to see an LPC Associate or LMFT Associate?

Yes. Associates are licensed, have finished their degree, and work under a board-approved supervisor, and they must tell you who that supervisor is. Check their license the same way, and ask your plan whether it covers their services.

Can my therapist prescribe medication?

Not if they're a counselor, social worker, marriage and family therapist, LCDC or psychologist. In Texas, psychiatrists and other physicians, psychiatric nurse practitioners and physician assistants can prescribe.

Can I see a therapist from another state by video?

Only if they're licensed, or otherwise legally allowed, to practice in Texas. The rule follows where you are during the session, not where the therapist is. Texas has no temporary license for counselors or social workers.