4 Types of Therapist Roles to Pursue with an MSW

View all blog posts under Articles | View all blog posts under Online Master of Social Work

A marriage and family therapist counsels a young couple.Individuals and families may seek the counsel of a therapist for many different reasons — to help cope with mental or physical health disorders; intervene in behavioral issues; assist with conflict resolution; or provide guidance for issues related to marriage, parenting, and other family dynamics.

Because therapeutic needs are so numerous and diverse, the therapist profession must encompass many areas of specialization. Indeed, different types of therapists can provide more precise, specialized care to those in need.

The different types of therapists reflect career paths that include social workers, psychologists, and psychiatrists, all of whom can provide therapeutic intervention according to highly specialized areas. For those who have obtained a Master of Social Work (MSW) degree, here are four specific types of therapist roles that provide significant opportunities to make a difference in people’s lives.

LGBTQ Therapist

Not everyone faces stress or anxiety due to their sexual orientation or gender identity. However, for those who identify as gay, lesbian, bisexual, transgender, asexual, queer, or questioning, a psychic toll can come from being in a social minority or simply from being stigmatized. The role of an LGBTQ therapist is to assist individuals who are experiencing this kind of stress, stigmatization, or discrimination, providing ways for them to cope with these difficult feelings.

Issues Addressed by an LGBTQ Therapist

While acceptance of diverse sexual orientations and gender identities is on the rise, much oppression and discrimination continue to be leveled against members of the LGBTQ community. As such, there are multiple challenging issues that patients might discuss with an LGBTQ therapist.

  • Feelings of being marginalized or excluded from different groups or society in general; the National Alliance for Mental Illness reports 40% of lesbian, gay, and bisexual individuals have been rejected by a family member or close friend
  • Anguish or anxiety at the thought of coming out to family members or the pain of rejection from family members
  • Heightened risk for anxiety, depression, and substance abuse issues, all of which are more pronounced in the LGBTQ community; the National Alliance for Mental Illness notes that gay, lesbian, and bisexual individuals are twice as likely to have substance misuse or overuse issues
  • Increased risk of suicidal thoughts and self-harm, which are especially common among LGBTQ youth; gay, lesbian, and bisexual youths are twice as likely to attempt suicide as their heterosexual peers, according to the Centers for Disease Control and Prevention (CDC)
  • Pain and trauma due to sexual assault
  • Pain and trauma due to bullying, including verbal or physical abuse
  • Harassment or perceived harassment in the workplace or discrimination in housing, employment, or basic human rights

An LGBTQ therapist may help patients find ways to cope with these and other serious — at times life-threatening — issues.

LGBTQ Therapist Strategies

A few guiding principles impact the work of an LGBTQ therapist, starting with the basic need to be affirming. Therapists should help their patients feel supported and validated in their identity. Additionally, when working with LGBTQ young people, therapists need to promote self-discovery and exploration. Patients should always have the freedom of self-definition.

One specific strategy that may be used by an LGBTQ therapist is cognitive-behavioral therapy, or CBT. This methodology may involve guiding the patient away from negative self-image and other harmful thought patterns. It can also facilitate greater understanding of how other people think and behave. LGBTQ therapists may use CBT principles to help patients determine specific strategies for dealing with difficult situations.

Being an Affirmative Therapist

Even therapists who do not work exclusively with LGBTQ issues may still be affirmative — that is, they may embrace a positive outlook toward a diverse range of sexual orientations and gender expressions. Some of the key aspects of being an affirmative therapist include the following.

  • Willingness to be self-reflective, recognizing the privileges incurred through a heteronormative and gender-binary society
  • Advocating for social justice and change, and in particular basic human rights protections for people regardless of sexual orientation or gender identity
  • Ensuring an affirming therapy area by including reading materials that are inclusive of LGBTQ individuals, among other actions
  • Being open and willing to speak candidly about commitment to affirmative therapy, even with heterosexual and/or cisgender clients

Marriage and Family Therapist

A marriage and family therapist is a mental health professional who specializes in diagnosing and treating mental, emotional, and behavioral issues that exist within the context of a marriage or family.

One of the defining distinctions of a marriage and family therapist is that, unlike most therapists, they don’t primarily focus on an individual; instead, they consider the broader implications of an individual’s behavior on their family structure, as well as how family dynamics impact the individual. The goal of the marriage and family therapist is holistic: They want to ensure healthy, happy outcomes for their clients and their entire family units.

Marital Issues

Therapists in this field may address specific issues that occur within a marriage, including those that have a disruptive impact on the bonds between spouses. Examples include those listed below.

  • Marital distress and disharmony, including frequent arguments or tension within the marriage
  • Incidents of marital infidelity or breached trust
  • Individual issues that have a broader impact on the couple and their family; for example, one spouse’s struggle with mental health or substance abuse issues may disrupt the marriage and the entire family dynamic

Ultimately, the marriage and family therapist can provide solutions for addressing these issues to bring greater happiness, health, and harmony to family life.

Other Family Issues

In addition to marriage issues, therapists may also help families deal with a broader range of relational issues or complicated interpersonal dynamics.

  • Therapists may work with parents to develop solutions to behavioral issues they experience with their children, including problems at school.
  • If a child has been bullied at school, a marriage and family therapist can work with the whole family to find ways to cope and support one another.
  • A marriage and family therapist may be able to provide strategies for supporting an older parent or a grandparent who is exhibiting signs of dementia.

Marriage and Family Therapy Approaches

There are several approaches that can be used in the context of marriage and family therapy.

  • Observing how spouses and family members interact with one another and noting the dynamics present within a marriage or family unit
  • Providing psychoanalysis both to individuals and couples
  • Diagnosing and treating psychological disorders or mental health issues within the family
  • Providing specific strategies for dealing with family crises such as divorce or the loss of a loved one
  • Highlighting problematic patterns or behaviors within the family and using disciplines such as CBT to help break those patterns

These are just a few of the ways in which a marriage and family therapist can have a positive impact on couples and families.

Eating Disorder Therapist

Eating disorders can afflict men and women of all ages and from all walks of life. While they can take many forms and have numerous root causes, eating disorders are always dangerous, potentially even life-threatening. While recovery from an eating disorder is certainly attainable, it’s difficult to achieve without the intervention of a trained counselor. The role of the eating disorder therapist is to guide the diagnosis and treatment of eating disorders and ultimately provide patients with strategies to live full, healthy lives.

Eating Disorder Statistics

The need for eating disorder therapists is on the rise because eating disorders are growing increasingly common. For example, a study from Harvard University notes eating disorders affect about 9% of the U.S. population. Close to 29 million Americans will experience an eating disorder in their lifetime. The effects of an eating disorder can be catastrophic: According to Harvard, a death occurs every 52 minutes as a direct result of an eating disorder.

Types of Eating Disorders

An eating disorder can be any mental health problem that disrupts a person’s relationship to food. Typically, eating disorders are characterized by an obsession with food and body weight, which sometimes means an obsession with exercise as well.

There are specific types of eating disorders, all of which may be treated by an eating disorder therapist. Some of the most common examples are listed here.

  • Binge-eating disorder. Those who have this condition will experience sessions of intense binging on food, often because it provides them with a sense of control.
  • Anorexia nervosa. Characteristics of anorexia nervosa include limited food intake and a general fear of being “fat.” Individuals with this condition typically weigh at least 15% less than the healthy body weight.
  • Bulimia nervosa. Those with this condition will binge-eat food and then purge it either by inducing vomiting or using a laxative.

Eating Disorder Recovery

The ultimate goal of the eating disorder therapist is to help those who are afflicted develop and implement a strategy for long-term recovery.

Often, this means using CBT and other therapeutic models to help identify destructive thought or behavioral patterns, ultimately restoring a more positive attitude toward food and body image. Additionally, it might mean diagnosing and treating underlying mental health conditions that contribute to the eating disorder, which might include anxiety, depression, or trauma.

An eating disorder therapist provides patients with practical strategies and tactics for living a healthier lifestyle. For example, a therapist might help patients identify “triggers” that exacerbate their dysfunction and then articulate ways to either avoid those triggers or better cope with them. Therapists may recommend specific strategies to encourage their patients to eat a more diverse range of foods, have a more balanced attitude toward exercise, and actively seek opportunities to eat socially rather than privately.

Often, therapists will work on a multidisciplinary eating disorder recovery team. This may include nutritionists and dietitians who help develop meal plans or nutritional guidelines that provide patients with the caloric intake and nutrient balance they require. In some cases, eating disorders cause other side effects. For example, routine purging may result in acid reflux or damage to the esophagus, which requires intervention from a medical doctor.

Group Therapist

One final career path for MSW degree holders who wish to enter the therapeutic profession is to become a group therapist.

While most therapists meet one-on-one with their patients, a group therapist holds sessions with multiple patients at the same time. The size of the group can vary, but usually falls somewhere between five and 15 people. Some of the individuals in the group may also attend one-on-one therapy sessions with a different therapist, while others may engage exclusively in group therapy.

The Aim of Group Therapy

The role of the group therapist is to provide simultaneous therapeutic intervention to multiple people in a comforting, safe setting. Generally speaking, this means members of the group will all face similar issues or be looking to address a shared problem.

There are multiple issues group therapy might address. These are some of the most common.

  • Addiction recovery. The members of the group may all struggle with drug or alcohol addiction. In these situations, the therapist will facilitate candid conversation about the recovery process and help group members develop strategies for staying sober.
  • Grief counseling. Group therapy may also involve individuals who have all recently lost a loved one and who seek a controlled environment in which to share their pain.
  • Anger management. Those who need anger management counseling may be recommended to group therapy, where they can work together to develop strategies for constructively addressing their anger.
  • Domestic abuse. A group therapist may also facilitate honest conversations between domestic abuse victims, allowing group members to encourage one another and stand in solidarity.

Group Therapy vs. Support Group

One of the benefits of group therapy is that it enables people with similar struggles to connect and feel less isolated. The opportunity to talk with those who’ve experienced similar challenges can certainly be helpful, but it’s important to note that group therapy is not the same thing as a support group.

While a support group is intended to help the members cope, group therapy asks members to change. The group therapist uses psychoanalytic techniques to encourage members to break out of bad habits or damaging patterns of behavior and, in cases such as substance abuse, find real recovery.

Also note that a support group may have a lay facilitator: that is, someone who leads the group discussion but isn’t necessarily licensed in any type of psychological or therapeutic intervention.

Group Therapy and Individual Therapy

Not all patients require group and individual therapy, but sometimes the two techniques can provide a more robust treatment plan. Individual therapy may provide a psychoanalytic foundation and a safe space for self-reflection, Group therapy, on the other hand, can help its members improve their ability to communicate and interact with others in healthy, constructive ways.

What Are the Counseling Skills and Techniques for Social Workers?

For social workers who wish to work in a therapeutic role, it’s important to develop certain skills.

Core Skills for Social Workers

Essential counseling skills and techniques for social workers who wish to administer effective therapy, regardless of their therapeutic specialty, include the following.

  • Analytical skills. Therapists must be keen-eyed in analyzing the relational dynamics of behavioral patterns among their patients, then drawing the right inferences.
  • Communication skills. The ability to communicate in both one-on-one and group settings is vital.
  • Listening skills. The ability to actively listen and express empathy as appropriate is critical to all therapeutic fields.
  • Critical thinking. One of the most challenging aspects of therapy is determining the best strategy for addressing a client’s specific problem. Critical thinking skills are a must.
  • Cultural Competency. Finally, social workers and therapists should be adept at interacting with people across linguistic and cultural barriers.

Tactical Skills for Social Workers

On the more tactical side, social workers can also benefit from knowing specific therapeutic modalities or behavioral health principles. This, in turn, can help them address the specific needs of the people they are working with.

For example, familiarity with CBT crisis intervention (a short-term strategy to stabilize a patient who is facing a real health emergency) and interpersonal psychotherapy (an approach to improve interpersonal relationships and social functioning) can all be beneficial to social workers no matter their area of specialization. These are the kinds of hard skills that are best learned in a formal academic environment, such as an MSW program.

Providing a Critical Helping Hand

From eating disorders to marital discord, to struggles with gender dysmorphia—any number of serious issues might send a person to therapy. As such, the need continues to grow for therapists and social workers who have the skills and competencies to address highly specialized issues on behalf of their patients.

One way to hone these skills and competencies is to enroll in a program such as Ohio University’s online Master of Social Work. Here, students can gain the academic foundation to lend a helping hand to those most in need.

Ohio University’s program is designed to help aspiring social workers and therapists offer compassionate, effective care to vulnerable individuals, and focuses on developing skills to assist historically underserved communities.

Completing the program can empower you not only to be an effective therapist but position you to enjoy long-term career success. 

Recommended Readings

Career Spotlight: Marriage and Family Therapist

Meditation for Anxiety and Addiction: The Ultimate Guide

The Complicated Role of Alcohol in Crimes of Abuse and Domestic Violence


American Association for Marriage and Family Therapy, “About Marriage and Family Therapists”

American Psychiatric Association, “What Are Eating Disorders?”

American Psychological Association, “Psychotherapy: Understanding Group Therapy”

American Psychological Association, “What is Cognitive Behavioral Therapy?”

American Psychological Association, “What Is the Difference Between Psychologists, Psychiatrists, and Social Workers?”

Centers for Disease Control and Prevention, Suicide and Violence Prevention

GoodTherapy, Group Therapy

GoodTherapy, LGBTQ Issues / Gender Identity and Sexual Orientation

Harvard School of Public Health, “Report: Economic Cost of Eating Disorders”

Healthline, “Depression in the LGBT Population”

Houston Chronicle, “Skills Needed to Be a Clinical Social Worker”

Mayo Clinic, “Eating Disorder Treatment: Know Your Options”

National Alliance on Mental Illness, LGBTQI

National Association of Anorexia Nervosa and Associated Disorders, Eating Disorder Statistics

National Institute of Mental Health, “Eating Disorders: About More Than Food”

New York State Society for Clinical Social Work, Definition/What Clinical Social Workers Do

Psychology Today, “Interpersonal Psychotherapy”