To become a licensed therapist in the US, you'll usually earn a bachelor's degree, then a master's in counseling, marriage and family therapy, psychology or a related mental health field, then complete a state-set number of supervised clinical hours after graduating and pass a state-recognized exam. Every state requires marriage and family therapists and mental health counselors to be licensed.
Therapist isn't one single license. The title you practice under depends on the route you take, and each route has its own degree, exam and supervised-hours rules in your state. Pick the route first, then the program.
Figures come from the Bureau of Labor Statistics (BLS) Occupational Outlook Handbook profiles for marriage and family therapists and for mental health counselors, read on 26 October 2026.
The two most common therapist routes
| Measure | Marriage and family therapists | Mental health and substance abuse counselors |
|---|---|---|
| Typical entry education | Master's degree | Master's degree for mental health counselors |
| Median pay (May 2025) | $66,940 a year | $59,350 a year |
| Jobs in 2025 | 76,300 | 533,400 |
| Projected growth 2025 to 2035 | 14%, much faster than average | 18%, much faster than average |
| Openings each year | About 6,900 | About 50,500 |
Those pay figures are as of October 2026. Both groups are growing far faster than the 3% BLS projects for all occupations.
How to become a therapist, step by step
- Earn a bachelor's degree. Common fields include psychology, public policy and social services, and social science. Some master's programs want specific coursework, such as counseling and statistics.
- Choose your route. Marriage and family therapy focuses on relationships and families; mental health counseling covers a wider range of issues, such as depression or addiction.
- Complete an accredited master's degree. Programs typically include a supervised practicum or internship where you work with clients.
- Do your postdegree supervised hours. You'll work under a licensed counselor, providing therapy directly to clients until you reach your state's required number of hours.
- Pass the licensing exam. Marriage and family therapists pass a state-recognized exam, and mental health counselors pass a national examination. Some states add a jurisprudence exam on their laws.
- Keep up continuing education. BLS says licensed therapists must complete continuing education every year.
The supervised hours are where the time goes
Here's what catches most people out. The master's degree isn't the end of training. BLS says licensure requires completing a state-specified number of hours of postdegree supervised clinical experience, working under a licensed counselor. Until you've logged those hours and passed the exam, you can't practice independently.
Because the number of hours varies by state, check your state licensing board before you choose a program. If you think you might move, check the board in the state you'd move to as well, because a program that works for one state may not cover everything another expects.
Substance abuse counseling has a lower entry point
If you want to start working with clients sooner, substance abuse and behavioral disorder counseling is more flexible. BLS says these counselors typically need a bachelor's degree, though some positions accept a high school diploma and others want a master's. Outside private practice, licensing rules vary by state, and some states require an exam without a specific degree.
Private practice is the line. All states require substance abuse and behavioral disorder counselors in private practice to hold a master's degree, complete supervised clinical hours, pass an exam and do continuing education every year. BLS also notes that counselors with personal experience overcoming addiction are sometimes seen as especially helpful to clients.
Where therapists work and what they earn
| Setting (marriage and family therapists) | Share of jobs | Median pay, May 2025 |
|---|---|---|
| Offices of other health practitioners | 33% | $64,430 |
| Individual and family services | 23 in every 100 | $61,060 |
| Self-employed | 11 in every 100 | Not listed |
| Outpatient care centers | 10 in every 100 | $75,560 |
| State government | 6 in every 100 | $92,150 |
State government paid the highest median for marriage and family therapists, as of October 2026. Mental health counselors in hospitals had a median of $63,310. Many therapists also offer telehealth sessions by phone or video, and some work evenings and weekends to fit their clients' schedules.
Running a practice
If private practice is your goal, the admin side arrives quickly: notes, scheduling and billing. Our comparison of the best EHR for therapists covers record-keeping, and this guide to setting up a therapy clinic walks through the practical steps of opening your doors.
What the work is like
Counseling work is rewarding but often stressful. BLS says many counselors have large workloads and don't always have enough resources to meet demand, and some must step in during crises or work with agitated clients. Most work full time, though part-time work is common, and residential settings may need evening, night or weekend shifts.
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My verdict
Becoming a therapist takes about as long as the supervised hours do, so plan around them, not just the degree. Decide whether marriage and family therapy or mental health counseling fits the clients you want to help, check your state board's hour and exam rules before you apply to a master's program, and treat your internship as the start of your clinical record. Demand is strong in both routes, which makes the long road worth planning.
Frequently asked questions
How long does it take to become a therapist?
A bachelor's degree, then a master's degree, then a state-set number of postdegree supervised clinical hours before you can be licensed. The total depends on your state's hour requirement.
What degree do you need to be a therapist?
Usually a master's degree in psychology, marriage and family therapy, counseling or a related mental health field from an accredited school.
How much do therapists make?
BLS reports a median of $66,940 a year for marriage and family therapists and $59,350 for mental health and substance abuse counselors in May 2025.
Do therapists need a license?
Yes. All states require marriage and family therapists and mental health counselors to be licensed, which means supervised clinical experience and an exam.
Can you be a therapist with a bachelor's degree?
Some substance abuse and behavioral disorder counseling roles accept a bachelor's degree, but licensed therapy and private practice need a master's degree.
Is there demand for therapists?
Yes. BLS projects 14% growth for marriage and family therapists and 18% for mental health counselors from 2025 to 2035.
Do therapists have to keep studying?
Yes. BLS says licensed therapists and counselors must complete continuing education every year.
Can therapists work online?
Yes. Some marriage and family therapists offer telehealth sessions by phone, video or other virtual methods.
