Credentials, Titles, and the Coaches Who Blur the Line: Perkins PsyCare

If you have been on social media lately, you have probably caught the conversation. A recent streaming podcast has sparked serious questions about credentials, degrees, and who exactly is qualified to speak on mental health. The word "Dr." is at the center of it. And it has people asking something they probably should have been asking all along.

Wait. What does that title actually mean?

I am not going to name anyone. But I am going to use this moment to educate, because this conversation is too important to let pass. The "Dr." title carries weight. People trust it. People make decisions about their mental health based on it. And when that title is unverified, misrepresented, or handed out without the work behind it, real people get hurt.

So let us walk through it together. What is a doctorate, really? Who can legally practice psychology in the United States? What is an honorary doctorate? And what about life coaches, the ones helping people and the ones causing harm?

You deserve to know what you are buying when your mental health is on the line.

What a Doctorate Actually Is

A doctorate is the highest academic degree most fields offer. In psychology, it usually looks like one of two things:

PhD (Doctor of Philosophy in Psychology): typically a research-heavy path. Five to seven years of full-time study after a bachelor's degree. Coursework, research, a comprehensive exam, and an original dissertation, a book-length contribution of new knowledge that gets defended in front of a faculty committee.
PsyD (Doctor of Psychology): a clinically focused path. Same level of rigor, just weighted more toward applied practice than original research.

And let us set the record straight while we are here: the PhD is the original doctorate. It predates the MD and every other doctoral designation by centuries, rooted in the European university tradition going back to the 1200s. The medical doctorate, the law doctorate, the education doctorate — they all came later, modeling themselves after the PhD framework. So when someone casually dismisses the academic doctorate in favor of a clinical or honorary title, they are skipping past the credential that started it all.

There are other legitimate doctorates too: an EdD (education), an MD (medicine), a DSW (social work), a JD (law). Each one means something specific about what its holder studied and is qualified to do.

What makes a doctorate real is three things: the program was accredited by a recognized body, the candidate completed and defended original research or its clinical equivalent, and the institution can verify the degree when asked. That last part matters. When a school loses accreditation or closes, transcripts and dissertations do not just vanish. They are transferred to a custodian institution by federal requirement so graduates can still prove what they did. There is almost always a paper trail. If there is not, that is a fair question to ask.

A doctorate is hard. It is supposed to be. Not because suffering is virtuous, but because the public is being asked to trust the holder of that title with something real.

Honorary Doctorates: A Problem Worth Naming

Let us talk about honorary doctorates, because this is where the conversation gets uncomfortable, and I think it should.

An honorary doctorate is a title conferred by a university to recognize someone's public impact, celebrity, or philanthropic contributions. No coursework. No dissertation. No clinical hours. No exams. No defense in front of a faculty committee. A board votes, a ceremony happens, and suddenly someone is "Dr."

Here is the problem with that.

If lived experience and real-world impact are enough to earn a doctoral title, then every person who has ever survived hardship, built something from nothing, or changed lives without institutional support deserves the same recognition. Every first-generation student working two jobs to fund their education. Every person spending seven years and six figures on a degree. Every clinician who passed boards, logged thousands of supervised hours, and earned the right to that title one grueling step at a time.

The fact that universities selectively hand this credential to celebrities and high-profile donors, while the rest of the world has to earn it, makes honorary doctorates less an honor and more a credibility transfer. The title borrows meaning it did not build.

And when someone uses that honorary "Dr." in a professional context, especially in mental health spaces, without clearly disclosing that it was gifted rather than earned, it is not just misleading. It undermines every person who actually did the work. The American Psychological Association and most academic institutions explicitly discourage using "Dr." from an honorary degree in professional contexts for exactly this reason.

Recognition is meaningful. Equity matters. And a title that can be awarded by institutional discretion rather than academic rigor is not a doctorate. It is a gesture. A very consequential one.

Who Can Legally Practice Psychology in the United States

Here is the part I most want you to hear clearly, because it affects your safety.

In all 50 states and the District of Columbia, you cannot legally practice psychology, or even use the title "psychologist", without a license. This is not a suggestion. It is the law.

To become a licensed psychologist in this country, a person must:

Earn a doctorate (PhD or PsyD) from a regionally accredited program, typically requiring 5 to 7 years after a bachelor's degree.
Complete a supervised pre-doctoral internship, usually around 2,000 hours of clinical work under a licensed psychologist.
Complete a postdoctoral year of supervised practice, another 1,500 to 2,000 hours, depending on the state.
Pass the EPPP, the Examination for Professional Practice in Psychology, a national licensing exam.
Pass a state-specific jurisprudence and ethics exam.
Submit to ongoing oversight by a state licensing board with the legal authority to investigate complaints, suspend a license, or revoke it entirely.

I want to be honest about something that has been said publicly in recent weeks: that licensure is "just for billing insurance."

That is not true. Licensure exists because the state has taken on a legal duty to protect the public from harm in fields where harm is possible. A license is the public's recourse. If a licensed psychologist behaves unethically, hurts a client, or practices outside their competence, there is a board you can call. There is a complaint you can file. There is accountability. Without licensure, none of that infrastructure exists for the person sitting across from that practitioner.

Psychologists are not the only licensed mental health professionals. Licensed Marriage and Family Therapists (LMFTs), Licensed Professional Counselors (LPCs), Licensed Clinical Social Workers (LCSWs), and Licensed Mental Health Counselors (LMHCs) all have their own rigorous paths, generally a master's degree, thousands of supervised clinical hours, state exams, and ongoing board oversight. Different titles. Same principle: someone is watching, so you do not have to watch alone.

Life Coaches: What They Can Do, and What They Cannot

Now let us talk about coaching. I want to do this carefully, because the picture is more nuanced than the internet likes to make it.

Life coaching is, as of today, an unregulated industry in the United States. There is no federal license. There is no state license. There is no official board with the legal authority to revoke anyone's right to practice. Voluntary credentialing bodies exist, including the International Coaching Federation (ICF), but the ICF itself acknowledges it has no legal enforcement power. Anyone in this country can wake up tomorrow, build a website, and call themselves a life coach by the afternoon.

That sounds alarming, and in some hands, it is. But I want to be very clear about something else: many life coaches are doing real, valuable, ethical work.

Good coaches help people set goals, build habits, navigate career transitions, prepare for big decisions, train for performance, and stay accountable to the changes they say they want to make. They walk alongside clients who are functional, growth-oriented, and clear-eyed about what they are paying for. I have referred clients to coaches I trust. I have seen coaching change lives. Coaching, done well, is not therapy's lesser cousin. It is a different thing entirely, with its own purpose.

The line that separates ethical coaching from harm is not a credential. It is scope.

An ethical life coach does not:

Diagnose mental health conditions like depression, anxiety, ADHD, PTSD, or trauma disorders
Treat mental illness or work with clients in active psychiatric crisis
Use licensed therapeutic frameworks such as Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), EMDR, or any other clinical modality without a license. Using these frameworks without licensure is not coaching. It is practicing therapy without a license, which is illegal.
Use protected titles like therapist, counselor, or psychologist without the license those words legally require
Provide what is essentially psychotherapy under a different name
Discourage clients from seeking licensed care when it is clearly needed

What separates the good coach from the harmful one is whether they know and respect where their work ends and where licensed mental health care begins. The ethical coach refers out. The harmful one keeps the client.

This is not about tearing down coaches. It is about protecting clients, including the clients of coaches who genuinely care.

Green Flags and Red Flags: How to Tell the Difference

If you are trying to figure out who you are actually working with, or considering working with, here are some honest signals.

Green Flags

Their credentials are easy to verify. A licensed clinician's name will appear in their state's licensing board lookup. A coach with an ICF credential can be found in the ICF directory.
They are transparent about scope. They tell you what they do and what they do not.
They refer out when something is outside their lane, without making you feel like you failed.
They explain their training, where they studied, and what their approach is.
They welcome questions about their qualifications instead of treating them as an attack.

Red Flags

They use protected titles like psychologist or therapist without an active license.
They treat trauma, depression, anxiety, or other diagnosable conditions without a clinical license.
They use clinical frameworks like CBT or DBT without being licensed to do so.
They refuse to verify their credentials when asked, or react with defensiveness at the question.
They speak dismissively about licensure or suggest it is only about money.
They imply that their celebrity clients, their results, or their following are proof enough that the rules do not apply to them.

You do not need to be an expert in credentialing to use this list. You just need to trust that asking is reasonable.

The Bottom Line

Here is what I want you to walk away with.

This is not about tearing anyone down. It is not about gatekeeping the helpers out of the world. There are coaches, counselors, mentors, pastors, sponsors, and friends who have changed lives, and I would never want to put any of them in a box smaller than the good they are doing.

It is about you. The person reading this. The person who is choosing where to spend money, time, and trust at a moment in life when those things feel scarce.

A degree means something. A license means something. A scope of practice means something. Not because credentials make a person worthy, but because you deserve to know exactly who you have hired before you hand them the most tender parts of your story.

Ask the question. Look up the license. Read the scope. The right helper will never make you feel small for wanting to know.

Credentials, Titles, and the Coaches Who Blur the Line: What You Actually Need to Know

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