Shopping for a Therapist
Most therapists are quite proficient in their profession and can help practically every client they work with. Just because all therapists share the same fundamental skills, this does not mean that all therapists are the same or that all therapists and clients are guaranteed to be a good match for each other. Most of the time, it is the client who chooses which therapist they will be working with. A prospective client has the right to shop around for a clinician that they think will best suit their needs. When a client decides that it is time to see a counselor, it’s tempting to just look on the internet or in the phone book and choose the one they find who is closest to home or cheapest. Though cost and location are clearly considerations, other things are important too. Therapy is a substantial investment in time, money and interpersonal commitment. Don’t feel compelled to latch onto the first therapist you find. It’s unfortunate but true that the same difficulties that compel a person to seek a therapist in the first place are those that can make even looking for one a challenge. Even making the first telephone call to a therapist is a huge step for many facing mental illness. It can feel intimidating to some. Often when clients do make a first call, they want to get it over and done with as soon as possible. Most people are reluctant to try new things and procrastinate. Looking for a therapist is even harder because it involves telling a stranger some of your most embarrassing difficulties and admitting you have problems with things “normal people” seem to handle just fine. Something good you can tell yourself when you are looking for help is that…You are a customer and therapists want to offer you their services. Remind yourself that a therapist is not there to judge, intimidate or make you feel inferior. They are there to help you. They are competing for your business. If you have ever had the misfortune of trying to get yourself an appointment squeezed into a medical doctor’s busy schedule, you will be pleasantly surprised to find that most therapists will have plenty of availability. With medical doctors, supply and demand often works in the doctor’s favor because there are so few doctors and so many that need their help. In mental health, the supply and demand equation works more in the favor of the client. As a prospective client, you are hiring somebody who wants to work for you; don’t be afraid to interview them a bit. Don’t be afraid to interview several and pick your favorite. In a true therapeutic relationship neither the therapist nor the client has power over the other; both work cooperatively for the benefit of the client. This is collaboration. Choose a therapist as a partner who you think you can have a cooperative and collaborative relationship with. Perhaps the first thing you should look for in a therapist is their personality. In most places there are plenty of therapists who have ample experience working with most common problems. Looking for one that you seem to feel a good rapport with can be a better start than considering their various licenses, degrees, schools and stated specialties. If you have particularly strong religious, political or cultural beliefs, don’t be afraid to ask a potential therapist about things that are important to you. Don’t be afraid to ask a therapist about what types of clients they seem to have the best experiences with. Even though therapists are trained to work effectively with people from very diverse backgrounds, they do have some types of people they just relate to better. Don’t be afraid to ask about past times or personal interests. Many times a client can feel much better understood by his therapist when he knows that therapist has had some similar experiences. More and more, psychotherapy is becoming a niche industry with various therapists catering to specific types of clientel. Why sell yourself short and work with the therapist down the street when there very well could be a clinician who better suits you in the next town?
Who Does What in Mental Health
Psychiatrist- A psychiatrist is a medical doctor who’s specialty is treating mental illness by means of modern medicine. Psychiatrists primarily treat mental illness by prescribing medication. Continued contact with a psychiatrist who prescribes medication is important so that they can monitor the benefits and side effects of those medications and decide if the results are good or if changes need to be made. In many ways, prescribing psychiatric medication is an art, and a good psychiatrist may have to try several different medications in different dosages to find what works best. Because they are medical doctors, they often use other medical techniques in their assessment and treatment of mental illness. Electroencephalography, CAT Scans, and MRIs are occasionally used. In some extreme cases even Electroconvulsive therapy is an option for psychiatrists. Psychiatrists rarely involve themselves in providing talking therapy. It is very common for other mental health professionals to refer clients to a psychiatrist when there appears to be need for psychiatric medication.
Psychologist- Generally speaking, Psychologists have a Ph.D. in the academic field of psychology (as opposed to psychiatrists who have medical degrees). Psychologists have a lot of flexibility in how they practice. Many serve as professors at universities and colleges. Aside from teaching, they also conduct psychological research and write academic papers. Psychologists are also very good at utilizing a wide variety of psychological tests. In many ways, practicing psychologists specialize in diagnostics and client’s who are particularly challenging. Many psychologists do talking therapy and are generally quite well trained in it. As a rule, psychologists do not prescribe medication because they are not medical doctors. It’s common for other mental health professionals to refer a client to a psychologist for psychological testing when there seems to be a need. Many places in the US are flirting with the idea of licensing psychologists to be able to prescribe a limited range of medications themselves.
The Psy.D.- A Psy.D. is really just another kind of Psychologist. It is an academic doctoral degree like a PhD which places less emphasis on research and more on clinical practice. Clinicians with a Psy.D are generally very skilled in talking therapy as well as psychological testing. A Psy.D. is a pretty good choice for any client that is in need of seeing a “Psychologist”; but a poor choice as a research associate.
Psychotherapist- A psychotherapist specializes in talking therapy. They do not prescribe medications and use few psychological tests. Most of the leg work in mental health is done by therapists. Generally speaking, a therapist talks to his clients and uses his specialized insights to help clients better understand things about themselves and the world around them. Therapists can help people with most mental illnesses as well interpersonal relation problems and difficult life transitions. Therapists specialize in helping clients feel more empowered and encouraged. They help client’s sort out how they think and feel about things. They gently challenge people when their thoughts and feelings are inconsistent or don’t fit reality. Ultimately therapists help clients to make better choices and think about things in a more appropriate manner.
Counselor- Counselor is a very generic term. It is often used interchangeably with psychotherapist. In some places anybody can call themselves a counselor. In other places there are licenses for several different types of counselor such as mental health counselor, pastoral counselor, vocational counselor, school counselor, substance abuse counselor, domestic violence counselor, and credit counselor. There are some places where “counselor” can refer to anybody who works with people on various problems by talking with them. In some places “counselors” can work with people who are having life problems like divorce, marital conflict and grieving, but can not work with people suffering mental illness or addiction. Ultimately this term can vary greatly based on the applicable local laws.
Social Worker- Social Workers are a remarkably diverse group. They work in schools, prisons, social service agencies, advocacy groups, hospitals, government bureaucracies, retirement communities, etc. Fundamentally, social workers are there to help other people. This can be one on one service helping a client locate community resources they need or even world wide activism promoting various ideas about “social justice”. In most places, social workers can be licensed and practice talking therapy like a psychotherapist. Though some are clearly qualified to help clients with life problems and even mental illness, that is not the specific specialty of all social workers.
Neurologist- Neurologists are medical doctors who specialize in treating problems with the central nervous system. People most often see neurologists when they have brain and spinal damage or malady. In the realm of mental health, professionals will refer to a neurologist when they think mental health problems are the result of a client having serious organic problems with their brains. Such problems generally come from head trauma, developmental disabilities or substance abuse problems. Viral infections, strokes tumors and plaque build up are also common organic brain problems that can produce emotional, cognitive and behavioral problems. Like any doctor, neurologists address medical problems with surgeries, medications and other medical treatments. Neurologists rely heavily on Electroencephalography, CAT Scans, MRIs and other ways to examine the physical brain. Mental health professionals will often refer to a neurologist when particular symptoms that suggest brain damage are present. A referral to a neurologist is often done “just to be sure” the client is not in medical danger and to “rule out” serious organic problems as the source of mental health problems.
Psychoanalyst- A psychoanalyst is much like a psychologist or psychotherapist that specializes in psychoanalysis. Psychoanalysis is style of talking therapy that is somewhat controversial. It was the talking therapy that started it all back with Freud. Since that time, most other mental health clinicians have evolved new talking therapy treatment approaches, but psychoanalysis continues on only somewhat altered. Where as most talking therapy today focus on helping clients process and grow in the present, psychoanalysis deeply examines a client’s past and tries to resolve hang-ups from formative periods in a person’s life. Unlike more modern psychotherapy approaches which seek efficient improvement for their client’s, psychoanalysis often occurs several times a week for 5-7 years.