Guest Author - Melissa Weise, LCSW
Gone are the days of Freudian style free association while laying on the couch. If you find that therapy could help or a loved one (see the article – Do I Need Therapy to find more information on this), you now have many options to decide from. The main things you need to figure out is what type of professional you would like to work with and what style of therapy would suite you best. This article addresses the different types of mental health professionals.
Many different professionals can do mental health therapy but the most common are Clinical Social Workers. Social Workers are required to have at least a master’s degree (four years of undergraduate college and then two to five years of graduate college study) and then take a test to be licensed and get a LCSW (licensed clinical social worker) credential. LCSWs can be found working in clinics, hospitals, or under the supervision of more experienced social workers in a private practice. Social workers with more experience can also have LICSWs (licensed independent social worker) credentials and these social workers can operate their own private practices and bill health insurance privately. They are the only masters level professional who can get the credentials to work independently.
Other masters level professionals can have studied clinical therapy, family therapy, or substance abuse therapy and there are a variety of licensing requirement and letters that will go after their names. Most of these professionals can be found in clinics or otherwise supervised by doctorate level therapists or medical doctors. These professionals’ strengths are specialization. While Social Workers have broad skills that cover many different forms of therapy or populations, other masters level therapists usually have focused on specific things such as couples therapy, art therapy, substance abuse therapy, or family therapy and have more experience and a deeper knowledge of this type of therapy.
All masters level therapists are credentialed for at least some form s of insurance and many also offer their services for private pay clients who pay out of pocket or sliding scale fees (based upon income). Always know that you can feel comfortable talking to your therapist up front about how much their services costs and how much will be covered by insurance and for how long.
Doctorate level professionals (four years of undergraduate college work and then two to eight years of graduate level work) are often either clinical psychologists who perform testing such as IQ testing, learning testing, emotional testing, or other forms of psychological testing or the other forms of therapists from above who have chosen to continue their education further. Doctorate level therapists often do not do ongoing regular therapy and instead specialize and do consultations or specialized short term therapy. Their services are also usually more expensive than masters level professionals and sometimes insurance will not pay for ongoing care.
Psychiatrists are mental health professionals who first earned their medical doctorate and then went on to specialize in mental health. This often takes ten to twelve years of education. Because of the cost of their services, most psychiatrists offer only medication services because they are one of the only mental health professionals who can prescribe psychiatric medication. They also usually work in partnership with professionals who offer ongoing therapy as an adjunctive intervention to the medication they prescribe. Psychiatrists can be found in many settings such as clinics, hospitals, and private practices. Sometimes a psychiatrist will also supervise a Nurse Practitioner who has specialized in mental health who, with this supervision, can also prescribe medication. Insurance almost always covers the costs of psychiatry or nurse psychiatry and the cost of medications.
Besides experience, education, expense and what type of professional you would like to work with; you also need to take into account personality when choosing a therapist. Therapy is in some ways more personal than even medical doctoring because you are sharing things which my make you feel uncomfortable and vulnerable. Because of this, you need to make sure that you feel comfortable with your therapist and feel that you can trust him or her. In the end, it usually is mostly about personality and not skill and being honest with your therapist about what is and is not working is helpful in deciding if you can build a therapeutic relationship or if you would like to find someone that you will work with better. It can feel difficult though because it may take a session or two to figure out if you click with your therapist and then going back and saying that you don’t could feel awkward. Most therapists know this and will encourage you to find the best way to do therapy.
