All About Therapy
How to find a therapist?
After much thought, you have come to the conclusion that it is time to find a therapist. Several questions may come to your mind: “What kind of therapist do I need?, How can I find a good therapist versus a bad therapist?, What really is the difference between a psychiatrist, psychologist, social worker, counselor, marital therapist? How much does therapy cost and does health insurance help cover it? All of these are great questions. Let’s first identify who can provide mental health services.
So what really is the difference between a psychologist and a psychiatrist? And what qualifications are needed for someone to be called a therapist?
Like subspecialties in medicine, there are a variety of groups that provide mental health care. Here is a quick overview of the primary groups-
- Psychiatrists: Psychiatrists are MD’s (completed medical school) who have extensive training after medical school in medication management. Some psychiatrists prefer to do medication management only, others also provide therapy.
- Psychologists: Psychologists (Ph.D, Psy.D.) complete four years of graduate school and are required to complete a one year internship after graduate school. Some folks, can not get enough of school and will go on to complete a postdoctoral fellowship. Psychologists are specialists in therapy, provide testing (IQ, learning disabilities, memory, personality, ect…) and typically do not prescribe medications (only allowed in limited areas).
- Nurse Practitioners: Nurse practitioners participate in a graduate program specializing in psychiatry. They are able to prescribe medications and will often provide therapy.
- Social Workers: Social workers complete a masters program and are able to provide therapy and are trained to access community resources. Additional training is available to become a licensed clinical social worker.
- Martial and family therapists: Marriage and family therapists complete a Masters program specializing in working with couples and families.
- Counselors: This is a more difficult and somewhat loose category, because how a counselor is defined varies from state to state. Some states require a masters degree for someone to be licensed as a counselor, others do not. As a result, this can be a “buyer beware” category. That’s not to say there are no bad professionals in the other categories, it’s just that there are more checks and balances on a state level (professional boards, licensing requirements). No matter which type of professional you are considering, the following steps will also help you make your decision.
What kind of therapist do I need?
Some questions to ask yourself before you begin the search for a therapist are:
- Do you prefer a therapist who interacts with you (gives you their opinion) or one who is more traditional and maybe not as interactive (Freud - psychoanalysis vs. Dr. Laura) or in between?
- Will you need medication. If the therapist is not able to prescribe medication, does the therapist work closely with a professional who does?
- Where is the therapist located? Will it be relatively easy for you to attend sessions? What times are available for appointments?
- Try to identify what issues you need to focus on. Marital problems, depression, anxiety, parenting, adjusting to an illness, a combination, etc…
How can I tell if the therapist I choose is really the right therapist for me?
- The most important thing to remember, is that therapy is a very personal treatment. As a result, it is important that you feel comfortable with your therapist. If you don’t, chances are that therapy with that particular therapist will not be as effective as it should be.
- Ask your friends or physician if they know of a good therapist.
- Ask how long the therapist has been in practice. Experience does matter in this profession. Or to put it another way, would you rather have a surgeon just out of medical school or one who has been practicing for some time?
- Beware of catchy claims. Such as “Guaranteed to improve your anxiety and depression within 30 days”, “I’m the best therapist in town”, etc..
- The therapist should be able to explain to you his or her approach to therapy.
- If you try to take a break from therapy or discontinue, and the therapist tries to convince you that you are making the biggest mistake in your life (excluding any recent suicide attempts or other impulsive behavior), RUN!!! Remember, you are the one in control here. Often, taking a break from therapy can be beneficial.
- Therapists are different than friends. You should be able to trust your therapist and know that they are there to be objective. A friend (a good one that is) will naturally be biased and be more likely to exclaim that you are a wonderful human being and that everything you do is correct, the other person is always wrong.
- A therapist should NEVER ask to join you for dinner, lunch, or even a snack outside of the office. A therapist should NEVER EVER have any romantic relationship with you. A therapist should NEVER have you pick up his or her dry cleaning.
- Before settling on a therapist, talk to two or three. Think of this as an interview and you are the one in control. Remember, you are the consumer and you do get to choose who you want to work with.
How much does therapy cost?
Prices for therapy vary from region to region. However, there is a way that prices always seem to break down. The more education a provider has, the higher the cost. Psychiatrists typically charge the most, followed by psychologists, nurse practitioners, social workers, marriage/family therapists, and counselors. Many providers will offer a sliding scale based upon income (don’t hesitate to ask). Health insurance will often pay for therapy as well. Your part of the bill could be as low as nothing to 50% of the allowed fee (set by the insurance company). Insurance usually does not cover treatment for marriage, family, or eating disorders; but this varies from plan to plan. To better understand your mental health benefits, you can contact your insurance company directly or obtain a copy of the insurance information book regarding your particular plan.