All Things Depression

Finding the right person to help with your depression, anxiety, anger or stress can be extremely confusing, but it's a good idea to choose carefully.

In the previous article I introduced you to the various degree types that clinicians will have.  So, let’s take a moment and sum up:

To Read Part I of this article, please click here

Psychologists are usually doctorate level clinicians (PhD or PsyD) whose expertise is in testing/assessment and providing behavioral therapies, but may also be trained in a variety of psychotherapeutic interventions.

Psychiatrists are a medical doctor (MD) who have completed a residency in psychiatry and whose primary role is to prescribe medications to help with psychiatric symptoms.

Licensed Clinical Social Workers (LCSW) are masters-level clinicians (MSW’s) who may use a variety of methods of treatment, and who often have expertise in linking clients to various services and programs in the community.

Licensed Professional Counselors (LPC) are masters-level professionals who are trained in the techniques of counseling to help clients probe feelings, emotions, thoughts and ideas in order to achieve deeper insight and greater awareness or understanding.

A couple other examples of masters level clinicians (MS’s) not discussed previously who chose a different course of study or obtained certification after licensure:

Registered Art Therapists (ATR) are licensed masters-level clinicians who assist clients in the creation of art to express their emotions, inner experiences and trauma.

Marriage and Family Therapists (MFT) are licensed masters-level clinicians trained to understand how the interactions and roles in our relationships shape our feelings, thoughts, self-image, behavior, and how to make changes in a client’s pattern of interaction in order to bring about change.

Substance Abuse Counselors (SAC) can possess any of the above mentioned degrees, but have spent at least 3 to 5 years working extensively with clients who suffer from substance abuse, dependence and other compulsive, addictive behaviors. SAC’s provide techniques to help achieve recovery.

Certified EMDR Counselor is a clinician with advanced seminars and supervision in EMDR (eye movement desensitization and reprocessing) who has been certified by the EMDR International Association.

Nationally Certified Gambling Counselor is a counselor who has taken extra seminars and supervision in the field of gambling addictions and has been certified by the National Council on Problem Gambling.

Certified Sex Therapist is a clinician with advanced coursework and supervision in the treatment of sexual disorders and certified by the American Association of Sex Educators, Counselors, and Therapists.

Play Therapist is a counselor who has taken extra studies in the use of play to help children express inner emotional problems and to change their behavior through guided play.

Now, after looking at all of the above, you might be thinking to yourself that it would be best to go see a PsyD, but that’s not necessarily the case.  There are other factors you have to consider and take into account whether one is better than the other.  One factor, for example, is how much each charge.  If you have insurance, it might not matter too much if your co-pay covers it.  However, if you have a high deductable, no co-pay, or are not using insurance, then price is a major thing to consider.  Especially when you consider that the length of time typically spent with a therapist is 8 to 20 weeks.  Getting charged $200 an hour by a PhD, might not be so bad for one session, but after 20 weeks (which is the typical limit most insurance companies place on the amount of time a clinician can see you) can add up to huge amounts you might not be comfortable with.  In addition, they might require you to participate in testing.  Each test can cost hundreds of dollars and is something to consider as well.  Ms’s and MSW’s are just as adept when it comes to providing talk therapy and are typically less expensive than doctor’s.  If you find yourself unable to obtain the services of any clinician due to monetary issues, please discuss them with your prospective therapist as they usually will give you a discount on their services.

Other factors to consider are:

• Is the location convenient?
  • Do you really want to drive an hour to see them?
• Types of clients they specialize in.
  • If you’re suffering from OCD and have an addiction, make sure your therapist has experience dealing with these issues.
• Do they strictly adhere to a particular theoretical orientation or are they able to adapt based on your situation?  If so, find out what orientation and then make sure to read up on it to understand their perspective and whether you have any issues with it.
• What are their reviews like online?  This applies for anyone you’d see, even medical doctors.  There are services out there that ask members to submit reviews of clinicians.  It might seem trivial, but be aware not all therapists are created equal.  There are some bad apples out there and it’s best to be aware of them.
• Call up various clinicians and ask whom they would recommend.  If you keep hearing the same name over and over again, it’s because they might be highly thought of amongst their peers.

Going through all this can be pretty overwhelming.  However, it’s better to do your homework in advance and not have to waste your time, money or patience bouncing from one therapist to another.  If you have any other advice or suggestions that you would like to share, please comment below as I’d love to hear them.

When trying to find a therapist that's right for you, it can be frustrating sorting through the myriad acronyms and vocabulary clinicians use to advertise themselves.

Note: For the sake of brevity, I’ve simplified greatly what the various fields of clinicians are in regards to their training and preparation.  Also, state licensure requirements vary state-to-state and sometimes have their own designations and acronyms.  This is purely meant to be an introductory primer and not an all-inclusive guide.

I’ve often wondered how the general public goes about finding a mental health clinician.  There are some things I hope everyone does before deciding to share intimate details about yourself to a complete stranger.  If you were to try and do some research on your potential therapist, you’d find a wide array of acronyms, orientations and terms that can simply overwhelm you.

This is why I think most people just go by word of mouth, “If someone’s good for one person, they’ll be good for me.”  That kind of logic might apply for some people, but certainly not everyone.  Depression, anxiety, stress, anger or any other mental health issue can be treated by a multitude of individuals several different ways.  To increase your odds of finding a clinician who will be a good fit for you, it would be a good start to understand what makes them different.  With that, let’s start with learning the various acronyms.

There are a multitude of degree’s and areas of specialization.  The most common are: Master’s of Social Work (MSW), Master’s of Science (MS), Doctorate of Philosophy (Phd) and Doctorate of Psychology (PsyD).  What’s the difference between these degrees?  Well, the MSW and MS are both master’s degrees and are the most common type of therapist you’ll find. Either one is proficient at conducting group or individual talk therapy.  The main difference is in their schooling: MSW’s are social workers and MS’s are counselors.  There’s been a lot of confusion between the two as the old way of thinking is that because there were so many MSW’s they became the norm.  Now, MS’s are becoming more and more popular and for good reason.  While social workers can become quite proficient at conducting talk therapy, it is not what they primarily go to school for.  For MSW’s, they focus on acting as an intermediary between client and provider putting them in contact with the services they require.  They are masters at navigating through red tape and allowing you to understand how various government programs work.  Counseling and talk therapy is touched on, but is certainly not the focus.

Now, enter the MS’s.  These are individuals who mostly majored in psychology for their bachelor’s and went on to a graduate program specifically geared towards talk therapy.  Within the MS degree are various areas of specialization: community counseling, Alcohol and drug abuse (AODA), School counselors and a multitude of others.  The main point to take home is that while MSW’s can be quite adept at providing talk therapy, it is not their forte.  That is, unless they decide to pursue a specialization after they obtain their master’s.  For MS’s, it’s all they’ve known.  Post master’s work typically entails additional practice and specialization within their chosen area.  For either person to be licensed so they may legally provide therapy, they must obtain 3000 hours post-graduate supervision experience.  We’re talking about working for free, or having to pay someone to supervise you, so you can get your hours.  The amount of time it takes to become fully licensed often takes upwards of 3 to 4 years AFTER they get their degree.  So, as you can see, for someone to take this path requires plenty of patience and dedication to their craft.

A quick side note; while it may seem like I’m not advocating you see a MSW for talk therapy, this is not the case.  They can be just as good, or possibly, better than some MS’s.  It’s all in what they specialize post-masters and whether they are licensed.  To tell if a person is licensed, they’ll have acronyms after their degree.  For social workers, you start out as first having your training license or APSW.  For MS’s, they’ll have LPC-TL.  Once full licensure is obtained, social workers can then use the acronym LCSW (Licensed Clinical Social Worker).  For MS’s, it’s LPC (Licensed Professional Counselor).

As for PhD’s (Doctor of Philosophy) and PsyD’s (Doctor of Psychology), while they are typically the only degrees that qualify one to become a psychologist, there are significant differences between the two.  Again, both degrees can do the job of the other, but one tends to focus on one area over the other.  For PhD’s, the emphasis is on research with the goal of adding additional resources for further analysis and investigation by both academia and those doing clinical work.  PsyD’s are a relatively new phenomena that caught on in the 80’s and 90’s as a way of obtaining a doctorate for those that wanted to focus on being consumers of research rather than producers of research.  The focus was on testing and diagnosing in a clinical environment.  To simplify things, PsyD’s concentrated purely on psychotherapy and diagnosing as opposed to PhD’s who concentrated purely on research.  Again, both can do the job of providing psychotherapeutic services to their clients, but PsyD’s primary focus is on the practical application of conducting therapy and testing.

One more thing to mention are Psychiatrists (MD’s).  The vast majority of individuals in this profession are not into conducting extensive talk therapy.  Typically, they are into providing brief psychotherapeutic interventions.  Meaning, they are there to assess your symptoms, diagnose you and prescribe medication that would lessen your symptoms.  They get a pretty bad rap for not being very patient when listening to their clients’ needs.  Much of this is due to how they make money.  For the time it takes to see one client for a talk therapy session, they can see four clients in that same amount of time if they focus purely on providing the right medication and ignoring all the background details.  Not all are like this and there are some I know that will conduct talk therapy and take into account the whole person.  To break it down simply, Psychiatrists are whom you go to when you need medication.  If you need talk therapy, and you will even if you’re on medication, then see one of the above mentioned degree types.

In part II, I’ll talk about some other factors to consider and give a few examples of the other MS’s and certifications one can obtain.  Keep in mind as well that I’m merely presenting this as an informational resource purely to give you a basic understanding of the myriad acronyms and vocabulary clinicians use to advertise themselves.  Armed with this knowledge, you can be better prepared, and have a better chance, to find the right kind of clinician for you.