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How To Choose The Right Help For You

I am often asked about the differences between mental health practitioners, for instance what are the differences between psychologists, social workers or psychiatrists? The academic of a mental health professional does not necessarily dictate how that professional practices. For example, a Psychologist is trained to do research and clinical work but may decide to conduct Psychological testing.

As a client, it is important to look at credentials while also looking beyond them. The credentials of a helping professional have less to do with informing you about the kind of help that will be provided. To find a therapist who will be helpful to your specific needs, it would be ideal to have information about their method of treatment, years of experience, and a receptiveness to exploring the unknown (not at the level of awareness) aspects of one’s difficulties. Simply put it is helpful to tolerate being uncomfortable in the initial meetings with a potential therapist. If you find yourself feeling “at home” in counseling, then it may not be a good fit with that psychologist or social worker. Why is this so? Although no one likes to be uncomfortable or stirred up, that is exactly what a good therapist, psychologist or social worker aims for. What you have done in the past to resolve your issues has not led to relief so that is why “unknown” is the aim. The goal of treatment is to stimulate areas of your mind that generate fresh thoughts, feelings, insights and eventually behaviors.

When searching for a mental health professional there are many considerations. Below are a few of the examples of professionals offering mental health services.

A PSYCHIATRIST (M.D.) is a medical doctor who administers medication for the treatment of mental health issues. Most psychiatrists do not also practice psychotherapy. They usually do an initial evaluation or session and subsequent sessions are shorter in duration. These shorter sessions are so that the doctor can check on the patient’s experience with the medication and make changes when necessary.

A PSYCHOLOGIST (PH.D. OR PSY.D.) a Ph.D. is a Doctor of Philosophy whereas a Psy.D. is a Doctor of Psychology.  Ph.D. students are generally trained following the scientist-practitioner model that puts greater emphasis on research than Psy.D. students, while Psy.D. students are generally trained with greater emphasis on clinical work than Ph.D. students. They are trained to do both counseling as well as research. Some psychologists also do psychological and educational testing. Some do only psychotherapy and some specialize only in research which means that they are not meeting with patients in a clinical setting.

A SOCIAL WORKER (L.C.S.W.) has a Master’s Degree in Social Work. They are required to complete a masters in either clinical (therapy), public policy, or research. If a person completes their MSW they can spend the equivalent of two years under supervision and provided they take a licensure exam and pass they will earn the title LCSW-C which allows the person to practice therapy or counseling independently.

A LICENSED PROFESSIONAL COUNSELOR usually has a Master’s Degree but this can vary from state to state. These professionals are also required to have thousands of hours of direct clinical supervision before practicing on their own.

While this is not an exhaustive list of mental health professionals, it will give you a sense for some of the differences. However, initial training or degrees are not enough to be a good clinician in treating people’s mental health. Professionals in the mental health field need to be in continuous supervision and postgraduate programs and to have had their own treatment. These ensure the practitioner takes the job of another person’s mental health seriously.

Whether you chose a counselor, a psychologist, or a social worker, you will also need to know what modality of practice resonates with your needs. Here is short list of some of the different types of therapy practiced by mental health practitioners.

CBT (Cognitive Behavioral Therapy). This refers to a group of therapies that are considered short-term and problem focused. The concept is that a person’s thought process influence their behaviors. Some Techniques that are used in different forms of CBT are mindfulness, journaling, and homework. Cognitive behavioral therapy is considered structured. CBT focuses on the conscious mind and both the patient and the therapist are aware of the problems the patient is struggling with. These types of therapies focus on one’s thinking and how it impacts one’s behavior. They are generally short-term treatments. Under the umbrella of CBT therapies are Dialectical Behavior Therapy, EMDR (Eye Movement Desensitization Reprocessing), supportive therapy, eclectic therapy and systems therapy.

Psychoanalysis and psychodynamic therapy are treatments that foster self- awareness in the context of a meaningful, ongoing therapy relationship. Central to psychoanalysis is the focus on making you aware of what was previously out of your awareness. The idea is that insight combined with a therapeutic relationship will promote awareness and an opportunity to make different choices.  You can gain understanding as to how your mind affects your thinking, feeling, and behaving, and most importantly, your relationships. Psychoanalysis helps you when you have tried every solution that you can think of. The frequency of meetings and the catharsis that comes with psychoanalysis affords you a setting to tackle long standing patterns which get in the way of a quality life. It has been understood since Freud that the unconscious parts of our minds greatly influence us in many ways.

DBT (Dialectical Behavioral Therapy) was designed to help these individuals understand their thoughts and behaviors as out-of-the-ordinary and extreme, and then learn coping and interpersonal skills that allow them to find more measured, moderate ways of acting and reacting. This treatment was designed to help different types of personality disorders.

Family Therapy is useful for anyone who wants to explore the challenges and conflicts he or she is experiencing in relationships, work, life, etc., and do so in a supportive group setting with other people who are struggling with the same or similar things. The idea that group members can share and help one another is the fundamental purpose for group therapy.  at is built on the belief that a family is a system. When one person in the family makes even a small change, it is believed that the entire system will change. Sometimes a family therapist will refer individual members from the family to individual therapy while also treating the family as a whole. Often times couple’s therapy can impact change in the family.

Addiction Therapists counsel those who have been diagnosed or feel they have a substance abuse problem. It is part of an addiction therapist’s job to help the individual find ways of coping with their destructive urges. Counselors may make referrals for their patients if they are found to have deeper emotional problems. Addiction therapists may work in residential treatment facilities, hospitals and prisons, or they may have private practices.

Professionally, I am a LCSW-C and a Psychoanalyst. With twenty years of experience I can say with conviction that choosing a therapist should not be based on a degree. Whichever licensed professional you chose, make sure you find someone who challenges and understands you. Don’t be afraid to be a bit uncomfortable. Change means embracing the unfamiliar you.

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