There’s a plethora of options available for people interested in seeing a mental health professional. But with so many choices of providers – each with different degrees, licenses, backgrounds, and approaches – you may feel overwhelmed when trying to figure out the best option for you. Let’s take a look at some of the most important things to consider when choosing a provider.
First, it’s important to understand the types of mental health professionals out there.
Psychiatrist: A psychiatrist is a medical doctor (M.D. or D.O.) who specializes in preventing, diagnosing, and treating mental illness. A psychiatrist’s training starts with four years of medical school and is followed by a one-year internship and at least three years of specialized training as a psychiatric resident. A psychiatrist is trained to differentiate mental health problems from other underlying medical conditions that could present with psychiatric symptoms. They also monitor the effects of mental illness on other physical conditions (such as problems with the heart or high blood pressure), and the effects of medicines on the body (such as weight, blood sugar, blood pressure, sleep, and kidney or liver functioning). As a doctor, a psychiatrist is licensed to write prescriptions. Many mental disorders – such as depression, anxiety, ADHD, or bipolar disorder – can be treated effectively with specific drugs. If you are working with a psychiatrist, a lot of the treatment may be focused on medication management. Sometimes medication alone is enough to treat the mental illness. Sometimes a combination of medication and psychotherapy or counseling is needed. If that is the case, the psychiatrist may provide the psychotherapy, or the psychiatrist may refer you to a counselor or other type of mental health professional.
Psychologist: A psychologist has a doctoral degree (PhD, PsyD, or EdD) in psychology, which is the study of the mind and behaviors. Graduate school provides a psychologist an education in evaluating and treating mental and emotional disorders. After completing graduate school, a clinical psychologist completes an internship that lasts two to three years and provides further training in treatment methods, psychological theory, and behavioral therapy. Licensed psychologists are qualified to do counseling and psychotherapy, perform psychological testing, and provide treatment for mental disorders. They are not, though, medical doctors. That means that, with the exception of a few states, psychologists cannot write prescriptions or perform medical procedures. Often a psychologist will work in association with a psychiatrist or other medical doctor who provides the medical treatment for mental illness while the psychologist provides the psychotherapy.
Licensed Mental Health Counselor: A psychological counselor is a mental health professional who has a master’s degree (MA) in psychology, counseling, or a related field. In order to be licensed, the professional counselor also needs two additional years’ experience working with a qualified mental health professional after graduate school. A mental health counselor is qualified to evaluate and treat mental problems by providing counseling or psychotherapy. Look for LMFT or LPC designations.
Clinical Social Worker: A clinical social worker has at least a master’s degree in social work and training to be able to evaluate and treat mental illnesses. In addition to psychotherapy, social workers can provide case management and hospital discharge planning as well as work as an advocate for patients and their family.
Psychiatric or Mental Health Nurse: Some nurses have had special training in providing mental health services. Depending on their level of training and certification, they can evaluate patients for mental illness and provide treatment in the form of psychotherapy. In some states, they are also licensed to prescribe and monitor medications, sometimes independently and sometimes under the supervision of a medical doctor. Nurses also provide case-management services and serve as patient advocates.
Second, consider the type of therapy that the practician provides.
Counseling: This is the most common type of therapy and is frequently used by individuals to help them get through a rough patch. It has less to do with medical problems and more to do with receiving help or support to get through common, everyday problems. It can be used to help an individual grapple with anger management issues or to help a couple looking to resolve relationship concerns. It can even help someone consider their career options. Counseling sessions are usually one hour long, and the client can decide how often they want to see their counselor, whether that’s once a month, once a week, or any other amount.
Cognitive-behavioral therapy (CBT): This type of therapy is often used to help people deal with depression and anxiety, but it can be used to treat a host of other mental health issues as well. The CBT approach focuses on the present instead of delving into problems of the past. The goal is to change a patient’s negative mindset and bring back positive feelings in their life. Studies have shown that CBT is useful for people suffering from Post-Traumatic Stress Disorder, Obsessive-Compulsive Disorder, eating disorders, phobias, and many other conditions. CBT is a goal-oriented approach to counseling. It works to change patterns of thinking to improve how a person feels. However, it must be stressed that CBT does not provide a physical cure for symptoms; it simply provides patients with the ability to deal with their symptoms, thereby lessening the distressing effects. In many cases, it’s a far more effective treatment than using medication, but in some cases, it’s most effective when combined with medicine. Because it’s such a specific style of therapy, CBT is not useful for everyone, and it requires a strong commitment and willingness to cooperate with the therapist. Like most types of therapy, CBT can be done in either individual or group settings.
Psychotherapy: While the types of therapies listed above all fall under the umbrella of Psychotherapy, psychotherapy in itself is also a type of therapy. Instead of focusing on the present like CBT, psychotherapy delves into the past to understand the issues and difficulties a person may be facing in the present. The underlying principle is that a person’s patterns of thinking and behavior affect the way that person interacts with the world. Depending on the specific type of psychotherapy that is being used, the goal is to help people feel better equipped to manage stresses, understand patterns in their behavior that may interfere with reaching personal goals, have more satisfying relationships, and better regulate their thinking and emotional responses to stressful situations. If someone has a form of mental illness such as depression, bipolar disorder, schizophrenia, or an anxiety disorder, psychotherapy also addresses ways in which the illnesses affects their daily life, focuses on how to best understand the illness and manage its symptoms and follow medical recommendations.
Overwhelmed yet? The good news: empirically, the biggest predictor of success in therapy is not credentials or approach – it is the client/therapist relationship. How do you assess fit? These are some dimensions to feel out:
Do you feel safe, heard, and supported?
Do you prefer someone who looks like you? This could include race, age, and gender. I found that I work best with male therapists of Asian descent that are around my age, even though most of my emotionally close friendships are with women.
Do you prefer someone that asks a lot of questions or that gives advice? I liked a mix of both – questions when tackling the past, but with a heavy coaching / practical bent to put insights and learnings into action. I appreciated that my therapist was also a life coach.
You may need to spend 1-2 sessions with mental health professional before you can really suss these things out, and that is a common path. Here are some resources that can help you with the search process:
- Lyra: An increasingly popular employee wellness benefit that your company may offer, encompassing therapy and coaching
- Psychology Today: The yellow pages of providers
- Zencare: Every profile has a welcome video so you can doa. virtual vibe check
- Mental Health Match Offers a matching tool to find licensed therapists that are best matched to your needs
- Alma and Headway: Find providers that take your insurance
- Open Path Collective: Affordable, in-office and online psychotherapy sessions between $40 and $70 with a one-time sign up fee of $65
This is not an exhaustive list, and given the pandemic, there’s been a renewed focus on mental wellness that has caused the number of companies in the space to expand.
Whether to deal with stress, anxiety, depression or a specific problem, choosing a therapist that fits you is one of the most important decisions you will ever make. Investing some time and research up front, being in touch with your feelings as you navigate the proces, and being intentional and mindful in the choice that you make can have a huge payoff for your well-being, and the well-being of the people that surround you.