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Quick and dirty guide to picking a therapist.

emilyvgordon:

Ok, I get this question a ton, so let me give some advice to those of you who are seeking therapy and don’t know where to start or what to do.

WHAT KIND OF THERAPY DO YOU WANT

• Med management- this is a physician who will evaluate you and prescribe you medication. Generally a psychiatrist. Typically, psychiatrists just don’t have the time to also do talk therapy, so you may have 15 minutes with them a month. 
  
• Talk therapy- This is the traditional sitting in a room with another human being and discussing stuff with a trained and licensed professional. That professional could come from a psychology, counseling, or social work background. This could include couples therapy, family therapy, play therapy, EMDR, and a host of other types of therapy that are done in one-on-one relationships. 
• Group therapy- therapy done in a group with other people and one or two professionals. This often helps with problems that often make people feel isolated and alone- addiction, eating disorders, domestic violence. 
• Intensive outpatient programs- these are programs, usually for problems that are more severe, where you make your treatment a part time or full time job. You are in several days a week, doing group therapy, individual therapy, education classes, etc, but you still sleep at home. 
• Treatment facility, aka inpatient- you stay at the facility for extended periods of time to focus full time on your recovery and safety. Not a hospitalization, although many inpatient programs are located in hospitals. 
• Life coaching- I don’t know much about life coaching. Here’s what Wikipedia says: “Coaching is training or development in which a person called a coach supports a learner in achieving a specific personal or professional goal. The learner is sometimes called a coachee. Occasionally, coaching may mean an informal relationship between two people, of whom one has more experience and expertise than the other and offers advice and guidance as the latter learns; but coaching differs from mentoring in focusing on specific tasks or objectives, as opposed to general goals or overall development.” What I don’t love about life coaching is that there are no regulations or certifications, so literally anyone can call themselves a life coach. Tread carefully. 

WHAT KIND OF THERAPIST

Ok, so some mental health profession types are nationally certified- meaning that the whole country of professionals agrees that this is how those professions should operate, and the people who are licensed have passed muster to practice all over the country. Some mental health profession types are state certified- meaning that they are only licensed to practice in that state. That doesn’t make them less qualified, just that America cannot decide on how to regulate them for every state. So here’s a list, broken down into name of profession- education level- licensure type- what they do

• Psychiatrist- has an MD (doctorate), licensed nationally as a Psychiatrist, prescribes medication
  
• Physician’s Assistant- has an MPAS/MHS/MMS/DScPA (not a doctorate but a medical degree), licensed nationally as a PA/PA-C/APA-C/RPA/RPA-C, prescribes medication, usually through a general practitioner’s office
• Psychiatric Nurse- has an MSN/DNP/PhD (may or may not have a doctorate), licensed nationally as an MHNP/NPP, prescribes medication, usually through a general practitioner’s office
• Clinical Psychologist- has a PhD/PsD (doctorate), licensed nationally as a Psychologist, does talk therapy
• Doctorate-level Counselor/Psychotherapist- has a PhD/EdD/DMFT (all doctorate degrees), licensed nationally as a Psychologist, does talk therapy  
• Counselor/Therapist/Mental Health Practitioner- has an MA/MS (masters degree) plus a few years of post graduate experience, licensed by state as an LPC/LCPC/LMFT/LMHC, does talk therapy (THIS IS WHAT I WAS)
• Clinical Social Worker- has a MSW/DSW/PhD (may or may not have a doctorate) and a few years of post graduate experience, licensed nationally as a LCSW/LMSW/LSW, does talk therapy
• Social Worker- has an MSW/DSW/PhD (may or may not have a doctorate), licensed nationally as a LMSW/GSW/LSW, does talk therapy but also is generally more experienced in handling the bureaucracy of mental health stuff
• Expressive Arts Therapist/Art Therapist- has an MA, licensed as an ATR-BC/MT-BC, does art therapy

HOW TO PAY

Here’s my advice: if you’re doing outpatient therapy, try to pay out of pocket. Tell the therapist that you don’t have insurance or mental health coverage in your insurance, even if you do, and request paying on a SLIDING SCALE. That’s where you pay based on how much you make. Often it’s just easier to pay this amount than to try and get your insurance to pay, or submit all the paperwork necessary. It’s just a nightmare. That’s my advice. 

Often companies will have EAP (Employee Assistance Programs) that offer free counseling to employees, usually around 6 sessions. These can’t get you in trouble at work, I promise, I used to work for one. 

HOW TO FIND THEM

I really like Psychology Today’s Therapist Finder. I usually recommend that people start with a talk therapist in the Licensed Clinical Social Worker/Therapist/Psychotherapist range (i.e., masters level) and then have that person recommend other forms of treatment if necessary. Masters level clinicians are going to be cheaper than doctorate level. 

Since I’m fairly liberal, I check off boxes for therapists that are willing to work with GLBT clients/sex workers/feminist stuff. Even though I’m only one of those things, I like to know that my therapist, going in, isn’t super conservative. Conservative therapists exist too and are fine if that’s what you want. 

HOW TO AUDITION THEM

When you go to see a therapist for the first time, be aware that it’s supposed to be uncomfortable. You shouldn’t feel judged or like you’re a freak show, but you will feel a bit uncomfortable. It’s an unusual relationship, unlike any other, and it takes a while to settle into it. If you don’t feel like you’re in an emotionally safe space that first session, don’t go back. Try another therapist. A good therapeutic relationship is based on personalities meshing just as much as anything else, and that’s just a result of trying. 

intpmusings:

I’m a laid-back person with a ton of anxiety.

(via bombdrea)