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So you've decided that you might want to get help from a professional about depression, anxiety, stress, or other issues that are weighing on your mind. But how do you decide who to see, how do you find them, and what can you expect from your visits? In our "Getting Help" series, we're going to hopefully break this down for you to make navigating the mental health field a little less daunting, and make sure you're connected with the right resource.
This week: Shrinks 101
There are many people who provide mental health services. These include: psychiatrists, psychologists, licensed clinical social workers, licensed clinical counselors, marriage and family therapists, hypnotherapists, life coaches, psychoanalysts, and I'm sure I'm missing a few. Here's a few in more detail:
Psychiatrists: These are medical doctors (MDs) who attended medical school then did advanced training in psychiatry. Therefore they can prescribe psychiatric medications, such as anti-depressants, anti-anxiety meds, and other medications for more severe mental illnesses like schizophrenia or bipolar disorder. In general, psychiatrists don't usually do talk therapy - but some do. Most will meet with you once a month or less, depending on how you're doing, and check in with you about how your medications are working. Appointment times can be short (15 minutes or so for a med check) to longer if the physician is also providing therapy services. If you are interested in getting a prescription for a psych medication, a psychiatrist is who you should see. Note: Primary care doctors also prescribe these medications, and many are comfortable with doing so.
Psychologists: These are people who hold a doctoral degree, either a PhD (Doctor of Philosophy) or PsyD (Doctor of Psychology) in clinical or counseling psychology. They completed 4-5 years of graduate school, which includes a 1-year internship, and then 1-2 years of post-doctoral work before they get their license in the state they practice. There are other types of psychologists, but only those who studied clinical or counseling psychology can get a license to practice and see people for therapy. Psychologists specialize in talk therapy and cannot prescribe medications except in a few states where this is now legal, like New Mexico and Louisiana, or in the military. While there are some differences in training, both PhD and PsyD psychologists are well-qualified to see clients for therapy. Psychologists work in a variety of roles including private practice, medical centers, veteran's centers, academic positions, consultants, and corporations to name a few.
Licensed Clinical Social Workers: LCSWs have a Master's degree in clinical social work, which includes a 1-year internship. They also cannot prescribe medication and specialize in psychotherapy. Other types of Social Workers may work in public service roles such as in schools or government agencies.
Licensed Clinical Counselors: These are people who hold a Master's degree in clinical or counseling psychology and have taken a state licensing exam. They may work in private practice, in college counseling centers, or other public service roles.
Psychoanalysts: These practitioners specialize in a certain type of therapy that was created by Sigmund Freud (or others in this area), and may be a psychologist, psychiatrist, or social worker. Psychoanalysis is meant to be long term therapy that explores issues from childhood and other defenses that may be causing you issues today. It can often take years to complete this type of treatment, meeting with your therapist multiple times per week.
Life Coaches: Caution should be taken when looking to work with a life coach. I'm sure there are many very qualified people who are in this line of work, but they typically do not hold the advanced training of the other clinicians I discussed.
Next week I will cover some of the different approaches to therapy that are out there, such as CBT (what we use at OP Behavioral Medicine). Picking the right therapist AND the right treatment approach is really important to getting the most out of your visits.