Finding a Community Therapist
When students are referred to the local community for psychotherapy, they often have questions about how to find a therapist, navigating health insurance, and making the first appointment. Below are a few guidelines to help you:
What’s the difference between a psychologist, psychiatrist, social worker and marriage and family therapist? Who prescribes medication?
Psychiatrists are MD’s who have completed a residency in Psychiatry. As physicians, they are able to prescribe medication and are experts in the use of medication to treat emotional distress. They also specialize in treating the medical and psychological interface between illnesses such as chronic headaches, gastro-intestinal disorders, asthma, and pain because these illnesses often have an emotional component.
If you are considering medication -- unless you are experiencing a fairly straightforward clinical depression or anxiety -- it is often best to see a psychiatrist for a medication evaluation. If you have a medical condition that you think might be complicating your emotional difficulties, then consult your physician first to see if it would be important to see a psychiatrist. Many medications and physical illnesses affect our mood. For example, diabetes is known to cause depression, and a psychiatrist will be best able to treat you. While some psychiatrists are trained as therapists, most are not, and it is generally recommended that you see one of the following practitioners for counseling or therapy.
Licensed Psychologists have a Doctorate in Clinical or Counseling Psychology. As part of their degree requirements, they complete a year-long supervised clinical internship emphasizing the theory and practice of therapy. In addition to being highly trained as therapists, Psychologists are the only discipline trained to administer and interpret psychological tests. They generally work in a wide variety of settings and with a range of individuals -- sometimes with clients who present with more severe disorders, such as psychoses and other mental illnesses as well as with individuals experiencing more typical life stressors. They may work in private practice, community mental health clinics, or hospitals.
Licensed Marriage and Family Therapists, and Licensed Clinical Social Workers most often have a Master’s Degree and are trained to work with individuals, couples, and families, and sometimes groups. As a requirement for licensure, they also must complete a year-long supervised clinical internship and are trained primarily in the theory and practice of therapy. They generally work in an outpatient private practice, agency, or mental health clinic.
Pastoral Counselors are ordained ministers or clergy who have additional supervised training in counseling that weaves together the religious or spiritual and the psychological. They may be certified by an organization, such as the American Association of Pastoral Counselors.
Does their degree really matter?
In general, when seeking therapy, the particular degree may not be as important as the therapist’s years in practice and areas of specialty – such as training in substance abuse, expertise working with gays and lesbians, eating disorders, sexual abuse or marital counseling. While a new therapist may be quite competent, there is no substitute for the years of life experience and practicing therapy.
What about licensure?
While the therapist’s degree may not be especially important, licensure is important. Anyone can hang up a shingle and call themselves a counselor or life coach. Although they may possess innate skills and life experience to help you, these individuals are not regulated by any State licensure agency. State governing boards, such as the Board of Behavioral Sciences, Board of Psychology, or the Board of Medical Examiners, regulate educational and licensure requirement, continuing education, and investigate any ethical violations. These regulating agencies are there to protect you, the consumer.
Feel free to ask about a therapist’s training, licensure, and expertise so you feel comfortable that he or she has the knowledge and experience to be helpful.
Will health insurance cover the cost of psychotherapy?
Health insurance may cover mental health treatment, depending on your particular plan. You may need a referral from your primary care physician or you may be free to seek a referral on your own. If a managed care company, or HMO, or PPO manages your health insurance, you will likely pay a smaller co-payment if you see a clinician on their list of preferred providers.
In order to determine your health insurance benefits, call the customer service number on the back of your insurance card. The number to call will be listed as customer service, or behavioral health, or mental health services. When seeking pre-approval for services from the insurance company, you may be asked a few questions, such as whether or not you are suicidal, if you have been in counseling before, and why you are seeking treatment. The case manager will then give you a list of several therapists in the community.
How do I make an appointment with a therapist?
Let’s assume you now have three referral names. Call the therapists and tell them in a couple of sentences why you’re seeking treatment. I’m having some trouble in school. I can’t concentrate and I think I’m drinking too much. Or I have an eating disorder and it’s taken over my life. Then ask the therapist if he or she thinks that’s something they can work with. Do they have experience with your particular concern? Ask about insurance coverage and fees. Some therapists will offer a sliding scale fee lower than what is customary. On occasion, therapists may be willing to negotiate their fee. You should expect the therapist to take 5-10 minutes on the phone to talk with you about these issues. If you’re comfortable with the therapist’s answers, then make an appointment. Feel free to interview a number of therapists until you find someone with whom you feel comfortable.