How To Find a (Good) Therapist: A Comprehensive Guide
- caminopsychology
- Oct 3, 2024
- 5 min read
Updated: Nov 17, 2024
Admitting that we need help is one of the hardest things we can do. It's a courageous first step, and it’s significant. However, the next step—finding a good therapist—has become increasingly challenging. This blog post is intended to help you determine what kind of therapist is right for you.
Not All Therapists Are Created Equal
My first and most crucial point is that anyone can call themselves a “therapist” and start a counseling practice. The term “therapist” is not protected in most states, meaning it doesn’t require any specific license, certification, or training. This is why it’s essential to recognize that not all therapists are created equal.
Moreover, even among licensed therapists, there is significant variation. Therapists differ in their years of training, the quality of that training, and their theoretical approaches to therapy. I aim to provide a comprehensive guide to help you navigate these differences and find the right therapist for your needs.
In Part 1, I will break down the various qualifications and licenses associated with different types of therapists.
In Part 2, I’ll delve deeper into the differences in modalities and theoretical approaches that guide various treatments.
Part 3 will address additional, yet crucial, factors to consider when choosing a therapist. In the spirit of full transparency, I am a clinical psychologist who practices from a psychoanalytic framework. You may notice a slight bias toward this approach, but I will strive to clearly explain the differences among various theoretical orientations so that you can decide for yourself.
Differences in Licenses and Level of Training
When seeking a therapist, understanding the differences in training and qualifications can help you make an informed decision. Below, I present the key types of mental health professionals and their typical training.
Psychologists
Degree: Doctor of Philosophy (Ph.D.) in Psychology or Doctor of Psychology (Psy.D.)
License: Licensed Psychologist
Training: Psychologists undergo extensive training, including a doctoral program that typically lasts 5-7 years. Ph.D. programs often emphasize research and teaching, along with clinical practice, while Psy.D. programs tend to focus more heavily on clinical practice. Both require supervised clinical experience and a doctoral dissertation. Psychologists are trained in a variety of therapeutic modalities (see Part 2). They work primarily in private practices, hospitals, mental health clinics, academic settings, and research institutions.
Psychiatrists
Degree: Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO)
License: Licensed Psychiatrist
Training: Psychiatrists are medical doctors who specialize in mental health. They complete medical school, typically within 4 years, followed by a residency in psychiatry, which usually lasts another 4 years. They are trained to diagnose mental health conditions, prescribe medications, and provide psychotherapy. Their medical training allows them to understand the complex relationship between physical and mental health. Psychiatrists often work in hospitals, private practices, and mental health clinics. In most states, psychiatrists are the only mental health professionals able to prescribe medications. Because psychiatrists receive broad training in all aspects of the mind and body, their training in psychotherapy tends to be less extensive than that of a psychologist unless they take a particular interest in psychotherapy and seek out further training.
Social Workers
Degree: Master of Social Work (MSW)
License: Licensed Clinical Social Worker (LCSW) or Licensed Master Social Worker (LMSW)
Training: Social workers focus on helping individuals, families, and communities improve their well-being. They are trained to assess, diagnose, and treat mental health issues. Clinical social workers receive training in psychotherapy and case management, often working in various settings such as hospitals, community agencies, and private practices. A master’s of social work degree typically takes 2 years to complete. The main difference between an LCSW and LMSW is that while both LMSWs and LCSWs are trained social workers, an LCSW has additional clinical experience (2-3 years of additional supervised clinical hours) and licensing, allowing them to practice independently and provide a broader range of mental health services.
Counselors
Degree: Doctor of Philosophy (Ph.D.) in Counseling
License: Licensed Professional Counselor (LPC) or Licensed Mental Health Counselor (LMHC), depending on state
Training: Counselors with a Ph.D. have completed a doctoral program that typically takes 4-7 years. This includes advanced coursework, clinical training, internships, and research, culminating in a dissertation. Ph.D. holders can practice therapy and mental health counseling. However, their doctoral-level training typically best positions them for roles in academia, research, clinical supervision, and leadership within the field.
Degree: Master of Arts (MA) or Master of Science (MS) in Counseling
License: Licensed Professional Counselor (LPC), Licensed Mental Health Counselor (LMHC), or equivalent depending on the state.
Training: Counselors are trained to help clients with a wide range of issues, including anxiety, depression, and relationship problems. Their education focuses on therapeutic techniques, human development, and ethics. A Master’s for counseling typically take 2 years to complete.
Marriage and Family Therapists
Degree: Master in Marriage and Family Therapy (MFT)
License: Licensed Marriage and Family Therapist (LMFT)
Training: MFTs specialize in relationship dynamics and family systems. They are trained to address issues within the context of couples and families. Their coursework includes topics such as family therapy, couple’s therapy, and child development. They work in private practices, clinics, and community agencies. This degree typically takes 2 years to complete.
Licensed Psychological Associates
Degree: Master in Psychology
License: Licensed Psychological Associate (LPA)
Training: LPAs are trained to provide a range of psychological services, including psychological testing, assessments, therapy, and counseling. However, their scope of practice may be limited compared to a licensed psychologist, particularly when it comes to independent practice. In most states, LPAs must practice under the supervision of a licensed psychologist. Completing this Master’s degree takes an average of 2 years.
Life Coaches
Degree: No specific degree required
License: Not a licensed profession
Training: Life coaches are not licensed therapists. Life coaches are not regulated like other mental health professionals. Their training varies significantly, ranging from self-study to certification programs. Life coaches typically work with clients on practical, non-clinical issues such as career advancement, work-life balance, achieving goals, improving relationships, and enhancing motivation or productivity. While they can offer valuable support, it’s important to distinguish their role from that of licensed therapists. Unlike therapists, life coaches do not diagnose or treat mental health disorders.
Key Differences and Considerations among the Different Types of Mental Health Professionals:
Scope of Practice: Licensed professionals are trained to diagnose and treat mental health disorders; life coaches are not. Training levels vary by degree.
Educational Requirements: Psychologists and psychiatrists undergo the longest and most intensive training and supervision. However, on average, psychologists are the most extensively trained in psychotherapy specifically.
Ability to Prescribe Medication: Psychiatrists and other medical doctors can prescribe medications. Nurse Practitioners (NPs) can also prescribe medications with some limitations. In 5 states—Idaho, Illinois, Iowa, Louisiana, and New Mexico—psychologists who undergo additional training can also prescribe certain medicines used in the treatment of mental disorders.
Focus Areas: Psychologists focus on all aspects of mental health treatment through psychotherapy. Marriage and family therapists specialize in relationship issues. Social workers often address broader social and environmental factors affecting mental health. Psychiatrists focus on medication management, although some also provide psychotherapy. For people who require or elect to include medication in their treatment plan, psychologists (and other kinds of therapists) work together with psychiatrists in service of a shared patient. When choosing a mental health professional, consider what type of support you need, and that will help narrow down your options.
Collaboration: It is important to recognize that many clients benefit from working with a team of professionals. For instance, you might work with a psychiatrist for medication management and a psychologist for psychotherapy. Collaboration between providers is common and can lead to a more comprehensive treatment plan.
What is a “Good Fit”?
A good fit is determined by three key factors: the professional’s level of training, their treatment modality or approach (see Part 2), and the personality match between patient and clinician. Trust and rapport are essential for effective therapy—without them, meaningful change is unlikely to occur.
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