It’s not uncommon to need mental health treatment at some point in life. Perhaps you’ve experienced a trauma, been feeling unusually sad or anxious, or are experiencing marital problems. Maybe you’re battling an addiction that you can’t seem to kick or feel completely overwhelmed and stressed out. Or maybe, your future feels so bleak that you’ve started to wonder if life is worth living at all.
Regardless of the specific reason, you know you need to get some help. Perhaps your physician, pastor, or someone else who cares about your well-being has suggested it’s time.
You may worry that seeing a “shrink” would be a sign of weakness – or even worse – an indicator that you’re certifiably “crazy”. And heaven forbid anyone else know that you are thinking about getting or already receiving “professional help”!
Not to mention, the mere thought of navigating the maze of alphabet soup that seems to come with the mental health territory – PhD, MD, PsyD, MA, LPC, LCSW, etc. – can be a bit daunting in and of itself! “Aren’t they all pretty much the same?” you may be wondering. (If so, you’re not alone.)
So, where do you start?
Types of Treatment Providers
It’s helpful to have a brief understanding of the different types of providers before choosing one. While your PCP can diagnose a mental health condition and write a prescription, it’s important to remember that mental health is not his or her area of expertise. That’s why it’s generally not a good idea to rely upon your PCP for your mental health care. Your PCP can, however, give you a referral and help point you in the right direction.
Psychiatrists are licensed medical doctors who have specialized training in the treatment of mental health conditions. Many specialize in treating specific populations (e.g. children or elderly individuals), or even specific disorders (e.g. OCD or addictions). Psychiatrists can prescribe medication and may also provide psychotherapy. Of all the various mental health providers, psychiatrists are often the most expensive per visit.
Psychologists hold a doctorate degree (Ph.D., Psy.D., Ed.D.) from a postgraduate training program and specialize in the diagnosis and treatment of mental health disorders and issues. They provide psychotherapy and may also offer psychological testing. As a general rule, they don’t prescribe medication (two states do allow psychologists to prescribe with additional training).
Clinical Social Workers
These individuals are social workers who specialize in providing mental health services. Most have a master’s degree, but some do go on to obtain their doctorate in social work as well.
Licensed Professional Counselors (L.P.C)
These individuals typically have a master’s degree (M.A. or M.S.) from a graduate program in counseling, psychology, or marriage and family therapy.
Psychiatric Nurse Practitioners (PMHNP-BC)
These nurses have at least a master’s degree in psychiatric-mental health nursing. They can diagnoses and treat mental health disorders, and, depending on the state in which they practice, may also prescribe medication.
It should be noted that training and licensing requirements vary for mental health professionals from one state to the next. Credentials also vary depending on the state, which can make it even more confusing.
Each of the mental health professionals listed above can be found in a variety of settings, including private practice, inpatient psychiatric settings, hospital ERs, and drug and alcohol rehab programs.
Master’s versus Doctorate Degree
When looking for a mental health professional, you may want to consider the difference in training between someone with a master’s degree only, and someone with a doctorate degree. With the exception of medical doctors, all other mental health professionals (in most states) are required to complete their master’s degree as a prerequisite to entering a doctoral level training program. This is important to understand because it means those with doctorates have more years of specialized training. So, for example, clinical psychologists have both a master’s degree and a doctorate degree.
Most master’s programs are two years of graduate level schooling. Most doctorate programs require two additional years of school, plus a one year internship. Psychologists and medical doctors are required to do a post-doctoral residency (a period of supervised clinical experience in the field) after they finish their doctorate degree.
This is not to say that a mental health professional with a doctorate degree is automatically superior to someone with only a master’s degree. Rather, it’s to point out that the level of training between the two is not insignificant and is something you may want to seriously consider when choosing a treatment provider.
Specialized versus General
Just like some physicians, dentists, and other health care professionals are very generalized in their practice while others are highly specialized, the same is true with mental health professionals. Some don’t specialize while others do.
So, how important is this?
As a general rule of thumb, it’s better to see someone specializes in treating your particular disorder (or category of disorder) or your age group (or other demographic) if possible, especially for particularly complex or less common disorders.
For example, OCD (obsessive-compulsive disorder) is a very complex psychiatric disorder that can be particularly difficult to treat effectively. A mental health professional who has very little experience treating OCD may end up doing more harm than good. Another example would be choosing a mental health professional who specializes in treating your particular age group (i.e. child, adolescent, adult, or geriatric), or even your particular sexual orientation (e.g. a therapist who specializes in treating lesbian, gay, bisexual, or transgender adults). The clinician who is specialized is going to have a much greater understanding of the unique aspects and treatment challenges that are part of your particular disorder, age group, and so on.
While working with a specialist is preferred, keep in mind that it’s not always possible. If you live in a small town or rural area, you’re likely going to have a difficult time finding someone who is specialized. That doesn’t mean you should just forget treatment altogether. It also doesn’t mean you should be too quick to dismiss the person you do see, and assume he or she isn’t qualified or competent. Working with a specialist is just a recommendation – if it’s possible to do so.
Licensed versus Unlicensed
Even the best clinicians started out unlicensed. Licensure doesn’t automatically mean someone is going to be truly competent or the best fit for you, and lack of a license doesn’t mean someone is incompetent or won’t be able to help you. Working with an intern, psychology resident, or any other non-licensed mental health professional doesn’t mean you won’t get very good care. Just be sure that he or she is working under appropriate supervision.
If your financial resources are limited, an intern or resident will often provide treatment at a lower fee than someone who is licensed. This can be an advantage also, in that it may enable you to stay in therapy for a longer period of time.
(This is not to imply that a license to practice isn’t important, but to remind you that a lot of people who are very good at what they do haven’t yet gotten licensed for one reason or another. As long as they are under appropriate supervision, don’t be too quick to rule them out.)
Unfortunately, mental health treatment almost always costs money. And it can be very expensive. Psychologists and other types of therapists typically charge anywhere from $75 an hour to $150 an hour. Psychiatrists’ fees may range from $125 to $200 or more per hour. This depends on many different factors, including location, level of specialization, and whether or not they are just starting a practice and seeking new clients or well-established with a waiting list.
When choosing a mental health provider, you need to make a thoughtful decision in terms of how much price will dictate who you choose. The more expensive, more specialized, more experienced clinician may be able to diagnose you more quickly (and accurately), and get you on the right path in terms of the most effective treatment regimen much more readily than a less experienced or less specialized colleague.
If you have health insurance, always check with your insurance company before selecting a provider. Some providers may not be covered at all, or you may be required from a list of “preferred providers”. It’s also important to know up front the extent of coverage (e.g. how many therapy sessions) and limits of the benefits you can receive.
Where to Start
It can be a bit daunting to start searching for a mental health professional. It’s important that you choose carefully, and find the best fit for you. Don’t hesitate to do some research and talk to several different people. The more informed you are, the better decision you can make. The last thing you want to do is jump into treatment with someone only to end up feeling you’ve wasted your time and money after several sessions.
In addition to your insurance company (if they have a provider list) and your PCP (who can offer some referrals), talk to people you know such as your close friends, relatives, or someone at your church.
Do some research online. Many mental health professionals have their own website. If you are struggling with PTSD, for example, you might do an online search for “PTSD therapist [your city]”, “PTSD psychologist [your city]”, or “PTSD treatment [your city]”. If you don’t know your diagnosis, you can leave that part out and just search “psychologist [your city]”, and so on. A website will give you both a feel for the particular provider (including his or her treatment approach, training, any specialty areas, and philosophy), and information regarding basics like office hours and fees.
The yellow pages are another good place to look for a provider if you don’t feel comfortable searching online.
Once you’ve narrowed your search, don’t hesitate to make some phone calls. Ask questions about the person’s treatment approach and experience. Talking to the prospective mental health provider on the phone will also give you some idea of whether or not you will feel comfortable with the person.
When you find someone you feel good about, set up an appointment. Keep in mind that your treatment is for YOU, not the therapist. If you truly feel it’s not a good fit, and just isn’t working, it’s OKAY to stop therapy and look for another provider. Of course, remember that therapy is often uncomfortable at times, because it’s like open up an infected wound and gradually cleaning it out. So, you owe it to yourself to be open-minded, but also to find a different provider if necessary.
Mental health treatment is an investment in yourself and in your future. Do your due diligence when looking for a mental health professional, and you’ll have a greater chance at finding someone who’s the right fit for you from the beginning.