You've decided that psychotherapy might be appropriate for you. You're not satisfied with some aspect of your life and have recognized that a skilled psychotherapist might be able to help. But, you don't know a "Psy.D." from an "MFT" ! It's all alphabet soup! All you want to know is,
"How do I find a psychotherapist that is 'right' for me?"
At present, there are four different types of psychotherapists licensed to practice:
- Psychiatrist
- Clinical Psychologist
- Clinical Social Worker (LCSW)
- Marriage and Family Therapist (MFT)
Trying to decide which one of these would be the best for you can be difficult and confusing.
A Psychiatrist is a Medical Doctor (MD) with a specialty in Psychiatry. Certain mental illnesses, such as major depression, schizophrenia, and bipolar disorder (manic/depression), may require medical intervention. This may involve prescription medication, and/or hospitalization. While some Psychiatrists perform psychotherapy, most perform psychiatric medical evaluations brief monthly follow-ups. Only a medical doctor may prescribe medication to a patient!
The Clinical Psychologist, in addition to a doctorate degree (Ph.D., Psy.D. or Ed.D.), must achieve a minimum of 3,000 hours of supervised experience prior to taking both a written and oral state licensing examination. With extensive training in psychotherapy, as well as in psychological testing, psychopharmacology and research, the psychologist is qualified to work with the more serious mental disorders. The psychologist can also effectively interface with the psychiatrist who may be medically managing the patient. The clinical psychologist is the most highly-trained non-physician licensed mental health practitioner.
The Licensed Clinical Social Worker (LCSW) completes a Master of Social Work degree and 3200 hours of supervised experience prior to sitting for the written and oral state licensing exams. While LCSWs may practice psychotherapy, most of their training is in social welfare, agency administration, case management, and adoptions.
The Marriage and Family Therapist (MFT) license requires a Master's degree in Counseling, and, in California, 3000 hours of supervised experience, and passing the written and oral State Board exams. The MFT specializes in relationships and the bulk of their training covers psychotherapy and relationship theory. They often view problems from a "Systems" orientation or through how the person is affected by their family of origin and current relationships.
"Now that I've determined which type of professional is appropriate, how do I select the "best fit" for me?"
Finally, another important consideration in picking the right therapist is your confidence in their ability. Ask if they will give you a complimentary session of 30 minutes to interview them. Ask to see a resume. Ask about their background and experience, qualifications, and specializations. (Beware of the therapist who can work with any problem!) Are they a member of their professional organization? If they are not yet licensed, (they are supposed to tell you), do they have supervision, as required by law? Another good question is whether they participate in their own therapy? Most good therapists do!
Also, what are their fees and financial policies? Can you afford weekly sessions? How comfortable do you feel asking these questions and how comfortable are they answering them? Do they appreciate your concerns? Your level of comfort is the third crucial factor in picking a therapist.
There are many excellent therapists in the community. Educating yourself and taking a few precautions, as suggested above, will protect you from those few who are not ethical or competent.
Remember, you are the consumer! You must feel both safe and comfortable if therapy is to progress.