Clients of mental health services can be considered consumers and in the past decade the rights and privileges of consumers has increased in emphasis. However, clients seeking a therapist may have limited opportunity to actually choose their therapist unless they are able to afford private treatment. Public clinics rarely offer clients the option of choosing their therapists.
When clients do have the opportunity to choose their therapist what are some of the characteristics they can look for that would give a higher probability of a good fit? There are several things a client should be looking for when choosing a therapist. One of the first decisions to make is which type of therapist is the most beneficial?
The Credentials and Education of the Therapist
The first decision to make is which type of therapist to see. Psychiatrists, psychologists, Marriage, Family Therapists or Licensed Social Workers are all options. In addition, the field has recently added Licensed Counselors in some states. Each type of therapist has specific areas of expertise, though some overlap.
Psychiatrists are medical doctors who specialize in the treatment of mental health issues. Most psychiatrists who work in a public clinic do not see clients for therapy other than prescribing and monitoring medication needs. The average visit time is 15-30 minutes. While the doctor will ask questions related to the treatment, he or she does not delve too deeply into psychotherapy. In the public clinics, the psychiatrists work hand-in-hand with the treating therapist. In the private sector, psychiatrists do treat the client with psychotherapy in addition to medication if needed. In the private sector, a session is generally 45-50 minutes and can cost $100-$250 or more per session.
Psychologists are the next level of treatment. They do not go to medical school, but do have a doctoral degree; either a Ph.D. (Doctor of Philosophy) in clinical or counseling psychology or a Psy.D. (Doctor of Psychology). Psychologists cannot prescribe medication in most states. In recent years, a few states have granted prescribing privileges to medical psychologists who have obtained a post-doctorate master’s degree or equivalent in clinical psychopharmacology. Psychologists are able to give clients different tests such as the Rorschach, commonly known as the ink blot test, IQ tests, learning disabilities tests as well as other tests related to the field. The cost for a session with a psychologist is about as much as a psychiatrist, though in some areas it may be slightly less. The sessions are also 45-50 minutes.
Licensed Marriage & Family Therapists (LMFT) require a Master’s Degree in the psychology field. LMFTs cannot prescribe medications. The parameters of the work LMFTs do are work with families, couples, children, and individuals who have emotional or behavioral concerns using a variety of techniques. LMFTs focus on viewing and understanding their clients’ symptoms and interactions within their current environments. In the private sector, LMFTs charge $60-$150 per session and sessions are usually 50 minutes.
Licensed Social Workers (LSW) are another option in the private sector of mental health. They hold a Master’s Degree in Sociology or Social Work. Their training is primary in the social field, but they also have psychology training as part of their required courses and have the ability to conduct therapy with families, couples, children, and individuals. They cannot prescribe medications. The fees for LSWs are similar to LMFTs as are the length of session.
Some states have recently licensed counselors as part of the field of mental health service providers. Licensed Counselors have a Master’s Degree in counseling or a related field. It is a relatively new licensed body within the mental health field. Licensed Counselors often work with clients in the areas of addiction and rehabilitation. The average fee charged is about $60 per session. Sessions are generally 50 minutes in length.
Before licensing, all categories in the field must complete some form of internship and/or residency. A practicing therapist must display their license and if not yet licensed, must disclose status, such as internship or residency at the initial meeting. Usually the first session is the assessment and is conducted for at least one hour. Initial assessments usually are charged a higher fee.
Other Things to Consider When Choosing a Therapist for Counseling Services
Regardless of which license they hold, therapists work from a particular theory for the most part. Many use an eclectic approach, but others adhere to specific techniques. Clients should ask questions about what approach the therapist uses in treatment. Therapists using psychotherapy techniques rather than behavioral generally fall into one of two categories:
- therapists who are more active by frequently asking questions and/or making comments to help their clients express their feelings and thoughts. They may or may not assign homework between sessions, but usually will give suggestions for changes the clients can make between sessions;
- therapists who primarily listen to their clients and offer well-timed comments to clarify what the clients are feeling and thinking. They may or may not give homework assignments between sessions.
Another thing to consider is whether or not a specialist is needed. Often therapists have a specialty either by extended education or years of experience working with a particular population. Examples of specializing includes years of experience working with children, addictions, victims of abuse or trauma or specific mental health disorders.
When seeking a mental health therapist in the private sector, consumers do have the right to ask questions as to the credentials, experience and approaches the therapists have and use. Fees charged depend upon the license, credentials, and experience as well as the region. Typically group therapy is less expensive than individual therapy sessions.
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Skinner, Adriane E. G. and Latchford, Gary. (2006, September). Attitudes to counselling via the Internet: A comparison between in-person counselling clients and Internet support group users. Counselling and Psychotherapy Research, 6(3), 158-163.
The copyright of the article “How to Choose a Mental Health Therapist” is owned by Cheryl Weldon and permission to republish in print or online must be granted by the author in writing.