A psychotherapist is someone you are going to trust to help you with your psychological and emotional well-being, and therefore, you want to feel confident that you are choosing a qualified psychotherapist who best fits your needs and interests. The following may help you in selecting the right therapist for you:
FINDING A COGNITIVE BEHAVIORAL THERAPIST
If you are suffering from anxiety or stress, it is important to know that decades of scientific research and clinical trials have shown again and again that for many people cognitive behavioral therapy (CBT) is an effective treatment for anxiety and stress and that these benefits tend to be long lasting.
Many therapists describe themselves as using CBT but some may only be using certain strategies in the context of a more traditional "talk therapy." A structured CBT approach, with specific strategies tailored to a specific treatment conceptualization and with relevant readings and monitoring forms, has been found to be both efficient and effective in the treatment of anxiety disorders, but that does not mean that is best for everyone. What's important is that you understand what your therapist is offering to be sure it is a good fit for you.
Some therapists may use CBT in general but may not have training in the cognitive behavioral treatment of specific anxiety disorders. For example, for Obsessive Compulsive Disorder and Panic Disorder there are specific treatment strategies and explanations that are unique to these particular disorders and are powerfully effective components of treatment.
Therefore, for these particular disorders, it may be more important to find a therapist with specialized training and experience in anxiety disorder who can also provide you with the materials and strategies that can help facilitate your treatment.
Do not be afraid to ask a therapist questions that will help you determine whether the therapist has the skills and expertise you are looking for.
Questions for a Potential CBT Therapist
Once you have described the problems you are struggling with, perhaps in your first session, you could ask:
If you do find a therapist who is experienced in the cognitive behavioral treatment of anxiety disorders, it is now up to you to decide how comfortable you feel with the therapist and whether you feel the therapist is able to communicate clearly about anxiety and fit the treatment to your particular needs. You will probably have a sense of this within the first one or two sessions of therapy.
This is your therapy, and you are in charge of getting the most out of it!
TYPES OF PSYCHOTHERAPISTS
Degree and License
The professional qualifications of a mental health provider are based on two factors: educational degree and license. The educational degree is typically a Masters or a Doctorate degree, while a license means that the therapist has met both national and state requirements to practice in that particular field of study.
An educational degree in a field of psychology usually means that a therapist has been exposed to multiple theories and techniques related to psychotherapy and therefore may be able to compare and contrast psychotherapy approaches to make informed decisions about their own work. Although a graduate degree in the field may not be necessary to be helpful to others, it does at least ensure that a therapist has received a basic level of knowledge about mental health and psychotherapy.
A license may also not be necessary to be helpful to others, as can be seen in the popularity and effectiveness of life coaches, but a license does ensure that a therapist has a certain level of education and experience to comply with the standards of their profession.
The primary purpose of a licensing board is to protect you, the consumer, from possible exploitation and harm by overseeing the competence of its therapists. Qualified education, supervised experience, passing standardized exams on psychotherapy and law and ethics, and continuing education are the standards met by a licensed practitioner.
The educational degree does not necessarily have to match the license. For example, it is possible to have a doctorate (PhD/PsyD) but be licensed to practice at a master's level (LMFT/LCSW). In addition, having a license to practice psychology does not necessarily mean that the psychologist’s doctoral training was in clinical psychology. Those with PhDs in cognitive, social, organizational, and developmental psychology can feasibly sit for the exam and become licensed as long as they have met the other requirements for licensure.
Therefore, it is in your best interest to look at both the degree and license along with training and experience to fully understand a therapist's competencies.
CLINICAL/COUNSELING PSYCHOLOGIST (PhD/PsyD):
Clinical and counseling psychologists have academic doctorates (PhD or PsyD) and, to officially use the term “psychologist,” must have a license to practice in the state. Clinical and counseling psychologists have expertise in psychological testing and in the assessment, diagnosis, treatment, and prevention of psychological disorders.
Academic training is usually 5-7 years and includes clinical experiences ending with a full time position at a pre-doctoral internship. In California, about one year pre-doctoral and one year post-doctoral experience and a passing score on a national examination are required for licensure. Licensure as a psychologist is denoted by the letters PSY followed by a series of numbers.
PhD and PsyD programs can vary widely in terms of admission requirements and quality of education and training.
There does not seem to be much of a difference between clinical and counseling psychology programs, though clinical programs have traditionally included more training in the areas of more severe psychological disorders and counseling programs have focused more on delivering services in university settings.
Traditionally, clinical psychologists have focused more on psychological or neurological assessments whereas counseling psychologists focused more on vocational assessments.
Both clinical and counseling psychologists can be seen in academia, community clinics, private practice, and college counseling centers, but in medical settings, it is more common to see clinical psychologists.
PhD vs. PsyD
Many PhD programs are based on a scientist-practitioner model that emphasizes the balance between clinical and research training whereas PsyD programs focus more on clinical training. The PhD scientist-practitioner model emphasizes the importance of developing practitioners who can also evaluate or produce research on the causes and treatments of psychological disorders.
SOCIAL WORKER (LCSW)
A licensed clinical social worker (LCSW) holds a master’s degree in social work (2-3 years of academic training), has completed about 2 years of supervised post-degree clinical experience, and has passed a written examination.
LCSWs have training in mental health and social welfare systems and are qualified to provide psychotherapy. For more information on California's requirements for social workers, click here.
MARRIAGE AND FAMILY THERAPIST (LMFT)
Psychiatrists, psychologists, social workers, and psychiatric nurses are the four nationally recognized mental health providers, but some states also provide licenses to practice psychotherapy to masters level counselors.
In the state of California, a Marriage and Family Therapist holds a master’s degree in a relevant field, has about 2 years of supervised post-degree clinical experience, and has passed the California licensing exam. While their training is in marriage and family therapy, they may also be qualified to treat individuals dependent on their training.
Click here for more information regarding MFTs and LCSWs in California.
PSYCHIATRIC/MENTAL HEALTH NURSE
To be listed in the state of California as a psychiatric/mental health nurse, a California Registered Nurse must hold a master’s degree in psychiatric/mental health nursing and either two years of supervised clinical experience or credentialing by the American Nurses Association as a Clinical Specialist in Psychiatric/Mental Health Nursing.
A psychiatric/mental health nurse often focuses on the treatment of psychiatric disorders and is qualified to provide psychotherapy. Those with special training in psychopharmacology hold an advanced nurse practitioner license that allows them to prescribe medication under a physician's supervision.
Psychiatrists are physicians with medical degrees (MD) who specialize in the diagnosis, treatment, and prevention of psychological disorders. It would be important to find a psychiatrist who has had post-graduate residency training in psychiatry (usually 3-4 years) and has passed a national examination to become board certified by the American Board of Psychiatry and Neurology.
In the state of California, only psychiatrists and other licensed physicians are approved to independently prescribe medications, electroconvulsive therapy, or other medical procedures.
Regarding psychotherapy, not all psychiatrists have had extensive training in psychotherapy, and therefore, it would be important to inquire about training and experience in psychotherapy if you are considering engaging in psychotherapy with a psychiatrist.
Most mental health practitioners would agree that a therapist's qualifications are based on more than just educational background or license. Other important qualifications to determine competence would be:
QUALITY OF EXPERIENCE