Finding The Perfect Therapist Part 2: What Happens When You Call

You're crazy! You need therapy!! If you are like every other normal person out there, the check-engine light of life has probably been on for some time. You have been walking around dealing with stressor after stressor, hoping that it would just magically go away; but, of course, it hasn't. By the time things have gotten bad enough that you recognize you need some counseling or therapy it's usually pretty bad. [caption id="attachment_1501" align="alignleft" width="483"] When stress hits and the check-engine light in your life comes on, you should get help![/caption] Congratulations! You're normal, just like everybody else! Getting to a place where you recognize you need to talk to someone can be humbling and anxiety-producing.  But it also takes a lot of courage to admit when you need help.  Don't let the fear of making a phone call (sooooo many people have phone anxiety - phone phobia) or opening up about your struggle rob you of healing! The next step is knowing what kind of help you need and who can provide it! This is part 2 of a 3-part series on How to Find the Right Therapist.  Part 1 can be found here Let me take a minute to pause and explain the difference between psychologist, psychiatrist and therapist/counselor because this one gets confused so often:

Psychiatrist vs Psychologist

Psychiatry - "A psychiatrist is a medical doctor (an M.D. or D.O.) who specializes in mental health, including substance use disorders. Psychiatrists are qualified to assess both the mental and physical aspects of psychological problems. Psychiatrists use a variety of treatments – including various forms of psychotherapy, medications, psychosocial interventions and other treatments (such as electroconvulsive therapy or ECT), depending on the needs of each patient."  Dr. Ralph Ryback writes an excellent article outlining the differences between psychology and psychiatry over at Psychology Today [caption id="attachment_1513" align="alignnone" width="560"] Often psychiatrists have become synonymous with medication...but that's not all they do.[/caption] It's rare these days to find a psychiatrist that still does traditional psychotherapy along with medication prescribing and management. Sadly, there aren't enough psychiatrists around. Many are filled up and appointment times can be as short as 10 to 15 minutes. Psychologist - Psychologists have not attended medical school, however, they have attended graduate school and obtained a doctorate degree (often a PhD or PsyD).  Depending on their focus and training they are capable of conducting assessments (ex. Intelligence testing, ADHD assessments, Rorschach Test - just to name a few), writing reports based off of the findings of those assessments, and they are capable of providing psychotherapy.  Not all psychologists provide assessments, not all provide therapy.  Some do a bit of both.  Some specialize in one or the other. [caption id="attachment_1508" align="alignnone" width="560"] It's important to know the difference between the terms - Psychiatrist, Psychologist, Counselor, Therapist, and Social Worker[/caption]

Counselor vs Therapist -

The American Counseling Association defines counseling as, "a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals." The term "counseling" is often used interchangeably with "therapy".  Therapy is defined as "a collaborative treatment" that includes "a supportive environment that allows you to talk openly with someone who is objective, neutral, and nonjudgmental" (American Psychological Association). A counselor or therapist is typically (but not always) a Masters-level clinician who provides psychotherapy.  Traditionally, they must be licensed with the state after meeting that state's requirements of education, direct service hours and supervision hours. That being said, there is no clear designation legally of the difference between the terms "counselor" and "therapist".  As mentioned previously, they are frequently used interchangeably; however, some states, insurance companies and clinicians themselves will prefer or use one term over another.  Those same states and insurance companies may define counselor/counseling separate from therapist/therapy.  Blake Griffin Edwards, MSMFT, LMFT writes a really thorough, in-depth explanation on the GoodTherapy.org blog. What's with all the initials?! PsyD, PhD, LPC, LMFT, LCSW...(and as Chris Lochhead put it in his recent appearance on Joe Sanok's Practice of the Practice podcast) "FART! We don't know what any of that" stuff means.  Most people have no clue what all the letters stand for. [caption id="attachment_1518" align="alignleft" width="433"] All those initials after a therapists name are their credentials or certifications[/caption] So the initials after the professionals name typically denote the type and level of training they have gone through. PsyD - Doctor of Psychology, PhD - Doctor of Philosophy, LPC - Licensed Professional Counselor, LMFT - Licensed Marriage and Family Therapist, LCSW - Licensed Clinical Social Worker.  There are so many more credentials out there in the professional alphabet soup; but, in the interest of "brevity" and not being sued for you falling asleep at whatever device you're reading this on, I'll stop here.  Each state has their preferred terms. You have to be licensed with the state you practice in and/or a national board in order to use those credentials with your name.  It's a way for those organizations and states to certify clinicians, meanwhile, protecting the public.

Which one is right for me?!

That depends on what you're looking for.  The next section will help you get those questions answered; but, put simply in layman's terms: If you need:     Then you need: Medication   -   Psychiatrist Testing/Assessment  -   Psychologist Counseling/Therapy   -   Counselor, Therapist, Social Worker (at least) Now back to our regularly scheduled program. I covered in the previous post about how to search for and find the right therapist for you and your needs. Some therapists will have the ability to email and schedule online, while others will ask you to call to set up the first appointment. Most everyone wants evening or weekend appointments; however, those are not always available. All therapists are not created equal and you will have to decide for yourself the importance of meeting with that particular therapist versus their availability and how severe your need is. Crisis Disclaimer - If you are experiencing suicidal or homicidal thoughts, having hallucinations where you are seeing or hearing things, or are struggling with self-injury and are NOT currently working with a therapist, you should stop reading this and go to your nearest emergency room to seek immediate attention. If what you're dealing with is not at crisis level, then please keep reading.  These are some things to think about and be prepared for when trying to schedule. When you call there are a couple of questions you should ask.

1. Are they taking new patients/clients?  Ask this first because getting #2 answered doesn't do you any good if they aren't taking new clients.

2. Do they accept insurance? Do they accept your insurance? As stated in the previous post, know your benefits (both in-network and out-of-network).  Most counseling practices offer additional options (like a sliding scale fee based on income) for their clients if the insurance isn't working out, so don't panic if the answer is no!

3. Do they specialize in… Fill in the blank? Any professional should be able to tell you whether or not they have training and are equipped to handle your particular struggle.  For instance, I specialize in working with anxious teens and adults, couples who are struggling to connect, and families dealing with terminal medical diagnoses such as cancer.  I am NOT trained in or licensed as a play therapist or dealing with eating disorders (just to name a few).  You may be aware of a particular type of therapy you need or prefer such as Cognitive Behavioral Therapy - CBT, Dialectical Behavioral Therapy - DBT or Eye Movement Desensitization Reprogramming - EMDR...oh God! More initials?!? They should also be able to speak to that.

[caption id="attachment_1530" align="alignright" width="425"] How far out are they scheduling appointments? 1-2 weeks? 3-6 months?[/caption]

4. How far out are they scheduling? You'll want to know if the soonest appointment you can get is 2-3 months out.  This can actually be considered a "short" wait for some practices.  I've even had horror stories of offices opening their appointment scheduling on a certain day of the month almost like Ticketmaster used to do for concerts (remember Ticketmaster, when you'd camp out at some mall parking lot to get tickets to your favorite show! Ahhh, the good ol' days).  First come, first serve! Once the spots are gone, that's it! Crazy, right?!  And people wonder why there is such a mental health crisis in our country; but, that's a topic for another time.

5. Do they have a short-notice cancellation list? This can sometimes be a way to get in with the therapist to be an established client and work your way to your preferred appointment day or time.

On the flipside, you should be prepared to type or tell a brief description about why you are seeking counseling. What is it that you are struggling with?  Be open and honest! You don't have to write a novel; but you shouldn't pull punches either.  Being forthcoming will help that counselor determine whether they can assist you with your particular issue and will get you the help you need faster. Nobody brings their car to the mechanic and says, "Yeah, the left turn signal isn't working" when in reality it's because they wrapped their car around a telephone pole and the car won't start! I know it seems like a lot!  But preparing yourself and getting these things out of the way will really help you find the right professional in the long run.  And that's the whole goal right?  To find you the best help possible. Next Post: Part 3 - What to expect from the first session!