06 Nov

I know I have spent many hours trying to find the right professional to help me with my health needs, and the process can be so daunting I end up putting off my appointments for another 6 months. I'm usually looking for someone who is the right mix of educated, compassionate, convenient to access, and available to see new patients. It's really hard to determine all of these things based on their headshot and the 3 google reviews written about them, but I somehow find a way. 

People tell me all the time how difficult it is to find a therapist, and it's true- many therapists have full caseloads, a growing percentage are no longer in network with insurance companies, and it is impossible for the lay-person to comprehend what the 4-15 additional letters that follow therapists' names actually mean.

So I will try to break this down for you, because I would hate for anyone to put off therapy for 6 months when they may need it now:

Psychologists are doctoral level professionals, and often have a PhD or PsyD after their name. They might also have the letters LCP (licensed clinical psychologist). Doctoral level psychologists often have the most graduate education among therapists, but degrees are only one piece of a person's training experience, and years in practice as well as training beyond graduate school are huge factors in a person's level of competence.

Therapists are also Master's level clinicians, and they might have degrees in counseling, clinical psychology, social work, or something similar. An "L" in front of their initials means they have passed the exams and other criteria necessary to meet the licensing standards of their state (i.e. LCSW is a licensed clinical social worker and LPC is a licensed professional counselor).

If you are looking for medication to manage your mental health, you are looking for someone with a medical degree (M.D.) and these are your psychiatrists, although many PCP's and psychiatric nurse practitioners (NPs) also prescribe psychotropic medication. They generally do not provide traditional "talk therapy" and their sessions are usually much shorter because of the volume of their caseload.

Marriage and family therapists have a specific curriculum they have completed and those who are trained to work with families and couples will have an LMFT after their name, although many other kinds of therapists do this work as well. 

A life coach may have completed some training or certification to do their job, which is to guide people in setting goals and making life decisions. They do not necessarily have any kind of clinical training, ethical training, and are not accountable to a governing body or licensing board who oversees and monitors their practice.

Lastly, many therapists have gotten additional training and certifications, denoted by even more letters. Some you might see:

CADC: Certified alcohol and drug counselor

CSAC: Certified substance abuse counselor

CEDS: Certified eating disorder specialist

ABPP: Designates board certification in a specialty area

NCSP: Nationally certified school psychologist

RYT: Registered Yoga Teacher

Next, every therapist ascribes to one or several theoretical orientations, which inform the interventions they offer their clients. Examples of these are psychodynamic (insight work, bringing unconscious material into the conscious realm, lots of focus on the past) and behavioral therapies (Cognitive Behavioral Therapy, Dialectical Behavior Therapy, Acceptance and Commitment Therapy, etc., which focus on examining and changing unwanted behaviors). Some therapists practice Interpersonal Therapy, which uses the therapy relationship to guide interventions and give the client direct feedback. Humanistic or Rogerian therapists rely heavily on empathy and reflecting what a client discusses, and they are generally not very directive. More and more common are therapists who are trained in EMDR (Eye Movement Desensitization and Reprocessing) and other biofeedback measures, often for trauma. Many therapists claim to be "integrative" which means they use a combination of all of these tools. It makes sense to ask your potential therapist what his/her theoretical leanings are, to find out whether their approach might be a good fit for you.

Nowadays, most therapists have an online profile which allows you to read a bit about them and the clients they typically see, and determine for yourself if you think you'd work well with them. Even in the cases when you think you've found the "perfect" therapist for you, meeting in person might not be what you expected. The therapy relationship is like any other relationship; sometimes you "click" and sometimes you don't. You might know right away whether someone will work well with you, and if you aren't sure, I encourage you to give it a few sessions to find out. Be wary of your own resistance to being vulnerable and letting someone else in, as this can cause you to decide too early that it is a fit problem when it may actually just be some run-of-the-mill urge to avoid discomfort.

If you still have questions, ask! Ask Google, ask any therapist, ask the health professionals with whom you are already working. Don't let the process delay you getting yourself help.

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