What’s the difference between mental health professionals, and how do you choose?
If you want counseling services, who might you see? Here, I’ll hope to narrow the list and clear up some of the various professionals you might find as you look into your mental health care.
If you think you need medication, who helps with that? And how about expert testing, who does that? What about specific areas, like clinical hypnosis, sleep disorders, addiction, EMDR, CBT and Neuro feedback? What is an eclectic mental health provider and how does online therapy play into this mix? And what about population based care, for example couples, batterers, rural mental health, schools, LGBTQ, online therapy or emergency mental health – and the myriad of categories in expertise?
Here is a summary of the various professionals you might find in a web search for counseling, therapy, mental health, psychiatrists, addiction – and a host of other search key words. The expertise variations are many by discipline but also by the provider area of “concentration.” Specialization in each discipline is common among mental health providers, similar to how a doctor might be a primary care physician, an ER medical doctor, or say a neurologist. Some providers are eclectic. Many are doctors, some are “medical doctors” (MD), some are doctors of philosophy (PhD), and others are clinical psychology doctors (PsyD). Many others are masters level professionals (MSW, MHC, MS, etc.) working within and across disciplines.
To be a provider of mental health there are several standards to be met, such as having a masters degree or higher, a lengthy period of supervised practice and a license to practice by a regulating board in state government. Most providers of mental health are in a class of what is known as a “protected title” area of treatment. This means that one specialist cannot use the “protected title” of another, because doing so is against the law and it would be considered practicing outside of ones expertise. To stay a provider, licensees must obtain continuing education credits every renewal period, where the governing boards of each state and of each discipline set the ongoing educational requirements.
It can be a bit stressful just to find help and to get to the right place. If you cannot “shop around” first (maybe in free consults for example) having a general view of who the mental health experts might be … here’s an overview. Let’s see if I can streamline things a bit, and if not, you can always just give me a call!
Provider specialties are not only governed by training and concentration, but limitations to practice are regulated by State and Federal law. Knowing what a provider can (and cannot do), as well as knowing what kind of help you think best fits your scenario can save you both time and money plus it can increase treatment outcomes. LaRose is licensed in two jurisdictions, both the State of Florida and in the District of Columbia.
Here’s a general summary of who and what you might find as you go about determining who you might see. This list is not exhaustive as specialties are many. If you are unsure about who to see feel free to contact me for more information and I’ll see if I cannot get you going in the direction that fits your interest.
Psychologists are highly trained professionals with advanced training in assessing and diagnosing mental disorders. They also provide mental health counseling, and usually they specialize in treating specific mental disorders. Psychologists often utilize and/or complete academic research as a basis of treatment. Other mental health professionals (such as Marriage & Family Therapists, Clinical Social Workers, and Mental Health Counselors) frequently refer people to Psychologists in order to seek comprehensive, valid, and reliable diagnostic testing. Such tests are used to confirm or rule out the diagnostic impression of therapists, and provide more definitive data to support mental health interventions.
Psychiatrists2 are very much like psychologists with one main exception—a Psychiatrist can prescribe medications. They often specialize in specific mental disorders and are generally the most expensive mental health practitioners. The reason Psychiatrists are more expensive is that they are medical doctors with training geared to biological dysfunctions and medication management. Sometimes a psychiatrist will provide mental health counseling—but this is very uncommon. Other mental health professionals usually refer clients to Psychiatrists when therapy alone is not curative.
A CLINICAL SOCIAL WORKER?
According to the National Association of Social Workers4 “there are more clinically trained social workers—over 190,000 in 1998—than psychiatrists, psychologists, and psychiatric nurses combined. Federal programs and the National Institutes of Health recognize social work as one of five core mental health professions.” Clinical Social Workers who provide mental health services have a graduate degree. The distinction between Clinical Social Workers and other mental health professionals is that CSW’s are specifically trained to view presenting problems by assessing them within a systems perspective; mental disorders are not presumed to exist (if they exist at all) merely as a biological process. “Disorders” are seen generally as by-products of life events (family, school, work, community, society, etc.). Often, when the resulting by-products are resolved, many “symptoms” subside. professional social workers are the nation’s largest group of mental health services providers. LaRose is an LCSW in Florida and LICSW in the District of Columbia.
A MARRIAGE & FAMILY THERAPIST?
According to the American Association for Marriage & Family Therapy5, MFT’s view mental health issues via family systems; “a family’s patterns of behavior influences the individual.” Like other mental health professionals, MFT’s can treat and diagnose mental illnesses via counseling methods. The distinction with MFT’s is their emphasis on the influence of family and marital factors in relationship to a clients presenting problems. The systems view is similar to that of Clinical Social Workers, but the system of attention that is central for MFT’s is most commonly linked to the primary family dynamic.
A MENTAL HEALTH COUNSELOR?
A Mental Health Counselor likely carries the most universal label that describes the profession. MHC’s treat mental disorders via talk therapy methods, and like most mental health professionals they often specialize. According to the American Mental Health Counselors Association6 “mental health counselors are uniquely qualified to provide high quality care that’s more affordable than other practitioners.” The profession is regulated by the same governing board that oversees marriage & family therapists and clinical social workers. “Consumer oriented therapy” is likely more prominent when working with the MHC as opposed to the clinical social worker or the marriage and family therapist.
A PSYCHIATRIC NURSE PRACTITIONER?
According to the American Psychiatric Nurses Association7 psychiatric nursing is considered a nursing specialty. To be an Advanced Registered Nurse Practitioner (ARNP) the nurse must have a master’s degree. Psychiatric ARNP’s can prescribe medications for mental illness provided they are working under the written protocol of a medical doctor. The medical doctor does not have to be working in the facility where the ARNP sees patients (in the state of Florida). Many psychiatric ARNP’s will provide some talk therapy as a component of medication management.
A PLAY THERAPIST?
Play Therapy is a method of intervention that uses play techniques to treat mental illness and behavioral disorders. Play therapy is a specialized treatment method used by social workers, mental health counselors and marriage and family therapists and it is a practice method that is credentialed through the Association for Play Therapy8. The methods of play therapy are not only used for children but also it is useful for adults. A unique component to play therapy is its more pronounced approach in prevention. The APT summarizes the specialty this way: it is “the systematic use of a theoretical model to establish an interpersonal process wherein trained play therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development.”
AN ART THERAPIST?
The American Art Therapy Association9 describes art therapy as a mental health profession whereby Art Therapists hold master’s degrees in the field. The practice, like most mental health treatment modalities, is rooted in research that shows effectiveness with a wide range of mental disorders. Art Therapists are regulated and credentialed via the Art Therapy Credentials Board. AT’s use “drawing, painting, sculpture and other media” to assess and treat mental illnesses. The practice, according to the AATA, “is based on the belief that the creative process involved in artistic self-expression helps people to resolve conflicts and problems, develop interpersonal skills, manage behavior, reduce stress, increase self-esteem and self-awareness, and achieve insight.”
A MUSIC THERAPIST?
The American Music Therapy Association10 explains the work of Music Therapists in the context of healing via music; “music therapy is an established healthcare profession that uses music to address physical, emotional, cognitive, and social needs of individuals of all ages.” In music therapy the application of music to all mental disorders for the purposes of treatment is the focus of the intervention. Whereas other therapists might specialize in certain disorders, the music therapist specializes in the use of music to accommodate healing. The use of music therapy is especially effective with the very young, the disabled, and the elderly in cases where more traditional counseling methods cannot be used (children with developmental disorders, brain injury patients, and people with dementia related disorders).
AN ONLINE THERAPIST?
Online therapy is continually entering the mainstream of mental healthcare. Increasingly clients are seeking options where they can work with a therapist (who could be an MD, PhD, PsyD, MSW, MHC, etc.) 24 hours a day, either synchronously or asynchronously. The practice of online therapy is still an emerging field in the US; encryption is a key to whether or not privacy is being maintained. LaRose practices online therapy (along with office and onsite options too) and has been doing so before even the online jargon was yet a thing!
The Best Possible Summary
In reality, the best person to decide “who to see,” is you. Eclectic care might be a great starting point if you’re really unsure. If you need mental health medication then the psychiatrist is the place to begin; if you are unsafe then emergency mental health is the consideration. Nearly all of the mental health practitioners listed here can provide talk therapy services; some may have free consults (check availability in your area too). Increasingly there are asynchronous services (24 hour online communications that vary between client and therapist) and other online models of care.
It is helpful to know the limitations and the benefits to various professionals who specialize. In general you should know that Psychiatrists and Psych ARNP’s usually focus on medication; Psychologists are known for their skill in testing; Art, Music and Play Therapists apply a specific technique to a majority of disorders; Marriage & Family Therapists treat individuals in the context of significant relationships; Mental Health Counselors frequently view problems and solutions via the consumer; Clinical Social Workers see mental illness (and mental health) via broad influences—to treat the person it is believed the systems from which people operate must also be understood. LaRose is an LCSW and an LICSW (in FL and in DC), who specializes in Clinical Hypnosis, offering traditional mental health services, Life Coaching, eclectic care and Practitioner Training Programs.
Where to begin? Look for state license numbers, ask for a initial consultation, ask if there is a diagnosis being made, ask to see a treatment plan and get a second opinion. It’s good to ask whoever you see, as many questions as possible before you begin any kind of therapy—and to be sure that therapy is needed. If you still have questions, you may contact us anytime.