Some General Information about the Mental Health Professions

And, my approach to counseling

What is the meaning of the different titles used by people in your profession?

          Mental health professionals in general use some sort of talk therapy.

          In some states almost anyone can call themselves a counselor or a therapist, even if they have no particular professional training. Other states license these professions and restrict the use of such terms to those who have undergone a training, testing and certification regimen. Thus, psychotherapy can be a more precise term than counseling.

          In Illinois "psychologist" is a protected term that can only be granted by the state. A clinical psychologist usually has a Ph.D. or a Psy.D., has gone through a year long internship, has passed a national licensing exam, and has met a variety of other requirements in order to be licensed by their state. Some psychologists also use standardized tests to help form a diagnosis and treatment plan.

          A psychiatrist has an M.D. degree and has gone through a medical residency to specialize in the diagnosis and treatment of mental disorders because many of these disorders have a physiological component. In most states a psychiatrist is the only type of mental health professional who can prescribe medication.

          A psychoanalyst is a therapist whose approach is based on Freudian psychology. There are many other kinds of specially focused therapies, such as Jungian, Rogerian, Adlerian, behavioral, cognitive, psychodynamic, object relations, brief therapy. Some therapists use one treatment method exclusively. Probably, most therapists try to match the treatment to the client.

          Any mental health professional that you see should be pleased to talk to you about academic credentials and clinical experience. As with any investment in time and money, be a cautious consumer--be skeptical about any counselor with a degree from a non-accredited institution. "Degrees" from internet schools, P.O. boxes, and "New Age" universities with exotic names are increasingly common and always troubling.

How would I find a listing in the phone book for a mental health professional in my area?

          Mental health counseling services might be listed under marriage counseling, counselor, therapist, psychologist, psychiatrist, physician or under behavioral health or mental health. Also, check local social service agencies and community college counseling outreach programs.

How does confidentiality work?

          Essentially, confidentiality means that your sessions are private matters between you and your therapist, and, by law, cannot be revealed except under limited circumstances. Your counselor will explain confidentiality to you. Members of the mental health profession have become concerned about intrusions into this area of trust by some insurance companies and HMOs that want reports on clients. That's one reason why many counselors and their clients prefer to work on a cash basis, so that no "psychological profiles" end up in corporate data bases. This is a significant ingredient of the patient's rights debates that have been conducted by federal and state legislatures.

I've been to a lot of therapists, but none seems right for me.

          "A good fit" is a critical ingredient in the healing process, but too much switching of therapists can be a sign that the client really isn't ready to make changes and is leaving therapists to avoid hard decisions. The real test of a successful therapeutic relationship is this:  do you know your goal and are you moving towards it? 

How do I know if a particular therapist is "a good fit"?

          Your own level of comfort with and confidence in your therapist is a good barometer. Again, is there trust, and do you sense that you're moving forward, even if that movement is, at times, slow or uncomfortable?

What about internet or phone therapy or coaching?

          These new modalities are an expression of the ongoing electronic age and people's hurried life styles. Some of the counselors offering these methods seem to be solidly credentialed. Many seem to be suspiciously short of genuine academic and clinical preparation, including "degrees" from on-line diploma mills or self-generated "expertise." Some fairly simple problems might lend themselves to electronic treatment. I would think that a person in genuine need would want to see a skilled helping professional face to face.