Choosing a Therapist

What To Look For In a Therapist

Licensed Professionals

I strongly recommend that you look to work with a person who is either licensed or being supervised by someone with a license.  Who can be licensed?  What does this mean?

Well, there are several types of mental health professionals, all of which are licensed by the state in which you live to be practicing their craft.  This means that the state has looked at their education and training and documented that the individual meets professionally established minimum requirements to provide services to the public.  In other words, the state has done some of your homework for you.  You don’t need to make sure that a licensed professional went to graduate school and passed or that they fulfilled their their profession’s requirement for supervised clinical hours.  So, basically, having a license makes it MUCH more likely that the person you are working with knows what they are doing.  Still, it can be helpful to get some recommendations from people you respect about licensed professionals in your area.

Looking for a Good Match

Understand how to find a therapist that is a “good match” for you will significantly increase the odds of therapy actually being helpful. Part of a good match has to do with the therapist ‘s personality, and part of it has to do with the philosophy and techniques that therapist will use with you from week to week.  If after meeting a therapist for the first time or while working with them for the while you feel like you are not able to talk with them in an open and honest manner, it could be that this is not the right match for you. Good therapists know that they are not the right match for every person and she or he shouldn’t  take it personally if you request to see a different therapist. Often, though, it can be helpful to talk with your therapist about how you’ve been struggling with feeling comfortable because it might be something that can be worked through in a clinically helpful way. But in the end, if you can’t get past these issues, or just don’t feel emotionally safe enough to bring these feelings into your therapy session, I really recommend that you try to find somebody else to work with.  In the end, therapy is something that is supposed to be helping you…you are “da boss,” and if it’s just not a good match it is time to move on. It is not your job to worry about whether you might hurt a therapist’s feelings.  They are professionals and should be able to take care of themselves. And, if a therapist should ever suggest otherwise, I would say that is further evidence that the therapist you’re seeing is not the professional that you need.

One caveat to throw in here is that in order for therapy to be successful YOU have to want change in your life and be willing to work for it. The best therapist in the world can’t help an unmotivated client that expects everybody else to run around and change except them. In this case, that means that you need to do your best to try to take emotional chances with your therapist by sharing the difficult things that have been floating around in your mind and causing you emotional pain.   So, if you wind up trying several different therapists and can’t find anybody that you feel comfortable sharing your deeper feelings with, this could mean that sharing your deeper feelings is actually a clinical issue for you to work on. Tell your therapist that you’re having a hard time sharing your feelings and ask for help with this issue so that you can make good use of your therapy time.

Types of Licensed Professionals (a.k.a. “Alphabet Soup”)

Important Notes: No one profession corners the market on having the best trained therapists.  Also, the abbreviations mentioned below (i.e., LPC) can vary by state.  So for example, in New York, I would be a LMHC (Licensed Mental Health Counselor)

Licensed Professional Counselor

This is a person who has, at least, a master’s degree (bachelor’s degree plus 2ish more years in their specialty) and has completed a certain number of hours of providing therapy under the supervision of another licensed professional.  LPCs are trained to provide therapy as well as how to interpret psychological testing and scientific research.  Sometimes a counselor’s training specializes in the areas of school counseling or rehabilitation counseling.  Bias alert: I’m putting this at the top of the list, to do a little promotion for my field but, really, I put us generally on par with licensed social workers (LSW) and licensed marriage and family therapists (LMFT). Furthermore, strictly in talking about quality of therapy, I would also put an  LPC, LSW or LMFT on par with a licensed psychologist.

Licensed Social Worker

Often abbreviated as LSW or LCSW, again depending on the state in which they practice, these are folks who have, at least, a master’s degree (bachelor’s degree plus 2ish more years in their specialty) and has completed a certain number of hours of providing therapy under the supervision of another licensed professional.  They are trained to provide therapy as well as knowing how to tap into (or develop/advocate for) community resources for the benefit of the individual.

Licensed Marriage and Family Therapist

LMFT’s have, at least, a master’s degree (bachelor’s degree plus 2ish more years in their specialty) and has completed a certain number of hours of providing therapy under the supervision of another licensed professional.  They are trained to provide therapy and do treat individuals but they specialize in marriage/couples and family issues.

Licensed Psychologist

This is a person who has, at least, a doctorate degree (bachelor’s degree plus 4ish more years in their specialty).  Their schooling includes a certain number of hours of providing therapy under the supervision of another licensed psychologist so they don’t do this after completing their degree like the aforementioned professionals did.  They are trained in both providing therapy.  Something that sets this profession apart is that they are also trained in administering various forms of mental health and “intelligence” testing, more so than the master’s level professionals.

Psychiatrist

This is a person who is a medical doctor, so they can prescribe medication.  Often, while they can, they often don’t directly provide therapy but are, instead, used as consultants, for diagnosis, and to determine appropriate level of care (hospital, day treatment, intensive outpatient, outpatient), whether medication would be beneficial and, if so, what type of medications should be tried.