Choosing the Right Mental Health Care Provider: What You Need To Know
This is the first of multi-part blog series on how to choose the right mental health provider for you.
There is a lot of information out there when it comes to choosing a mental health provider and it’s easy to feel overwhelmed. When the average person looks for a provider, they’re inundated with long lines of initials, lots of vague abbreviations, and clinical jargon. It’s tough enough to make the decision to reach out for help, let alone figure out who you want to work with or what you should look for in a provider.
You deserve to have a clear understanding of who you’re seeing, as well as what qualifications best fit your needs. In order to do that, you need to know how to make sense of what they put on websites and directories. You also deserve to learn about distinctions between different providers and how those differences translate to the services they provide. You deserve to be an informed consumer of your mental health care.
Types of Mental Health Care Providers
Let’s start with the basics. Who are all these people?! There are many types of providers but not every provider is a good fit for each person. Read on for help making sense of all those initials.
To start, there are two main categories of providers, those who prescribe medication and those who provide psychotherapy. You may want to explore a pharmaceutical option, try talk therapy, or a mix of both.
Providers Who Prescribe Medication
- Psychiatrists
- Psychiatric Nurse Practitioners
- Psychiatric Physician Assistants
Providers Who Provide Psychotherapy
- Psychologists
- Social Workers
- Marriage and Family Therapists
- Counselors
Who’s Writing My Prescription?
Withing the realm of prescribing providers, there are several options. Technically, any physician can write a prescription. It’s not uncommon for a primary care doctor to write prescriptions for medications to address anxiety, depression, or attention difficulties. In fact, sometimes it’s primary care doctors or OB/GYNs who first notice or are informed of emotional difficulty. They can be powerful allies and conduits to specialty care. However, there are several types of specialists who can prescribe medication specifically for mental health concerns and have been trained in-depth to do so.
Psychiatrists
Psychiatrists are medical doctors who have chosen to specialize in mental health. They have completed a bachelor’s degree, attended four years of medical school, and spent a rotation focused on psychiatry. They then complete their training following graduation from medical school with a four year residency in psychiatry. Their degree is abbreviated as M.D. or D.O.
Psychiatric Nurse Practitioner
Psychiatric Mental Health Nurse Practitioners complete a bachelor’s degree, and must complete an registered nurse (RN) qualifying exam before applying to graduate school for nursing. One year of work experience is usually required prior to graduate school. Graduate work may be towards either a master’s (MSN) or doctoral degree (DNP). An MSN equates to two years of study post-bachelor’s degree, while a DNP is an additional three years. Nurse Practicioners abbreviate their degree as PMHNP or NP.
Psychiatric Physician Assistant
Physician Assistants typically complete a bachelor’s degree and three years of work experience before applying to graduate school. A graduate degree includes three years of coursework at the masters level for an MPAS degree. Completion of a national certification exam is required to become licensed. Physician Assistants abbreviate their degree as PA. PA’s work under the supervision of a doctor.
Though some prescribing providers receive training is psychotherapy, the focus of their work is prescribing medication and appointments are generally shorter and spaced further apart (every couple of months) in acknowledgment of this.
Who Do I See For “Talk Therapy”?
When you’re overwhelmed, upset, or ready for change, nothing feels as good as talking to a therapist. Several types of therapist exist. In fact, the term “therapist” is not a regulated term. Anyone can call themselves a therapist without repercussion. That’s why it’s so important to make sure you know how to read between the lines to discern the qualifications of an experienced provider. Talk therapy, or psychotherapy, typically involves meeting with your provider on a weekly basis. Therapy is a commitment of time, effort, finances, and emotional energy. If done correctly, the pay-off is an incredible return on your investment. Let’s make sure you know how to find the best match for your needs.
Psychologists
The term “psychologist” is regulated and may only be used by those who have completed graduate degrees in the field. Psychologists must complete a bachelor’s degree prior to entering graduate school. Grad school may consist of a master’s level degree (M.A. or M.S.) or a doctoral level degree (Ph.D. or Psy.D.). The American Psychological Association recognizes that “the doctoral degree is generally recognized and accepted as the education credential for license eligibility to practice independently as a clinical psychologist.” Most practitioners obtain a master’s degree either as preparatory work for doctoral training or as part of their doctoral program. Following four to five years of graduate study and training, doctoral level psychologists must complete a year-long internship. Many psychologists further specialize and hone their training by completing a one or two year-long postdoctoral fellowship. While it is not standard practice, there are a few states that allow psychologists who have a clinical or counseling psychology master’s degree (2-3 years of study) to become licensed. This type of study is known as a terminal master’s degree and is followed by a year-long internship. North Carolina is one of those states. Master’s level psychologists are licensed with the term “Psychological Associate” or the initials PA and must be supervised by a doctoral-level licensed psychologist for the entirety of their career. Doctoral level psychologists are independently licensed with the term “Licensed Psychologist” or the initials LP.
There are also two types of doctoral degrees for psychologists. Originally, doctoral study was awarded the Doctor of Philosopy (Ph.D.). This approach was based on the scientist-practitioner model, which is grounded in research and practice where each must inform the other for best practice in research and clinical work. In the 1970s, the Doctor of Psychology (Psy.D.) emerged based on an idea called the practitioner-scholar model, which acknowledged that some students did not want to complete training in research or teaching, and wanted an applied program. Rates of acceptance to Ph.D. programs are 10-15% with cohorts of approximately 5-7, while Psy.D. programs accept around 40% of students with large cohorts. Ph.D. programs typically take 5-8 years to complete and require the completion of a dissertation, while Psy.D. programs last around 4-6 years and do not require a dissertation. All psychologists must pass a national qualifying exam at the level required by their degree type (e.g., different cut of scores for master’s level vs. doctoral level examinees) prior to becoming licensed. A far less common type of doctoral licensure is the Doctor of Education of (Ed.D.) degree. Ed.D.’s usually focus on developmental and scholastic issues and work in the capacity of a school psychologist rather than in a clinical setting. There are many specialties within the realm of psychology (e.g., developmental, social, clinical, counseling). Clinical psychologists have the most advanced training in mental health, ranging from severe mental illness to positive psychology and thriving behaviors. They possess a deep understanding of human experience through a focus on cognitive processes and behaviors. Counseling psychologists are generally trained in how to help clients work through life transitions and problems. Psychologists are also the only degree type with specialty training and ability in psychological assessment (testing).
Social Workers
Social Workers need a bachelor’s degree to work in the field and may provide social services at this level. Social workers in private practice are known as Licensed Clinical Social Workers, or LCSWs. They have completed a master’s degree in social work (1-2 years), a year of clinical experience, and must pass a licensing exam. Social Workers focus on improving quality of life by helping clients develop the skills they need for successful living. A doctoral degree is not required but is a possibility. This would equate to three years of study.
Marriage and Family Therapists
Marriage and Family Therapists must complete a bachelor’s degree followed by a master’s degree in their field. This typically takes between one to two years. LMFTs focus on helping clients understand their relationships and emotions by examining patterns in their marriages, family dynamics, and other relationships. They must pass a licensing exam. Similar to social work and counseling, MFT is a master’s level field and a doctoral degree is not required. However, a doctoral degree in MFT is possible with three years of course work.
Counselors
Licensed Professional Counselors must complete a bachelor’s degree and one or two year-long master’s degree before a required licensing exam. Their degree is abbreviated (LPC). Counselors are trained to provide general psychotherapy for problems in living. Some states allow counselors to administer limited forms of psychological testing in limited conditions (such as under the direct supervision of a psychologist). It is possible but not as common to obtain a doctoral degree in this field within four years. This is known as a Ph.D. in Counselor Education. This Ph.D. generally focuses on teaching, supervision, and research within the field.
Making Sense of It All
Phew! We did it. We made it through the twisty, turning road of provider and licensure types. Now it’s time to think about what type of provider(s) best fit your current needs. Be sure to examine where the provider obtained their degrees. Was it a reputable institution? Brick and mortar, or online? Have they had post degree specialized training? More specifically, make sure to note that some initials after names may not pertain to the practice of psychotherapy. Some individuals list their name as So and So, Ph.D. when they have a doctoral degree in an unrelated field like art, followed by the actual abbreviations that they are licensed under (e.g., Jane Doe, Ph.D., LPC).
This is your mental health, so be picky, ask questions, and be discerning. You matter and your experience matters. In a perfect world it would be extremely easy to make sense of all this, but in our current environment what is required to find quality care is diligence and a willingness to be informed. Each provider has unique skills and applications so you deserve to know as much as possible about them and their training.
Great providers are out there and there is a perfect match for you. Now, armed with your trusty guide, you can navigate through provider listings like a seasoned pro. Good luck and smooth sailing!
