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Doctoring the Mind: A Guide to Modern Therapy

 

Psychotherapy[i] is an extremely valuable tool for those suffering from any kind of mental disorder or issue. In my experiences with anxiety, depression, and alcoholism, I have found it very healing to talk through my problems with another person, whether it’s a trained therapist or simply a trusted friend. In my experience, I found it difficult to navigate the vast array of different mental health professionals offering therapy. I had a hard time deciphering the differences between psychiatrists[ii], psychologists[iii], social workers[iv], and counselors[v]. I was aware of what my mental health issues were, however I had no idea which of these professionals would be a good fit for me.

It was distressing enough to admit that I needed therapy in the first place. After doing so, I was then faced with the daunting task of searching for a compatible shrink. In this article, I hope to clarify the differences between these mental health professionals and help guide you through the process of selecting one. Therapy has been one of the driving forces in my recovery and has greatly improved my self-esteem and quality of life. I and all of us here at Treatment4Addiction do our best to help you or someone you care about get the support you need.

There is a vast array of mental health professionals to suit your needs; their titles do not necessarily correspond to specific fields or mental health disorders and many psychiatrists, psychologists, therapists, and counselors can treat the same things. As a result, it’s not as simple as choosing the appropriate doctor to fit your situation or ailment. For example, you may see a podiatrist if you sprain your foot, or a dermatologist for a persistent skin rash.

All types of shrinks can treat people with different types of mental ailments and degrees of severity. However, their titles do signify their level of training, medical degrees, and certifications – a fundamental one being whether they can prescribe medications. For instance, psychiatrists are medical doctors and psychologists are not. The suffix “-iatry” denotes “medical treatment,” whereas “-ology” indicates “science” or “theory.”

Psyche is a term originating from ancient Greek. It initially meant “life, in the sense of breath,” or “soul,” but its modern definition is “center of thought, feeling, and motivation, consciously and unconsciously directing the body’s reactions to its social and physical environment.”

In other words, psychiatry is the medical treatment of the psyche and psychology refers to the scientific study of the psyche. Both can employ psychotherapy and also perform research. The chief difference between the two is that psychiatrists can prescribe medications, while psychologists cannot.

A common misconception about psychiatrists is that they only specialize in the treatment of people with more severe mental illnesses, such as bipolar disorder[vi] or schizophrenia[vii], where medication can be very imperative, and psychologists focus on psychotherapy and patients with less severe mental issues.

However, this may not always be the case. While many psychiatrists who work in hospitals see extreme cases, they may also see patients with less severe mental ailments who are not on any medication at all and also engage in psychotherapy.

Recently, however, many private practice psychiatrists are focusing more exclusively on medication management rather than psychotherapy. Oftentimes therapy is conducted by other mental health providers, and if medication is deemed necessary, the patient will then see a psychiatrist. The psychiatrist will conduct his or her own evaluation and possibly write a prescription.

While most psychiatrists would like to both practice psychotherapy and write prescriptions, the fee structure of many health insurance plans can discourage patients from seeing psychiatrists as frequently, since they are oftentimes more expensive, and psychotherapy can be a longer, more in-depth process.

Psychologists often use additional methods to look at a patient’s underlying mental condition and personality, besides psychotherapy and existing research. These include psychological testing and questionnaires, such as the prevalent Minnesota Multiphasic Personality Inventory (MMPI[viii]), or the Million Clinical Multiaxial Inventory (MCMI[ix]).

Other examples include well-known Rorschach test – where patients view different inkblot patterns and asked to tell what they see – or neuropsychological tests that examine innate functions of the brain to evaluate any damage from an injury or illness.

Regardless of the various tools psychologists may use, these mental assessments can provide very valuable information on how people see themselves and their resulting behavior. In my experience, psychological tests, while daunting and seemingly inane, were beneficial to providing a clear image of my overall mental well-being and receiving the proper care I needed.

It may be somewhat disconcerting if you are sent to therapist who is neither a psychiatrist nor a psychologist. However, many clinical social workers[x] (CSWs) or counselors are licensed to practice therapy and more than qualified to suit your needs. Like psychologists, CSWs and counselors are not permitted to prescribe meds, though they can also refer you to a doctor for this purpose.

Licensed counselors generally work with those suffering from mental, behavioral, or emotional issues, though many work in other areas that don’t focus specifically on mental health or emotional problems. Various types of counselors can help you work through difficulties such as personal decisions, career planning, and relationships. Many licensed counselors may also be able to provide group or family therapy in addition to individual therapy. A social worker or counselor can be an integral part of your treatment team, and many may have specific expertise to suit whatever your issues or situation may be.

I have provided a list of key characteristics for each class of mental health professionals:

Psychiatrists:

  • Are medical doctors
  • Are licensed to prescribe medications
  • Have the following credentials:
    • Must graduate from medical school to earn MD.
    • Must complete four years of residency training in mental health, usually in a hospital’s psychiatric department.
    • After completing their residency, these physicians can attain a license to practice psychiatry.


Psychologists:

  • Do not have MDs.
  • Are not licensed to prescribe medications

* The state of Louisiana has recently begun to permit psychologists to write prescriptions, but only after consulting with a psychiatrist.
* New Mexico has allowed psychologists to prescribe medications since    2002.

  • Have the following credentials :
    • Usually complete five to seven years of academic graduate study, culminating in a doctorate degree.
    • May have a PhD or a PsyD. Some may obtain a PsyD if they are primarily interested in clinical psychology, i.e. treating patients rather than concentrating on research.
    • Required to complete an internship for a minimum of one to two years in order to apply for a license to practice psychology, though licensing regulations vary from state to state.


Clinical Social Workers (CSWs):

  • Are not licensed to prescribe meds.
  • Make up 60 percent of the licensed mental health professionals in the United States, according to the National Association of Social Workers.
  • Have the following credentials:
    • Are mental health professionals and must obtain master’s degrees in social work.
    • Obtain licenses to practice psychotherapy after completing a minimum of two years of clinical training.


Counselors:[xi]

  • Are not licensed to prescribe meds.
  • Specialize in the following areas:
    • Marriage and Family Counselors
    • School Counselors
    • Mental Health Counselors
    • Addiction and Substance Abuse Counselors
    • Rehabilitation Counselors
    • Spiritual Counselors
    • Geriatric Counselors
    • Veterans Counselors
    • Domestic Violence Counselors
    • Child Pediatric Counselors
    • Child Abuse Counselors
    • Community Mental Health Counselors
    • Suicide Counselors
    • Depression Counselors
    • Transformational Counselors
    • Grief Counselors
  • Have the following credentials:
    • Must obtain, at minimum, a master’s degree education
    • Must complete a certain number of hours of field work – a post-degree supervised clinical experience
    • Must pass the National Counselor Examination or equivalent exam recognized in specific state of practice. All states, including the District of Columbia and Puerto Rico require a certification to be a Licensed Professional Counselor (LPCs)


Which Type of Therapy is Right for Me?

If you were to ask a psychiatrist, psychologist, or CSW who offers the best therapy, they would likely each claim their own type is superior. Despite differing credentials and levels of experience, you could have a great therapeutic relationship, or a bad experience, with any of them.

“The professional credentials alone don’t determine that someone would be helpful to any particular patient,” says Rebecca Curtis, PhD, a professor of psychology at Adelphi University, and director of research at the W.A. White Institute of Psychiatry, Psychology, and Psychoanalysis in New York. (Downs)

Due to the personal and intimate nature of psychotherapy, it is crucial to find a therapist with whom you feel both comfortable and secure, and whom you can trust. As I have learned, you must be willing to be completely honest with your therapist, or else you are both wasting your time and will not reap any of the benefits. At the same time, however, Curtis states that experience and training are just as significant as whether or not your therapist is personable and compatible with your personality.

Your ideal mental health professional will fulfill both of these requirements, and you must interview a potential therapist carefully. It is important to “ask them specifically about their training during the initial session,” even though might be tempted to delve into your issues right off the bat, Curtis advises.

According to Dr. Curtis, “Everybody thinks they can sit down and talk to people and be helpful, but it really helps to have a lot of experience and training.”

Psychotherapy has changed my life for the better, and I hope my experience will help guide you through the process yourself!

 

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A staff writer here at T4A, Roscoe enjoys investigating and writing on a variety of topics concerning addiction and mental health. His articles cover everything from the latest news stories to his own experiences with addiction and/or mental illness. He is a recovering alcoholic from New York, NY who is grateful not only to be sober, but also to have a life back. His interests include reading, writing, running, and anything involving the outdoors. Now that he is sober, he hopes to graduate college in the next few years with a degree in Business. He strives daily maintain a positive attitude and to work on himself; to make up for all of his past wrongdoings, and to give back by helping those who are struggling. Roscoe cherishes the opportunity to share his thoughts and ideas through the T4A blog, and welcomes any sort of feedback from readers!

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