Author: Carla Lempera, LPC
Participating in therapy is a brave and challenging step, particularly in a world where immense stigma around mental health and wellness still exists. It can also be an overwhelming step, made no less overwhelming when starting the process of selecting a practitioner. In the world of therapists, the initials, credentials, certifications, and acronyms rival that of the military and create an intimidating quest for what should be an accessible and fundamental part of human wellness. The goal of this article is to help demystify the alphabet soup of therapy and, like any good clinician, I’ll begin by normalizing the experience. Here is a dirty little secret…the first chapter of the first textbook of my first class in graduate school was focused on teaching us the difference between all the mental health practitioners. I was in a Clinical Mental Health Counseling graduate level program, and step one was clarifying the difference. I found it both astonishing and validating. What’s more, I found it to be incredibly helpful and recall thinking this information should be more readily available. So, here we are.
When selecting the right type of clinician for you, there are three primary things to consider: training, theoretical orientation, and modality. Training will dictate the lens through which a clinician learned to think about and treat mental health conditions. Theoretical orientation boils down to the way a clinician will engage with you during a therapy session. Modality refers to the interventions in which the clinician approaches problem-exploration and solutions. Theoretical orientation and modalities will be covered in more detail another time, but the following breaks down what those initials after a clinician’s name mean, and how to navigate the differences.
Following are the various types of mental health and wellness clinicians and what makes each unique. Keep in mind that licensing requirements and names can vary by state, so the below is specific to Illinois.
Social Worker (LSW, LCSW): Social workers take a systemic approach to helping people across many facets of life. According to the National Association of Social Workers (2022), “Social workers are found in every facet of community life, including schools, hospitals, mental health clinics, senior centers, elected office, private practices, prisons, military, corporations, and in numerous public and private agencies. Some social workers help clients who face a disability or a life-threatening disease or a social problem, such as inadequate housing, unemployment, or substance abuse. Social workers also assist families that have serious domestic conflicts, sometimes involving child or spousal abuse”. Of particular interest to social workers is the notion of "person-in-environment fit," meaning that the clinician considers the effect of environment on an individual's well-being, and uses a holistic lens to support clients.
Counselor (LPC, LCPC): Counselors work with individuals, couples, families and groups using a wellness approach to improve and prevent mental health challenges and promote psychological wellness and personal growth. According to the American Counseling Association (2022), “professional counselors help clients identify goals and potential solutions to problems which cause emotional turmoil; seek to improve communication and coping skills; strengthen self-esteem; and promote behavior change and optimal mental health…counselors foster a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals”.
Marriage and Family Therapist (MFT, LMFT): With a focus on relational challenges, “marriage and family therapists are mental health professionals trained in psychotherapy and family systems, and licensed to diagnose and treat mental and emotional disorders within the context of marriage, couples and family systems. Marriage and family therapists treat a wide range of serious clinical problems including: depression, marital problems, anxiety, individual psychological problems, and child-parent problems “(American Association for Marriage and Family Therapists, 2022).
Psychologist (PsyD, PhD, EdD): Psychologists are trained using a medical model to diagnose, treat and prevent mental, emotional, behavioral and social challenges and use interventions to help clients improve their mental wellness. According to the American Psychological Association (2019), “practicing psychologists have the professional training and clinical skills to help people learn to cope more effectively with life issues and mental health problems. After years of graduate school and supervised training, they become licensed by their states to provide a number of services, including evaluations and psychotherapy. Psychologists help by using a variety of techniques based on the best available research and consider someone’s unique values, characteristics, goals, and circumstances”. With some additional training in psychopharmacology, some psychologists can also prescribe medication, but most cannot.
Psychiatrist (M.D., D.O.): Psychiatrists specialize in the diagnosis, treatment and prevention of mental, emotional and behavioral disorders. Psychiatrists can treat both physiological and psychological symptoms. According to the American Psychiatric Association, “A psychiatrist is a medical doctor (completed medical school and residency) with special training in psychiatry. A psychiatrist is able to conduct psychotherapy and prescribe medications and other medical treatments”. Because of their ability to administer tests and prescribe medication, most psychiatrists will focus more on patients with these needs than those looking exclusively for psychotherapy.
Final Thoughts
I would be remiss if I did not spend a moment on the importance of “fit”. Research has shown that the therapeutic alliance between a clinician and a client, meaning the compatibility, rapport, and trust, makes a substantial impact on successful outcomes in therapy. In fact, in an article published by the American Psychiatric Association (APA), it was found that this can account for almost 30% of the therapeutic outcome” (Stubbe, 2018)! Many clinicians will offer a brief, free, initial consultation prior to working together to help gauge fit. It is strongly recommended to take advantage of that and treat the first 2-3 sessions like an interview. During this time the clinician will be gathering information about your background and key details relevant to goal setting and treatment planning. This is also a time for you to assess the rapport you are building and your mutual compatibility. We recommend using the guide above to narrow your options, but keep chemistry and goodness of fit top of mind when interviewing potential clinicians, and don't hesitate to reach out to us at Invited, for further guidance in your search.
Carla Lempera, LPC is a psychotherapist at Invited Psychotherapy and Coaching, a private practice outside of Chicago, specializing in supporting high performing professionals in embodying their highest potential.
References:
Stubbe, D. E. (2018). The Therapeutic Alliance: The Fundamental Element of Psychotherapy. American Psychiatric Association, 16(1), 402-403. https://doi.org/10.1176/appi.focus.20180022
National Association of Social Workers (2022). Types of Social Work. https://www.socialworkers.org/News/Facts/Types-of-Social-Work
American Counseling Association (2022). WHAT IS PROFESSIONAL COUNSELING? https://www.counseling.org/aca-community/learn-about-counseling/what-is-counseling
American Psychological Association (2019, December 11). What do practicing psychologists do? https://www.apa.org/topics/psychotherapy/about-psychologists
American Association for Marriage and Family Therapists (2022). About Marriage and Family Therapists. https://www.aamft.org/About_AAMFT/About_Marriage_and_Family_Therapists.aspx?hkey=1c77b71c-0331-417b-b59b-34358d32b909
American Psychiatric Association (2022). What is Psychiatry? https://www.psychiatry.org/patients-families/what-is-psychiatry
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