Therapists and Therapies

Don't just pick a name from an ad or the yellow pages. Difficult as it may be when you're in distress, try to approach therapy as an active consumer, prepared to do a little comparison shopping.

Many therapists favor a particular theoretical approach, although they often use a combination. No one type of therapy is best for all patients; however, certain individuals may respond better to particular methods. In psychoanalysis, descended from Freud's technique employing free association and dream interpretation, patients are encouraged to recall and confront troubling childhood experiences. In psychodynamic therapy, the emphasis is on discovering unconscious conflicts and defense mechanisms that hinder adult behavior. The goal of interpersonal therapy is to enhance relationships and communication skills. Cognitive therapy is aimed at helping people recognize and change distorted ways of thinking. Behavioral therapy seeks to replace harmful behaviors with useful ones (Consumer Reports, 1999).

What do Mental Health Professionals do? Psychologists, Psychiatrists, Clinical Social Workers, Therapists, and Counselors who specialize in psychotherapy and other forms of psychological treatment are highly trained professionals with expertise in the areas of human behavior, mental health assessment, diagnosis and treatment, and behavior change. They work with clients to change their feelings and attitudes and help them better develop healthier, more effective patterns of behavior (Higgins, 1998).

Psychotherapy is a collaborative effort between a client and mental health professional. It provides a supportive environment to talk openly and confidentially about concerns and feelings. Maintaining your confidentiality is extremely important and you will be informed of those rare circumstances when confidential information must be shared.

To find a practitioner who's right for you, start by collecting the names of several therapists in your area. Ask your doctor for a referral, making sure to specify if you have preferences regarding your therapist's gender, academic background, therapeutic approach, or other characteristics. Other good referral sources are national professional associations as well as local universities, hospitals, and psychotherapy and psychoanalysis training institutes. Family or friends may be able to recommend suitable therapists as well.

Speak to each potential therapist over the phone or in the office. (Many will meet with you briefly without charge.) Talk about your problem and ask how the therapist would approach solving it - and how many sessions might be needed. Even a brief interview should tell you if you'd be comfortable sharing your most intimate thoughts and feelings.

In most states, even people who haven't had proper training can legally call themselves psychotherapists. So make sure your therapist is licensed or certified as one of the following:

• Psychiatrists are physicians who have completed three years of residency training in psychiatry following four years of medical school and a one year internship. Only psychiatrists can prescribe medication and have the training to diagnose underlying medical problems that can affect a person's mental state.

• Psychoanalysts have a professional degree in either psychiatry, psychology, or social work, plus several years of extensive supervised training at a psychoanalytic institute.

• Psychologists with the credential Ph.D., Psy.D., or Ed.D. are licensed professionals with doctoral level training, typically including a year of clinical internship in a mental health facility and a year of supervised post doctoral experience.

• Social workers typically train in a two year masters degree (M.S.W.) program that involves field work in a wide range of human services, including mental health. Those who seek state certification or licensing as a clinical social worker (C.S.W.) need two years of supervised postgraduate experience and must pass a state exam.

• Professional counselors have a masters degree in the counseling field and must obtain from 2,000 to 3,000 hours of postmasters supervised experience prior to licensure, depending on state requirements. Professional counselors must also pass a national or state administered exam.

• Marriage therapists and family therapists may have a masters or doctoral degree from an accredited graduate training program in the field, or some other professional degree with supervised experience in the specialty.

• Psychiatric nurses are registered nurses who work in mental health settings, often as part of a therapeutic team. Advanced practice nurses have a masters degree and can provide psychotherapy (Consumer Reports, 1999).