[nushi]

hi everyone...

i just moved from egypt to america to start my phd. so now, i'm trying to find a counselor or psychologist to start psychotherapy here. i will have to meet with a counselor in the student health center within my university, 'cause it's affordable, 'cause its cost is already covered by the fees of the university.

after the in-take, they assigned me to a counselor. this counselor has a phd, but she still didn't earn her state license yet. but she told me that she has experience of four or seven years of counseling. her specialties are related to college students, their anxieties & depression (probably all the counselors in this center have only this specialty).

now the problem is that i'm a really complicated person. i'm not young (& i don't like to have a counselor younger than me - i'm not sure if she is or not), i'm 32, & my problems are not just college problems - i've been suffering from OCD, OCPD, Bipolar, MDD, GAD, & other things since my childhood - & these problems are kind of paralyzing my life. so i really think that i'd need a person who's got so much experience - like a "senior" person in the field.

since i'm new to america, i don't know the difference in effective counseling & experience between licensed & unlicensed counselors? & what to do? should i specifically ask for a licensed counselor? or does it not make a difference? or do counselors in the beginning of their profession are better than seniors?

[SlumberKitty]

Personally I wouldn't see an unlicensed counselor because there would be no board to hold them accountable if they break ethics rules. I don't know if beginning counselors are better than more seasoned. I've seen both therapists that are just starting out and more seasoned ones and my current therapist which I've seen twice, I'm not sure how long she's been practicing. It just depends on who you "click" with, what their experiences are that led them to this profession, what type of skill set they have and so forth but you won't know that until you see them and get to know them. But as for the unlicensed thing--is it that the counselor is an intern working towards her license? Or is it just unlicensed. Because if the counselor is working towards their license and is a registered intern then they have supervision and a licensing board. I hope that made sense. I'm kind of all over the place today. Good luck on your PhD.

[AllHeart]

Why doesn't she have her license? Does she claim to be a mental health/psychology counselor? If so, I'm not sure that's legal or ethical. Best to check your state's regulations around that. You should also find out what rules an unlicensed counselor has to adhere to around client privacy. You may have none.

[NP_Complete]

She's probably in the process of getting her hours she has to have for licensure, but your best bet would be to ask the clinic or your counselor why she isn't licensed.

[feralkittymom]

Welcome and good luck in your studies!

Given that she is employed by a University counseling center, I don't think you need worry about her licensing. You can check her status on the Counseling Center's web-site, or call and speak to the Center Director for an explanation. You can also check to see if the Center is APA accredited (at a large University, it probably is). Since she has a PhD, she is likely accumulating practice hours in order to qualify for licensing. This is the normal procedure. Legally, she is practicing under the Center's license, and as such, she also is supervised. Such positions are highly competitive, so I would not worry about her general competence.

Whether or not she is the right therapist for you, is a different matter. The web-site of the Center usually has profiles of staff members where you can check on specialties. While depression/anxiety, young adult and student issues will be a focus (and given how over-burdened most Univ counseling services are, they will be a specialty), it doesn't mean there will not be staff whose experience is more general than such a focus. For better or worse, over the last 15 years there has been a significant increase in the number of students seeking health services at Universities, and a related increase in the seriousness/ chronic nature of health concerns presented (both mental and physical health). This has really forced Universities to broaden and deepen their facilities and staff expertise. At my former University, in the town in which I still live, the Health center is fully accredited as an urgent care facility that offers comprehensive services.


Meet with her and see what you think. You can always request a change at any time if you believe she isn't meeting your needs. Some Centers have a limit on the number of available sessions, some do not. There are likely to be a number of staff pre and post intern with MA degree certifications, a lesser number with PhDs, one or more full-time or consultant psychiatrists. The fact that you were assigned a PhD level counselor after in-take suggests to me that they agreed that your case may be more complicated than simple student adjustment issues.

My former PhD therapist many years ago was at my University center and was very accomplished. I later switched to his private practice when I was no longer eligible as a student. Advantages of seeing a therapist at a Univ center, especially one that is APA accredited, is that there is a high level of accountability/supervision; also, as many hold, in addition, academic appointments, there is a research/professional expectation, so most staff will be current in their field.

[Ididitmyway]

I'm a licensed therapist today, but, at some point, I was also an unlicensed intern and was seeing clients at different agencies, so let me explain briefly how the system works here.

First off, it is just as safe to see an unlicensed therapist than a licensed one in terms of their ethical conduct, I'd say even safer because they are under a regular supervision of a licensed therapist and they have to have weekly supervision group meetings where they discuss their clinical cases. It's much more difficult to break ethical rules with this kind of an oversight as opposed to when they work alone in private settings. Interns are held accountable by the licensing boards the same way licensed therapists do. If they are found guilty of professional misconduct, their registration number gets revoked and they have to go through a waiting period before they register with the board again and start collecting their clinical hours from scratch. In addition, their supervisor gets in trouble.

Ethics aside, experience wise and competence wise, I've met interns who were excellent and very gifted at this work and I've met licensed therapists who were horrible, even the so-called "seasoned" ones who had a big number of years in practice under their belt. Generally speaking competence is correlated with experience, but correlation is not the same as causation. In other words, the number of years someone's been in the field doesn't necessarily translate into a high level of competence. And the possession of license, in and of itself, has nothing to do with competence at all. If the therapist has just recently received their license, they are on the same level they have been up to date as an intern. When someone's just got licensed, all it means is that they have passed their professional exam. That's all. Then, as they continue to practice, competence will usually grow with experience but not always. Experience is valuable only when one is able to learn the right lessons from it. As I said, I've met therapists who've been in practice for a very long time and who were awful.

I encourage you to give that counselor a chance. She may or may not be what you need but that may have little to do with the absence or possession of license. In any case, she will be supervised by a licensed therapist, that's for sure. If you are getting counseling at the university, keep in mind that they may not have licensed therapists on board and the reason you are getting an unlicensed therapist is because you are not paying for counseling. This is usually a trade off. Many agencies offer free counseling when you agree to work with an intern or even a student. They need to practice their craft and you need to get counseling for free, sot that's a trade off. So, you are sort of a guinea pig in this case. Like it or not, that's how the system works.

So, yes, you can certainly ask for a licensed counselor, but they may not have them. If it's very important for you to see a licensed person, you'd have to see someone privately and that's usually expensive. Hope this helps.

[PurpleBlur]

Originally Posted by nushi

hi everyone...

i just moved from egypt to america to start my phd. so now, i'm trying to find a counselor or psychologist to start psychotherapy here. i will have to meet with a counselor in the student health center within my university, 'cause it's affordable, 'cause its cost is already covered by the fees of the university.

after the in-take, they assigned me to a counselor. this counselor has a phd, but she still didn't earn her state license yet. but she told me that she has experience of four or seven years of counseling. her specialties are related to college students, their anxieties & depression (probably all the counselors in this center have only this specialty).

now the problem is that i'm a really complicated person. i'm not young (& i don't like to have a counselor younger than me - i'm not sure if she is or not), i'm 32, & my problems are not just college problems - i've been suffering from OCD, OCPD, Bipolar, MDD, GAD, & other things since my childhood - & these problems are kind of paralyzing my life. so i really think that i'd need a person who's got so much experience - like a "senior" person in the field.

since i'm new to america, i don't know the difference in effective counseling & experience between licensed & unlicensed counselors? & what to do? should i specifically ask for a licensed counselor? or does it not make a difference? or do counselors in the beginning of their profession are better than seniors?

reduced cost services like those at your school are often provided by students, or interns- none of whom are licensed. in order to get licensed they do things like work for free at various places to earn hours towards licensure. after graduating they are interns and so are often paid for this work as i suspect your phd therapist is. at the phd level she has been doing therapy for some time as part of her education even if she doesnt have enough hours for licensure yet. seeing an unlicensed therapist, you are essentially getting two therapists in one, because she us supervised by a licensed therapist. but its a trade off for free or reduced cost services.


if you want a licensed therapist you should look outside your school and be prepared to pay 60-75 per hour for an lcsw, 120-180 for a psy.d or phd, more if you are in a ritzy upscale area like beverly hills, pacific palisades etc...


good luck with your search.

[amandalouise]

welcome to america....

first thing here we have many different credentials...

here where I am New York ....

CSW - Certified Social worker. here in america this a any therapist (counselor means the same thing here) that has been to college, completed their masters degree in psychology, and is working as a mental health therapist while under supervision, and they completed their state boards for licensing as a CSW.

LCSW in some places is the same thing as CSW. here where I am its a bit different in that they have different boards (tests) more hours they had to work before being able to take the boards.

MSW is someone who is a therapist that has their colleges masters degree

PHD is a psychiatrist and psychologist. it allows them to do the medication part of mental health. most times a psychologist does the same as therapists and the meds are psychiatrists here in NY.

a volunteer is someone that works in counseling at places like crisis centers, domestic violence, type work. they are there just to listen and help you get services elsewhere. like if you are in am abusive relationship a counselor who is a volunteer with domestic violence can help you find a therapist, go to court with you and be there with you. but they dont do deep therapy work usually these counselors are still in college psych classes their self or they have already gone through the things their "clients" have been through so they can listen and be a shoulder for someone else.

as for who you should see..... here in america thats a personal choice, you get to decide yourself who you want to see. and why.

my suggestion is maybe sit down and make a list of why you want to be in therapy and what you want to work on in therapy, then call around and ask mental health places if they can help you work on those things you want to work on.

[feralkittymom]

Nushi, because there is some conflicting info on this thread, you may find this report from the Assoc for Univ and College Counseling Center Directors annual survey to be of use. It provides a current picture of the functioning of a broad selection of Centers with stats broken down by size of institution. There is even a list of participating schools, so you can check to see if your Univ is a respondent.
https://www.aucccd.org/assets/docume...blic-apr26.pdf

[nushi]

Dear all,

Thank you so so so much for all this detailed information about counselors in university health centers, and licensing in America. I'm so grateful that I'm a member here in PC Forums, within a community of wonderful people

I hope my psychotherapy would be well, as I was looking forward so much for this moment, a long time ago since I was in Egypt & not able to find therapists there. I'm so grateful that I reached this opportunity finally, & I hope it goes well...

And anyway, if I don't feel comfortable with the counselor, or that she's not helping me, I could ask to change her.

And as you said, I cannot afford to get therapy outside the university, so I can't get the best therapy... it's really sad how everything depends on money & how much one can afford! ah, capitalism! well, part of my phd research anyway, is going to be about wealth & stratification

[Ididitmyway]

Originally Posted by nushi

Dear all,

Thank you so so so much for all this detailed information about counselors in university health centers, and licensing in America. I'm so grateful that I'm a member here in PC Forums, within a community of wonderful people

I hope my psychotherapy would be well, as I was looking forward so much for this moment, a long time ago since I was in Egypt & not able to find therapists there. I'm so grateful that I reached this opportunity finally, & I hope it goes well...

And anyway, if I don't feel comfortable with the counselor, or that she's not helping me, I could ask to change her.

And as you said, I cannot afford to get therapy outside the university, so I can't get the best therapy... it's really sad how everything depends on money & how much one can afford! ah, capitalism! well, part of my phd research anyway, is going to be about wealth & stratification

Good luck with your counselor If you don't like how it goes, ask for a different one, and if that doesn't work, there are other places that offer low-cost counseling that you might be eligible to get.

I also want you to know that it's a good idea to check information you get on public forums by contacting licensing boards. You can contact the licensing board of the state of your residence and they will explain to you exactly how the system works and what kind of work unlicensed therapists a.k.a interns do. I am saying this because on forums you will always come across people who are not informed on the subject because they are not professionals but they believe they know. They can confuse you and point you in the wrong direction, so it's always a good idea to contact regulatory agencies like licensing boards and professional associations to verify information you get on forums.

For example, many interns work as "volunteers" (meaning unpaid) in order to accumulate the required number of clinical hours to be eligible to take their licensure exam. They are not exactly "volunteers". They simply don't have any other way to collect their professional hours except to slave for an employer who takes advantage of their situation and uses them as slave labor. Those people are professionals, just like licensed therapists. They do the deep work and all other kinds of work that licensed therapists do. The type of work they and licensed therapists do depends on their chosen therapy method, not on the absence or possession of a license. So, they are not there just for emotional support. They provide 100% legitimate professional service. It cannot be otherwise because the hours they have to collect for the board exam are supposed to be the hours of professional service, not the hours of emotional support. If an agency uses interns for emotional support or other non-professional services, that agency is non-compliant with the legal and ethical requirements of the mental health care system and the interns who work there should report it to their licensing board. If their supervisor signs off on the hours they collected by providing a service which is different from their professional service, that supervisor would get in trouble if this gets reported. In other words, the system has regulations in place that ensures that you will get the same type of service from an unlicensed therapist as you'd get from a licensed one. The quality may not be the same, but the type of service will be the same.

You may PM me if you want more details about how the system works, and, again, I also recommend you to contact your state's licensing board for more information.

Most importantly, I agree with you that CAPITALISM SUCKS Can't wait to see it gone. Solidarity!

[feralkittymom]

Nushi, the fact that we have a market-based system definitely adds layers of potential confusion. One of the greatest benefits of a Univ Center is that the structure provides a great deal of oversight which goes a long way to insure legal and ethical mandates are followed. Something which has not been mentioned is that unlicensed therapists, whether students or post docs, working within public agencies (like Univ or Community Health) are professional; however, you would be wise to not see an unlicensed therapist in private practice. Certain titles--like "psychologist"--are protected legally; other titles--like "therapist"--are not protected legally in the US. So there are charlatans out there! Always check the credentials of a private practitioner through the state gov't web-site (usually the Attorney General's office or Health Service Providers or Medical Board).

Please don't assume that paying more equals better therapy. Univ counseling positions, especially at large Universities (25,000+ students) are extremely competitive. The talent is not reflected by the budget price! Universities have responded regularly with increases in student health budgets, in part because our country's health care costs have increased so dramatically. This is not necessarily true for smaller colleges, but if you're in a PhD program, you are in a larger Univ by definition.

My former T was the Center's Director, then chief psychologist and director of training. The Center was APA accredited and usually carried @ 6 MA interns, 2-3 PhD interns or post docs, 14 MA level licensed counselors, 8 psychologists, 1 FT psychiatrist and 2 consulting psychiatrists. The Center is even bigger now. My T was also Board Certified (similar to a specialist designation for physicians), served on the State Board of Examiners for many years, held national office within APA. In his private practice, his fee for service was the average rate for my area. I paid a fraction of that cost by seeing him as a student, but the quality of therapy I received was in no way compromised by the little I was paying.