[meccorad]

Oh haven't we all heard that one a gazillion times, I'm sure.

But I'm really just shooting in the dark right now, looking for a therapist...basically one that I'm fairly certain will be experienced enough to help me. I made contact with a therapist a few days ago, but after sending back and forth a few informational emails, I just don't think she's experienced enough to handle my drama. She's been working less than a year, and I'm pretty certain with my history I need someone else...

I'm pretty sure I'm going to need someone that can prescribe meds (if I should need any) so that leaves "counselors" out of the group.

Now what about Therapists and Psychologist and Psychiatrists? Basically what's the difference between the three? Is there a difference? Who prescribes meds and who will study me like a lab rat?

Could anyone explain this for me in their own words? I'm just not getting anything beneficial by looking on my own since I'm clueless about this whole "self-help" idea....

thanks....

[gardenergirl]

Hi,
You're right, choosing a therapist is a tricky thing, and often it's a bit of a crap shoot. It's important to work with one who is a good fit for you and your needs. Sometimes that means seeing a few before you hit on the right one, sometimes you hit it off with the first one.

About your specific questions...First, the word "therapist" is rather generic. It doesn't even apply only to mental health workers. Many different clinicians and practitioners can legally call themselves "therapist". When talking about therapy, most of us refer to the person we see as our therapist (or "T"), but they could be a psychiatrist, a psychologist, a counselor, social worker, or some other type of practitioner. For the most part, among the types you mention, only a psychiatrist can prescribe medication. There are two (I believe) states where certain psychologists with specialized, extra training can prescribe, NM and LA. They are very few in number, so the majority see a physician of some kind, such as a psychiatrist for meds. A clinical psychologist is someone with a doctoral degree (PhD or PsyD) in clinical psychology and specific training in working with people with mental illnesses. They focus on psychotherapy of all kinds. It's common to see a psychologist for therapy and a psychiatrist for medication, and it's great if the two communicate about your case as needed.

Hope this helps.

gg

[DoggyBonz]

Hi,

Been there...after a really bad experience with a therapist (had to hire a lawyer and almost go to the licensing board), I was really gun shy of the whole process.

A good friend knowing that I needed some help asked a friend of hers if he knew anyone who could handle someone with high drama, a bad experience and trouble opening up.

He knew instantly of a person who has turned out to be pretty right on. I guess what I am saying is that if you have some friends that you trust or even some other professionals that you know ask them. Good people always know good people. You can even ask your friends not to let them know who it is for if you don't feel comfortable.

Hope this is helpful. If you do get some names you can look them up on the web to find out how long they have been practicing and if they have been published.

Good Luck

[sunrise]

meccorad, many people go to 2 different professionals: one for therapy and one for meds. I go to a family therapist for psychotherapy, and if I need meds, I go to my family doctor.

Good luck finding a therapist that is right for you.

[meccorad]

Hmm...this suddenly all got more complicated then I would have liked. I can't seem to find a therapist/psychologist/whoever that's going to be in my price range, yet experience range....

I feel like charlie brown and lucey with her 5cent psych help lol....

Thanks everyone...perhaps I'll just keep emailing docs from the psych central list until I hit a keeper...hahah.

Since you did not specify your "issues, " I will be fairly generic.

The top of the line clinical psychologist is one with a PhD. This is a doctorate of philosophy in psychology and the psychologist has had years of training, research, and in-depth studies regarding different theories and methods of practice. Most PhDs can utilize various types of therapies and are comfortable working with "difficult cases."
Clinical psychologists have seen it all!

Next would be a PysD. This is a Doctor of Psychology and is a "newer" doctoral degree, usually linked with more professional training. It is rare (but becoming more common) to find these people in academic settings, mostly because they are not research types. Personally, I believe you need to be careful with this degree, because some of these programs DO NOT have APA approved internships and the acceptance rates into APA approved internships are usually lower in the "no-name schools." Clinicians without APA approved internships and experiences are usually poorer treaters.
If you are going to see a PsyD, ask where they went to school and where they did their internship and if it was APA approved. Also, how long have they been practicing and what types of problems they specialize in.

There is a huge debate among classic PhD and newer PsyD which I won't go into, but you could probably Google and find out.

In addition, there are MS degrees in counselling and family therapy and social work. These people can be very good, but tend to focus on what I call "skills" training and not in-depth analysis. If you don't want to do in-depth analysis or find the true answer to your problem, skills training can be great for getting rid of symptoms quickly. Many of these level treater practice Cognitive Behavioral Therapy techniques.

Personally, I also believe it is EXTREMELY important that the treater has had therapy. Today, many programs do not require therapist to have therapy, nor do they require therapist to "be free of defect."....which could be a HUGE problem.

My point here is if you are dealing with eating disorders and your T has an active eating disorder, RUN LIKE HELL. This T could not properly help you and model good behavior for you....same with issues of Addiction and Self-harm.

Remember, you are the buyer. The T must fit what you need, but be educated for what you are looking for.

[sunrise]

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Riptide said:
In addition, there are MS degrees in counselling and family therapy and social work. These people can be very good, but tend to focus on what I call "skills" training and not in-depth analysis. If you don't want to do in-depth analysis or find the true answer to your problem, skills training can be great for getting rid of symptoms quickly. Many of these level treater practice Cognitive Behavioral Therapy

</div></font></blockquote><font class="post">My therapist has only a master's and does do depth work and works with the client to find the true cause of the problems, so meccorad, if you are looking for depth work, don't necessarily eliminate these people. It is a very diverse group, with many different trainings. My T is not CBT, however another master's level therapist I went to was CBT. And my daughter's therapist has only a master's and does do depth work. It is probably best just to ask what their therapeutic approach is at the outset and see if it matches what you are looking for.

Here's a short article on PsychCentral that might be of interest and has some links to related articles as well:
Do Educational Degrees Matter?

[meccorad]

I've been checking out the list of therapists on psych list and then seeing what their strengths are and then what other experience they have in...

Think of it this way..."I'm multi-talented" and I need someone who can address "all" my talents. So I'm not sure if I need to see a specialist in drug addictions and depression or anxiety and depression...just so long as I can find someone who can at least touch all my bases, if not cover them.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
sunrise said:
</font><blockquote><div id="quote"><font class="small">Quote:</font>
Riptide said:
In addition, there are MS degrees in counselling and family therapy and social work. These people can be very good, but tend to focus on what I call "skills" training and not in-depth analysis. If you don't want to do in-depth analysis or find the true answer to your problem, skills training can be great for getting rid of symptoms quickly. Many of these level treater practice Cognitive Behavioral Therapy

</div></font></blockquote><font class="post">My therapist has only a master's and does do depth work and works with the client to find the true cause of the problems, so meccorad, if you are looking for depth work, don't necessarily eliminate these people. It is a very diverse group, with many different trainings. My T is not CBT, however another master's level therapist I went to was CBT. And my daughter's therapist has only a master's and does do depth work. It is probably best just to ask what their therapeutic approach is at the outset and see if it matches what you are looking for.

Here's a short article on PsychCentral that might be of interest and has some links to related articles as well:
Do Educational Degrees Matter?

</div></font></blockquote><font class="post">

I must agree with Sunny here. My T has an Masters in Social Science and he is also a Licensed Social Worker. I started with him at a psychoanalytic institute so that tells you how in depth even someone with "just a Masters" can get. We don't do skills training or anything like that. It is LONG term therapy. I am also a therapist with a Masters and I focus mostly on the psychodynamic orientation with other things added in, depending on the client. I do therapy with many psychotic individuals, so straight psychodynamic isn't always going to work.

Also, as someone who is attending a Psy.D. program, I would have to say that there is nothing less about a Psy.D. than a Ph.D. They are equal degrees, one being focused in research and the other in clinical studies.

Just keep doing your research-- I wouldn't worry so much about the degree than what the person actually specializes in. I chose my T because he specialized in psychoanalytic and psychodynamic therapy. I didn't even know what degree he had until the 2nd year into our therapy. I didn't care. We have such an awesome relationship, he could be a bum off the street, lol.

[MissCharlotte]

</font><blockquote><div id="quote"><font class="small">Quote:</font>

In addition, there are MS degrees in counselling and family therapy and social work. These people can be very good, but tend to focus on what I call "skills" training and not in-depth analysis. If you don't want to do in-depth analysis or find the true answer to your problem, skills training can be great for getting rid of symptoms quickly. Many of these level treater practice Cognitive Behavioral Therapy techniques.

</div></font></blockquote><font class="post">

Well I have to vote here too because my T has a Masters degree. I won't use the word only here though! However, I am in long term psychoanalytical therapy. He was also trained in analysis and he just got an additional certification in somatic psychotherapy. He doesn't teach any cognitive behavioral therapy technique training or skills training. He doesn't promise to get rid of symptoms quickly.

So, I tend to agree with Sunny and Pinksoil on this one. Keep interviewing. Your therapist's approach, level of experience and willingness to listen first are the important factors here.

Best of luck!

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pinksoil said:


Also, as someone who is attending a Psy.D. program, I would have to say that there is nothing less about a Psy.D. than a Ph.D. They are equal degrees, one being focused in research and the other in clinical studies.
.

</div></font></blockquote><font class="post">

Actually, there are more differences between the PsyD and PhD than "just research." The statistics prove it.

In general, those students in PhD programs are higher quality students because they are accepted into programs and paid to goto school. PsyD programs, most of the students pay themselves. The average acceptance rate for PsyD programs is 40-41%. By contrast, the average acceptance rate for clinical PhD programs is 11-15%.

Students in PhD programs get more training, they take on average 1-1.5 years longer to finish their doctoral degree.

One disconcerting trend is that PsyD graduates do not perform as well as PhD graduates on the national licensing examination for psychologists (Kupfersmid &amp; Fiala, 1991; McGaha &amp; Minder, 1993; Yu et al., 1997). That is, doctoral students who graduate with PsyDs score lower, on average, than doctoral students who graduate with PhDs on the Examination for Professional Practice in Psychology (EPPP), the national licensing test.

The training models are different ~ the PsyD program uses the Vail Model whereas PhD uses the Boulder Model.

Also, match rates are much lower in "non-respected university based PsyD programs." For example:

Argosy Santa Ana: 45.5% Match
Forrest: 59% Match
Walden
17% Match Clinical
12% Match for Counseling

"Respected Psyd programs- university based with PhD programs as well"
Baylor: 89% Match
Rutgers: 92.6% Match

The match rates for PhD's are generally above 90%.

Furthermore, PhD's hold 85% of academic faculty positions (Morris et al, J Psychology and Theology, 2004)

For these reasons, it is important to understand the training a PsyD has had, where they went to school, whether it was APA accredited, whether they had an APA internship, and how long they have been practicing. Additionally, because not all PsyD's are equal, I would do research on the university or professional school that they received their degree from and understand whether it is accredited or not and the history of the accreditation.

[MyBestKids2]

Only psychiatrists can prescribe meds, and generally (not all the time) they don't perform regular therapy sessions. Have you tried the yellow pages? Sounds corny, but I've found some real gems in there!

Good luck!

[pachyderm]

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Riptide said:

Actually, there are more differences between the PsyD and PhD than "just research." The statistics prove it.

In general, those students in PhD programs are higher quality students because they are accepted into programs and paid to goto school. PsyD programs, most of the students pay themselves. The average acceptance rate for PsyD programs is 40-41%. By contrast, the average acceptance rate for clinical PhD programs is 11-15%.

</div></font></blockquote><font class="post">

How about statistics on the success rates of therapists with patients?

The best student doesn't necessarily make the best therapist. I'd rather have an Masters level therapist who has been to therapy himself and deeply understands the therapeutic relationship.

[(JD)]

The PhD is the highest academic degree the USA bestows; not the MD, not the PsyD.
But do I know some really off beat PhDs? You betcha!

[gardenergirl]

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mybestkids2 said:
Only psychiatrists can prescribe meds,

</div></font></blockquote><font class="post">

That's generally true of the majority of practioners, however there are some psychologists who have completed specialized training and field work who have earned the right to prescribe psychotropic medications in states which allow this, LA and NM are two. There may be more now; I haven't been following it as closely as I once did. A few armed service psychologists also can legally prescribe. This is where the pilot programs for training psychologists to prescribe began. Still, the overwhelming majority of psychologists cannot legally prescribe meds. Just to clarify. lol Clearer as mud?

gg

[sidony]

Meccorad, I wish you a lot of luck with this!

I guess the distinction has already been explained pretty well -- you probably want a therapist and a psychiatrist since most therapists don't prescribe meds. I guess some do, but I'm sure it's not the majority.

I figure the recommendation from someone you know (another health professional, etc.) is probably one of the best ways to start finding a therapist. I'd worry less about their credentials than how you feel about them when you first meet. I suspect you'll know during the first session or two whether or not you're a good fit. Even someone with less experience than you might like could well be a good fit. Don't rule anyone out based on years, specialties, etc! (Just my advice.) You never really know what will work.

My own therapist has a PhD. I went to him purely on a recommendation and only learned he had a PhD because it was on his business card (though later I learned more about his background). And I could tell you in all seriousness: I could care less what his background credentials are. He's just a good fit for me. If he had a masters or a psyd or any other kind of credential, it wouldn't change my feelings one whit. I think you're just going to know when it's right. You'll feel it. So get a recommendation, make an appt and see what happens! If you don't click, repeat the process. :-)

Okay that's just my advice....

Sidony