One of the most common complaints I hear when I read about people having trouble with therapy is this. "The doctor just wanted to prescribe a bunch of medications! She barely talked to me!" OR "He only talks, he won't prescribe medications."
There are a dizzying array of options for therapy. Thousands of providers and hundreds of specialities. Sorting out what you're expecting from therapy will help you choose the right provider and avoid this frustrating experience.
In this post, I've listed four questions to help you narrow down your choices. Answer each and you'll be well ahead of the game when it comes to finding the right therapist for you.
Finding the right person to help with your problem can be intimidating at the start. All professionals at all levels can be great or terrible or somewhere in between at counseling. You really need to find someone you're comfortable with, regardless of their degree.
But these tips can help you narrow down the search and hopefully find the right person more quickly.
4 Questions to Find The Right Therapist
Question 1: Do I think I will need medications?
There are two types of mental health providers that prescribe medications in the US: Psychiatrists and Psychiatric Nurse Practitioners.
Psychiatrists are medical doctors (MD) with extra training in mental health and prescribing mental health medications. Medical doctors usually have 7-8 years of training. Psychiatrists are usually focused on shorter appointments, assessing your symptoms, and prescribing medications. Most of them usually don't do therapy.
Psychiatric Nurse Practitioners have a degree called Advanced Registered Nurse Practitioner (ARNP) and special training in mental health. Psych ARNP's usually have 3-4 years of training. Psychiatric ARNP's would be more likely to provide some therapy in addition to medications. The American Association of Nurse Practitioners has a searchable database here, be sure to choose "psychiatric" from the drop-down list.
If you have a primary care physician, sometimes that person can also provide you with medications for mental health needs. In some US states (like Tennessee), a few psychologists also have the ability to prescribe medications, but they are few and far between.
In the US, it can be very hard to find open appointments with a Psychiatrist or a Psych ARNP. If you aren't sure you need or want medications, check out other types of therapists first. A good therapist can always refer you to a prescribing physician if s/he believes you might benefit from medications too.
If you're outside the US, just ask providers before you make appointments. Or find the degree and license of the person you're considering seeing, and type "Can [this type of license] prescribe medication?"
Question 2: Do I need testing or evaluation?
If you need any kind of neuropsychological test, you'll need an appointment with a Licensed Psychologist in the US. This type of testing is often needed to evaluate people for ADHD, learning disorders, Alzheimer's Disease and other cognitive disorders, Personality Disorders, and Intelligence testing (IQ tests of all kinds).
Psychologists have doctoral degrees in psychology (PhD or PsyD). Psychologists have 5-6 years of formal graduate training in clinical work and research. Psychologists specialize in a whole range of treatment options. Most psychologists who perform this type of testing will list it prominently on their website or advertising. Many of them focus only on testing and may refer you out for longer term therapy if needed.
You can find a neuropsychologist by searching for "neuropsychologist" + your city. You can also find a list of licensed neuropsychologists here.
Question 3: Do I want therapy for myself, or do I need couples or family counseling?
Not all therapists are good at everything. There are therapists who specialize in treating couples and families. This is where Marriage and Family Therapists (MFT, LMFT) are usually your best bet. Marriage and family therapists usually have 2-3 years of formal graduate training. Most marriage and family therapists see a broad range of clients, including adults, children, and couples. They typically have 50-60 minute appointments and work with people for as many sessions as needed. They typically do not do testing, evaluations, or research. The American Association of Marriage and Family Therapists has a therapist finder here.
Many Psychologists also treat children and families. They often will list this as a specialty on their website or advertising. Licensed Mental Health/Professional Counselors (LPC/LMHC) are licensed counselors with 1-3 years of formal training. They do both short and long term treatment, group therapy, adults, children, and couples. Many people with this degree are supervised by psychologists and might do some testing, research, and evaluation under supervision.
Question 4: Do I need help with the basics, like housing, finances, finding work?
If you need help with getting back on your feet, recovering from homelessness, or are struggling in any way with the basics, the person you want to see is a Licensed Social Worker (LSW, or LCSW for Licensed Clinical Social Worker). These professionals usually have 2-3 years of graduate training and they really excel at helping people get back on their feet. They usually practice in community health centers and group practices. If you need help finding low-cost therapy, search for your city + "community mental health" to find clinics near you.
The National Association of Social Workers has great resources for finding a social worker on their website.
Where do Life Coaches fit in?
Anyone can use the term Life Coach, and the practice of "coaching" is not formally regulated by any US state as of 2016. There are some places to get a life coaching "certification" that require less than 10 hours of training. As of this writing, there is no formal code of ethics for life coaches in the US.
Life Coaches are strongly discouraged from practicing therapy. If you need help, see a licensed mental health professional.
Too Long; Didn't Read (TL;DR)
Need medications? See a Psychiatrist (MD) or Psych ARNP
Need testing and evaluation? See a Psychologist (PhD or PsyD)
Need marriage or family counseling? See an MFT, PhD, or LPC
Need help with basics? See an MSW or LCSW
If you've been thinking about therapy, but still have questions about the process, check out this book. I give you more search strategies for finding therapists and referrals. The book includes scripts of exactly what to say or type in an email to reach out to a therapist.
And I've made a free workbook you can use to help guide you through the process of finding the right therapist and getting the help you need to feel better.