How to Find a Therapist
Finding a therapist/counselor can be overwhelming for many reasons, and that can be a barrier to actually getting help. When I finally realized that I needed to see someone I felt like I was in over my head- and that’s with my schooling in this subject and my work in the medical field! Being so overwhelmed, and anxious, caused me to delay the process several times but with this experience, I can tell you it’s worth it to work through everything and find someone. Some things that may be helpful to know when starting to look for a provider are what the different credentials that you see mean, the different types of therapy that may be provided, and how to start the search. Hopefully, this guide will help you find the person who’s the best fit for you.
Credentials
A mental health practitioner will have either a master’s degree, doctoral degree, or both. In addition to that, they will be licensed by their state licensing board. Given that licensure is done on a state-by-state basis the exact requirements will vary; in general, it includes completion of required schooling, completion of a set number of supervised hours, and passing the state exam. Below are some specific things you may come across in your search (this is not an exhaustive list, partially because one degree/licensure can have multiple acronyms associated with it):
Psychiatrist:
has an MD or DO;
licensed by the state;
can diagnose mental health disorders, prescribe medications, and provide therapy.
Psychiatric Nurse Practioner:
every psychiatric NP will have a master of science in nursing. They may also have a doctoral degree which can be a DNP, Ph.D., or Psy.D.;
licensed by the state;
can diagnose mental health conditions, prescribe medications, and provide therapy.
Psychologist:
has a PhD or Psy.D.;
licensed by the state;
can diagnose mental health disorders and provider therapy;
cannot prescribe medications.
Licensed Professional Counselor (LPC):
has a master level degree;
licensed by the state;
can diagnose mental health disorders and provide therapy;
cannot prescribe medications.
Licensed Marriage and Family Therapist (LMFT):
has a master level degree;
licensed by the state;
can diagnose mental health disorders and provide therapy;
cannot prescribe medications.
Licensed Mental Health Counselor (LMHC):
has a master level degree;
licensed by the state;
can diagnose mental health disorders and provide therapy;
cannot prescribe medications.
Licensed Clinical Social Worker (LCSW):
has a master level degree;
licensed by the state;
can diagnose mental health disorders and provide therapy;
cannot prescribe medications.
None of these providers is inherently better than the other; which one will be the best fit depends on what you’re looking for. Although there is a lot of overlap, certain degrees may lend themselves more easily to specific issues or specific types of therapy. You should also think about if having one provider to do your therapy and manage your medications is important to you (versus having your PCP and therapist work together if medication is used). If in your search you come across the term therapist and counselor and want to know more about why different language is used, this article is a good read for what the difference between the two is.
Types of therapy
The type of therapy that is used depends on what you’re being seen for and your provider's training. There are several schools of thought that different techniques fall into:
Psychoanalysis: this is an expanded and modified version of the concepts provided by Freud. It focuses on figuring out the unconscious causes of problematic behaviors, thoughts, and feelings and changing them by working through those unconscious causes.
Behavior Therapy: this looks at the role of learning in normal and abnormal behavior.
Classical Conditioning: many people are familiar with this because of Pavlov’s dogs (who were taught to associate a bell with food and began drooling when they heard the bell, even without food being present). At its most basic level, this is the process of linking two stimuli to produce a learned response.
Operant Conditioning: this uses reinforcement/rewards and punishments to teach behaviors (this is typically seen in animal training). This includes positive reinforcement/rewards, negative reinforcement/rewards, positive punishment, and negative punishment (I loved learning about this in undergrad so I recommend looking into it because I find it fascinating and could geek out but I won’t subject you to that).
Cognitive Behavioral Therapy (CBT): this focuses on changing the dysfunctional thought process that leads to maladaptive behaviors.
Humanistic therapy: this has a focus on people having the ability to make rational choices; it also focuses on concern and respect for others.
Client-centered therapy or person-centered therapy: the client takes the lead in this type of therapy while the therapist is more of a facilitator. In this process, the patient finds the solution to their problems (versus the therapist presenting the solutions or guiding the patient to them directly).
Gestalt therapy: “whole person therapy”; emphasizes the present and self-responsibility with the thought that in order to get past current anxiety, anger, etc. the feelings need to be actively expressed- not just discussed.
Existential therapy: focuses on self-determination, free will, and the search for meaning.
Integrative therapy: not focusing on any one of the above, but mixing them as needed for each patient.
How to start the search
Bringing everything together, you now need to know how to search for a therapist. There are several different ways you can do this. Most insurance companies will have a list of in-network providers which you can get either by calling the insurance carrier or going to their online portal. Psychology Today also has a handy search function where you can put in your location, insurance, and preferences (male versus female, language, type of therapy provided, etc.). The problem with both of these options is that at the end, you have a list of people you have to pick from. This is why I recommend talking to your PCP; if you have a good relationship with them and they know you, they will hopefully be able to recommend a therapist that is both in-network and that they think will be a good fit for you. If you’re in college, you may be able to go to campus health for either a referral or to be seen there (not all campuses provide mental health services). No matter what your situation is, you may not click with the first therapist you see (regardless of if you picked them from a list or if your PCP recommended them). This is a common issue and causes a lot of people to give up; not clicking with the first person you see is not abnormal and doesn’t indicate a problem with you. As disheartening as it is, don’t give up! The therapist won’t take it personally (they understand how important comfort and a good relationship is, that’s part of their training) and they may be able to provide a recommendation for someone else that you can try.
References
https://www.apa.org/topics/therapy/psychotherapy-approaches
https://www.psychologytoday.com/us/basics/cognitive-behavioral-therapy
https://www.psychologytoday.com/us/therapy-types/person-centered-therapy
https://www.psychologytoday.com/us/therapy-types/gestalt-therapy
https://www.psychologytoday.com/us/therapy-types/existential-therapy
https://www.nami.org/Learn-More/Treatment/Psychotherapy