When you first begin searching for a mental health professional, you may feel overwhelmed by all the new terminology. What’s an LMFT or an LCSW? What’s the difference between a generalist and a specialist? What credentials, if any, might be misleading?
First, it’s important to remember there isn’t a right or wrong method for finding your ideal therapy solution. Good therapy can be such a subjective experience. However, there are a few key indicators you can consider when narrowing down your options. Knowing a bit about the many common phrases, titles, and specialties in therapy puts you in a better position to use those indicators to your advantage.
This guide will demystify that new language for you. Ideally, it will also help you feel more informed in moving forward with your treatment. Let’s get to it!
Education & Qualifications
Choosing Between a Therapist or a Psychologist
Understanding Different Specialties
How Do You Know if a Therapist Has Expertise in Your Issue?
Understanding Different Therapy Modalities
What Is Most Important When It Comes to Therapeutic Modalities?
How Should You Feel After Your First Therapy Session?
How Technology Can Help You Find the Right Fit
“Therapist” is an umbrella term that many mental health professionals share. When looking for a therapist, you may see various letter combinations behind each person’s name. Let’s review some of the common ones.
MD stands for Doctor of Medicine. Psychiatrists have this level of education. They attend medical school for approximately four years after college. Afterward, they must complete a residency in psychiatry, which entails about 3-4 years of additional training. Psychiatrists can prescribe psychiatric medication, and some of them also practice therapy.
PhD stands for Doctor of Philosophy. Psychologists have this level of education. They must graduate from a doctoral program (which ranges from 4-6 years) and complete a dissertation. Psychologists receive extensive training in research, data collection, and psychological assessment. Many of them teach after graduation. Subsequently, some of them also practice therapy.
PsyD stands for Doctor of Psychology. This degree is newer than the PhD, and it’s geared towards students who want to specialize in clinical practice. The PsyD also takes about 4-6 years to complete, and students usually need to complete a dissertation or equivalent project. PsyDs often work in direct client care by practicing therapy.
Master’s Level Degrees
LCSW stands for Licensed Clinical Social Worker. This is a master’s level degree, and it’s recognized in all states (although licensure in one state does not guarantee licensure in another state). Social workers intervene in several areas, such as community settings, public policy, and with individual therapy clients.
LMFT stands for Licensed Marriage and Family Therapist. This is a master’s level degree, although some LMFTs also hold doctoral degrees. LMFTs specialize in working with individuals, families, couples, and groups.
LPC stands for Licensed Professional Counselor, and LPCC stands for Licensed Professional Clinical Counselor. The only difference is the licensing state. These are both master’s level degrees. Most counselors specialize in clinical services providing therapy.
LCMHC stands for Licensed Clinical Mental Health Counselor. It’s fairly synonymous with the LMFT, LPC, and LPCC titles.
LCAT stands for Licensed Creative Arts Therapist. These therapists must earn a master’s degree specifically in art therapy.
These credentials stand for certified or licensed alcohol and drug counselors. They typically work in addiction settings.
Pastoral counselors may have the letters MA, CCPT, NCPC, NCCA, or CpastC behind their names. Additionally, some may also have other master’s level degrees. Pastoral counselors combine theology with spiritual counseling.
Unlicensed therapists may have the letters APCC, AMFT, or ACSW behind their names. This status means that they have received their degrees, but they are still accruing hours towards licensure. Most licenses require completing anywhere between 2500-3000 clinical and passing board exams. Interns and associates can provide therapy, but they work under a supervisor. That said, most online therapy platforms only hire licensed professionals.
Here’s What Really Matters When It Comes to Credentials
Even mental health professionals often disagree about the “right” education or skills for establishing competence in this work. That being said, there are still a few essential factors all licensed therapists must have:
- A graduate-level degree.
- Extensive clinical training, which can range from 1,000-4,000 hands-on hours.
- Successful completion of board exams.
- Active licensure within their practicing state.
You can always check to see if a potential therapist’s license is in good standing. The Association of State and Provincial Psychology Boards (ASPPB) is a good place to start. You can also ask what specific license the therapist holds and look it up through your particular state.
Therapists and psychologists can both provide therapy. Both professionals treat a variety of populations and issues, and they both receive similar mental health training.
Psychologists have more education than therapists. They must complete a doctoral degree as part of their practice. In addition to therapy, many psychologists actively conduct research, teach, and perform psychological assessments.
While therapists may also engage in research or academia, most of them have exclusive training in talk therapy. They tend to look at problems through a systemic lens, which means they perceive how individual behavior emerges from familial or cultural expectations.
Ultimately, there isn’t a universal answer to how you should choose. Many people benefit from working with a therapist at first. However, those who have a highly specialized issue might consider meeting with a psychologist.
Finally, it’s important to remember that only qualified psychiatrists can prescribe medication. Your therapist or psychologist can provide you with referrals if you need this service. If you work with a psychiatrist, they may provide therapy themselves. They may also coordinate their care with your therapist.
All therapists have different areas of focus. It’s important to find a professional who specializes in your specific concern.
Therapy can help you work through a drug or alcohol addiction. Your therapist will work with you to identify triggers, develop alternative coping skills, and build a healthy support system. If your addiction is severe or life-threatening, your therapist may refer you to a higher level of care, such as a detox setting.
Over 18% of Americans experience an anxiety disorder in a given year. Your therapist will help you identify situations that trigger anxiety and collaborate with you to develop effective strategies for managing fear.
Relationship stress can have a tremendous impact on your overall well-being. Many couples benefit from working with a professional who can shed insight into problematic relationship patterns. In therapy, you can work on communication and intimacy issues and restore happiness in your relationship.
Depression can make ordinary tasks feel impossible. When left untreated, it can affect your work, relationships, and self-esteem. Therapy helps you challenge your negative thinking and implement new ways to cope with your feelings.
Someone dies from an eating disorder every 52 minutes. Your therapist can help you build a healthier relationship with food and increase your sense of body positivity.
Even when we love them, families can be our greatest stressors. Therapy can help you work on boundaries and healthier communication. You may also benefit from family therapy to improve relationship satisfaction between members.
The LGBTQ population suffers from mental health conditions at a significantly high rate. Therapy can help with LGBTQ issues, and it can also help with other concerns.
Grief and Loss
Although death is inevitable, that doesn’t mean the experience doesn’t hurt. Grief therapy helps you work through these challenging feelings. If you’re struggling with feeling like things are hopeless, it can provide a roadmap for healing.
Personality disorders refer to conditions like narcissistic personality disorder, borderline personality disorder, and obsessive-compulsive personality disorder. Therapy helps you find healthy ways to cope with your condition.
Significant Life Transitions
Whether you’re changing jobs, planning for a baby, or moving to a new city, even positive change can be stressful. Therapy provides support and reassurance during this difficult time.
Teen and Adolescent Concerns
It’s no secret that teens are under enormous pressure. Although young people struggle with mental health concerns, they don’t usually receive adequate support. Therapy can help with issues related to self-esteem, peers and relationships, and family problems.
Trauma can impact every area of life functioning. Furthermore, at least one in 11 people will be diagnosed with PTSD at some point during their lifetime. If you’re struggling with trauma, therapy can help you process your emotions, work through your fears, and develop a new sense of meaning.
Unfortunately, expertise can be somewhat knotty as an attribute in the mental health industry. The term itself isn’t regulated, and anyone can claim they are an “expert” in a certain topic. Some providers may take a class or training in one issue and then believe they know how to treat it.
If you’re concerned about a therapist’s competence or unsure whether they can help you with your particular needs, it’s okay to ask about their background. Some good questions include:
- What kinds of experience do you have working with this problem?
- What kind of training have you done in this area?
- What types of outcomes can I expect in this work?
- What types of treatment styles do you typically use?
- How will we collaborate on my therapy goals?
- What happens if I don’t make progress?
Qualified therapists will answer these questions with ease. Many times, they’ll invite you to address any of your concerns before and during the treatment process. It’s important for you to ask about anything that you deem as significant.
Choosing Between an Experienced Versus a New Therapist
Many people assume that more experience inherently means more competence. While this is sometimes the case, it isn’t a universal truth.
Experienced therapists tend to be older (due to simply having more years of practice!), and they may have more extensive training working with your specific issue. They may also charge more for their services and have fewer availabilities.
However, it’s a misconception that newer therapists cannot provide effective work. Newer therapists receive consistent supervision, training, and feedback. Fresh out of school, many of them are well-versed in the latest treatment models. Additionally, their services may be more affordable.
More than anything, therapy is about the relationship. Feeling comfortable, heard, and understood tends to be far more important than the level of experience your provider brings to the equation.
Just like therapists specialize in different issues and populations, they also intervene differently with their clients. Some therapists use one modality exclusively, but most integrate various techniques from several modalities.
Let’s explore some of the most common approaches.
Cognitive-Behavioral Therapy (CBT)
CBT is a popular, evidence-based modality that treats a wide variety of mental health conditions. CBT focuses on the connection between thoughts, feelings, and behaviors. In this therapy, you’ll learn how to identify and challenge negative assumptions you have about yourself. Your therapist will also encourage you to replace negative behaviors with more positive ones.
Dialectical-Behavioral Therapy (DBT)
DBT is also a behavioral therapy. It focuses more on mindfulness, distress tolerance, and interpersonal skills. DBT can be beneficial for people with personality disorders, impulse control issues, and eating disorders.
Group therapy refers to attending structured groups focused on a specified topic. Trained facilitators generally follow a curriculum each week. This option allows you to learn how to cope with your issues while receiving support from other like-minded individuals. There are many different groups, such as bereavement groups, substance abuse groups, and self-esteem groups.
Humanistic therapy focuses on your ability to make rational, effective choices. With this method, your therapist will typically encourage you to guide the session and discuss whichever information seems most important.
Narrative therapy focuses on exploring the stories (narratives) you have about yourself and others. Your therapist will help you understand how to separate yourself from your issues to solve them more objectively.
Psychodynamic therapy examines how past events impact your future self. Your therapist will increase your insight into subconscious material to help you understand the root of your issues. This insight can help you feel more empowered to make changes.
Now that you know more about these different modalities, how can you decide which one is best for you? The answer may depend on why you’re seeking therapy in the first place.
If you are in distress and want immediate relief, cognitive models like CBT or DBT focus on substituting negative coping skills for more positive ones. These models tend to be short-term, and your therapist may assign homework to help keep you on track between sessions.
Support and Validation
Many people enter therapy because they feel alone, frustrated, or scared. They may not know how to process these emotions or reach out to others about how they feel. In these cases, humanistic models like client-centered therapy or existential therapy may be a good fit. Additionally, you may benefit from group therapy, as groups can provide support and reassure you that you aren’t alone in your struggles.
Do you continue to find yourself wondering why you do the things you do? Do you feel like issues from your past continue to impact your present life? Psychodynamic therapy helps you understand your unconscious motives and reconcile parts of your past.
Couples or family therapy can be extremely helpful for people struggling in their relationships. These therapies focus on treating the entire unit as a client. In other words, it’s not about assigning blame or choosing who’s right in a particular argument. Your therapist will teach you all how to assume personal responsibility, set healthy boundaries, and increase appropriate communication with your loved ones.
Dissatisfaction With Previous Therapy Experiences
You might be seeking a therapist after feeling disappointed with past treatment episodes. If that’s the case, it’s important to share these concerns during your first session. Try to be specific about what did or didn’t work for you. It’s impossible for all therapists to be a good fit for all clients. But by highlighting the issues, a new therapist can intervene differently.
Therapy can be scary, and it’s not always apparent to know if it’s working. But after meeting with a new provider, consider if you feel these positive signs:
- A sense of being understood.
- Feeling validated about your feelings and needs.
- The desire to return and continue talking.
- Increased energy, as if you feel motivated to work on this issue.
- Feeling like your therapist showed a genuine interest in your life.
- A clear understanding of how the therapeutic process will work.
- Some discomfort (usually associated with talking about vulnerable topics).
If you feel some or all of these positive signs, that’s a strong indicator that you may have found a successful match.
Keep in mind that it may take a few more sessions to feel more comfortable with your therapist. After all, just like in any relationship, it takes time to get to know someone! Making the most of therapy requires effort and commitment whether you’re seeking therapy online or in person. If you’re one of the many people accessing therapy from home through a device, visit our guide to getting the most out of your online therapy.
When choosing a therapist, many popular platforms like BetterHelp or Talkspace use algorithms to match clients with qualified professionals. At this time, the nature of these algorithms isn’t known. However, these sites indicate they match clients to counselors who fit their specific objectives and preferences.
Regardless of the exact details behind this approach, this convenient option takes some of the guesswork out of combing through endless therapists. Many times, people feel so overwhelmed by finding the right person that they don’t know where to start.
Instead of making an initial phone call, scheduling a consultation, and waiting a few days (or even weeks), these platforms offer instant access to a qualified professional. If you’re looking for immediate relief, this option can be invaluable.
Furthermore, many online platforms make it incredibly easy to change therapists. Just like with any therapy, you don’t owe anyone an explanation for making a change. You’re allowed to switch providers at any time. For those using BetterHelp, we’ve compiled our top 7 insider tips to finding the best therapist for you.
It’s not uncommon to meet with several therapists before finding the one that feels best to you. Keep that in mind if you’re finding yourself feeling dismayed or even resentful by the process.
The process of finding the right therapist will look different for everyone. There isn’t a precise science because there is no true way to quantify the abstract symbiosis within a successful therapeutic relationship.
Additionally, it’s okay if you don’t know exactly what you need. Many people enter therapy because they know something isn’t working, but they may not know what that something is.
It’s normal to feel hesitant about starting therapy. If this is your first time asking for help, congratulate yourself for taking that brave, initial step. Help is available – many people find that reaching out is one of the best decisions they make for improving their mental health.