It's Your Time, Your Money, Your Life--Your Therapy. Who Do You Choose?

So, you've come to an important decision: you'd like some help with the distress in your life, and you want to choose the right person to help you.  You've heard of counselors, therapists, psychologists and psychiatrists? Who's right for you?

Only you can answer that question.  It can be a complicated decision, based on many factors. But, depending on your difficulty and the help you're looking for, you may find it helpful to consider the following.

One place to start: What are the symptoms of your distress?

Are you having intrusive thoughts that won't go away? Feeling depressed and can't shake hopeless feelings?  Wondering if you have Attention Deficit Disorder?  Frustrated with your life choices? Feeling angry with a loved one? Struggling with an alcohol addiction?

So you'll want to determine Is this person qualified to help me with my particular difficulty?

There are many ways to choose a person to help, but one way is to consider the scope of practice of the person you're considering.  Scope of practice refers to what this person is trained to do and services he or she is deemed capable of providing safely, by either a state licensing board or other certifying body.

If you seek a counselor, be aware there are many types of counselors with varying degrees of training.  For example, a peer counselor may be trained to listen and provide practical life advice, but is not trained to assess or provide treatment of mental illness.  Career and rehab counselors usually have master's degrees in their  specialty. Other counselors such as "life coaches" may have varying degrees of training (from several weeks to several years).  Pastoral counselors may offer counseling tempered with a particular religious view. When you interview your counselor, ask: What training have you had? Do you have a specialty? How long have you been practicing? Do you have a license or a certification?


A licensed therapist has received the training and the approval of a state licensing board to treat a variety of mental disorders that can cause moderate to severe distress such as depression, anxiety, chemical dependence, anorexia, bulimia, stress, personality disorders and marital and relationship problems, among many others.  A licensed therapist has studied human psychology, lifespan development, individual as well as couple/family counseling techniques, drug addiction and treatment, psychopharmacology, multicultural implications for counseling, theories of psychotherapy--among other studies--over the course of several years. When you interview your therapist, ask: Are you licensed? Do you have a specialty? How do you like to work with your clients? Where did you go to school? 


You may choose to see a clinical psychologist. In addition to the talk therapy work that therapists do, clinical psychologists are trained to administer and interpret a variety of diagnostic tests which can clarity diagnoses of mental disorders or addictions.  They have extensive training and are licensed.

Finally, you may choose to see a psychiatrist. A licensed medical doctor, a psychiatrist cannot only assess and diagnose your difficulty, she or he can also prescribe medications to help combat the symptoms of depression, anxiety, Attention Deficit Disorder, and a host of other disorders which have been shown to respond to medical treatment.  Psychiatrists can provide short- or long-term talk therapy as well, or  provide medication management while working in conjunction with your therapist or psychologist to coordinate your care.

What about insurance? Most insurance companies invite licensed therapists (MFTs), psychologists and physicians to serve on their panel of providers, subject to the approval of the insurance company.  Some providers of mental health care choose not ally with insurance companies and therefore require you to reimburse them directly.  When you contact any mental health care provider, be sure to ask: Do you accept reimbursement from medical insurance plans? If so, which ones? How can I find out if you are on my insurance panel of providers? What are your fees? How are insurance claims submitted?


You can see that you have many choices when it comes to mental health care, and this discussion just scratches the surface.  When it comes to sorting out who to choose, ask questions. Decide if you want to utilize your insurance coverage. Consider the scope of practice, experience and training of the person you're considering. Ask friends for recommendations.

And finally, try him or her on for size.  If it's not a good fit, you have the right to say goodbye and try someone else.  After all, its your time, your money, your therapy--and your life.

Thanks for listening.