Thankfully, seeking help through professional therapy or counseling no longer carries the negative stigma that it once did. In fact, in today’s society, people are encouraged to acknowledge their mental health issues and get the help they need. There are a number of things to consider, however, when determining if you would benefit from counseling, identifying how to get started, and finding the right professional to address your needs and goals.
1. Would I benefit from therapy?
Are you experiencing grief, addiction, marriage or relationship issues, PTSD (post-traumatic stress disorder), depression, abuse, anxiety, OCD (obsessive compulsive disorder), or other issues that are impacting your ability to function productively in society? Are any of these issues consuming your thoughts, causing harm to yourself or others, or interfering with your work and relationships? If so, then it is likely time to seek help. On the other hand, if these emotions or circumstances are temporary and your personal management tools and/or support of family and friends are helping you cope, you may be able to wait to determine if you need professional help down the road.
2. What type of professional do I need?
It can be confusing when deciding what type of therapist or counselor you need. Each type of professional has their own niche and training requirements. However, you can select the type of therapist that will best address your unique needs and achieve the results you are looking for. The important thing is to make sure that the professional you choose is licensed and follows the industry’s guidelines and code of ethics.
- Licensed Professional Counselor (LPC) – One of the most common mental health professionals, LPCs specialize in treating various mental health conditions, anxiety, depression, phobias, trauma, marital conflict, drug addiction, or a range of other issues. Many also utilize specific therapy approaches. In most states, LPCs must have a master’s degree and 2-3 years of supervised experience but do not allow LPCs to provide a diagnosis.
- Psychiatrist - A psychiatrist is a medical doctor who is board certified by the American Board of Psychiatry and Neurology and has completed a 4-year residency. Their practice focuses on research and biological factors, such as genetics, neurology, or social sciences, as contributors or causes of mental health disorders. They identify these causes through a variety of tests to diagnose and treat the client and prescribe medication, if needed.
- Psychologist – Psychologists hold a doctorate degree, pass a national exam, and complete a one-year supervised internship, along with a one-year supervised post-doctoral fellowship. Psychologists are able to diagnose specific mental health conditions by conducting professional exams and assessments. Following diagnosis, they generally use talk therapy to help patients manage or overcome their mental health issues.
- Social Worker – Social workers are professionals who earn a master’s degree in social work, followed by two years of supervised clinical experience. They must be state licensed. The social worker’s focus it to guide individuals or groups towards healthier, happier lives by developing skills such as good communication, self-care, empathy, conflict resolution, and financial responsibility. The average social worker is not qualified to address mental health issues directly. However, a licensed clinical social worker (LCSW) has licensure or is being supervised to assess, diagnose, and treat mental and emotional conditions or addictions, though unable to prescribe drugs.
- Therapist – Almost a cross between an LPC and a psychologist, licensed therapists are mental health professionals who hold a doctorate, though in some instances only a master’s degree is required. They can diagnose and treat mental health conditions using various therapy approaches. Many specialize in a particular area, like marriage and family therapy, gender dysphoria, or trauma and abuse.
You will often see some of the following credentials associated with these professionals:
- LCDC: Licensed Chemical Dependency Counselor
- LCSW: Licensed Clinical Social Worker
- LMFT: Licensed Marriage and Family Therapist
- LMHC: Licensed Mental Health Counselor
- LPC: Licensed Professional Counselor
- MD: Doctor of Medicine (for a physician psychiatrist)
- NCC: National Certified Counselor
- PhD: Doctor of Philosophy
- PsyD: Doctor of Psychology
3. What counseling format is best for me?
While many seeking counseling prefer to meet with their therapist face-to-face in an office or in a group setting, today’s digital age offers a variety of non-traditional options. For example, online therapy is becoming more and more popular, in part because of its convenience, affordability, and immediate access to a therapist. Based on a study of participants, online therapy is most frequently used by those suffering from anxiety, depression, stress, and relationship issues.
Clients are usually matched with a licensed professional after setting up an account with an online therapy service like Talkspace or BetterHelp, completing an assessment questionnaire, and visiting with a consultation therapist. Online sessions with a therapist can take place via video conferencing, text-based messaging, live-chat sessions, or phone consultations.
4. What are my needs and goals?
Before you can select a therapist, you must do some self-reflection to identify exactly what you are wanting to get out of the experience. What issues are you facing? What specific results are you wanting to achieve and how quickly do you want to achieve them? Would a group setting or a faith-based counseling program suit you better? Do you have a family history of mental illness that requires a psychiatrist? Will you require detox? Medication? Do you want family therapy or a therapist that matches your demographic?
And while you may rely on the therapist to suggest the approach to be taken with your treatment, it’s also possible you want to find a professional who specializes in a therapy approach you already have in mind. For example, art therapy uses art to help people express emotions and process trauma; cognitive behavioral therapy (CBT) helps identify and change negative thinking patterns and behaviors; dialectical behavioral therapy (DBT) is a type of talk therapy for people who experience emotions very intensely; eye movement desensitization and reprocessing (EMDR) therapy interactively relieves psychological and trauma-based stress; interpersonal therapy focuses on relationships with other people; and psychodynamic therapy addresses unconscious thoughts and emotions. Most therapists will list on their website or in their bio the treatment methods in which they specialize.
5. What questions should I ask to find the right therapist?
Many therapists will offer a consultation to conduct an initial assessment and allow you to ask any questions. This is your opportunity to narrow down your search to your top two or three choices. Be sure to write down the questions prior to your visit to ensure you don’t forget them. According to the American Psychological Association1 and the Anxiety and Depression Association of America2, some good questions to ask include:
- Are you licensed in this state?
- How many years have you been in practice?
- How much experience do you have working with people who are dealing with [your specific issue]?
- What is your specialty or area of expertise?
- What kinds of treatments have you used effectively in resolving [your specific issue]?
- What insurance do you accept?
- Will I need to pay you directly and then seek reimbursement from my insurance company, or do you bill the insurance company?
- Do you accept Medicare or Medicaid?
- Are you able to prescribe medication if I need it?
- How soon can I expect to start feeling better?
- What do we do if the treatment plan isn’t working?
- Do you offer any alternatives to office visits, such as teletherapy?
- What if our professional relationship winds up not being a good fit?
6. How important is the client/therapist relationship?
More than the therapy approach, in-office vs online sessions, and type of counselor chosen, research3 has shown that the client/therapist relationship is the primary factor in achieving successful therapy outcomes. Often referred to as the “therapeutic alliance,” this relationship encompasses the bond between therapist and client, their alignment on goals and methods, trust, communication, and willingness to work together. The research also shows that when a client feels supported by their therapist, they are more likely to make the changes needed to improve their mental or behavioral health.
The question becomes, then, how do you know if your therapist is a good fit, and what can you do if it isn’t? First of all, there are some red flags to look for when questioning whether to stay with your current therapist.
- Do you genuinely connect with the therapist? Is he or she fully present and engaged throughout your sessions?
- Can you tell them anything without feeling judged or uncomfortable?
- Are they providing you with techniques and tools that are producing measurable or noticeable results?
- Do you feel overwhelmingly anxious around them, even after a few sessions?
- Are you physically uncomfortable in the office setting?
While you should give the counselor a fair shake, it’s important to know that you are not obligated to stick with a therapist whose demeanor, methods, and/or communication style are not meeting your needs. While it may feel a bit awkward, you can “break up” with your therapist – you won’t be the first. Then quickly move on to someone who is a better fit.
7. What is the cost?
The cost of therapy will largely depend on the type of therapist you choose (e.g. LPC, psychiatrist, social worker), the therapist’s experience, whether you’re conducting in-person or teletherapy sessions, and whether you have insurance that covers all or part of the cost. Generally, therapists charge between $100 and $200 per session for in-person appointments, though in big cities it could be more. However, some therapists offer sliding scale rates, depending on income. Others take Medicare and Medicaid. Teletherapists usually range from $50-$90 a session, though some services may discount the cost or offer unlimited visits with a monthly subscription. Of course, if you have insurance that covers the particular therapist you use, you will likely pay a portion of the fee, depending on your coverage.
8. Where do I find a therapist?
Now that you know the primary things to consider and questions to ask, how do you go about finding a therapist that aligns with your criteria? Here are some of the best places to look. Be sure to read the therapists’ bios and visit their websites to garner as much information as you can up front. Then schedule a consultation with those that seem like the best fit and narrow it down from there.
- Insurance Directory - If you have insurance, start with the list of approved therapists, both in and out of network.
- Friend Recommendations – If you have a trusted friend or family member who has undergone counseling, check with them for references. Keep in mind, however, that their needs might be significantly different from yours.
- Primary Physician Referral – If you have a good relationship with your doctor, he or she might be a great resource for pointing you to a good therapist.
Association of Gay and Lesbian Psychiatrists, National Eating Disorders Association, Anxiety and Depression Association of America, and National Center for PTSD.
- Industry Resources - Many industry organizations and trade unions have resources to help identify mental health professionals. For example, the International Association of Firefighters offers help with mental health, post-traumatic stress disorder (PTSD), and substance use.
- Online Therapy Services – Various online therapy services will pair you with a therapist based on an initial assessment, questionnaire, and/or consultation. Some of the most popular services include BetterHelp, ReGain, Talkspace, Talkiatry, Brightside, and E-Therapy Cafe.
- Local Services – It’s possible you have access to local counseling services that will meet your needs, whether it’s a university counseling center, a workplace wellness program, group or one-on-one therapy through a local advocacy organization, or a faith-based treatment program. Area support groups like Alcoholics Anonymous or Celebrate Recovery can also help maintain sobriety or other rehabilitation by sharing experiences and holding one another accountable.
From Counseled to Counselor
You may be surprised to learn that many professional counselors previously went through therapy themselves. It is often their own healing journey that led them to become therapists so they could help others. If you believe that becoming a licensed counselor is your professional calling, Ottawa University offers a number of relevant online degrees, both at the bachelor’s and master’s levels. Contact us today to find the program that’s right for you!