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A Primer on Psychotherapy & Psychotherapists
Getting to that first step takes strength and courage. It requires recognition that there are vulnerabilities, problems, and challenges. It requires a true desire for change.
Question may arise for many who have chosen to embark on the journey of psychotherapy: “OK, now what? Who do I call? What type of therapist is right for me and my situation?”
WHAT IS PSYCHOTHERAPY?
Psychotherapy is a general term referring to therapeutic interaction or treatment contracted between a trained professional and a patient, family, couple, or group. The problems addressed are psychological in nature and can vary in terms of their causes, influences, triggers, and potential resolutions.
There are a variety of therapists who can provide differing types of treatments; individual therapists; group therapists; child therapists; family and marital therapists; psychoanalysts; sex therapists; art therapists; music therapists, and others. These modalities are not inclusive of all types of psychotherapeutic treatment but are the most well-known. Creative arts therapists and music therapists usually train in specialized programs specifically geared to their specialties, though they may also have initially trained as social workers, psychologists and mental health counselors.In general, most of the therapists listed in the above categories are usually initially trained as social workers, psychologists, and mental health counselors, and then obtain specialty training. For example, a child therapist may receive initial training as a social worker or psychologist, but then continues on to receive specialized training in child treatment under close supervision of a child therapy expert.
In addition, psychotherapists have different orientations, meaning that in addition to being trained in their specialty they may follow a particular theory or technique that informs their approach towards treatment. For example, a child therapist may work within a cognitive-behavioral framework or within a more psychodynamic framework. The different orientations refer to the theory behind and method in which the treatment will be provided.
However, no matter what the modality or the orientation, one standard remains non-negotiable: the therapist must be licensed in their field. In addition, it is also highly recommended that the therapist receive advanced certification in their specialty, i.e. family and marital therapy, etc. Although this is important, and certainly adds to the expertise of the therapist, it does not take the place of licensure in their particular profession. Licensure signifies that the person has attended a program approved by the Illinois Department of Financial and Professional Regulation (IDFPR), has complied with all requirements, placements, internships, and has passed the licensing exam of the state where the therapist wishes to practice. It should be noted that it is illegal for a therapist to practice without current licensure. It is strongly advised to look up an individual therapists’ license on the IDFPR website (www.idfpr.com) to ensure, 1) They indeed have an active license to practice and; 2) Whether they have any malpractice claims and for what reason.
WHO ARE THE PRACTITIONERS?
As noted above, although psychotherapeutic treatment is usually sought by specialty, most therapists are usually trained initially in one of three disciplines. Though this is not totally inclusive, (i.e. psychiatric nurses, etc.), these disciplines encompass the training of most treating professionals:
Clinical Psychologists are doctoral level clinicians who have completed 4-5 years of postgraduate training in clinical psychology from an accredited institution. Clinical psychologists will have the letters PhD, PsyD or in some cases EdD following their names. In addition to coursework, clinical psychologists must complete several years of part- time pre-doctoral externships and a full year internship prior to being graduated. Some psychologists choose to pursue board certification from the American Board of Professional Psychology (ABPP), which offers certification in 13 distinct clinical specialties. Board certification is earned through a series of comprehensive written and oral examinations administered by a committee of clinical specialists.
Clinical psychologists are qualified to provide a range of mental health services such as comprehensive psychological evaluations (tests of cognitive ability, social/emotional functioning, personality assessment, neuropsychological, and academic functioning), various forms of psychotherapies, including but not limited to treating individuals, couples, families, and groups. Clinical psychologists can also be qualified to serve as consultants, researchers, scholars, and teachers.
It should be noted that the term “psychologist” is a legally protected title in the state of Illinois. This means that in order to be called a psychologist, one has to have completed a doctoral course of study and be licensed by the Illinois Department of Professional Regulations. Licensing requirements vary from state-to-state, though clinical psychologists need to be licensed in the state where they wish to practice. 1,750 hours of supervised post-doctoral experience is also required in order for clinical psychologists to be considered for licensure in Illinois.
Social Workers who provide therapy are Master’s level clinicians who have completed a 2-year postgraduate academic program along with a 2 year practicum in Social Work from an accredited university. Social Workers must be licensed by the state in which they practice. A social worker who has just finished her MSW (Master of Social Work) must pass her first licensure exam. This will enable her to have her name listed, followed by the letters LSW. In order for a social worker to open a private practice he/she must then become an LCSW, (Licensed Clinical Social Worker). In order to accomplish this he/she must 1) complete at least 3000 hours of supervised post graduate experience in diagnosis, psychotherapy and assessment based treatment, 2) pass a second licensure exam. Some social workers continue on for their doctorates, which will be noted by a PhD or DSW following their names.
Mental Health Counselors are Masters level clinicians (LCPCs) who can provide psychotherapy and counseling. They are also trained in psychological evaluation but to a much more limited degree than psychologists. What distinguishes MHCs from social workers or psychologists is their emphasis on prevention via psycho-education and a holistic approach to treatment. Mental health counselors receive training via a 2-3 year post-graduate program which involves coursework and 600 hours of pre-masters supervised experience at various externships. Upon graduation, they are awarded a degree in mental health counseling (MHC). However, they can only sit for licensure after they have completed 3,000 hours of post- masters supervised clinical experience.
Psychologists, social workers and mental health counselors often receive further training in clinical sub-specialties such as cognitive behavior therapy, marital therapy, group psychotherapy, psychodynamic psychotherapy and psychoanalysis, or in the treatment of eating disorders or substance abuse disorders, to name a few. In should be noted that Marital and Family therapists (LMFT) may be trained specifically in their area, without first receiving a pre-specialty degree in social work, psychology, etc.
Licensure regulations vary from state to state, so it is important that the therapist be licensed in the state where they are providing treatment.
A NOTE ON PSYCHIATRY
Psychiatrists are physicians who have completed 4 years of medical school and a post-medical school residency training program in psychiatry. Some psychiatrists obtain additional board certification in child psychiatry or geropsychiatry (geriatric treatment). Psychiatrists are qualified to evaluate for medication treatment and can dispense psychiatric medications to treat symptoms such as depression or anxiety. If psychiatric medications are necessary in the treatment of any psychiatric disturbance, they should only be dispensed by a qualified and licensed psychiatrist (as opposed to a general medical practitioner or other medical specialty).
Although psychiatrists are most often utilized for medication evaluation and treatment, some psychiatrists will engage patients in psychotherapeutic treatment. To that end, some psychiatrists receive further clinical training in psychotherapy.
The road to recovery via psychotherapy can be exhilarating, painful, difficult and enlightening. Most often psychotherapy evokes all of those feeling as well as a myriad of others. What is most important is that the treatment be provided by someone who is well trained, competent, experienced and licensed in their profession. Although this is not a fool-proof system, it certainly ensures a greater probability that you will be effectively treated with dignity and respect in a highly confidential, safe setting.