Types of therapists

Dear Alice,

I'm thinking about seeking therapy for my anxiety and I was wondering if you could talk about the different types of therapists out there. I know the difference between psychologists and psychiatrists is a psychologist didn't go through med-school and so can't prescribe drugs, but what about cognitive-behavior therapists versus... well, whatever else is out there?

Thanks!
Thinkin' about Therapy

Answer

Dear Thinkin' about Therapy, 

Addressing anxiety is no small feat, and it sounds like you’re headed in a great direction by considering therapy. As you’ve gleaned, a therapist can refer to a number of different specialists. Along with considering the type of mental health professional you’re looking for, you may also consider which method of therapy best fits your needs and goals. Asking a few questions about a therapist’s approach to treatment may help you find one that’s a good fit for you. 

Many different mental health professionals can provide counseling and therapy. Some of the types you may be searching for could include: 

  • Masters-level clinicians: These are mental health professionals with a masters-level degree. Some of the certifications you may come across include licensed professional counselor (LPC), licensed clinical alcohol & drug abuse counselor (LCADAC), or a licensed marriage and family therapist (LMFT). 
  • Clinical social workers: These are social workers who specialize in using therapeutic techniques to support a person’s mental health. Some of the licenses they may hold include a Licensed Independent Social Worker (LISW), Academy of Certified Social Workers (ACSW), or a Licensed Clinical Social Worker (LCSW). 
  • Psychologists: These professionals hold doctorate degrees in clinical or counseling psychology. Some of the degrees they hold include a Doctor of Philosophy (PhD) or a Doctor of Psychology (PsyD). 
  • Psychiatrist: These mental health professionals are medical doctors with the ability to diagnose and prescribe treatment for mental health. They may have a Doctor of Medicine (MD) or a Doctor of Osteopathic Medicine (DO). 

Within their fields, some mental health professionals may specialize in certain conditions, life experiences, or identities. For example, someone may choose to seek out a mental health professional that has experience with managing chronic illness. 

In addition to having a specific degree, licensure, and specialty, mental health professionals can use a variety of therapeutic techniques. A number of these may help your anxiety, so it’s about finding the approach that best fits your needs. Some of these approaches may include: 

  • Cognitive behavioral therapy (CBT). CBT is a strategy that helps people recognize, understand, and change negative thought or behavior patterns. This supports the client's thinking and reacting in more positive ways. CBT is often used to help with anxiety disorders, bipolar disorder, and depression, among other mental health conditions. 
  • Dialectical behavior therapy (DBT). DBT is a type of CBT that teaches the patient skills to help tolerate stress, regulate emotions, and improve relationships. DBT is often used to help those diagnosed with eating disorders, borderline personality disorders, or suicidal ideation. 
  • Exposure therapy. This exposes the patient to situations or triggers that are upsetting or disturbing to them. Exposure therapy may be used with disorders such as obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). 
  • Interpersonal therapy. This is used to address interpersonal issues related to depression in adults. This therapy helps the patient express their emotions in a healthier way. It also improves relationships or helps resolve conflict. 
  • Mindfulness-based therapy (MBT). This type of therapy uses mindfulness techniques to help the patient focus their attention on their immediate experience. Using MBT may help clients be less judgmental and more accepting of their anxiety. It can also bring more awareness to how thoughts and feelings come and go. 
  • Psychoanalysis. Often psychoanalysis is used to examine unconscious emotions and behaviors that may lead to unproductive patterns. This process allows the client to address them and move forward positively. 
  • Psychotherapy (also known as talk therapy, counseling, or just therapy). This type of therapy uses a more general strategy that consists of talking with a mental health professional about any thoughts, feelings, past experiences, etc. This is done as a way to help you deal with the situation. 

When it comes to anxiety treatment, the National Institute for Mental Health recommends cognitive behavioral therapy, sometimes in combination with medication. That being said, you may find that some of these other techniques are more effective or more aligned with your goals for treatment.  
If you find yourself overwhelmed by the variety of options, you may think about asking the mental health professional more about their approach to treatment and their training. Some questions to consider include: 

  • What kind of training do they have in treating anxiety disorders (or whatever concern you have)? 
  • Do they have specialized training for working with particular populations? 
  • What’s their approach to treatment? 
  • Can they prescribe medication (if needed) or refer to someone who can? 
  • How long is the typical course of treatment? 
  • How long is each individual session? 
  • Are family members asked to participate in therapy sessions? 
  • What kind of insurance do they accept? 

Some mental health professionals may not be a good fit for your personality or what you’re going through. This is normal, and it may take a few sessions to find the best fit for you. Establishing a rapport with your mental health professional may take some time as well. Taking the effort to establish achievable goals and expectations with a trusted mental health support can greatly improve your experience and outcomes. Even if it takes a few tries, finding someone with whom you can speak openly and honestly which may be more beneficial to you in the long run. 

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