Common Questions About Counseling
By: Dr. Debra Moore, Ph.D.
Frequently when new clients phone me they have questions about the
various types of therapists and therapies. Psychiatrists...psychologists...social workers...marriage counselors...family therapists...-it can be quite confusing. And what is it you actually do? How long does therapy take? Will my insurance cover this service?
First, let's start with the various professional disciplines. Psychiatry is a medical specialty, much the same warlike oncology or surgery is. Psychiatrists finish medical school, then complete a residency in psychiatry. They are also trained in pharmacology and can prescribe medication. Many psychiatrists also have affiliations with psychiatric hospitals and can provide continuity of care if inpatient admission is needed.
Psychologists can generally be recognized by the Ph.D. or Psy.D. behind their names. We have a doctorate degree which has focused on personality development and the recognition and treatment of emotional conflict. We are also specially trained to administer various types of tests - personality, intelligence, and often career testing. In reality this is usually a small part of our practice, with most of our focus on counseling. Two other specialties are fairly similar and are designated by the initials LCSW for licensed clinical social worker or MFCC for marriage, family and child counselor. These therapists have at least a master's degree with focus on the relationships between individuals, particularly within families.
So now you have some understanding of the various professionals. How do you go about finding a therapist? You can always look in the yellow pages, and in fact many clients do come to us in that way, but it really is a shot in the dark method. A much better way is to have a personal referral. Studies estimate that about 60% of people see a therapist at some point in their lives. It is likely that one of your friends or family members can give you a personal referral if only you will ask. Your family doctor is another good source. If they are attentive to their patients overall well-being, they are quite accustomed to referring to mental health providers. They will not be surprised by your request. Also, if you need medication and are not working with a psychiatrist, they may also work with your therapist in prescribing.
If you are employed, your company may have an employee assistance program, in which case they will have referral names available. They may offer a few no-cost appointments with their own counselors. If your insurance is a managed care policy, you will probably have to select a therapist from their list and will most likely be restricted to brief therapy. Also, you may not be covered for family, marital or group counseling.
Once you have a name or two, phone the therapist and take a few minutes to ask questions and get a feel for the person. It's a good idea to briefly state what you are seeking therapy for and ask if this person has experience in that area. Don't hesitate to ask about fees, and if needed, whether they are willing to lower their fee based on your circumstances.
An initial session is a time for both client and therapist to decide whether they are a good "fit". Psychotherapy is a uniquely personal, intimate relationship and it is vital that you feel understood and respected by your therapist. A sense of trust is imperative. If you are not reasonably comfortable it is OK to speak with another therapist and compare your feelings.
One question that is many new clients have is how long therapy will take. This is tough to answer since it depends on many factors - the issues you want to work on, your pace and expectations, other situations that may emerge as we work together. Many times the question reflects a need to know that the therapist will not unnecessarily prolong the therapy. If this is your concern, be honest and share it. Use your intuition and common sense to evaluate the therapist's answer.
Therapy is in a basic way like any contractual agreement. You are hiring a professional to provide a service based on their expertise. You are not giving up control. You can disagree with the therapist and decide to stop at any point. The most important advice I can give you is to trust your gut and always honestly and openly share your concerns. You and the therapist will both benefit.
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