How to Find a Therapist

I can imagine that trying to find a mental health provider might feel like a daunting task, especially with so many different suffixes. You’ll see PhD, PsyD, LMFT, LPC, or LCSW. You also might see M.D., MA or the term Psychoanalyst. What do they all mean, you might wonder? The following is my attempt at distilling the various options in a quick and concise manner. That way, you, the consumer, can be better informed about the various levels of credentials and corresponding training, enabling you to make the best choice.

Are all THERAPISTS the same?

The term " Psychotherapist" is actually an unregulated title, meaning that anyone can use it to identify the type of work they do. There are no legal restrictions on designating oneself as a psychotherapist. The training and experience of each of these professionals is different and therefore their approach to psychotherapy will most likely be different. Typically, psychotherapists are one of the following:

Clinical Psychologist
A Clinical Psychologist is an individual with a doctoral degree (usually a Ph.D. or a Psy.D.) in clinical psychology who has training and experience in understanding human behavior, brain-behavior relationships, and the diagnosis and treatment of emotional disorders. They may provide psychotherapy, psychological testing, supervise other mental-health providers, or teach. Clinical psychologists have acquired their skills through a rigorous graduate school curriculum that is accredited by the American Psychological Association, received substantial training experiences in mental health settings, extensively researched an area of academic interest, and written and defended a dissertation. Because of their doctorate level training, clinical psychologists can also pursue specialized training in neuropsychology, forensics, industrial psychology, expert witness, and family mediation for the court system. In order to become licensed to practice psychology, individuals must complete an approved internship, receive significant post-doctoral experience under supervision, and pass a series of licensing exams.

Psychiatrist
Psychiatrists are physicians who earned a medical degree (M.D.) and completed specialized training internships and residency in psychiatry (a medical specialty focusing on the study, diagnosis, and treatment of mental illness). They often go on to train in post-doctoral fellowships in psychiatry and have ample psychiatric hospital experience. Psychiatrists are specialists in the prescription of psychotropic medications, and are the only mental health specialists who can prescribe medications that treat psychiatric conditions (except in the US Army, Illinois, Louisiana, and New Mexico. Psychologists also have prescribing privileges in those states/jurisdictions).

Clinical Social Worker
A Licensed Clinical Social Worker (LCSW) holds a masters degree in social work. Many go on to secure further clinical training in areas of specialized interest. They are trained in both psychotherapy and social interventions aimed at helping the individual cope with problems in his or her environment and/or relationships with others. They may also provide case management and community consultation, but cannot do psychological testing, nor prescribe medications.

Marriage and Family Therapist
MFT’s (individuals with a Masters degree in marriage and family theory) may become licensed by the state to practice psychotherapy. MFT’s generally focus on diagnosis, treatment, evaluation, assessment, counseling, and management, of mental and emotional disorders, whether cognitive, affective or behavioral, within the context of marriage and family systems.

Counselors
Counselors (usually individuals with a masters degree in education, counseling, or psychology) may become licensed by the state to practice counseling. Their designations are usually Licensed Professional Counselor (LPC) or a Master’s of Arts or Science (MA or MS) with a particular focus in Clinical Psychology. Counselors generally focus on problem solving, prevention, development, and adjustment. They often provide psycho-educational techniques focusing on lifestyle and career development, social, cultural, or family issues, and substance abuse.

Psychoanalyst

Psychoanalysts already have a matriculated degree (such as a psychologist, MFT, or psychiatrist) but are interested in pursuing the study of psychoanalysis, which is often another 4 – 5 years of training! The psychoanalytic doctorate is made up of two parts: a clinical training component followed by a research component. The degree usually consists of undergoing one’s own psychoanalysis (meeting with a psychoanalyst 3 – 4 times a week), methodology seminars, research workshops and writing a thesis.

Choose Life

"Choose life."  That's God's call for us, and there is not a moment in which we do not have to make that choice.  Life and death are always before us.  In our imaginations, our thoughts, our words, our gestures, our actions ... even in our nonactions.  This choice for life starts in a deep interior place.  Underneath very life-affirming behaviour I can still harbour death-thoughts and death-feelings.  The most important question is not "Do I kill?" but "Do I carry a blessing in my heart or a curse?"   The bullet that kills is only the final instrument of the hatred that began being nurtured in the heart long before the gun was picked up..."

Henri Nouwen

Psychotherapy is for "Crazy people" - or is it?

Psychotherapy is for “Crazy People” – or is it?

Although many of Sigmund Freud’s theoretical ideas have since been debunked or altered in significant ways since his lifetime, one the ideas of his that I find still relevant today is the idea of defense mechanisms. I say this because I see them emerge all the time in my psychological practice. Defense mechanisms operate at an unconscious level and help ward off unpleasant feelings (i.e. anxiety) for the individual. Freud’s original list included such defenses as projection, regression, displacement, and denial. (More have been added since his time!)  It’s important to note that even healthy people use different defenses throughout life. For instance, sublimation can be useful. Sublimation is turning an uncomfortable feeling into something acceptable – like turning aggression into boxing or marathon training. It can be an adaptive response to an uncomfortable feeling. A defense mechanism becomes pathological only when its persistent use leads to maladaptive behavior such that the physical or mental health of the individual is adversely affected. For example, an individual who experiences social anxiety may avoid so many social situations that her/his ability to engage in normal adult behavior becomes compromised. Perhaps the individual has dreams and goals for his/her life but can never take the steps toward their fruition, leaving them feeling stuck and depressed. One of the defense mechanisms I most often see is that of Withdrawal – or what I like to call avoidance. Withdrawal entails removing oneself from events, stimuli, and interactions to avoid being reminded of painful thoughts and feelings. The common stigma attached to psychotherapy is that it’s for “crazy folks.” Or that it’s an endeavor only to be pursued for “weak” people. On the contrary, pursuing and committing to the process of psychotherapy actually takes a lot of courage and has consistently been shown to result in greater psychological health and more contented human beings. Believing that therapy is only for weak or crazy people is actually a perfect example of a defense mechanism – it’s finding a very creative way to avoid an uncomfortable situation BECAUSE of the difficult feelings that can emerge with authentic self-reflection.  Once an individual begins therapy, it’s also not uncommon to see missed or cancelled sessions (always for VERY good reasons, mind you!) or discussing safe topics and avoiding the more difficult ones.  The human being is very creative and often committed to avoiding the very thing that needs to be addressed. Hopefully, with the assistance of a safe and genuine psychologist, people can overcome humanity’s natural tendency toward avoidance and face their pain (or difficult feelings), allowing themselves to experience greater freedom and healing.

 

 

Six therapists tell funny, touching, thought-provoking moments...

Psychotherapy is a mysterious art, and this mystery scares some people away. One in four Americans are afflicted with mental illness, but many avoid seeking help because of the shame and stigma about having and treating these problems. We’d like to present one entertaining, educational, and meaningful solution.

On Friday, September 19, a group of Pasadena therapists will demystify psychological treatment by giving a glimpse behind the doors of their own practice through a spoken-word performance. In the tradition of TED Talks or the Moth Radio Hour, these are funny, moving, engaging ten-minute stories from six real clinicians — client information appropriately disguised to protect confidentiality, of course.

This event is presented by the San Gabriel Valley Psychological Association (SGVPA) to raise awareness and funds for the San Gabriel Valley chapter of the National Alliance on Mental Illness (NAMI-SGV), in honor of National Psychotherapy Day. There will be wine, light appetizers and live music during intermissions to promote a festive, meaningful evening for all in attendance. 

Please join us for “Moments of Meaning” at the Senior Center in Old Pasadena (85 E Holly) on Friday, September 19th from 7 to 9pm. The cost is $15, and seats are limited. Email to RSVP: stephanie@drstephanielaw.com

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