What’s the DIFFERENCE? Choosing YOUR Mental Health Professional | Kati Morton
By Bryan Wright
Psychiatrist, psychologist, therapist, counselor, licensed counselor, LCSW, LMFT! Today we’re going to talk about all the different types of mental health professionals out there. What does it mean and what kind of help can they offer? *intro music* I tried to put these in an order that kind of makes sense, where we go from potentially least amount of school and lowest cost, up to the potentially most amount of school and highest cost and I hope that kind of makes sense as I roll through these and I’m gonna reference my notes because I actually had to do a surprising amount of research to figure this out for you so let’s get into it! The first mental health professional I want to talk about are counselors. Someone can call themselves a counselor by getting a four-year degree from a college and then getting trained in whatever area they work in. A counselor can work in a treatment facility and be like an addiction counselor, recovery counselor or they can work in a school and be a school counselor. Now a counselor, such as this, isn’t someone who can offer a diagnosis, or would put together a treatment plan for you. These are usually people that kind of guide and support you along the way and get you into the proper help that you really need. So these can often be the first person you have access to and are oftentimes free through different programs, whether it be a school or addiction treatment or anything like that. The next mental health professional I’m going to talk about are licensed professional counselors, or LPCs. That’s the acronym still put at the end of their name, telling you what their licensure is. Now I had to look up a lot about licensed professional counselors because I didn’t really know that much about it and I don’t have any colleagues that I interact with who have this. But from my research it sounds like they do the exact same thing that I did. They get a four-year degree in psychology from undergraduate program, then they go on to get their masters, two years, then they gather 3,000 hours and they call them 3000 clinical hours, meaning I’m sitting down with a client and I’m talking or I’m doing group therapy, some kind of therapeutic hours and then they take a licensing exam. Their licensing exam is called the “National Counselor Examination” or NCE, and then they’re licensed, and they can practice just like I do. Asked what licensed professional counselors do and how it can feel is a client, in truth, and all the reading that I did, it sounds very similar to what a therapist does, to what I do. They can offer diagnoses, offer treatment to you, they create treatment plans, they can let you know we need a higher level of care, they can do behavioral techniques. It sounds like they pretty much do the very same thing. The only thing that I found a little different from literature about what I do is that with licensed professional counseling, they talked a lot about addiction and so I wonder if that’s something that maybe they’re more specialized in or something they have more emphasis on? So I guess I need to do even more research to find that out, but that’s really the only difference. The next mental health professional that I want to talk about is myself! An LMFT. What does that stand for you might wonder? It’s a licensed Marriage and Family Therapist. Now for many of you who’ve been watching me for a long time you’ve heard this story but what I did to become a licensed Marriage and Family Therapist is, I got a four-year degree in psychology from Pepperdine University, and then went back to Pepperdine, cause I couldn’t get enough and got a master’s. So two more years and got my masters in clinical psychology with an emphasis on marriage and family therapy. Then I got out, I gathered 3000 clinical hours and then I studied to take my licensing exam and here I am! Just, you know, I don’t know, like, 12 short years later. As for what I can do as a licensed Marriage and Family Therapist, I can diagnose and I can treat a wide variety of mental illnesses, I can put together treatment plans, I work in conjunction with hospitals and inpatient wards and pretty much what it is, is you come into my office, we talk about things I offer some tips and tricks and tools and you use utilize those in your regular everyday life and we work through things. They like to think of an MFT as a person in relationship model. And that would kind of make more sense as we go through the next few types of mental health professionals, but I work a lot with relationships. Relations with yourself, relationships with others, and improving those. The next mental health professional that I want to talk about, are licensed Clinical Social Workers or LCSWs. And that’s the acronym that you’ll see at the end of their names. Now licensed Clinical Social Workers have been around the longest. They were the first. That was like the first program available for people who wanted to offer up therapy and just like I did, just like the licensed professional counselors do, they go through four years of undergrad education to a master’s degree in clinical social work, they gather 3000 clinical hours and they study and take licensing exam. Now because I have a lot of friends and colleagues who are LCSWs, I know firsthand that the testing is very similar and we could actually study together and we all passed! So to me, as a client, if you went in to see an LMFT or an LCSW or even an LPC, I don’t really think you’d feel any different. As always the most important component in therapy is that you actually like the therapist and you feel connected to them. You feel like you can tell them anything. And I think that that is really what we need to focus on rather than what particular degree they received. Now social workers were created out of a need. Out of the hospital setting. That’s really where they came from and so I like to think of the model that they work within is person in environment. So a lot of social workers, like my friend Rocio, who has been on the channel, she goes out into the field and go to people’s houses and makes sure that they have the programs and things set up for them so they can get to and from work or group or whatever it is that they’re needing in life. She makes sure that their whole environment is set up to be therapeutic and helpful for them. The next mental health professional that I want to talk about, are psychologists. Now a psychologist, unlike LCSWs, LMFTs and LPCs, have not only a four-year undergraduate degree, but then a four-year doctorate program. These are doctors! You call them, you know, like Dr. Alexa Altman. She’s a psychologist she got four more years after her four year undergrad, unlike me who did two years. But similar to LCSWs and LMFTs and LPC’s they also finish their four-year doctorate program and they gather clinical hours, they gather 3,000 clinical hours and then they sit for their licensing exams. Now I don’t know, I haven’t talked to Alexa about what the licensing exam really looks like, because she took a while ago as well, but I would guess that it is very similar, however, people who have a Doctorate can, this is the one big difference, they can focus on research. They don’t have to be clinical and that is the difference between of PhD potentially and a PSYD, and that’s why a PSYD was created because the clinical doctorate program. Now that doesn’t mean that someone with a PhD couldn’t have done a clinical emphasis and have gathered clinical hours and become licensed, that’s just why there are those two options. For those of us in school we can kind of choose early on whether we want to focus on potentially research-based, or we want to focus more on clinical treatment, one-on-one, person-to-person. Due to the fact that psychologists kind of come out of the research realm, that’s where it was kind of born out of, a lot of them do much of the testing and assessment that I refer my clients out for. Now that doesn’t mean that I can’t do it as well but I have to go through these certain trainings and I just think that maybe it’s because it’s born out of research, that a lot of psychologists are interested in testing and assessment. But other than that, just like I said before, as a client coming to see a psychologist or an LCSW, LMFT, LPC, it won’t feel any different. Just like Alexa, she works out of her office, one-on-one, with clients just like I do, where you come in and you talk to put a treatment plan together and we work towards our goals. The only big differentiation between any of these is honestly, specialties. What are they trained in? What do they work with the most? What do they understand the most? And as a client trying to find the proper fit, I think those are the questions that you really need to be asking. What are you specializing in? Have you worked in an inpatient ward with that particular issue? What is your training like? Did you do CEUs in these? And CEUs are ‘Continuing Education Units’ that we all,, LPCs, all the people I’ve talked about are required to do, every two years, are responsible for 36 hours. So I would just ask for more information on their specialties so that you can make sure you’re getting a treatment that you need and deserve. The last mental health professional I want to talk about are psychiatrists! You guys remember Barry. He came on. We sat in his office, we talked about medication and all of those things because Barry is a psychiatrist. He is a medical doctor. He went to medical school and that’s really what differentiates them from all of the other mental health professionals. He not only got his four-year undergraduate degree. He did years of medical school, two years of residency and then went on to, you know, take his boards and all the other things that come along with being a medical doctor and so just like we call psychologist doctors because they have their doctorate we call psychiatrists doctors. As to what psychiatrists can do, they can offer therapy and mostly they prescribe medication. Back-in-the-day, psychiatrists used to do hour-long sessions where they would offer therapy just like I do, just like LCSWs and psychologists do and then they would prescribe medication as needed. However, due to the way that our system kind of works, and insurance, you know, wanting to pay them less and less for less and less time, most psychiatrists, nowadays, spend anywhere from 15 to 30 minutes with you doing what we call “med checks.” They want to meet with you, they want to see how your side effects are, what you’re feeling, if you’re improving if you have anything going on, everything like that and it’s mainly focused around how the medication is helping or not helping you. They can also do a lot of research. Many psychiatrists don’t actually do clinical work where they see clients. A lot of them will be in labs and running studies. I’ve heard from many of you that when you first went to see a psychiatrist they often aren’t as warm and fuzzy as therapists and I think that’s really because, first, they’re pressed for time. If they are seeing someone every 15-30 minutes, I don’t even know how they manage their schedules. But also it comes out of the medical model where they do a lot of research and they do a lot of behind-the-scenes stuff and they read more on medication and not so much on clinical, you know, interaction or bedside manner. But there are a ton of wonderful psychiatrist out there and there are some that don’t do any clinical work at all and do only research. And the greatest thing is that I know a lot of wonderful psychiatrists. And they work with me on many clients that we share and they are all part of your treatment team, especially if you are changing medications, or going through any kind of side effects, they’re the one I’m gonna send you to you and the one I’m going to talk to make sure that you’re going to help you want. I hope you found that helpful, I know we use a lot of different acronyms and there are a ton of different mental health professionals and I hope that just kind of helps you better understand what they’ve done in school, what their specialties can be and how they can best help you. And as always know that you don’t have to be at the end of your rope to see a therapist. I see a therapist and mainly I do it because I need to vent, and I need someone to talk to and I need an outside perspective and I think getting into therapy sooner rather than later can save us all a lot of pain and hurt. I find that by going in early and before I feel really bad, I end up feeling better much more quickly and it’s easier to kind of nip it in the bud. Ideally I would love all of you to be able to have a therapist on board, a psychiatrist, as well as your general practitioner, your regular medical doctor, because that way we have all bases covered, right? We have mental health, physical health, and the pharmacological stuff that can go on with different medications they can put you on. I know that not all of you have the ability or the resources to do that and so a very slimmed down version of what a treatment could look like could be seeing your school counselor, or recovery counselor, that comes at a very low cost to you, and seeing psychiatrist, that hopefully your insurance will cover and that can be enough to get us through. But know that you need more support there’s no shame in asking for it. People who get into this field, any kind of mental health professional, do it because we want to help people. And want to be there for you. We want to help understand what’s going on and give you the treatment that you need and deserve. I love you all! If you’re new, click here to subscribe and I will see you all next time. Bye!