What are the differences between mental health providers: a counselor, a therapist, a psychotherapist, a psychologist, and a psychiatrist?
Mental pain may seem less dramatic or immediate than physical pain, but it is more common and may be harder to bear. The frequent attempt to conceal mental pain increases the burden: It is easier to say "'My tooth is aching' than to say 'My heart is broken.'" (Author, C.S. Lewis) It is easier to see a broken arm than a broken mind or to see bleeding wounds rather than a mind that isn't in touch with reality or hears voices you don't hear.
That is the reason it is smart to know about the different providers, to match the one(s) that will be best suited to meet a person's needs most effectively. The time spent researching the best providers for a client's specific needs is time well spent and most likely will end up saving future time, and costs, and increase the possibility of outcome success.
No one bats 100%. No football quarterback passes with 100% success. No parent, child, person, patient, or client is perfect. A doctor is not godlike, even though highly educated and trained. They will not save every patient. Not every therapist is 100% successful, nor does every psychiatrist prescribe the exact medicine every time as all patients react differently to different medications. Knowing that, we can still make the best decisions possible for our care, and knowing the type of care, and the specifics of our needs, will greatly increase a positive outcome for the care we seek.
Empowered with knowledge about different types of providers, researching them online, through their licensing boards, and from family or friend referrals and recommendations is a bonus.
Just like your selection for the type of medical provider you use is important, so is the type of mental health provider you decide to use for mental health services. You wouldn't want to make an appointment with an ear-nose-throat specialist if your arm is broken or you're having problems with your feet. You'd carefully research the doctors for the issue you were addressing and then research to see if they were the best for your care.
Checking out your medical doctors' credentials and references is important, and the same scrutiny should also apply when seeking mental health care.
Do you know the differences between different mental health professionals?
Below is a quick overview of the difference between mental healthcare providers, their licensures, and how clients can select the best professional to address their needs.
If a client (or patient) needs specific mental health care, the professional they choose may shorten the time, cost, and successful care outcome. Do your research!
Some mental health providers can prescribe medications, while others cannot.
Some mental health professionals focus on medications, while others aim to "get to the root problem" through talk therapy, feedback, discussions of past and present events, or evaluating behaviors and outcomes.
Some mental health providers work with specific age groups; others work with all ages;
Some work in specialized fields; others work with many other mental health or counseling issues.
If that isn’t confusing enough, to top it all off, the title "therapist" and "counselor" are used interchangeably. Lawyers are often called "counselors" in the courtroom, but they are not mental health counselors and mental health counselors are not lawyers; they are therapists.
Confusing, to say the least, isn’t it?!
First, let's look at Licensure Requirements: Some mental health providers carry multiple licensures in their state or even in other states. Each state has different licensing laws that licensed professionals within that state must meet for specific credentials or licenses. These requirements usually include specific educational degrees, documented experience with an approved supervisor in the licensing field, application, approval of and registration with the state for the license, and continued CEU (continuing academic requirements) to be met and documented for continued licensure coverage.
Not all states require licensing, so always verify with your state to see what standards are needed to ensure you seek care from a qualified professional.
How to Verify a License:
Most states have online license verification, or patients can call the capital government office for each state for information.
Most insurance companies require that professionals on their provider panels be licensed; however, some states' requirements changed due to shortages of providers in the medical and mental healthcare field. Contact your insurance carrier for their "provider panel list," which should include licensee information.
Most providers list licensure information on their websites. If not, call their offices.
What are the differences between mental health professionals, talk therapists, psychologists, and psychiatrists?
"Talk Therapy" is usually provided by a licensed professional who assists clients with mental health, emotional, life, and relationship challenges. Clinicians have a Master’s degree (Master of Science or Master of the Arts) or Doctorate (Ph.D., PsyD) in a mental health-related field such as psychology, social work, counseling, or marriage or family therapy.
Most are allowed to provide clients with a diagnosis, but each state varies, so it's important to verify the licensing information of the different professionals within your state.
“Talk therapy” professionals may include:
LPC: Licensed Professional Counselor (LPC can diagnose mental illness to plan treatments for each individual, allows insurance to pay for mental health counseling)
LCSW: Licensed Clinical Social Worker (authorized to assess, diagnose, and treat individuals and families of all ages & economic groups. Insurance will cover LCSW diagnosis).
LMFT: Licensed Marriage & Family Therapist (MFTs can independently diagnose by the DSM, allowing insurance to cover sessions that carry a diagnosis).
LCDC: Licensed Chemical Dependency Counselor (LCDC can diagnose substance disorders but is not qualified to treat a person with a mental health disorder or provide family counseling to an individual presenting problems that do not include substance use).
LMHC: Licensed mental health counselors (LMHC can make a diagnosis for mental health issues, and allow for insurance coverage).
What does "Associate" by a license indicate?
That is a professional who has received their Master’s degree but is still "under the supervision" of a licensed, approved supervisor, and who is still obtaining the required hours of experience working in the profession. Once their supervisor(s) and the state licensing board approve their testing scores and application, they can seek approval to operate under a full license.
What does "S" after a license indicate?
It means that the licensing board in that state has recognized that the professional has a higher level of experience and skills, has approved that professional to carry a "supervisor" status in the state, and allows them to supervise new professionals entering the mental healthcare field. Supervisors are required to obtain continuing education requirements specific to their supervisory designation and their licensures.
Speciality Areas of Counselors and Therapists:
What are the specialty areas of counselors (also known as psychotherapists or therapists)?
The list is extensive and addresses almost every aspect of mental health except for medication management (provided by psychiatrists) and standardized testing (provided by psychologists).
To see a fairly complete list, check out the "Big List" of topics for current & future articles.
When seeking care, the first question to ask is probably, "What type of therapy do I seek?" Is it individual counseling, couples counseling, group therapy, family or marital therapy?
The second question might be: "What am I trying to address?" If there is a conflict in a marriage, you may want to seek the services of a marriage therapist. If it's agoraphobia, you may want to seek the services of a virtual therapist who addresses agoraphobia online until the patient can leave their home without anxiety or phobias.
If a client is elderly, the best services would be to seek those who work with the elderly population, and most likely accept their insurance if on Medicare. If it is for an adolescent who is struggling in school or "acting out", seek the care of a therapist who works with this age group, as many therapists don't. The same thing applies to all age groups; some work with children while other therapists don't; some therapists work with battered women, while other therapists don't. Some therapists will work with personality disorders such as narcissism or borderline personality disorders, while other therapists will not accept those clients and will refer them to other providers.
It's important to know the full range of specialty areas a therapist has if you are considering going to them. The same thing applies to psychologists and psychiatrists.
Due to the access now of virtual telehealth services, former barriers to care have been decreased. Some clients prefer virtual counseling, while other clients prefer in-office sessions. Both are face-to-face with the counselor, but in different formats (online or in-office).
Studies indicate equal positive outcomes in either setting. It no longer depends upon the "brick and mortar office location" as much and comes down to a client's preference, the experience and qualifications of the therapist, time and energy, and the travel (or lack thereof) to and from the therapist's office.
Many psychologists and psychiatrists now offer virtual sessions, as well as in-office sessions. This has resulted in shorter times between appointments and greater access to providers than previously available.
Psychologists (PhDs or PsyDs)
Psychologists have doctoral degrees and provide standardized testing, IQ testing, school testing, specialized assessments, and formal diagnosis of mental health illnesses or educational needs for schools, courts, and hospitals. They often consult with communities, diagnose and treat patients, and teach those pursuing the discipline. They may assess behavioral and mental function compared to a patient’s well-being.
They do not prescribe medication, and some may offer limited talk therapy, as their focus is usually on testing, research, and assessment. They must obtain a master’s degree that focuses on the mental health or psychology field, plus an advanced doctoral degree. They, too, must be supervised for a certain number of hours after attaining their degree to practice independently.
Psychologists may have one of two degrees, a Ph.D. or a Psy.D. In Ph.D. (Doctor of Philosophy) programs, the focus is tilted more toward research. A Psy.D. (Doctor of Psychology) the degree focuses more on clinical practice and less on research. Even though they hold a doctoral degree, they are not medical doctors (which a psychiatrist is). Insurance companies will cover psychologists, depending upon the service provided.
Some specialty areas of psychologists may include the study, research, and testing of patients related to:
Clinical Psychology
Counseling Psychology
Experimental Psychology
Forensic Psychology
Human Factors Psychology
Industrial-Organizational Psychology
School Psychology
Social Psychology
What’s the difference between clinical and counseling psychologists? While there’s substantial overlap between a counseling psychologist and a clinical psychologist, the main difference is that clinical psychologists focus on psychopathology (study of mental health conditions); while counseling psychologists may address emotional, social, or physical stressors in a patient's life. Clinical psychologists generally address more serious mental health issues.
Psychiatrists (MDs or DOs)
Psychiatrists are medical doctors who focus on mental health issues. Psychiatrists make diagnoses, like talk therapists and psychologists. However, talk therapists and psychologists cannot prescribe medications to treat mental health issues, but psychiatrists can because they are also doctors.
Psychiatrists must graduate from medical school, earning an MD (medical doctor) or DO degree, followed by at least four years of residency. They must then be tested for competency by a professional board (as are talk therapists and psychologists, but at a much higher level of knowledge as it pertains not only to mental health but also to the medical healthcare field).
Specialty areas of psychiatrists may include:
Child and adolescent psychiatry
Adult Psychiatry
Geriatric psychiatry
Addiction psychiatry
Consultation–liaison psychiatry
Forensic psychiatry (court-related)
Neuropsychiatry
Perinatal and infant psychiatry
Psychiatry: intellectual & developmental disabilities
Psychiatric psychotherapy
Academic psychiatry
Eating disorder psychiatry
Does insurance cover mental health professionals?
Insurance companies cover services psychiatrists, psychologists, and most mental health professionals provide. Insurance will only cover services if there is a medical diagnosis on the patient and for a type of service covered by the insurance carrier.
An insurance carrier may determine a different pay rate (or reimbursement), depending upon if a provider is "in-network" or "out-of-network." Some insurance companies may penalize their members (i.e. pay less) to force the members to seek care only from in-network providers, as the insurance company has a contracted lowered provider fee scale for those providers, and has greater access to all patient notes (due to provider's contract with insurance carrier), whether a client wants those notes released or not.
Insurance companies are all different and some will cover both in-office and virtual counseling. Some will cover group counseling, while others don't. Some insurance companies will cover family therapy, but not marriage therapy...while other insurance companies will cover both. Most insurance companies will cover individual therapy, depending on the diagnosis. (Mental health providers provide a diagnosis based on the DSM-5-TR; Diagnostic and Statistical Manual)
It's important to learn more from your insurance carrier if seeking care or payment coverage is dependent upon your insurance coverage plan.
The more you know about the choices you have for the care you seek, the better your choices will be.
Want to learn more?
Click here to read more about the difference between in-network and out-of-network professionals.
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