Different types of therapists and finding one that works for you

patient-therapistWhy are there so many types of therapists? It seems when you look for a therapist, you’re bombarded with one suffix after another: PhD, MSW, MFT, PsyD, etc. It’s confusing and it can be annoying. Well this is what I’m hoping to clear up.

One of the reasons I created this site was because I realized how confusing psychology can be and how complicated it can be to just understand what therapy is. Most people don’t really know much behind the superficial aspects of psychology, therapy, the research in the field, etc. First of all, not all therapists are psychologists and not all psychologists are therapists. There are some psychologists who only do research. Also, therapists can have a masters degree to practice clinical work; thus, they are not technically psychologists – they simply practice psychology. Also, psychologists are not psychiatrists. Psychologists go to graduate school for a Ph.D. or a Psy.D. (I’ll explain more later), whereas, psychiatrists get their MDs and go to medical school. They learn clinical tools and psychotherapy in their residency as well as in their postdoctoral fellowship if they choose, but it just depends on each person and the level of training they want to receive.

There are several areas of clinical psychology and there is a difference between people who practice “psychology” and people who are actually “psychologists.” Why is this important? Because those people differ in the type of training they receive. It’s not necessarily that one is better than the other, but it depends on what you’re looking for.

These differences in psychologists are confusing. I too had to learn about these levels and choose my own path when deciding on a program. My first experience with psychology in college came during an internship at a clinic in San Diego. There were several levels of clinicians from MSWs (Masters in Social Work) to LCSWs (Licensed Clinical Social Worker) to MFTs (Marriage and Family Therapists) to PhDs (Clinical Psychologists) to PsyDs (Clinical Psychologists) to MDs (Psychiatrists). And just so you know, we as Clinical Psychologists cannot prescribe medications (except for a couple states in the US) – that is what psychiatrists do. All of these are often housed under the “therapist” umbrella.

Even within the realm of Clinical Psychology PhDs, there are even more options. There are professional schools such as California School of Professional Psychology (CSPP), plus National and Alliant University and then there are research universities that more people know about, such as USC, UCLA, Yale, University of Washington, Duke, Harvard, etc. The difference is that professional schools, National and Alliant Universities are generally more clinically focused and don’t do as much research. On the other hand, research universities take a more scientific approach to both clinical work and research. They put a greater emphasis on using research to understand what people are going through and treat them accordingly (while at the same time understanding the “human” component).

So what does all this mean to you? It means that when you are seeking a therapist, you have lots of options. Each of these options carries different generalizable orientations. Some do a more old school, free-flow, psychodynamic type of therapy with longer treatment periods. Conversely, those from a scientific orientation operate using what’s referred to as Evidence-Based Treatments (EBTs). These are scientifically supported treatments that work. Think about it like a clinical trial drug study that undergoes multiple testing sessions where people are randomly assigned to different treatments and then tested to see which provides better results. These treatments are designed to be time-limited with the idea being that by the end you have made significant progress and are no longer experiencing many of the complaints you initially came in with. In real-world practice, treatment may take longer depending on individual issues, but these EBTs are usually time-limited and goal-oriented. These treatments often come with homework and designated goals along the way, but with built-in points to be able to adapt to individual clients, so don’t get too scared if it sounds too rigid. A couple of these evidence-based treatments I have talked about on the blog thus far are Cognitive Behavioral Therapy and Acceptance and Commitment Therapy.

The bottom line is that do what you feel comfortable with. Certain people will work better with certain approaches. People who just want advice from a third party’s perspective and have relatively minor life complaints will benefit from a different type of treatment than someone suffering from a more severe mental illness. So take that into consideration as you move forward and do what is best for you. If you find a therapist that you gel with, then go for it. If a particular type of intervention works for you, then go for it. Regardless of what you choose though, I encourage you to ask questions. Don’t be afraid to ask your “therapist” what their psychological orientation is, what kind of treatment plan they plan on using, how they plan on moving forward. Be an active participant in your well-being. You ideally do the same with your own medical care, so do it with your psychological care. We want what’s best for you, but you know you better than anyone.

The analogy I like to relate to choosing a therapeutic intervention is choosing a medication.  With medications there are different dosages and different meds that all act towards the same thing to fight the same disease. Similarly, there is a buffet of therapeutic interventions available to treat the same mental illness. Some will respond better to certain types of treatment depending on their own state of being. This is true for both pharmacological interventions and psychotherapeutic interventions.

There are great clinicians at any level you choose, so it’s not about which is better or worse. It’s simply a matter of finding one that works for you and with you.

Related articles: Acceptance and Commitment Therapy, How important is the client-clinican relationship?

Rubin Khoddam, PhD Clinical Psychology student at University of Southern California, founder of Psych Connection.

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7 replies

  1. While it’s true that many psychiatrists (MDs) focus on medical and biological treatment of mental illness, many of us begin supervised psychotherapy training in our first year of our four year residencies. Those who go on to do fellowships have even more opportunity to pursue intensive psychotherapy training. Six years of supervised psychotherapy training is more than many PhD psychologists receive.

    • Hi Jessica,
      Thanks for your note! I in no way meant to imply that psychiatrists are any less trained, but that they generally are more focused on the biological treatment of mental illness, which is just as important in some cases. There are many psychiatrists who do clinical work and that is great as well – so long as they did receive the training that you talked about. PhD psychologists are supervised for several years as well, including 4-6 years pre-doctoral training with one year being a full-year of full-time clinical work (~1500-2000 hours) plus an additional 1-2 years post-doctoral training are necessary for licensure. All the different variety of clinicians offer something great, so thank you for your work! I also added a section to my post to reflect my respect for all clinicians. Thank you again. Take care. PS you have some really great content on your site! Definitely keep in touch and hopefully we can work together towards a common goal!
      -Rubin

      • Thanks for the thoughtful response. I have nothing for respect for my fellow therapists (all degrees). I firmly believe that medicine is only one tool in working towards wellness and besides, doing therapy is fun!

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