This is a question I get asked all the time by family, friends, and even people I’ve just met. The American healthcare system is sadly dysfunctional and access to quality mental health services is challenging. For this series of posts, I’m going to give the same rundown that I give to my friends in hopes that it will make your process easier as well. Please note that my knowledge is limited to California, so your experience may vary.
First things first, finding a good therapist is HARD. Money, time, cultural fit, and availability all get in the way. Demand is high right now and most of my colleagues are burnt out to some degree or another. In my own practice, I’m noticing that clients are no longer leaving my caseload, whereas in years past there was a fairly constant turnover rate. Acknowledging that you need more support is an amazing first step, and it’s normal to feel demoralized when you really start looking. So cut yourself a bit of slack if you feel tempted to give up - it’s rough out there.
Secondly, a clarification of the different types of providers out there:
Psychiatrists (M.D.) have gone through medical school training (4 years) and a psychiatric residency (4 years) afterwards and maybe some additional fellowships. They are allowed to prescribe medication and most of them focus on medication management (prescribing, monitoring, etc.). Some psychiatrists also offer individual therapy, but it’s not common.
Psychologists (Ph.D or Psy.D) have a doctorate degree, which is usually a 3-7 year training program. They are trained to facilitate psychological assessments, such as if you wanted to find out if you have ADHD. They also have more research and clinical experience as well. Generally psychologists charge more for therapy because of their extended training.
Psychotherapists are Master’s level clinicians, meaning that they’ve gone through a 2 year graduate school program. There are a couple of different licenses that you might see out there, but in my experience as long there is enough variation between different graduate schools that their type of license doesn’t make much of a difference. I would say their clinical work experience is more important to take note of, mainly if they have experience working with clients like you.
Licensed Marriage & Family Therapist (LMFT)
Licensed Clinical Social Worker (LCSW)
Licensed Professional Clinical Counselor (LPCC)
Check out the other posts in this series, “How Do You Find a Therapist?”