Sydney Counselling & Psychotherapy

Jennifer Perkins MFT Counselling & Psychotherapy

Tips For Finding and Selecting a Therapist (in the United States)

Jennifer PerkinsComment

Finding yourself at the bottom of your game is insulting enough without the hassle of deciphering the mysterious language of therapy licensing, therapy models, specialties, and  how to find one that suits your particular issue. Below is a small tutorial in finding and selecting a therapist that matches your needs.

What’s with all the alphabet letters?  Mental health therapists have letters after their names that denote their licensing.  Example:  Jennifer Perkins LMFT, LPCC denotes I have two licenses; Marriage and Family Therapy plus Professional Clinical Counselor.  Below is a list of common state licenses for mental health therapists:

  • LCSW -Licensed Clinical Social Worker
  • LMFT -Licensed Marriage and Family Therapist
  • LPCC  -Licensed Professional Clinical Counselor
  • PsyD  -Doctorate in Psychology, clinical focus
  • PhD    -Doctorate (probably in psychology)
  • MD     -Medical Doctor (may be psychiatrist- usually not a therapist)

All licensed mental health therapists essentially do the same work with remarkably similar training.  They need to have at least a masters degree in their field and a minimum of 3000 hours of supervised therapy with clients.  They must also pass the state exam(s).

Three of these licenses require a doctorate degree.  Three do not. The education requirements for the three licenses that do not require a doctorate have a great deal of overlap.  The license to perform therapy on specific populations and specific issues is called “Scope of Practice.”  Scope of Practice varies slightly based on education and training (licensing), but is probably not visible to the general public.

Quick and Dirty:

All three allow the therapist to diagnose and treat the same wide variety of mental health issues.  There are limitations for treating children, couples and families but most therapists have obtained the additional training.

The licenses requiring Doctorates (not Medical Doctor/ MD) are called psychologists and require additional education above the masters level.  They also have training in psychological testing and interpreting tests.  It is possible they may charge more per session since they have advanced degrees.

M.D.s are medical doctors and may be psychiatrists.  Psychiatrists do not usually perform talk therapy and are primarily used for medication management.  It is not uncommon to work with a psychiatrist as well as a therapist.  Usually both will get you to sign a release in order to consult with each other on your case.

What are all these types of therapy and what is it that I want?  Therapists vary widely on the types of therapy they provide.  Most therapy models will be based in talk therapy techniques, however therapy can rely on other interesting modalities as well.  Some of these models are:

If you are interested in a particular therapy model, do a little investigation to learn about it as well as the regulatory boards. Your therapist should have specific training and possibly certification in that specialty.  Remember, there is no defining evidence that one type of therapy is better than another, however, specific therapy issues often have what are called Best Practices.  Therapists will incorporate Best Practices into whatever type of therapy model they subscribe too.

Where do I find a list of therapists?  With the use of the internet this question is really limitless.  Most therapists have websites, but of course, you will need to find their URL. If you have clarity about the kind of therapy you are looking for, type in a few keywords and google will spit out matches for you.  However, if you are unclear about search terms, there are many clearinghouses for clients seeking therapists.  You can google your geographic area and search “therapist.”  This will give you the clearinghouses for your area.  A list of some of California’s top sites:

These sites will allow you to enter your geographic area as well as some basic information about your issue and then provide you 4-5 pages of therapists meeting your requirements.  You simply need to click and read the profiles to see who might be a good fit.   These clearinghouses are paid-for marketing tools used by therapists, so not all therapists are represented on every site.

One last note:  Be aware that judging a therapist based on Yelp or other social networking sites may not benefit you.  Due to confidentiality, it is very difficult for therapists to manage social networking pages and many do not even attempt. 

What are therapist specialties? / Do all therapists work with every issue? The many years of education and internships have trained therapists to be very good at most things.  However, therapists usually have a niche or ‘area of competency’ they especially enjoy working with.  Competency can be a special population such as LGBT, or it can be an area of treatment such as Trauma and Abuse. Therapists usually have additional education, training and experience for these niches they also call ‘area of expertise’.  They can even have additional certifications for these areas. Niches can be broad such as:

  • Relationship breakups
  • Personal Growth
  • Trauma and abuse
  • LGBT population
  • Stress and Anxiety

Or as specifically defined such as:

  • LGBT in the Mormon/ LDS culture
  • Stress and Anxiety in the high-tech/ biotech industry

Bottom line?  Licensure dictates the education required, but not necessarily the expertise of the therapist. Check with the therapist to get more information on the type of issues they work with and the type of client populations they have experience with.  And remember, therapists are very good at treating most things, so don’t exclude a therapist simply because they are not advertising a specific expertise. 

OK.  I’ve found a few I like.  Where to now?  Get a feel for the therapist by reading their site.  If it looks like a good fit make a phone call. Most therapists will offer a 20-30 minute free phone consultation.  This consultation is your chance to ask your questions and see what it’s like to work with them.

Before making the call:  Be sure you are in a quiet space where you won’t be interrupted and where you can have privacy. You may want to write down your questions beforehand. Some potential questions:

  • Do you feel comfortable working with (insert issue)
  • Do you have experience working with (insert issue)
  • Do you have specific certification and training to work with this?
  • What are your hours of operation?

Making the call:  It is important to be specific and concise about why you are seeking therapy, as well as what you hope to accomplish.  Answer questions truthfully.  Chances are the therapist is trying to gauge her competency with your issue.  If they feel it is beyond their scope of competency, they will probably offer you the names of therapists who will be able to work with you.  Don’t take it personally.  Not every therapist is a specialist for every issue.

The therapist is going to have some questions for you as well:

  • Who referred you/ how did you find me?
  • What is going on right now that you are seeking therapy?
  • Do you have a history of _____? (depending on your issue)
  • Are you currently in crisis?

She will gently guide you through the interview.  If you have specific questions, don’t hesitate to ask. She’s more than happy to share the information about her services with you.

Discussing Fees:  You will most likely talk about fees on the first telephone conversation.  If you are having trouble financially, many therapists offer a sliding scale.

Setting up an Appointment:  If during the conversation you feel comfortable this is somebody you could work with, let her know so she can arrange a first appointment.

See, it wasn’t really that difficult after all.